Massachusetts hospitals, union clash over cost of nurse staffing ballot issue

The Massachusetts hospital industry and Massachusetts Nurses Association have differing views on the estimated financial effect of the proposed November statewide ballot initiative to mandate nurse staffing ratios in hospitals, The Boston Globe reported.

Hospital executives opposed to the ballot initiative cite a study by Mass Insight Global Partnerships and BW Research Partnership. The study, commissioned by the Massachusetts Health and Hospital Association, estimated mandated nurse staffing ratios would cost the state's healthcare system $1.3 billion in the first year and at least $900 million per year after that. 

Healthcare organizations have come up with their own individual estimates. For instance, the parent company of Cape Cod Hospital in Hyannis, Mass., estimates mandated nurse staffing ratios would cost it more than $34 million annually, according to the report. Boston-based Partners HealthCare, the state's largest hospital system, estimated a cost of $140 million across its facilities.

Question 1, proposed by the Massachusetts Nurses Association, calls for mandated nurse staffing ratios that would vary by unit, floor or department.

Supporters of the initiative are part of a group called the Committee to Ensure Safe Patient Care, while opponents are part of a group called the Coalition to Protect Patient Safety.

Supporters argue mandated nurse staffing ratios will improve patient care, and opponents say the ratios will worsen nurse care delivery, lead to longer emergency room wait times, and hurt community hospitals and mental health facilities.

The nurses' union contends the hospital industry "grossly" exaggerated the cost of the ballot initiative. On Sept. 10, the union announced that a study it backed by Judith Shindul-Rothschild, PhD, RN, a nursing economist at Boston College, estimated mandated nurse staffing ratios would cost Massachusetts acute care hospitals between $35.1 million and $46.8 million. The opposition group has said the union's study "includes misleading information and flawed research."


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