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Author Archives: henrykotula
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UVM Medical Center, nurses reach tentative labor deal
University of Vermont Medical Center in Burlington has reached a tentative contract agreement with the union representing about 1,800 licensed practical nurses, registered nurses and nurse practitioners.
The three-year tentative agreement, reached Sept. 19, includes a 16 percent average base salary increase over the life of the contract, according to hospital officials. They said raises for ambulatory nurses will be retroactive to the first pay period in September.
Additionally, the Vermont Federation of Nurses and Health Professionals conceded on its previously proposed increases to certain shift differentials as part of the deal.
The tentative agreement comes after six months of bargaining and demonstrations by nurses, including a 48-hour strike in July. Both sides said they were pleased they were able to make progress.
“We are looking forward to implementing the many positive changes that result from the new contract, which will enhance patient care, provide additional support for nurses and allow for new opportunities to advance the nursing profession,” hospital officials told Becker’s.
Molly Wallner, lead negotiator for the union, said: “We are proud of the unity, strength and perseverance our nurses have shown. This has been a long and difficult road for all of us, and we are proud of what we have accomplished. Our fight for patient safety is not over, and we will continue that fight through the [state] legislature.”
Nurses are expected to vote on the tentative agreement soon.
Fitch: Nonprofit hospital balance sheet metrics improve, operating margins don’t
U.S. nonprofit hospitals continue to struggle with operating margins, but key balance sheet metrics have improved, according to Fitch Ratings.
Fitch’s 2018 hospital median report, based on audited 2017 data, shows operating margins declined for the second consecutive year in every rating category. The 2017 median operating margin was 1.9 percent compared to 2.8 percent in 2016.
But the agency said key balance sheet metrics, such as days cash on hand, cash to debt and leverage, got better and are at all-time highs. For example, the median days cash on hand climbed from 195.5 in 2016 to 213.9 in 2017, and cash to debt increased to 159 percent from 142.8 percent year over year.
“Despite this apparent contradiction — which may be temporary in nature — the clear signal through the noise is that operating margins remain under pressure for the second year in a row, indicating ongoing stress in the sector,” Fitch said.
The agency said the ongoing operating margin struggles are attributable to salary and wage expense pressures, increasing pharmaceutical costs, and the shift from fee-for-service to value-based care.
Fitch finalized rating criteria changes for nonprofit hospitals revenue debt in January, which focus more on balance sheet strength compared to operating profitability. Even with declining operating margins, Fitch said its median rating for nonprofit hospitals remains ‘A.”
But “should operational pressures continue for an extended period of time, even strong balance sheets will begin to come under pressure,” said Fitch Senior Director Kevin Holloran.
Illinois Supreme Court: Hospitals’ property tax exemption is constitutional
The Illinois Supreme Court ruled Sept. 21 that non-profit hospitals in the state do not have to pay property taxes as long as the value of the charitable services they provide is equal to or greater than the taxes they would have paid, according to The Chicago Tribune.
The ruling was an affirmation of a lower court decision that previously upheld the constitutionality of the property tax exemption, which was challenged in the lawsuit against the Illinois Department of Revenue by Cook County taxpayer Constance Oswald.
“When you give these hospitals a pass on paying real estate taxes, people within the counties where the hospitals are located have to make it up,” Edward Joyce, Ms. Oswald’s lawyer, told The Tribune.
But advocates for nonprofit hospitals argued the law allows them to fully dedicate themselves to delivering care to underserved patients.
“For nonprofit hospitals, property tax exemption fosters [transformation] by permitting them to focus their time, energy, and financial resources on new strategies to better serve all of the residents of our state.” said A.J. Wilhelmi, president and CEO of the Illinois Health and Hospital Association. “Taxing nonprofit hospitals would hurt the communities they serve by diverting dollars that are better used to care for patients and to upgrade equipment, modernize facilities and hire needed staff.”
5 Ways to Choose Important Over Urgent
People tend to choose urgent tasks they can complete quickly and put off important tasks that take longer to complete. (The Mere Urgency Effect)
Important tasks take longer and are more demanding than unimportant urgencies.
The Mere Urgency Effect:
You tend to delay important tasks by saying, “Just let me finish this and I’ll do that later.” But we all know that ‘later’ seldom comes.
The Mere Urgency Effect indicates …
We choose unimportant tasks with lower payoffs over important tasks with better payoffs.
We let artificial deadlines drive us to choose unimportant tasks.
You didn’t change the oil in your car because you had more urgent things to do. One day the car starts making scary noises. You neglected the important – scheduled maintenance. Now you have an urgency.
The same can be said for relationship building. You just don’t have time! But skillful leaders build and strengthen relationships before they need them.
In an age when running around with your hair on fire is desired and admired, important work gets pushed aside.
5 ways to choose important over urgent:
Put important work on your calendar. Expect important work to take longer than expected.*
Use values to guide decisions.
Establish short-term goals for long-term projects. Suppose you have an important task due at the end of the week.
Create effective urgency by setting a goal to be completed by 3:00 p.m. today. (Set short-term daily goals for important long-term work.)
Turn off social media. Check email at scheduled intervals. Turn off email alerts. (Yes, not everyone can do this.)
Bonus: Identify important work with your team or boss. Ask, “What’s important this week?” It helps to know what’s important if you plan to do what’s important.
How might leaders choose important over urgent?
How might leaders distinguish between important work and unimportant urgencies?
Temple University Health System’s finances improve as Epic install costs shrink
Philadelphia-based Temple University Health System saw its financial position improve in the 12 months ended June 30, according to recently released unaudited financial documents.
The health system reported revenues of $1.84 billion in fiscal year 2018, up from $1.75 billion in the year prior. The increase was attributable in part to higher net patient service revenue. Temple said inpatient revenue grew year over year due to increased acuity and improved payer mix at Temple University Hospital, and that higher outpatient revenue was attributable to growth of TUH’s outpatient pharmacy and higher outpatient volumes.
The health system’s operating expenses climbed 4.7 percent year over year to $1.83 billion in fiscal year 2018. Higher expenses related to supplies, pharmaceuticals, salaries and faculty support primarily drove the growth. However, those expenses were partially offset by lower costs attributed to TUH’s implementation of the Epic EHR system that took place in fiscal year 2017. The health system said it spent $15.1 million in fiscal 2017 on staffing needs related to the Epic go-live.
The health system ended the most recent fiscal year with operating income of $17.23 million, compared to operating income of $471,000 in the year prior, according to the financial documents.
HENRY KOTULA 