Blacklists are legal when used internally. What constitutes an internal use of privileged employment information? The simplest example is when you are terminated from a hospital and attempt to be rehired in a different department. Your employment details are available via Human Resources to all managers and is likely that you will not be hired. Too obvious, right? Well, let's expand this simple example.

Now imagine that this hospital is part of a group or chain of hospitals such as HCA or Tenet. Sharing your personnel file with all of the hospitals is still internal to one employer and thus legal. If you try to get another position with an HCA hospital, even one in another state, you may out of luck.

Human resources will keep a file on travelers just as they do their own direct employees. So if you are terminated from any HCA hospital (for example), you may have difficulty in working for another HCA hospital for a travel assignment or as staff.

A similar example involves large agencies who maintain a number of separately branded agencies. Cross Country for example, also operates NovaPro and MedStaff. With the same corporate parent, personnel information is also centralized. This means your ability to switch agencies in the same group may be restricted.

The next example involves prime ("first") vendors. A prime vendor is one who manages travel contracts and agencies for hospitals under an exclusive or primary contract. They utilize subcontracting agencies to fill their hospital client needs, and sometimes have their own staffing agencies. Examples include names you will have never heard of such as Broadlane because they do not hire travelers directly, only travelers through separately owned agencies under subcontract. Larger agencies with exclusive contracts with hospitals also act as prime vendors such as American Mobile, Cross Country, Nursefinders, and AAS (All About Staffing).

AAS is a special example of a prime vendor as they are fully owned by HCA and only staff HCA. That means they have access to the file of anyone who has ever worked at an HCA facility, including not only former and current staff members, but also any traveler who has ever worked for any agency that has placed that traveler at an HCA facility (as all travel contracts go through AAS).

All of these examples should be of concern to the best of travelers. The concern is that the reasons for termination or negative reports may have nothing to do with your professional skills, abilities, or work ethic. Often hospitals are faced with unexpected low census, and due to their contract with the agency or prime vendor, have to fabricate a professional excuse to terminate the travel contract. Other hospitals are notorious for breaking a contract in the last week to avoid paying a large completion bonus. Often there is a personal component to a breached contract where the traveler clashed with a staff member. There can be a number of trivial reasons for a contract to end early.

Such a termination may never happen to you, but it is more likely than you think. Industry wide, about one out of ten contracts end prematurely. Only a very small percentage of these involve real clinical deficiencies. The chances are that no matter how great a clinician you are, the longer you work, the greater the odds of such an occurrence.

While knowledge of these arrangements should not necessarily stop you from taking a desirable assignment, it is helpful to know about them. It can help you avoid situations either before, during, or after such assignments. You should ask your agency if they are a prime vendor, are subcontracting for one, or if the facility belongs to a chain. While better recruiters and agencies will steer you away from problematic assignments, it is worth asking them about the business reputation of the hospital and if they have a reputation for terminating travelers.

This should give you an overview of legal types of blacklists. The more notorious and illegal blacklists involve sharing of personnel information between unrelated agencies. There have been some cases involving travel companies that while not going to court, have caused the affected agencies the loss of reputation and business. They quickly stopped when the blacklist became publicly known.

Recently it has come to light of a federal loophole involving credit reporting agencies allowing a type of legal blacklist. A group of agencies is trying to implement such a scheme, and while it may fail for the usual historical reasons of bad publicity, the loophole is so generally unpopular that several states have initiated legislation against it (some states have already passed it) and there is a bill circulating in Congress. You can read more about it in this full article. You can also lend your support for the Congressional bill here.