With Multiple Degrees and a Stable Job – Why Do They Still Leave?

I recently received an application from a Philippine-based RN ‘dreaming’ to work in US. The application packet, although complete and very professionally prepared, was sent through the applicant’s mother’s friend’s friend — infamously and laughably a common cultural practice in the Philippines that seeped its way into the modern workplace and overseas. Known as the ‘padrino system’ or patronage,  this is a system where one primarily gains favor through family affiliation  or friendship  before an applicant’s merit. 

The applicant is initially a BS Biology graduate of one of the best universities in the country, of which entries to both the system and the course program are cut-throat battles in the Philippine academe. Yet despite the laurels, the applicant immediately  went back to school after graduation and took up BS Nursing. Armed with this new degree, he simultaneously applied to reputable hospitals in Metro Manila while diligently preparing for the exam administered by the Texas Board of Nursing. Bright and determined, the applicant succeeded in both: got a much desired job in a famous modern hospital and passed the Texas Board exam for nurses in one take. Unfortunately for the applicant, the visa classification for RNs and professionals is on retrogression so US is definitely not in the applicant’s horizon. Unfortunately for the Philippines, if not the United States, there will be other Western countries that will employ him. Unfortunately for all the developing countries in the world such as former African colonies, Carribean Islands, East Germany, Soviet Union, India,  the case is not isolated in the Philippines. These countries’ brain drain is a brain gain to most highly developed North American, European and Asian countries.

For more info on retrogression, click here for our previous post.

This biologist turned RN wanting to work in US is a classic case of brain drain. Brain drain aka human capital flight is the not only the departure of educated or professional people from one country, it can also be from one economic sector, or field for another, usually for better pay or living conditions. Brain drain is often associated with de-skilling of emigrants in their country of destination, while their country of emigration experiences the draining of skilled individuals. Worse, a lot of these professionals emigrate to another country taking with them a fraction of value of their training sponsored by the government or other local organizations. They can’t be blamed though. They move to countries where their highly marketable skills are  financially rewarded.

Just to better illustrate the disparity in compensation, below is an official rate sheet of an RN working in an Upscale hospital in Metropolitan Manila.

The current market rate of an RN working in an Upscale hospital in Metropolitan Manila. 





















Cut this by half or third, and that’s the approximate salary of RNs working in less prestigious hospitals. Some RNs don’t even get paid and many others pay the hospital in order to get work experience.

This is the salary equivalent in US dollars based on $43.00-Php 1.00 exchange rate. 

Salaries in converted to US dollars.








Illustrated below is the estimated annual compensation  of Med-Surg and CCU RNs in Metro New York as published by http://www.salary.com. A Med Surg nurse’s median annual salary is $76, 937 ($6,412/month) while a CCU nurse gets $ 77, 303 ($6,442/month) based on a 35-40 hour work week. 


Visa Retrogression – What does it mean to professional immigrant workers?

Before June of this year, there were two major visa categories that are popular among professional immigrant workers: the H1b Visa aka work visa and EB2 or the greencard route.

H1B visa is a non-immigrant visa that allows US employers to temporarily employ professional foreign workers in specialty occupations. On the other hand, EB2 Visa is a permanent residency route for professionals holding advanced degrees (Ph.D., master’s degree, or at least five years of progressive post-baccalaureate experience) or persons of exceptional ability in sciences, arts, or business.

Unfortunately, the USCIS has announced that the 2013 H-1B visa cap has been reached as of June 11th. Any cases received after June 11th will be rejected and returned with filing fees uncashed. However, the rejected and would-be applicants may file again next fiscal year. The next blow is that the July 2012 visa bulletin shows that the ‘worldwide EB2′ visa category has retrogressed almost 3 years. This is the one category that remained consistently ‘current’ in recent years (together with EB1).

What happens now?

Photo from http://redbus2us.com. Edited by author.

For more information about RETROGRESSION, click this link.

For USCIS Visa Bulletin, click here.

What does RETROGRESSION mean to professional immigrant workers and their employers? This could mean long waiting times for green cards.  This means job employment offers need to be rewritten or  projects be off-shored.  In uncertain cases such as this, not much can be done than to persevere and tuck growing disappointment. There are surely other legal routes to continue working in America while hoping that these two visas will be available again soon.

US immigration system is not ideal and reform is essential to ensure Uncle Sam does not lose talented people to help boost the economy and create jobs.Right now, all that is left to do is wait. Let us see what the future has in store.

SOURCE: http://www.uscis.gov

Disclaimer: This is a post written from a layman’s perspective and should not be regarded as an immigration advice.  For valid legal advice, consult an immigration lawyer.

Happy 4th of July!

Liberty that was won needs to be celebrated. The freedom enjoyed must be defended. Happy 4th of July, America!

Factors Affecting Tenure of Nurses

In this post some recurring patterns that may affect the duration of stay of nurses working in a facility are enumerated. These observations are derived from our interactions and involvement with different healthcare facilities mostly in the Tri-State area.

1. PsychologicalNurses, at the time of hire, may not be psychologically equipped to deal with pressures coming from work. Upon hire, recruits usually show the best of themselves and recruiters are given very little clue as to how one would fare at work.

♦What we do to counter this concern is to perform a multilayered assessment process that doesn’t just focus on credentialing, but also pays attention to attitude and personality clues of our candidates.

♦We work closely with the HR of a facility in pre-qualifying candidates. We usually send the facility representative several pre-qualified candidates to select whom she thinks will work out best for the facility.

♦Another tool we use is an Evaluation Form that functions as ‘check and balance‘ for the healthcare facility and agency. For the nurse, a regular evaluation reaffirms his work, leading to greater confidence in himself and his work that ultimately benefits everyone in the equation.

2. Personality and Culture. A big question is matchingIs the nurse, personality-wise, matched to the culture of the new workplace? In culturally diverse workplaces such as New York City where customs and traditions are fanned alive by immigrants, the ‘standard’ becomes confusing. Add to that the variety of patients’ cases, situations and other factors that come into play further blurring the lines between the acceptable and what is not.

♦We have a culturally sensitive recruitment procedure that looks deeper into a candidate profile. Insights drawn from our deliberations are then used to match our retinue of nurses to facility needs and requirements.

3. Education. A lot of local schools did not prepare the nurses for real-life work situations. Nurses, especially the new ones, have these preconceived ideas of what the ideal work setup should be as shown in media (i. e ER, Grey’s Anatomy, Nurse Jackie), which they unwittingly bring to the workplace. Comparison of their ideal versus the reality results to confusion, disappointment and in some case, extreme disgruntlement.

♦What we do to counter this issue is to let the nurses undergo our uniquely designed orientation that is most often customized according to facility requirements. This orientation covers the basics such as scheduling, policies, facility idiosyncrasies, documentation and many more. The objective is to let the nurses be given an overview of the setup of the facility of assignment. As early as possible, we proactively address all predictable issues and manage the expectation of nurses in these sessions.

4. Work EnvironmentSeveral environmental dynamics come into play as well. Factors such as union policies, lackluster attitude of ‘regular workers’ towards ‘agency workers’, minor politics, cultural insensitivity of some parties, difficulty adapting to technology required in modern patient care tasks, gaping difference in rates and benefits between regulars and agency workers, and many other factors are likely to affect the employment duration of a nurse.

One glaring example is in one huge geriatric care facility where we placed nurses that were given 2-day orientation as opposed to the 2-week to a month-long orientation of directly hired nurses. The agency nurses had some apprehensions about continuing work at the at the facility because of lack of orientation. They further reasoned that they were frequently on ‘float status’, thus requiring more orientation days in order to avoid any unwanted incident that may cost them their license.

♦The best answer here is preparation.  As mentioned earlier, a nurse that has been prepared right beforehand has a higher likelihood of staying committed to a place of assignment.

5. Options. Once issues are not resolved timely, any worker would seek other opportunities. Fortunately for nurses, they have numerous options at bay that may look like the cure-all to their employment ails. So once dissatisfied, they would rather leave than take the excruciating process of correction. The handling agency should have foresight and proactive ability in managing the issues in a timely manner.

Our office is always open to suggestions on how we can further improve our services. We customize our services according to a healthcare facility’s current setup, preferences, and situation. We are available for consultation. Email me at mprimero@meridiannurse.com for an appointment.

Happy Father’s Day!

Switching Roles

The man’s name is Rommel. Rommel’s routine everyday included dropping and picking up 3 kids in school, and running errands, making the house tidy, preparing meals, doing the laundry  in between. His wife is a successful nurse practitioner who works full time in a large New York hospital and serves as consultant in several other healthcare facilities. She leaves at 7 am and goes home past 8 every night. After she parks the car in the house garage, the exhausted and work-weary wife turns to the TV until she falls asleep. Rommel, who just took out the dishes from the rack, then makes sure the children are ready for bed. With the children in slumber, he can then prepare the things he need to survive the following day before he goes to bed.

This is Rommel’s life. There are more husbands like him today. They are slowly redefining the word ‘father’. Roles are being switched by occupational demands and requirements, but fathers will always be fathers in our hearts.

Happy Father’s Day!

Happy Mother’s Day from Meridian Nurse Recruiters Staff and Friends!

Culture at Work

“Culture is about societal norms, communication preferences, and global outlook. At the organizational level, this includes which leadership styles are most effective, and how workers interact with each other. In dealing with customers, it’s about understanding customer segmentation, digital readiness, and inclination to participate.”                                                         

From How to Engage Your Customers and Employees

Wang, Ray. “How to Engage Your Customers and Employees.” Harvard Business Review. 9 May 2012. Web. 10 May 2012.

Thank you!

Healthcare – Online Application Form

Talk to a job counselor about your career options. Simply fill out this form. Explore your options and develop your career plan for free!

You may also email your resume to jobs@meridiannurse.com

POLL: Is the Big Apple a recruiter’s market?

Gone are the days when hospitals and other healthcare facilities run after the nurses for employment. It is now recruiters’ market in the Big Apple.

Back in 2004, I remember how a cousin, a Registered Nurse educated outside US, was offered great pay and hefty sign-in bonus in exchange for committing to a 2-year contract with a reputable hospital in the City. The deal was a no-brainer because according to her, two years was nothing since the same contract that binds her to the hospital actually assures her of a regular job. On top of the monetary gains, the hospital also invested in sending her to conferences and continuing studies program that further developed her managerial and nursing skills. Today, she is a top-tier nurse executive in another reputable hospital. Back then her story wasn’t special; a lot of pro-active nurses then rode the way to success during the nursing crunch of the earlier days — a time when there were more needs for nurses and immigration of qualified healthcare professionals were so much easier. There were even hospital programs that offered nurse scholarships and stipends to qualified individuals.

In New York City, the queue for nurse applications grew since then. Today it is common to encounter nurses that are still searching for a regular job (with benefits) even six months after getting licensed. Their common complaint is a paradox: The nurses are not hired for lack of experience, yet how will they gain much required experience if they don’t get hired? For the ones that get hired, the working conditions are more pro-employer than pro-worker. Times have certainly changed.

Apply Now!

Career Assistance Program

At Meridian Nurse Recruiters, we have proven and effective ways to promote your resume. To the new nurse, we can help equip you with the right tools to get noticed. To the veterans, we can further propel your career to greater heights. Call us at 718-255-5830 for more information about our organization.

Old or New … What kind of nurse are you?

We live in a definitive age. As healthcare institutions transition more towards the computerized systems, there exists the ‘in-between’ population of those who can do both traditional and electronic recording. As the older and paper and pencil generation dies out, the industry is breeding a group of workers whose preference and skills would soon just be electronic means. This reality struck me just recently when one of my nurse friends quit because her place of assignment didn’t utilize an EMR platform.  This nurse reasoned that although she still knows the old method, she is far more comfortable using computers for efficiency.  This is a far cry a decade ago when nurses quit new assignments because of computer fright. Today the table has been turned.

An electronic medical record (EMR) is a computerized medical record created in an organization that delivers care, such as a hospital, nursing home or physician’s office. Federal, state and other government agencies promote the adoption of EMR by awarding incentives and meting out penalties as part of the MEDICAID and MEDICARE reimbursement programs.

At Meridian, we assess the type of experience, skills set and other parameters that affect every staff member’s performance and tenure at an assignment to ensure a better working relationship among stakeholders. For more information about our company, you may call us at 718-255-5830.

2011 in review

The WordPress.com stats helper monkeys prepared a 2011 annual report for this blog.

Here’s an excerpt:

A San Francisco cable car holds 60 people. This blog was viewed about 1,600 times in 2011. If it were a cable car, it would take about 27 trips to carry that many people.

Click here to see the complete report.

Growing Up … and Old Without Nursing Homes

In modern and busy US and most European countries there are numerous nursing homes, adult-care facilities and assisted living centers whose primary goal is to care and provide the best living conditions for the elderly or disabled patients whose skills for daily living have greatly depreciated either by old age or prolonged illness. The nursing homes or Skilled Nursing Facilities (SNFs) employ healthcare professionals such as nurses, licensed practical nurses, nurse assistants, therapists and many others that work hand-in-hand in caring for the patients 24/7.

The situation is exactly the opposite in the Philippines and many other third world nations where economies aren’t humming as fast as America and Europe. Nursing homes are simply not the status quo for many reasons. Foremost reason is that these countries, like the Philippines, has a culture that expects the kin and a huge extended family to care for their elderly.  Just as parents are expected to provide for the children and make sure they have the best education possible, the children/grandchildren are expected by society to ‘give back’ by taking care of their parents in their twilight years. Traditionally, one person in the family is designated to care for the parents. A daughter is expected to care for both parents in their senior years, thus oftentimes ending up a matron. This was a practice that was probably brought to the Philippines by the Spanish conquistadores who were in the country for more than 300 years or for some other countries such as the Trinidad, India, Haiti, Caribbean Islands, Guyana, etc… simply an old-age tradition that just wouldn’t go away.

Click here for a video clip of the critically acclaimed book-film Like Water for Chocolate that required the protagonist to undergo such practice of requiring a member of the family to care for the parent/s.

In modern times, when the children started working abroad and inevitably leave the parents at home, they will setup a living arrangement for a distant relative to care for their ailing parents in exchange for lodging and minimal financial support. The more affluent ones will hire  professional nurses that manage the daily needs of the elderly patient. The goal is for the old folks to remain comfortably cared for in their own homes as they await their final days.

Historically, there was an exodus of foreign healthcare professional since the 1960s to the early part of the 1990s. The nurses and therapists were petitioned as either immigrant or on work visas by hospitals and for the most part, nursing homes. When they came to American shores, these new workers expected to be assigned at hospitals and other similar short-term care facilities. Little did they know that a lot of them will be performing jobs that is second nature to them — caring for geriatric patients.

Click here to view a Philippine McDonald’s commercial showing a granddaughter caring for her grandfather with Alzheimer’s condition. Subtitles are included.

Rehabilitation Professionals Apply Now

Online Application Form

Getting Informed is the Best Route to America

Much has been said about the US economic downturn and how a lot of first world countries have overtaken America in most aspects, but still the nation has built itself as a symbol of democracy and land of opportunity that many smaller nations look up to for economic growth. In US Consulates in most countries, people come in droves daily to try their luck with the Consuls. A lot of foreign nationals go through a lot of trouble just to get to America. Whether America delivers the dream to the people or not, is another story. Still the greencard and the US visa remain one of the world’s most sought after commodities.

There are many paths to working and finally settling in US such as an employee-sponsored work visa or greencard. But the reality is the requirements are so stringent and costs are high making it almost impossible especially with the ever changing and unpredictable Immigration laws. Sadly, as if this isn’t bad enough, some erratic agencies and individuals take advantage of the ignorance of the prospective immigrants.

The best route is being informed and prepared. Online information is readily available just make sure to visit the official sites.




For License Reciprocity Information: https://www.nursys.com/

For more information and advise on how to prepare for a career in US and New York, email us at jobs@meridiannurse.com.


During last month’s heat wave that covered a part of the Northeast in unbearable heat which reportedly has not been seen since the 1940s, one of the nurses in a Brooklyn nursing home called out complaining about sleepless night because of an overnight power interruption in his Queens home. His voice was course and sounded really sick as he was telling me that he is expected to work the following shift, which is 7a-3p. The call was placed at 3:10 am that gave us barely four hours to find coverage. Good thing for us, we had a bevy of nurses working at night shift who agreeably took the shift for the poor nurse. We even provided coverage for other on-staff nurses who called out on the night of heat wave crisis.

Staffing 24/7 really pays off for facilities that has this kind of service. With such in place, RN Supervisors are not burdened to do the calls themselves. A dedicated and live staffing coordinator working round-the-clock can be informed of any staffing need. Within minutes, she would report to the RN Supervisor on duty to confirm replacements or emergency coverage. With such ease in staffing, nurses can focus more on what is important, patient care.

Meridian Nurse Staffing offers 24-7 Staffing at no cost to the facility. Talk to an agency representative on how to avail of this valuable service. Email mprimero@meridiannurse.com or call 718-255-5830.

Take charge with 24-7 Staffing.

Becoming an Army Nurse Can be Rewarding

Considering an Army post as RN can indeed be very rewarding. Here’s an excerpt from an email a nurse in London sent me recently:

I have an Aunt who migrated from the Philippines when she was 21. Her first stop was as staff nurse at Mt. Sinai Hospital as a L & D nurse and later got offered to teach nursing courses at nearby Hunter College. She did both, teaching and nursing until one time, she got invited to a recruitment event that needed professional nurses to join their team of army nurse educators. Initially she said, she went there out of curiosity,  but after she learned more about the program, she came home a new person.

Forty years forward,  she retired as a Colonel who despite being civilian now still enjoys recognition in several organizations and worldwide events she attends without costing her anything. She has a centrally located apartment in Manhattan, 2 houses located in New Jersey and Seattle and a mansion in the Philippines. She travels 4 times a year paying almost nothing for airfare, gets discounts in a lot of stores, and gets superior medical and dental care in recognized hospitals in New York. The children’s tuition are fully paid off and the husband enjoys same healthcare benefits she has. Add to her list the sizable pension she receives … What a life!

Listed below are the benefits of enlisting in the Army as a healthcare professional. (Source:www.goarmy.com)

Health care professionals who serve as Officers in the U.S. Army Medical Department (AMEDD) enjoy a wide range of opportunities and financial incentives. There are benefits, tangible and intangible, available to Officers who choose to serve full-time in the Army. These benefits are also conferred upon those who choose to serve when needed and maintain careers in their communities as part of the Army Reserve.

Active Army professionals are members of a multidisciplinary team focused on providing the best health care possible. Here, there aren’t any concerns about running a practice, hiring employees, processing insurance, purchasing equipment, stocking supplies or paying malpractice insurance.

You’ll also have opportunities to develop even more specialized skills than those you already have. From continuing education courses and seminars to clinical research and teaching, you’ll be able to enhance your level of expertise.

Plus, the U.S. Army offers scholarships and student loan repayment assistance to students and recent graduates in many health care fields.

You have many career options. Learn more about the benefits that come with serving your country.

via Benefits | GoArmy.com.

Visa Sponsorship for Physical and Occupational Therapists

Our company is currently screening  for internationally sourced Physical and Occupational Therapists applicants. Talk to a recruiter to check if you qualify.  A foreign applicant recruiter is also available for advising prospective candidates wanting to immigrate to US. Contact jobs@meridiannurse.com or visit our website at http://www.meridiannurse.com.

Meridian Nurse Recruiters Now Hiring Rehab Professionals

Online Application for Nurses and Rehabilitation Therapist

Go to http://www.meridiannurse.com/online.phpAnd other Allied Healthcare PositionsApply online now and be considered to placements all over New York City and New York State.

A Shift From Nursing Homes to Managed Care at Home

Faced with soaring health care costs and shrinking Medicare andMedicaid financing, nursing home operators are closing some facilities and embracing an emerging model of care that allows many elderly patients to remain in their homes and still receive the medical and social services available in institutions.

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Todd Heisler/The New York Times

Dr. Fredrick Sherman at Harlem PACE with Edna Blandon. “My spirits would drop if I went to a nursing home,” she said.

Readers’ Comments

Readers shared their thoughts on this article.

The rapid expansion of this new type of care comes at a time when health care experts argue that for many aged patients, the nursing home model is no longer financially viable or medically justified.

In the newer model, a team of doctors, social workers, physical and occupational therapists and other specialists provides managed care for individual patients at home, at adult day-care centers and in visits to specialists. Studies suggest that it can be less expensive than traditional nursing homes while providing better medical outcomes.

The number of such programs has expanded rapidly, growing from 42 programs in 22 states in 2007 to 84 in 29 states today. In New York City, a program run by a division of CenterLight Health System, formerly known as the Beth Abraham Family of Health Services, has over 2,500 participants at 12 sites in the metropolitan area.

“It used to be that if you needed some kind of long-term care, the only way you could get that service was in a nursing home, with 24-hour nursing care,” said Jason A. Helgerson, the Medicaid director for New York State. “That meant we were institutionalizing service for people, many of whom didn’t need 24-hour nursing care. If a person can get a service like home health care or Meals on Wheels, they can stay in an apartment and thrive in that environment, and it’s a lower cost to taxpayers.”

The recent influx of adult day-care centers and other managed care plans for the frail elderly is being driven by financial constraints as President Obama and Congressional leaders seek hundreds of billions of dollars in savings in Medicare and Medicaid. Nursing homes, which tend to rely heavily on Medicare and Medicaid dollars, are facing enormous financial pressure — Mr. Obama’s proposed budget includes a $56 billion Medicare cut over 10 years achieved by restricting payments to nursing homes and other long-term care providers.

Nationally, the number of nursing homes has declined by nearly 350 in the past six years, according to the American Health Care Association. In New York, the number of nursing homes declined to 634 this January from 649 in October 2007, and the number of beds to 116,514 from 119,691.

Over the next three years, New York State plans to shift 70,000 to 80,000 people who need more than 120 days of Medicaid-reimbursed long-term care services and are not in nursing homes into managed care models, Mr. Helgerson said.

The move away from nursing homes was highlighted on Thursday when Cardinal Timothy M. Dolan announced that the Archdiocese of New York, one of the state’s largest providers of nursing home care, is selling two of its seven nursing homes and opening or planning to open seven new adult day-care centers over the next three years.

“Seniors and others who have chronic health needs should not have to give up their homes and independence just to get the medical care and other attention they need to live safely and comfortably,” Cardinal Dolan said in a statement before he opened a 250-patient program at Saint Vincent de Paul Catholic Healthcare Center in the South Bronx.

These new adult day-care centers, known around the nation by the acronym PACE — Program of All-Inclusive Care for the Elderly — provide almost all the services a nursing home might, including periodic examinations by doctors and nurses, daytime social activities like sing-alongs and lectures, physical and occupational therapy and two or three daily meals. All the participants are considered eligible for nursing homes because they cannot perform two or more essential activities on their own like bathing, dressing and going to the toilet. But they get to sleep in their own beds at night, often with a home health care aide or relative nearby.

The nonprofit groups that operate them receive a fixed monthly fee for each participant and manage their entire care, including visits to specialists, hospitalizations, home care and even placement in a nursing home. Because Medicare and Medicaid pay set fees instead of paying for specific procedures, center operators are motivated to provide preventive care to avoid costly hospitalizations or nursing home care.

Some elderly people, however, spurn PACE programs because under managed care, they would have to switch their physicians to those at the PACE center or in its network. Most elderly people want to live out their lives at home, a desire evident in interviews in the PACE center the archdiocese opened in 2009 in Harlem, which has a staff of three doctors and is visited regularly by a dentist, a podiatrist and a psychiatrist.

Todd Heisler/The New York Times

Rick Leeds, who teaches yoga and other wellness programs at the ArchCare PACE Center in Harlem, gives a massage to Edna Blandon, who goes to the center three times a week.

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Readers’ Comments

Readers shared their thoughts on this article.

Edna Blandon, 74, a diabetic weakened on her left side by a stroke who relies on a wheelchair, is transported by specialized van to the Harlem PACE center three days a week and appreciates that it provides not only a home care attendant but sends a nurse every two weeks to change pills in her pillbox and load a 14-day supply of insulin into syringes that she will inject.

“My spirits would drop if I went to a nursing home,” she said. “I love the fact that I can go home at night. There’s no place like home. I can sit down, look at the TV and go to bed when I want.”

James Harper, 70, a retired bank employee who spent 10 months at the archdiocese’s Kateri Residence, a nursing home on the Upper West Side, after a stroke paralyzed his right side, enjoys yoga breathing classes and discussions about black history. Yet he gets to spend nights and weekends with his wife, Albertene, and daughter, Traci, both of whom work during the day and are not around to care for him.

“This way I’m around people,” he said.

Dr. Fredrick T. Sherman, the Harlem PACE medical director, said that a 2009 study showed that PACE programs reduce lengths of stays in hospitals and delay assignments to nursing homes.

The archdiocese, whose new centers will serve a total of 1,500 people, receives an average of $4,000 a month from Medicaid for each participant and $3,300 from Medicare. By comparison, said Scott LaRue, the chief executive of ArchCare, the archdiocesan health care network, a month of nursing home care can cost the government $9,000.

Ultimately, the archdiocese hopes that half of its elderly clients will be served in community settings rather than in nursing homes, which currently serve about 90 percent of the archdiocese’s clients. For-profit companies have not yet moved into the managed care market, in part because of uncertainties about reimbursement formulas and the risks of taking on a nursing home population.

The PACE population tends to be younger than that at nursing homes, which raises the question of whether many PACE clients would really need nursing homes without PACE. Dr. Sherman replies to such skepticism by saying that his clients “need that level of service — the question is where they’re going to get it.”

Without PACE, he said, “they’re going to end up in nursing homes.”

Robert Pear and Christopher Reeve contributed reporting.

Local Civil Registry

The power of positive

I recently listened to a Pod cast of the different effects Positive Thinking and Acting can have on the human body.


It’s amazing how easily your mind, body and soul can easily be influenced from a few key words that help you relive and make alive certain emotions that make you feel whole again.


Public speakers have mastered this art and have used their gift to rally crowds to the greater good. History have shown that a true leader (whether we believe in their motive or not) usually wins the minds of many by his/her words.





Encourage Employees to Be Active for Spring

Encourage Employees to Be Active for Spring

As we watch the snow melt away across the Tri-State area one thing is for certain: spring is just around the corner! Now is the perfect time to encourage your employees to increase their physical activity for good health. With warmer weather, most will be more than happy to spend a little time outside and being active has physical, mental and emotional benefits for everyone.

One of the most popular outdoor activities that employees can do on their lunch hour or break is to take a quick walk. To get the most benefits from a walk, you want to keep the pace fast enough as if you were trying to catch a bus or if you were running late for an appointment. If someone hasn’t exercised in awhile, they may want to check with their primary care physician before starting any exercise regimen.

Taking a short 20 to 30 minute walk everyday has many benefits which include:

• Weight loss/weight management

• Reduction or management of daily stress

• Sounder sleep

• Help with digestion and bowels

Try encouraging your hospital or medical facility employees to walk daily for a week, creating a walking challenge. You could offer prizes or incentives for those employees who do walk, such as entry in a raffle. Or there could be group walks at certain times that employees could join that would go to a certain destination such as a local park and back to the hospital.

More and more employers are understanding that a good work/life balance is critical for keeping employees happy. Hospitals and medical facilities are the first on the forefront to know that health is a priority for everyone, and to encourage your employees to be healthy is an excellent goal. With spring just around the corner – now is the perfect time!


3 Tips to Attract Top Notch Employees

3 Tips to Attract Top Notch Employees


In today’s economy every employer knows that many people are looking for a job. But you don’t want to find “just” anyone to fill that position at your hospital or medical facility – you want to get top notch employees. Here are 3 tips to attract top notch employees every time!


Reward Excellence. This sounds very simple, but create an environment where doing an excellent job is noticed and recognized. When employees see that they go the extra mile and it makes a difference to your facility – you are going to discover that more employees will push themselves to do more and more as the group dynamic changes to encourage excellence. A reward can be an “Employee of the Month” plaque, a Thank You from the President of the hospital or anything else you think employees would enjoy.


Encourage Continued Education. Yes, this is a benefit you would need to invest in – but employers who invest in continued education for their employees often discover they have a smarter & more effective workforce. You will also find that your employees are promotable and offer even more transferable skills to grow and advance with your hospital and facility. That is an environment that top notch employees want to work in.


Respect Work Life Balance. One of the biggest challenges many employees face on the job is trying to create a good work life balance – being available to their children for special moments like watching a school play or getting time off for a family vacation. Do what you can as a hospital or medical facility to encourage managers and top executives to create a work environment where work life balance is respected. Most healthcare professionals work 12 hour shifts and some work in very stressful circumstances. It is critical to give them time off to restore and renew themselves and to be with loved ones. They will come back to work more energized, ready to do more for your hospital or medical facility.


Doing these 3 tips will easily create an environment where top notch employees will put your hospital or medical facility at the top of their list when searching for a position!

Is Your Facility Covered for Upcoming School Vacations?

Is Your Facility Covered for Upcoming School Vacations?


Most of us in the Tri-State area have eagerly begun counting the days ‘till Spring arrives. We’re tired of shoveling snow and walking over icy sidewalks to get everywhere. Let Old Man Winter blow his chilly winds someplace else! But before you cross another day off your calendar, its time to ask yourself: is your facility or hospital ready to cover upcoming school vacations?


Both public & private schools from pre-K to grade 12 typically take one week off during the spring. There also may be a short break for the Passover and Easter holidays, depending on the calendar and the school’s preference for scheduling breaks. These spring breaks are peak times for families to plan that fun vacation to visit a theme park such as Disneyworld or to visit Grandma a few states away from home. So more than likely, your hospital or facility will have quite a few employees asking for time off during these school breaks.


Getting time off when an employee wants it is considered one of the top benefits. BusinessWeek.com reports that Gallup reported on how unhappy employees cost companies in the U.S.A. more than $300 billion a year. Keeping your employees happy is one of the best ways to contribute to their productivity levels. And giving them a day or week off when they’ve requested it is a very helpful way to do this.


Your hospital or medical facility needs to be prepared for the upcoming school holidays, such as spring break and the religious holidays. Now is also the ideal time to plan for summer vacation, as schools typically break for three to two and a half months, and many families take a one to two week vacation during this time. Getting coverage plans organized well in advance is the proactive and practical solution, so there is far less stress for everyone working on the unit or the floor.


Those school holidays will be here sooner than you think. Contact Meridian Nurse Recruiters today at 718-255-5830and let us know how we can help with your spring and summer vacation coverage!



What Are You Doing to Avoid “the Revolving Door” of Employee Turnaround?

What Are You Doing to Avoid “the Revolving Door” of Employee Turnaround?


Everyone knows that hiring and finding a job in the medical field is far simpler than in many other industries. But HR Managers and top executives at hospitals and medical facilities “in the know” understand the great value in doing what they can to avoid the “revolving door” of employee turnaround.


While you may not always be able to control an employee’s decision to exit – a spouse can get a job across the country or several states away, an employee can decide they want to be a stay-at-home parent or they could choose to go back to school full-time. But every medical facility should do what they can to prevent losing employees to their competitor’s great offer of a fantastic job that a current employee can’t say “No” to. Fortunately there are some steps you can take right now to help close that revolving door – firmly shut!


Improve Communication at Your Hospital or Medical Facility. A lack of or poor communication is one of the top reasons cited for low employee morale. Employees who don’t feel valued and motivated are going to be tempted by an offer from a competitor. It may take time & effort to improve communication in each department or you may need to implement a few simple practical steps to make things run smoother for everyone – but the most important thing to do is to ask staff “what needs to be better?”


Offer Continuing Education for All Staff. This is a benefit many employees appreciate – and it is actually one that benefits you immensely. A highly trained work force at work in your hospital or medical facility shows that you attract top-notch employees and retain them – it also shows that you care about medical innovations to keep everyone up-to-date. A hospital or medical facility that offers continuing education is one where employees will get excited about what they are doing and also be eager to make both short and long term plans to work with them.


Create a System of Awards and Rewards for Employees. Everyone likes to be appreciated for hard work. Work with each department and create a system of both awards and reward, to show your appreciate for employees on each level. Whether employees receive a plaque, thanks from the hospital’s President or attend a special luncheon or breakfast in their honor, all of these are well worth it to help retain employees.


Finally: Be Open to Feedback. Your employees care about patients and may see things that can be changed to help improve the quality of care for patients – and even the “bottom line” in some circumstances. Maintain an open door policy as much as you can and welcome both positive and negative feedback, with the understanding that there is value in each from employees who care deeply about what they are doing.


Your facility doesn’t have to have a “revolving door” for turnaround, not when you work to retain employees! 

Encourage Employees to Manage Job Stress Before it “Manages” Them

We think everyone knows that healthcare employees work hard. Often they work long hours and under tense situations, sometimes facing critical care patients and concerns. It’s logical to understand that many healthcare employees would face job stress, something that many professionals deal with from time to time.


But as healthcare professionals, it is a delicate balance: it is crucial that they manage their job stress before it “manages” them because they care for patients. Many of the signs related to job stress can wind up affecting your on-the-job performance. As a hospital or medical facility, don’t think you can hope that job stress doesn’t happen in your facility or “wish” it all away. It is far better to be proactive and have a plan than to see top-notch employees become vulnerable to job stress and experience uncomfortable symptoms that put everyone at risk.


According to WebMD, the symptoms of job stress are:


Difficulty sleeping


Trouble concentrating




Losing your temper or “a short fuse”


Stomach aches


Low morale at work or job dissatisfaction


There are some common causes of job stress, some which an employer can help with.


One of them is more responsibility at work. This can come through a promotion – or simply adding more duties onto someone’s already hard working shoulders. This creates a stressful situation for any employee. As a hospital or medical facility if you realize you are in a circumstance where you will need to add additional duties for employees, look for ways you can relieve their stress. This is a valuable contribution you can make to the employees, patients and the entire facility.


Job satisfaction is another concern that often leads to job stress. Admittedly, this is not always under an employee’s control. If you have a healthcare employee who dreams of being an opera singer, you could have a top-notch medical facility and they would still long to be singing arias! But if you feel morale could be slipping in departments, look for ways to raise it. Giving employees feedback and praise about their performance is one of the top ways you can help to relieve job stress. Don’t forget to say “Thank you.”


A working environment with poor communication can often lead to great job stress for just about everyone. If morale is down and most employees seem frustrated and are verbalizing this, this is often a sign that communication skills need to be improved. Yes, this can be a lot of work but it is well worth the effort, to improve each department and the quality of care for your patients. Smoothing out what may be simple misunderstandings between coworkers and departments may increase your facility’s performance in ways you can’t begin to image.


Take the time to think now: what can I do to prevent job stress for my employees this quarter?


Source: http://www.webmd.com/balance/stress-management/tc/managing-job-stress-topic-overview

The Snow is Melting. Are You Prepared for Spring Break and Holiday Coverage?

Its hard to believe as another 2 snowstorms are headed towards the Tri-State area, but the snow is melting, and spring is about 30 days away. That gives HR professionals and managers approximately one month to plan for spring break and holiday coverage.


Most schools take a week off in the spring, coinciding with the Easter holiday. Many schools also take off time in late February for President’s Day, whether it is a long weekend or a full week. Moms and Dads will be eager to take this week off from work to be with their children, whether they go visit family, go to a fun theme park or simply enjoy a staycation at home together. But is your hospital prepared to cover these shifts?


It is important to let employees have time off if they are due this time whenever it is possible. Taking a vacation or time off is often needed for stress release and is especially good for staff morale. One thing that concerns many employees is having a healthy work/life balance – being unable to take a vacation when they would like to have one may cause some employees to question if this is an environment they want to remain in. Though most employees do understand at times it is simply impractical or impossible for an employer to let everyone or too many employees have the exact same shifts off, hospitals can be proactive and work to arrange coverage to allow for some to have this time off.


Now is the time to put a plan in place to prepare for President’s Day weekend/week, Spring Break and all of the spring holidays. Contact Meridian Nurse Recruiters at 718-255-5830 to talk about your spring vacation and holiday needs, we’ll create a successful plan to cover EVERY shift without hassle or stress! http://www.meridiannurse.com/


Hospitals Know Patients Come First Even When Balancing the Budget

According to The New York Times, the for-profit hospital chain health Management Associates set aggressive goals to admit patients based on increasing their bottom line and not on patient care. Physicians were actually coded – like stop lights – at green, yellow and red to show not their quality of care or even their efficiency – but their successful rate of admission – where it did not matter whether the patient was sick or healthy – they were just all admitted for care.

Many hospitals and medical facilities are carefully watching the bottom line, especially with concerns over the changing regulations for health insurance and how this will affect reimbursement. But 99.9% would never consider schemes and scams like the one that Health Management Associates actually put into play for their unsuspecting patients. Hospitals know they care for patients and want them to leave healthier and better, not with emptier wallets.Hospitals and facilities are looking at other ways to lower their costs and improve their bottom line – all while keeping patient care their #1 concern. Sadly, when potential patients hear of hospitals and hospital groups such as Hospital Management Associates and their wrong doings, it can be easy to wonder if their hospitals nearby are efficient and would ever take aggressive measures to cut costs.

How have you shown patients that patient care is your top priority – all while keeping the bottom line in mind? Many hospitals and facilities do face cutbacks but still are dedicated to their patients.

Quite likely the biggest cutbacks your patients will notice are changes in staff. If you decrease your staff, doctors, nurses and other healthcare professionals there may be cause for concern. Patients will worry there will not be someone to care for them when they are ill, or for their loved one when they need that critical care.

If the time comes when you need to consider your bottom line, remember that other cuts affect patient care less. It may be easier to cut back on landscaping for the hospital grounds than to consider decreasing nurses in the E.R. or the maternity ward.


Make Patients and the Public Aware of the Need for a Living Will

There have been some stories recently in the news that focus on the challenging circumstance of what occurs when someone does not leave a living will. They may talk about their wishes with a loved one, or assume that others know what they would like done, but this is not enough. A legal document, a living will must be in place to ensure that what an adult would like to happen during end-of-life or serious circumstances happens as they wish.


Every adult needs a living will. Hospitals know that unexpected circumstances can arise at just about any age. Making your patients aware of the importance and need for living wills will help serve your community more effectively and successfully.


According to MayoClinic.org patients will want to have advanced directives in place. This is not simply a living will, but several other documents to protect patients – and patients should be aware of the importance of each.


Advanced directives give written instructions with your medical care preferences. If you are unable to make decisions regarding your healthcare, these written instructions will offer clarity.


A living will is also a form of an advanced directive and specifically states the types of medical treatments and what kinds of life-sustaining measures you would like to be given – or not to be taken if they are to be considered for your medical treatment.


A medical/healthcare power of attorney will designate a person (called your health care agent/proxy) who can make medical decisions for you if you are not able to do so.


A DNR order (do not resuscitate) is a request to not have CPR (cardiopulmonary resuscitation if the patient’s heart stops or if they stop breathing.


No one likes to think of the unexpected or tragic occurring, but it is helpful to be prepared to best take care of your family and loved ones so they can manage the circumstance well. It also means that your wishes for how this circumstance will be managed will happen. Patients should be aware of the need for advance directives such as living wills and putting them in place.


Source: http://www.mayoclinic.org/living-wills/art-20046303