Mount Sinai Health System fined for understaffing nurses, will pay $2 million

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Mount Sinai Health System in New York City will pay a little more than $2 million in fines due to a ruling of understaffing of nurses at three of its hospitals, after the New York State Nurses Association (NYSNA) won arbitration awards.

The ruling found nurses worked understaffed shifts. Management was ordered to pay nearly $934,000 in the Morningside Emergency Department, more than $957,000 in the Sinai West labor and delivery unit and more than $240,000 in the Mount Sinai Hospital 11 C oncology unit.

For nurses in the Morningside ED, this is their second award for understaffing. The hospital was first cited for it on June 9, 2023.

In the new ruling, the arbitrator found persistent understaffing on both day and night shifts that had not improved over the previous six months. In fact, only five full-time nurses were hired during that period. In addition to the financial remedy, the arbitrator ordered Morningside management to hire up to the 94 full-time equivalents (FTEs) required, provide break relief and pay the overtime incentives owed to nurses during the next pay period.

One of the Morningside nurses who testified before the arbitrator detailed how she had been assaulted three weeks in a row by different patients, and attributed the increase in workplace violence to the overcrowded and understaffed conditions in the ED.

WHAT'S THE IMPACT

On February 11, an arbitrator found there to be persistent and continuous understaffing on both day and night shifts of Mount Sinai West's labor and delivery unit, and rejected the argument that it was due to sick calls or personal leaves.

He ordered Mount Sinai to cease and desist, hire enough nurses to comply with the union contract, assign enough RNs, adopt and provide break relief measures to allow for full meal and break periods free from patient assignments on all shifts, and pay relief to RNs who worked the understaffed shifts.

On Jan. 25, an arbitrator found persistent staffing violations and awarded more than $240,000 to nurses in Mount Sinai Hospital's oncology unit. The arbitrator specifically rejected the employer's arguments that sick calls are to blame for short staffing and that nurses were inflating the numbers of understaffing. He found Mount Sinai's efforts to recruit more nurses to address understaffing lacking.

Overall, this is the eighth time arbitrators have ruled against Mount Sinai Health System for understaffing and ordered remedies, including hiring more nurses, providing break relief nurses to meet safe staffing standards, and paying financial penalties since nurses won this provision in their union contract in January 2023.

THE LARGER TREND

According to the Nurse Salary Research Report published by Nurse.com in 2022, 29% of nurses said they were considering leaving the profession, a steep rise from the 11% who were considering such a move in the 2020 survey.

Part of the issue is that nursing shortages have reached crisis levels, the report found.

The vacancy rate for registered nurses was almost 10% in 2020, for example, almost a full point higher than the prior year. Over a third of hospitals reported a vacancy rate higher than 10%. And nurse turnover rates are increasing, standing at about 22% in 2021, compared to 18% in 2019.

In a separate 2022 survey issued by Wolters Kluwer Health and UKG, 92% of respondents predicted they would be short of their budgeted nurse headcount over the next 18 months. And 58% of health leaders said they don't expect to bring in additional staff or new roles due to financial constraints.

Jeff Lagasse is editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Media publication.