Roy Exum
It has been reported the Erlanger Hospital Board of Trustees will approve a $50,000 bonus this Thursday for CEO Will Jackson when, in my opinion, the guy has hurt more hospital employees than any other person since the cornerstone for the place was laid in 1891.
The claim is that under Jackson’s leadership the hospital has made “critical financial and management goals” in the last fiscal year when a closer look solidly proves this is untrue. It also lends credence to the belief by some that Chattanooga’s only Level 1 trauma center is a house made of cards and that “more sooner than later” the truth will be found out in a startling way.
When the 2020 fiscal year ended, a certified audit declared the largest hospital in Hamilton County had a profit of $30.2 million but then compared to $4.2 million in losses in FY2019, the specter of doubt was immediately raised with the cost of COVID included.
It was then learned that in the year-end budget, Erlanger had included what was clearly a Federal loan of approximately $40 million as income. According to those familiar with the “CARES Act Provider Relief Fund,” Erlanger will be required to pay back the loan at a pace of $7 million a month beginning is April of 2021. Further, the alleged $30.2 million in profit doesn’t include several million interest that is due.
For Jackson to “honk his own horn” is as ludicrous as it is obvious; one quiet Friday this spring he coldly fired about 100 mid-management employees, including the highly-regarded head officer of Children’s Hospital. He has levied back-breaking furloughs on hundreds of other employees, ignored a very pressing deficit in the hospital’s pension fund, silently watched as revealing numbers of physicians have left the hospital, and tried to ignore the hospital nurses as they were being harassed and abused. The neonatal mortality rates are abysmal. Ask any battle-weary nurse or seek help in the emergency room – it is clear that Erlanger hospital is woefully – and dangerously - understaffed.
At another point, Jackson forced several hundred of his top staff and employee-doctors to take a pay cut through the summer. The pay cuts were restored in August but now, working closely with Meredith O’Keefe (vice president for Physician Relations), they are confronting these staff doctors on some sort of “breach of contract” charges. Because of COVID, doctors across the country were stymied from seeing patients. All elective surgeries were cancelled. Office nurses and clerical/support staff were furloughed without a care for their families.
Most doctors at every hospital in America were not able to meet their normal “contract quotas” but now the Jackson/O’Keefe duo is telling the doctors they owe Erlanger Hospital thousands of dollars for not reaching their patient quotas. Of course, this will prompt more doctors to resign. “Erlanger actually closed floors this summer due to lack of patients … who is going to assess the hospital for ‘lack of patients’?” one very irritated doctor asked. “The place is being run like a fiefdom.”
According to a Times Free Press report, the performance bonus that Jackson is urging this week is based on three areas:
* -- TO MEET CRITICAL FINANCIAL GAINS: The new budget actually states, “revenue could be reduced $0-$40 million.” Erlanger is betting that President-Elect Biden will forgive the debt. Right now, as of this minute, the $40M is a viable loan and Jackson’s wish it would be counted as earned income can only come from a washed-up bottle on some beach with a genie eager to get on this side of the cork. One independent study of Erlanger’s true picture shows that for FY 2020 the hospital was roughly $28-30M in the red.
* -- IMPROVE HOSPITAL MANAGEMENT: Jackson has attempted to achieve this mark by firing those who disagree with him. While the Board oversees Jackson, all employees must rely on Jackson for bonuses.
* - DEVELOP ACCEPTABLE PLANS FOR PHYSICIAN RELATIONSHIPS: This has not happened and will not happen under the Jackson-O’Keefe hospitality plan. To hear one tell it: “This is a time of great uncertainty in medicine and the wise advice to a doctor is to stay put with your loyal patient base, but Erlanger has had an abnormal number of physician departures. Don’t let anyone tell you the doctors at Erlanger are happy to be there.”
It is totally beyond all understanding and logic that with COVID at its height, unemployment frightful, a pension ignored and decimated, nurses understaffed and over-worked, morbidity rates high in neonatal ICU, and Erlanger the epicenter for area treatment in a pandemic, for Will Jackson to clamor and pursue for a most unearned and factually fraudulent bonus – one week from Christmas Eve, mind you -- proves the Grinch is still alive and well.
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A VETERAN ERLANGER NURSE TELLS ME …
This summer, in a quest to find a need and fill it, I was made aware the nurses and house staff at Erlanger Hospital were being abused and mistreated in a manner where there was no escape. So, I exposed what I discovered was a seething dictatorial mess, some high-level management changes were made, and hospital life was better.
After news surfaced of Will Jackson’s attempt to heist an undeserved $50K bonus was broached earlier this week, I sent a request for comments to some of my nursing pals. One, a veteran expert with a brilliant reputation (and spotless resume), said of the Jackson bonus, “That is the worst thing I have ever heard. I have heard the hospital is finally giving us a raise after five years, but they are raising our insurance cost simultaneously so in reality no raise.
“I worked in the emergency department the other day and it finally broke me,” the nurse described a war zone. “The things this hospital really wants, it spends money on, like the new outpatient center for pediatric doctor offices … but what we really need is staff. How do you get staff? You have to pay... are they willing to pay? Apparently not, so they must not really want to staff us correctly. As my parents always told me, if you want something badly enough, you’ll get it.” What bothers this nurse most is “(The Trustees) clearly don’t want (full staffing) bad enough but do want management bonuses and fancy outpatient centers.”
Have nursing conditions gotten better since this summer’s upheaval? “The only visibly good thing that’s happened since (the executive change) is they will block beds when staffing is low. Doesn’t mean the ratios are protected every shift but it has helped.”
Do the ‘front line’ nurses get extra pay? “I work specifically in COVID … ICU, floor duty, emergency department, and I have never seen any (additional compensation) for ‘risk’ … I haven’t heard of anything, either.
“It’s really horrible right now. We’re running out of beds. And let me tell you how horrible this is … once people end up on a ‘vent,’ (ventilator) with COVID, basically none of them live. Vent, then crrt (continuous renal replacement therapy), then they die. Please mask, distance, wash your hands.”
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THE WORDS OF ANOTHER ERLANGER TOP NURSE
“Roy …. People seem to forget; the hospital isn’t just caring for COVID patients right now. Cancer, heart disease, strokes, etc. don’t care that there is a new disease. We are still caring for all types of patients, not just COVID patients, and we still have more patients than our staff can handle.”
TALK ABOUT RAISES: “I don’t know that the nurses/staff have gotten actual raises in the last five years. Maybe enough to get close to what they call ‘market’ compensation (basically what the other area hospitals pay). We have gotten 'bonuses' of $250 for a year twice I think in five years. After Uncle Sam gets his cut there’s nothing left."
HAZARD PAY? “No. We’ve said since the beginning of this mess, anyone in direct contact with patients or specimens of patients with the virus, need Hazard Pay. If they desperately need extra help, they will use incentive pay for an extra $5-$10 an hour (on top of overtime), but they don’t approve this often. Incentive pay is offered to even those not in direct contact with the virus so it can’t be considered hazard pay due to COVID.”
UNDERSTAFFING: “I’ve seen entire floors with two RNs for the whole unit (especially at night). I have, however, also seen a few rooms on each floor ‘closed due to staffing’ and this varies by day. But this is still not really enough. The lab is understaffed as well as they can’t seem to get us results we need for dying patients. CT always seems backed up as well. The entire hospital definitely feels understaffed. Even now the employee parking lots that used to be overflowing are ghost towns. I know more are parking ‘illegally’ in the garage, but it’s not enough to empty the outside lots.”
ARE NURSES BEING TREATED BETTER? – “While morale seems a bit better because (former administrator) is gone, but there are still other issues. Short staffing, taking away our (personal time off) and retirement for months while Dr. Jackson gets $50k extra. It’s hard to say anything good about our employer right now. Many of us have lost thousands of dollars. They are giving us each a ‘T-shirt’ for our troubles. Those shirts should read ‘I’m an essential employee who worked during the pandemic and all I got was this lousy T-shirt.’ That’s how it feels to get one of those shirts.”
PERSONAL NURSES CASELOADS – “Other than closing a couple rooms on each floor or closing entire floors, I don’t know that there is much that can be done to reduce nurse caseloads. People still get sick or ill (not from COVID) and those people still need hospitals. Perhaps if all the hospitals in the area worked together more instead of thinking about their own pockets, it might help. I’ve seen them as high as 6-8 patients per one nurse in the last month.”
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Erlanger nursing shortages preceded COVID. Nurses all agree that staffing is the key to quality patient care and the consensus is that ridiculous short staffing in ICU units and acute care is – in a word – deadly.
One thing is for certain: It is a good thing the Board of Trustees must decide whether to give Will Jackson a $50K bonus because the hospital nurses are unanimous in calling out the scam for what is really is.
“It’s a lie.”