Literature Review

31 positions eliminated as St. Mary’s lays off employees, cuts hours for some amid financial woesPortland (ME) Press HeraldDecember 12, 2023Lewiston, ME—St. Mary’s Healthcare System laid off at least 31 employees effective Monday, according to St. Mary’s news release. ... The decision comes as the hospital system has sustained operating losses over the last five years, according to the press release. 

Nurses’ union renews push for safe staffing levels in Maine hospitalsMaine BeaconDecember 12, 2023The Maine State Nurses Association, the state’s largest nursing union, has renewed its legislative campaign in support of a bill to address unsafe staffing levels at Maine hospitals. The Maine Quality Care Act, a bill sponsored by Sen. Stacy Brenner (D-Cumberland) that would establish minimum staffing requirements based on patient needs, will be one of the top labor proposals that lawmakers will consider when a new legislative session begins early next year. 

University of Kansas deal with Missouri hospital feels ‘terribly wrong’ to lawmakersMissouri IndependentDecember 11, 2023The proposed takeover of Liberty Hospital in Missouri by the University of Kansas Health System is being greeted with scorn by lawmakers from both sides of the state line and both political parties. Leading the charge against the takeover in Missouri is Kansas City Democratic state Sen. Greg Razer, who said the idea of KU owning a hospital in suburban Missouri is “terribly wrong.” “There are boundaries for a reason, and they’ve crossed one,” said Razer, a graduate of the University of Missouri-Columbia. 

Operating in the redPuget Sound Business Journal (Seattle, WA)December 10, 2023... Across Washington, health systems representing 93% of the state’s beds have incurred more than $750 million in operational losses in the first half of 2023, according to data from the Washington State Hospital Association. ... Those losses were much steeper in 2022, but a majority of Washington hospitals are still operating at a deficit, burning through cash reserves to keep their doors open. Statewide, 17 hospitals have less than three months of operating costs in their reserves, per WSHA. ... “Folks have probably heard the term ‘no margin, no mission.’ So, no matter how foundational your mission statement is, if you don’t have the finances to run the organization, then there really can’t be a mission for you,” [EvergreenHealth Chief Medical and Quality Officer Dr. Ettorre] Palazzo said. ... As hospitals look for ways to stave off financial losses, they’re faced with another crisis—a population that is demonstrably sicker than it was prior to Covid 19. That’s leading to high hospital censuses and clogged emergency departments, further stressing hospital systems, employee well-being and financial viability.

Kansas’ unrivaled rural hospital crisis—58% at risk of closing, 82% lost money on patient careKansas ReflectorDecember 12, 2023Topeka, KS—Financial weaknesses at four of every five rural Kansas hospitals provide leverage to Medicaid expansion advocates who are eager for the infusion of $680 million annually in new government investment into the state’s health care system. The Center for Healthcare Quality and Payment Reform says 84 of the state’s 102 rural hospitals recorded financial losses on patient services in the most recent year data is available. The health policy organization reports 59 of the state’s rural hospitals are in jeopardy of closing. Twenty-eight are at immediate risk of collapse. A health care delivery calamity has been building for years, as 10 of Kansas’ rural hospitals closed since 2005. ... “How much more evidence do we need that rural communities need our support to keep health care affordable and accessible?” said Democratic Gov. Laura Kelly. Kelly said expansion of Medicaid eligibility to about 150,000 lower-income Kansans will narrow coverage gaps and throw a lifeline to hospitals and communities. ... “We can only judge the impact of not expanding Medicaid by looking at the states around us that have,” Kelly said. ... Administrators at hospitals in Kansas are urging lawmakers to break from the 10 Southern and rural states that—so far—reject Medicaid expansion.

CT hospitals need nurse-to-patient ratios. Legislators should mandate themBy Kristin Henry, RNCT MirrorDecember 9, 2023As a registered nurse in Connecticut—one who graduated in 2019 shortly before the COVID-19 pandemic made its boisterous presence—I have seen firsthand the detrimental effects that inadequate staffing and unsafe nurse-to-patient ratios can have on the health of your loved ones. ... Appropriate nursing staff not only would achieve clinical and economic improvements in patient care, it would decrease nurse fatigue and burnout. ... Unsafe nurse-to-patient ratios have been statistically shown to increase patient mortality. ... Gov. Ned Lamont signed a bill into law effective October 1 of this year. Under Public Act 23-204, CT hospitals must create a dedicated staffing committee to develop nurse staffing plans. Hospitals that fail to comply can face penalties. This bill is a small step in a very long staircase. Nowhere in this bill does it mention mandating specific staffing ratios. Until nurses and patients are protected from unsafe situations by the state, the battle is not over.

Hospitals Think Some Dead Patients Are AliveBloombergDecember 7, 2023Neil Wenger, a professor of medicine at UCLA, was researching different ways of encouraging patients to make end-of-life care plans when he discovered something troubling—hundreds of patients who were seriously ill, according to the health system’s records, were actually dead. This is a well-known but little-studied phenomenon, according to Wenger—until now. Wenger and his colleagues wrote up their findings in a short paper that was published Monday in JAMA Internal Medicine. They identified 676 patients from UCLA’s health system that were recorded as alive, but were actually dead, according to state data. At face value, it sounds absurd. But there are many reasons why it might happen, Wenger says. While patients who die in the hospital are automatically recorded as deceased in that system’s database, patients who die at home are not. Same goes for patients who die at another health system with a different electronic records database. “The health system continues to act as if they’re alive,” Wenger says. “If we don’t know they’re dead, we can’t do the right thing.” ... “We think this is a really important finding that needs to be corrected,” Wenger says.

Ascension nurses begin strikesBecker’s Hospital ReviewDecember 7, 2023Nurses at three Ascension hospitals in Texas and Kansas began one-day strikes Dec. 6, marking the second strikes for each hospital this year. The strikes involve members of the National Nurses Organizing Committee, an affiliate of National Nurses United. ... Union members have been in contract negotiations at the two Wichita hospitals since February 2023 and at the 391-bed Austin hospital since November 2022. They are striking to call attention to equipment and staffing issues at their organizations, according to NNU. ... “Patient safety is our top priority, and our hospitals remain open and well-prepared to continue to provide patient-centered, holistic care during these strikes,” an Ascension spokesperson told Becker’s on Dec. 6.

Tower Health laid off 30 people on TuesdayPhiladelphia InquirerDecember 6, 2023Tower Health laid off 30 people on Tuesday, citing efforts to streamline operations at the nonprofit health system based in Berks County. Not included in that total were an unspecified number of people in Tower’s information technology department, whose jobs were moved to an outside vendor. “Although Tower Health’s financial position has improved, we still face challenges and are working hard collectively as an organization to improve performance,” Tower said in a statement. 

The Center to Advance Palliative Care Celebrates 20th Anniversary of its Palliative Care Leadership CentersNews ReleaseDecember 5, 2023New York, NY—Since 2000, the percentage of hospitals (with 50 or more beds) with a palliative care program has more than tripled, from 25% to more than 83%. Additionally, palliative care has expanded beyond the hospital into community settings such as long-term care facilities, nursing homes, office practices, and patient homes. This expansion and growth has been fueled by the Center to Advance Palliative Care’s Palliative Care Leadership Centers first launched in 2003 with funding from the Robert Wood Johnson Foundation. ... Over the past 20 years, more than 1,300 palliative care teams have trained with a PCLC. And, 80% of them went on to institute palliative care services within two years. Today, there are eight Palliative Care Leadership Centers, including:

After strike, Everett nurses, Providence agree on tentative contractEverett (WA) HeraldDecember 5, 2023Everett, WA—Providence Regional Medical Center Everett reached a tentative contract agreement with more than 1,300 union nurses, the hospital announced Monday. The agreement—reached Friday night—comes after nearly nine months of talks and a five-day strike in November. Nurses walked out Nov. 14 to protest understaffing, the main sticking point between both sides. ... If the new agreement stands, nurses will have a contract that includes most of the terms they have asked for. The nurses’ union, United Food and Commercial Workers 3000, declared victory in a message to nurses Saturday. 

Northwell’s operating income drops $104M in Q3Becker’s Hospital CFO ReportNovember 30, 2023New Hyde Park, N.Y.-based Northwell Health reported a $103.9 million drop in operating income in the third quarter, from a $92.4 million gain in the third quarter of 2022 to an $11.6 million loss in the third quarter of this year, according to financial documents published Nov. 29. Revenue increased 5.8% year over year to $4.1 billion while expenses increased 8.6% to $4.2 billion.

Medical City Healthcare buys Wise Health System, increasing D-FW footprintDallas Morning NewsDecember 1, 2023Dallas-based Medical City Healthcare has again expanded in North Texas with the purchase of Wise Health System, bringing the health system giant to 19 in-patient hospitals. Medical City, a division of HCA Healthcare in Nashville, announced the acquisition Friday, nearly a year after word surfaced of discussions with the Decatur, Texas-based hospital system.