Case Studies

PRN Nursing Staffing Support for Rural Residential Facility

The Challenge

A state agency required PRN nursing support (RNs, LPNs, and CNAs) for a rural residential facility. While the need for nursing support could be anticipated in advance for vacations and holidays, the facility needed a reliable partner to also provide support within a two-hour window of notification. Due to its rural location, the pool of qualified local providers able to provide PRN support is extremely limited. The facility originally contracted with another medical staffing company, but after six months, they needed to reissue the contract due to the incumbent’s inability to provide coverage of open shifts.

Management Registry Inc.’s Solution

After researching the local labor market, our team proposed using a dedicated recruiter to build a pool of local and qualified RNs, LPNs, and CNAs who were interested in PRN and had the ability to pick up different shifts – from first, second, and/or third. Our proposed account manager brought ten years’ medical staffing experience and medical account management. To test our approach, our team proactively began recruiting for local RNs, LPNs, and CNAs, and interested applicants began our application and Joint Commission standard credentialing process.


Upon award, our account manager initiated communication with the facility’s director of nursing and provided our candidate’s credentialing packets for review. Working with the facility scheduler and director of nursing, our account manager worked with facility stakeholders and our employees to schedule facility orientation prior to beginning work at the facility. During weekly review meetings of our account team, we track historical usage of positions and maintain communication with the facility’s director of nursing on patient census and anticipated shifts needing coverage. Our pool of employees is checked against forecasted needs, and should additional nursing staff categories show as “yellow” or “red,” our account manager tasks the recruiter to build a pool of staff in the healthcare specialties we anticipate an increased demand. By using our recruiting process, Management Registry Inc. has been able to build a pool of local nursing staff to provide support services to this facility.


One issue that arose during the building of our facility nursing staff pool was a lack of communication between the facility personnel, our employees, and our account team. Our team was informed that several of our employees were not to return, which in turn lead to shifts not being filled by Management Registry Inc. and the secondary contractor. Opening lines of communication with the facility administration and stakeholders, Management Registry Inc’s. account manager discussed our resolution process where an employee can undergo additional orientation, skills development, or one-on-one discussion of issues and ways to correct deficiencies. After discussion of our resolution process with facility stakeholders, we discovered that our employees did not undergo the “shadowing” period prior to working, and now our employees do have the option to “shadow” prior to working independently at the facility. The facility administer looked at our proposed lines of communication between facility stakeholders, our account team, and our employees, and implemented our suggestions. Additionally, the facility administrator was able to reference our employee feedback and initiate a program to increase team building between our personnel and facility personnel. The outcome of better communication between all parties has allowed Management Registry Inc. to continue providing PRN nursing support to the facility and ensuring the client’s mission to providing top-notch care to their residents.

Locum Tenens Staffing Support for State Psychiatric Hospital

The Challenge

A state acute adult psychiatric hospital requires long-term Registered Psychiatric Nurse (RN), Licensed Practical Nurse (LPN), and Certified Nursing Assistant (CNA) staffing support. Based on the patient demographic, nursing staff need at least one (1) year experience in psychiatric nursing and certification in Non-Violent Crisis Prevention Intervention (NVCPI). In order to ensure adequate coverage to meet the facility’s mandatory state and federal requirements and to ensure continuity of care to the patients, qualified and accepted nurses needed to commit to a 13 week contract and be open to overtime. To meet the facility’s needs, the state issued a multi-award contract to meet its historical usage requirements.

Five months into the contract, the state agency added seven (7) additional facilities to this contract vehicle. These facilities were located in rural and urban areas throughout the state. The state facilities require a 72 hour turn-around time from request to submission of a candidate’s full credentialing packet.

Management Registry Inc.’s Solution

We proposed a streamlined approach with a designated recruiter to maintain and build the candidate pools for each modality. Sourcing both active and passive candidates, this recruiter would augment our local pool of nursing staff. Management Registry Inc. already had a presence in the initial facility region, and we had nursing staff fully credentialed to include the State background screening. Our proposed recruiter knew the local nursing labor market, and had developed a strong local professional network. To meet the historical usage demands, Management Registry Inc’s. temporary housing and stipend program coupled with our incentive and retention program would allow us to maintain continuity of care with our placements.


Immediately upon award our recruiter began posting openings, contacting our established networking contacts, and collecting referrals from our current employees. Our Account Manager in conjunction with our credentialing specialist began contacting nursing staff who met the facility’s qualification and were either coming off an assignment or waiting for a new assignment to gauge their interest. Those who were interested updated any information to include updated immunizations and undergoing a current drug screening. Within 72 hours of award, Management Registry Inc. submitted RN, LPN, and CNA credentialing packets to the facility’s representative for review by the Director of Nursing.

When our candidates were accepted, our team worked closely with the facility’s representative to help schedule the required facility orientation, provided our nursing staff a client tailored Employee Handbook, and arranged housing for those that required temporary housing.


Management Registry Inc’s. plan for building a deep pool of qualified and pre-credentialed nursing staff candidates allows us to meet the client’s 72 hours candidate packet submission requirement. When the seven (7) additional facilities were added to the existing contract, Management Registry Inc. already had pre-credentialed and qualified candidates ready to provide nursing support services. Our housing coordinator has built strong working relationships with local housing providers, ensuring our employees have a clean, safe, and convenient place to stay. Our quarterly on-site visits with the facility stakeholders and our nursing employees allow us to gauge the success of our efforts and make minor adjustments to our staffing approach. The most significant adjustment we’ve made to add a specialist recruiter to build out our pool of nursing staff for the rural facilities.

Call Center Staffing Support for Student Loan Corporation

The Challenge

A main goal of a State’s Council on Postsecondary Education is to double the numbers of state residents empowered by a higher education degree. An independent de jure municipal corporation and political subdivision of a State government provides critical financial aid and information resources to state residents. This agency with its two offices provides telephonic call center support for residents to navigate Federal and State Financial Aid programs and forms. Additionally, they provide loan servicing support services to residents who have their Student Loans with the agency. This agency requires both “surge” and long-term temporary Loan Servicing Technicians, Call Center Representatives, and Administrative Associates for Verifications and Documentation, and Collectors staffing support. The current vendors used by the agency were unable to provide qualified, experienced, and reliable staffing support.

The agency’s Human Resources decided to fill temporary positions through their office. During an interview with an applicant, the agency learned the candidate had worked for another State agency as an Management Registry Inc. employee. After interviewing our former employee, the Agency reached out to Management Registry Inc. to ask if we would be willing to provide Temporary Staffing Support.

Management Registry Inc.’s Solution

After meeting with the agency stakeholders to get the agency’s job descriptions, average duration, and historical usage data, Management Registry Inc. tailored a staffing plan for the client. Since the agency’s staffing needs fluctuated based on “seasonal” requirements, Management Registry Inc’s.  Account Manager proposed a streamlined approach with a designated recruiter to maintain and build the candidate pools for each position. Sourcing both active and passive candidates, this recruiter would continually source candidates for all the agency’s positions. Management Registry Inc. proposed developing a client-tailored applicant assessment process to include position specific testing and behavioral assessments to ensure our candidates would meet or exceed the client’s position requirements.


Immediately upon verbal agreement with the agency, our recruiter began posting openings, contacting Management Registry Inc. temporary Loan Servicing, Call Center, and Administrative employees in our database who were not currently on assignment or were reaching the end of their current assignment. Our recruiter began collecting referrals from our current employees. Management Registry Inc’s. online application process allowed us to source 5 to 10 viable applicants for each position, screen these applicants to include a background and drug screening, skills testing, behavioral assessment, and a structured interview. Within 72 hours, Management Registry Inc. submitted our first round of candidates to the agency for review.

When our candidates were accepted, our team worked closely with the agency’s representative to develop an onboarding processes tailored to meet their guidelines and procedures. This included developing a client tailored Employee Handbook. Management Registry Inc’s. Account Manager followed up with the agency within one week to discuss the performance of our employees. As is our policy, Management Registry Inc. continued our follow-up 60 days after the initial placement of our employees and then transitioned to quarterly follow-ups. The agency’s Management Registry Inc.  Account Team meets bi-annually with the client to discuss areas for improvement and to ideas to further streamline our staffing solutions for their needs.


Management Registry Inc’s. plan for building a deep pool of qualified, experienced, and reliable candidates has ensured our client has the temporary staffing support when they need it. Because of our continuing communication with client stakeholders and our proactive recruiting endeavors, we have a 98% fill-rate with the client. Additionally, Management Registry Inc’s. tailored Applicant Assessment ensures that our employees meet the client’s needs and our employees are committed to seeing through the duration of their assignments.

Comprehensive Staffing Solution

The Challenge

An autonomous municipal corporation needed a committed staffing partner to fulfill all its temporary staffing requirements. Because of the nature of its business, the client’s operations work in tandem with multiple U.S., State, and Local agencies. The client required temporary staff who would meet federal background screenings, who were reliable, and who had prior experience providing the requested services. Additionally, one division requires an on-site staffing supervision from the vendor.

Management Registry Inc.’s Solution

After initial discussions we discovered that while satisfied with the current the incumbent’s temporary employees the client needed more responsive account management. Our team proposed a streamlined approach with a designated recruiter and a single point of contact for the client’s stakeholders. This management plan allowed our team to maintain regular, open, on-going communication with the client stakeholders.

We developed a transition plan expressly for this client in order to transition all incumbent temporary employees. A key element of our plan was establishing initial communication with the incumbent’s personnel immediately upon notification of award. We proposed using our online application portal, which allowed employees working any of the three (3) shifts to complete our application forms at their convenience. Additionally, we proposed rolling over the incumbent’s temporary employees Paid Time Off (PTO), and our proposed benefits were more comprehensive than the incumbent’s employee benefits. Our team also proposed an integrated recruiting effort in order to address the 50% turn-over rate in one job category.


Immediately upon award, our Account Manager reached out to the client stakeholders in order to start our transition plan. After confirming the client’s needs for both temporary employees and for account management, our team concurrently began our transition the incumbent’s temporary employees and began our integrated recruiting plan.

To quickly transition the incumbent’s temporary employees without negatively impacting the client’s business, our Account Manager worked to set up an onsite “meet and greet” pizza station. At this station, transitioning employees could meet our Account Manager and our Lead Recruiter in an informal setting. We had information packets for each transition employee with dates and times for our New Employee Orientation sessions. To accommodate the transitioning employees’ schedules and the needs of the client, we ran New Employee Orientation sessions over the span of a week and at a location near the client’s facilities.

Our integrated recruiting plan was launched simultaneously with our transition plan. Key elements were proving transitioning employees referral bonuses, holding local job fairs, leveraging our online application process, and partnering with local and state government job resource programs.


Management Registry Inc.’s customized transition plan allowed us to transition the incumbent temporary employees within 14 days and with no interruption to the client’s daily operations. Our team was also able to transition the incumbent’s on-site project manager. Our integrated recruiting and retention plan has taken the 50% turn-over rate for one job category (with only a 75% fill-rate) and reduced the turn-over rate to 35% and raised the fill-rate to 90%. Management Registry Inc’s. proactive Account Team uses on-going and open communication with the client stakeholders to prepare for seasonal/event staffing support demand. Our employee retention program has kept our overall turn-over rate to 9%.

Locum Tenens Nursing and Allied Staffing Support for Teaching Hospital

The Challenge

Located in a major metropolitan city, this teaching hospital encompasses a full-service hospital, three (3) community-based health centers, and a free-standing Dialysis Center. Providing care to the over 2 million residents, this hospital offers professional education and training to over 30 health-focused programs including a College of Medicine, a College of Nursing, and a College of Public Health.

This client provides medical care to a culturally diverse and medically varied patient demographic population. As a nationally noted healthcare teaching institution, the client requires healthcare providers to meet the highest levels of competency and experience. To maintain required staffing levels, the services of multiple healthcare staffing companies to provide nursing and allied locum tenens. The contract providers must meet the client’s requirements for a providers’ levels of competency and experience and supplemental providers must undergo a thorough testing and orientation process. Based on the scope of nursing specialties and the specialized technicians being requested, the client offered bidders options to provide local and/or travel nurses and technicians.

Management Registry Inc.’s Solution

Management Registry, Inc. crafted a comprehensive nursing and technician staffing support plan based on our team’s:

  • Knowledge of the client and their facilities
  • Familiarity with the location and its cultural diversity
  • Understanding of the local healthcare labor market

Management Registry, Inc. decided to partner on this endeavour with an established local minority-owned business. Based on our prior partnerships with the business and our team synergy, we were confident Management Registry, Inc. would provide a comprehensive staffing solution that met the client’s requirements and was cost effective for the client. With our partner on board, Management Registry, Inc. proposed an intensive, targeted recruiting campaign.

To meet the client’s usage needs, we required a tailored recruiting plan in order to build a deep pool of CNAs, LPNs, RNs of all specialties, Nurse Practitioners, and EKG, OR, and Haemodialysis Technicians.

  • We spotlighted the positions on our companies’ websites, our social media platforms, local job boards, community specific print media, and emails to current and prior nursing and technician staff in our database.
  • Our team proposed holding one week of Community Job Fairs. During these job fairs, applicants could use computers to complete their online application, take our skills and medication tests, provide copies of their credentialing information including copies of their immunization records, contact information for their physicals and their references, and undergo our the first of our structured interviews. Applicants would be able to return subsequent days to submit any missing documentation, sign any outstanding release forms, take remaining skills tests, or do their first structured interview.

As we developed our pool of nursing providers and technicians, Management Registry, Inc. proposed maintaining open lines of communication with facility stakeholders. With open, ongoing communication we could proactively prepare for anticipated increases in position requests, and plan for our new provider client testing, orientation, and floor orientation based on the client’s training calendar.


Immediately upon notification of award, Management Registry, Inc. reached out to the client stakeholders to exchange contact information with the Client’s Contract Officer, Testing and Orientation Department, and the Credentialing Department. We confirmed the contract start date and received the list of anticipated position requisitions.

Our Account Manager and our teaming partner booked a community location for our week-long Community Job Fairs. Our Staffing Specialist began posting of the jobs descriptions on our websites, social media platforms, and strategic job boards. Our Marketing Department been advertising our Community Job Fair dates and locations.

Our Credentialing Specialist processed all qualified applicants, and once primary verification had been completed, our Account Manager submitted the credentialing packets to the client for review. Upon approval by the client, our team assisted our providers with navigating the process to register for the client testing modules, register for the week-long client classroom orientation, and followed up with our provider to gauge how the following floor orientation went.


Management Registry, Inc. has been providing the client the nursing services of OR, Medical/Surgical, Postpartum, and Dialysis RNs, CNAs, LPNs, Dialysis, EKG, and OR/Surgical Technicians. Our recruiting approach has proven effective. All but one of our nursing providers have been local, and all our technicians have been local. Our approach using extended Community Job Fairs has been so successful that we and our partner hold a week-long Community Job Fair at the same time of the year.

Our tailored applicant assessment process has also resulted in our ability to retain our nursing and technician professionals through the extended (approximately 45 days from submitting a credentialing packet to the provider working on their assigned floor/clinic) onboarding process. Our Staffing Specialists and our Account Manager have built a close relationship with our providers, and they help them navigate the client’s onboarding process.

Management Registry, Inc.’s competitive compensation package has allowed us to retain our providers. By ensuring we retain fully client onboarded nursing and technician professionals, Management Registry, Inc. helps the client realize continuity of care for their patients and reduces the time to fill rate for the client. Our approach has helped the client to meet their need for patient coverage and maintain their high standards of care.

PRN Staffing Support for State Agency Facilities

The Challenge

A State Agency charged with the care of adolescents (13 – 18 years old) operates over 25 facilities across the state. These facilities fall into three (3) distinct categories with each category providing specific services to the juveniles. State and Federal regulations require a Registered Nurse (RN) on duty for one category of facilities; the other facilities have either a RN or a Licensed Practical Nurse (LPN) provide nursing services to the adolescents. Additional Federal regulations require that all personnel providing services must pass a stringent background check and must complete PREA (Prison Rape Elimination Act) training prior to providing services at the facility.

To meet State and Federal regulations, the State Agency needs nursing staff onsite at the facilities on a consistent basis. The State Agency required the services of a healthcare staffing company to provide nursing support services to ensure they meet all State and Federal requirements. The chosen staffing company must be able to provide qualified, screened, trained, and experienced RNs and LPNs on a PRN basis and/or short-term contracted periods of time.

Management Registry, Inc.’s Solution

Working within their state budget constraints, we proposed a streamlined approach with our Account Manager leading our recruiting efforts. Based on the stringent background screening and training required, our Account Manager knew that the three (3) to four (4) week wait for background results would severely constrain our ability to build a deep pool (8 to 10 candidates per facility) of qualified candidates. Many RN and LPN candidates would find positions within the three (3) to four (4) week wait. With this knowledge, our team proposed a two-prong recruiting approach.

To counter the background screening result wait, Management Registry, Inc. proposed expanding our recruiting efforts to include offering increased employee referral bonuses. We also proposed augmenting our social media and job board recruiting approach to include spotlighting these RN and LPN positions on and our company website and social media. In tandem to the augmented recruiting plan, we proposed tailoring the work description to assess whether RNs or LPNs would be willing to travel to other facilities to provide nursing services.

To fully ensure the variable nurse service needs of the State Agency facilities were meet, Management Registry, Inc. proposed maintaining open lines of communication with the State Agency’s Director of Nursing and designated representative. We proposed a single point of contact, our Account Manager, in order to streamline the communication process for State Agency stakeholders.


Within 24 hours of notification of award, our Account Manager reached out to the State Agency’s stakeholders. We asked for any historical usage numbers for each of the facilities, discussed transitioning the incumbent’s RNs and LPNs, and establishing the required account with the State to run the required background screenings.

Based on the historical usages numbers, projected usage needs, confirmation of the job descriptions, and approval for qualified incumbent RNs, and LPNs to transition, our Account Team began implementing our new account ramp-up plan. The projected variable usage needs per facility showed that certain facilities required standing coverage (the same day of the week, every week). Other facilities were waiting for lines to open in the State budget to allow hiring a nurse full-time. These facilities required long-term nursing coverage for an indefinite amount of time. Other facilities employees who were scheduled for vacations.

With this information, Management Registry, Inc.’s Staffing Specialist posted job descriptions and reviewed our data base to identify RNs and LPNs with the required experience, were located near facilities requiring nursing services, and were either not on assignment or were PRN at a nearby facility. Our Account Manager reached out to transitioning RNs and LPNs, and our Credentialing Specialist began the credentialing process for these transitioning personnel and began the background screening process for our interested field RNs and LPNs and new candidates.


Management Registry, Inc.’s tailored recruiting process allowed us to have all open shifts at the various facilities covered by the contract start date. As predicted the wait period of three (3) to four (4) week for background screening results did reduce our pool of RNs and LPNs.

To counter the reduced pool of RNs and LPNs, we maintain a core group of 7 to 10 RNs and LPNs who are willing to travel to facilities. Our commitment to ongoing communication with our clients has allowed us to prepare for increased usage requirements such as holiday coverage, vacations, family leave, and State Agency internal employee changes.

Management Registry, Inc.’s ability to retain nurses, to use traditional and nontraditional methods of recruiting, and to maintain open lines of communication with the client has allowed our team to maintain a 96% fill rate.

Locum Tenens and PRN Comprehensive Healthcare Correctional Staffing

The Challenge

A State agency required comprehensive healthcare staffing support for its facilities. The agency wished to streamline invoicing and billing, reporting and tracking, and improve services to inmates, which would allow for increased operational efficiency and quality of care. The agency sought staffing contractors who could provide nursing, professional, and allied healthcare staffing support. Additionally, due to state and federal correctional facility regulations, the agency required staffing contractors who could ensure compliance with these regulations.

Management Registry, Inc.’s Solution

Our team assessed the specific healthcare staffing needs of each of the state-wide facilities. We looked at the following aspects for each facility:

  • What services were provided at each facility?
  • Were they strictly internal clinics?
  • Did the facility provide diagnostic services such as x-rays/ultrasounds or lab work?
  • Did the facility provide dental care?

Our team also assessed the historical usage at each facility and projected future use based on current correctional facility populations.

With this information, we developed a staffing plan that would meet the agency’s long-term and short-term staffing requirements. Leveraging our presence in the state, we proposed using an overlapping talent pool. Several of our clients required only Allied Staffing Support. Others required only Nurse Staffing Support.

Immediate Coverage:
For immediate coverage of the facilities, we proposed initially cross-utilize our resource pools with employees waiting for an assignment or coming off of an assignment to meet all potential modality requests. Our cross-utilization approach allows us to retain the most qualified and experience healthcare providers and to provide our clients quality healthcare staffing support. Additionally, we reached out to our current Allied and Nursing professionals for referrals.

Building a Dedicated Pool
Once awarded, our Client Account Manager would work with recruiters building a pool of pre-qualified Allied and Nursing Healthcare Professionals for the Client’s state-wide facilities. We proposed using a multi-pronged recruiting process.

Supplementing traditional recruiting avenues such as job boards and our company website, our team proposed rolling local job fairs within 30 miles of each facility. Due to the specialized correctional applicant screening, our Recruiters proposed a client tailored applicant process. This tailored approach would ensure compliance to the client’s staffing requirements and allow us to move pre-qualified candidates efficiently through the screening process.


Upon award of the contract, Management Registry, Inc.’s Account Manager reached out to the client stakeholders. We confirmed the job descriptions and the open shift request process with the client stakeholders.

With this information confirmed, we contacted current Management Registry, Inc. Allied and Nursing professions who were in-between assignments or were working strictly PRN for other clients and wished for additional shifts. If our employees were available and interested in providing services, our Recruiters quickly updated their files to meet the client’s screening requirements. We worked with the client to schedule PREA (Prison Rape Elimination Act) training and to schedule facility orientation.

In tandem to leveraging our current pool of Allied and Nursing professionals, Management Registry, Inc.’s Recruiters scheduled strategic rolling job fairs in towns and towns near the client’s facilities. We begin our application process with interested professionals, and our Recruiters worked with qualified applicants to gather all necessary information and to sign-off on all necessary screening requirements. This allowed for Management Registry, Inc. to clear our employees quickly and efficiently.


Because we had already prepared client-required screening and our ability to cross-utilize employees, Management Registry, Inc. could begin providing Allied and Nursing Staffing Support to the client’s facilities within 7 business days.

Our continuing strategic recruiting and client tailored applicant screening process allowed our team to build a deep pool of qualified and experience Allied and Nursing professionals to meet the clients PRN and long-term staffing requirements.