Online job listings were up sharply in January in many employment sectors across the nation, with continued strong demand for nurses and healthcare technicians, a new report released today shows.
The Conference Board's Help Wanted Online Data Series report, which tracks more than 1,000 online job boards across the United States, found that advertised vacancies for highly skilled healthcare practitioners and technical occupations, such as registered nurses and radiographic technologists, increased by 24,500 listings in January, for a total of 567,800.
Demand for healthcare support personal, such as dental assistants and home healthcare aides, also rose by 6,500 listing for the month, for a total of 119,000, the report shows.
The Conference Board Associate Director Gad Levanon says the overall uptick of 382,000 job listings in most employment sectors in most areas of the country is further evidence that the economy is on the rebound. January's overall online advertised vacancies—which surpassed 4 million for the first time since November 2008—are consistent with listing growth in November and December and reflect recent strong growth in GDP numbers for the fourth quarter of 2009.
"The last three months have shown a sharp upturn in employer demand for workers," Levanon said. "These increases have brought us back near the labor demand levels that existed in November 2008 just prior to the huge losses resulting from the financial turmoil in the last quarter of 2008. This is very good news since these seasonally adjusted increases come in two months when we normally see employers cut back on advertising for workers."
The Conference Board report jives with the most recent Bureau of Labor Statistics preliminary data, which show that the healthcare sector created 267,000 new jobs in 2009, including 22,000 payroll additions in December. However, BLS data also show the overall economy shed 85,000 jobs in December as the nation's unemployment rate remained unchanged at 10%.
Of the 22,000 new jobs in the healthcare sector in December, the biggest job growth came from physicians' offices, with 9,000 payroll additions, and home health services, with 8,000 payroll additions. Physician offices added 55,000 jobs in 2009, BLS data show.
BLS figures also show that the healthcare sector—which includes everything from hospitals to outpatient surgery centers to podiatrists' offices—has added 631,000 jobs since the recession began in December 2007. In that same timeframe, the number of jobless people in the nation has risen from 7.7 million to 15.3 million.
The newest BLS employment data for January will be released on Friday.
The Conference Board data show that for every unemployed person looking for work as a healthcare practitioner or technical occupation in January, there were three advertised vacancies with an average wage of $32.64/hour. Because healthcare is a broad field, the report notes that the relative tightness of the labor market varies substantially from the higher-paying practitioner and technical jobs to the lower-paying support occupations.
For some lower-paid healthcare support occupations, such as dental assistants and pharmacy aides, there were more than two unemployed people for every advertised vacancy, with an average wage of $12.66/hour, The Conference Board report states.
Woody Guthrie must be spinning in his grave. His rousing labor song "Union Maid" warns working men and women about "goons and ginks and company finks and the deputy sheriffs who made the raid."
So what would Woody make of the internecine organizing battles for healthcare workers in California? The fight that pits the giant Service Employees International Union against the upstart National Union of Healthcare Workers has been most remarkable for its very public vitriol. These guys hate each other, and they're not bashful about saying it.
"We don't trust them with our contracts, and we don't trust them with our dues," NUWH supporter Shayne Silba, a psychiatric technician with Alta Bates Summit Medical Center in Oakland, said of the SEIU at a media conference.
I'll spare you the "he-said she said" of the fight, which started more than a year ago when the California leadership of an SEIU Oakland local was ousted by the national office amid allegations of financial mismanagement. The ousted SEIU officials formed the NUHW, and the battle was joined. For more than a year, California media have provided scintillating stories about the two sides throwing knives—and the knife drawer, pots, pans, and the kitchen sink—at one another.
It's been an ugly divorce.
Last week, SEIU suffered a major defeat when workers at Kaiser Permanente hospitals in Southern California voted overwhelmingly to accept NUHW as their union. The vote capped months of bad-mouthing from both sides. Bad feelings linger.
"We heard they were thugs and henchmen and cronies out to destroy our union," Denny Henriques, an SEIU supporter and respiratory therapist at Sutter Delta Medical Center told the Los Angeles Times. "It wasn't true. They've represented us well."
Henriques wasn't talking about KP management's anti-union campaign. He was talking about NUHW.
In fact, about the only people you didn't hear from in the KP union battle was KP management. Wisely, KP watched from the sidelines, and kept quiet.
"Kaiser Permanente respects the right of our employees to choose whether they want to be represented by a union and which union will represent them," said John Nelson, a spokesman for KP. "We have a long history of working constructively with the unions that our employees select to represent them. We did not favor one union over the other in the elections . . . We will bargain in good faith with the certified union. Any questions concerning the outcome of the elections or next steps in the legal processes should be addressed to the NLRB."
A disclaimer: I'm not anti-union. If it wasn't for unions, we'd still have smudge-faced 9-year-olds working 12-hour days picking coal chunks off conveyor belts. Every American who's ever drawn a paycheck, whether or not they've ever been in a union, enjoys better working standards because of the hard-fought victories of organized labor. That is simply a fact.
But it must be asked: Does anyone in organized labor see how badly this California fight reflects on the union movement?
Does it instill public confidence and support for the labor movement—particularly in a sector as vital, personal and invasive as healthcare—when unions accuse each other of corruption and incompetence?
The fight in California comes as unions are lobbying for passage of the card check bill, which many are calling the most important piece of pro-labor legislation in the last 50 years. So, at a time when unions need public support, this California scorched earth campaign is remarkably dumb. It demonstrates that union leaders on both sides are not above being short-sighted, self-defeating, vindictive, and mean.
If I were a hospital or nursing home executive, I'd Google all of these media accounts, the snarky press releases from the unions, the interviews where the rival unions are calling one another out of touch, or corrupt, or ineffective, or all of the above, and I'd compile a thick dossier.
Then, when a healthcare union came to my hospital to organize, I'd hand out copies of the dossier to my employees, and highlight the accusations of corruption and incompetence. I'd pin up the derogatory interviews on the break room bulletin board, and I'd ask "Do you want these people representing you?"
Forget Solidarity Forever! Healthcare unions in California should quote Pogo: "We have met the enemy and he is us."
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The U.S. Justice Department's Civil Rights Division has filed a motion for immediate relief to "protect the health and safety of hundreds of patients from dangerous conditions" in seven state-run psychiatric hospitals in Georgia, federal officials announced today.
The motion, filed late Thursday, seeks appointment of a monitor who will set targets and timetables for reducing the number of residents at the hospitals, and expand community-based services.
"States responsible for the care of individuals living in state-run facilities have a duty to protect them from harm," said Thomas E. Perez, assistant attorney general in charge of the Civil Rights Division. "Individuals in Georgia's hospitals are being subjected to a widespread pattern of violence and are not being protected from preventable deaths. We need quick action to protect these individuals."
In response to the charges, Georgia Department of Behavioral Health and Developmental Disabilities Commissioner Frank Shelp said in a prepared statement, "We have always preferred that people be served in communities where possible and that they should receive safe and effective care while in hospitals. What we disagree with is the notion that change can happen overnight or that there's no role for hospital care for those who need it and want it. We're busy building a continuum of care to best serve the people of Georgia in the appropriate places. The DOJ's motion, if adopted, would divert resources and endanger that progress."
Last year, Georgia and DOJ entered into an agreement to ensure that the patients were served in the most appropriate settings and that reported unlawful conditions in the hospitals were fixed. A federal judge has yet to approve the agreement.
DOJ said conditions at the hospitals continue to be dangerous and that hundreds of patients who could be placed in the community remain institutionalized and exposed to danger. "Georgia continues to fail to serve patients in the most integrated setting appropriate to their needs, and preventable deaths, suicides, and assaults continue to occur with alarming frequency in the hospitals," DOJ said in a media release.
In his statement Friday, Shelp said his agency will "continue to improve and we're in the middle of major changes. Already the people we serve are safer are getting better care. What we need now is the resources and time to continue. Governor Perdue has provided us the resources. But this lawsuit by the Department of Justice would deny us the critical time we need.
"We've cooperated with the Department of Justice, we've invited them into our hospitals to make recommendations, and we've worked diligently to fulfill our settlement agreement. We will continue improving our hospitals because it's the right thing to do. But we will dispute every allegation in this motion with facts and law," he added.
More than a decade ago, in Olmstead v. L.C., the Supreme Court found that Georgia Regional Hospital in Atlanta was allegedly segregating two disabled patients who could have been served in more integrated settings. The high court ordered states to serve individuals with disabilities in the most integrated settings appropriate to their needs. The same hospital involved in that landmark case, and the other six hospitals run by Georgia, continue to impermissibly segregate hundreds of individuals, according to DOJ.
In addition to the unlawful segregation, the feds reported that individuals in the hospitals are exposed to egregious harm. According to DOJ, some examples include:
In 2009, the state failed to supervise a patient who had previously killed. The patient assaulted and killed another patient in the hospital.
In 2008, hospital staff failed to intervene in a fight between patients, one of whom was knocked unconscious and died a few days later from blunt force trauma to the head.
In 2009, staff failed to supervise a patient who raped another individual.
In 2009, a patient committed suicide by hanging himself from an upended bed. DOJ had repeatedly warned hospital staff during on-site visits of the dangers posed by beds that were not bolted to the floor.
This month, the state failed to supervise an individual who expressed suicidal thoughts the day before she committed suicide.
The seven hospitals are East Central Regional Hospital, Georgia Regional Hospital at Savannah, Georgia Regional Hospital at Atlanta, Southwestern State Hospital, Central State Hospital, West Central Georgia Regional Hospital, and Northwest Georgia Regional Hospital.
After years of delay in the federal bureaucracy, a national data base for background checks on licensed medical professionals from all 50 states will be available for hospitals to examine on March 1, the Health Resources and Services Administration announced today.
Hospitals can already access the National Practitioner Data Base, which contains records on physicians and dentists, such as license or privilege suspensions, and malpractice payments that are reported by state and federal oversight agencies and health plans.
Now, restricted access data stored in the separate Healthcare Integrity Protection Data Bank, which records adverse licensure actions for all medical professionals, including nurses, technicians, chiropractors, and podiatrists, will be added to the NPDB for hospitals to examine.
HIPDB has been available only to health plans, state and federal oversight agencies, and individual medical professionals for self-queries.
"This means there will be a wider variety of information available to hospitals on healthcare professionals whose information wasn't available before," says HRSA spokesperson David Bowman. "They will have access to a broad array of information that will assist them in making their due diligence when they are in the hiring process."
The data will be collected by sources that include malpractice payers, state licensing and certification boards, hospitals, peer review organizations, accreditation organizations, and professional societies that conduct peer review.
It will be available for hospitals, healthcare professional societies that conduct peer review, state medical and dental boards, law enforcement, and for self-queries from medical professionals.
Businesses like temporary healthcare staffing companies, however, will usually not be allowed access to the data.
Hospitals must prepare for the retirement of the aging Baby Boomer workforce, improve efficiency and staff satisfaction to retain existing workers, and make the healthcare industry an attractive job choice for a new generation of workers as the labor market tightens in the coming decade, recommends a new long-range report released this week by the American Hospital Association.
"For more than 30 years, the U.S. workforce has been dominated by the growing presence of the 'baby boomers' and their characteristics. The workforce has grown rela¬tively rapidly because of the large number of boomers and the employment of large numbers of women," stated the report Workforce 2015: Strategy Trumps Shortage, written by the AHA's Long-Range Policy Committee.
"The boomers are now beginning to approach retirement, and there is little room for a substantial growth in the percentage of working women. Thus, hospitals and health systems face a workforce environment characterized by limited growth in the number of workers. Large numbers of employers throughout the economy will also need those workers," the report stated.
AHA Chairman Richard P. de Filiippi, a trustee at Cambridge (MA) Health Alliance, and the chair of the Long-Range Policy Committee in 2009, said the report "focused on changing environments" and the changes in how healthcare will be delivered and demographics and cultural attitudes of the future workforce.
"It will be critical for us to work with these new realities in devising strategies for best utilizing scarce human resources—strategies that include using new technologies, accommodating the blend of work cultures and habits of multiple generations and retaining existing employees well into traditional retirement years," he said.
The report's recommendations included a call for hospitals to:
1. Redesign work processes and introduce new technologies to increase efficiency and employee satisfaction; retain existing workers, including those able to retire; and attract the new generation of workers.
2.Help staff develop the skills necessary to work effectively in teams.
3. Prepare to provide care with a smaller workforce, and increase the involvement of patients and families in the care process, including home- and community-based services.
4. Continuously assess whether changes in payment, scope of practice regulations, and work practices are reinforcing the current occupational patterns or encouraging new caregiver occupations and task allocations.
5. Work with colleges and universities to help them rapidly transform their traditional degree programs to meet the requirements of new work models, and to provide the critical thinking skills necessary to work with the increasingly sophisticated technology.
6. Work with employees approaching retirement age to identify attractive options regarding roles, schedules, and benefits for continuing to work full- or part-time.
7. Replace traditional HR policies, which were applied uniformly to all workers with policies and programs that include flexibility and choices, to accommodate the preferences of the multiple workforce generations.
8. Orient young workers to the expectation of patients and staff from the traditional, baby boomer, and Y generations as well as to differences in expectation by gender, race, and ethnicity. This should include more substantial orientation and mentoring programs as well as clear policies and guidelines for access to and use of internet sites, including social networking sites.
Carilion Labs, a for-profit affiliate of Roanoke, VA-based Carilion Clinics, will merge with Spectrum Laboratory Network to form one of the nation's largest regional hospital lab companies, the two companies announced today.
The merger, which is expected to close by the end of February, will create a new company serving 37 hospitals and 14,000 physicians in eight states, with more than 2,600 employees and annual revenues above $300 million, the two companies said in a joint media release.
David Weavil, a laboratory industry veteran executive, will be CEO of the new company—the name of which has yet to be announced. The new company will be headquartered in Roanoke, and Greensboro, NC, where Spectrum is located.
Carilion Clinic will own 33% of the new company. Carilion President/CEO Edward G. Murphy, MD, and two other Carilion appointees will sit on the board.
"A new company that combines the strengths and shared values of Carilion and Spectrum with a focus on hospital laboratory services will significantly improve services to our customers and their patients, and provides a strong platform for further expansion within the region and across the nation," Murphy said.
Novant Health, a minority owner in Carilion Labs, will remain an equity owner in the new company and will hold a seat on the board.
The pending merger, subject to FTC approval, follows the recent purchase of Spectrum by Welsh, Carson, Anderson and Stowe, a private equity firm.
Florida Gov. Charlie Crist has immediately suspended state licensure requirements for traveling U.S. nurses, who have valid licenses in their home states or territories, and who want to work in Florida. The suspension is slated for 90 days.
The governor said in an executive order this week that the move was needed to cover a temporary nursing shortage that was created because many Florida nurses are in Haiti to help the recovery effort from the Jan. 12 earthquake.
Willa Fuller, executive director Florida Nurses Association, says her organization supports the governor's order.
"From my understanding, some of the nurses down in south Florida are Haitian and wish to go home to help, but that would affect the staffing at their hospitals," Fuller says. "This would allow nurses at other states who have licenses that are pretty much equal to ours could come here and work and cover them in the hospital so those nurses could take short trips to Haiti. We certainly support anyone who wants to help."
The American College of Radiology, The Joint Commission, and the Intersocietal Accreditation Commission have been designated as accrediting organizations for medical imaging facilities, CMS said in a Federal Registry notification published today.
The designation gives the three organizations the authority to accredit providers of advanced medical imaging mandated by the Medicare Improvements for Patients and Providers Act of 2008, which requires that providers of CT, MRI, PET, and nuclear medicine exams, who bill Medicare for the technical component under the fee schedule, be accredited by Jan. 1, 2012.
"While advanced diagnostic imaging procedures can be useful in identifying health problems that might otherwise require surgery, the rapid growth in their use raises important questions of quality and safety," said CMS' Barry Straube, MD, CMO, and director of the Office of Standards and Quality in a media release. "The three organizations that will be accrediting suppliers have the expertise and authority to set a standard of excellence industry-wide."
The three accrediting organizations had to demonstrate that they were experienced in advanced diagnostic imaging, and that their accreditation requirements met or exceeded the standards set out in MIPPA, including requirements for:
Qualifications of non-physicians performing the imaging
Qualifications and responsibilities or medical directors and supervising physicians
Procedures to ensure the safety of the individuals furnishing the imaging procedure and of the patients
Procedures to ensure the reliability, clarity, and accuracy of the technical quality of the diagnostic images
Procedures to assist the patient to obtain his/her imaging records on request
Procedures to notify CMS of changes to the imaging modalities subsequent to the accrediting organization's decision
The accrediting organizations were also required to develop a plan for reducing the burden and cost of accreditation to small and rural suppliers, and to provide CMS with detailed information about their survey processes.
MIPPA specifically excludes from the accreditation requirements: X-rays, ultrasound, and fluoroscopy procedures. The law also excludes diagnostic and screening mammography, which are regulated by the FDA under the Mammography Quality Standards Act.
CMS plans a provider education outreach program to ensure that suppliers understand the requirements and are able to comply with them prior to the Jan. 1, 2012, deadline.
Two former hospital executives in Los Angeles have agreed to pay the State of California and the federal government $10 million to settle civil claims that they recruited and treated homeless people for unnecessary medical procedures and then billed the government, according to the Department of Justice.
Robert Bourseau and Rudra Sabaratnam, MD, the former owners of City of Angels Medical Center, have already pleaded guilty to separate criminal Anti-Kickback Statute charges stemming from the case, in which City of Angels reportedly paid "recruiters" employed at homeless shelters in the skid row area to deliver their homeless clients by ambulance to the hospital for unneeded medical treatment.
City of Angels billed Medicare and Medi-Cal for treatment allegedly rendered to the homeless patients, much of which was not medically necessary, said the Department of Justice. The two men are awaiting sentencing.
One other former senior executive of City of Angels and two of the medical center's recruiters have also pleaded guilty to similar charges in connection with the alleged scheme.
"Performing unnecessary medical procedures just to take money from taxpayers' pockets is bad enough, but to prey on homeless people struggling to survive day to day is particularly reprehensible," said Tony West, DOJ's assistant attorney general for the civil division, in a media release. "We won't tolerate illegal conduct and we will continue to hold companies, institutions and individuals accountable for health care fraud."
DOJ said it has used the False Claims Act to recover approximately $2.2 billion since January 2009 in cases involving fraud against federal healthcare programs. DOJ's total recoveries in False Claims Act cases since January 2009 have topped $3 billion, according to the department.
Language in the House healthcare reform bill that would strip an antitrust exemption for medical professional liability insurers could increase premiums, the American Academy of Actuaries (AAA) said.
"The end result of the enactment of H.R. 3962, relative to medical professional liability insurance, is likely to be reduced availability with fewer willing insurers, less vigorous competition among those that do write the coverage, and higher costs to the consumer," Kevin Bingham, chairperson of AAA's Medical Professional Liability Subcommittee, told congressional leaders in his Jan. 21 letter.
If Congress repeals the exemption, AAA wants lawmakers to restore language from an earlier version of the bill that would permit information gathering and rate setting activities, which are currently allowed under the McCarran-Ferguson Act. He said aggregated data "provides credible information, supports competition, and guides companies, self-insurers and regulators in reducing the likelihood of insolvencies."
Bingham said that a single company's data is often not sufficiently credible to determine basic loss costs and determine reasonable premiums. He attributed this to the "low-frequency, high-severity, long-tailed" nature of medical professional liability claims, which makes the estimation of losses and premiums more uncertain than in other insurance lines.
"The bill does not specify what loss data may be collected. Additionally, it is unclear about what actuarial activities are allowable," Bingham wrote. "If such limitations on data-gathering apply, it will result in a reduced level of reliability of determinations, with less data available to state regulators charged with evaluating rates."
