Kaiser Permanente Backs Union Proposal to Increase Nurse Staffing Levels in California Hospitals

In an "apparent departure" from its previous stance on nurse staffing levels, Kaiser Permanente yesterday announced its support for a union proposal to increase nurse-to-patient ratios at California hospitals, the Los Angeles Times reports. Under the proposal, drafted by the Service Employees International Union and the United Nurses Associations of California, general medical and surgical wards would have a minimum of one nurse for every four patients, compared to the one nurse for every 10 patients ratio suggested by the state hospital industry (Ornstein, Los Angeles Times, 7/20). In addition, the union staffing plan calls for one nurse for every two women in labor wards and one nurse for every three pediatric patients (Appleby, USA Today, 7/20). Kaiser Permanente's endorsement of the stricter staffing levels comes as Department of Human Services officials are working to set minimum nurse-staffing levels as mandated by a 1999 law set to take effect Jan. 1. The Times reports that while Kaiser Permanente "strongly opposed" the 1999 staffing measure when the Legislature was debating it, the company believes that the union's standards are "reasonable and doable." Mary Ann Thode, senior vice president and COO of Kaiser Permanente, said, "We are kind of taking a giant leap of faith here with our labor partners to say, 'This is what really needs to happen to improve quality of care in California hospitals'" (Los Angeles Times, 7/20). Kaiser Permanente officials estimate the union staffing plan will cost the company between $120 million and $200 million annually (USA Today, 7/20). Company spokesperson Terry Lightfoot said it was "too early to tell" what effect the proposal will have on members' premiums and other costs (Ashley, Contra Costa Times, 7/20).

Kaiser Permanente's announcement came under "immediate attack" from rival union officials and consumer advocates, who called the endorsement "more of a public relations effort than a worthy proposal." In addition, critics said that Kaiser was attempting to stall implementation of the state-mandated staffing ratios still under development (Los Angeles Times, 7/20). Noting that it could take two to five years to implement the union's staffing goals, Kaiser this week wrote state officials recommending a "transition" period for hospitals to comply with such staffing standards (USA Today, 7/20). Calling Kaiser's move a "death-bed conversion," the California Nurses Association, which represents 18,000 of Kaiser's registered nurses, expressed concern that the company would use licensed vocational nurses, who are "less skilled" than RNs, to meet higher staffing levels. SEIU represents many licensed vocational nurses. CNA Executive Director Rose Ann DeMoro said, "The irony here is just tremendous. Kaiser probably under-staffs more significantly than any of the employers in Northern California. They have been trying to derail the safe-staffing bill for years." Jamie Court, executive director of the Santa Monica-based Foundation for Taxpayer and Consumer Rights, said, "This is not a safe-staffing ratio. It's a cheap-staffing ration. And that was not the intent of the law" (Los Angeles Times, 7/20).