Tag Archives: nursing homes

Worker Shortages Are Pushing Wages Up at the Bottom

New Orleans       With more than twenty candidates signed up for the Democratic primary, they are undoubtedly getting more advice than they want from all corners, friend and foe, including for many that they need to get out of the race, so who am I to throw water on their fire?  Regardless, I’ll say this one thing more than one year out, remember James Carville’s line, “it’s the economy, stupid!”  Once they do, they need to not take lower wage, service workers for granted in the race against Trump, nor should they mistakenly assume they will turn out in huge numbers to beat him despite the rising inequality, his tax cuts for the corporations and the rich, his anti-immigrant and anti-poor positions and policies, and the endless list of other infractions and embarrassments in the White House.

Why?  Because record unemployment is finally forcing wages up at the grassroots.  I’ll tell you from the frontlines of the battlefield how I know.

A chain of nursing homes where our union, Local 100, United Labor Unions, has a contract for a number of homes in Shreveport in north Louisiana, had changed hands over recent years.  One company in more of a real estate play got in trouble with a REIT and had to declare bankruptcy.  A new one has taken over and was bargaining the successor contract for the homes with us.  We made our proposal to improve wages, and they came back.  We are now going to have a starting wage there of $11 per hour, a significant jump in the land of $7.25 minimums, and there were seniority bumps and shift differentials.

Was this one off, you might ask?  No, another contract that came up in Napoleonville on the west side of the Mississippi River between New Orleans and Baton Rouge at another nursing home a month ago.  There we also won record increases on starting wages and up and down the scale of almost a dollar an hour.

Did we just become stronger or better?  I wish!

The reality is that we are catching the wave of record, 50-year lows in unemployment rates close to statistical full employment.  Nursing homes require certified nurse aides, so it’s not simply hire-off-the-street, even though companies have not always valued the wages in the same way.

This wave of wage increases shows up in the Fight for $15 effort certainly and has spread to mass employers like McDonalds, Walmart, Amazon, and many others, who can’t get the workers they need.  I’m not pretending this is trickle-down and every boat will rise.  That won’t happen with the level of precariousness, gigging, and less than full-time work. Nonetheless, there are going to be a ton of lower wage workers who would normally be base voters, and still might be, but who are going to hit the polls with more money in their pockets, and less desperate to throw the bum out.  They won’t be focused on whether this employment run is a continuation of the Obama recovery and whether or not Trump’s claims are valid, but they will know their money is better.

Anyone taking these voters for granted will lose badly.  They aren’t Trump voters, but truth to tell, many of them are not chronic voters, so the message to our members and many millions more is going to have to be better than, “come out and vote for anybody but….”  They don’t like him, but they won’t break a leg to beat him, because they don’t like the elites any better than he does, and for all the sound and fury, they will know their money is better now, even if the rich are richer.

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Readmission Guidelines are Not Without Risk

New Orleans       I’ll admit it.  I’m looking for silver lining in the clouds.  In the midst of the Trump administration’s unraveling of critical labor, environmental, health, safety, and welfare standards to see the FDA continue to crack down on e-cigarettes or HHS continue to hold nursing homes more accountable for care must count as patches of sunlight on dark days.

Of course, touting the readmission penalties imposed on hospitals and now extended to nursing homes with financial penalties seemed like a win all the way in increased accountability and lower costs.  It pains me to be “Debbie Downer” on my own parade here, but there are some big caveats and question marks that are also emerging about these readmission penalties being sounded by cardiologists.  An op-ed in the Times by several of them pointed out some of the risks that are now emerging, partially because of the way hospitals are gaming the rule.

The rule emerged when Medicare officials and researchers realized a decade ago that 20% of Medicare patients hospitalized for fairly common occurrences were being readmitted to the institutions within 30 days with about half of those readmissions coming from causes thought to be preventable.  Implementing the penalties for quick readmissions on a half-dozen different medical ailments saved Medicare about $10 billion a year.

The researchers have now found that hospitals are hustling the rule in order to avoid the penalty, which is a reduction of their Medicare reimbursement rate, by caring for comebacks in the emergency room to avoid readmitting, even if they really belong in a hospital bed. Furthermore, hospitals serving lower income patients with more health issues are also being penalized because they have higher readmission rates.  Those are my people, which is why this piece got my attention!  Worse, they claim that death rates now seem to be rising for pneumonia and some heart cases, even as the penalties are saving money.

These are big-time researchers from Harvard Medical School, Washington University School of Medicine, and Beth Israel Deaconess Medical Center in Boston so they are cautious even as they raise red flags about the rule.  Their concern is prompted by a “save money at all cost” caucus in Washington that wants to extend the six health reasons that can trigger readmission penalties to all Medicare patients for all reasons.

The doctors want an investigation by Centers for Medicare and Medicaid Services before expanding the rule in order to make sure that unintended consequences aren’t killing people. I’m not saying their position will prevail, but I find it hard to argue against looking harder before we leap farther in this direction.  Poor people are dying too fast already.  There’s no reason to kill any more of our people off before their time, even as we hold money-grubbing health institutions accountable.  This shouldn’t be a tradeoff.

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