The state’s largest health-care union Tuesday condemned what it called “profound flaws” in the state Health Department’s oversight of hospitals, saying lax oversight allowed new for-profit owners to drive up health care costs and reduce access to services, while depriving nurses and other hospital employees of their rights.
The Health Professionals and Allied Employees’ 24-page report called upon the state to enforce its own laws and regulations, do its own regular hospital inspections rather than cede responsibility to proprietary agencies, and update hospital staffing requirements last established in 1987.
“New Jersey’s failure to use its own monitoring and enforcement powers places New Jersey health-care consumers and employees of hospitals at risk,” said Patrice Mareschal, an associate professor at Rutgers University who wrote an afterword to the report. “Quality oversight is an inseparable element of good government, not a luxury to be dispensed with in the face of austerity.”
Mareschal and Janice Fine, another associate professor at Rutgers, were among co-authors of a recent Rutgers study about the state government’s dwindling oversight role, from administration of hurricane-relief funds to the corrections department’s halfway houses. Both participated in the conference call to release the union’s report, entitled “The Christie Administration’s Department of Health: Failures in Enforcement, Accountability and Transparency.”
A spokeswoman for the health department said that it “has taken an increasingly aggressive approach toward enforcement and oversight,” following passage of a 2008 law that enabled it to monitor hospitals for early signs of financial distress.
Last year, the department “took the first ever enforcement actions against a hospital for failing to comply” with conditions imposed when its license was transferred, said spokeswoman Donna Leusner, referring to fines levied against the owners of Meadowlands Hospital Medical Center in Secaucus for failing to submit its audited annual financial report.
Department staff “also attends the board meetings of several hospitals in financial distress and, if necessary, calls in hospital management and board members to discuss strategies to improve their fiscal health,” Leusner said.
The union represents nurses and other employees at several hospitals sold to for-profit owners in recent years, whose business practices were the focus of the report’s criticism. They include Meadowlands, Bayonne Medical Center, Christ Hospital in Jersey City, Memorial Hospital of Salem County, and Bergen Regional Medical Center, which is managed by a for-profit company.
The union’s position is “that we need to stop the proliferation of for-profit healthcare in New Jersey and gain greater accountability of existing hospitals,” according to its web site.
In approving hospital sales to for-profit companies without reassessing the services that are offered, the health department has “abdicated its role as any sort of regional planner or regulator,” said Renee Steinhagen, of New Jersey Appleseed public interest law group, who joined the union teleconference.
The union cited several concerns that it said undermined the transparency of the department’s work and of hospital operations.
ä Inspections necessary for hospital license renewals are conducted by proprietary agencies hired by the hospitals, and detailed reports of findings and corrections are not made available to either the health department staff or to the public, in a departure from previous policy.
ä Results of the department’s complaint investigations are no longer posted on the department’s web site.
ä For-profit hospitals are not required to disclose the same financial information required of non-profit hospitals in their tax filings, such as executive compensation and distribution of operating profits. Governor Christie conditionally vetoed a law that would have changed that, and directed the state Health Commissioner, Mary E. O’Dowd, to recommend changes to the measure. But she has not done so, the union said.
In response, Leusner noted that New Jersey is one of 48 states relying on outside accreditation agencies for routine inspections, which allows the state to use its resources for complaint investigations. All hospitals submit the same monthly financial information to the department, she said.
On Thursday, officers and members of HPAE will be in Trenton for a day of lobbying to advocate for a law that establishes staffing ratios throughout hospital departments.
By LINDY WASHBURN