Study says costs after an OK on nurse-patient ratio law will be manageable; foes say no

Nine Massachusetts hospitals already meet the staffing requirements proposed under Question 1 and would not incur extra costs if the proposal passes, according to an analysis by a Boston College professor that tallied the initiative’s annual cost at between $35 million and $47 million.

Out of the 67 acute care hospitals studied, 37 would face no additional costs under the proposal if they shifted 3 percent of their personnel budget from administrative and non-direct care costs to pay for registered nurses, said researcher Judith Shindul-Rothschild, a registered nurse, associate professor at Boston College’s William F. Connell School of Nursing, and former president of the Massachusetts Nurses Association, which supports approval of Question 1.

Released Monday afternoon by supporters of the initiative, the report said the question would add between 539 and 1,617 full-time registered nurses to the 24,544 already employed at the 67 hospitals, and carries a total implementation cost of between $35,070,376 and $46,830,087. Shindul-Rothschild said in a briefing with reporters that hospitals could defray those costs by reallocating their personnel budgets.

“That’s existing money you have,” David Schildmeier, a spokesman for the Massachusetts Nurses Association, said. “We might lose some senior vice presidents of marketing for international affairs or whatever, and shift it to the bedside.”

According to the study, the 54 Massachusetts hospitals that reported a profit in fiscal 2017 would remain profitable if the question passed. Of the 13 that reported a loss in fiscal 2017, four would not experience a financial impact and the remaining nine would incur losses ranging from $55,670 to $1.4 million, Shindul-Rothschild said. “There are vulnerable hospitals,” she said, noting that nursing labor costs are “not an explanation” for why those hospitals are in “precarious” positions financially.

Dan Cence, a spokesman for the Committee to Protect Patient Safety, which opposes Question 1, blasted the report as one that was “created by union leadership for union leadership and has no relation to reality. The numbers presented here are simply negligent – they grossly underestimate the cost of this measure and are intended to mislead voters,” he said in a statement. “And yet, even THIS biased ‘report’ concedes that nine hospitals already operating at a loss will fall even deeper into the red if these rigid mandates pass – including a number of community hospitals serving populations with few other options. Even in the union’s best case scenario, they acknowledge community hospitals will be pushed over the financial edge – they simply do not care.”

An April report commissioned by the Massachusetts Health and Hospital Association, which opposes approval of Question 1 found that the change in policy would cost the health care system $1.3 billion the first year and $900 million annually in subsequent years while adding an additional $100 million in state obligations. That report, by Mass Insight Global Partnerships and BW Research Partnership, said implementation would require the hiring of 5,911 registered nurses within 37 business days.