2024 Annual Report

On August 28, 2022, Senate Bill 710 became law, requiring the Department of Health and Senior Services (DHSS), Division of Regulation and Licensure (DRL), to monitor and collect data for registration of each supplemental health care services agency (SHCSA) that provides or procures temporary health care personnel in Missouri health care facilities. Any registered supplemental health care services agency that contracts with a health care facility that participates in Medicare or Medicaid is required to submit quarterly reports to the department that contain the following information:

• A detailed list of each health care facility participating in Medicare or Medicaid with whom the agency has contracted over the prior quarter;
• A detailed list of the average "hourly" amount charged by the agency to the health care facility over the prior quarter, broken down by health care facility and each individual health care personnel category within each job classification (including but not limited to nursing, therapy, dietary/nutrition, lab, and radiology); and
• A detailed list of the average "hourly" amount paid by the agency to health care personnel over the prior quarter, broken down by health care facility and each individual health care personnel category within each job classification, including but not limited to nursing, therapy, dietary/nutrition, lab, and radiology.

Section 198.640, RSMo, defines a health care facility as a licensed hospital as defined under section 197.020, RSMo, or as a licensed assisted living facility, intermediate care facility, residential care facility, or skilled nursing facility as defined under section 198.006, RSMo.

Section 198.640, RSMo, defines health care personnel as any individual licensed, accredited, or certified by the state of Missouri to perform specified health services consistent with state law. Health care personnel as defined in section 198.640, RSMo, include: Certified Medication Technician (CMT); Certified Nursing Aide (CNA); Dietitian; Emergency Medical Tech (EMT) (ER only); Hearing Instrument Specialist (HIS); Level One Medication Aide (LIMA); Licensed Practical Nurse (LPN); Occupational Therapist (OT); Occupational Therapist Assistant (OTA); Paramedic (ER only); Perfusionist; Pharmacy Technician (Pharm Tech); Physical Therapy Assistant (PTA); Registered Nurse (RN); and Speech Language Aide (SLA). As noted in the supplemental health care services agency definition, the term shall not include an individual who engages only on his or her own behalf, or to provide the individual’s services on a temporary basis to health care facilities or a home health agency licensed under section 197.415, RSMo, and shall not include a person, firm, corporation, partnership, or association engaged in the provision of contracted specialty services by a practitioner as defined under subdivision (4) of section 376.1575, RSMo, to a hospital as defined under section 197.020, RSMo, or to other individuals or entities providing health care that are not health care facilities

The department began accepting SHCSA registrations when regulations became effective on September 30, 2023. Quarterly reporting of registered agencies began January 1, 2024. Pursuant to section 198.644, RSMo, the department is required to prepare an annual report of aggregate data received from the agencies without including information specific to any one agency. This report summarizes data received by the department in 2024, which was the first full year the department received reports. It is important to note that data reflected within each quarter may not include all personnel defined, as some personnel may not have been reported by all agencies each quarter. Averages of data include personnel that may work in a specialty area (Emergency Department, Telemetry, Operating Room, Step-down, Pediatric, Oncology, Rehabilitation, etc.). Charges to health care facilities reported to the department may or may not include labor-related costs paid by agencies for health care personnel, such as payroll taxes, worker’s compensation insurance, professional liability coverage, credentialing, per diems, and other employee-related costs.

1^st Quarter 2024 Report

At the time the 1st quarter 2024 reporting opened on April 1, 2024, 200 agencies were registered with DHSS. All 200 agencies submitted responses to the department. Only 125 agencies reported personnel working in Missouri between 1/1/24 and 3/31/24 AND contracted personnel in a Medicare/Medicaid certified hospital or long-term care facility. Out of the 125 agencies that reported data, 113 agencies had personnel working in a certified hospital(s) and 54 agencies had personnel working in a certified long-term care facility(ies).

AVERAGES OF HEALTH CARE PERSONNEL REPORTED IN CERTIFIED LONG-TERM CARE FACILITIES 1^ST QUARTER 2024

AVERAGES OF HEALTH CARE PERSONNEL REPORTED IN CERTIFIED HOSPITALS 1^ST QUARTER 2024

2^nd Quarter 2024 Report

At the time the 2nd quarter 2024 reporting opened on July 1, 2024, 240 agencies were registered with DHSS. All 240 agencies submitted responses to the department. Only 132 agencies reported personnel working in Missouri between 4/1/24 and 6/30/24 AND contracted personnel in a Medicare/Medicaid certified hospital or long-term care facility. Out of the 132 agencies that reported data, 109 agencies had personnel working in a certified hospital(s) and 59 agencies had personnel working in a certified long-term care facility(ies).

AVERAGES OF HEALTH CARE PERSONNEL REPORTED IN CERTIFIED LONG-TERM CARE FACILITIES 2^ND QUARTER 2024

AVERAGES OF HEALTH CARE PERSONNEL REPORTED IN CERTIFIED HOSPITALS 2^ND QUARTER 2024

3^rd Quarter 2024 Report

At the time the 3rd quarter 2024 reporting opened on October 1, 2024, 259 agencies were registered with DHSS. Four agency reports were not obtained by the department during the submission period due to registration expiration or voluntary closure of agency. Only 141 agencies reported personnel working in Missouri between 7/1/24 and 9/30/24 AND contracted personnel in a Medicare/Medicaid certified hospital or long-term care facility. Out of the 141 agencies that reported data, 117 agencies had personnel working in a certified hospital(s) and 58 agencies had personnel working in a certified long-term care facility(ies).

AVERAGES OF HEALTH CARE PERSONNEL REPORTED IN CERTIFIED LONG-TERM CARE FACILITIES 3^RD QUARTER 2024

AVERAGES OF HEALTH CARE PERSONNEL REPORTED IN CERTIFIED HOSPITALS 3^RD QUARTER 2024

4^th Quarter 2024 Report

At the time the 4th quarter 2024 reporting opened on January 1, 2025, 268 agencies were registered with DHSS. Five agency reports were not obtained by the department during the submission period due to registration expiration. Only 132 agencies reported personnel working in Missouri between 10/1/24 and 12/31/24 AND contracted personnel in a Medicare/Medicaid certified hospital or longterm care facility. Out of the 132 agencies that reported data, 109 agencies had personnel working in a certified hospital(s) and 50 agencies had personnel working in a certified long-term care facility(ies).

AVERAGES OF HEALTH CARE PERSONNEL REPORTED IN CERTIFIED LONG-TERM CARE FACILITIES 4^TH QUARTER 2024

AVERAGES OF HEALTH CARE PERSONNEL REPORTED IN CERTIFIED HOSPITALS 4^TH QUARTER 2024