National Nurses United

National Nurse magazine June 2014

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allegations made in the Tenet lawsuit were also advanced in subse- quent shareholder lawsuits against CHS, which remain in litigation. Likewise, the HMA chain CHS just purchased in January is also under scrutiny by the feds for similar allegations, as well as facing shareholder lawsuits and a securities investigation. Critics like to point out that HMA's former CEO, Gary Newsome, was hired from CHS. Essentially, CHS and HMA are accused of pressuring emergency room physicians to admit Medicare patients who didn't really need to be admitted into the hospital. A 60 Minutes report titled "The Cost of Admission," which aired in December 2012, revealed that HMA set quotas for admissions and hinted that physicians who did- n't meet them were at risk of losing their jobs. In January 2014, the Justice Department announced that it was joining eight different whistle-blower lawsuits against HMA in six states, according to a Jan. 23, 2014 New York Times article. Though CHS has put aside $101.5 million to settle these federal cases, according to its SEC 10-K filing, it also revealed in a Feb. 26, 2014 SEC filing that it is unable to estimate the extent of its liability due to the HMA investigation and that there may be additional law- suits against CHS hospitals. These allegations seem to jibe with what CHS nurses have observed anecdotally. Nurses have heard stories from friends or family members about questionable admissions, and Wilson, the RN at Affinity Medical Center, said that her hospital gets a lot of what she calls "nonsense admissions." "The ER docs insist that the hospitalists admit patients at night, and then the hospitalists come around at 8 or 9 a.m. and discharge them," said Wilson. "If you're getting admitted at 9:30 at night, well, that means the patient probably could have just gone home." F ed up with what was happening to their community hospitals, the risk that understaffing and lack of equipment was posing to their patients, and the disrespect CHS displayed toward nurses, RNs have started a wave of unionizing within CHS. RNs at Fallbrook and at Barstow Community Hospital in California voted to join in May 2012. Affinity, Bluefield Regional, and Greenbrier Valley Medical Center in Ronceverte, W.V. won their elections in August 2012. After including Watsonville Community Hospital in Watsonville, Calif., which has been unionized for years, CHS nurses are becoming a growing contingent within NNU. It's been a tough fight for CHS nurses so far, but they are perse- vering. In addition to heavy union-busting by management during their election campaigns, the RNs have continued to face harass- ment, intimidation, and firings of union supporters in their quest to win first contracts. At some of the facilities, management pretends that the RNs don't have a union or simply won't sit down to bargain. After a group of CHS RNs traveled to shareholder meetings in Flori- da and New York to publicly speak against the buyout of HMA by CHS, CHS fired two of them, 30-year RN Tim Thomas, from Watsonville Community Hospital, and RN Veronica Poss, from Fallbrook Commu- nity Hospital. CHS did the same thing in 2012 to Ann Wayt, a 24-year Affinity RN beloved and respected by the community, in retaliation for her union activity. But a federal judge in January ordered CHS to fully reinstate her, retract any reports it made to the Ohio Board of Nursing, and to cease and desist from union-busting behavior. Thomas and Poss hope to, like Wayt, eventually win their jobs back. CHS' actions, howev- er, show how far it is willing to flout the law; the firings of Thomas and Poss came just one week after CHS was ordered to reinstate Wayt. In 2013 and 2014, NNU won three injunctions against CHS ordering it to bargain in good faith and reinstate RNs who were ille- gally fired for union activity. In April, nurses won an unusual National Labor Relations Board decision and order directing Fall- brook Hospital to pay the union costs of failing to bargain in good faith for a six-month period. In May, RN leaders from all NNU-represented CHS facilities met for the first time to share stories, check in on bargaining progress, and strategize about how to apply more public pressure to the cor- poration to improve patient care and win first contracts. On May 19, union representatives wrote to the Securities and Exchange Commission to alert them that CHS did not accurately disclose the state of its labor relations with employees. In its most recent Form 10-K filing with the SEC for the year ending Dec. 31, 2013, CHS wrote, "We currently believe that our labor relations are good." The letter counters, "It is false to characterize the labor rela- tions at CHS as 'good.' In fact, labor relations at CHS may be worse than at any other healthcare system in the United States." It goes on to detail many of the labor rights violations CHS has committed and for which it has been disciplined, as well as to discuss how the cost of poor relationships with employees may affect shareholders, since CHS made a relatively low profit margin of about 1.09 percent on its 2013 annual revenues of about $13 billion. The cost of a single strike could have a significant impact on CHS' profits. "The labor relations policies that CHS has chosen to pursue clearly have material finan- cial risks for the company," reads the letter. "We urge [the SEC] to analyze the omissions and misleading statements." As another example of CHS' censorship of RNs, billboards criti- cizing CHS for its excessive pricing practices that NNU placed this May in Knoxville, Tenn. and Biloxi, Miss. were removed after hospi- tal representatives complained to the billboard company. Many of the RNs subjected to CHS' business practices said they question the very idea of running a hospital for profit. "A hospital should be for the health of the community," said Poss. "There shouldn't be profit in it. This idea that the less care we give you, the more goes in my pocket? That's not right. We're not trying to sell people cars, furniture, or clothing. This is our health." Lucia Hwang is editor of National Nurse. J U N E 2 0 1 4 W W W . N A T I O N A L N U R S E S U N I T E D . O R G N A T I O N A L N U R S E 15 Got your own stories about Community Health Systems? We know there are many more stories about CHS' bad behavior out there. Please consider sharing what you know to help CHS nurses win the ability to provide safe care to their patients and contract protections for them- selves. To report a story, please visit the website and click on the big eye on the right side of the page. On that website, you can also find additional information about CHS and links to many of the original documents and lawsuits cited in this article. "A hospital should be for the health of the community. There shouldn't be profit in it. This idea that the less care we give you, the more goes in my pocket? That's not right. We're not trying to sell people cars, furniture, or clothing. This is our health."

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