An Open Letter to Michigan Patients and Communities

The following letter is on behalf of all Michigan hospitals and health systems signifying their unified opposition to proposed House Bills 4550-4552, which threaten to put patient care at risk across Michigan.

Dear Michigan Families,

Our shared mission as hospitals is to advance the health of individuals and communities. For decades, we’ve worked collaboratively – not competitively – on the things that matter most to you: delivering safe, high-quality care when you need it, where you need it, whether that’s in downtown Detroit or the farthest reaches of the Upper Peninsula and everywhere in between. Maintaining timely access to services for every patient is what we work to preserve every single day.

Unfortunately, the Michigan Legislature is currently considering legislation that would result in the closure of more than 5,100 hospital beds statewide. That’s the equivalent of closing every hospital north of Grand Rapids and Flint. The legislation sounds good in a sound bite: more nurses at the bedside, ‘round the clock. But like most things in life, it’s not that simple. Michigan hospitals currently have 8,400 nurse openings posted on job boards. Hospitals are focused at the local level on listening to nurses, getting them the resources they need to do their jobs effectively and have work-life balance, and protecting them from violent attacks in the workplace. Hospitals proudly fought to get tougher penalties enacted for visitors who attack healthcare workers, and this week that bill will go to Governor Whitmer’s desk. We’re also focused on building effective care teams and not relying only on RNs to care for patients 24/7. We’re partnering with higher education to build nurse training and education programs and capacity.

Sadly, House Bills 4550 – 4552 override local nurses’ decision-making about how to staff their units and care for patients. Instead, they would implement a government mandate that would apply a one-size-fits-all nurse-to-patient ratio for RNs in every hospital, no matter its size, location, how sick its patients are or how experienced its nurses and care teams are. We, 100% of Michigan’s hospitals, stand united in our opposition to this misguided legislation. The Michigan Organization of Nursing Leadership and the American Nurses Association – Michigan, who both recognize the unintended consequences the legislation would have on patient access, also oppose mandated staffing ratios.

We all want more nurses. That’s why we’re trying to hire 8,400 of them today. For hospitals to meet the mandates in the legislation, they would have to find more than 13,000 nurses to hire. If we can’t fill the 8,400 openings we have now, how would we fill 13,000 positions – and at a time when nurses are also critically needed in nursing homes and other settings? Unfortunately, this legislation will force the hospitals you rely on to be there if you’re in a car accident, fall off the ladder hanging Christmas lights or are battling a terrible disease, to either break the law and keep services running without the mandatory nurse ratios (which will also make healthcare more expensive due to billion dollars in fines that will be assessed), or instead, they will close services and beds. That means longer wait times for everything from emergency visits to surgeries. It means many of Michigan’s 130 hospitals could all be “on diversion” at the same time, meaning patients get bounced around because nobody has open beds. This is an awful experience for patients and could be deadly especially in Michigan’s rural areas or amidst bad weather. Studies have proven that statewide nurse patient ratios implemented in California did not improve safety or outcomes. Their hospitals overall are not safer than Michigan’s. Nurses did not flock to California when they adopted ratios. In fact, California currently has a nurse shortage numbering in the tens of thousands. Ratios didn’t fix that – and it won’t fix the shortage in Michigan.

Hospitals and our nurse leaders – as well as a large coalition of organizations across industries, who all oppose this legislation – are imploring the Legislature to preserve access to care, and let local patients’ needs drive a hospital’s staffing models. Let’s use innovative programs like virtual nursing to support patient care and let nurses do the bedside work they do best. Let our care teams work together across professions to ensure a patient gets what they need and we maintain a robust and diverse pipeline of patient care professionals. Let’s work together on common-sense solutions that nearly every other state has adopted, like being part of the national Nurse Licensure Compact allowing licensed nurses to work in other states. Let’s work together on rebuilding our nursing and patient care professional talent pipeline.

Adopting misguided legislation that will reduce services and close hospital beds, and that will do nothing to create the thousands of new nurses we need in Michigan, is bad public policy. Instead, let’s remember that there’s so much we have done, and can do, together. Let’s get to work on real solutions that will protect patients, protect access, grow the nursing workforce and ensure those nurses have safe, fulfilling workplaces.

Sincerely,

Brian Peters
CEO
Michigan Health & Hospital Association

Carol Schmidt
SVP Ascension, & Ministry Market Executive
Ascension Michigan

Dean Kindler MD
President & CEO SW Region
Ascension Borgess, Lee, Pipp & Allegan Hospitals

Douglas Apple MD
Chief Clinical Officer & Interim President and CEO Ascension Genesys Hospital

Michael Wiemann MD
Regional President & CEO
Ascension Michigan – Southfield, Novi, Rochester

Kevin Grady MD
Regional President & CEO
Ascension Michigan – Warren, Madison Heights, St. John and River District

Jordan Jeon
Interim Regional President Ascension
Ascension Standish Hospital and St. Joseph

Christine Harff BSN
Regional President, Upper Peninsula
Aspirus Iron River, Keweenaw and Ontonagon Hospitals

Paula Chermside
Chief Administrative Officer
Aspirus Ironwood Hospital & Clinics, Inc.

Rob Stowe
Chief Executive Officer
Baraga County Memorial Hospital

Maria Behr
President
Beacon Health System – Three Rivers Health System, Inc.

Dustin Ames
Chief Executive Officer
Beaumont Behavioral Health

Bill Manns
President & CEO
Bronson Healthcare Group

Steve Vernon
Chief Executive Officer
Cedar Creek Hospital

Fazleomar Mahmood MD
Chief Medical Officer
Chelsea Hospital

Benjamin Miles
President
Chelsea Hospital

Cheryl Taylor MSN, RN
Chief Nursing Officer
Chelsea Hospital

Tina Freese Decker
President & CEO
Corewell Health

Andrea Leslie MSN, RN
Regional Market Leader
Corewell Health Big Rapids, Greenville, and Reed City Hospitals

Darryl Elmouchi MD
Interim President, Corewell Health in Southeast Michigan
Corewell Health East

Chris Fox RN
Chief Nursing Officer
Corewell Health Lakeland Hospitals – St. Joseph Hospital

Drew Dostal BSN
Regional Market Leader
Corewell Health Ludington and Gerber Hospital

Bill Hoefer
Market Leader
Corewell Health Pennock and Zeeland Hospitals

Loren Hamel MD
President, Corewell Health in Southwest Michigan
Corewell Health South

Connie Harmon RN
Chief Nursing Officer
Corewell Health Watervliet Hospital

Alejandro Quiroga MD
President of Corewell Health West
Corewell Health West

Debbie Guido-Allen BSN, RN
President
Corewell Health’s Beaumont Hospital, Dearborn

Derk Pronger
President
Corewell Health’s Beaumont Hospital, Farmington Hills and Grosse Pointe

Daniel Carey MD
President
Corewell Health’s Beaumont Hospital, Royal Oak

Kristine Donahue RN
President
Corewell Health’s Beaumont Hospital, Taylor, Trenton and Wayne

Nancy Susick MSN, RN
President
Corewell Health’s Beaumont Hospital, Troy

Beth Charlton BSN, RN
President/CEO
Covenant HealthCare

Angela McConnachie MSN, RN
Chief Executive Officer
Deckerville Community Hospital and Marlette Regional Hospital

Brittany Lavis
Group Chief Executive Officer
Detroit Medical Center

Archie Drake BSN
Chief Executive Officer
DMC Children’s Hospital of Michigan

Brady Dubois
Chief Executive Officer
DMC Detroit Harper and Receiving Hospitals

Patty Jobbit
Chief Executive Officer
DMC Rehabilitation Institute of Michigan

Lance Beus
Chief Executive Officer
DMC Huron Valley-Sinai Hospital

Gary Purushotham
Chief Executive Officer
DMC Sinai-Grace Hospital

Timothy Johnson
President and Chief Executive Officer
Eaton Rapids Medical Center

Michael Nanzer
Chief Executive Officer
Forest View Hospital

Saju George
Regional CEO – Prime Healthcare MI Market
Garden City Hospital and Lake Huron Medical Center

Jill Wehner
President & CEO
Harbor Beach Community Hospital Inc.

Jamie White
Chief Executive Officer
Havenwyck

Michael Beaulieu MD
Chief Medical Officer
Helen Newberry Joy Hospital & Healthcare Center

Hunter Nostrant
President & Chief Executive Officer
Helen Newberry Joy Hospital & Healthcare Center

Michele Petersen MSN, BSN, RN
Chief Nursing Officer
Helen Newberry Joy Hospital & Healthcare Center

Robert Riney
President and CEO
Henry Ford Health

Andrew Daniels
President & CEO
Hills & Dales General Hospital

Jeremiah Hodshire
President & Chief Executive Officer
Hillsdale Hospital

Dale Sowders
Chief Executive Officer
Holland Hospital

Patti VanDort MSN, RN
President
Holland Hospital

Melany Gavulic RN
President and CEO
Hurley Medical Center

Kevin Rogols
Chief Executive Officer
Kalkaska Memorial Health Center

Karen Cheeseman
President & Chief Executive Officer
Mackinac Straits Health System, Inc.

Amanda Shelast
President
Marshfield Medical Center – Dickinson

Kent Riddle
Chief Executive Officer
Mary Free Bed Rehabilitation

Steve Barnett CRNA
President & CEO
McKenzie Health System

Darrell Lentz
President & CEO
McLaren Bay Region

Connie Koutouzos
President & CEO
McLaren Caro Region & McLaren Thumb Region

Robert David
President and Chief Executive Officer
McLaren Central Michigan

Jeannie Sage MSN, RN
Chief Nursing Officer
McLaren Central Michigan

Chris Candela
President & CEO
McLaren Flint

Kirk Ray
President & CEO
McLaren Greater Lansing

Philip Incarnati
President and Chief Executive Officer
McLaren Health Care

Tim Vargas
President & CEO
McLaren Lapeer Region

Thomas Brisse
President & CEO
McLaren Macomb

Chad Grant
Executive Vice President and Chief Operating Officer
McLaren Northern Michigan

Tracey Franovich RN
President & CEO
McLaren Oakland

Eric Cecava
President & CEO
McLaren Port Huron

Brian Long
President and CEO
Memorial Healthcare

Marilyn Beverly
President, Board of Trustees
Munising Memorial Hospital

Jim Parker
Chief Executive Officer
Munising Memorial Hospital

Edwin Ness
MHC President & CEO
Munson Healthcare

Peter Marinoff
Cadillac Community President, South Region President
Munson Healthcare Cadillac Hospital

Joanne Schroeder
President
Munson Healthcare Charlevoix Hospital

Kirsten Korth-White
President and CEO, Grayling Hospital & East Region President
Munson Healthcare Grayling Hospital

Kelly Tomaszewski MSN, RN
President
Munson Healthcare Manistee and Paul Oliver Memorial Hospital

Christopher Squire
Community Hospital President
Munson Healthcare Otsego Memorial Hospital

Kathy Laraia
Interim President
Munson Medical Center

Lydia Watson MD
President and Chief Executive Officer
MyMichigan Health

Marita Hattem-Schiffman
Central Region President
MyMichigan Medical Center Alma, Clare and Mt. Pleasant

Michael Erickson
President Northern Region
MyMichigan Medical Center Alpena

Ray Stover
Eastern Region President
MyMichigan Medical Center Gladwin and West Branch

Chuck Sherwin
President
MyMichigan Medical Center Midland

Kevin Kalchik
President
MyMichigan Medical Center Sault

Gregg Beeg
President & CEO
Oaklawn Hospital

Kelly Jefferson MSN, RN
President
OSF St. Francis Hospital and Medical Group

Mark Eastburg
President and Chief Executive Officer
Pine Rest Christian Mental Health Services

Julie Yaroch DO
President
ProMedica Charles & Virginia Hickman Hospital

Darrin Arquette
President
ProMedica Monroe and Coldwater Regional Hospitals

Ross Ramsey MD
President and CEO
Scheurer Health

Andy Bertapelle MSN, RN
Chief Executive Officer
Schoolcraft Memorial Hospital

Lili Petricevic BSN
Chief Executive Officer
Sheridan Community Hospital

Mark Brisboe
President
Sparrow Carson and Clinton Hospital

Linda Reetz BSN, RN
President
Sparrow Eaton and Ionia Hospitals

Denny Martin DO
President, University of Michigan Health-Sparrow Lansing
Sparrow Hospital

Bradley Bescoe
President and CEO
Straith Hospital for Special Surgery

Bobby Morin
Chief Operating Officer and CFO
Sturgis Hospital

Rob Casalou
President & CEO
Trinity Health Michigan, Florida and Georgia Regions

Shannon Striebich
President & CEO
Trinity Health Michigan

Katy Hoffman MSN, RN
Chief Nursing Officer
Trinity Health Ann Arbor and Livingston

David Vandenberg MD
Chief Medical Officer
Trinity Health Ann Arbor and Livingston

Alonzo Lewis
President
Trinity Health Ann Arbor Hospital

Shelleye Yaklin
President
Trinity Health Grand Haven Hospital

Michelle Pena MSN, RN
Chief Nursing Officer
Trinity Health Grand Rapids

Matthew Biersack MD
President
Trinity Health Grand Rapids Hospital

Cindy Elliot MD
President
Trinity Health IHA Medical Group

Mohammad Salameh MD
Chief Medical Officer
Trinity Health IHA Medical Group

John O’Malley
President
Trinity Health Livingston Hospital

Nick Nickolopoulos BSN, RN
Chief Nursing Officer
Trinity Health Livonia

Lisa Kinsey Callaway MD
Chief Medical Officer
Trinity Health Medical Group – West Michigan

Douglas Dascenzo DNP, RN
Regional Chief Nursing Officer
Trinity Health Michigan

Rosalie Tocco-Bradley MD
Chief Clinical Officer
Trinity Health Michigan

Linda Dunmore RN
Chief Nursing Officer
Trinity Health Muskegon

Gary Allore
President
Trinity Health Muskegon Hospital

Fabian Fregoli MD
Chief Medical Officer
Trinity Health Oakland

Marschall Runge MD
Chief Executive Officer
Michigan Medicine

Margaret Dimond
Regional System President
University of Michigan Health

Ronald Grifka MD
President & CMO
University of Michigan Health – West

David Miller MD
President
University of Michigan Health

Mitch Leckelt
Chief Executive Officer
UP Health System – Bell

Gar Atchison
Chief Executive Officer
UP Health System – Marquette

Tonya Darner
Interim CEO
UP Health System – Marquette

Ryan Heinonen MSN, RN
Chief Executive Officer
UP Health System – Portage

Michigan Hospitals Express Unified Opposition to Legislation Threatening Access to Care

Brian Peters testifying in the House Health Policy committee.

The MHA published a letter today on behalf of all Michigan hospitals and health systems signifying their unified opposition to proposed House Bills 4550-4552, which threaten to put patient care at risk across Michigan. MHA CEO Brian Peters announced the letter during his testimony in the House Health Policy Committee, which contains the names of leaders from all Michigan hospitals and health systems.

“Our hospitals are prepared to serve you and your loved ones on your worst day with high-quality, safe care,” said Peters. “We can’t risk losing experienced clinical judgment and local access to care. It is for these reasons that our membership is publishing a letter today signed by every hospital leader indicating our complete unified opposition to these bills.”

The proposed bills would mandate one-size-fits-all nurse staffing ratios for all Michigan hospitals, which do not create more nurses nor solve staffing shortages, as evidenced in other states that have tried this policy. California has a shortage of 40,000 registered nurses, despite the presence of mandated staffing ratios for 25 years. Michigan hospitals are currently trying to hire more than 8,400 nurses for vacant positions despite a national staffing shortage. Data from the Michigan Public Health Institute and the Bureau of Labor Statistics show that 85% of all licensed Michigan registered nurses currently living in the state below the age of 65 continue to work as nurses from a pool of 119,714 RNs.

Peters was joined for testimony by Beth Charlton, president and CEO, Covenant HealthCare; Doug Dascenzo, DNP, RN, chief nursing officer, Trinity Health Michigan; and Bonnie Kruszka, DNP, FNP-C, ENP-BC, RN, VP & chief nursing officer ambulatory services, Munson Healthcare.

A representative from American Nurses Association – Michigan also testified in opposition. The committee hearing included approximately 60 hospital representatives in attendance.

The testimony opposition follows the announcement earlier this week of a comprehensive coalition of healthcare, business and advocacy organizations opposing the bills.

To learn more about the impact of the proposed legislation on care in Michigan, visit www.mha.org/issues-advocacy/key-issues/nurse-staffing-ratios.

Comments Due Nov. 6 on LTC Nurse Staffing Standards Proposed Rule

The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule Sept. 1 which would establish comprehensive, minimum nurse staffing standards for long-term care (LTC) facilities. There are three core components to this rule:

  1. Sets minimum staff hours per resident per day – 0.55 hours by registered nurses (RNs) and 2.45 hours by nurse aides (no mention of licensed practical nurses).
  2. Requires an RN on site 24/7.
  3. Enhances facility assessment requirements.

The MHA is deeply concerned about the implications of this legislation due to the current challenges securing long-term care placements and expects more beds will come offline or facilities will close to meet the proposed standard. Michigan is currently experiencing a shortage of nurses, and implementing a blanket staffing mandate for healthcare institutions will have a negative impact on access to care.

The MHA encourages members to consider responding to this proposed rule by Nov. 6. Members interested may provide comments to the MHA to be included in a comment letter.

More information can be found in the White House fact sheet or CMS press release. Members with questions or input may contact Kelsey Ostergren at the MHA.

Legislation to Codify Affordable Care Act Sees Action

capitol building

capitol buildingSeveral bills being tracked by the MHA saw action during the week of June 5. In both chambers, bills to enshrine the protections of the federal Affordable Care Act (ACA) into state law saw initial testimony. In the House, bills to regulate labor service agencies and ban the practice of conversion therapy were taken up for a hearing. On the Senate side, action was taken on previously seen bills to expand opportunities to join the organ donation registry and allow pharmacists to order and administer certain immunizations and diagnostic tests in Michigan.

Both the House and Senate Health Policy Committees began action on a package of bills intended to codify ACA protections into state law. Introduced in both chambers by Republican and Democratic policymakers, the package would ensure that many of the consumer protections found in the ACA remain in Michigan if there were significant federal changes to the law. The package includes Senate Bills (SBs) 356 through 358 and House Bills (HBs) 4619 through 4623. The MHA is supportive of the package, which has been passed in at least 15 other states to date.

The House Labor Committee took testimony on HB 4034, sponsored by Representative Kara Hope (D-Holt), which would seek to regulate Temporary Staffing Agencies. The MHA opposed the legislation in committee given concerns about how it could impact the availability of temporary nurse staffing in Michigan and the detailed provisions around requirements for how the services would be provided. The MHA will work with the bill sponsor on potential changes to ensure it does not limit access to temporary healthcare staffing. No further action is scheduled on the legislation at this time.

In House Health Policy Committee, testimony was also held on Sen. Sylvia Santana’s bill intended to increase access to vaccines and certain laboratory tests. SB 219 would allow pharmacists to order and administer immunizations and certain diagnostic tests for their patients without physician supervision. Under the current language, pharmacists wishing to provide these additional services must also complete some additional continuing medical education courses as part of their licensure process. While no votes were taken at the hearing, the MHA is supportive of SB 219.

In Senate Health Policy Committee, testimony was taken on a package of bills that would allow Michigan citizens to designate themselves as an organ donor on state tax forms. Introduced by Rep. Felicia Brabec (D-Pittsfield Twp), HB’s 4362 through 4364 would allow the question to be asked on tax forms starting in the 2023 tax year. The MHA is supportive of the legislation, which is being led by Gift of Life Michigan as a way to reverse the decline in donor registrants. Gift of Life Michigan testified in committee that many states are seeing this as a result of the pandemic and online services leading to fewer trips to the Secretary of State. No votes were taken at this time.

Members with questions about state legislative action can reach out to Adam Carlson at the MHA.