Top 100 Private Companies: American Nursing Services Inc.

A NURSING SHORTAGE that has local hospitals worried helped boost the revenues of American Nursing Services Inc. by 25% to $18.8 million in 2000. Hospitals are scrambling to find qualified nurses, says P.K. Scheerle, chief executive officer of the nurse staffing firm.

About 70% of the company's

An October 2000 survey of 29 local hospitals performed by the Metropolitan Hospital Council of New Orleans revealed that about 15% of registered nurse positions stood vacant. Meanwhile, not as many applicants seem eager to enter a nursing career. The long wait that applicants to nursing schools once faced to gain admission into Louisiana nursing schools in years past is history, Delgado Community College officials say.

American Nursing plans new offices in Mandeville, and as far away as Las Vegas and Jacksonville, Fla. It already runs offices in New Orleans, Houston, Shreveport, Dallas, Fort Worth and San Diego.

Even when there isn't a nursing shortage, Scheerle says hospitals often call upon staffing companies to help them keep pace with fluctuations in the number of patients admitted to the hospital.

Meanwhile, Scheerle says nursing is becoming more difficult. With the advent of managed care and outpatient surgery, the average nurse sees more patients, and more seriously ill patients, than ever before.

"The med-surg patient of yesterday 'is now at home and the ICU patient of yesterday is now in a med-surg bed," she says.

Revenue has also grown in American Nursing Services' home health activities, and Scheerle says that segment is about to experience explosive growth. In October, the federal government changed the reimbursement system for home health under Medicare. Many of the smaller home health agencies have decided to get out of the business in fight of the changes. That leaves a larger market share for companies such as American Nursing Services that have the ability to process the heaps of paperwork that the new reimbursement system requires.

Under the old payment system, a home health agency was paid based on how many visits it made to the patient's home, which many critics thought encouraged waste. The new system categorizes the patients into payment groups and reimburses a fixed amount for nursing services, regardless of how many visits the nurse makes.

Scheerle says a hand-held computer system the company has begun using for its home health nurses will help it keep up with the increased paperwork. "Although we spent a small fortune on that, it will help us out with the new payment system," she says.