Standard & Poor's Corp. believes the trend toward increased union membership could hurt hospitals' and health systems' ability to achieve needed cost savings, and thus bring down their credit ratings.
Controlling salary and benefit expenses may be more difficult in unionized shops, where workers generally earn 90 cents to $4 an hour more than nonunion employees. The Aug. 7 issue of Standard & Poor's CreditWeek Municipal gives examples of hospitals that failed to achieve a higher rating or suffered a downgrade because of job actions by union workers.
So what's management to do to maintain credit quality? Here are a few pointers extracted from the rating agency's report:
Factor labor negotiations and demands into operational and financial plans to decrease the potential for service disruptions that can affect fiscal results.
Reduce employee unrest by addressing their needs point by point.
Try to anticipate cost reductions that have an impact on workers.
Focus on cutting nonlabor costs.
Unfair advantage.When Jeanette Garrison, the owner of Augusta, Ga.-based Healthmaster Home Health Care, recently pleaded guilty to Medicare and Medicaid fraud and agreed to repay $11.5 million, the investigation into her company was not quite over.
A few days later, Healthmaster's former chief financial officer, Dennis Kelly, was still on trial for fraud. The most eyebrow-raising part of his trial has been testimony that he procured a prostitute for three Medicare auditors at the end of a two-week audit in 1991. He says the auditors hired the prostitute on their own.
That transgression, whether initiated by Healthmaster employees or the auditors themselves, has somehow riled one of Healthmaster's local competitors, First American Health Care, based in Brunswick, Ga. The company wants to set the record straight about a General Accounting Office report accusing it of defrauding Medicare.
In a letter to Rep. John Dingell (D-Mich.), First American points out that some of the information it provided to the GAO-but was omitted from the final report-referred to the incident with the prostitute. In fact, First American alleges, one of the same auditors who received services from the prostitute was responsible for auditing First American as well, and that is perceived by the company as an unfair advantage for Healthmaster.
Acid tongues.Some of the nastiest exchanges between members of Congress in recent years have occurred between Reps. Fortney "Pete" Stark (D-Calif.) and Nancy Johnson (R-Conn.).
The two serve together on the House Ways and Means health subcommittee and by all accounts are not on good terms.
During the healthcare reform debate, Stark said Johnson, whose husband is a physician, learned all she knew about healthcare from "pillow talk."
The remark drew angry letters from female members of Congress, and Stark eventually apologized for it.
Not to be deterred, Stark later called Johnson a "whore for the insurance industry," another remark for which he later apologized.
Now the latest. During a recent television debate with Johnson over Medicare reforms, Stark and Johnson got to arguing about whose mom could afford to pay more for Medicare coverage.
"Your mother can probably afford it because your husband is rich," Stark said.
Stay tuned. The health subcommittee hasn't even started on Medicare reform yet.
Slice of life.The Visible Human Project, spearheaded by the National Library of Medicine, is well on its way to fabricating a pair of "virtual humans," which can be examined from the inside out via the World Wide Web on the Internet.
After a two-year search for the perfect pair of male and female cadavers, the $1.4 million project got under way when it found its male, a 39-year-old murderer who had been executed in Texas and had agreed to donate his body to science. The cadaver was sliced into 1,870 one-millimeter thick sections, head to toe. Each section was photographed, then scanned into a computer.
Some of those images are currently available to the public on the Web, at http: www.nlm.nih.gov. The female will go on-line this fall.
The electronic pictures of the slices can be manipulated to form 3-D images, providing an invaluable learning tool for medical researchers, students, doctors and anyone else with a penchant for graphic physical examination.
Someday the pictures may be used for risk-free simulation of surgical procedures. The entire data set of the male cadaver can be downloaded by anyone who obtains permission from the National Library of Medicine. But because the information would fill 50 encyclopedias, the downloading process takes two weeks.
Yo hablo espanol.Officials of Dallas' Parkland Hospital recently approved a 25-cent-per-hour raise for Spanish-speaking employees.
In some areas of the 911-bed county-owned hospital 40% of the patients are Spanish-speaking, making it crucial to have staff members who can communicate with them.
To get the 25-cent incentive, employees must pass a proficiency test in which they answer 10 questions in Spanish. Basic questions include "Where is the outpatient clinic?" and "How do I get to day surgery?" said Ron Van Iderstine, the hospital's associate director of human resources.
Inside the hospital, bilingual employees are easy to spot: Their hospital identification badges include a black "n" with a tilde on a green background.
Quotable."I've skied before in Utah and I've eaten a lot of snow, but I've never eaten dust."-Richard Scott, president and chief executive officer of Columbia/HCA Healthcare Corp., joking at the ground-breaking ceremonies for a $50 million hospital in Orem, Utah. Before his remarks, a sudden afternoon windstorm blew through the area, causing event organizers to throw out the dust-laden food on the outdoor buffet.