Stop Pushing Nurses and Patients Out of Hospital Care

Registered nurses from Northern California Kaiser Permanente facilities will pay a visit to a Kaiser recruitment event in Sacramento this afternoon, September 17 to bring a message to the HMO giant and doctors it is trying to enlist – stop cutting care by pushing nurses and patients out of the hospital.

When:                  Tuesday, September 17, 5:30 p.m.

Where:                 Sacramento Hyatt Regency, 1209 L Street, Sacramento

Kaiser has been increasingly blocking admission of seriously ill or injured patients to the hospital and inappropriately discharging patients who still need hospital care to other settings from clinics to the home, nurses say. Many patients are held in “clinical decision units,” also known as “observation units” for up to 24 hours and then sent home without being admitted to the hospital even if the patient’s condition indicates they should have received in-patient hospital care.

As an HMO, Kaiser derives its revenue and profits from premiums not from care delivered.  By slashing hospital expenditures, Kaiser can further increase its revenues – which last year alone hit $2.6 billion Medicare imposes financial penalties – reduced reimbursements – for high hospital readmission rates, but not for a patient who returns to the ER or an ER “observation unit.” Kaiser also sees itself as a model for implementation of the Affordable Care Act which discourages hospital treatment.

The RNs, members of the California Nurses Association/National Nurses United will ask the doctors to join the public to support a Patient’s Bill of Rights to assure proper care at all time for patients. That includes the right to be cared for by RNs, to not be denied hospital care when needed or sent home early before the patient is fully recovered.

“It’s great to stay out of the hospital, but decisions on hospital stays should be made for clinical reasons, what’s in the best interest of individual patient need, not on the basis of generating ever more revenue and profits,” says Zenei Cortez, RN, a CNA co-president and Kaiser RN.

“Cost cutting measures should not come at the expense of direct patient care Kaiser members receive and adequate RN staffing is an integral part of that patient care,” wrote Lou Paulson President of the California Professional Firefighters in a letter to Kaiser CEO Bernard Tyson September 5.California firefighters “and their families utilize Kaiser for their health care needs and have personally witnessed the drastic increase of premium costs with reductions in benefits and services.” 

“We see patients in the Emergency Room, sometimes in beds in the hallway, or treated in wheel chairs, held for hours and then sent home while still very ill in need of hospital care rather than be admitted. Many of those patients bounce back the next day and are still not admitted,” says a Kaiser Oakland Emergency Room RN. 

As part of its drive to limit hospital care, Kaiser is calling for the elimination of up to 400 RNs from hospital care delivery in Northern and Central California hospitals. Many of those nurses may be eligible for positions in Kaiser outpatient settings, but, nurses say, expanded outpatient services should never be made at the expense of guaranteeing patients receive hospital care when they need it.

In Sacramento, the RNs will urge the doctors targeted for recruitment by Kaiser and its for-profit arm, The Kaiser Permanente Medical Group (TPMG), not to put organizational profits ahead of the highest quality care, and show their support for patient safety and appropriate RN care by signing the Patient Bill of Rights Pledge which says, “Our community supports our RNs and their efforts to ensure that we get the hospital care we deserve if we are ill.”

For more on the pledge, see http://www.nationalnursesunited.org/pages/ca-kaiser-affiliates