Striking nurses at Illinois hospital return to work without new contract

https://www.healthcaredive.com/news/university-illinois-nurses-back-to-work-after-strike/585631/?utm_source=Sailthru&utm_medium=email&utm_campaign=Issue:%202020-09-22%20Healthcare%20Dive%20%5Bissue:29794%5D&utm_term=Healthcare%20Dive

Dive Brief:

  • Nurses at the University of Illinois Hospital in Chicago returned to work Monday following a weeklong strike over their new contract. The two sides were unable to reach an agreement despite negotiations “that ran well into the evening” each night of the strike and planned to resume talks Monday.
  • They made some progress on key issues. The hospital agreed to hire more than 200 nurses to quell staff-to-patient ratio concerns at the forefront of the strike, according to the Illinois Nurses Association. UIH also proposed slight wage increases for nurses opposed to previously offered freezes, though the union countered with larger increases, INA said.
  • UIH agreed that it’s closer to making a deal on the contract despite not reaching a tentative agreement. Nurses will report to work under the existing terms of their past contract until a new deal is reached.

Dive Insight:

Nurse staffing levels have been an issue since long before the COVID-19 pandemic, but the crisis has accelerated those concerns, along with labor activity, as clinicians on the front lines have faced grueling conditions.

Before the strike began, UIH said staff-patient ratios are too rigid and remove flexibility, instead favoring acuity-based models focused on “obtaining the right nurse at the right time for each patient.”

But it amended that proposal last week, now agreeing to hire 200 nurses “to improve the staffing ratio, addressing the most important issue the nurses insisted on as a primary reason to strike,” according to INA.

Illinois has a Safe Patient Limits bill before its legislature that would spell out the maximum number of patients who may be assigned to a registered nurse in specified situations. HB 2604 was introduced in February 2019 and is currently before the House rules committee, though it has not received a full vote.

On Sept. 11, the day before the UIH strike began, a judge granted a temporary restraining order forbidding nurses in certain critical care units from going on strike.

The lawsuit, filed by the University of Illinois Board of Trustees, claimed a work stoppage among those nurses would endanger public safety due to the unique nature of the services provided in the units, specialized needs of patients they serve and lack of qualified substitutes to perform nurses’ duties.

About 525 nurses out of 1,400 represented by INA were barred from striking at UIH, according to the union.

Two days after UIH nurses walked off the job, service workers at the university main campus, hospital and various other facilities also went on strike.

Some 4,000 clerical, professional, technical, service and maintenance workers represented by Service Employees International Union 73 went on strike Sept. 14 over similar issues as the nurses, mainly staffing and pay.

The planned duration of the SEIU strike is unclear, though it’s been a week since it began.

“As UIC nurses return to work, we will continue our strike,” the union said in a statement. “We won’t quit until UIC respects us, protects us and pays us. Working through a pandemic and seeing our co-workers die has stiffened our resolve to fight for however long it takes to ensure the safety of all workers and those we serve.”

 

 

 

 

Where furloughs stand at 92 hospitals, health systems

https://www.beckershospitalreview.com/finance/where-furloughs-stand-at-92-hospitals-health-systems.html?utm_medium=email

Virus: Idaho school district furloughs 145 employees

U.S. hospitals and health systems were forced to make cost reduction a priority this spring to offset decreases in patient volume, a ban on elective procedures and increased expenses due to the COVID-19 pandemic.

While cost reduction strategies differed across organizations, more than 266 hospitals and health systems announced plans to furlough a portion of their staff to help address the financial fallout.

Below are status updates on many of the hospital and health system furloughs announced this spring, such as how many workers have been called back, how many are still on furlough and how many have been let go.

1. Adena Health System (Chillicothe, Ohio)

Since mid-April, the health system has furloughed 579 employees. Adena projected a deficit of  more than $50 million through 2020 due to a lack of elective procedures.

As of Aug. 31, all of Adena’s furloughed workers have been called back to work, the health system told Becker’s Hospital Review.

2. Altru Health System (Grand Forks, N.D.)

The health system reduced the number of staffing hours by 10 percent to 15 percent through furloughs and a system-required absence program during April. An Altru Health System spokesperson provided Becker’s the following statement Sept. 2:

“Altru responded to reduced volumes and changing patient and community health needs during the COVID situation by implementing system requested absence time for employees. This is mandatory time off when an employee is removed from the schedule, implemented on a shift-by-shift and at times week-by-week basis, while maintaining their benefits. During COVID when we experienced periods of sustained lower volume, Altru had upwards of 100 employees who consistently were not able to work all of their typically scheduled hours. Approximately 90 percent of these employees have since returned to their full time equivalent.  We continue to respond to changing patient needs, placing employees where they are needed throughout the health system.”

3. Ann & Robert H. Lurie Children’s Hospital (Chicago) 

In April, the hospital furloughed about 20 percent of its staff through the end of the month, though staff members still received pay and healthcare benefits. Lurie CFO Ron Blaustein told Becker’sthat as of Aug. 31 the furloughs and pay cuts are over.

“However, we continue to align our resources with the projected lower than expected volumes as a result of the impact of the pandemic and continued masking and social distancing,” Mr. Blaustein added.

4. Arnot Health (Elmira, N.Y.) 

In April, the health system laid off 400 employees to shore up finances.

As of Aug. 27, about 300 of the 400 employees have returned to work. “Decisions on the balance of the workers who were furloughed are being made based on a careful analysis of patient volume, to ensure our ability to be responsive to the community’s needs while maintaining our financial stability at a time where revenues have been severely impacted by the COVID-19 pandemic,” a spokesperson for the health system told Becker’s.

5. Aspirus Health (Wausau, Wis.)

Citing the financial hit from COVID-19, Aspirus Health furloughed a portion of its staff beginning May 1, according to a system press release. The furloughs primarily affected employees who did not work directly in patient care.

“As of the end of August, Aspirus had recalled 214 of our furloughed team members. Our goal is to recall all remaining furloughed employees; fewer than 40 percent have yet to be recalled,” Aspirus Health wrote in a Sept. 2 email to Becker’s.

6. Ballad Health (Johnson City, Tenn.)

On April 10, citing severe patient volume disruptions caused by the COVID-19 pandemic, Ballad Health furloughed 1,300 team members. The furloughs affected about 10 percent of its workforce.

As of Sept. 8, about 200 team members remain on furlough, a hospital spokesperson told Becker’s.

“Those team members are still receiving medical benefits and are being contacted this week to discuss other opportunities within Ballad Health in order to return them to full employment within the organization as soon as possible,” the spokesperson said Sept. 8.

The spokesperson added that while the majority of the other 1,300 furloughed members have returned to their roles, some found other positions within Ballad Health or have secured other employment opportunities outside of the health system.

7. Baptist Health (Little Rock, Ark.) 

Baptist Health this spring furloughed an unspecified number of employees to remain financially stable amid the COVID-19 pandemic. The health system also reduced benefits, and took additional steps to offset a drop in patient volume and revenue losses.

As of the end of July, Baptist Health brought its workforce back, and it has also restored some of the retirement benefits the health system stopped in April, President and CEO Troy Wells told news website Talk Business & Politics.

8. Bay Area Hospital (Coos Bay, Ore.)

Seventy-one employees from the hospital opted to take voluntary furloughs this spring. All of them have been called back to work, according to a hospital spokesperson.

9. Beaumont Health (Southfield, Mich.)

The health system implemented furloughs in April to offset pandemic-induced losses in revenue. A Beaumont Health spokesperson provided the following statement to Becker’s in a Sept. 2 email:

“Throughout this pandemic, Beaumont Health has made the difficult decision to lay off about 2,700 employees. Though approximately 2,000 have been returned to their previous roles or comparable positions, we are actively working with the remaining 550 to match them to available open jobs across the organization.”

10. Blount Memorial Hospital (Maryville, Tenn.)

In April, the hospital furloughed 211 employees due to low patient volume amid the pandemic. All but one of them have been brought back, according to a spokesperson for the hospital.

11. Boston Medical Center

Boston Medical Center furloughed this spring 10 percent of its workforce, or about 750 staff members, due to financial losses from the COVID-19 pandemic.

A hospital spokesperson told Becker’s Sept. 3 that about 660 furloughed employees have returned to work and about 90 employees are still furloughed. The health system expects the remaining 90 workers to return to work by the end of September.

12. Bronson Healthcare (Kalamazoo, Mich.)

Citing the suspension of elective procedures and a 50 percent reduction in revenue, the health system furloughed hundreds of employees in April. Furloughed employees were not paid and could not use paid time off.

“Bronson Healthcare’s 16-week furlough period for several hundred employees ended in August as planned with the exception of those who work in its fitness centers which, by governor’s order, cannot reopen until Sept. 9, 2020,” a spokesperson for the health system told Becker’s.

13. Campbell County Health (Gillette, Wyo.)

The health system furloughed an undisclosed number of employees in April. All of them have returned to work, according to the hospital’s spokesperson.

14. Cape Cod Healthcare (Hyannis, Mass.) 

Cape Cod Healthcare furloughed 595 employees in May due to reduced patient volumes and financial losses related to the pandemic.

On Aug. 28, the health system announced that it had recalled 477 of the 595 furloughed workers, and 118 will be laid off.

15. Cape Fear Valley Health(Fayetteville, N.C.)

The health system furloughed 783 employees this spring to help offset financial damage from the COVID-19 pandemic.

As of late July, Cape Fear Valley Health had brought back 721 furloughed employees and the remaining 62 employees would not be returning, according to the health system.

16. Carthage (N.Y.) Area Hospital

Citing the financial burden caused by the COVID-19 pandemic, the hospital furloughed 20 percent of its staff April 17. About 83 staff members were affected. Furloughed employees with health insurance could still receive those benefits.

The hospital received its Paycheck Protection Program loan April 20, allowing all furloughed employees to return to work, a spokesperson for the hospital told Becker’s.

17. Catholic Health (Buffalo, N.Y.)

The health system furloughed nearly 1,100 employees in April. Most have returned to work, but “about 50 associates in support roles” remain on furlough, a Catholic Health spokesperson told Becker’s Sept. 2.

18. Catholic Medical Center (Manchester, N.H.)

In April, the hospital furloughed 423 employees after canceling elective procedures to save staff and supplies for COVID-19 patients. It also reduced hours for 914 other employees.

In late July, the hospital permanently laid off 50 furloughed employees as well as another 21 employees who weren’t on furlough.

As of Aug. 26, all furloughed workers not affected by the layoffs had been brought back, the hospital told Becker’s.

19. Central Maine Healthcare (Lewiston)

The health system furloughed about 330 employees to help offset the revenue loss caused by the COVID-19 pandemic in April. The furloughs affected about 10 percent of its workforce.

A Central Maine Healthcare spokesperson in June said about three-quarters of its 300 employees furloughed in April were recalled.

As of Aug. 31, the remaining employees on furlough had been called back, a spokesperson told Becker’s.

20. Children’s Mercy (Kansas City, Mo.)

The hospital furloughed 575 employeest on April 26. Hospital officials said the furloughs were imposed to help offset fiscal losses attributed to the pandemic.

“As we have started ramping back up, all but 60 of the furloughed employees have been called back. For those eligible, severance packages will be made available. We are deeply grateful for their contributions to Children’s Mercy and the patients and families they have served,” a June 22 letter to employees read.

21. Claxton-Hepburn Medical Center (Ogdensburg, N.Y.)

In April, about 175 of the medical center’s 850 employees were affected by salary reductions, reduced hours or unpaid leave. A spokesperson for the medical center provided Becker’s with the following statement Sept. 3:

“We have been able to return all but 4 percent of our workforce to employment and restore salaries to pre-COVID levels. Nearly half of the layoffs are employees on unpaid leave. Other positions that have remained open or unfilled at this time have also been eliminated, but have not affected current employees. These changes came into effect around July 31, 2020.”

22. Columbia Memorial Hospital (Astoria, Ore.)

The hospital furloughed 90 of its 740 employees in late March after the facility scaled back nonemergent procedures to concentrate on the coronavirus.

As of July 28, the facility reinstated 34 of the 90 furloughed employees.

23. Connecticut Children’s Medical Center (Hartford)

The children’s hospital furloughed 400 employees across its system in April. The system said its patient volume has been cut in half due to halting elective procedures. Furloughed employees were mainly nonclinical workers.

As of Aug. 10, most are back at work, CEO James Shmerling told the Hartford Business Journal.

24. Cookeville (Tenn.) Regional Medical Center 

Citing a decrease in patient volume and revenue due to the pandemic, Cookeville Regional Medical Center furloughed about 400 employees of its 2,300-person workforce.

A hospital spokesperson told Becker’s Sept. 3 that staff members were brought back to the medical center in phases over several weeks. The health system has now called back all of its employees.

“We are happy to report that all our employees have been called back to return to work with full schedules, and almost all services are reopened with processes in place to protect our patients and staff from the spread of COVID-19,” a hospital spokesperson toldBecker’s Hospital Review. 

25. Edward-Elmhurst (Ill.) Health 

The health system furloughed a portion of its 8,000-person workforce due to the pandemic. The furloughs took place across departments over June, July and August.

The health system told Becker’s Aug. 21 it is unclear how many employees were still on furlough.

26. Elizabethtown (N.Y.) Community Hospital

The hospital furloughed 25 staff members in April after experiencing a revenue cut of 50 percent due to the suspension of elective procedures during the COVID-19 pandemic. All but one of the affected employees have returned to work, a hospital representative told Becker’s in a Sept. 2 email.

27. Emory Healthcare (Atlanta) 

Emory Healthcare cut hours or furloughed 1,500 workers to help offset a revenue shortfall due to the COVID-19 pandemic.

The health system told Becker’s Aug. 25 that it continues its clinical and financial recovery program after experiencing its second peak of COVID-19. “It would be premature to comment further at this time,” a spokesperson said.

28. Erlanger Health System (Chattanooga, Tenn.)

Erlanger Health System said in March it was implementing a cost-reduction plan that included furloughs and pay reductions for leadership. The moves were prompted by the COVID-19 pandemic.

The health system ended its furloughs June 22, but had to lay off 93 workers who were previously furloughed across the health system, a spokesperson confirmed to Becker’s Sept. 2.

29. Essentia Health (Duluth, Minn.)

Citing the COVID-19 pandemic, Essentia Health in March placed about 500 nonclinical staff on a special administrative leave.

Of those 500 employees, all but 65 of have been brought back to work, a spokesperson for Essentia Health told Becker’s Sept. 2.

30. Evangelical Community Hospital (Lewisburg, Pa.)

This spring, as the pandemic was declared and certain services slowed, Evangelical Community Hospital furloughed a portion of its staff. In March, 250 employees were furloughed, including 173 full or part-time employees and 77 per diem employees.

As of Sept. 8, 155 full and part time employees have been recalled and the per diem employees are used as needed, a hospital spokesperson said. Additionally, nine full and part-time employees were laid off, seven full and part-time employees retired and two full and part time employees remain on furlough, the spokesperson said.

31. Faith Community Health System (Jacksboro, Texas)

In April, the health system furloughed, cut hours or reassigned about 75 percent of its staff due to the suspension of elective procedures.

CEO Frank Beaman told Becker’s Aug. 31 that all furloughed staff have been brought back to work. He added that none of the staff affected by the furloughs or who had their hours cut lost any income, as they were able to use vacation time to supplement their income.

32. Fayette County Memorial Hospital (Washington Court House, Ohio)

Citing a revenue and patient volume drop from the COVID-19 pandemic, the Ohio hospital furloughed 71 of its 352 employees this spring.

A hospital spokesperson told Becker’s that everybody was brought back mid-May. Since workers were brought back, one employee has been laid off, the spokesperson said.

33. Fenway Health (Boston) 

In March and April, Fenway Health furloughed 143 employees in response to the COVID-19 pandemic.

As of Sept. 1, 52 of those employees have been brought back to work, Fenway told Becker’s. Of the 83 still on furlough, about 65 of them work in Fenway’s retail, dental and acupuncture operations.

Fenway has not laid off any of the furloughed staff and they have all received full health insurance coverage during their furloughs. Eight of the furloughed employees have left Fenway, a spokesperson told Becker’s.

“We ultimately expect to bring everyone back as our patient care volume continues to return to pre-pandemic levels,” the spokesperson added.

34. Freeman Health System (Joplin, Mo.) 

Freeman Health System implemented a voluntary furlough program for its staff members this spring after suspending elective procedures.

A hospital spokesperson told Becker’s Sept. 2 that all of the employees who volunteered to take furloughs have returned to work. The furloughs lasted about one month and had no impact on benefits. Freeman Health System was also able to implement staff raises during this time, according to the hospital spokesperson.

35. Froedtert Health (Wauwatosa, Wis.) 

Froedtert Health furloughed and cut the hours of some workers in April, according to furloughed nurses from the system.

“Like all healthcare organizations, we continue to evaluate the daily operational and staffing needs for our organization. Since March, staff members continued to remain active Froedtert Health employees during low-census and furlough status. At this time, approximately 1 percent  of our staff are impacted by reduced hours,” a hospital spokesperson told Becker’s Sept. 2.

36. Halifax Health (Daytona Beach, Fla.) 

In April, the health system furloughed nearly 400 of its staff members and required all nonclinical staff take one day off per week.

In July, Halifax laid off 95 of the furloughed workers. Employees no longer had to take one day of paid time off each week as of July 1 and employees who took a pay cut instead of paid days off had their salaries restored.

All furloughed workers unaffected by the layoffs returned to work Aug. 3, Halifax told Becker’s.

37. Henry Ford Health System (Detroit)

In April, the health system furloughed 2,800 staffers not directly involved in patient care due to financial damage from the COVID-19 pandemic. Ninety-two percent of furloughed staff have returned to work, a Henry Ford representative told Becker’s in an Aug. 31 email.

38. Hillcrest HealthCare System (Tulsa, Okla.)

Hillcrest HealthCare System said in April it would furlough 600 employees for up to 90 days. The furloughs affected about 9 percent of staff and were a result of a decline in routine and elective procedures due to the COVID-19 pandemic.

A hospital spokesperson told Becker’s Sept. 1: “We made the difficult decision to reduce staffing in some areas across our system as part of a strategic restructuring due to the devastating impact from COVID-19. While the reduction represents less than 1 percent of our workforce, it does not make the decision any less difficult or impactful to those team members affected.”

39. Hospital Sisters Health System (Springfield, Ill.)

Hospital Sisters Health System furloughed a portion of its staff in April due to the COVID-19 pandemic.

In August, the health system announced plans to reduce its workforce by 10 percent. The reductions include some of those who were furloughed.

40. Infirmary Health (Mobile, Ala.)

Citing a decrease in patient volume and revenue, the health system furloughed a portion of its staff in April. All affected employees have returned to work, according to an Infirmary Health spokesperson.

41. Kaleida Health (Buffalo, N.Y.)

The health system offered a temporary, voluntary furlough program for its staff in April. The furlough program is a joint agreement with two unions that represent 8,000 Kaleida Health employees. All of the health system’s furloughed employees have since returned, according to Michael Hughes, its senior vice president and chief of staff.

42. Lake Cumberland Regional Hospital (Somerset, Ky.)

In April, the hospital placed 17 percent of its workforce on temporary leave. Those workers continued to receive health insurance and 25 percent of their wages.

As of Sept. 2, all of those employees have returned to work, according to CEO Robert Parker.

“We are extremely grateful to our many dedicated team members, across all of our departments, who have worked tirelessly to keep one another and our patients safe as we continue the fight against COVID-19,” Mr. Parker said.

43. Lawrence (La.) General Hospital

In early April, Lawrence General placed 8 percent of its staff, or 160 employees, on a four-week furlough. Most of the furloughs affected nonclinical workers.

The hospital told Becker’s Sept. 2 that the safety-net facility had to extend the initial time frame of the four-week furlough four more weeks to address the volume dip and subsequent revenue loss attributed to the pandemic.

Although most of the furloughed workers returned to work June 15, 10 furloughed positions were eliminated, and a few employees remained on furlough until July 15. Now, those workers are back.

“Within weeks, canceling all elective volume and ramping up staff, supplies and equipment for the COVID-19 pandemic resulted in a 40 percent decline in patient volume and income and an increase in costs. The response required by Lawrence General Hospital to fight the pandemic, combined with an already challenging financial outlook for safety-net hospitals,” a Lawrence General hospital spokesperson said.

44. Lee Health (Fort Myers, Fla.)

Lee Health offered voluntary buyouts and voluntary summer leave program to help offset losses attributed to the COVID-19 pandemic.

About 600 employees took voluntary buyouts, and a lot of workers took summer sabbaticals, but no one is keeping track of the exact number, a spokesperson for the health system told Becker’s Aug. 24. The spokesperson said about 150 people took leaves of absence. Lee Health is trying to get all of these workers back as patient volume returns to  normal.

45. Lewis County Health System (Lowville, N.Y)

The health system placed 14 percent of its workforce on unpaid leave in April due to the pandemic. They have all returned to work, according to a spokesperson from the health system.

46. Marshfield (Wis.) Clinic

Marshfield Clinic in April said it would furlough employees who are not involved in preparing for the anticipated surge in COVID-19 patients.

As of Sept. 1, the system had recalled 96 percent of the employees who were on furlough, a Marshfield Clinic spokesperson confirmed to Becker’s. Some of the employees who did not return retired or ended employment with the health system, the spokesperson said.

47. Mary Free Bed Rehabilitation Hospital (Grand Rapids, Mich.)

The hospital furloughed 32 percent of its staff members in April, affecting 603 employees. As of Aug. 31, 512 employees had returned, 34 remain furloughed and 57 were terminated, a hospital representative told Becker’sSept. 1.

The spokesperson also said that Mary Free Bed augmented unemployment benefits when it issued the furloughs so employees would receive about 75 percent of their regular wages. Affected employees also received dental, vision and life insurance, as well as 100 percent coverage for behavioral health telehealth visits and COVID-19 treatment.

48. Maury Regional Health(Columbia, Tenn.)

Maury Regional Health implemented two rounds of furloughs this spring that affected 414 employees; the first round affected 340 employees.

A hospital spokesperson told Becker’s Sept. 2 that of the 414 employees affected, 287 staff members were called back to work, and 127 employees were laid off.

49. McDonough District Hospital (Macomb, Ill.)

The hospital furloughed 60 workers in April amid declining revenue from the pandemic. It has brought back 14 of those employees, a hospital representative told Becker’s in a Sept. 2 email.

50. Mid-Columbia Medical Center (Dalles, Ore.) 

The medical center began furloughing employees May 3 in an effort to help offset losses attributed to the COVID-19 pandemic. The furloughs primarily affected departments that were not seeing a lot of patients.

A Mid-Columbia Medical Center spokesperson told Becker’s the medical center has brought back all of its furloughed staff members, except for those who worked within its spa services, which have been closed due to financial instability.

51. Melissa Memorial Hospital (Holyoke, Colo.)

Melissa Memorial Hospital, a 15-bed critical access hospital with about 100 employees, placed 19 employees on furlough this spring due to a reduction in volume amid the coronavirus pandemic. The hospital had a layered approach to cost reduction, as some employees were on reduced hours, some on furlough, and managers volunteered to take pay cuts.

Cathy Harshbarger, BSN, RN, and the hospital’s CEO, confirmed with Becker’s that due to restructuring to respond to the pandemic, eight employees were laid off, and the remaining employees were brought back to work. Terminated employees were offered a severance package.

Six of the eight terminated employees were part of the hospital’s dental and optical departments, which were struggling with volume before the pandemic. The hospital looked at operations and reworked many of the departments to gain efficiencies. Due to this restructuring, the other two employees were laid off.

All employees who took pay cuts have had their regular salaries restored, Ms. Harshbarger said.

“It’s scary for a rural hospital. Our little hospital was dealing with trying to build cash again after a loss in volume. At the beginning, we were worried because we had just 32 days of cash on hand. We had to act very quickly and tighten things down,” Ms. Harshbarger said. “Through teamwork, we developed and found efficiencies we really needed.”

52. Mercy Medical Center (Canton, Ohio.)

Mercy Medical Center began implementing furloughs in March  due to the COVID-19 pandemic. The system placed 349 employees on full furlough and 376 employees on partial furlough.

As of Sept. 3, 15 employees remain on full furlough, two remain on partial furlough, and 19 employee  positions were eliminated, according to a hospital spokesperson.

53. Mohawk Valley Health System (Utica, N.Y.)

The health system furloughed about 20 percent of its workforce of 4,000 in April as part of a cost-cutting plan to recover from lost revenue caused by the pandemic. A spokesperson for the health system told Becker’s that about “300 employees have been brought back so far” in a Sept. 2 email.

54. Monument Health (Rapid City, S.D.)

In April, Monument Health placed 200 employees on furlough to help preserve protective gear and save costs after suspending elective surgeries. The furloughs affected 4 percent of its workforce. The health system “brought its furloughed caregivers back as needed through Aug. 17, when the furlough officially ended,” a Monument representative told Becker’s.

55. Munson Healthcare (Traverse City)

Citing a financial hit from the suspension of elective procedures, the health system furloughed a portion of its staff in April.

“While the COVID-19 pandemic continues to impact Munson Healthcare in significant ways, we can report that 90 percent of the individuals who were placed in furlough status are no longer on furlough,” a Munson Healthcare spokesperson told Becker’s in a Sept. 2 email.

56. MUSC Health (Charleston, S.C.)

The eight-hospital system said it would temporarily lay off 900 employees, or 5 percent of its workforce, to offset the financial hit caused by the COVID-19 pandemic. The temporary layoffs, which do not affect nonclinical workers, were effective April 7.

MUSC Health said in late June it has called back nearly half of the employees who had been furloughed.

57. Myrtue Medical Center (Harlan, Iowa)

The medical center furloughed a portion of its 422 employees in April due to a revenue drop from the pandemic. All of the furloughed employees have returned to work, according to a hospital spokesperson.

58. Niagara Falls (N.Y.) Memorial Hospital 

The hospital furloughed 52 employees in April to offset a revenue loss due to the pandemic. It received federal Paycheck Protection Program funding and was able to bring back all of its furloughed staff, a spokesperson for the hospital told Becker’s.

59. North Bend Medical Center (Coos Bay, Ore.)

North Bend Medical Center this spring furloughed 130 employees to prepare for the novel coronavirus pandemic.

According to John Burles, North Bend Medical Center CEO, most of the furloughed workers have been called back to work, but about 30 did not return, many of whom were offered their positions back. The hospital has been able to hire new people to fill some of those positions.

60. Northern Light Health (Brewer, Maine)

The health system asked staff to volunteer for furloughs in early April.

A spokesperson for Northern Light Health told Becker’s Aug. 31 that 187 employees were granted a voluntary furlough, the average length of which was 36 days. The last furloughed employee was slated to return Sept. 6.

61. Noyes Health (Dansville, N.Y.)

In April, Noyes Health furloughed some of its staff for one to two weeks on a rolling basis, citing a revenue decline of 50 percent due to the pandemic. All affected employees returned from furlough by June, and the health system’s budgeted revenue has bounced back into the upper 90 percent range for June and July, according to a spokesperson for the health system.

62. Olmsted Medical Center (Rochester, Minn.)

The medical center furloughed 200 people in April to offset the financial hit caused by the pandemic. All affected employees have returned to work, according to a spokesperson.

63. Pikeville (Ky.) Medical Center

The medical center furloughed more than 200 employees April 26 amid mounting financial pressure due to the COVID-19 pandemic. Most employees have returned to their positions, and the medical center is bringing back the fewer than three dozen remaining employees, according to a medical center spokesperson.

64. Premier Health (Dayton, Ohio)

The Dayton-based health system said this spring it would furlough an undisclosed number of employees due to an anticipated financial hit from Ohio’s interim ban on nonessential surgeries.

In response to Becker’s request for an update on furloughs, the organization provided a statement from the Greater Dayton Area Hospital Association, which includes Premier Health, but is not specific to Premier Health.

“The Dayton region’s hospitals employ more than 34,000 individuals across our 11-county region. During COVID-19, 5,648 healthcare workers and hospital employees were temporarily furloughed due to Ohio’s executive order that suspended elective and nonessential surgeries. At this time, most furloughed employees have returned to work,” the hospital association stated.

65. Prisma Health (Greenville, S.C.)

Citing the financial hit from the COVID-19 pandemic, Prisma Health said it furloughed about 3,900 of its 30,000-person workforce this spring.

“We are on the front end of a long-term recovery effort, as is the entire U.S. economy. As we need staffing for patient care, we have continuously been recalling furloughed clinical staff or increasing hours for those team members whose hours were previously reduced. We do not have an update on the number of earlier announced furloughs or reduced hours because staffing is constantly shifting to accommodate the impact of COVID-19 as it ebbs and flows in our communities,” Prima Health told Becker’s Sept. 3.

66. Providence Oregon (Portland)

Providence Oregon implemented staff furloughs and leadership pay cuts to help offset financial losses attributed to the pandemic. At the time, the health system said its core leaders would take a one-week unpaid furlough between May 17 and July 31. In addition, the health system said caregivers would flex their hours during the same time period.

Providence Oregon has since seen its patient volumes recover to near-expected levels, with 95 percent of budgeted volume in June, the health system told Becker’s Sept. 3. Therefore, the health system has ended most patient-facing caregiver furloughs. “We continue to manage our operations during the pandemic based on the new economic realities,” Providence Oregon said.

67. St. Agnes Medical Center (Fresno, Calif.) 

The medical center furloughed 161 employees in April to better align its resources with the pandemic-induced reduction in services. As its volume has been slowly ramping up, it has brought back 94 of those employees.

“We’re hopeful this trend will continue so we can soon return even more,” a spokesperson for the medical center told Becker’s Aug 27.

68. St. Claire HealthCare (Morehead, Ky.)

St. Claire HealthCare announced in late March it would furlough 300 employees who are not involved in direct patient care to ensure it can sustain clinical operations during and after the COVID-19 pandemic.

A hospital spokesperson told Becker’s Sept. 2: “We are very fortunate we have been able to return the vast majority of our furloughed staff to work.”

69. St. Joseph Health (Syracuse, N.Y.)

The hospital system furloughed about 500 workers to deal with an “unprecedented fiscal fallout” from the COVID-19 pandemic, according to Syracuse.com.

St. Joseph’s Health brought back 135 workers as of June 1, according to Syracuse.com.

Most of the remaining furloughed employees have since been recalled back into employment, according to an Aug. 31 press release emailed to Becker’s.

70. St. Lawrence Health System (Potsdam, N.Y)

The three-hospital system temporarily furloughed 427 workers in April to help offset the revenue loss caused by the COVID-19 pandemic. By the end of June, 25 of those positions were permanently eliminated, all of which were full time and primarily at the management level.

71. St. Luke’s Hospital (Chesterfield, Mo.) 

St. Luke’s offered a voluntary furlough program to employees in May. A spokesperson told Becker’s Sept. 8 that about 300 employees accepted the offer and received paid benefits while they received unemployment insurance and the additional benefits provided by the Coronavirus, Aid, Relief and Economic Security Act.

The furlough program ended at the end of July, the hospital said, and most furloughed employees are back in their normal positions.

“For those whose normal positions were and are still impacted by the pandemic, they have the opportunity to be part of a COVID-19 screening pool to cover essential needs and to minimize reductions in their work schedules whenever possible,” the spokesperson said.

72. Sarasota (Fla.) Memorial Hospital

Sarasota Memorial Hospital furloughed 640 staff members in March and April as patient volumes dropped amid a statewide elective procedure ban.

A hospital spokesperson told Becker’s Sept. 3 that staff were brought back in phases as the ban was lifted and volume returned. Specifically, most employees were brought back in May and the rest returned by the end of June.

73. Scotland Health Care System (Laurinburg, N.C.)

The health system furloughed nearly 70 employees through June 30 due to a pandemic-induced drop in patient volume and revenue, according to The Laurinburg Exchange. Most affected employees work in nonclinical roles, though some front-line staff were furloughed. All furloughed employees have since returned to work, a human resources representative told Becker’s.

74. Sinai Health System (Chicago)

Crain’s Chicago Business reported the health system would lay off 24 nonclinical employees, furlough about 150 caregivers and cut hours for another 200 employees during April, citing a loss of $10 million per month due to the COVID-19 pandemic. All but 13 of Sinai’s furloughed employees have been brought back, according to the hospital’s spokesperson.

75. Stamford (Conn.) Health

Stamford Health furloughed 375 employees to help offset a revenue loss from the COVID-19 pandemic.

As of Aug. 31, five full-time employees are still on furlough, and the health system plans to bring those employees back, a spokesperson told Becker’s.

76. Stanford (Calif.) Health Care

Stanford Health Care’s Temporary Workforce Adjustment program, which began on April 27, required all exempt, non-represented employees, including executive leadership, to take 12 days off in a 10-week period or a pay reduction of 20 percent for the 10 weeks. More than 99 percent of its workforce chose to use paid time off. The program allowed all staff who did not have enough PTO hours to use hours they had not yet earned to maintain their pay level. Those who needed to were allowed to go into a negative PTO balance and earn the hours back.

The program ended for Service Employees International Union employees June 20 and ended for all other employees July 4. All furloughed employees have returned to their regularly scheduled hours, a spokesperson told Becker’s.

77. Stephens Memorial Hospital (Breckenridge, Texas)

Stephens Memorial Hospital furloughed a portion of its staff in April due to the pandemic.

The hospital was able to bring back all furloughed employees after a few weeks, a hospital spokesperson told Becker’s Aug. 31. “We have been fortunate to benefit from the programs that have been offered to help rural hospitals stay open during this time,” the spokesperson added. “Our volumes have consistently increased back up to or near pre-pandemic levels with the exception of our emergency department. They are still seeing about 60 percent of average based on historical data.”

78. Summa Health (Akron, Ohio) 

Throughout the spring, Summa Health furloughed 728 of its 7,200 employees in an effort to cut costs.

In August, the health system brought back the majority of the furloughed employees. As of Aug. 25, 12 employees remained on furlough, the health system told Becker’s.

79. Thomas Health (South Charleston, W.Va.)

Thomas Health, which had 1,663 employees at the start of the pandemic, furloughed 584 of those staff members.

Due to attrition and reorganization, the health system brought back all but 80 employees, a health system spokesperson told Becker’s Sept. 2.”Since then, we have already hired 50 new full-time employees,” the spokesperson added.  

80. Tower Health (Philadelphia)

In April, the seven-hospital system furloughed at least 1,000 employees due to the financial hit from the COVID-19 pandemic, affecting roughly 7 percent of the system’s 14,000-person workforce. In a Sept. 2 email, a Tower Health spokesperson told Becker’s “almost all staff furloughed in April have been recalled.” 

81. Trinity Health (Livonia, Mich.), which includes Trinity Health of New England (Hartford, Conn.)

Trinity Health, a 92-hospital system, implemented furloughs across its network. At its Michigan hospitals, 2,500 employees were furloughed this spring, while an undisclosed number of employees were furloughed at Trinity Health of New England.

In July, the health system said it would lay off and reduce work schedules of 1,000 employees.

A Trinity Health spokesperson told Becker’s Sept. 3: “Our staffing reductions were less than 3 percent of our workforce nationally, which is much lower than we originally anticipated would be required due to stronger-than-expected resurgence of patient volume. Many furloughed colleagues have either returned to work or are anticipated to return to work as patient volumes grow.”

82. UK Healthcare (Lexington, Ky.) 

The health system furloughed 1,500 employees to help offset a COVID-19-related revenue loss in April. Only two of the affected employees remain on a partial furlough, which is one day per week, a UK Healthcare spokesperson told Becker’s in a Sept. 2 email.

83. UnityPoint Health (West Des Moines, Iowa)

The health system began implementing furloughs April 26, which affected employees in areas of the system that were operating at capacity or experiencing closures. Most of them have been brought back.

“UnityPoint Health has returned more than 95 percent of our team members from furlough and has reinstated our standard pay practices,” a spokesperson said in a Sept. 1 email. “We continue to evaluate opportunities to respond to the rapidly evolving dynamics of the pandemic including executive benefit offerings and other options. Our top priority remains the health and safety of our team members, patients and communities.”

84. University Hospitals (Cleveland)

The health system cut the hours and pay of 4,100 employees not involved in patient care in April, all of whom have since returned to work.

“Furloughs for nonclinical caregivers were temporary and involved 20 percent reduction in hours over a 10-week period,” a system representative told Becker’s. “Our caregivers continued to receive benefits and were eligible to continue pay by using earned or borrowed paid time off. UH leaders in clinical and nonclinical positions continued to work through the 10-week period at reduced levels of pay. The temporary furloughs have ended, and all of our caregivers are focused on restoring care for our patients that may have been delayed because of the pandemic.” 

85. University of Chicago Medical Center  

University of Chicago Medical Center furloughed more than 800 employees in May.

A hospital spokesperson told Becker’s Aug. 26 the furloughs have ended, and no other layoffs or further furloughs have been announced.

86. University of Kansas Health System St. Francis Campus (Topeka)

The University of Kansas Health System in April laid off 29 employees and furloughed 235 to help offset the financial impact of the COVID-19 pandemic.

In mid-June, the health system restructured and consolidated some services and laid off 33 employees to manage the effect of COVID-19. The 33 affected employees represent about 2.3 percent of the hospital’s workforce, and most had already been put on furlough.

Becker’s reached out to the University of Kansas Health System to provide an update on whether the remaining furloughed employees have been brought back.

87. University of Vermont Medical Center (Burlington)

University of Vermont Medical Center furloughed hundreds of employees this year. More than 660 employees were affected by furlough at some point, with numbers fluctuating throughout the spring and summer as some redeployed into new positions, such as screening employees and patients for COVID-19 symptoms at hospital entrances, or assisting colleagues with proper PPE usage, a spokesperson told Becker’s Sept. 8.

The medical center has recalled more than 400 employees to their normal roles amid the resumption of nonurgent and routine procedures. The spokesperson said nearly all affected employees will be back in their normal roles by the end of September.

88. UW Medicine (Seattle)

UW Medicine announced furloughs of approximately 1,500 professional and non-union staff members in May. It also announced furloughs of approximately 4,000 union employees in May and layoffs of 100 staff members in July due to financial challenges from the pandemic.

The health system told Becker’s Aug. 26 that 260 staff furloughs were canceled, either due to increased patient volumes or a need for staff coverage.

89. Vidant Health (Greenville, N.C.)

To address the financial hit and patient volume dip caused by the pandemic, the health system furloughed 212 of its employees. A Vidant Health spokesperson told Becker’s in a Sept. 2 email that 207 of them had returned to work.

90. Virginia Mason Medical Center (Seattle)

Virginia Mason Medical Center furloughed an undisclosed number of employees this spring amid the COVID-19 pandemic. Most of the affected employees were in nonclinical roles.

A Virginia Mason spokesperson said the hospital system has resumed services in compliance with Washington state’s guidelines, and some furloughed workers have returned to work.

“While some team members who were temporarily furloughed during the peak of the pandemic have returned to work, I am unable to provide specific figures or percentages,” a hospital spokesperson told Becker’s Sept. 3.

91. Washington Regional Medical Center (Fayetteville, Ark.) 

In April, the hospital furloughed 305 full-time employees to help offset revenue losses tied to the COVID-19 pandemic.

Of those employees, 288 had been brought back by late July and the remaining workers returned to work by Aug. 2.

Natalie Hardin, director of marketing and public relations at the hospital, told Becker’sthat a small number of the furloughed workers resigned or found other jobs. No employees remain on furlough as of Aug. 25.

“This does not mean that Washington Regional’s pandemic related revenue troubles are over — far from it. The pandemic presents an unpredictable challenge that we recognize will remain with us for some time to come. As a result, we will continue to focus on our financial and clinical operations to ensure that our health system is on a sound footing now and into the future,” CEO Larry Shackelford said in a statement.

92. West Tennessee Healthcare (Jackson)

West Tennessee Healthcare furloughed 1,100 individuals of its 7,000-person workforce. The health system said it lost $18 million in March due to the statewide ban on elective procedures that went into effect March 23.

“We have three employees who still aren’t working their normal hours, but the other employees who were furloughed are working,” a spokesperson wrote in a Sept. 1 email to Becker’s.

 

 

 

 

Industry Voices—6 ways the pandemic will remake health systems

https://www.fiercehealthcare.com/hospitals/industry-voices-6-ways-pandemic-will-remake-health-systems?mkt_tok=eyJpIjoiTURoaU9HTTRZMkV3TlRReSIsInQiOiJwcCtIb3VSd1ppXC9XT21XZCtoVUd4ekVqSytvK1wvNXgyQk9tMVwvYXcyNkFHXC9BRko2c1NQRHdXK1Z5UXVGbVpsTG5TYml5Z1FlTVJuZERqSEtEcFhrd0hpV1Y2Y0sxZFNBMXJDRkVnU1hmbHpQT0pXckwzRVZ4SUVWMGZsQlpzVkcifQ%3D%3D&mrkid=959610

Industry Voices—6 ways the pandemic will remake health systems ...

Provider executives already know America’s hospitals and health systems are seeing rapidly deteriorating finances as a result of the coronavirus pandemic. They’re just not yet sure of the extent of the damage.

By the end of June, COVID-19 will have delivered an estimated $200 billion blow to these institutions with the bulk of losses stemming from cancelled elective and nonelective surgeries, according to the American Hospital Association

A recent Healthcare Financial Management Association (HFMA)/Guidehouse COVID-19 survey suggests these patient volumes will be slow to return, with half of provider executive respondents anticipating it will take through the end of the year or longer to return to pre-COVID levels. Moreover, one-in-three provider executives expect to close the year with revenues at 15 percent or more below pre-pandemic levels. One-in-five of them believe those decreases will soar to 30 percent or beyond. 

Available cash is also in short supply. A Guidehouse analysis of 350 hospitals nationwide found that cash on hand is projected to drop by 50 days on average by the end of the year — a 26% plunge — assuming that hospitals must repay accelerated and/or advanced Medicare payments.

While the government is providing much needed aid, just 11% of the COVID survey respondents expect emergency funding to cover their COVID-related costs.

The figures illustrate how the virus has hurled American medicine into unparalleled volatility. No one knows how long patients will continue to avoid getting elective care, or how state restrictions and climbing unemployment will affect their decision making once they have the option.

All of which leaves one thing for certain: Healthcare’s delivery, operations, and competitive dynamics are poised to undergo a fundamental and likely sustained transformation. 

Here are six changes coming sooner rather than later.

 

1. Payer-provider complexity on the rise; patients will struggle.

The pandemic has been a painful reminder that margins are driven by elective services. While insurers show strong earnings — with some offering rebates due to lower reimbursements — the same cannot be said for patients. As businesses struggle, insured patients will labor under higher deductibles, leaving them reluctant to embrace elective procedures. Such reluctance will be further exacerbated by the resurgence of case prevalence, government responses, reopening rollbacks, and inconsistencies in how the newly uninsured receive coverage.

Furthermore, the upholding of the hospital price transparency ruling will add additional scrutiny and significance for how services are priced and where providers are able to make positive margins. The end result: The payer-provider relationship is about to get even more complicated. 

 

2. Best-in-class technology will be a necessity, not a luxury. 

COVID has been a boon for telehealth and digital health usage and investments. Two-thirds of survey respondents anticipate using telehealth five times more than they did pre-pandemic. Yet, only one-third believe their organizations are fully equipped to handle the hike.

If healthcare is to meet the shift from in-person appointments to video, it will require rapid investment in things like speech recognition software, patient information pop-up screens, increased automation, and infrastructure to smooth workflows.

Historically, digital technology was viewed as a disruption that increased costs but didn’t always make life easier for providers. Now, caregiver technologies are focused on just that.

The new necessities of the digital world will require investments that are patient-centered and improve access and ease of use, all the while giving providers the platform to better engage, manage, and deliver quality care.

After all, the competition at the door already holds a distinct technological advantage.

 

3. The tech giants are coming.

Some of America’s biggest companies are indicating they believe they can offer more convenient, more affordable care than traditional payers and providers. 

Begin with Amazon, which has launched clinics for its Seattle employees, created the PillPack online pharmacy, and is entering the insurance market with Haven Healthcare, a partnership that includes Berkshire Hathaway and JPMorgan Chase. Walmart, which already operates pharmacies and retail clinics, is now opening Walmart Health Centers, and just recently announced it is getting into the Medicare Advantage business.

Meanwhile, Walgreens has announced it is partnering with VillageMD to provide primary care within its stores.

The intent of these organizations clear: Large employees see real business opportunities, which represents new competition to the traditional provider models.

It isn’t just the magnitude of these companies that poses a threat. They also have much more experience in providing integrated, digitally advanced services. 

 

4. Work locations changes mean construction cost reductions. 

If there’s one thing COVID has taught American industry – and healthcare in particular – it’s the importance of being nimble.

Many back-office corporate functions have moved to a virtual environment as a result of the pandemic, leaving executives wondering whether they need as much real estate. According to the survey, just one-in-five executives expect to return to the same onsite work arrangements they had before the pandemic. 

Not surprisingly, capital expenditures, including new and existing construction, leads the list of targets for cost reductions.

Such savings will be critical now that investment income can no longer be relied upon to sustain organizations — or even buy a little time. Though previous disruptions spawned only marginal change, the unprecedented nature of COVID will lead to some uncomfortable decisions, including the need for a quicker return on investments. 

 

5. Consolidation is coming.

Consolidation can be interpreted as a negative concept, particularly as healthcare is mostly delivered at a local level. But the pandemic has only magnified the differences between the “resilients” and the “non-resilients.” 

All will be focused on rebuilding patient volume, reducing expenses, and addressing new payment models within a tumultuous economy. Yet with near-term cash pressures and liquidity concerns varying by system, the winners and losers will quickly emerge. Those with at least a 6% to 8% operating margin to innovate with delivery and reimagine healthcare post-COVID will be the strongest. Those who face an eroding financial position and market share will struggle to stay independent..

 

6. Policy will get more thoughtful and data-driven.

The initial coronavirus outbreak and ensuing responses by both the private and public sectors created negative economic repercussions in an accelerated timeframe. A major component of that response was the mandated suspension of elective procedures.

While essential, the impact on states’ economies, people’s health, and the employment market have been severe. For example, many states are currently facing inverse financial pressures with the combination of reductions in tax revenue and the expansion of Medicaid due to increases in unemployment. What’s more, providers will be subject to the ongoing reckonings of outbreak volatility, underscoring the importance of agile policy that engages stakeholders at all levels.

As states have implemented reopening plans, public leaders agree that alternative responses must be developed. Policymakers are in search of more thoughtful, data-driven approaches, which will likely require coordination with health system leaders to develop flexible preparation plans that facilitate scalable responses. The coordination will be difficult, yet necessary to implement resource and operational responses that keeps healthcare open and functioning while managing various levels of COVID outbreaks, as well as future pandemics.

Healthcare has largely been insulated from previous economic disruptions, with capital spending more acutely affected than operations. But the COVID-19 pandemic will very likely be different. Through the pandemic, providers are facing a long-term decrease in commercial payment, coupled with a need to boost caregiver- and consumer-facing engagement, all during a significant economic downturn.

While situations may differ by market, it’s clear that the pre-pandemic status quo won’t work for most hospitals or health systems.

 

 

 

Canceled elective procedures putting pressure on nation’s hospitals

https://www.healthcarefinancenews.com/news/canceled-elective-procedures-putting-pressure-nations-hospitals

U.S. Hospitals Brace for 'Tremendous Strain' from New Virus - JEMS

Even upticks in COVID-19 patients haven’t made up for the revenue losses, since reimbursement for those services is comparatively slim.

Elective procedures are in a strange place at the moment. When the COVID-19 pandemic started to ramp up in the U.S., many of the nation’s hospitals decided to temporarily cancel elective surgeries and procedures, instead dedicating the majority of their resources to treating coronavirus patients. Some hospitals have resumed these surgeries; others resumed them and re-cancelled them; and still others are wondering when they can resume them at all.

In a recent HIMSS20 digital presentation, Reenita Das, a senior vice president and partner at Frost and Sullivan, said that during the pandemic, plastic surgery activity declined by 100%, ENT surgeries declined by 79%, cardiovascular surgeries declined by 53% and neurosurgery surgeries declined by 57%.

It’s hard to overstate the financial impact this is likely to have on hospitals’ bottom lines. Just this week, American Hospital Association President and CEO Rick Pollack, pulling from Kaufman Hall data, said the cancellation of elective surgeries is among the factors contributing to a likely industry-wide loss of $120 billion from July to December alone. When including data from earlier in the pandemic, the losses are expected to be in the vicinity of $323 billion, and half of the nation’s hospitals are expected to be in the red by the end of the year.

Doug Wolfe, cofounder and managing partner of Miami-based law firm Wolfe Pincavage, said this has amounted to a “double-whammy” for hospitals, because on top of elective procedures being cancelled, the money healthcare facilities received from the federal Coronavirus Aid, Relief, and Economic Security Act was an advance on future Medicare payments – which is coming due. While hospitals perform fewer procedures, they will now have to start paying that money back.

All hospitals are hurting, but some are in a more precarious position than others.

“Some hospital systems have had more cash on hand and more liquidity to withstand some of the financial pressure some systems are facing,” said Wolfe. “Traditionally, the smaller hospital systems in the healthcare climate we face today have faced a lot more financial pressure. They’re not able to control costs the same way as a big system. The smaller hospitals and systems were hurting to begin with.”

LOWER REVENUE, HIGHER COSTS

Some hospitals, especially ones in hot spots, are seeing a surge in COVID-19 patients. While this has kept frontline healthcare workers scrambling to care for scores of sick Americans, COVID-19 treatments are not reimbursed at the same level as surgeries. Hospital capacity is being stretched with less lucrative services.

“Some hospitals may be filling up right now, but they’re filling up with lower-reimbursing volume,” said Wolfe. “Inpatient stuff is lower reimbursement. It’s really the perfect storm for hospitals.”

John Haupert, CEO of Grady Health in Atlanta, Georgia, said this week that COVID-19 has had about a $115 million negative impact on Grady’s bottom line. Some $70 million of that is related to the reduction in the number of elective surgeries performed, as well as dips in emergency department and ambulatory visits. 

During one week in March, Grady saw a 50% reduction in surgeries and a 38% reduction in ER visits. The system is almost back to even in terms of elective and essential surgeries, but due to a COVID-19 surge currently taking place in Georgia, it has had to suspend those services once again. ER visits have only come back about halfway from that initial 38% dip, and the system is currently operating at 105% occupancy.

“Part of what we’re seeing there is reluctance from patients to come to hospitals or seek services,” said Haupert. “Many have significantly exacerbated chronic disease conditions.”

Patient hesitation has been an ongoing problem, as has the associated cost of treating coronavirus patients, said Wolfe.

“When they were ramping up to resume the elective stuff, there was a problem getting patients comfortable,” he said. “And the other thing was that the cost of treating patients in this environment has gone up. They’ve put up plexiglass everywhere, they have more wiping-down procedures, and all of these things add cost and time. They need to add more time between procedures so they can clean everything … so they’re able to do less, and it costs more to do less. Even when elective procedures do resume, it’s not going back to the way it was.”

Most hospitals have adjusted their costs to mitigate some of the financial hit. Even some larger systems, such as 92-hospital nonprofit Trinity Health in Michigan, have taken to measures such as laying off and furloughing workers and scaling back working hours for some of its staff. At the top of the month, Trinity announced another round of layoffs and furloughs – in addition to the 2,500 furloughs it announced in April – citing a projected $2 billion in revenue losses in fiscal year 2021, which began on June 1.

Hospitals are at the mercy of the market at the moment, and Wolfe anticipates there could be an uptick in mergers and consolidation as organizations look to partner with less cash-strapped entities. 

“Whether reorganization will work remains to be seen, but there will definitely be a fallout from this,” he said.

 

 

 

 

Coronavirus’s painful side effect is deep budget cuts for state and local government services

https://theconversation.com/coronaviruss-painful-side-effect-is-deep-budget-cuts-for-state-and-local-government-services-141105

Coronavirus's painful side effect is deep budget cuts for state ...

Nationwide, state and local government leaders are warning of major budget cuts as a result of the pandemic. One state – New York – even referred to the magnitude of its cuts as having “no precedent in modern times.”

Declining revenue combined with unexpected expenditures and requirements to balance budgets means state and local governments need to cut spending and possibly raise taxes or dip into reserve funds to cover the hundreds of billions of dollars lost by state and local government over the next two to three years because of the pandemic.

Without more federal aid or access to other sources of money (like reserve funds or borrowing), government officials have made it clear: Budget cuts will be happening in the coming years.

And while specifics are not yet available in all cases, those cuts have already included reducing the number of state and local jobs – from firefighters to garbage collectors to librarians – and slashing spending for education, social services and roads and bridges.

In some states, agencies have been directed to cut their budget as much as 15% or 20% – a tough challenge as most states prepared budgets for a new fiscal year that began July 1.

As a scholar of public administration who researches how governments spend money, here are the ways state and local governments have reduced spending to close the budget gap.

Cutting jobs

State and local governments laid off or furloughed 1.5 million workers in April and May.

They are also reducing spending on employees. According to surveys, government workers are feeling personal financial strain as many state and local governments have cut merit raises and regular salary increases, frozen hiring, reduced salaries and cut seasonal employees.

Washington state, for example, cut both merit raises and instituted furloughs.

survey from the National League of Cities shows 32% of cities will have to furlough or lay off employees and 41% have hiring freezes in place or planned as a result of the pandemic.

Employment reductions have met some resistance. In Nevada, for example, a state worker union filed a complaint against the governor to the state’s labor relations board for violating a collective bargaining statute by not negotiating on furloughs and salary freezes.

Most of the employee cuts have been made in education. Teachers, classroom aids, administrators, staff, maintenance crews, bus drivers and other school employees have seen salary cuts and layoffs.

The job loss has hurt public employees beyond education, too: librarians, garbage collectors, counselors, social workers, police officers, firefighters, doctors, nurses, health aides, park rangers, maintenance crews, administrative assistants and others have been affected.

Residents also face the consequences of these cuts: They can’t get ahold of staff in the city’s water and sewer departments to talk about their bill; they can’t use the internet at the library to look for jobs; their children can’t get needed services in school.

Most of these cuts have been labeled temporary, but with the extensions to stay-at-home orders and a mostly closed economy, it will be some time before these employees are back to work.

Suspending road, bridges, building and water system projects

As another way to reduce costs quickly, a National League of Cities survey shows 65% of the municipalities surveyed are stopping temporarily, or completely, capital expenditure and infrastructure projects like roads, bridges, buildings, water systems or parking garages.

In New York City, there is a US$2.3 billion proposed cut to the capital budget, a fund that supports large, multiyear investments from sidewalk and road maintenance, school buildings, senior centers, fire trucks, sewers, playgrounds, to park upkeep. There are potentially serious consequences for residents. For example, New York housing advocates are concerned that these cuts will hurt plans for 21,000 affordable homes.

Suspending these big money projects will save the government money in the short term. But it will potentially harm the struggling economy, since both public and private sectors benefit from better roads, bridges, schools and water systems and the jobs these projects create.

Delaying maintenance also has consequences for the deteriorating infrastructure in the U.S. The costs of unaddressed repairs could increase future costs. It can cost more to replace a crumbling building than it does to fix one in better repair.

Cities and towns hit

In many states, the new budgets severely cut their aid to local governments, which will lead to large local cuts in education – both K-12 and higher education – as well as social programs, transportation, health care and other areas.

New York state’s budget proposes that part of its fiscal year 2021 budget shortfall will be balanced by $8.2 billion in reductions in aid to localities. This is the state where the cuts were referred to in the budget as “not seen in modern times.” This money is normally spent on many important services that residents need everyday –mass transit, adult and elderly care, mental health support, substance abuse programs, school programs like special education, children’s health insurance and more. Lacking any of these support services can be devastating to a person, especially in this difficult time.

Fewer workers, less money

As teachers and administrators figure out how to teach both online and in person, they and their schools will need more money – not less – to meet students’ needs.

Libraries, which provide services to many communities, from free computer use to after-school programs for children, will have to cut back. They may have fewer workers, be open for fewer hours and not offer as many programs to the public.

Parks may not be maintained, broken playground equipment may stay that way, and workers may not repave paths and mow lawns. Completely separate from activists’ calls to shift police funding to other priorities, police departments’ budgets may be slashed just for lack of cash to pay the officers. Similar cuts to firefighters and ambulance workers may mean poorly equipped responders take longer to arrive on a scene and have less training to deal with the emergency.

To keep with developing public safety standards, more maintenance staff and materials will be needed to clean and sanitize schools, courtrooms, auditoriums, correctional facilitiesmetro stations, buses and other public spaces. Strained budgets and employees will make it harder to complete these new essential tasks throughout the day.

To avoid deeper cuts, state and local government officials are trying a host of strategies including borrowing money, using rainy day funds, increasing revenue by raising tax rates or creating new taxes or fees, ending tax exemptions and using federal aid as legally allowed.

Colorado was able to hold its budget to only a 3% reduction, relying largely on one-time emergency reserve funds. Delaware managed to maintain its budget and avoided layoffs largely through using money set aside in a reserve account.

Nobody knows how long the pandemic, or its economic effects, will last.

In the worst-case scenario, budget officials are prepared to make steeper cuts in the coming months if more assistance does not come from the federal government or the economy does not recover quickly enough to restore the flow of money that governments need to operate.

 

 

 

700+ Chicago nurses reach labor deal after 2-week strike

https://www.beckershospitalreview.com/hr/700-chicago-nurses-reach-labor-deal-after-2-week-strike.html?utm_medium=email

How Have Health Workers Won Improvements to Patient Care? Strikes.

More than 700 nurses who walked off the job for two weeks approved a new contract July 20 with Amita Health Saint Joseph Medical Center Joliet (Ill.), hospital and union officials confirmed to Becker’s.

The nurses are represented by the Illinois Nurses Association, and both sides had been negotiating a new contract since early spring. Nurses had worked without a contract since May 9 and went on strike July 4.

Pay and benefits have been key sticking points at the bargaining table. Additionally, the Illinois Nurses Association had claimed the hospital was not adequately addressing staffing issues.

The new contract includes agreements by the hospital to improve the staffing guidelines on certain units before Dec. 31 and to meet and confer with the union by that date to improve staffing throughout the facility, the union said in a news release. Health insurance premium contributions were also capped at 25 percent for full-time nurses and 35 percent for part-time nurses, the union said.

“While a majority of nurses voted for this contract, there are still many nurses who want to see more progress on safe staffing,” said Pat Meade, RN, one of the lead union negotiators. “We will continue the fight for safe staffing through enforcement of our contract and in Springfield.”

In an emailed statement to Becker’s, hospital spokesperson Tim Nelson said Amita Health is pleased with the agreement and called it “fair and just for all involved.”

The hospital hired temporary nurses from an outside agency to fill in during the strike.

Mr. Nelson said the hospital’s nurses will return to work July 22 for their regularly scheduled shifts.

 

 

 

 

Pandemic spurs national union activity among hospital workers

https://www.healthcaredive.com/news/coronavirus-spurs-healthcare-union-activity/581397/

Pandemic spurs national union activity among hospital workers ...

When COVID-19 cases swelled in New York and other northern states this spring, Erik Andrews, a rapid response nurse at Riverside Community Hospital in southern California, thought his hospital should have enough time to prepare for the worst.

Instead, he said his hospital faced staffing cuts and a lack of adequate personal protective equipment that led around 600 of its nurses to strike for 10 days starting in late June, just before negotiating a new contract with the hospital and its owner, Nashville-based HCA Healthcare.

“To feel like you were just put out there on the front lines with as minimal support necessary was incredibly disheartening,” Andrews said. Two employees at RCH have died from COVID-19, according to SEIU Local 121RN, the union representing them.

A spokesperson for HCA told Healthcare Dive the “strike has very little to do with the best interest of their members and everything to do with contract negotiations.”

Across the country, the pandemic is exacerbating labor tensions with nurses and other healthcare workers, leading to a string of disputes around what health systems are doing to keep front-line staff safe. The workers’ main concerns are adequate staffing and PPE. Ongoing or upcoming contract negotiations could boost their leverage.

But many of the systems that employ these workers are themselves stressed in a number of ways, above all financially, after months of delayed elective procedures and depleted volumes. Many have instituted furloughs and layoffs or other workforce reduction measures.

Striking a balance between doing union action at hospitals and continuing care for patients could be an ongoing challenge, Patricia Campos-Medina, co-director of New York State AFL-CIO/Cornell Union Leadership Institute.

“The nurses association has been very active since the beginning of the crisis, demanding PPE and doing internal activities in their hospitals demanding proper procedures,” Campos-Medina said. “They are front-line workers, so they have to be thoughtful in how they continue to provide care but also protect themselves and their patients.”

At Prime Healthcare’s Encino Hospital Medical Center, just outside Los Angeles, medical staff voted to unionize July 5, a week after the hospital laid off about half of its staff, including its entire clinical lab team, according to SEIU Local 121RN, which now represents those workers.

One of the first things the newly formed union will fight is “the unjust layoffs of their colleagues,” it said in a statement.

A Prime Healthcare spokesperson told Healthcare Dive 25 positions were cut. “These Encino positions were not part of front-line care and involved departments such as HR, food services, and lab services,” the system said.

Hospital service workers elsewhere who already have bargaining rights are also bringing attention to what they deem as staffing and safety issues.

In Chicago, workers at Loretto Hospital voted to authorize a strike Thursday. Those workers include patient care technicians, emergency room technicians, mental health staff and dietary and housekeeping staff, according to SEIU Healthcare Illinois, the union that represents them. They’ve been bargaining with hospital management for a new contract since December and plan to go on strike July 20.

Loretto Hospital is a safety-net facility, catering primarily to “Black and Brown West Side communities plagued with disproportionate numbers of COVID illnesses and deaths in recent months,” the union said.

The “Strike For Black Lives” is in response to “management’s failure to bargain in good faith on critical issues impacting the safety and well-being of both workers and patients — including poverty level wages and short staffing,” according to the union.

A Loretto spokesperson told Healthcare Dive the system is hopeful that continuing negotiations will bring an agreement, though it’s “planning as if a strike is eminent and considering the best options to continue to provide healthcare services to our community.”

Meanwhile in Joliet, Illinois, more than 700 nurses at Amita St. Joseph Medical Center went on strike July 4.

The Illinois Nurses Association which represents Amita nurses, cited ongoing concerns about staff and patient safety during the pandemic, namely adequate PPE, nurse-to-patient ratios and sick pay, they want addressed in the next contract. They are currently bargaining for a new one, and said negotiations stalled. The duration of the strike is still unclear.

However, a hospital spokesperson told Healthcare Dive, “Negotiations have been ongoing with proposals and counter proposals exchanged.”

The hospital’s most recent proposal “was not accepted, but negotiations will continue,” the system said.

INA is also upset with Amita’s recruitment of out-of-state nurses to replace striking ones during the COVID-19 pandemic.

It sent a letter to the Illinois Department of Financial and Professional Regulation, asserting the hospital used “emergency permits that are intended only for responding to the pandemic for purposes of aiding the hospital in a labor dispute.”

 

 

 

 

HCA nurses issue 10-day strike notice at California hospital

https://www.healthcaredive.com/news/hca-nurses-issue-10-day-strike-notice-at-california-hospital/580359/

UPDATE: June 23, 2020: Riverside Community Hospital on Tuesday told Healthcare Dive the motivation behind the union’s strike notice “has very little to do with the best interest of their members and everything to do with contract negotiations.” The system said it has plans to ensure appropriate staffing and continued services for any type of event, including a strike.

Dive Brief:

  • Nurses at HCA Healthcare’s Riverside Community Hospital in south-central California issued a 10-day strike notice last week, citing a breakdown in discussions over safety and staffing, the union representing them said Monday.
  • The nurses plan to strike from Friday, June 26 through July 6, prior to starting contract negotiations with HCA on July 7.  The union plans to push for better staffing and safety measures, particularly hospital preparedness during states of emergency.
  • Neither HCA nor Riverside were available for comment, but the hospital told Becker’s Hospital Review it had hoped the union “would not resort to these tactics” during the COVID-19 pandemic and said it had not laid off or furloughed any employees due to the crisis.

Dive Insight:

The strike notice follows a recent job posting from the nation’s biggest for-profit chain seeking qualified nurses in the Los Angeles area in the event of a job action or work stoppage.

Nurses at Riverside Community Hospital pushed for an improved staffing agreement last year and got it — but the hospital recently ended that agreement, resulting in fewer RNs taking care of more patients amid a pandemic, according to the union.

Insufficient personal protective equipment, inadequate safety measures and recycling of single-use PPE is also putting nurses at increased risk of COVID-19 infection, the union alleges.

Scores of RNs at the hospital have fallen ill with COVID-19, according to a release, including deaths of an environmental services worker and a lab technician, that “have not caused RCH to improve staffing or increase PPE.”

PPE shortages have been a problem at all of the 27 hospitals SEIU Local 121 RN represents, the union says. But a member survey found HCA hospitals were particularly unprepared for shortages. Only 27% of local 121 RN members at HCA hospitals reported having access to N95 respirators in their unit, significantly lower than other hospitals surveyed, according to the union.

Nashville-based HCA has received the most among for-profits in Coronavirus Aid, Relief, and Economic Security Act funding so far, about $1 billion. The amount is about 2% of HCA’s total 2019 revenue.

The 184-hospital system said it has not had to furlough employees like other systems have, though some employees have been redeployed or seen their hours and pay decrease. HCA implemented a program providing seven weeks paid time off at 70% of base pay that was scheduled to expire May 16, but has been extended through this week.

A spokesperson with the country’s largest nurses union, National Nurses United, told Healthcare Dive the program isn’t technically a furlough because some HCA nurses participating said they must remain on call or work rotating shifts.

NNU has also recently fought with HCA over other pandemic-related labor issues. Nurses at 15 HCA hospitals protested in late May over contractually bargained wage increases the hospital says it can’t deliver due to financial strains, asking nurses to give up the increases or face layoffs.

Another dispute involves a last-minute change mandating in-person voting for nurses deciding whether to form a union at HCA’s Mission Hospital in Asheville, North Carolina, according to an NNU release.

SEIU Local 121 RN said HCA can “easily weather this storm financially, continue to provide profits for their shareholders, while at the same time support and protect nurses as they fight this disease and fight to save their community.”