Starbucks softens its union stance

Posted on December 15, 2023 by henrykotula • Posted in Labor Activism, Labor Agreement, Labor Cost Structure, Labor Organizing, Labor Relations, Labor Shortages, Labor Strike, Labor Union, Labor Union Grievance • Leave a comment

https://www.axios.com/newsletters/axios-markets-0545b7bd-57c8-4181-aae8-569abdcfc91e.html?utm_source=newsletter&utm_medium=email&utm_campaign=newsletter_axiosmarkets&stream=business

Starbucks is softening its stance toward unionization after years of pushing back.

Why it matters:

It’s a potentially huge shift for the chain and a signal of the staying power of the labor movement that surged in the wake of the pandemic.

“They know this isn’t going away,” said Nick Setyan, an equity analyst at Wedbush who covers Starbucks. He called the company’s new posture “capitulation.”
Setyan said recent worker walkouts were a turning point. Also, at least five more stores this month voted to unionize.

Zoom out:

Union organizing efforts have been a public relations headache for Starbucks since at least 2021 when a store in Buffalo became the first to vote for a union. Meanwhile, pressure from labor regulators isn’t slowing.

Zoom in:

Starbucks’ strategy shift began in March when Laxman Narasimhan took the CEO reins from founder Howard Schultz, who had repeatedly clashed with workers over unionizing. The new CEO spoke of the need to care for customer-facing staff, per Reuters.

It’s accelerated over the past week — last Friday, Starbucks vice president Sara Kelly sent a letter to Workers United (the union that reps workers), saying the company wanted to restart bargaining.
The union has yet to bargain a contract. Starbucks now says it wants an agreement by next year.
On Wednesday, the company released an audit on its labor relations practices that was commissioned by Starbucks — after a shareholder vote forced its hand — and conducted by a former management-side lawyer.
Though the report asserted Starbucks didn’t have an “anti-union playbook,” it did find the company was unprepared to deal with its unionizing workforce and acknowledged that store managers made mistakes in how they handled the situation.
The report offers recommendations for improvement — including better training. Change starts with “tone from the top,” the audit says, suggesting that the company should reach agreements with the union “expeditiously.”

What happened:

Starbucks initially believed it could fend off unionization by messaging about best-in-class wages and benefits, Setyan said, noting that it’s true the chain offers better compensation than competitors.

“Internally, they felt kind of aggrieved,” he said, that workers who management perceived as well-compensated would want to organize.
For a while it seemed like the messaging campaign was working, but the Red Cup Rebellion walkout last month and a flurry of new union votes changed minds.
Starbucks has historically been very sensitive to public relations — and it became clear pushing back isn’t great for its image, Setyan said.

The other side:

Union representatives are skeptical of Starbucks’ new position.

“We are hopeful your letter is indeed the beginning of a sincere effort, and not a publicity move in the face of pressure from partners, Wall Street, shareholders, and others,” Workers United president Lynne Fox, said in a letter to Kelly last week.

What to watch:

If Starbucks’ change in tone is a sign that the company will finally come to terms with these workers, and agree to a contract, or just a shift in its public stance while it continues efforts to avoid a deal.

2023 State of Healthcare Performance Improvement Report: Signs of Stabilization Emerge

Posted on October 24, 2023 by henrykotula • Posted in Denial, Denial Management, Denial Rates, Financial Distress, Financial Instability, Financial Performance, Financial Pressure, Financial Stewardship, Financial Strength, Health System, Hospital, Hospital Industry, Labor Cost Structure, Labor Shortages, Labor Spend Management, Medicare Advantage, Operating Expense Reduction, Operating Expenses, Operating Income, Operating Margin, Operating Metrics, Operating Performance, Operating Revenue, Physician, Recruiting, Retention, Rev Cycle Management, Revenue Cycle, Talent Imperative, Talent Management • Leave a comment

https://www.kaufmanhall.com/insights/research-report/2023-state-healthcare-performance-improvement-report?utm_source=mkto&utm_campaign=performance-improvement-report&utm_medium=em&utm_term=231024&mkt_tok=NjU0LUNOWS0yMjQAAAGPAPUh710iwb064xaRlzY2WARShgaprdNgJVvWDHv-EME-8h09yOjwqrm4xTcKRudO8J4tgkmKnc5lTtM08o8H7-ncGEvE4iTRowqwBdti-kuW

Executive Summary

Hospitals and health systems are seeing some signs of stabilization in 2023 following an extremely difficult year in 2022. Workforce-related challenges persist, however, keeping costs high and contributing to issues with patient access to care. The percentage of respondents who report that they have run at less than full capacity at some time over the past year because of staffing shortages, for example, remains at 66%, unchanged from last year’s State of Healthcare Performance Improvement report. A solid majority of respondents (63%) are struggling to meet demand within their physician enterprise, with patient concerns or complaints about access to physician clinics increasing at approximately one-third (32%) of respondent organizations.

Most organizations are pursuing multiple strategies to recruit and retain staff. They recognize, however, that this is an issue that will take years to resolve—especially with respect to nursing staff—as an older generation of talent moves toward retirement and current educational pipelines fail to generate an adequate flow of new talent. One bright spot is utilization of contract labor, which is decreasing at almost two-thirds (60%) of respondent organizations.

Many of the organizations we interviewed have recovered from a year of negative or breakeven operating margins. But most foresee a slow climb back to the 3% to 4% operating margins that help ensure long-term sustainability, with adequate resources to make needed investments for the future. Difficulties with financial performance are reflected in the relatively high percentage of respondents (24%) who report that their organization has faced challenges with respect to debt covenants over the past year, and the even higher percentage (34%) who foresee challenges over the coming year. Interviews confirmed that some of these challenges were “near misses,” not an actual breach of covenants, but hitting key metrics such as days cash on hand and debt service coverage ratios remains a concern.

As in last year’s survey, an increased rate of claims denials has had the most significant impact on revenue cycle over the past year. Interviewees confirm that this is an issue across health plans, but it seems particularly acute in markets with a higher penetration of Medicare Advantage plans. A significant percentage of respondents also report a lower percentage of commercially insured patients (52%), an increase in bad debt and uncompensated care (50%), and a higher percentage of Medicaid patients (47%).

Supply chain issues are concentrated largely in distribution delays and raw product and sourcing availability. These issues are sometimes connected when difficulties sourcing raw materials result in distribution delays. The most common measures organizations are taking to mitigate these issues are defining approved vendor product substitutes (82%) and increasing inventory levels (57%). Also, as care delivery continues to migrate to outpatient settings, organizations are working to standardize supplies across their non-acute settings and align acute and non-acute ordering to the extent possible to secure volume discounts.

Survey Highlights

98% of respondents are pursuing one or more recruitment and retention strategies

90% have raised starting salaries or the minimum wage

73% report an increased rate of claims denials

71% are encountering distribution delays in their supply chain

70% are boarding patients in the emergency department or post-anesthesia care unit because of a lack of staffing or bed capacity

66% report that staffing shortages have required their organization to run at less than full capacity at some time over the past year

63% are struggling to meet demand for patient access to their physician enterprise

60% see decreasing utilization of contract labor at their organization

44% report that inpatient volumes remain below pre-pandemic levels

32% say that patients concerns or complaints about access to their physician enterprise are increasing

24% have encountered debt covenant challenges during the past 12 months

None of our respondents believe that their organization has fully optimized its use of the automation technologies in which it has already invested

California sets $25 per hour minimum wage for healthcare workers

Posted on October 23, 2023 by henrykotula • Posted in Employee Compensation, Executive Compensation, Health System, Hospital, Hospital Industry, Labor Cost Structure, Labor Spend Management, Labor Union, Minimum Wage • Leave a comment

https://www.healthcaredive.com/news/california-sets-minimum-wage-healthcare-workers/696672/?utm_source=Sailthru&utm_medium=email&utm_campaign=Newsletter%20Weekly%20Roundup:%20Healthcare%20Dive:%20Daily%20Dive%2010-21-2023&utm_term=Healthcare%20Dive%20Weekender

The law, which was heavily backed by healthcare unions, is expected to affect approximately 469,000 healthcare workers and will be phased in over the next several years.

Dive Brief:

California Gov. Gavin Newsom on Friday signed a law raising the minimum wage for thousands of healthcare workers in the state from $15.50 an hour to $25 per hour.
State lawmakers argued in the law’s text that competitive wages are necessary to attract and retain healthcare workers who provide critical services, noting that “even before the COVID pandemic, California was facing an urgent and immediate shortage of healthcare workers, adversely impacting the health and well-being of Californians.”
Although wage increases will begin rolling out next year, the timeline for implementation depends on facility type. Large health systems with more than 10,000 workers and dialysis clinics must implement the law fully by 2026, while rural independent hospitals and those with a high mix of Medi-Cal and Medicare patients have until 2033 to implement the new wage minimums.

Dive Insight:

The law, backed by California healthcare unions, broadly defines healthcare workers as full-time or contract employees of a healthcare facility, including those in roles supporting the provision of healthcare, such as janitors, clerical workers, food service workers and medical billing personnel.

The wage increase is projected to impact approximately 469,000 employees, many of whom are currently living on the margins, according to an analysis from the University of California, Berkeley’s Labor Center.

Nearly half of California’s healthcare workers do not presently earn enough to cover basic needs, such as housing, and are enrolled in public safety net programs, according to the UC Berkeley Labor Center.

Newsom signed the bill into law on the same day that Kaiser Permanente unions announced they had secured a tentative $25 per hour minimum wage for over 60,000 California-based Kaiser employees, pending ratification from members. California healthcare workers were represented by SEIU-United Healthcare Workers West president Dave Regan during Kaiser bargaining.

In Senate analyses of the minimum wage bill conducted in May and September, lawmakers said that SEIU-UHW’s organizing elsewhere in the state had motivated the state-level analysis of pay. The union spearheaded several similar local ordinances last year, including in Los Angeles and San Diego.

SEIU California, which sponsored the bill, released a statement on Friday saying that raising healthcare workers’ wages is a matter of equity. Three out of four workers who will see increases in wages thanks to the new law are women, and 76% are workers of color, according to SEIU California. Almost half of all healthcare workers affected are Latino, the union said.

“Governor Newsom signed SB 525 into law because he heard our call for change to a status quo that has left us exhausted and struggling to pay our bills,” Dr. Kelley Butler, resident physician at San Francisco General Hospital and member of SEIU California, said in a statement. “I’m proud of our collective advocacy as a union and proud of our Governor for doing right by the California healthcare workforce and the patients it serves.”

The law went through several edits since the beginning of the legislative session to make it more palatable to healthcare facilities, which largely opposed its passage earlier this year. An earlier version of the bill, debated in May, tasked all healthcare providers with instituting the new minimum by June 2025.

The final version of the law has a phase-in approach that grants some workers the new minimum by 2026 and leaves others waiting ten years to reap the full sum. Healthcare facilities that are in financial distress can also apply for a waiver program to temporarily delay payroll hikes. Tribal clinics are excluded from the new pay requirements entirely.

The California Hospital Association, a lobbying organization, ultimately supported the law, saying in a statement that it provided “stability and predictability for hospitals” by providing more reasonable phase-in requirements and “preempting city and county minimum wage measures for 10 years and local compensation measures for six years.”

The dialysis industry also got on board after lawmakers added an amendment which prevents SEIU from pushing for ballot measures targeting dialysis centers. The union’s unsuccessful lobbying for changes in the dialysis industry has cost the healthcare industry over 100 million dollars in recent years, according to reporting from CalMatters.

Is there a silver lining for the systems who had the highest contract labor use?

Posted on September 12, 2023 by henrykotula • Posted in Cost Management, Cost Reduction, Cost Structure, Cost-Effective, Flexibility, Health System, Hospital, Hospital Industry, Labor Cost Structure, Labor Shortages, Labor Spend Management, Labor Temporary, Nurse Agency Staffing, Nurse Travelers, Nurses Compensation, Silver Lining • Leave a comment

https://mailchi.mp/d0e838f6648b/the-weekly-gist-september-8-2023?e=d1e747d2d8

Across the hospital industry, heavy reliance on contract labor in 2021 and 2022 caused a significant challenge for profitability.

However, a chief financial officer recently posited that his system’s large contract labor load has had unexpected benefits.

“Other hospitals [in our market] thought we were crazy to keep staffing with high contract rates until recently,” he shared. “But by keeping the agency nurses around a little longer, we were able to avert raising base salaries quite as much, and are in a better place today now that the labor market has softened.” It’s a story we’ve heard several times now.

While market rates for nursing and other clinical labor have undoubtedly been rebased, salary increases are sticky—it’s hard to adjust wages downward when the labor market loosens.

Systems who were able to avert large wage increases by increasing bonuses and other non-salary benefits, or forestalled permanent hiring at higher salaries by extending contract labor, now find themselves with more flexibility and potentially lower staffing costs in the long-term.

Hospitals average 100% staff turnover every 5 years — Here’s what that costs

Posted on January 3, 2023 by henrykotula • Posted in Continuity of Care, Labor Cost Structure, Labor Shortages, Labor Spend Management, Nurse Agency Staffing, Nurse Retention, Nurse Travelers, Nurses Compensation, Nurses Shortage, Operating Expense Reduction, Operating Expenses, Quality of Care, Talent Competition, Talent Management, Workforce Retention, Workforce Shortages, Workforce Turnover • Leave a comment

https://www.beckershospitalreview.com/finance/hospitals-average-100-percent-staff-turnover-every-5-years-heres-what-that-costs.html?origin=RCME&utm_source=RCME&utm_medium=email&utm_content=newsletter&oly_enc_id=2893H2397267F7G

Hospitals have been paying astronomical prices for staff turnover, according to the “2022 NSI National Health Care Retention & RN Staffing Report.”

It covers 589,901 healthcare workers and 166,087 registered nurses from 272 facilities and 32 states. Participants were asked to report data on turnover, retention, vacancy rates, recruitment metrics and staffing strategies from January to December 2021.

The survey found a wide range of helpful figures for understanding the financial fallout of one of healthcare’s hardest labor disruptions:

The average hospital lost $7.1 million in 2021 to higher turnover rates.
The average hospital loses $5.2 to $9 million on RN turnover yearly.
The average turnover cost for a staff RN is $46,100, up more than 15 percent from the 2020 average.

The average hospital can save $262,300 per year for each percentage point it drops from its RN turnover rate.
To improve margins, hospitals need to control labor costs by decreasing dependence on travel and agency staff, but only 22.7 percent anticipate being able to do so.
For every 20 travel RNs eliminated, a hospital can save $4.2 million on average.

In the past 5 years, the average hospital turned over 100.5 percent of its workforce:

In 2021, hospitals set a goal of reducing turnover by 4.8 percent. Instead, it increased 6.4 percent and ranged from 5.1 percent to 40.8 percent. The current average hospital turnover rate nationally is 25.9 percent, according to the report.

While 72.6 percent of hospitals have a formal nurse retention strategy, less than half of those (44.5 percent) have a measurable goal.
Overall, 55.5 percent of hospitals do not have a measurable nurse retention goal.
Retirement is the number four reason staff RNs leave, and it is expected to remain a primary driver through 2030. More than half (52.8 percent) of hospitals today have a strategy to retain senior nurses. In 2018, only 21.6 percent had one.

Historically, RN turnover has trended below the hospital average across all staff. For the first time since conducting the survey, this is no longer true:

In the past five years, the average hospital turned over 95.7 percent of its RN workforce.
Close to a third (31.0 percent) of all newly hired RNs left within a year, with first year turnover accounting for 27.7 percent of all RN separations. Given the projected surge in retirements, expect to see the more tenured groups edge up creating an inverted bell curve.
Operating room RNs continue to be the toughest to recruit, while labor and delivery RNs are trending easier to recruit than in the year prior.
Hospitals are experiencing a dramatically higher RN vacancy rate (17 percent) compared to last year’s rate of 9.9 percent.
The vast majority (81.3 percent) reported a vacancy rate higher than 10 percent.

The dire state of hospital finances (Part 1: Hospital of the Future series)

Posted on December 26, 2022 by henrykotula • Posted in Administrative Footprint, Average Length of Stay (ALOS), Business Model, Business Transformations, Clinical Management of Complex Patients, Cohesive Care Teams, Competition, Cost Management, Cost Reduction, Deferred Healthcare, Disruption, Elective Procedures, Elective Surgery, Employee Layoffs, Employee Loyalty, Employee Staffing, Employee Staffing Shortage, Experience Complexity Gap, External Market Forces, Financial Instability, Financial Pressure, Financial Stewardship, Financial Strength, Financial Viability, Financially Distressed, Health System, High Deductible Health Plans, Home-Based Care, Hospital, Hospital Industry, Inflation, Innovation, Labor Cost Structure, Labor Market, Labor Shortages, Labor Spend Management, Leadership, Mission, Nonoperating Income, Nonoperating Income Dependency, Nurse Agency Staffing, Nurse Retention, Nurse Staffing, Operating Expense Reduction, Operating Expenses, Operating Income, Operating Margin, Operating Metrics, Operating Performance, Operating Revenue, Outpatient Care, Outpatient Surgery, Patient Demand, Patient Safety, Payor Contracting, Payor Mix, Post Acute Care, Quality of Care, Rationalization, Recession, Reorganization, Retention, State of the Union, Strategy, Strategy Sustainable Long Term, Streamlining Operations, Supply Chain, Talent Acquisition Strategy, Talent Competition, Talent Management, Turnover, Turnover Rates, Work Life Balance, Work-Life Balance, Workforce Challenges, Workforce Strategy • Leave a comment

https://radioadvisory.advisory.com/142?utm_source=member_db&utm_medium=email&utm_campaign=2022Dec22&utm_content=member_trendingnow_final_x_x_x_x&elq_cid=4838956&x_id=0033b00002owB9sAAE

About this Episode

The majority of hospitals are predicted to have negative margins in 2022, marking the worst year financially for hospitals since the beginning of the Covid-19 pandemic.

In Part 1 of Radio Advisory’s Hospital of the Future series, host Rachel (Rae) Woods invites Advisory Board experts Monica Westhead, Colin Gelbaugh, and Aaron Mauck to discuss why factors like workforce shortages, post-acute financial instability, and growing competition are contributing to this troubling financial landscape and how hospitals are tackling these problems.

Links:

As we emerge from the global pandemic, health care is restructuring. What decisions should you be making, and what do you need to know to make them? Explore the state of the health care industry and its outlook for next year by visiting advisory.com/HealthCare2023.

Cartoon – Managing the Downturn

Posted on September 28, 2022 by henrykotula • Posted in Cartoon, Downturn, Downward Trend, Employee Layoffs, Job, Job Loss, Job Market, Labor Cost Structure, Labor Market, Labor Spend Management, Management, Sign of the Times • Leave a comment

Recession fears are rising. Why are people still quitting their jobs?

Posted on August 31, 2022 by henrykotula • Posted in Employee Staffing Shortage, Job, Job Abandonment, Job Market, Job Satisfaction, Job Security, Labor Cost Structure, Labor Force Participation Rates, Labor Market, Labor Market Participation Rate, Labor Shortages, Recruiting, Sign of the Times, Talent Management • Leave a comment

Recession fears are rising. Why are people still quitting their jobs?

Interest rates are rising, inflation is lingering at four-decade highs, the economy appears to be slowing and experts fear a recession is on the way. But Americans are still quitting their jobs at near-record rates in the face of growing economic uncertainty.

The percentage of American workers who quit their jobs set a record earlier this year and has only dropped slightly as the economy slows from two years of torrid growth. After reaching 2.9 percent this spring, the quits rate dropped to 2.7 percent in July, according to data released Tuesday by the Labor Department.

The idea of quitting a job amid a period of increased cost of living and a dubious economic future may seem counterintuitive. But the labor market has remained stacked in favor of workers, who see ample opportunities to boost their earnings to supplant increased costs from inflation.

“Despite recent declines, job openings still outnumber unemployed workers by a sizable margin, illustrating just how tight the labor market remains,” wrote AnnElizabeth Konkel, an economist at Indeed Hiring Lab, in a Monday analysis.

There were roughly two open jobs for every unemployed American, according to Labor Department data, giving job seekers ample opportunities to find new jobs with better pay or working conditions. Businesses are still scrambling to find enough workers to keep up with consumer spending — which is well above pre-pandemic levels — from a workforce that remains smaller than it was before COVID-19.

“It seems possible that employer demand would need to cool significantly more before recruiters start to notice an easing in recruiting conditions,” Konkel wrote.

In other words, employers still have too many open jobs and not enough candidates to avoid boosting wages and other perks to find talent. And that means workers still have ample incentive to quit for a better-paying job, particularly with inflation still high.

Job seekers on Indeed.com are looking for ever-higher wages, Konkel explained. The number of Indeed users seeking jobs with a $20 per hour wage rose above those seeking $15 per hour in June 2022, and the number of jobseekers looking for $25 per hour is up 122 percent over the past 12 months.

Konkel attributed the spike in job seekers looking for more money to the steady increase in advertised wages and the inflation they’ve helped to feed.

“Once job seekers know it’s possible to attain a higher wage, their expectations may shift and act as a pull factor in searching for a higher dollar amount. In this case, the shift in job seeker expectations from searching for $15 to instead $20 is clear,” Konkel explained.

“On the flip side, inflation continues to take a bite out of workers’ paychecks,” she continued, noting that only 46 percent of workers saw wage gains that outpaced inflation.

The pressure to quit for a higher paying job has been highest in the private sector, where 3.5 percent of the workforce left their current employer in July. Workers in industries with historically low wages, tough working conditions and limited teleworking options have led the charge.

The leisure and hospitality sector posted a whopping 6.1 percent quit rate in July, down sharply from 6.9 percent a year ago but still nearly twice the national quit rate.

Restaurants and bars in particular have struggled to return to pre-pandemic employment levels despite rapidly raising wages. The pressure has also made it nearly impossible for those businesses to fire or lay off employees, even amid usual season turnover.

“Hospitality companies tell us that what was once a ‘one strike, you’re out’ rule for employees who failed to show up at work without notice is now more like a ‘ten strikes, you’re out’ rule. They cannot afford to fire workers because they cannot afford to replace them,” said Julia Pollak, chief economist at ZipRecruiter.

“The decline in terminations in industries like hospitality have been so large, they have more than offset the increase in layoffs in the tech sector,” she explained.

Quits have also remained high in retail (4 percent) and the transportation and warehousing sectors (3.5 percent), with both industries facing threats from a decline in goods spending and rising interest rates.

Even so, there are some signs of waning worker confidence, which may lead to a decline in quits.

ZipRecruiter’s job seeker confidence index dropped 4.5 points in August to an all-time low of 97.8, Pollak said, with a greater number of applicants looking for job security over higher wages.

“Since the pandemic, job seekers have been looking for higher pay, less stress, and greater flexibility. In August however, job security rose to the second-place spot in their priority ranking,” Pollak explained.

“One in four employed job seekers say they feel less secure about their current job than they did six months ago. Rising risk of a recession, paired with a wave of recent tech layoffs, has made employees more concerned about the precarity of their jobs.”