Non-profit hospitals’ status raises questions

Once again the California Hospital Association is mounting a crusade that the survival of the multibillion-dollar California hospital industry is in grave jeopardy.

The threat? Earthquakes? Climate change? Godzilla? Not exactly. The big threat is AB 503, a bill that would let the public know whether non-profit hospital corporations justify their enormously profitable tax-exempt status by providing sufficient charity care and community benefits.

In a recent Capitol Weekly column the head of the lobbying arm for the well-heeled California hospital industry wrote that AB 503 “is a solution in search of a problem that doesn’t exist.”

Apparently they forgot to tell the California State Auditor and the California Legislative Analyst Office, both who have separately observed that a problem, in fact, does exist.

In 2012, for example, the Legislative Analyst noted there is “no federal, state, or local requirement on the amount of charity care that nonprofit California hospitals must provide in order to maintain their non-profit and tax exempt status.”

That same year the State Auditor issued its second report in five years recommending the legislature amend state law to include requirements for the amounts of community benefits non-profits should provide and define a methodology for setting uniform standards.

As Principal Auditor Grant Parks put it more colorfully in a legislative hearing in 2012, state law on what counts as community benefit is “fairly permissive… it’s like the Wild West of what is required.”

AB 503 is a response to those recommendations. It would clearly define what charity care is – the direct provision of care to the uninsured and under insured. And what it is not – for example, declaring a “loss” on payments it did not collect for wildly inflated charges in a state where hospitals, on average, set their charges at four and a half times their costs.

Community benefit programs under AB 503 must go to actual health improvement programs, such as vaccinations for low-income families, chronic illness prevention, and school based health centers. Marketing and promotional activities, like handing out headbands and water bottles with your corporate logo at 10k races, or sponsorship of sports teams and events, would not qualify as a “community benefit.”

AB 503 also would improve reporting requirements on how and if the non-profit giants are really meeting their charity care and community benefit moral imperative. Maybe that’s why they are in such a panic over the bill.

Or maybe the hospital industry executives are just embarrassed that for-profit hospitals, which also provide charity care, do not get the same lucrative tax-exempt gift handed to non-profit hospitals.

A 2012 California Nurses Association research study found that non-profit California hospitals piled up $1.8 billion in taxpayer funded subsidies beyond what they return to communities in charity care the prior year.

Or the fact that 100 non-profit hospital executives collect compensation packages of over $1 million each, as the CNA report also disclosed.

While a few small independent hospitals remain, many of which are exempted by AB 503, California’s hospital scene today is dominated by giant corporate chains who account for the $5.8 billion in profits California hospitals record in 2012 alone.

With all that cash on hand, is it really too much to ask that they stop hiding what they count as charity care and community benefit, that all hospitals be held to the same standard, and that the public has a right to know how their tax dollars are being used?

The hospital industry lobbyists insist they are more than living up to their obligation. If that’s the case, increased public transparency and consistency in reporting should hardly be a cause for all the fuss.

Ed’s Note: Deborah Burger is a registered nurse and co-president of the California Nurses Association/National Nurses United.

 

Travel Nursing Experience

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How much and what kind of experience do you need to work as a Travel Nurse?

How much and what kind of experience do you need to work as a Travel Nurse?

Travel Nursing is such an appealing career path that Travel Nursing Blogs often hears from nursing students — and even high school students! — who want to know how they can get started on the path towards their first assignment.

First, of course, you must have the proper nursing school education, earn your RN degree, and pass the NCLEX-RN test. Once that’s taken care of you’ll need to gain some hospital experience prior to traveling.

So what kind of experience and how much experience do you need to start working as a travel nurse?

Before you ever hit the road, hospitals want to see 1-2 years current hospital experience in order for them to hire you for a travel assignment. The industry standard used to be one year, but now hovers more around two years. (Be wary if an agency tells you they can get you an assignment right out of school; it might mean they are misrepresenting your prospects and/or cutting corners.)

If you are just out of school, you’ll want to find perm or per diem work that will allow you to practice your profession and amass the necessary experience to begin traveling.

Another scenario is that you could have 10 years hospital experience, but if it’s not current you may not be accepted to an assignment. Say you worked in a hospital for 10 years but then spent 5 as an elementary school nurse, you should get some more recent hospital experience in order to travel. Per diem work is a great way to accomplish that.

Remember, experience in order to travel is not an arbitrary requirement, it is very important for you to be practiced in your professional game as Travel Nursing requires you to jump right in and succeed in an unfamiliar facility. Your license and reputation are at stake, and you definitely want to be able to perform well.

The Gypsy Nurse Recognizes Holly Fenn for National Healthcare Recruiter Recognition Day!

In honor of National Healthcare Recruiter Recognition Day, we asked the members of our Facebook community to nominate a GREAT recruiter to be spotlighted; Congratulations to Holly Fenn of Fusion Medical Staffing on your nomination from The Gypsy Nurse Network members, as the recruiter who they feel most embodies the 3 C’s of Camaraderie, Collaboration and Community.    The Gypsy […]

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