When Nurses Rejected the Plan, Tenet Issued Threat to Proceed with Mandatory Furloughs and Staff Cuts
Tenet’s Dangerous Directive Issued Just Days After the State Announced $800 million in Funding for Hospitals and Tenet Boasts of Reaping Millions from the Federal Stimulus Package to Boost its Bottom Line
WORCESTER, Mass. – This week, when state officials predict the onset of a surge in COVID-19 patients that threatens to overwhelm our state’s hospitals, nurses at for-profit, Tenet Healthcare-owned St. Vincent Hospital in Worcester are calling out Tenet for its recently announced decision to reduce desperately needed staff to respond to the pandemic.
The decision comes as nurses represented by the Massachusetts Nurses Association (MNA) and other staff at St. Vincent Hospital have been working to care for a significant number of COVID-19 patients at the hospital, and Massachusetts has the sixth highest population of COVID-19 patients in the nation.
It follows an announcement by Gov. Charlie Baker last week that the Massachusetts healthcare industry will have access to more than $800 million in state and federal funding. Tenet’s corporate leaders in Dallas have also touted their plan to use furloughs and hundreds of millions of taxpayer dollars from the federal stimulus package to “to ensure we were focused on maximizing our cash position” – not to improve care for patients. Tenet reported this month that it had $500 million “cash in hand” and access to a $1 billion line of credit, according to the Dallas Morning News.
“This is no time to be sending staff home, when our patients and our community needs us more than ever before,” said Marlena Pellegrino, RN, a medical surgical nurse at the hospital and co-chair of the nurses local bargaining unit of the MNA. “Tenet is putting its concern for the bottom line over the safety of our patients, and we will not be silent when lives are at stake. Our staff have been proudly and courageously coming to work every day, often without the proper protective equipment, because this is our obligation and our community. It is time for Tenet to stand up and make the same commitment.”
As Tenet decides to cut staff, across the street from St. Vincent Hospital the state and the City of Worcester have transformed the DCU Center into a makeshift hospital to respond to the surge. The cuts are also happening while the state has:
- Issued an order allowing the recruitment of retired health workers to be called into active service.
- Issued an order allowing senior nursing students, who haven’t completed their education, to provide care in this emergency.
Last week, the MNA wrote to the governor and the legislature opposing any efforts by healthcare providers to cancel, furlough or layoff staff as the surge approaches and in light of the financial windfall they have just received.
In response to Tenet’s decision, the nurses and the MNA have begun reaching out to Congressman James McGovern, Senator Elizabeth Warren and Senator Edward Markey, who worked tirelessly on the federal legislation to secure funding for the state’s hospitals, as well as the Worcester legislative delegation and the Worcester City Council to alert them about this callous and dangerous decision and its impact on the residents of Central Mass.
“As nurses we have an obligation to advocate for our patients, no matter what, and we intend to do everything we can to ensure we have the resources we need to provide the care you need,” said Dominique Muldoon, RN, co-chair of the nurses bargaining unit and nurse on one of the hospital’s seven COVID-19 units. “Every day, we are putting our lives, and the lives of our families on the line to provide the best care possible. We need all the help we can get, and this decision cuts our legs right out from under us. It is our patients, scared and struggling for breath, who may pay the ultimate price.”
Timeline of Tenet Plan to Force Furloughs and Staffing Cuts in Face of Pandemic Surge
From the onset of the pandemic, nurses at St. Vincent Hospital have been trying to work with Tenet management to ensure the best care for patients, including:
- Securing much-needed personal protective equipment.
- Establishing safe protocols for the handling of patients.
- Safe redeployment of nurses to respond to the pandemic surge. This included an effort by the MNA nurses on the Post Anesthesia Care Unit (PACU) to create a plan to be trained to use the PACU as an additional source of intensive care.
- Other nurses were asking to be allowed to support their colleagues on the COVID-19 floors.
Last Friday, April 10, nurses were outraged when Tenet threatened to implement a mandatory furlough, including the right to cancel and reduce staff on a daily basis. The MNA immediately alerted local, state and federal policymakers about the plan, who then helped to convince Tenet to put the plan on hold, with the hope of convincing Tenet to rescind this dangerous plan.
The nurses and Tenet management engaged in negotiations over the weekend and through Wednesday, April 15. Some progress was made to devise a plan to allow for only voluntary furloughs, and minimal staff reductions. However, Tenet refused to provide the nurses with a protection they sought, which was to ensure that when nurses are redeployed to a different unit or floor that they did so in partnership with a nurse on that unit, which is a standard protocol accepted by other hospitals undergoing redeployment. Over several days, the nurses worked to convince Tenet to remove that provision, but Tenet refused.
On Wednesday, Tenet sent a message to the MNA saying the nurses had until 6 p.m. on Wednesday to accept their plan, and if not, Tenet sent an email to the MNA stating “the Hospital intends to implement measures… which will likely include mandatory furloughs and necessary flexing,” which is a term referring to daily staff cuts.
“Tenet management’s response to our concerns, their refusal to agree to providing nurses with widely accepted policies to keep our patients safe, and their attempt to bully us into accepting this dangerous plan is reprehensible,” Pellegrino said. “Tenet’s decision demonstrates their true intent all along, which is to cut staff to increase profits while patients could be suffering and dying waiting for our care.”
”We have made clear to management that we oppose any efforts to furlough, cancel, or otherwise remove from service any frontline staff during this crucial phase of the pandemic,” said Marie Ritacco, RN, MNA Vice President and a PACU nurses at the hospital who led the effort to have her unit serve as an alternate ICU. “Their decision to move ahead with this plan is nothing short of shameful, and a callous display of corporate greed and medical malpractice.”
Tenet Reaps Billions from CARES Act to Boost Profits, While Cutting Patients Access to Nursing Care
Tenet’s decision follows a period of unprecedented financial success at St. Vincent Hospital, with the Center for Health Information and Analysis (CHIA) reporting that the facility has posted profits in excess of $282 million between 2014 and 2018, with a total profit margin in 2018 of 14.6 percent. That is more than three times the state average of 4.5 percent and six times the regional average of hospital profit margin of 2.4 percent.
In addition to this local largesse, on April 2, an article in the Dallas Morning News, where Tenet’s corporate headquarters is located, featured statements made to the corporation’s shareholders by Tenet’s CEO and other corporate leaders explaining that the use of furloughs and funding garnered from the recently passed CARES Act stimulus package is being pursued “consciously… to ensure we were focused on maximizing our cash position.” Tenet reports having more than $500 million cash in hand, and access to a credit line of $1 billion.
In an effort to support hospitals’ loss of revenue due the cancellation of elective procedures and the costs associated with confronting the pandemic, the federal CARES Act included more than $100 billion in funding for the nation’s hospitals, through increased reimbursements, direct Medicare payments and cuts to payroll or social security payments. Instead of using this funding as intended, to allow their hospitals to maintain care and services during this crisis, Tenet is using it to boost its profit margins.
Tenet executives stated that they will access $1.5 billion in advances on its Medicare payments, one of the key provisions in the act designed to bolster hospitals’ cash flow; and it also expects to save $127 million this year from other Medicare and Medicaid changes. Tenet said it plans to tap another provision of the stimulus package to defer $250 million in Social Security payroll taxes for the rest of the year.
“It is obscene for this corporation to use our taxpayer dollars – funds specifically allocated to ensure that patients get the care they need – to instead maximize their profits while denying patients in Worcester access to nurses who are ready and willing to care for them when it matters most,” said Donna Kelly-Williams, RN and President of the MNA. “We can’t allow this organization to profit off the suffering and potential death of our residents.”
Founded in 1903, the Massachusetts Nurses Association is the largest union of registered nurses in the Commonwealth of Massachusetts. Its 23,000 members advance the nursing profession by fostering high standards of nursing practice, promoting the economic and general welfare of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Legislature and regulatory agencies on health care issues affecting nurses and the public.