Worcester Business Journal

wbjournal.com | October 15, 2018 | Worcester Business Journal 9 Don't mandate nurse staffing levels Question 1 on this November's state election ballot seeks to impose required min- imum nurse-to-patient staffing levels in hospitals. Proponents say it will improve patient care while opponents – largely hospitals and healthcare companies – say the addition of new standards would cause significant financial harm to healthcare facili- ties. When polled online, nearly two-thirds of WBJ readers opposed the initiative. F L AS H P O L L "The quality of care in Massachusetts is superior to the care delivered in California where ratios are currently mandated." Should Massachusetts have required nurse- to-patient ratios? "Quite dismayed that this question is on the ballot. Implies that nurses are the only care providers in a hospital setting. Ignores the importance of the multi- disciplinary teams that we have worked so hard to build. Ignores that fact that most nurses have been trained to highly professional levels and not longer do the type of bedside care of 25 years ago." "There needs to be a balance but far too often nurses are assigned too many patients to handle with the proper amount of attention and their energy level. Tolerance and quality of care suffers, leaving the patient to pay the price." Yes. Nurses should not be overburdened with patients. 14% No. Adding more nurses would unnecessarily increase costs in an already high-cost healthcare system 28% Member FDIC | Member DIF APY rates guaranteed through 1/31/19. All accounts will be converted to a Money Market Account on 2/1/19. A minimum deposit of $10,000 in new money is required to open this account. Rate may change after the account is opened. Fees could reduce earnings on the account. Only one account per social security number or EIN number. Daily Balances Of: $0.01 – 9,999.99 $10,000 – 49,999.99 $50,000 – 4,999,999.99 $5,000,000+ *Annual Percentage Yield 0.10% APY 1.75% APY 2.00% APY 1.75% APY Interest Rate 0.10% 1.74% 1.98% 1.74% BEST RATES AROUND. *$50,000 MIN BALANCE TO EARN THE APY 2.00% APY * Open an account now at countrybank.com/earn-up-money-market Question 1 could require UMass to cut unprofitable programs benefiting low- er-income patients or close money-los- ing HealthAlliance-Clinton Hospital. "is is the biggest threat to health care, and certainly to our system, in well over a decade," Brown said. "It would truly be devastating." At Worcester's UMass Memorial Hos- pital, close to 300 nurses are projected to be needed to meet the new standards. Brown said hiring that many nurses, when positions are already unfilled, would be hard, especially if salaries rise to match the flood of new positions. "e problem is, these nurses aren't available," Brown said. Proponents of the ballot question, on the other hand, say cost estimates are exaggerated. One study cited by the Committee to Ensure Safe Patient Care, which is campaigning for the new staffing standards, pegged additional hospital costs at less than $47 million across the state, a fraction of what oppo- nents have said. Flagg doubted hospitals couldn't absorb the costs, and nurses weren't allowed to take part in the hospital's cost analysis, even aer they asked. Flagg wasn't sure what to predict for Nov. 6. "e hospitals are fearing it'll pass, and I'm fearing it's not going to pass," she said. Proponents include U.S. senators Ed- ward Markey and Elizabeth Warren and U.S. Rep. Jim McGovern of Worcester. HPC: High cost, little benefit e state's Health Policy Commission released a nonpartisan report on the is- sue Oct. 3, estimating costs for hospitals and other facilities would rise by up to $949 million a year. e commission said new standards would force hospitals to increase staffing by 2,286 to 3,101 additional full-time equivalent registered nurses. Communi- ty hospitals serving higher proportions of MassHealth and Medicare patients would be affected the most. Savings would be realized through reduced hospital stays, the commission said. But those possible savings, roughly $34 million to $47 million, would be far more than offset by higher costs. An estimated $676 million to $949 million in additional annual costs are likely con- servative, the commission said, because of a lack of detailed staffing data for some units, including emergency and outpatient departments. Only California has mandated staffing ratios like what is proposed for Massachusetts. Implementation in Cal- ifornia was done in stages over several years, the Health Policy Commission said, while in Massachusetts, they would go into effect quickly, by the start of 2019. California standards are less strict. e commission said no systematic improvement in patient care was found in California aer the standards went into effect. Public opinion seems to have shied aer the state's report. A UMass Lowell poll released Oct. 10 found 51 percent of likely voters oppose the mandate, and 43 percent support. at's compared to a September poll finding 52 percent in support. Another poll, by WBUR in Septem- ber, found 44 percent both for and against the staffing question. More staff, narrow margins e financial question is an import- ant one for hospitals always fighting rising costs. MetroWest Medical Center, Nasho- ba Valley Medical Center in Ayer and HealthAlliance-Clinton Hospital each ran financial losses in the 2017 bud- get year, while Emerson Hospital in Concord and UMass Memorial Medical Center in Worcester both had profit margins of under 2 percent. Four Central Massachusetts hospitals had profit margins of 6 percent or more: Athol Memorial Hospital, Harrington Memorial Hospital in Southbridge, Marlborough Hospital and Saint Vin- cent Hospital in Worcester. If the question passes, standards would vary by specialty. In the emer- gency department, a nurse would be in charge of just one critical patient at a time, or two patients if the nurse has as- sessed each patient's condition as stable. A nurse could have up to five patients if they are deemed non-urgent stable. So far, financial support has largely gone to those looking to strike down the ballot question, according to the Massachusetts Office of Campaign & Political Finance. e Coalition to Protect Patient Safety, which was organized with an aim of defeating the staffing requirement, reported roughly $10.5 million in do- nations through mid-September, along with $9.2 million in spending, largely on advertising, consulting and polling. Nearly all of the donations have come from the advocacy group Massachusetts Health & Hospital Association, which claims 70 member hospitals. e Committee to Ensure Safe Patient Care has received $5.7 million in dona- tions in support of Question 1. Nearly all came from the Massachusetts Nurses Association, with 23,000 members at 85 healthcare facilities. Yes. Hospitals should first look to provide quality patient care before looking to save money on personnel. 21% No. Hospitals can be trusted to provide the staffing levels needed for quality patient care. 37% COMMENTS: W

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