By Evangeline Domingo Keefe, RN and PSARA member
This era of hospital mergers is leaving not just patients but also communities behind. As our community hospitals become part of large multi-state chains with their eye more on the bottom line than on patients’ needs, it’s up to us to make sure their priorities reflect ours.
In 2012, Providence, a five-state chain that operates 32 hospitals, purchased Swedish, where I work as a nurse at the Ballard Campus. What used to be our local hospital with an industry-leading focus on quality patient care is now part of a Catholic-affiliated non-profit that made $412 million in profits and investment returns in 2012.
An end to an era of quality, cutting-edge care?
Not long after Providence’s takeover, staff began noticing that the culture started shifting. Support services like dietary and housekeeping were deeply cut, leaving the remaining staff scrambling to pick up the extra work. Groundbreaking partnerships forged with the staff to promote staff wellness and keep down employee healthcare costs got abandoned. And workers with simple HR questions had their calls re-routed to Providence headquarters.
From inside the hospitals, the change was dramatic.
For two years in a row- both years since Providence took over- management has hiked the cost of employee healthcare coverage to the point where some of us cannot afford to cover our own families.
Nurses in particular are alarmed at the new resistance we’re facing as we work to ensure we get the rest and meal breaks we need to stay alert at the bedside. Staffing is one of the biggest indicators of patient safety, yet short staffing often means we don’t have time to even use the restroom. Our nurses’ union, SEIU Healthcare 1199NW, is standing up for safer staffing.
Community benefits, minus the Community
The impact of the merger extends beyond the hospital walls, too. Hospitals, particularly non-profits, have a unique position in our communities. They don’t pay income taxes like the rest of us. These institutions are instead expected to offset their contribution to our communities in the form of “community benefits.” The IRS very loosely defines this term and often hospitals count doctor education, giveaways at community events, and even sponsoring sporting events (where the end result is self-promotion). Charity care is scarce and the system is difficult to navigate. And the benefits our community really needs are passed up for flashier options.
But what would a true community benefit be to us, the community? And why haven’t hospitals asked us?
What should Swedish-Providence be doing?
Swedish-Providence has a responsibility to our community to provide safe, accessible, affordable care and to use some of its profits to meet our community’s needs. Swedish-Providence can be a good healthcare provider and a good neighbor again, as it once was. But it needs to take responsibility for offering the benefits we need. That ranges from in-person translation (as opposed to the phone service they now use), accessible transportation to the hospital, good jobs for our community, openly available charity care to all who need it, affordable healthcare for its employees and its patients, and access to all the services patients need regardless of the Catholic directives.
A campaign is beginning to hold Swedish-Providence accountable. Washington CAN! is working with patients, and SEIU Healthcare 1199NW is leading a staff effort. It’s going to take all of us to hold this huge corporation accountable. Stay tuned for how you can get involved!