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Nurses group says staffing proposal would carry few costs for hospitals

Boston Business Journal: The Massachusetts Nurses Association says its ballot proposal to set limits on how many patients nurses can oversee at hospitals would cost no more than $47 million annually — far less than the $1 billion estimate put forward by a hospital lobby group fighting the measure.

The Massachusetts Nurses Association on Monday cited a new study by Boston College professor Judith Shindul-Rothschild, the group’s past president, finding that it would cost $35 million to $46.8 million per year for hospitals to hire new nurses to fill the staffing needs. If hospitals shifted money spent on nurse managers and administrators to nurses caring for patients, it would only cost them $23.6 million annually, the study found.

“It’s not going to cover the whole cost, but a bulk of it,” Shindul-Rothschild said. “It’s shifting those personnel resources to more direct-care people.”

The study is the latest volley of opinion around the nurse staffing ballot question, which will be decided by Massachusetts voters in November. Separately on Monday, the Emergency Nurses Association and the Massachusetts College of Emergency Physicians released a study finding that nurse staffing limits would prolong wait times in emergency departments. That would leave hospitals scrambling to staff up before offering care when people unexpectedly arrive at hospital ERs, the study said.

Last week, Beth Israel Deaconess Medical Center published its own study claiming that nurse staffing limits do not help patients.

For her study, Shindul-Rothschild used Massachusetts Hospital Association data to determine how many nurses hospitals are currently employing, and compared it to the number of nurses that would be required under the ballot proposal. The hospitals would need to hire to make up the difference.

While many hospitals throughout the state — such as those in the Partners Healthcare system — are currently meeting the standards the ballot would impose, some others would have to staff up to comply, Shindul-Rothschild found. Her study found that hospitals throughout the state would need to hire approximately 539 to 1,617 full-time nurses annually, adding to the 24,544 full-time nurses currently employed in Massachusetts.

Using starting nursing wages from the Nurses Association, Shindul-Rothschild calculated that it would cost $35 million to hire more nurses under the ballot proposal. At the average nurse salary, it would cost $46.8 million. The study didn’t include figures for the higher end of nurse salaries.

The study added that the ballot would not affect the profitability of the 54 Massachusetts hospitals that reported net profits in fiscal 2017, and wouldn’t create additional losses for four hospitals reporting a net loss. Only nine hospitals — which were already reporting a net loss in fiscal 2017 — would incur an additional loss as a result of the nurse ballot, of between $55,670 and $1.4 million each.

“There are vulnerable hospital … those need to be addressed,” Shindul-Rothschild said. “They just don’t have the market clout to get the reimbursement. But nursing labor costs is not an explanation for why they are in such a precarious financial position.”

The recent studies add to a bitter debate being waged on the airwaves by both the union nurses and the hospital-backed opposition group, which also includes a number of smaller nurses groups.

According to data published by the Office of Campaign & Political Finance, the Committee to Ensure Safe Patient Care, which is backed by the union nurses, has so far spent $3.9 million in support of the ballot. The Coalition to Protect Patient Safety, which is backed by the hospitals, has spent $7 million.

Political ads by both sides claim the backing of nurses groups, a tactic that the nurses union says is an effort to confuse voters, but that the hospital-backed group says represents the views of non-union nurses throughout the state.

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