Payroll Services for Healthcare Staffing Agencies

What staffing payroll has to handle

• Weekly payroll. Temporary and per-diem staff expect to be paid every week, on time, from timesheets that arrive from many facilities.
• Multiple client facilities. One nurse may work a hospital shift Monday and a skilled nursing facility Thursday. Each shift needs to be tied to the right client for billing and reporting.
• Temporary and as-needed staff. PRN and short-assignment workers start and stop often, so onboarding and offboarding have to be quick and complete. Paying them on a 1099 rarely holds up; see 1099 vs. W-2 for healthcare workers.
• Different hourly pay rates. Pay often varies by facility, unit, credential, and assignment. Each rate needs its own earning code.
• Shift differentials. Night, weekend, holiday, and critical-need differentials are part of the regular rate used for overtime. How differentials and bonuses affect overtime.
• Overtime across facilities. When your agency is the employer, hours at every facility in the workweek add together. 36 hours at one hospital plus 8 at another is 4 hours of overtime, owed by you.
• Per diems and reimbursements. Reasonable reimbursement for real travel expenses can stay out of wages and overtime, but tax-free stipends depend on IRS rules such as the worker having a tax home elsewhere. Per diems that replace wages are wages. Get tax advice on your stipend design.
• Assignment-related reporting. Hours, pay, and cost by client and assignment, so you can check margins and invoice accurately.
• Onboarding and offboarding. W-4, Arizona A-4, I-9 and E-Verify, a new hire report within 20 days, and final pay on time when an assignment ends in a termination.
• Multi-location payroll. Staff placed outside Arizona may bring other states' tax withholding, unemployment, and wage rules with them.
• Payroll tax administration. Federal and Arizona withholding, Social Security and Medicare, and federal and state unemployment taxes, deposited and filed on schedule.
• Workers' compensation reporting. Clinical staff and office staff are rated very differently. Report payroll by classification so the audit is accurate.
• Benefits for temporary and permanent staff. Health coverage and retirement can help you recruit, and once you reach 50 full-time-equivalent employees, federal health coverage rules make tracking variable-hour staff important. Eligibility depends on plan rules.

Example: one nurse, two facilities

Neither facility saw more than 36 hours, but the agency still owes overtime because it's the employer for all 44.

A PEO and a staffing agency are different things

A staffing agency recruits and places workers with client facilities. A professional employer organization (PEO) handles employer administration, such as payroll, benefits, and HR compliance, for a business's own employees. A staffing agency can use a PEO, but PEO eligibility depends on the provider's underwriting, and some providers limit or decline staffing companies, travel nursing, or certain worker types. We'll find out what's available for your agency before you spend time on it. Payroll-only service and standalone benefits are options too.

What to ask a payroll provider or PEO

• Do you accept healthcare staffing agencies, and are any worker types or placements excluded?
• Can you run weekly payroll from timesheets collected at many client facilities?
• Can one employee have several pay rates and differentials in one week, with overtime on the combined regular rate?
• How are per diems and reimbursements set up and reported?
• Can reports show hours and labor cost by client and assignment?
• What happens when staff work outside Arizona?
• Which benefits are available for temporary and permanent staff, and what are the eligibility rules?
• What is included in the quote, and what could cost extra?

For the payroll process step by step, see how to do healthcare payroll. Run a home care agency? See caregiver payroll services.