Report: How short staffing undermines patient care standards at Sonoma County’s St. Joseph hospitals

April 24th, 2016

Falling Behind 20160424 cover SM

Click to read the report.

Public Health Dept. records show deficiencies increased as St. Joseph cut staffing levels

Company posted unprecedented profits while putting patients at risk, cutting benefits for staff

A report released April 25, 2016, by caregivers at Santa Rosa Memorial Hospital and Petaluma Valley Hospital documents the harmful impacts of short-staffing at the two St. Joseph Health System facilities. “Falling Behind: How Short-Staffing Has Undermined Patient Care at Sonoma County’s St. Joseph Hospitals” uses government inspection reports, patient staffing records, and survey data from nursing staff to document worsening staffing problems that undermine caregivers’ ability to deliver quality care to patients.

St. Joseph caregivers also  released a video (below) that summarizes the findings. It can be viewed on Facebook here and on YouTube here

According to the California Department of Public Health’s Licensing & Certification Division, the two hospitals, which together provide nearly half of Sonoma County’s licensed hospital beds, recorded twice as many regulatory incidents per occupied hospital bed than did hospitals operated by Sutter Health or Kaiser Permanente and ten times as many violations of state standards governing the quality of care and treatment. From 2011 to 2015, the CDPH documented more violations of state and federal health standards at Santa Rosa Memorial Hospital than at any other hospital in Sonoma County. St. Joseph’s understaffing has contributed to patient falls, bedsores, risk of infection, and increased possibility of errors in patient care, and state investigators documented multiple injuries suffered by patients at the two St. Joseph hospitals.

“It’s documented proof of what we’ve been saying for years,” said Sue Daly, a licensed vocational nurse at Memorial Hospital for 36 years. “Hospital administrators have refused to heed our warnings about short-staffing and its effects on the care we provide.”

In a survey conducted among NUHW-represented nursing personnel, more than 98% reported that short staffing limits their ability to provide quality care to their patients. Government data confirm nursing personnel’s reports about declining staffing levels. Nursing staffing levels declined by 15.5% from 2011 to 2014, according to the California’s Office of Statewide Health Planning and Development. During the same period, Sutter increased its Sonoma County nursing staff by 39.3% and now has 62% more staff per patient than does Memorial.

“Memorial nurses support our NUHW coworkers in their efforts,” said Sue Gadbois, RN, president of the Staff Nurses Association of Memorial Hospital. “SNA nurses are deeply concerned about inappropriate staffing levels and the negative impact it has on patient safety.”

During the same period that St. Joseph cut staffing levels, the company’s Sonoma County profits skyrocketed. Since 2009, Memorial and Petaluma Valley Hospital together have brought in more than $242 million in profit for St. Joseph. Memorial’s profits are up 1,600% since 2009.

But while profits have soared, turnover has increased due to low staffing levels, lower standards of care, and stagnant wages. St. Joseph caregivers are paid far less than their Kaiser and Sutter counterparts, undermining St. Joseph’s ability to recruit and retain caregivers. On average, St. Joseph’s Sonoma County caregivers make 25% less than Kaiser caregivers and 9% less than those at Sutter. And while it takes a Kaiser worker just seven years to get to the highest wage level, it takes 21 years for a St. Joseph caregiver, meaning they make hundreds of thousands less over the course of their careers. St. Joseph unilaterally implemented drastic benefit cuts on Petaluma Valley workers two years ago and has proposed the same cuts for Memorial workers.

“St. Joseph’s benefit cuts sent morale plummeting at Petaluma Valley,” said Patricia Barnett, a radiology tech at the hospital. “That’s one of the reasons we formed a union — they were cutting staffing levels, cutting benefits, and keeping wages low while making huge profits.”

Caregivers urge St. Joseph Health to:

  • Establish staff-to-patient ratios for non-RN nursing personnel and an effective acuity-based staffing system in order to ensure that frontline caregivers can deliver timely, effective care to patients.
  • • Adopt caregivers’ proposal to establish patient-care committees composed of frontline caregivers and hospital managers to investigate staffing problems and design workable solutions. The committees would be equipped with a dispute-resolution system including, if necessary, the use of a neutral, third-party expert to resolve disagreements. Such a system has already been adopted by dozens of California hospitals.
  • • Improve the pay and benefits of St. Joseph employees to match those of Kaiser in order to enhance the recruitment and retention of a stable, qualified, and experienced workforce.

NUHW represents more than 800 caregivers at Santa Rosa Memorial and Petaluma Valley, as well as 400 St. Joseph healthcare workers at St. Joseph Eureka and Redwood Memorial in Humboldt County. NUHW.org.