Minnesota Attorney General Lori Swanson listening to Sanford executive testimony

Sanford Health has a lot of money and a lot of hospitals, but one more thing they’re bringing to Minnesota is scrutiny.  The nonprofit healthcare giant that runs facilities from Adrian to Wheaton now wants to add the Twin Cities to its corporate footprint, but Sanford executives got an earful of how their arrogance caused them to underestimate the height of the hurdles needed to takeover Fairview Health and the University of Minnesota Medical Center and research labs.

Minnesota Nurses have been talking about the short staffing situations in Bagley, Bemidji, Thief River Falls, and other facilities since Sanford took those over.  MNA President Linda Hamilton and Bemidji bargaining unit chair Peter Danielson were invited to give testimony.  Hamilton was asked to speak about the effects of the continued corporatization of healthcare through hospital takeovers.  She prepared a statement showing how local hospitals become funnels for corporate giants to send patients to their hospital headquarters out of state.  She also came ready to talk about the lack of investment in needed women’s care versus Sanford’s expansion into high-dollar facilities such as orthopaedics and cath centers.

Danielson was invited to speak as a nurse in a Sanford facility who has seen patient care decline due to cost-cutting.  He tells of how a nurse with a patient recovering from lung surgery, for example, should only receive one more patient assignment but at Sanford they can get five more.

The Attorney General’s inquiry into a possible Sanford takeover of Fairview reveals that the cruel cost-cutting nurses have experienced is only the proverbial tip of the iceberg.

Swanson started by indicating that her office had been investigating Sanford Health for months for, of all things, incomplete nonprofit paperwork.  Swanson said, when her office subpoenaed Sanford for 21 necessary inquiries to approve nonprofit status in Minnesota, Sanford failed to respond, and her office noted that Sanford only recently replied with one document of answers.

Before calling representatives of the three parties, Sanford, Fairview, and the U of M, Swanson established through healthcare and non-profit experts that a deal of this type would have to be extraordinarily analyzed to pass muster.

Brian Short, a consultant in non-profit governance, noted that non-profits do have shareholders because the taxpayer pays the taxes that non-profits don’t to help them with their mission.

Swanson thanks MNA President Linda Hamilton and Bemidji nurse Peter Danielson for agreeing to testify in the Sanford-Fairview merger

David Feinwachs, former attorney for the Minnesota Hospital Association, agreed that not only would this deal be like selling the county library to Barnes & Noble, but Sanford getting the U of M Medical Center sounds more like the library going to Wal-Mart.

Sanford executives clearly looked uncomfortable in their seats when their speakers, COO and Senior Vice-President Becky Nelson, and Senior Executive Vice-President David Link got grilled by Swanson.  Nelson told the Attorney General and her staff that Sanford and Fairview should be allowed to pursue these preliminary talks but then revealed that months of regular meetings between the two companies had been going on, which produced 10-15 “synergy” documents and cost analysis.

Sanford Vice-Presidents under cross-examination by Minnesota Attorney General

Nelson and Link both shrank from questions about Sanford’s many donations to sports teams and stadiums by calling them investments into youth physical fitness.

Then Sanford execs sounded unclear on the relationships between the non-profit Sanford Health systems and Sanford’s other, for profit companies.  It was revealed that Sanford Health still uses the Sanford-owned Premier Bank to process payments.  The hospital chain uses a debt-collection company called Rushmore Service Center, also a Sanford company.  The A-G also pressed the two vice-presidents on a new company, Sanford Applied Bioscience, a medical research company.  When Swanson pressed for who sits on the board of the for-profit laboratory, neither could answer.  When she asked Link again, he suddenly remembered that he was.

Sanford attorneys answering the Minnesota AG about why they haven’t responded to simple requests for license information

Nurses and patients in the standing-room only hearing room heard some news that would indicate that a Sanford-Fairview takeover is far from a done deal.  Fairview acting-CEO Chuck Mooty said that if the University of Minnesota is opposed to this deal, it won’t go through.  When Swanson asked him to clarify who would make that decision, Mooty indicated that U of M President Eric Kaler has the veto vote.  U of M General Counsel Mark Rotenberg also said that any deal would have to address the U’s missions of educating healthcare professionals and medical research.  Rotenberg also told the Attorney General that the U of M would not accept any alumni contributions to any sports teams or facilities that could show a conflict of interest during this inquiry.  That may have been in response to a recent newspaper story that Kaler was spotted in Augusta, Georgia, with T. Denny Sanford at the Master’s Golf Tournament.

Due to the length of the cross-examination of witnesses, two invited MNA witnesses didn’t get a chance to speak.  Swanson said Hamilton, Danielson and other witnesses will take the stand at the second public hearing over Sanford and Fairview on April 21.

NOTES ON NURSING

Better Staffing Would Help  Hospitals Fail to Take Simple Measures to Thwart Deadly Infections    The culprit is a strain of a spore-forming bacterium known as Clostridium difficile, or C. diff—in particular, a relatively recent strain that has grown more virulent and resistant to drugs.

LABOR UPDATES

Twin Cities Metro Plumbers Devote a Day of Service to Help Those in Need   It’s a chance to help Minnesotans who might not otherwise be able turn to a professional plumber, and to reduce wasted expenses going down the drain.

CEO Percs Flying High    Dodd-Frank rules? Securities and Exchange Commission lawyers? Leave them behind. And let yourself sink into the buttery leather seat of your corporate jet as it soars through the clouds.

HEALTH CARE

Swanson Grills Sanford Execs on Fairview Merger; MNA Leaders Testify    The merger proposal that could give Sanford Health control of the University of Minnesota Medical Center also has focused attention on the U’s relationship with Denny Sanford, an alum who is a major benefactor of U athletics.

MN Safety Net Hospitals Changing the Rules of the Game to Help Underprivileged   Under the Minnesota experiment, “those at a higher risk now have a care team who works with each patient, to keep them out of the emergency room,” said Peggy Metzer, CEO of People’s Center Health Services.

Nevada Discharging Mental Health Patients with Bus Tickets to Other States   Preliminary reports suggest that Nevada has made a habit of discharging mental patients by bus to other states. Rawson-Neal, the state’s primary hospital for mentally ill people, bused about 100 state psychiatric patients to California between July 1, 2012, and the end of February, and scores more to other states, according to data provided by Nevada health authorities.

Standards of Care Update

MNA nurses and representatives continue to meet with legislators to update them on the goals of the Standards of Care Act.  MNA is proposing that hospitals be required to report their staffing plans and actual nurse hours per patient day, and a Department of Health study of hospital staffing and its effect on nursing sensitive indicators like infections, falls and pressure ulcers.  We are confident that a MDH study will validate what nurses already know–that proper nurse staffing leads to better nurse outcomes–but we also recognize the need for Minnesota-specific data.  Our main objective for the remainder of the 2013 legislative session is to ensure that a comprehensive and accurate study is completed.  Ultimately, our goal is safe staffing in every facility, on every unit and during every shift.

We still differ significantly from the hospitals on this bill. So it continues to be very important for nurses to contact our legislators to ask them to support a comprehensive and accurate study.

Contact your state legislators and ask them to support strong consumer transparency language, nurse staffing reporting and a comprehensive study that gathers real data about the correlation between staffing and health outcomes. Let them know unsafe staffing is still a problem for Minnesota patients and we need meaningful data-collection to protect patients.

Click here to use the MNA Grassroots Action Center to send an email.

Possible Sanford/Fairview Merger

Attorney General Lori Swanson is holding a public hearing this Sunday, April 7 at 1:30 pm to shed light on the possible merger of Fairview Health Services and South Dakota-based Sanford Health. This merger would further the trend of the corporatization of healthcare in Minnesota, where profits and productivity are a higher priority than patient care. Please support the Attorney General’s effort to hold these two health care corporations accountable to the taxpayers of Minnesota. RSVP to geri.katz@mnnurses.org.  

WHAT:                 Attorney General Lori Swanson’s public hearing on possible Sanford-Fairview merger
WHEN:                 Sunday, April 7, 1:30pm
WHERE:               Room 15, State Capitol, 75 Rev. Dr. Martin Luther King Jr. Blvd, St. Paul, MN 55155
DIRECTIONS/PARKING INFO: Click here

Meanwhile, the news broke yesterday that the University of Minnesota is also interested in taking over the entire Fairview system. Read the Star Tribune article here.

We are glad to see some competition for this important health care system, and we are looking forward to learning more details about both proposals. Our ultimate concern is that whatever happens, patient care and safety be the first priority of any change to Fairview.

Governor’s Budget
The Governor’s Health and Human Services budget proposal was heard in the legislature this week. The Governor proposes to increase Health and Human Services spending by $170 million, after many years of cuts to services for the elderly, disabled and vulnerable. His proposal would provide access to health care for 145,000 uninsured low-income Minnesotans, invest in school-based mental health services for our children, and reform and streamline the delivery of health care services in Minnesota.

MNA continues to support the Governor’s commitment to progressive taxation and investment in key state priorities.

Mayo “Destination Medical Center” Proposal
MNA has joined other unions to raise questions about Mayo’s request for over half a billion dollars from the state for their “Destination Medical Center” expansion project in Rochester.

We are concerned this plan lacks transparency and leaves too many questions unanswered about patient care, jobs and the impact of the project on the community. For the state to consider such a major investment in a private entity, we believe these questions must be answered first. Read more here.

Willmar State Mental Health Facility
Both the Governor’s supplemental budget and legislation proposed by Willmar lawmakers Sen. Lyle Koenen and Rep. Mary Sawatzky propose keeping the 16-bed state mental health facility in Willmar open. This facility has been slated for closure in past years, so we welcome these proposals and remain dedicated to keeping this important mental health facility open.

Legislator Town Hall Meetings

MNA nurses Cassie Hamilton, Pat Webster and Mary Turner speak up about patient safety at a town hall meeting with Sen. Alice Johnson, Sen. John Hoffman and Rep. Jerry Newton in Coon Rapids on Thursday.

Governor Dayton and many legislators will be holding public meetings this spring to discuss the state budget and hear constituents’ concerns. These meetings are a great opportunity to meet your elected officials close to home, build a relationship with them, and educate them about nursing issues. Please attend a town hall meeting if one is coming up in your district:

Saturday, April 6

Senator Ann Rest
9:30-10:30 am
Robbinsdale City Hall, 4100 Lakeview Avenue North, ROBBINSDALE

Senator Lyle Koenen and Representative Mary Sawatzky
8:30-10:00am – Coffee and conversation
Sunberg Creamery Café, 403 Central Avenue, SUNBURG

Representative Shannon Savick
9:00-11:00am – coffee and conversation
The Bakery, Retail Room, 345 E. Main St., BLOOMING PRAIRIE

Representative John Persell
10:00am-12:00pm – Coffee and conversation
Common Ground Coffee, 1428 Hwy 5, LONGVILLE

Representative Barb Yarusso
10:00am-12:00pm
Mounds View Public Library Meeting Room, 2576 County Road 10, MOUNDS VIEW

Representative Paul Marquart and Senator Kent Eken
10:00-11:00am
Minnesota State Community and Technical College, 1900 28^th Ave S, MOORHEAD

Representative Ben Lien
10:00-11:00am
M State Technical School, MOORHEAD

Senator Rod Skoe, Senator Tom Saxhaug and Representative John Persell 1:00 – 2:30pm
Bemidji City Hall, 317 4th Street NW, BEMIDJI

Tuesday, April 9

Governor Mark Dayton, Meetings with Mark town hall tour
6:00-7:30 pm
Conference Hall/ Auditorium at South Central Community and Technical College 1920 Lee Blvd, NORTH MANKATO

Saturday, April 13

Representative Zach Dorholt
9:00-11:00am
Whitney Senior Center, 1527 Northway Dr., ST. CLOUD

Representative Shannon Savick
9:00-11:00am – Coffee and conversation
Prairie Wind coffee, 211 S. Broadway, ALBERT LEA

Representative Mary Sawatzky
9:00-11:00am – Coffee and conversation
Lulu Bean’s, Small downstairs meeting room, 1020 1^st St. S, WILLMAR

Tuesday, April 16

Governor Mark Dayton, Meetings with Mark town hall tour
6:00-7:30 pm Commons Area of Mesabi Range Community and Technical College 1001 West Chestnut Street, VIRGINIA

Click window link to view story

KSTP-TV reports the final audit confirms what Minnesota Nurses have long argued-that the healthcare system in the state is need of greater transparency and some of Minnesota’s HMOs owe the taxpayers a refund.

“When taxpayer dollars for patient care are so scarce,” said MNA President Linda Hamilton, “it’s unconscionable that even one penny could be wasted when it could’ve gone to treat somebody’s mother or grandmother.  Instead it’s padding somebody’s bank account somewhere.”

An independent auditor, the Segal Company, reveals in a report issued March 31 the government overpaid the four insurance companies that run the state’s Medicaid program by $207 million.  They say the amount owed is “concerning,” and they question the length of time HMOs were overpaid.   From 2003 to 2011, HMOs were able to run even double-digit profits on Medicaid programs and pocket millions of dollars into their own “reserve” accounts that were many times over what’s considered the minimum.

MNA President Linda Hamilton told KSTP-TV in 2010 that it’s a “disgusting” show of how taxpayer dollars can be used compared to how it could’ve been utilized to care for patients.  The reason behind this is the industry’s lobbying of the state of Minnesota to avoid transparency, battle back against public reporting, and to remove caps on how much they can collect to manage public programs.

Link to KSTP-TV story: http://kstp.com/news/stories/S2982096.shtml?cat=127

More background on the HMO overpayments story:

http://mnablog.com/2012/04/24/mna-rns-and-the-nearly-4-billion-question/