Travel Nurse Credentialing: What you need to know about the complex process

With the recent nursing shortages, traveling nurses help fill critical roles in organizations to help ensure that patient care is not affected. However, nursing shortages may require expedited credentialing, which can put your healthcare institution at risk. 

In general, independent staffing agencies employ travel nurses. These agencies oversee the credentialing process; however, ongoing exclusion monitoring is ultimately the responsibility of the hiring healthcare entity or organization. This is because the healthcare organization bills for services the travel nurse performs. 

As the demand for traveling nurses increases, it is essential to understand the important aspects of credentialing them.

Why is travel nurse credentialing difficult? 

Travel assignments can change quickly. Assignments are usually 13 weeks long, sometimes less. Healthcare organizations can increase the duration of the nurse’s contract toward the end of the initial appointment if both parties agree. 

Each new assignment requires credentialing by either the staffing agency or hospital administration. This can be problematic as a rigorous credentialing process can take weeks to complete and may cut into a nurse’s assignment.

What are the risks when hiring a travel nurse? 

As healthcare experienced during the COVID-19 pandemic, disruption to the workforce poses significant risks to healthcare institutions. Visiting under-resourced units or observing overworked staff working in a high-stress environment may lead to shortcuts in credentialing. These shortcuts place a healthcare organization at risk of hiring an excluded or sanctioned provider. 

The costs of having an excluded nurse treat patients at your organization are high and can result in the following:

• Reimbursement delays and denials
• Severe penalties and fines
• Lawsuits
• Reputational damage

Travel nurses’ high turnover rates and frequent movements across state lines can lead to exclusions or disciplinary actions that go undetected when state and federal exclusion lists are not properly monitored. In addition, delays in reporting sanctions or disciplinary actions increase the risk that an excluded provider can outrun disciplinary actions by moving across state lines.

What is the NLC?

Created by the National Council of State Boards of Nursing (NCSBN), the Nurse Licensure Compact (NLC) is an agreement that allows recognition of a nursing license between member U.S. states and jurisdictions.

The compact enables nurses to move across the country without obtaining additional licenses. This has been especially helpful during the pandemic because it allows nurses to move across state lines quickly to relieve staffing shortages.

Under the NLC, all nurses must abide by the state’s laws in which they practice. However, if a nurse’s license in a new state is revoked, the nurse’s home state is still responsible for administering disciplinary action. State disciplinary action against a nurse is shared with other states via a national database known as the Coordinated Licensure Information System (CLIS), or the Nurses License Verification database. 

Although the database allows states to share information in order to verify a nurse’s licensure, discipline, and practice privileges, it is still subject to delays. If healthcare entities use outdated information when hiring nurses, they could subject themselves to significant patient and institutional risk.

NLC States

At the time of this writing:

• 41 jurisdictions participate in the compact
• 7 jurisdictions are pending NLC legislation
• 6 jurisdictions have no action regarding the compact
• 3 jurisdictions have passed NLC legislation, but implementation is pending
• 2 jurisdictions have partially implemented the compact

Check out the complete map to see the status of each jurisdiction.

For jurisdictions not part of the compact, a travel nurse must obtain an individual license for that state. This can complicate the already complex credentialing process. Yet, credentialing is necessary before a nurse begins practicing in your institution. 

How does a nurse apply for a multi-state license? 

To apply for an NLC multi-state license, a nurse must do the following:

• Reside in an NLC state
• Declare an NLC state as their primary state of residency
• Hold an active registered nurse (RN), licensed professional nurse (LPN), or licensed vocational nurse (LVN) license
• Meet requirements for licensure held by their home state 

Regardless of the nurse’s home state, the traveling nurse is held to the state’s standards for where they are providing care, even if those standards differ from their home state.  

What is the best way to provide ongoing exclusion monitoring for traveling nurses?

Because of the complicated credentialing process for travel nurses, it is critical to have ongoing monitoring for any new providers –  temporary or permanent –  to avoid reimbursement delays, severe fines and penalties, and reduce risk to your patients. 

Verisys’ automated software will quickly alert you to sanctions, exclusions, disciplinary actions, and expiring licenses affecting traveling nurses on your staff. Our software also helps streamline a complex credentialing process. 

By automating alerts, your healthcare institution can rest assured that your providers are in good standing, thus, mitigating risk to your organization and your patients. To learn more about Verisys’ automated software, schedule an appointment today.