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Will nurse staffing ballot question cost Baystate Franklin?

  • The Baystate Franklin Medical Center in Greenfield. Recorder Staff/Matt Burkhartt



Staff Writer
Friday, September 14, 2018

GREENFIELD — Baystate Franklin Medical Center is saying the “Question 1” ballot initiative on nurse staffing will cost $3.3 million annually, while a newly released study by a Boston College professor says it won’t cost anything.

The question of actual cost is the latest development over the Massachusetts Nurses Association ballot initiative, as the conversation around it ramps up ahead of the November election.  

The refrendum is potentially “devastating for our hospital,” Chief Nursing Officer and Chief Administrative Officer at Baystate Franklin Medical Center Deb Provost said in a press release. If passed by voters in November, it could require hospitals in the state to meet certain ratios based on staffing and patients. 

The ballot question could require the hospital to employ an additional 19 nurses per year to meet the required staffing ratios, which would add up to $3.3 million, Provost said. 

This is a clear departure from the study by Judith Shindul-Rothschild, a Boston College associate professor, which estimates annual cost of the ballot question at $35 million to $47 million, requiring a 2 to 7 percent increase in the number of nurses to be employed by Massachusetts hospitals.

A total of 67 acute care hospitals were studied, and nine were found to need no additional nurses to meet the requirements of the referendum, using publicly available 2016 and 2017 data from the Massachusetts Hospital Association. 

Of the nine hospitals that the researcher said would face no additional costs, one of them was Baystate Franklin Medical Center.

Conversely, Springfield’s Baystate Medical Center is projected to face by far the most severe costs, according to the study. 

On average, hospitals will need two more nurses to meet the demands of the ballot question, but Baystate Medical Center is projected to need 17 more nurses. The average cost per hospital, according to the study, is about $699,000, but Baystate Medical Center would need to put up an estimated $5.5 million. 

Baystate Health did not respond to comment for whether the potential costs to its flagship hospital could influence costs to its Greenfield hospital. 

Provost and Baystate Franklin asserted the ballot will in fact be costly to the Greenfield hospital. 

If “Question 1,” which was put on the ballot by the Massachusetts Nurses Association, passed, the hospital said it could result in a reduction of 3 percent of its medical capacity, 16 percent of its behavioral health capacity and 15 percent of its emergency department capacity. 

If Baystate Franklin cannot meet the staffing ratios, which if violated could set off a $25,000 per incident, per day fine, its administration said it could lead to a 7 to 15 percent decrease in patient volume. 

The $3.3 million price tag accounts for the cost of enough nurses “required to stay in compliance with the mandate, as well as implementing an acuity tool in all hospital units,” according to the hospital. “The estimate accounts for wage inflation, fringe benefit costs and non-productive time costs.”

This translates to 10 patients a day either sent away from the emergency room or “forced to experience extensive delays,” the hospital said; there will be 110 medical patients a year who will not be able to seek treatment from Baystate Franklin; and 250 patients will experience “dangerously long wait times” for behavioral health treatment. Asked to define an extensive or dangerously long time, Provost said, “The definition depends on many factors, flu season for example. There is no exact calculation.”

The local unionized nurses are not clear on how these costs were calculated, especially in comparison to the study that says the hospital will require zero more nurses to meet staffing requirements of the referendum and the language in their own contract that gets the hospital up to sufficient staffing numbers, as budgeted. 

“It makes no sense,” Suzanne Love, an emergency department nurse at Baystate Franklin and a member of the union’s bargaining team that settled its contract in May. 

She pointed to the new contract, which took about a year and a half to settle, as addressing the perceived holes in schedules of nursing units at the hospital. In this new contract, Love said, it called for the hiring of  about two dozen nurses to make sure the hospital is fully staffed, as hospital staff defines it. She said this is currently being done.

Love pointed to language in the contract that says the hospital needs only to comply with what is in the contract. The ballot queston, she said, is written to not supersede a union contract.  

You can reach Joshua Solomon at: jsolomon@recorder.com, 413-772-0261, ext. 264