Penn Medicine CEO supports staffing minimums for nurses, breaking with his peers

Penn Medicine CEO Kevin Mahoney supports a bill that would impose nurse staffing minimums on Pennsylvania hospitals, while nurse leaders of nearly every other health system in the Philadelphia area have signed a letter in opposition.

If enacted, the Patient Safety Act would make Pennsylvania one of the first states in the nation with a law detailing nurse staffing standards. The bill sets specific nurse-to-patient ratios for hospitals units, based on the level of care. For example, one nurse would be required for every patient in active labor, and for every two intensive-care patients.

The House of Representatives passed the bill last month with mostly Democratic votes. Its future remains uncertain in the Republican-controlled Senate.

» READ MORE: Pennsylvania House approves bill to require nurse staffing minimums in hospitals

Unions representing nurses want the staffing standards, which they say will reduce burnout and bring back nurses who left hospital jobs. But many other nurses in hospital management positions, hospital executives, and industry groups, such as the Hospital and Healthsystem Association of Pennsylvania, criticize the bill as too expensive and impractical to implement.

Mahoney said he supports the legislation because the financial pressures on the American health-care system should not result in fewer nurses working with more patients at the bedside.

“We have huge problems, but we shouldn’t solve them by crushing the physicians and nurses,” Mahoney said.

The Penn Medicine executive first expressed his support in an opinion piece published Sunday on the PennLive/The Patriot-News website. “We believe safe staffing standards will help relieve nurse burnout, improve care for patients and create better work environments to attract and retain dedicated frontline caregivers,” Mahoney cowrote with Penn nursing professor Linda Aiken.

» READ MORE: Should hospitals be required to have a certain number of nurses?

Penn Medicine’s leadership support contrasts to the opposition from other health systems.

Dozens of nurses in leadership positions in health-care systems statewide signed a letter opposing the measure prior to the House vote. The June 14 letter was addressed to General Assembly leaders from both parties, according to a copy obtained by The Inquirer.

“If strict, government-mandated [registered nurses] staffing ratios are required in Pennsylvania, we believe that there will be real and lasting damage to Pennsylvania’s entire health care system,” the nurses wrote.

Among those who signed on are nurse managers and chief nursing officers from most other Philadelphia-area hospitals, including Children’s Hospital of Philadelphia, Jefferson Health and Einstein, Main Line Health, Temple Health, Nazareth Hospital, and St. Luke’s.

In a May state House Health Committee hearing and during the debate prior to the House vote, opponents of the bill argued that smaller and rural hospitals that are financially struggling won’t be able to bear the added costs. They said hospitals are already experiencing nursing shortages.

Yet Penn’s Aiken, the director of the Center for Health Outcomes and Policy Research, told the health committee that Pennsylvania has enough nurses to comply with the requirements in the bill if nurses return to bedside jobs in hospitals.

Her analysis of the bill found that if Pennsylvania hospitals had the staffing levels it would require, the state could prevent 1,155 hospital deaths and 771 hospital readmissions every year.

» READ MORE: University of Pennsylvania Health System has a $160M operating profit so far in fiscal 2023

Mahoney told The Inquirer that Penn hospitals also share many of the recruitment challenges. Although Penn was the only health system in the Philadelphia region to report a profit last year, he said the cost concern is valid.

In addition to the bill, he wants hospitals, the government, and insurers to work together on regulations designed to bolster hospitals’ financial stability.

“This shouldn’t just be, increase the staffing ratios and the hospitals have to pay for it,” Mahoney said.