EDITORIAL | A red flag from Rochester on nursing staff rules

Opinion Editor’s Note: Editorials represent the views of the Star Tribune editorial board, which operates independently of the newsroom.

Minnesota lawmakers should heed as the Mayo Clinic, the state’s largest employer, warns it could direct billion-dollar investments elsewhere if controversial health care reforms undo the legislature this year.

The Rochester-based medical center recently showed its political strength as bills regulating nursing staffing levels and setting spending growth targets for hospitals quickly advanced to the Capitol. In an email to Gov. Tim Walz earlier this month, a Mayo lobbyist cited the “damages” that could result if the legislation passes. If necessary, the note warned, Mayo could channel future construction dollars to locations outside Minnesota.

While there are legitimate questions about the outspoken force with which Mayo wielded his power, his tough stance should still serve as a serious red flag for lawmakers in the waning days of the session.

If an institution as large and wealthy as Mayo sees the proposed reforms as a threat, the measures will almost certainly be even more challenging for other hospital systems in the state. In particular, they are less likely to absorb the potential additional staffing costs and administrative requirements that would arise from nursing legislation.

For these reasons, the Star Tribune editorial board continues to oppose the bill. If it goes ahead, the compromises reached in the days ahead, as alternatives that would deploy sophisticated technology to increase staff faster than a committee should be open to all medical centers in the state, not just one.

“We absolutely love our nurses. … I am privileged to observe every day how committed they are to their patients and the community,” said Lisa Shannon, President and CEO of Allina Health. In an interview with an editorial writer on Tuesday, she addressed her criticisms of her personnel legislation.

“The way it’s been built, there hasn’t been enough analysis and it would make Minnesota an outlier. There is time needed to study and understand what this model would mean for all hospitals. We have a healthcare ecosystem that is already striving for beyond anything I have ever seen.”

The editorial board opposed the nursing staffing bill in mid-March. His objections included the current dismal financials of many Minnesota hospitals, along with the severe labor shortage plaguing the state and nation.

Hospitals are already rushing to hire more nurses. Passing legislation that would likely create additional demand was called “unattainable” and “doomed to fail” at the time by one health care expert. “It’s a supply problem. We don’t have enough people,” said Robert Hackey, a professor of health care policy and management at Providence College.

The Minnesota Nurses Association union has long tried to legislate staffing, but has also been unsuccessful with state government control of the DFL in past years. The latest effort requires nurses and hospital administrators to establish a “basic staffing plan” for inpatient units. Arbitration would ensue if there is no agreement, a process that seems cumbersome at best given the frenetic demands of providing patient care.

And again, how would hospitals hire additional nurses in this job market? It will take time to raise the ranks of these vital assistants.

In an interview Tuesday, Minnesota House Speaker Melissa Hortman stressed the importance of ensuring Mayo continues to invest in Minnesota. It is comprensible. Rochester’s famed medical center is truly a vital cog in the state’s economic engine. Hortman also noted that the House bill’s lead author has been working diligently with the state’s healthcare community to accommodate the concerns and improve the legislation.

But so far, that work has failed to allay the concerns of the Minnesota Hospital Association and many individual medical centers. All health care systems in Minnesota contribute to the health and prosperity of the state. Lawmakers should recognize this and work carefully to ensure that any health care reform helps, not hinders, this mission.

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