If hospitals are no longer having to spend huge amounts covering charity care and bad debt write-offs, will they be seen as a potentially big source of revenue not only for the feds but for state governments as well? +
You won't often overhear a hospital marketer loudly proclaim at a dinner party that their organization is trying to attract more insured patients. But high-value patients keep hospitals in business and enable them to care for the poor and uninsured. +
As good as 2008 was for organized labor, union leaders believe 2009 will be even better.
Monica Russo, president of the 15,000-member SEIU Healthcare Florida, says union membership will grow "a whole lot" this year with the expected passage in Democratically-controlled Congress of the Employee Free Choice Act.
EFCA, aka "card check," is seen by supporters and opponents as one of the most important pieces of pro-labor legislation in decades. "The biggest outcome of the EFCA is healthcare workers being able to more-freely join unions so we can improve the healthcare system," Russo tells HealthLeaders Media.
She says healthcare workers are flocking to unions because they're anxious about the economy and job security, but even more so because they want a greater role in delivering quality healthcare. "Economics is a huge piece of it, but I cannot overemphasize the importance in having a voice in the care they provide. That is a huge. This is a calling," Russo says.
EFCA could add an additional 5 million workers to the 16.1 million workers now unionized, who represent about 12.4% of the workforce.
The card check provision all but eliminates secret ballot elections and instead allows for union recognition when a majority of employees in the bargaining unit sign an authorization card. EFCA also calls for mandatory binding arbitration if a contract isn't finalized within 120 days of forming a union. The bill also raises fines against businesses and employers that are found guilty of union-busting tactics. EFCA is expected to breeze through the heavily Democratic House, but could get bogged down in negotiations with Senate Republicans.
Even without EFCA, organized labor is on the upswing. The Bureau of Labor Statistics reports that union membership grew by 428,000 workers in 2008, even as the overall economy shed about 2.9 million jobs. An additional 1.2 million jobs were lost in the first two months of 2009.
Most impressively, National Labor Relations Board data show that healthcare unions won 75% of certification elections in 2008. That victory rate is even higher for sophisticated and well-funded unions like Service Employees International Union and California Nurses Association/National Nurses Organizing Committee, which won more than 80% of the elections they entered in 2008. SEIU accounted for 44% of all certifying petitions filed in 2008.
Jim Trivisonno, president of Detroit-based IRI Consultants to Management, Inc., says organized labor's gains in 2008 mark the first time in 20 years that union membership gained ground as a percentage of the total workforce.
He says healthcare unions focus on three areas: management treatment, or what the union calls dignity and respect; employee engagement and involvement in the decisions that affect their jobs; and communication, or lack thereof. "People rarely organize over wages and benefits," Trivisonno says. "A nurse can go across the street or across town and get the same deal. It's that people don't understand their wages and benefits and there is more of a communication issue than there is a pay issue."
With membership growing and so much at stake, healthcare unions are for the most part resolving turf wars and collaborating. On March 19, SEIU and CAN/NNOC, announced joint efforts to organize hospital workers across the nation, with CNA/NNOC as the "leading voice" for RNs, and SEIU concentrating on all other hospital workers.
The organizing campaign will target the nation's largest hospital systems. The two unions also pledged to stop "raiding" from one another's existing membership. "This agreement provides a huge spark for the emergence of a more powerful, unified national movement that is needed to more effectively challenge healthcare industry layoffs and attacks on RN economic and professional standards and patient care conditions," CAN/NNOC President Rose Ann DeMoro says.
In February, the 85,000-member CAN/NNOC announced a merger with the United American Nurses and the Massachusetts Nurses Union that when finalized will form the nation's largest RNs union, with 150,000 members.
Trivisonno says the collaborations should be as "equally worrisome" to healthcare organizations as EFCA. "As good as SEIU is, CAN/NNOC is almost better. For them to collaborate with a common cause in a single industry is a great concern, Trivisonno says. "What they've realized is that there is a bigger prize out there in EFCA, and they have to put their differences aside. That is huge."
What's the best way to fight a union effort?
The key, Trivisonno says, is for hospital management to acknowledge that labor is making a concerted and aggressive push into healthcare. Understand the threat to your hospital and get ready to push back by providing employees with alternatives that address their concerns. Smart managers are speaking with staff, making the management's case against unions, listening to employee grievances and addressing those grievances before they're exploited by union organizers. "Oftentimes healthcare organizations are a little reluctant to react because they feel they are going to push forward the union's message.
Nothing could be farther from the truth, Trivisonno says. "Stating your position on labor unions before an organizing attempt occurs, and particularly once you see the first signs of organization is essential so that people understand what your position is."
John Commins is the human resources and community and rural hospitals editor with HealthLeaders Media. He can be reached at jcommins@healthleadersmedia.com.
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Whidbey General Hospital is moving forward with its search for a new hospital CEO. The hospital board of commissioners has selected Korn Ferry International to aid in the search for a CEO instead of KL Kingsley, a smaller firm based in Walnut Creek, CA. Only four people applied for the CEO position at Whidbey General, prompting the commissioners to expand their search into a nationwide recruitment effort.
Molina Healthcare, Inc. has named Joanne Volovar president of its health plan subsidiary, Molina Healthcare of Missouri. Volovar will be responsible for Missouri health plan operations, as well as the implementation and execution of various strategic initiatives. Molina Healthcare of Missouri has approximately 77,000 members enrolled in its health plan.
William J. Schuler, President and CEO of Portsmouth Regional Hospital, has announced his plan to retire on June 30. Schuler has been with the hospital for 25 years and an administrator with HCA for 30 years.
The Schneider Regional Medical Center board chose an executive search firm to help select a new chief executive officer and adopted a Fiscal Year 2009 budget. The board's executive search committee recommended Tyler & Company, an Atlanta-based executive search firm that specializes in the healthcare industry, to help them select the right candidate for the Schneider Regional CEO position. The hospital has been without a permanent CEO since August, when the territorial hospital board placed CEO Amos Carty Jr. on paid administrative leave and named Elizabeth Harris, who had been vice president of quality and performance improvement, interim CEO. On Sept. 5, the territorial board fired Carty.
The New Jersey Hospital Association has named Ronald C. Rak, CEO/president of Saint Peter's Healthcare System, as a member of its 2009 Board of Trustees. Comprised of 107 member hospitals, the Princeton-based NJHA is a statewide advocate for its members and the patients they serve. The installation of the 2009 NJHA board was held during the organization's 90th annual meeting. Rak was named president and chief executive officer of Saint Peter's Healthcare System in October 2007.
Harris M. Nagler, MD, chairman of the Sol and Margaret Berger Department of Urology at Beth Israel Medical Center since 1989, has been appointed interim president of the Medical Center. Nagler succeeds David J. Shulkin, MD, who is stepping down from the post, and a transition in leadership is immediately under way.
Fabrizio Michelassi, MD, the Lewis Atterbury Stimson professor and chairman of the Department of Surgery at Weill Cornell Medical College and surgeon-in-chief at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, is the newly elected president of the Society of Surgical Oncology.
Dogs and cats cause more than 86,000 falls requiring emergency room care each year, according to a report from the Centers for Disease Control and Prevention. That translates into about 240 people who are treated for injuries caused by pets every single day in the United States, the study found.
