MCSA ancillary employees report staffing, pay issues

Over the past two months, the general medical staff of Medical Center of South Arkansas has taken two votes of no confidence in the hospital’s administration.

A representative of some members of the group of doctors who took the votes on June 5 and Aug. 12 and four nurses have spoken to the News-Times about issues and concerns with MCSA leadership, particularly Chief Executive Officer Scott Street.

The doctors are represented by attorney Vicki Gilliam and the nurses, who are still employed with MCSA, were not named in the News-Times at their request.

Following the first vote of no confidence, MCSA brought in independent legal counsel to launch “a thorough and complete investigation of the matters raised.”

The probe wrapped in late July and the findings were presented to the MCSA Board of Trustees on July 29.

Per a memo that was sent to employees by Street and dated July 30, the investigation yielded several recommendations, including strengthening the relationship between MCSA’s administrative team and the medical staff; bringing in an interim chief medical officer; establishing a physician advisory council; expanding clinical support by exploring the potential for a second operating-room call team; and working on additional training related to patients who transfer to MCSA.

The hospital’s board of trustees did not move to implement any of the recommendations and voted instead to request a new administrative structure.

Community Health Systems (CHS), which owns MCSA, also announced in early August that it was sending a “resource team” to support the hospital’s administration.

As of July 30, MCSA has decided to end its contract with ER and hospitalist staffing agency, SCP Health, formerly known as Schumaker Clinical Partners. The contract expires in late fall. Gilliam represents 11 doctors who participated in the votes of no confidence and are employed at MCSA through SCP Health.

They include Dr. Ezinne Nwude and her husband, Dr. Ugo Nwude; Dr. Greg Smart; Dr. Joseph DeLuca; and Dr. Abrar Khan.

Other actions that have been taken by MCSA as a result of the independent investigation include some changes and reshuffling of the administrative team — namely, the resignation of Chief Nursing Officer Amy Triplet and the pro

motion of Chief Quality Officer Danna Taylor to associate administrator; and the return of former Director of Operations Mark Allman to his previous role as director of respiratory therapy, as well as the addition of interim “nursing and quality leaders” as MCSA works to fill the positions of chief nursing and quality officer.

Another group of employees who are a part of the MCSA team have also asked to speak out without being named and expressed complaints and concerns about issues within their departments and the hospital administration.

Some employees from the MCSA ancillary departments — including radiology, phlebotomy, laboratory and respiratory services — said they were not included in the investigation that followed the first vote of no confidence.

They also said they feel their complaints and concerns are often overlooked and they would like to have their voices heard.

And MCSA is responding. Ancillary employees

The ancillary employees (AEs) emphasized that MCSA health care providers are providing “A-plus, quality care” for patients but a seeming lack of support from the administration and some department heads often make their jobs more difficult.

They cited such issues as under-staffing, a lack of pay raises, supply shortages, low morale and tensions in the work environment.

While the coronavirus (COVID-19) pandemic presented new, unprecedented challenges for MCSA and health care facilities across the world, the public health crisis also exacerbated issues that employees faced at MCSA long before the virus hit, the AEs said.

The employees said they feel they do not have an avenue with the MSCA administration or their respective department heads to voice complaints or concerns without fear of retaliatory action.

“We do not have anyone who will sit down and really listen to us and address our concerns,” the AEs said.

“Employees who complain have been told (by at least one member of the MCSA administrative team) that they are welcome to find employment somewhere else and we wish you the best wherever you go,” one employee contended, with others agreeing.

Some of the AEs, a few of which have worked at MCSA for more than two decades, said they have not received pay raises in several years.

They said a wage and salary survey that was commissioned by MCSA years ago showed they were being underpaid in their respective positions but the hospital did not raise AE pay to the levels that were recommended in the survey.

“Now, there is an even bigger pay gap because a Costof-Living Adjustment has not been granted in a number of years and pay has not gone up with the federal minimum wage,” an AE said.

One department head, they allege, told some AEs that “the best way to negotiate more pay is to quit and reapply or if you seek employment somewhere else, bring us an offer letter so we can look at it and if they offer higher pay, we’ll see if we can match it.”

In an email to the NewsTimes, Alexandria Bennett, executive director of business development for the hospital, wrote that all full-time employees are eligible for an annual merit increase, which is based on job performance.

“The hospital also monitors wages and benefits across the market in an effort to offer competitive compensation and from time to time, may adjust wages for some job classifications,” Bennett said.

“New-employee compensation is based on job classification, skills and years of experience. New employees are not offered the same or higher compensation than existing employees, unless their skills and experience place them at a higher rate,” she added.

Further, Bennett said signon bonuses are industry standard for hard-to-fill positions and MCSA’s sign-on bonus program is consistent with other hospitals across the country.

The sign-on bonus program includes nursing, radiology, medical technologist, physical therapy, occupational therapy and respiratory positions.

The AEs also allege that some of their departments were under-staffed throughout the past year, particularly during peak COVID-19 cases, and complaints about the matter were ignored.

For instance, at times over the past 18 months, the number of respiratory therapists was cut for day and nighttime shifts, even though the number of patients was higher than usual because of COVID-19, workers said.

At one point, only one respiratory therapist was assigned to the night shift and was being pulled among various departments throughout the hospital who needed respiratory services for patients, the AEs said.

“When people (AEs) said something about it, (the therapist) was told that she was complaining too much when she asked for help and all we kept hearing (from a department head) was that his numbers were down,” the AEs said, referring to expenditures/costs.

“We provide quality care and we’re going to do what we have to do to make sure of that but these are the conditions that we have to do it under. We’re overworked,” one of the AEs said.

Bennett said patient population and acuity determine how MCSA shifts are staffed.

“That means staffing levels change based on the needs of patients currently in the hospital. As the number of patients and the complexity of their medical care increases, staffing levels increase too,” said Bennett. “We have supplemented our … team with contracted staff to ensure safe, quality care. We are meeting daily – sometimes more than once a day – to review and enhance staffing levels when needed.”

Current MSCA staffing levels are adequate for the patients in our care and are being monitored closely on a shift-by-shift basis when patients come in with COVID-19 and other health care needs, said Bennett.

AEs also raised questions about another COVID-19-related issue: funding that was made available to MCSA, via the state, from the Coronavirus Aid, Relief, and Economic Security (CARES) Act of 2020, particularly hazard and other applicable payments that were allocated for health care workers.

Bennett said MCSA applied for CARES Act funding on behalf of employees and all eligible employees who reside in and out of state “were given the full amount of funds allocated,” according to Arkansas guidelines for the program.

She also said the funds were disbursed “properly and promptly” to employees, with in-state staff members receiving their allotments within the same week the funds were released to MCSA and out-of-state staff members, shortly thereafter.

However, some of the AEs insist they endured a long wait in receiving CARES Act pay, as did out-of-state employees, who, allegedly, were initially told they did not qualify for the funds.

“We also don’t feel like we got what were supposed to get, based on our understanding of the guidelines, and we would like to see an accounting of what the hospital got and how the CARES Act pay was disbursed,” one of the AEs said.

Employee feedback

Bennett said MCSA employees have several avenues by which to provide any feedback, including grievances and complaints, and the hospital’s administrative team lends an open ear for legitimate concerns of employees.

“Throughout the pandemic, we have been communicating with our team about the evolving public health crisis, COVID safety, supply and (personal protective equipment) usage, staffing levels and other things that help our employees confidently do their jobs” she said. “Every employee is empowered to share feedback and speak about concerns.”

She also said MCSA has zero-tolerance for retaliation against employees who lodge complaints.

Bennett noted that MCSA’s turnover rate is “better than industry norms and has remained consistent during the pandemic.”

The most recent MCSA employee satisfaction survey was conducted in 2020 during the COVID-19 pandemic, Bennett said, adding that 87% of the employees who responded rated overall satisfaction with the hospital at a score of 4.07, up from 3.8 in 2019.

AEs said that in the midst of the votes of no confidence and follow-up actions that were taken by the hospital, they were asked — not required — to sign a statement affirming their support of the hospital staff and administrative positions.

Some said they declined to sign.

“There are some good people who work here and do their jobs with excellence and there are some good people who have left here because of all of what’s been going on,” one of the AEs said.

“We do not support some of the administrative positions and we agree with what the doctors are fighting for,” the employee continued. “We were saying this way before any of this started. We just didn’t have anyone who would listen to us and we didn’t feel like we had anyone we could go to.”