Mount Sinai ordered to pay $127K fine for understaffing NICU

New York City-based Mount Sinai Hospital was ordered to pay nurses a $127,000 penalty after an arbitrator found it had a "persistent pattern" of understaffing its neonatal intensive care unit, Politico reported May 17.

The unit's nurses are supposed to be assigned no more than two babies at a time per their union contract. However, the arbitrator found the 46-bed unit was routinely short-staffed by as many as six nurses between mid-January and mid-April. That left about two dozen nurses working in a unit with an average of 52 patients daily, according to the report.

The ruling marks the first time a New York City hospital has been held financially liable for violating the contractual staffing ratios won by the New York State Nurses Association. Such a provision with clear financial penalties is unprecedented in the nursing industry, according to the report.

However, Mount Sinai pushed back on the arbitrator's conclusion:

"Hospitals everywhere have grappled with nursing and other health care worker shortages, and these are not challenges unique to any healthcare provider and have been well documented across the city, state and country," Mount Sinai spokesperson Lucia Lee told Politico

In a statement to Becker's, Ms. Lee added, "Mount Sinai is appropriately resourced to provide excellent care for our NICU babies and families and we continue to recruit top caregiver talent to maintain the highest standards of clinical quality. The ratios included in the agreement with NYSNA ignore the reality that our NICU consists of two sections: NICU East and NICU North. Of the 46 licensed beds, 20 in NICU East are licensed for actual Neonatal Intensive Care and 26 in NICU North are used predominantly for intermediate/continuing care. Intensive care patients are always staffed at a 1:1-1:2 ratio, while those in intermediate and continuing care are staffed 1:3 or 1:4, based on the clinical needs of the baby. That said, let us be clear. These penalties are an unfortunate consequence of an agreement negotiated with NSYNA in the waning hours of the strike and do not recognize the superb team care that makes our NICU one of the safest in the nation."

The arbitrator calculated the penalty based on nurses' average daily base pay of $643 per shift and the number of nurses short on a given shift. He then gave the hospital a 20 percent discount because the penalty amount "does not reflect the extraordinary financial efforts Mount Sinai Hospital has made to address staffing and meet ratios."

Approximately 150 nurses may be eligible for compensation from the penalty, according to a nurses association spokesperson.

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