Patients before Profits

Fighting to reshape a healthcare business model built for profits, not patients.

AS NEGOTIATIONS between more than 1,000 members of the Health Professionals and Allied Employees (HPAE) and CarePoint Health began this past spring, the workers made their goals clear: They wanted patient safety and workers’ rights to be the top priority.

HPAE, the AFT Nurses and Health Professionals affiliate in New Jersey, represents 850 nurses and health professionals at Bayonne Medical Center and 400 nurses at Christ Hospital in Jersey City. Members at both facilities know the hospital system CarePoint well. The for-profit company took over both community hospitals as well as Hoboken University Medical Center (which is not represented by HPAE) nearly two years ago. Since then, CarePoint hospitals in New Jersey are among the most expensive places to be a patient.

In May, HPAE members were deep in negotiations with CarePoint when state lawmakers introduced legislation to increase transparency in out-of-network care costs. Many of them saw CarePoint Health as a prime example of why such legislation was needed.  For example, Medicare data released this year noted that the national average cost to treat severe sepsis was $48,465. CarePoint’s Christ Hospital charged nearly $223,000 for patients with severe sepsis. The goal of the legislation was to provide consumers with protections from excessive charges for out-of-network care.

Patients before profits image. Michael Dempsey/The Jersey JournalCarePoint CEO Dennis Kelly has said high network charges for patients is a “survival strategy” and that insurance companies leave no choice for hospitals like his because the insurers’ reimbursement rates are inadequate. “If you’re not going to offer me a fair reimbursement that would allow me to sustain my business practice, then I’m going to use whatever I have at my disposal to try to secure adequate revenues to continue to operate the enterprise,” Kelly told

But Jeanne Otersen, HPAE chief of staff, in her testimony supporting the legislation, said that consumers have a right to know about the network status and costs of healthcare providers. Transparency is a tenet of AFT NHP’s Patients Before Profits campaign.

“CarePoint would like credit for saving these hospitals—ignoring the efforts of the community and workers. Yet the profits CarePoint has amassed go unmentioned,” she pointed out. “Yes, we have a hospital, but we also have two of the most expensive hospitals in the country, in a community that cannot afford to go elsewhere and cannot afford to pay these charges. This model has serious repercussions for our communities, our patients, and for the healthcare workforce,” Otersen said. “Our members live and work in these communities and utilize these hospitals. We do support a solution that would establish fair reimbursement rates for our hospitals and providers.”

Stuck in the middle

The union’s support of the legislation put the nurses and health professionals who work at the CarePoint facilities right in the middle of the debate when CarePoint threatened that it would be forced to close its hospitals should the legislation pass. 

In response to threats made against nurses and health professsionals, HPAE members decided to file unfair labor practice charges against CarePoint. The first charge was that the hospital system had threatened nursing leaders with a lawsuit for supporting the legislation. 

“We fought hard to save our hospitals and protect services and quality of care when CarePoint took over our community hospitals,” says Nicole Mankowski, registered nurse and president of the local at Christ Hospital. “We will not readily give up our right to speak up for safe staffing, for our workplace rights, and for our patients.”

A contract that values nursing

During negotiations, union members met with state and community leaders, including the mayors of Bayonne and Jersey City, state senators, assembly members and city council members to garner support for the efforts to improve patient safety in their hospitals. In a show of support for its health professionals, the Bayonne City Council passed a resolution in support of the union’s call for safe staffing legislation at CarePoint hospitals. John Bauer, president of the union local at Bayonne said the support of elected officials was “crucial” in getting CarePoint to address the issue of safe staffing as well as getting safe staffing legislation at the state level. 

In spite of the politicians’ support, negotiations were at a standstill. To bring attention to the situation and inform the community, HPAE held an informational picket at both hospitals, one day before the contract between CarePoint and the hospitals expired.  Hundreds of members descended on the facilities chanting for safe staffing and a fair contract. Former patient Pamela O’Donell joined the picket. “I think they deserve everything they’re asking for. Bayonne is a small community hospital, and we depend on this hospital being here and the staff being as educated and talented as they are.”

On June 30, after two months of difficult negotiations, a tentative agreement was reached for both hospitals. The new deal includes improved staffing levels as well as wage increases and limits on health insurance increases. “Our main priorities have been keeping qualified nurses at the bedside,” said Christ Hospital’s Mankowski. “This contract values nursing and represents stability and continuity of care for caregivers and patients. It’s the result of our union working together to insist on raising and protecting standards.” [Photo: Michael Dempsey/The Jersey Journal]

Healthwire, Fall 2015 Download PDF (6.95 MB)
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RightCare Action Week

AFT Nurses and Health Professionals seeks to raise awareness of changes in healthcare

RightCare Action Week gives members a chance to get involved

AS AFT’S HEALTHCARE professionals move toward the goals of their recently launched Patients Before Profits campaign, the focus has been on finding ways to raise awareness of the changing healthcare landscape. One way to do that is to take part in RightCare Action WeekOct. 18-24, a grass-roots event organized by the Lown Institute.  The week of action is an initiative of the institute’s RightCare Alliance, and the AFT NHP is a partner. 

“RightCare Action Week offers an opportunity to talk about changing the system into one that provides the kind of care that we want and gives frontline workers a voice in decision-making,” says Aaron Stupple, a medical resident at Beth Israel Deaconess Medical Center in Boston and member of the institute’s RightCare Action Week working group.  

“It’s important for us to share what we see that is wrong with the system,” says Candice Owley, an AFT vice president and president of the Wisconsin Federation of Nurses and Health Professionals. 

There are two worldviews of healthcare, says Shannon Brownlee, senior vice president at Lown. “We face a choice of seeing healthcare as just another business or as a public good. For most, the reason they go into healthcare is to take care of people; it is a social mission. We are seeing consolidation of the healthcare system, which should improve the quality of care and bring down costs, but that is not the reality,” says Brownlee, who notes that overtreatment and waste in hospitals are driving up the cost of care. “That’s money that could be spent in other areas such as education, transportation or other services in a state budget.”