D.C. Hospitals And Nurses Fight Over Staffing Ratios

Nurses Union

Published

D.C. Hospitals And Nurses Fight Over Staffing Ratios - Kaiser Health

By David Schultz

Feb 22, 2013

Hospital administrators in Washington, D.C., are furiously lobbying against a bill modeled on a California law that would require them to maintain a minimum nurse-to-patient ratio at all times.

Nursing unions say the proposed Patient Protection Act codifies into law minimum staffing levels that are needed to maintain patient safety, while hospitals say the cost of hiring new nurses to comply with the law would put them out of business.

The ratios called for in the bill vary depending on the hospital department. In a pediatrics unit, the bill would require no less than a 1-to-4 nurse-to-patient ratio. In the operating room, hospitals would have to maintain a 1-to-1 ratio -- one nurse for every patient at all times.

Deidre Beckford, a nurse at MedStar Washington Hospital Center who has worked there for more than 20 years, says understaffing has forced her to take care of five to six patients at a time. ...

The nursing bill in D.C. would reduce some of this fluctuation. It's modeled after a nearly identical law that took effect in 2004 in California, the only state to require minimum staffing ratios in its hospitals. So far, it's unclear whether this requirement has had a positive or negative effect in California hospitals.

Studies have shown that the law has led to an increase in nurse hiring in California and a decrease in nurse turnover due to burnout. But researchers also found that the law put significant financial pressure on some hospitals. ...

The hospital is owned by Med Star. Their net assets for 2008 were $235,090,744.00.

Washington Hospital Center Corporation in Washington, District of Columbia (DC) - faqs.org

2009 there was an article on area non profit CEO compensation:

How disgusting. At the risk of sounding very cliché, how do they sleep at night?

SleepyRN, and Herring_RN, what does that number mean to you?

I personally have no context to determine if that is a healthy asset margin or not. I do know that hospitals barely stay afloat on 1-3% profits a year.

And I really hope their net assets aren't calculated WITH non-investment assets because that would make the number seem VERY small if we take into consideration things you probably don't want to liquidate like say, CT scanners or real estate.

The hospital is owned by Med Star. Their net assets for 2008 were $235,090,744.00.

Washington Hospital Center Corporation in Washington, District of Columbia (DC) - faqs.org

2009 there was an article on area non profit CEO compensation:

Have to issue a caution here with respect to net assets. This is the total of assets less liabilities and does not reflect profit of any sort. For this, you need to look at total revenues ($1,028.6 million) less total expenses ($1,014.4 million), which gives a net profit of about $14.2 million. With this, you can determine the Return on Net Assets (RONA), which is about 6%. The historical average of the RONA for the S&P 500 companies is in the range of 10% to 15%. While the Washington Hospital Center RONA is 6% (it's actually a bit a different than this because the calculation isn't quite as simple as presented above, but this is close enough), less than the lower end of the S&P 500 corporation's range, given that this is a non-profit healthcare company, they are doing very well.

There are other more interesting elements in the balance sheet though.

We would expect that the largest asset component should be property, plant and equipment (PPE) and indeed it is, reported on this hospital's balance sheet at about $210.7 million. A much more interesting balance sheet asset is the $64.5 million of "Investments - publicly traded securities." This amount is large relative to both PPE and indeed, total assets (reported at $406.6 million). For a not-for-profit to have nearly 16% of their total assets in "publicly traded" investments plus another 2.5% in "Other assets including program-related investments" ($9.9 million) plus 6% in cash ($24.9 million) raises more red flags for me than the reported net assets figure. The total of cash and investments is nearly $100 million, roughly a quarter of this institution's total assets - a large percentage for any services institution, let alone a not-for-profit hospital corporation whose primary purpose is ostensibly health care.

Bottom line: This hospital is doing just fine (at least as of 2007, the latest year reported) and should not have trouble meeting the nursing staffing levels under consideration. Quite frankly though, both the reported executive compensation and the profit levels are relatively low compared to that at really big non-profit hospital corps, such as the Texas Medical Center, many of whose over 50 not-for-profit institutions make staggeringly large profits and pay their executive truly obscene salaries.

Specializes in Critical care, tele, Medical-Surgical.

Thank you chuckster for your informative answer.

As a nurse I care deeply about providing the best patient care possible.

Pages ten and eleven of this article lists studies that show that ratios not only save lives, but save money.

Safety in Numbers - Focus on Ratios

Interesting info in the brochure herring. It's regrettable that so many institutions reject those studies and refuse to consider realistic nurse-patient ratios.

Specializes in Critical care, tele, Medical-Surgical.
Specializes in PICU, NICU, L&D, Public Health, Hospice.

She did a good job...

I wonder if she had to answer their questions?

I wonder how many legislators were even there to listen to her?

Specializes in Critical care, tele, Medical-Surgical.

Nurses union urges D.C. Council to approve nursing ratios on international day of action

A decade after the first and only strict law on nursing ratios went into effect in California, the nation's largest nurses union on Monday again targeted D.C., hoping it can convince the 13-member D.C. Council to break a national stalemate over the issue.

National Nurses United, which represents 185,000 registered nurses nationwide, organized a rally on Pennsylvania Avenue of about 50 RNs on International Nurses Day. The group delivered to council members a list of alleged incidents of unsafe care in D.C. hospitals due to nurses being stretched thin in recent months in caring for patients....

... In D.C., a majority of Council members actually signed on in support of the measure last year, but one of those signatories-Yvette M. Alexander (D-Ward 7), chair of the health committee, has delayed the bill. Alexander said in March that she had grown sympathetic to the hospital industry's arguments against the bill: that its effects on patient safety is unproven and that increasing nurse staffing will lead to decreases in other key hospital personnel.

But nurses who spoke outside the Wilson Building on Monday morning said they believe they eventually will win over the council with the help of constituents who face poor service in D.C. hospitals...

http://www.washingtonpost.com/local/dc-politics/nurses-union-urges-dc-council-to-approve-nursing-ratios-on-international-day-of-action/2014/05/12/159afaac-d9df-11e3-8009-71de85b9c527_story.html

nursesDC_5-2014_zps26883049.jpg

Aaron D. Davis/The Washington Post - On International Nurses Day, the D.C. Council was targeted by protesters seeking approval for a bill to force mandatory staffing ratios for nurses and patients at D.C. hospitals.

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