Get­ting or­ga­nized

HCA agree­ment gives way to more unions

Modern Healthcare - - The Week In Healthcare - Joe Carl­son

HCA hos­pi­tals in Texas and Florida are see­ing the for­ma­tions of new unions at a fast clip this year, in­clud­ing two last week, fol­low­ing the sign­ing of an agree­ment that gave la­bor unions easy ac­cess to work­ers.

Last spring, the in­vestor-owned hos­pi­tal com­pany qui­etly signed a pact with two of the fastest-grow­ing unions in health­care, the Ser­vice Em­ploy­ees In­ter­na­tional Union and Na­tional Nurses United, HCA and union of­fi­cials said.

As a re­sult, new unions of nurses, tech­ni­cians and ser­vice work­ers have sprung up this year in at least nine HCA hos­pi­tals in Florida, Kansas, Mis­souri, Ne­vada and Texas, with five more elec­tions ex­pected in Florida by next year. Two Florida HCA hos­pi­tals union­ized just last week.

In ex­change for re­ceiv­ing un­fet­tered ac­cess to em­ploy­ees at the 20 HCA hos­pi­tals, the unions agreed not to tar­get work­ers at HCA’s other 142 hos­pi­tals for sev­eral years, ac­cord­ing to peo­ple who claimed knowl­edge of the se­cret agree­ment, in­clud­ing Ed Bruno, the south­ern re­gional di­rec­tor for the NNU’s Na­tional Nurses Or­ga­niz­ing Com­mit­tee.

“Peo­ple are say­ing, ‘Texas? Florida? Are you kid­ding me?’” Bruno said of suc­cess­ful or­ga­niz­ing ef­forts in tra­di­tion­ally union-hos­tile south­ern states. “Cer­tainly in nurs­ing work … you’ve got years and years of pent-up frus­tra­tion that is look­ing for an out­let.”

The neu­tral­ity agree­ment gives union or­ga­niz­ers ac­cess to em­ploy­ees while pro­hibit­ing hos­pi­tal man­age­ment from cam­paign­ing against the union. Elec­tions cov­ered un­der the agree­ment take place by se­cret bal­lot­ing su­per­vised by the Na­tional La­bor Re­la­tions Board. So far, all but one pro­posed bar­gain­ing unit has been ap­proved, mov­ing about 6,000 NNU-af­fil­i­ated reg­is­tered nurses and 4,500 other SEIU hos­pi­tal work­ers into new unions at HCA hos­pi­tals in 2010.

HCA of­fi­cials con­firmed the ex­is­tence of the agree­ment but did not elab­o­rate on the specifics con­tained in it.

“While we do not be­lieve hav­ing a union is in the best in­ter­ests of our hos­pi­tals, we re­spect out em­ploy­ees’ rights to make this de­ci­sion,” HCA spokesman Ed Fish­bough said in a writ­ten state­ment.

The HCA pact ap­pears to have led to more new unions than guide­lines pub­lished last year by the U.S. Con­fer­ence of Catholic Bish­ops that were de­signed to en­cour­age not-for­profit Catholic sys­tems to make union or­ga­niz­ing smoother though co­op­er­a­tion agree­ments. (June 22, 2009, p. 12) Ex­perts say the new or­ga­niz­ing at HCA hos­pi­tals has in some mar­kets caused a cor­re­spond­ing back­lash in anti-union ac­tiv­ity at com­pet­ing hos­pi­tals.

That’s partly be­cause the com­mon in­dus­try prac­tice of em­ploy­ing part-time nurses and other work­ers of­ten leads to hos­pi­tals hir­ing peo­ple who work jobs at mul­ti­ple com­pet­ing hos­pi­tals in the same mar­ket. Now, in some cases, these dually em­ployed nurses be­long to unions in one work­place.

“Se­nior HR vice pres­i­dents are very concerned,” said Jim Triv­i­sonno, pres­i­dent of IRI Con­sul­tants, a man­age­ment­con­sult­ing firm in Detroit.

Though it might seem coun­ter­in­tu­itive that for-profit chains are more re­cep­tive to union ac­tiv­ity than com­mu­nity-based not-for-profit, ob­servers say HCA of­fi­cials must be­lieve they can ben­e­fit fi­nan­cially from the deals—as of­fi­cials at Tenet Health­care Corp. be­lieved when they signed a sim­i­lar pact with SEIU in 2003.

HCA of­fi­cials ap­pear to be seek­ing la­bor peace and cost sta­bil­ity by lock­ing in worker wages at cer­tain hos­pi­tals and se­cur­ing agree­ments to pre­vent union­iza­tion at oth­ers. This year’s en­hanced union ac­tiv­ity comes as sys­tem ex­ec­u­tives plan for their up­com­ing ini­tial pub­lic of­fer­ing of an es­ti­mated $4.6 bil­lion in stock.

Tom Ser­vo­didio, who chairs the la­bor law prac­tice group for law firm Duane Mor­ris, said such agree­ments also can ap­pear at­trac­tive to em­ploy­ers be­cause they can help es­tab­lish a “pat­tern agree­ment” for la­bor con­tracts while avoid­ing spend­ing large sums on anti-union ac­tiv­i­ties.

Of­fi­cials with Car­i­tas Christi Health Care Sys­tem in Bos­ton cited la­bor-cost sta­bil­ity when asked why the not-for-profit sys­tem signed a five-year union con­tract just one week be­fore the sys­tem was bought by for-profit Cer­berus Cap­i­tal Man­age­ment (Nov. 1, 2010 , p. 13).

Ser­vo­didio: Em­ploy­ers can ben­e­fit from la­bor agree­ments.

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