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A new beginning

Healthwire
September/October 2012
Feature Story

A community coalition gives a neighborhood hospital new life.

THE INK ON A NEWLY RATIFIED CONTRACT was barely dry when the nurses of Christ Hospital in Jersey City, N.J., first heard about a proposal to sell their hospital. In May 2011, they learned that Prime Healthcare Services was in line to buy the hospital by the end of that year.

The news of the sale came as a complete surprise to Nicole Mankowski, a critical care nurse at the hospital and president of  Health Professionals and Allied Employees Local 5186, which represents 400 registered nurses at Christ Hospital. “The possibility of a new owner was never mentioned in negotiations,” she says.

It wasn’t long before questions about the hospital’s potential new owner began to surface. Prime Healthcare Services wasn’t what it seemed to be. And upon further inspection, neither was the proposed sale. More questions arose. What kind of company is buying the hospital?  Why the secrecy? What was the rush?

With so many questions arising about Prime Healthcare Services, HPAE set out to get some answers. The local began doing some research, says Mankowski. “We knew at some point we would have to negotiate with the company, and we wanted to be prepared.”

A checkered past

Officials at Prime Healthcare Services, a for-profit  company based in California, had hoped to fast-track the sale of Christ Hospital. But HPAE and the Jersey City community wanted to take a closer look at the purchasers.

Prime Healthcare Services had a reputation in California, and HPAE didn’t like it. A watchdog group in California found that the company boosted its profits by transferring an unusually high number of patients from the emergency room to hospital beds. On top of that, Prime Healthcare had suspended some necessary, but unprofitable, services at its hospitals, including chemotherapy, mental health care and birthing centers. And the California attorney general on two occasions had refused to allow the company to purchase financially distressed hospitals.

Based on the findings, “We didn’t feel that this company was the best buyer for our hospital,” says Mankowski.

Starting over

Christ Hospital, which has served the Jersey City community for 140 years, has struggled financially. The nonprofit hospital also serves a large uninsured and indigent population, and their access to care could be limited if the hospital were sold to a for-profit company. In addition, many of the hospital’s employees grew up in the city and have worked at the facility for most of their careers.

“We knew we needed to protect the hospital and its patients so they could continue to receive the best possible care,” says Mankowski, who has worked at Christ for 23 years.

When the nurses began to see how the change in hospital ownership could affect  their ability to take care of patients, the nurses decided it was time to step up their involvement. For the nurses at Christ, the best way to make their voices heard was to take their case to community groups throughout Jersey City, educating residents and hoping to gain their support.

That’s how Paul Bellan-Boyer, a social worker and community organizer who has lived in Jersey City for most of his life, first heard about the situation at Christ.

“Christ is a good local hospital,” says Bellan-Boyer. “It’s one of two remaining hospitals in Jersey City. Without it, a significant portion of the city would be underserved and, its loss would have severely limited choices for the community.”

Bellan-Boyer says the nurses’ campaign showed him what was at stake for the community if Christ Hospital was not protected. So he used his experience as a community activist to help HPAE galvanize the community. Together they created Save Christ Hospital, a coalition of 16 neighborhood groups. “It was very easy to get going,” explains Bellan-Boyer, “because we had a good cause.”

While HPAE researched and disseminated its information, the entire coalition went to work on talking to community members and lawmakers at the local and state levels. New Jersey Citizen Action, a citizen watchdog coalition, circulated a petition to protect the mission of the hospital, and teams of canvassers hit the streets of Jersey City to talk to people about the sale. In the end, more than 5,000 city residents signed the petition.

Local lawmakers even expressed their concerns. In a letter, Assemblyman Ruben Ramos called on the state district attorney to hold off on expediting the deal and to consider alternative bids.

Perhaps sensing defeat, Prime Healthcare Services backed out of the deal in February 2012. A week later, Christ Hospital filed for bankruptcy.

“It was another hurdle for us, but we were prepared,” says Shelley Crowe, a nurse in the medical-surgical unit, who has worked at Christ since 1980. The nurses saw a chance to start over.

“It’s not the path we would have chosen, but Christ Hospital board members have an opportunity to get it right this time, to choose a bidder and financing that puts patients and community first,” said HPAE president and AFT vice president Ann Twomey following the bankruptcy annoucement.

A new mission

The community coalition that had forged a fight against the Goliath that wanted to take over their hospital now had a new mission: find an acceptable buyer that would commit to the community and the hospital’s workers.Fortunately, the search didn’t last long.

In late March 2012, the hospital’s board of trustees voted unanimously to endorse Hudson Hospital Holdco’s bid to purchase Christ Hospital. It was the buyer with the best offer. Even better, Holdco owned two other HPAE facilities: Bayonne Medical Center and Meadowlands Hospital.

The deal is a victory for residents, community activists and HPAE members.  Christ Hospital will continue to operate as an acute care facility in the community. The company has promised to keep all of the hospital’s nurses and 90 percent of other hospital staff. In addition, HPAE has negotiated a tentative contract with Holdco.

“It was great that so many of the things we had advocated for were reflected in the sale. Our advocacy and ability to mobilize people and work with our elected officials made bids for the hospital that much stronger,” says Bellan-Boyer.

In May, the state health planning board held hearings in Jersey City to collect public comments on the sale of Christ to Hudson Hospital Holdco. Thanks to the efforts of HPAE members who were instrumental in securing passage of the Community Healthcare Assets Protection Act in 2000, such hearings are required by state law before a hospital can be transferred from one owner to another. The law also requires that all proposed sales of hospitals be reviewed by the state attorney general and approved by the Superior Court.

At the end of June, Judge Hector Velazquez signed an order approving the sale of Christ Hospital to Hudson Hospital Holdco. Many of the conditions requested by HPAE and Save Christ Hospital also were approved.

In the minds of many of Christ Hospital’s nurses and health professionals, Christ has a new beginning. “We have a fresh start, and we are looking forward to a much brighter future. Thankfully, all signs point to that happening,” says Mankowski.

“It’s very gratifying to have such a direct and immediate impact on a local scale,” says Bellan-Boyer. “We were able to strengthen the hospital’s future, and we won protection for the people we know and care about: Christ’s healthcare workers.”

The challenge today for HPAE and for all unions, says Bellan-Boyer, is to continue to build community relationships before the crisis and keep those relationships going after the crisis, because “if all you are doing is fighting fires, there’s no time to plant trees.” 

—ADRIENNE COLES