REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
September 23, 2025
FROM
PETE MENDOZA, Director, Purchasing Department
SUBJECT
Title
Amendment to Agreement with ShiftMed, LLC for Contracted Nursing Services
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 1 to Agreement No. 23-961 with ShiftMed, LLC, for contracted nursing services, reassigning the agreement from CareerStaff Unlimited, LLC, with no changes to the existing fixed contract rates or the term of October 1, 2023 through October 1, 2028
(Presenter: Pete Mendoza, Director, 387-2073)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Provide for the Safety, Health and Social Service Needs of County Residents.
FINANCIAL IMPACT
Approval of this item will not result in the use of Discretionary General Funding (Net County Cost). The County’s annual expenditure for contracted nursing services is estimated at $41,592,000. Departments that require these services are responsible for ensuring there is adequate funding in the respective approved budgets and future recommended budgets.
BACKGROUND INFORMATION
Agreement No. 23-961 (Agreement) allows multiple County departments to supplement staffing for daily operations. County departments use contracted medical staff to cover vacancies and absences of regular staff, and in emergency situations to meet required staffing levels. Contracted nursing services are vital to maintain nurse-to-patient ratios required by Assembly Bill 394 passed in 1999.
Ratios in acute care hospitals and psychiatric hospitals reflect the maximum number of patients that may be assigned to a Registered Nurse during one shift. In addition, Arrowhead Regional Medical Center (ARMC) has nursing units, such as the Neonatal Intensive Care Unit and Labor and Delivery Unit, that require specialized training provided by the contractor(s). Amendment No. 1 to the Agreement will allow for the assignment from CareerStaff Unlimited, LLC to ShiftMed, LLC, enabling departments to continue to supplement staffing for daily operations.
On September 12, 2023 (Item No. 55), as the result Request for Proposal (RFP) No. AGENCY23-PURC-4933, the Board of Supervisors (Board) approved the Agreement with CareerStaff Unlimited, LLC for Nurse Registry, Travel Nursing, and Allied health personnel for County departments, at fixed rates, for the term of October 1, 2023 through October 1, 2028.
In May 2025, the County received a letter from ShiftMed, LLC, notifying the County that CareerStaff Unlimited, LLC had been acquired by ShiftMed, LLC in April of 2024. Due to an administrative error, September was the first available date this item can be presented following the necessary time to complete the required fiscal, administrative, and legal reviews. The Purchasing Department has taken steps to ensure future items remain on track for timely presentation to the Board.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Adam Ebright, Deputy County Counsel, 387-5455) on July 8, 2025; Arrowhead Regional Medical Center (Jeff Emery, Associate Chief Financial Officer, 777-0708) on July 10, 2025; Purchasing (Ariel Gill, Supervising Buyer, 387-2070) on July 10, 2025; Human Resources (Gina King, Assistant Director, 387-5560) on July 9, 2025; and County Finance and Administration (Kathleen Gonzalez, Administrative Analyst, 387-5412) on August 28, 2025.