Union alleges TUHS overcharges patients

In a recently distributed flyer, PASNAP makes gutsy claims against TUHS.

In a recently distributed flyer, PASNAP makes gutsy claims against TUHS.

Oct27_HannahPilling_PASNAP7
HANNAH PILLING TTN Following its strike threat at the beginning of the month, the union representing Temple Hospital nurses distributes propaganda alleging that TUHS overcharges patients for care.

Amid heated contract negotiations between Temple University Health System and the union representing the Temple nurses and professional staff, the Pennsylvania Association of Staff Nurses and Allied Professionals is claiming Temple has distorted priorities.

“Support Temple’s dedicated caregivers,” read a flyer recently distributed by PASNAP, accusing TUHS of overcharging patients.

According to recent reports filed by the Pennsylvania Health Care Cost Containment Council, the average charge per medical procedure for the Temple University Hospital is considerably higher than other area hospitals.

“If you look at [the Pennsylvania Health Care Cost Containment Council’s Web site], it has a page by page list of diagnoses, and it has the average charge. On the page that says abnormal heartbeat, the average charges on this at the different hospitals range from a low of [around $10,000] to a high of [$98,328] which is Jeanes, closely followed by Temple at [$96,222].

“And Hahnemann comes in at [$83,593],” Jerry Silberman, staff representative for Temple nurses, said. “And they are the highest on them. The average statewide charge is [$32,586]. So Temple’s charge is 300 percent of the average charge for the state. And they are out of [about 54] hospitals that are listed here, the two that charge the most are Temple and Jeanes, which is Temple.”

Interim CEO of TUH Sandy Gomberg said the accusation is wrong.

“It speaks once again to their uninformed position about health care finances in general,” she said.
Gomberg said the charges that appear in the reports are “like the sticker price when you buy from a car dealer. Nobody really pays the sticker price.”

Contracts for the various services and procedures, Gomberg said, are negotiated with the individual’s insurer, and the price paid is the result of that contract.

“The most important thing I want to reinforce is about uninsured patients. So first, anybody who comes here who needs any kind of care gets that care, regardless of their ability to pay,” she said.

“We have financial counselors who work privately with those patients [without the ability to pay] to help enroll them in medical assistance or other programs in order to help them get the coverage they need,” Gomberg said. “Now, not everybody is eligible for that medical assistance coverage, so for people without insurance, what we [ask them to pay] is based on a sliding scale, the cost of their care and of their ability to pay based on the federal poverty guidelines. They are not based on charges.”

The only other area hospital whose charges were comparable to TUH’s was the for-profit Hahnemann University Hospital.

“We’re a not-for-profit hospital,” Gomberg said. “So at the end of the year, any surplus that we have on the bottom line gets reinvested back into the organization so we can recruit new physicians, buy new equipment, upgrade or maintain the building of the hospital. All the things we need to do to keep improving patient care.”

PASNAP’s flyer, however, addressed Temple’s “distorted priorities.”

“Well, basically, the hospital was preparing for a strike, which did not happen. Temple spent, in our best estimate, based on our experience, Temple probably spent $6 [million] to $10 million preparing for a strike, hiring scabs, hiring replacements in all the categories, having approximately 1,000 people here in town,” Silberman said. “Now, all our demands would not have cost $10 million. If they met every single proposal that we [had] on the table, at that time, it wouldn’t have cost them $10 million.”

Gomberg said strike preparedness and negotiation terms were not financially related.

“From a preparedness standpoint, we are obligated and feel very strongly about our responsibility to provide uninterrupted patient care if the union decides to walk out and go on a strike,” she said. “We will do what ever it takes to provide the right staff to take care of the patients. Right now, because we don’t have a contract, there remains a strike risk. We’ll be ready if the union gives us another strike notice.”

Silberman emphasized that the heart of PASNAP’s concerns remain non-economic. The language in the contract that Temple currently has on the bargaining table, she said, limits the nurses’ ability to advocate for their patients and fails to address poor working conditions.

“They tell us across the table, ‘You don’t have anything to say about the quality of care we provide, it’s not your place to address those issues.’ Well, I’m sorry but it’s not only a nurse’s place and responsibility as a professional, but it’s our responsibility as a union to fight for our members’ better working conditions, which means better patient care,” Silberman said. “You can’t divide those two things. The working conditions of the nurse is the quality of care that the patient receives.”

Silberman pointed to money wasted on corporate management, explaining that several of the hospitals in TUHS have closed since creating the existing management structure.

“Do you need a separate tier of million-dollar executives to manage two hospitals? It doesn’t make any sense to us,” he added. “That’s what we think are distorted priorities.”

But Gomberg said TUH’s priorities revolve around providing quality patient care and a quality education to medical students.

“Our top priority is the delivery of quality and safe patient care to all of those who come here seeking care, so obviously, the nurses and technical staff are very important to making sure our patients get the best care,” Gomberg said. “We also have a strong academic mission, because we’re training the next generation of physicians, so what we’re all about is patient care, and our mission begins and ends with patient care, and certainly our employees, specifically the nurses and the allied health professionals are very important to making sure we provide great care to those patients.”

“[There] are non-economic proposals,” Silberman said. “They don’t cost the hospital anything. They are issues which are really blocking us and keeping us from getting to the serious discussion of finance.”

Valerie Rubinsky can be reached at valerie.rubinsky@temple.edu.

16 Comments

  1. Having read and then reread this article, there are a few qoutes By Interim CEO Sandy Gomberg that are a bit perplexing. In para 12 Gomberg states “So at the end of the year any surplus that we have on the bottom line gets reinvested back into the orginization so we can recruit new physicians, buy new equipment, upgrade and maintain the building of the hospital. All things we need to keep improving patient care.

    Well I didn’t see an mention in Para 12 of the the nurses or other technical and professional staff that provide wonderful care and support to the patients and community surrounding Temple. I quess the worker bees don’t deserve a piece of the surplus pie.

    Para. 15 – Gomberg “Strike preparedness and negotiation terms were note financially related”.

    If the union members had as much money to put into their strike cause as Temple did into recruiting staff to continue operations should they strike, how long do think it would be before Temple actually began to bargain in ernest.

    Para. 16 – Gomberg ” Will do whatever it takes to provide the right staff to take care of our patients”.

    Sure, Sure, Sure! Tell that to all the people that live near Front and Lehigh, Frankford and Allegheny or the kids that live around Broad and Tioga

    Temple Administration has a bad track record, Budd building- millions spent for admininstration big wigs ( this is a non profit?), Northeastern – closed it and spent 4 million to put in a parking lot when Walmart wanted to move in (jobs lost) Episcopal, Temple Childrens Etc. What should make me think they’re doing the right thing now?

    A once proud Temple Grad:{

  2. Thank you Valerie, for your insightful article which serves to hold a mirror up in front of the Temple top brass. So, Ms Gomberg feels the union members have an “uninformed position on health care finances in general” — well it doesn’t take a business suit to figure out that between A)Temple’s haphazard and inefficient supply management system and B)the number of inflated six-figure plus salaries on the payroll, that huge amounts of money that should rightfully be used for the support of quality patient care is flying right out the window.

  3. Excellent article Valerie! It is a great example of speaking truth to power. Enjoy that freedom! The RNs at Temple Hospital have a newsletter where we discuss and report on serious issues within the hospital and within healthcare. Temple management wants to have the power to edit our newsletter. What do you suppose that would look like? If Temple had that power over your media, how would your article be different? I can only imagine….

  4. Most RN’s hold more than one job for various reasons…even Temple RN’s. During my years as a per diem or agency nurse I know that the non-full time employees rely HEAVILY on the continuous guidance, support, and mentorship of the regular full-time employees —and most especially during high acuity and code/near code situations. People choose to come to Temple because they know that the care they will receive will reflect past experiences or endorsements from those who have received their care at Temple. The current situation between Temple management and its UNIFIED CAREGIVERS does not serve well for the community nor does it insure return visits. Money in terms of financial survival during these difficult times can be recovered and earned. Trust in Temple’s ability to serve the community without its caring and patient focused nurses and other caregivers (should they go on strike) is a detrimental risk. The PASNAP members are the frontline warriors of Temple Hospital. The scabs are the bandaid solution to cover for the missing warriors. The value of each PASNAP member to Temple’s organization is priceless !!!

  5. I applaud you Valerie in your depiction of the nurses and allied health professionals at Temple Hospital. We are a very dedicated staff caring for the community that surrounds the hospital. We take pride in our patient advocacy, care and support for the tiniest in the NICU to the adult.
    Being a nurse for over 33 years, patient centered care is the reason I chose my career and the main reason I came to Temple. I feel this standard is being compromised by the seemingly total disrespect Temple has been displaying towards its nurses and health care professionals. The lack of good faith negotiations on the part of hospital administration also reflects this point. We work tirelessly 24hrs/day, 7 days a week on weekends and holidays for 365days a year. PASNAP members are dedicated and hardworking. We are worthwhile and worth it. We are Temple.

  6. Sandy needs to put the money where her mouth is. Ms Gomberg constantly drones on about Temple’s desire to better serve it’s patients. One only need to come through the emergency department to see how far from the truth that is. While the props…the hallways, the lobby, the landscaping, get face lifts to make every thing look pretty, the ER has wallowed in an outdated mode that is laughable in the year 2009.
    The search for supplies and equipment is ongoing in every department at Temple and Temple always manages to place blame elsewhere instead of seeking real solutions(but they will pay alot of money to have consultants come in to point out the obvious).
    Security in the ER is lacking. Staff are verbally assaulted, phyically assaulted and staff’s safety is not high on the priority list at Temple.
    Ms Gomberg compares healthcare to car buying, maybe we should work on improving our consumer rating.

    So Sandy keep slinging the mud at your “fellow nurses”, keep portraying nurses at Temple as greedy,misinformed little people, keep acting like you really care about your employees and the patients. It would be in everyones best interest if you put your money where your mouth is — start walking the walk, and talking the talk — ACT…first by giving NURSES and care providers a FAIR CONTRACT! You need more indians than chiefs to get the job done right!

    So let’s stop wasting time and money being ready for a strike and let’s get down to business and NEGOTIATE a fair contract!

  7. Thanks for what this Union has done. However I need to no if benefits are changing? DX’d as a diabetic. Numerous meds I am taking. Need to keep my Primary, and Endocrinology doctors. Need to no and want to participate with any hearings.

  8. “We will do whatever it takes to provide the right staff to take care of the patients” Sandy Gomberg, RN Interim CEO. PLEASE, the “RIGHT STAFF” are already there. All the administration has to do is come to the table and negotiate in good faith and all the right staff will always be available. But, when the administration arrives several hours after the scheduled meeting times and then spends less than an hour out of nine across the table, it is clear their intentions are NOT to reach an agreement.
    Ms. Rubinsky, I applaud you on your reporting of the stalemate. I wonder if the university settled with the faculty after 2 years because having both the flagship medical facility and the university striking together would not present be very well received by the public.
    Speaking of the public, if the government can restrict salaries in the private sector for receiving government financial support, should that not also apply to a nonprofit medical institution that receives significant state and federal support.
    It strike me as very hypocritical that while on one hand the hospital sites economic differences in our proposals, yet on the other hand they are paying the executives of a nonprofit health care organization millions in salaries.
    As a final note, if the hospital had its way, there would be a non-disparagement clause in the contract and I would now be at risk to be disciplined for having written this piece, regardless of the 15+ years and many hours on call I have dedicated to the care of our patients.
    Beware, the President Weaver may get an idea!

  9. I as well applaud you on this article! I have been a Temple employee for over 10 years, and have been upset about the current contract situation. I am on the bargaining committee and have sat for hours upon hours awaiting the arrival of our administrators. They show us disrepect and ignorance when we have met with them. We have gotten no where fast! It’s not about the money, as anyone would tell you. It’s about respect and good quality patient care! For myself I come to work with a positive and caring attitude, taking pride in my work and where I work! I put my heart & soul into my patient care, as well as every other RN does here at Temple. Many have come here for the benefits that Temple has to offer, isn’t that what most people looking for a job do? Look at benefits?(healthcare, tuition reimbursement, retirement plans, etc.) Then, talk about retention, there are nurses here for 10, 20 & even 30 years! You don’t see that in other hospitals. Temple’s employees take pride in their jobs and are under appreciated. We all work hard to make Temple what it is! We are Temple and the hospital wouldn’t be able to survive without us, not even for one day! We care about the patients, the scabs care about the money! As nurse’s we are at the patient’s bedside, we are there 24/7. As for the comment of buying new equipment, improving and maintaining the building and to improve patient care, I personally question Sandy Gomberg on this! We all have dealt with lack of supplies, broken equipment and areas that need to be updated and remodeled. We need to settle the contract and move on with what really matters….taking care of “our” patients! Thank you!

  10. Having worked at Temple University Hospital these past 29 years I kknow that our benefits have been hard fought for and hard won. In our quest to become the PREMIER HOSPITAL, we have learned the vital importance of serving not only our patient population to whom we devote ourselves but our own staff and colleagues, by entrusting to them fair and decent wages and a fair and decent contract. We do not want to lose ground now nor do we want to lag behind. It is the very nature of our working environment that motivates us to spring out of bed daily, ready for action, to advocate and to serve our patients tirelessly. I would say to our administration, let us not regress and undermine the progress we have gained. In fact, let us seek to build on what we have achieved so we can better serve this neighborhood who will then be proud to call Temple University Hospital, their hospital.

  11. What a great article. During these negotiations Temple seems to have gotten nastier. The more we don’t seem to budge in negotiations to their way of thinking, the more they seem to want to attach. For example changing the vacation and holiday pay status for professional and technical. Now we will not get paid time and half for overtime worked if during that week we have holiday and/or vacation. I have been here for 18 yrs. and have seen temple do some unfair things but it just seems now they are going out of their way.

  12. Thank you Valerie for your support. I have not been at Temple for very long, 2 years. I was drawn to work here first of all, I wanted to provide patient care for my community. i have noticed that there are many things that this hospital lacks in order to provide proper “patient care”. I am sooooo tired of administration using that term since they have no idea about patient care. I work in the general ultrasound department and we are working with equipment that is over 10 years old, which is constantly malfunctioning. This is a huge patient care issue, it effects patient wait time and the quality of the diagnosis.
    We work on a rotating call shift meaning every fifth week I am on call. That week I work eight hours mon-fri. After my regular shift I am on call then I am on call on the weekend. Before I was hired administration decide to invest in ultrasound machines for the ER so that call can be cut, and it has work, according to my co-workers. Recently management added a mandatory 8-12 shift on the weekends which has decreased the amount we get called in. Which has in effect lowered our pay.
    Sandy Gomberg stated that “administration has taken pay freezes”; well the ultrasound department as already taken pay cuts. With the new contract, and i’m only talking about the call issue, we will make approximately 10,000 less a year. This is ridiculous; administration wants to increase insurance premiums and take away tuition reimbursement and cut our pay. How can we live? We are falling into a lower tax bracket while they take pay freezes, wowwwwwww, making 200,000 plus a year. And i will not start on the holiday pay issue, because this was only supposed to be a comment, so sorry about the length.

  13. The week I told my daughter (having worked 8 years Temple Hospital)she could go away to a State College which she was counting on, my supervisor tossed a memo from Temple Administration stating that my Family College Tuition benefit was canceled. We canceled her dream that I a single father of two couldn’t afford!
    This month I got another memo that canceled my OT pay if I used a Vacation Day that week. The PASNAP Union keeps telling us that TEMPLE HOSPITAL is NOT negotiating in GOOD FAITH. Well I believe them!
    This is not about $ for RNs and Allied Health Workers, this is about control. At a time in our Nation where our economy is fragile and people are stressed and concerned and scared, TEMPLE wants to take back.
    Take back from those who have put in the time to make TEMPLE what it is today. Temple’s behavior is selfish and uncaring. Its shameful actions are revealing about how it really feels about its workers. If they really wanted the best care for their patients then wouldn’t they want the best caregivers?
    No No what matters most to Temple is their share of the pie and where it goes? We no longer have an employee day but they have new Administration offices with a GYM and an Executive Chef. We no longer have education benefits for our children but they have a multimillion dollar new College for Doctors. It shows what is important to TEMPLE and now everyone will know!

  14. Bravo! Let’s keep the facts coming. When I came to work for Temple it was the #1 place in Philadelphia to work. That statement could never be stated now. You may get applicants but not experience. I had safety, I had equipment, I had respect. These are all gone. Sandy Gomberg signs with the RN title, but does she really remember what a Registerd Nurse means where safe patient care is concerned.
    Sandy Gomberg comments about the importance of the medical school education, yet who is at the bedside with these students, watching their step, keeping them save? In my department it’s the NURSE.
    It’s time for Temple administration to stop acting like stubborn children, calling names, i.e. nurses are greedy and uncaring. If we were anything close to that we wouldn’t be at Temple.
    The public needs to be aware, Temple nurses aren’t asking for anything more. We don’t want to loose what we work so hard for. Negotiations are just that, to negotiate. It’s time Temple steps up and shows some respect.
    This comment is my freedom of speech, one of the many things Temple wants to take away from our nursing and professional staff.

  15. Great article Valerie, Thankyou! The bottom line here is temple administration wants to weaken our union for the many years and contracts to come. These negotiations are not about money, and sorry to say not about patient care (from administration standpoint) these negotiations are about power. Sandy Gomberg should be ashamed of herself for stating publicly that the top priority is patient care especially when the hospital looks a mess I mean the first floor is nice but just take the elevator up one floor and you question whether your still in the same hospital, There are never ever enough supplies to provide patient care, on my unit we bring SOAP from home cut it in squares to wash patients. More importantly when you do see adminstration in the patient care areas once in a blue moon, They walk past, do not speak, give you the evil eye, with their noses in the air. They do not stop in any patients room say how are you feeling, nor can i get you anything, they harass and intimidate the nurse managers and assistant nurse managers about issues beyond their control (like doctors leaving cups and empty bottles at the desk) is that what you would consider priority patient care? All the nurses at temple would like is what’s fair, what we have is all we want, why all of a sudden is this a problem. Oh and as for the education of medical students (ha ha ) if it wasn’t for the nurses and technical staffs education and common sense there would be a hell of a lot more lawsuits circulating through the legal representation department of Temple Universily Hospital because medical students./interns have no clue especially when it comes to patient care. I firmly believe in kharma and if temple adminstration does not wake up and smell the coffee look for many many years of bad luck and failed adminstrations to come GOD DOES NOT LIKE UGLY!!!!!!!!!

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