Pick a staffing partner by asking for proof, not promises. Check how the agency verifies licenses, whether an outside body has reviewed its processes, how often it really fills shifts, and what the contract locks you into. An agency that answers those four points with documents and numbers is usually safe to pilot. One that stays vague usually is not.
This guide walks through that review in the order most facility teams need it, then gives you a scorecard to compare two or three providers side by side. If you’re new to locum tenens, learn more about how healthcare staffing agencies connect healthcare professionals with facilities and assignments.
What should you settle internally before calling any agency?
Agencies sell what you ask for. If your request is fuzzy, every proposal will look good. Spend an hour with your nursing director or medical staff office first.
Define the gap you are actually filling
A leave cover, a seasonal surge, and a chronic vacancy are three different problems. Leave coverage calls for clinicians who can start quickly and adapt to short-term schedules. A chronic vacancy such as an ongoing psychiatrist job opening, requires clinicians who are open to longer-term coverage or a clear path to permanent hire. Before contacting an agency, define the role, shift pattern, expected duration, and desired start date. .
Write down your deal-breakers
List what is not negotiable: license types, minimum experience, certifications such as BLS or ACLS, background and health screening, and orientation needs. Giving every agency the same list saves weeks of back-and-forth and keeps later comparisons fair.
How do you verify an agency’s credentialing and compliance?
Credentialing is where a weak agency puts your facility at risk. A clinician with a lapsed license becomes your problem the moment they step onto the unit, so look here before anything else.
Ask how licenses and exclusions are checked
A solid answer names primary sources: the state licensing board for each license and the federal exclusion list kept by the HHS Office of Inspector General. Ask how often checks repeat, not just whether they happen at hire. Licenses expire mid-assignment. Also ask who owns the process, a named compliance lead or a general recruiter, and request a sample credential file with personal details removed.
Check screening, health clearances, and onboarding readiness
A valid license is only part of the file. Ask what else is complete before a clinician reaches you: background checks, drug screening, immunization and TB records, and any facility-specific training. Then ask how the agency delivers that paperwork to your medical staff office. The best answer is a complete packet before the first shift, not a trickle of documents on day one.
Look for independent certification
The Joint Commission offers a Health Care Staffing Services certification. Its reviews are unannounced and repeat every other year, and they examine how a firm gathers credentials, evaluates competence, and matches staff to assignments. Certification is not legally required, and a small, excellent agency may not hold it. If an agency does, ask to see the certificate. If it does not, ask what independent checks it uses instead.
Confirm insurance before you sign
Ask for certificates showing professional liability and workers’ compensation coverage. Check that the limits meet what your own contract or risk team requires.
Which questions expose an agency’s real track record?
Every agency says it is fast and high quality. Numbers separate the ones that are from the ones that are not.
Fill rate, speed, and cancellations
Ask for the share of requests filled in the last 90 days for roles like yours, the average time from request to first submitted candidate, and how often confirmed clinicians cancel. Then ask what happens when they do. Insist on definitions, too. One agency counts a shift as filled if it is eventually covered; another counts only shifts covered on time. If an agency cannot share any metrics, treat that as an answer.
Why reliability matters more than it looks
Your own team is already stretched. The 2026 NSI National Health Care Retention & RN Staffing Report found RN turnover of 17.6% in 2025 and an average cost of $60,090 per departing staff nurse, with behavioral health leading all specialties at 22.5%. A no-show or a poor match lands on people already near their limit. Ask for references from facilities with a similar specialty and volume, and call at least two.
What to ask during reference calls
References are only useful if you ask more than “Were you happy?” Try these instead: Did clinicians arrive prepared for your unit? What happened the last time something went wrong, and how fast did the agency respond? Were invoices accurate? Would you rely on them for a hard-to-fill role? Finally, ask what the reference would change. The answer to that last question is often the most honest one.
What should you look for in pricing and contracts?
The lowest bill rate rarely means the lowest cost. A cheap rate paired with frequent cancellations costs you overtime and last-minute backfill.
Ask for an itemized rate structure
Request rates broken out by role, shift type, overtime, holidays, and cancellations. Seeing how the markup is built lets you compare offers fairly. Our guide to the average fee for a staffing agency explains common pricing models.
Read the fine print on terms
Check the conversion fee if you hire a clinician directly, the notice needed to cancel a shift without penalty, minimum assignment length, auto-renewal, payment terms, and who documents incidents. Have your legal team review the agreement before anyone signs.
Does the agency fit your setting and specialty?
An agency that staffs hospital med-surg units well may struggle in a prison infirmary or a state psychiatric hospital. Ask how many clinicians it has placed in your type of setting and how it prepares them for site rules, security procedures, patient population, and your charting system. You can see the roles we fill across our correctional facility and state hospital job openings.
Geography matters too, because state licensure rules and local candidate pools differ. If you operate in the Golden State, our overview of [healthcare staffing agencies in California]([ADD BLOG URL]) shows who operates there.
Test their communication before you need it
The sales process is a preview of the service. Notice how quickly the agency answers questions and whether you get one point of contact or a rotating inbox. Ask who you call at 2 a.m. when a clinician cannot make a shift, and how fast you should expect a reply. An agency that is slow while trying to win your business rarely speeds up afterward.
How can you compare agencies side by side?
After each discovery call, score every agency from 1 to 5 on the criteria below. The table shows what to ask and what separates a strong answer from a warning sign.
| Criteria | What to Ask | Strong Sign | Warning Sign |
| Credentialing | How are licenses and exclusions checked and rechecked? | Primary-source checks, named owner, sample file | We handle it with no detail |
| Certification and Insurance | What outside review and coverage do you hold? | Certificate and policy proof on request | Vague or delayed answers |
| Performance Data | What are your fill and cancellation rates? | Clear definitions, recent numbers | No metrics shared |
| Pricing | Can you itemize the rate? | Line-by-line breakdown | One blended number |
| Contract Terms | What are the exit and conversion terms? | Plain language, fair notice | Heavy penalties, auto-renewal |
| Setting Experience | Where have you placed clinicians like these? | Relevant references | Generic examples |
Weight the rows by your risk. A unit with a license-heavy workforce should count credentialing double.
Why should you run a small pilot first?
Strong answers on paper can still fall apart on shift one. Start with a limited batch of shifts on a single unit. Track whether clinicians arrive on time and ready, how fast the agency responds to problems, whether invoices match what was worked, and what the unit manager thinks. A short feedback note after each shift is enough. Expand only when the pilot earns it.
What do facilities often overlook?
Three things rarely show up on a proposal. First, how the agency treats its clinicians. Late pay and slow recruiters drive cancellations, and those cancellations become your problem. Second, the backup plan: ask what happens when a clinician drops at 5 a.m. Third, your own urgency. Facilities that pick an agency during a crisis tend to skip the steps above, so build your shortlist before you need it.
If you would like to talk through a need in state hospitals or correctional facilities, you can work with Intuitive Locum Services.
How to choose the right healthcare staffing agency
The right agency is the one that can prove its credentialing, share real performance numbers, and put fair terms in writing. Shortlist three, send each the same deal-breaker list, score them with the table, and call their references. Then pilot the best fit on a small scale before you commit. That sequence takes little time and protects your patients, your staff, and your budget.
Questions facility leaders ask before hiring an agency
How can I tell if a staffing agency is legit?
Look for verifiable references, a real business address, consistent contract terms, and willingness to share compliance documents. Walk away if an agency asks for upfront fees, dodges credentialing questions, or pushes you to sign the same day.
Is it better to use one agency or several?
One main agency simplifies management and can improve service. Many facilities add a second for specialty roles or surges, which also gives you a live comparison. Avoid spreading shifts so thin that no agency learns your unit.
How do staffing agencies make money?
They bill you a rate higher than what the clinician earns. The gap covers payroll taxes, insurance, recruiting, and compliance work, with the remainder as margin. Not all of the markup is profit, which is why itemized rates matter.
How long does it take to start with a new agency?
It depends on your vendor approval, contracting, and onboarding steps more than the agency. Ask for its typical timeline and begin the paperwork before you have an urgent gap.
What is the difference between a staffing agency and a locum tenens firm?
Locum tenens firms traditionally place temporary physicians and advanced practice providers. General healthcare staffing agencies more often supply nurses and allied health staff. Many firms do both.
