An extremely complicated mess of redundant paperwork and recordkeeping. Employees need to punch in on computerized time-keeping system and then record hours on paper and then fax the paper to corporate and to senior management (this is for a two hour assignment). You chart what you did for patient in the EMR in completely arcane ways and then, again, do it on paper and fax it to corporate offices and then some manager
Management has an adversarial attitude towards front line staff.
When I was first interviewed I was told I'd get a mileage reimbursement and pay for travel time. Then, a couple of weeks later, I was told "not for the first half hour or first 20 miles". Then, a week after that, it was "no travel time, no mileage" for the little two hour assignments I was offered for calls as far as an hour away. I declined the assignments.
So, two pay cuts before I even started working!
I had responded to a job listing for 'Per Diem' but the work was offered to me in only 2 hour increments. If I needed a piece of equipment picked up I had to call some number in Pennsylvania and leave a detailed voice mail message, then send the information via email to two different people. And heaven help you if you forgot any of these repetitive emails, voice mails and faxes.
About a month and a half elapsed between my 'offer letter' and my first actual work. My background report, drug screen, etc., etc., were all completely clean but it took weeks after receiving them for HR to actually look at them and say 'OK'.