Documents show Alberta’s Catholic healthcare body paying private staffing agencies nearly $110 an hour per nurse

Covenant Health is spending nearly $110 an hour per nurse to obtain registered nurses from private, for-profit staffing agencies, more than double the hourly wages of unionized nurses earning the highest possible hourly wage, according to figures provided by the province’s Catholic health-care body.

These figures reveal that from April 2022 to April 2025, Covenant is projected to have spent more than $20 million on private nursing contracts, bringing the total known projected public health-care spending on private nursing agencies in Alberta to nearly $350 million since the 2022/23 fiscal year.

The Bonnyville Healthcare Centre was Covenant’s biggest spender on nursing staff from private, for-profit agencies, spending $9.8 million from April 2021 through September 2024. Photograph by Jonathon Koch / Creative Commons

At Covenant, the funds were disbursed to eight Catholic hospitals and five continuing care facilities across the province to hire registered nurses (RNs), licensed practical nurses (LPNs) and health-care aides (HCAs). 

When asked, Covenant provided data on the dollar amounts spent at each health-care facility per fiscal year, including projections for the second half of 2024/25, as well as the numbers of contract nursing positions per fiscal year broken down by job at each hospital.

Covenant Care, which is the continuing care arm of Covenant Health, provided much more fulsome data than its mother organization. This data included the number of hours worked, and how much was spent and budget amounts at each position per fiscal year, providing an exclusive look at how much the Catholic health-care provider spends per hour on RNs, LPNs and HCAs. 

Broken down by position, Covenant Care spent $109.68 an hour on RNs, $91.16 an hour on LPNs and $53.99 an hour for HCAs—more than double what the agency is spending on its unionized employees at the highest end of its wage grid for each position—between April 2021 and September 2024. 

These costs do not mean that the staffing agency nurses themselves are making $109 an hour. The private staffing agencies pocket their own share of the fee, which is undisclosed. Covenant told us they do not actually know how much the agency nurses themselves are being paid.

“As the customer, Covenant Care does not have access to information about how much the agency retains or pays its staff,” said Covenant spokesperson Stephanie Odayen. 

“Our agreement is based on contracted hourly rates for each level of work, but the breakdown of those payments is not disclosed to us.”

From April 2021 through September 2024, Covenant spent $969,776 to have agency LPNs cover 10638 hours of work, $822,966 for 7503 hours of work by RNs, and $156,994 for 2907 hours of work by HCAs.

Under the Alberta Union of Provincial Employees (AUPE)’s collective agreement with Covenant Care, which is in force until next year, RN hourly wages range from $39.21 to $51.46, LPNs range from $27.45 to $35.94 and HCAs from $20.69 to $25.90. These figures exclude pension and benefits, which agency nurses don’t get. 

AUPE vice president Curtis Jackson, who chairs the union’s anti-privatization committee, told the Progress Report that exorbitant spending on private nursing contracts is the “result of a crisis.” 

“It’s a crisis that is the government and Alberta Health Services and Covenant Care’s own making. They seem to have an inability to recruit and retain qualified, skilled health professionals, and honestly, it’s something this province has been struggling with for years,” Jackson told the Report. 

He said this predicament is an “atrocity when you consider we’re the richest province in the country.” 

Covenant agency nurse spending follows a similar pattern as AHS

The amount of overall spending on agency staff at Covenant followed a similar trajectory as AHS, albeit on a smaller scale, with a sharp uptick from $856,000 in 2021/22 to $4.5 million in 2022/23, peaking at $10.2 million in 2023/24 before falling to a projected $5.5 million for 2024/25. 

While the AHS numbers this outlet obtained didn’t include projections for the second half of 2024/25, requiring the Report to make its own projection by doubling the expenses for the first half of the fiscal year, Covenant provided their own cost projections. 

From April 2021 to April 2024, agency nursing costs at Covenant Health increased by 1,100 per cent. By contrast, during the same period at AHS, they increased by 3,000 per cent.

Alberta Health Minister Adriana LaGrange acknowledged the “need to make sure we wean ourselves off the reliance on agency nursing” in front of the Legislature Standing Committee on Families and Communities in March. 

Odayen told the Progress Report that Covenant is weaning itself off of agency nursing through targeted efforts at recruiting nurses in rural areas, working with “community partners,” such as schools, unions and other organizations, to “support retention and recruitment,” and ongoing “[efforts] to streamline agency contracts and manage costs.” 

“Building a sustainable workforce takes time, but we are committed to supporting staff wellness, improving retention, and creating career growth opportunities for rural healthcare workers in Alberta,” she said. 

In internal documents obtained by the Report for a previous story, the AHS finance, audit and risk committee acknowledged it was able to reduce its dependency on nursing agencies from 2023/24 to 2024/25 by lifting constraints it imposed on unionized nurses’ ability to work overtime. 

Catholic hospitals spent $19 million on agency staff

By April, Covenant hospitals are projected to have spent almost $19 million on staffing agency fill-ins for 224 RN, 35 LPN and nine HCA positions. 

The Bonnyville Healthcare Centre was the most prolific contractor of nursing staff, hiring 117 RN and three LPN agency nurses from April 2021 to October 2024 at a cost of $8.6 million.

The Bonnyville hospital is projected to spend an additional $1.2 million on nursing staff during the second half of 2024/25, bringing the anticipated total to $9.8 million.

St. Mary’s Hospital in Camrose placed a distant second, hiring 60 agency nurses—47 RNs and 14 LPNs—from April 2021 to October 2024 at a cost of $4.3 million. 

St. Mary’s is projected to spend an additional $304,000 on agency staff in the second half of 2024/45, bringing the projected total to $4.6 million.

Of the eight Covenant hospitals that used agency nurses, just one was based in a major city—St. Michael’s Health Centre in Lethbridge, which hired 13 RNs and one LPN in the three-and-a-half fiscal years examined at a cost of $452,000.

Covenant spent $2 million contracting continuing care staff in major cities

The continuing care numbers tell a different story. Of the five continuing care facilities that used contracting services, three are located in major cities—Calgary, Edmonton and Red Deer. The other two are in Beaumont and St. Albert, which are both part of the Edmonton Metropolitan Region. 

Friends of Medicare executive director Chris Gallaway previously told the Report that private nursing contracts are intended to fill “those hard-to-fill positions in northern and remote areas,” so their use in major cities reflects a broader problem with health-care worker retention and recruitment. 

Jackson of AUPE agrees that the use of nursing contracts in big cities reflects a “broadening crisis … that is just getting worse and it’s spreading into our urban areas.”

Overall, Covenant continuing care homes spent nearly $2 million on nursing staff costs, more than double the $913,000 budgeted, hiring 12 full-time equivalent positions over the three and a half-year period examined. 

The vast majority of these funds were spent at one facility. 

Villa Marie in Red Deer, which includes supportive living and long-term care, spent $1.7 million from April 2021 to September 2024, more than double its $795,000 budget and 85 per cent of total continuing care nursing expenses during that period. 

One reason Villa Marie had such high costs is, according to Odayen, it was the only location where Covenant paid for its agency contractors’ mileage and hotel costs. But while the size of Villa Marie’s spend is an outlier, blowing past its budget was not.

Chateau Vitaline in Beaumont spent $143,000 on agency nurses in the same period, more than double its own budget of $56,000.

The most glaring discrepancy between budgeting and spending was St. Thomas Health Centre in Edmonton, which had no funds budgeted for agency nursing but spent a combined $73,000 in 2022/23 and 2023/24. St. Marguerite Manor in Calgary, which also did not budget for agency nurses, spent $21,000.

Foyer Lacombe in St. Albert was the only facility whose expenses came in under budget, spending $35,000 out of a $62,000 budget.

Odayen attributed Covenant spending more than twice its agency nursing budget to the Covid-19 pandemic “and the increased sensitivity around reporting to work with symptoms,” adding that “staffing nursing positions became more challenging during this period.” 

Progress Alberta’s ongoing series investigating Alberta’s use of private staffing agency nurses is made possible in part by a grant from the United Nurses of Alberta, a labour union representing registered nurses in Alberta. The Progress Report maintains editorial independence throughout the investigation and reporting process.