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Targeting small hospitals

to go on strike for the second time this year

, Minnesota hospitals have announced they have reached tentative deals to avert a walkout.

Allina Health, The Twin Cities Hospital Group, Essentia Health and St. Luke’s have all announced Tuesday that they have reached agreements with the Minnesota Nurses Association, the union representing the nurses. Twin Cities includes Children’s Minnesota, Fairview Health, North Memorial Health and Methodist Hospital in St. Louis Park.

In response, the nurses have agreed to rescind their strike notice, the systems said. Nurses had planned to strike at 16 hospitals across Minnesota.

Nurses were slated to begin a strike on Sunday and were planning to be out for at least 20 days at most hospitals. Nurses, 

who went on a three-day strike in September

, said they were ready to strike again to get better pay and improved working conditions, including better staffing and safety measures.

In a statement, Allina Health said, "We are pleased to announce that Allina Health and Minnesota Nurses Association reached a tentative agreement early this morning. The settlement, which the union is recommending, is now subject to ratification by union membership. MNA has rescinded all strike notices at Abbott Northwestern, United (St. Paul campus) and Mercy (both campuses) hospitals."

"Allina Health is pleased with the settlement, which reflects the priorities of both parties and is fair and equitable to our employees, patients and communities. We are thankful to be able to return our full attention to caring for the community at this time of increased illness and demand."

Tuesday that it was pleased to reach a tentative deal with the Minnesota Nurses Association. 

"This positive outcome is the result of hard work at the bargaining table," Essentia said. "As a part of the tentative agreement, the MNA agreed to withdraw its strike notice.

"The MNA will share details of the tentative agreement with its membership and conduct a ratification vote on the agreement no later than Dec. 12. The MNA bargaining committee unanimously agreed to recommend ratification. We will share the results of that vote when we learn them." 

Negotiations between the MNA and St. Luke's Lake View Hospital in Two Harbors are still ongoing, the

St. Luke's issued a statement Tuesday morning, saying, "We are pleased to announce that St. Luke’s and MNA reached a tentative contract agreement. MNA has withdrawn its strike notice and will bring the contract to nurses for ratification in the near future. We want to thank all who have worked so diligently at the table to reach a fair and equitable contract."

As for Lake View, the system said, "We have multiple bargaining sessions scheduled in December, with the next session set for Friday, December 9."

"Lake View will continue our strong tradition of working collaboratively with the MNA to reach an agreement that is fair to all of our stakeholders, including our patients, community, and our entire Lake View team."

Before reaching agreements, the nurses had said they needed better compensation and that nurses were routinely asked to work double shifts due to insufficient staffing. They also said nurses were increasingly dealing with violent incidents in hospitals, which were exacerbated by staffing shortages.

While the deals still need final approval, hospital officials are undoubtedly glad to avoid the prospects of another walkout at a time when health systems are packed with patients with RSV and other respiratory viruses. Hospitals had warned that some services would have to be curtailed and some patients could have needed to be transferred to other states.

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Health systems announced the agreements, which still need ratification from union membership. About 15,000 nurses were poised to go on strike beginning Sunday.

Minnesota hospitals reach tentative deals with nurses, averting strike

At times, Rebecca Love feels as if she's shouting into a void.

Rebecca Love, chief clinical officer, IntelyCare

Love is the chief clinical officer of IntelyCare, a Massachusetts-based company which helps match nurses with openings at healthcare facilities. She’s talked about the crisis in the nursing workforce, and called on healthcare organizations to make changes to keep nurses.

She says she is trying to raise awareness of the heart of the issue: the lack of any government reimbursement model that finances hospitals appropriately to pay for nursing.

“It feels like nobody is focusing on the real problem,” Love told 

. “There is not a sustainable model of nursing. I think it’s going to become more acute, more apparent.’’

Unlike other roles in healthcare, such as occupational therapists and respiratory therapists, hospitals don’t get Medicare reimbursements for nurses, and nurses end up being a straight cost to health systems.

“I think if I can say one thing to hospital and healthcare leaders, it is time that we address a lack of a reimbursement model for nurses so that we can create a sustainable workforce to deliver the outcomes that we all want to deliver across healthcare,” Love said. “So until we as healthcare leaders organize and come together to change the misalignment in Medicare regulatory work, we're never going to be able to solve that problem.”

 at the HLTH Conference in Las Vegas in November. She talked about the state of nursing, the stress on nurses driving them from the profession, and what healthcare leaders can do to support them.

Love participated in a panel on nursing at HLTH, which was actually the first panel on nurses in the conference’s five-year history. Panelists discussed 

the need for hospitals and health systems to create a better working environment for nurses

“There has been a small shift to recognize that there should be further attention on the nursing workforce,” Love said.

But she said the crisis in nursing deserves much more attention from healthcare leaders.

“I think for the first time my profession is beyond burnout, and recognize that the risks and the challenges of being a nurse far outweigh what the profession called us in to do,” Love said.

“So I am literally standing here looking into an abyss of wondering, how is the frontline going to survive? Who is going to keep our hospitals and our nursing homes open? Because right now, what I'm seeing in the market is very few impactful resources or attention …  And it feels to me that much of the conversation, the focus is still that it is a system problem and not a societal problem.”

 (See excerpts of our conversation with Rebecca Love in this video. The story continues below the video.)

To address burnout, return nurses to being nurses

Nurses have been leaving hospitals, and more are thinking about walking away, at least in part due to the stresses of the pandemic. The number of registered nurses fell by more than 100,000 in 2021, the biggest decline in 40 years, according to an analysis published in 

Two out of five nurses are thinking about leaving their jobs

 (67%) said they intend to leave their position within three years, according to an August poll by the American Association of Critical-Care Nurses. Among those who are thinking of walking away, 36% of those nurses said they would leave within the next year, the AACN poll found.

Nurses cite a litany of problems siphoning the joy from their jobs. As staffing shortages have worsened, they are putting in longer hours with less help, with little chances for breaks.

, and many nurses say they don’t feel their organizations care enough about their safety. John Hawkins, president and CEO of the Texas Hospital Association, said 

the uptick in violence during the COVID-19 pandemic is making it more difficult for hospitals to retain nurses

Nationwide, there are five million nurses, and Love said the issue isn’t so much a shortage of nurses. “We don’t have enough of them willing to work in the healthcare environment,” Love said.

Many of those nurses have left healthcare roles, she said. “There is a shortage of bedside nurses,” Love said. “There is absolutely a shortage of those providing critical care.”

Recognizing the host of issues driving nurses from the profession, Love acknowledged feeling mixed emotions at the HLTH Conference. While admiring the innovations and healthcare technologies on display at the conference, she said putting more money into recruiting and retaining nurses would go a long way toward improving care for patients.

“If you simply took those dollars and invested in the nursing workforce, and created more nurses, that one nurse would drive out better outcomes for patients,” Love said.

With hospitals facing limited resources as they face their own financial difficulties in the pandemic, health systems would get a better return on investment by investing in nurses, she argues.“Who is going to actually put their hands on the patient and change the wound, and turn the patient and get the oxygen on them and elevate the bed and assess those vital signs?

“Nurses still see changes in status well before technology does,” she said.

Hiyam Nadel, right, director of the Center for Innovations in Care Delivery at Massachusetts General Hospital, unfurls a list of responsibilities for nurses. Mike Golebiowski, corporate vice president of B. Braun Medical Inc., helps hold the list. They discussed challenges in nursing at the HLTH Conference. (Photo: Ron Southwick)

, a former nurse charged in the death of a patient, has driven more nurses from the profession, Love said.

Vaught was convicted in March of negligent homicide and gross neglect of an impaired adult after a trial in Nashville, Tennessee. Davidson County Criminal Court Judge Jennifer Smith sentenced Vaught to three years of probation. Under the terms of her sentence, her conviction could be wiped off her record if she completes the probationary program successfully.

Groups representing nurses derided the prosecution and said it could have a chilling effect on healthcare, because it could deter nurses and doctors from disclosing mistakes. They also feared it would drive more nurses out of the profession at a time when health systems can’t afford to lose more good nurses.

“The RaDonda Vaught verdict, which led to a criminal prosecution of a nurse for a self-reported medical error, has led the vast majority of nurses to reconsider their profession,” Love said.

“The reason being is that as a nurse, previously, we knew if we made a medical error, we could lose our job, we could lose our license, and we could lose our livelihood,” she added. “But as a nurse, I don't believe any of us ever believed that in our best intentions to save patients' lives, if we made an unintentional error that results in harm to a patient, that we could also go to jail.”

The verdict is yet another factor in driving experienced nurses from hospitals, at a time when hospitals are already struggling to keep veteran nurses, Love said. The average tenure for nurses on 12-hour shifts dropped to 2.8 years in March 2022, down from 3.6 years in January 2021, according to 

“The most experienced, the best, are fleeing and running for their lives, from this profession, so they don’t risk going to jail,” Love said.

Hospitals and health systems looking to keep or bring back experienced nurses need to think about 

, Love said. While those shifts can be popular with younger nurses because they can work fewer days, the 12-hour shifts are more difficult for nurses with families and older nurses. Nearly half of all registered nurses are over the age of 50, according to the 

Nursing leaders have called on hospitals to 

devise more flexible schedules to recruit and retain nurses

“The nurse's knowledge is not something that anybody has ever taken the time to capture and replicate,” Love said. “If you want to save patients’ lives, we need to figure out a way to bring back those experienced nurses to transfer that knowledge, and save patients’ lives.”

Nurses across Great Britain plan to go on strike this month

, staging an unprecedented walkout. Love said healthcare leaders in the United States should be watching what’s happening in the United Kingdom. She pointed out that 

about 15,000 nurses staged a three-day strike in Minnesota in the fall

. The Minnesota Nurses Association is planning another strike starting Sunday.

“It will be a warning shot to the United States,” Love said of the planned strike in England. “What is going to happen there, will also happen here.”

The healthcare system doesn’t have a sustainable model of nursing, says Rebecca Love of IntelyCare. And she’s trying to get more people to focus on the problems.

Nursing profession is ‘beyond burnout,’ and needs greater attention

About 15,000 nurses in Minnesota say they are going on strike for a second time this year, and the next walkout is slated to be for a longer period.

, the Minnesota Nurses Association is planning a second strike that will last 20 days. Nurses plan to walk out at 16 hospitals across Minnesota. The association touted the September strike as the largest private sector nurses’ strike in U.S. history.

Minnesota hospitals announced a tenative deal with nurses to avert the strike

The second walkout is slated to begin Sunday, Dec. 11 and continue at most of the hospitals through Dec. 31. Nurses at two hospitals -  St. Luke’s in Duluth and at Lake View in Two Harbors - have chosen to strike without setting an end date, the association said. The nurses have been working without contracts for months.

The nurses’ union said health systems haven’t addressed demands to improve compensation and nursing conditions at the hospitals. Conversely, hospitals have said nurses in Minnesota receive competitive pay, and some hospital officials said they are alarmed that nurses are walking out at a time when hospitals are packed with patients with RSV and other respiratory illnesses.

Mary C. Turner, a registered nurse at North Memorial Hospital and president of the Minnesota Nurses Association, said the hospitals aren’t addressing issues that 

have made nurses so stressed and prompted some to leave the profession

“We never wanted to get to this point,” Turner said at a news conference last week. “When we came back from our last strike in September, we hoped our hospital executives would hear us about the urgency of the crisis in our hospitals. But since then, things have gotten worse, and not better.”

In recent negotiations, Turner has brought up incidents with nurses that have been hurt in hospitals. 

Nurses and emergency physicians have said they’ve dealt with more violence in hospitals

“Workplace violence is unacceptable, and a lot of that can be cured if we have proper staffing,” Turner said. She added that insufficient staffing has had some nurses working 16-hour shifts.

Hospitals: Strike threatens patients’ health

The hospitals say the timing of another strike couldn’t be worse, as facilities are filled with patients with respiratory viruses. Some said a walkout will endanger patients and could lead to health systems transferring patients to other states.

Children’s Minnesota operates two hospitals that are slated to be affected by the planned strike: Children’s Minneapolis and Children’s St. Paul.

“We are deeply alarmed about the timing of this decision,” Children’s Minnesota said in a 

. “We are experiencing a historic respiratory surge, which includes RSV and flu. Sick kids are coming into our hospitals and clinics in massive numbers. This is leading to full hospitals and intensive care units. We have long wait times in our emergency departments and clinics.”

Children’s Minnesota said nurses would be going on strike “at a time when our patients are at their most vulnerable."

"If a strike were to take place, some critical units at Children’s Minnesota will have to close due to the staffing shortage," Children's Minnesota said. "This includes our inpatient mental health unit. Dozens of patients in our ICUs would possibly be transferred to another state, separated from their families over the holidays. A strike at this time would risk the health of our patients.”

, which represents four health organizations affected by the planned strike, said it has offered raises of more than 10 percent and has also agreed to revised workplace safety measures. Twin Cities said the nurses are seeking a raise of 22%-28% and said the increase is “simply unaffordable.”

Allina Health said it has asked for an independent mediator to resolve the dispute but said the union has not agreed to that request.

“We are deeply disappointed by Minnesota Nurse’s Association’s choice to issue a strike notice when our community is experiencing a triple threat of illnesses – influenza, RSV and COVID - and before they have exhausted all available options to reach agreement,” Allina said in a statement.

“Providing the necessary care for our community during this surge of seasonal illness, in addition to the many other health care needs of our patients, has put unprecedented stress on Minnesota’s health care system. To be clear, the union is deciding to withdraw critical health care resources at a time when the community’s healthcare needs are high and at the risk of those who are depending on us for care.”

Nurses with the Minnesota Nurses Association, who are planning to go on strike Dec. 11. (Photo: Minnesota Nurses Association)

The Minnesota Nurses Association said it has been negotiating in good faith, but leaders of the hospitals have not followed suit.

The nurses’ association said hospitals have engaged in unfair labor practices and have “colluded” to suppress the compensation for nurses.

Trisha Ochsner, a registered nurse at Children’s Minnesota in Minneapolis, spoke at a press conference last week when nurses announced their plans for another strike. She said the hospital is at capacity and “we have reached our limits.”

“The staffing crisis is dire, as we have been sharing for months,” she said. “There’s no end in sight, and things have only become worse.”

“We do not want to have to take this step,” she added. “We want to settle a fair contract at the negotiation table, but the future of the nursing profession matters. ”

Nurses also point out that most of the CEOs of the hospitals are paid $1 million or more annually and earn anywhere from 10 to 40 times as much as the pay of the average registered nurses.

Chris Rubesch, a registered nurse at Essentia in Duluth and first vice president of the Minnesota Nurses Association, said nurses are ready to fight and win a better contract.

“At the same time hospital CEOs tell nurses and patients there is no money to retain staff and prioritize care, executives are taking million-dollar raises and pursuing corporate expansions that put community access to affordable care at risk,” Rubesch said in a statement. “Nurses and patients need safe staffing and quality care in our hospitals, not more corporate healthcare policies.”

These are the hospitals that would be affected by the strike;

Nurses are planning to walkout beginning Dec. 11, and most plan to be on strike for about three weeks. Hospitals, packed with patients with RSV and other illnesses, say the strike comes at a particularly difficult time.

About 15,000 Minnesota nurses are planning their second strike, and this one would be longer

Atrium Health and Advocate Aurora Health say they have completed their merger. The new system will be known as Advocate Health and will operate 67 hospitals in six states, and it has a combined $27 billion in annual revenue.

Atrium Health and Advocate Aurora Health say they have completed the merger of the two health systems, concluding one of the hospital industry’s most watched deals and potentially setting the stage for more consolidations.

Eugene Woods, CEO of Atrium Health, becomes co-CEO of the new Advocate Health.

 Friday saying they have formally combined to create a new system called Advocate Health.

The newly merged system organization becomes one of America’s largest nonprofit hospital systems. The new Advocate Health boasts a combined $27 billion in annual revenue with about 150,000 employees, and the merged system operates 67 hospitals in six states. They first 

announced their intentions to merge in May

Jim Skogsbergh, CEO of Advocate Aurora Health, will serve as co-CEO of the new Advocate Health for 18 months, and then plans to retire.

“Powered by 150,000 teammates – including the best and brightest physicians, nurses, researchers and faculty – we are poised to push past traditional geographic and care delivery boundaries to create a healthier tomorrow for all,” Eugene A. Woods, chief executive officer of Advocate Health, said in a statement.

Woods had been CEO of Atrium Health. Wood and Jim Skogsbergh, the CEO of Advocate Aurora, will serve as co-chief executive officers until Skosbergh retires in 18 months.

“We couldn’t be more pleased to bring our organizations together to do more, be better and go faster to help more people live well while training the next generation of health care professionals,” Skosbergh said.

Advocate Health is going to be headquartered in Charlotte, North Carolina, while the organization said it will maintain a strong presence in the Chicago and Milwaukee areas. The new system is planning to build a new institute focused on health equity in Milwaukee.

The Atrium Health, Advocate Health Care and Aurora Health Care brands will continue to be used in their local communities, officials said. The Wake Forest University School of Medicine will serve as “the academic core” of the organization, the system said.

A spokesman for Advocate Aurora said via email Saturday that the systems have taken all the necessary steps needed for regulatory approvals.

North Carolina Attorney General Josh Stein said Thursday that his office won’t be opposing the deal, the 

 reported. In a statement, Stein said “my office has conducted a thorough review into this transaction and concluded that there is no legal basis to prevent it.”

“Therefore, the state will take no further action,” he said.

However, Stein said, “I am concerned about this combination’s possible effects on health care access in rural and urban underserved communities.”

The planned deal has drawn some scrutiny. 

North Carolina State Treasurer Dale Folwell

 said Friday, “I have deep concerns about this merger.” Folwell said Atrium is “notorious for its aggressive medical debt collections”, and noted Advocate Aurora has been sued for allegations of anticompetitive behavior.

Folwell said he worries about the impact of the deal for consumers. “There is widespread evidence that mergers make hospital care less affordable and less safe,” he said.

 with a key regulatory board in Illinois. The Illinois Health Facilities and Services Review Board initially voted against the deal in September, but then reversed course and allowed the systems to present more information for more consideration. The Illinois board signed off on the deal in November, 

Federal Trade Commission has applied more scrutiny to hospital consolidations

, and some systems have abandoned planned deals due to regulatory opposition. The FTC has taken action on deals involving systems in overlapping markets, saying the deals would lead to higher prices and reduced services for consumers. President Biden signed 

 in July 2021 directing regulators to closely examine mergers, including hospital consolidations, to be sure they don’t hurt consumers.

These planned hospital mergers and acquisitions collapsed. Here’s why.

However, the Atrium-Advocate merger involves two systems operating in very different markets, thus avoiding a concern of regulators about reduced competition in overlapping or adjacent markets. Atrium, based in Charlotte, runs hospitals and care sites in North Carolina, South Carolina, Georgia and Alabama. Advocate Aurora, with corporate offices in Downers Grove, Illinois and Milwaukee, Wisconsin, operates in Illinois and Wisconsin.

Jim Skosbergh, left, and Eugene Woods, will serve as co-CEOs of the new Advocate Health.

Atrium-Advocate Aurora merger could spur other health systems, including larger systems, to pursue similar mergers

. The deal sets a model for other transactions by partnering with systems in other areas, as opposed to trying to form a deal with an organization in the same region and risking regulatory opposition, analysts say.

Kenneth Kaufman, managing director and chairman of Kaufman Hall, a healthcare consulting firm, said he expects to see more mergers and acquisitions. Kaufman Hall advised Atrium Health and Advocate Aurora Health in their plans to merge.

“I’d be really surprised if this is a one-and-done deal. I think we’ll see a handful of these other transactions,” Kaufman told 

“The reason this deal is so important is it addresses really critical healthcare decisions coming out of the pandemic,” Kaufman said.

“Healthcare is no longer a solely community-based product,” he continued. “It’s a series of really hard problems and trying to create an organization with the size and scale and intellectual capital to solve those problems.”

When Atrium and Advocate Aurora first announced their intentions to merge, Woods said one of the driving factors among the organizations is, “We change before we have to.” Both systems have said they are focused on improving health equity in the deal and aim to expand access to healthcare in urban and rural areas.

The last two years have seen fewer hospital mergers, as hospital officials have been consumed with the COVID-19 pandemic and have had less time to devote to long-term planning.

 In 2021, there were 49 hospital mergers and consolidations, compared to 79 the previous year

In the first half of 2022, there were 25 hospital transactions announced

, roughly matching the slower pace of 2021.

the pace of hospital deals is starting to pick up

Intermountain Health completed its merger with SCL Health this year

, one of America’s largest Catholic systems, completed its acquisition of MercyOne, an Iowa-based system, in September.

More deals have been announced in the fall. 

Gundersen Health System and Bellin Health

 completed their merger last week. The new system will operate 11 hospitals and more than 100 clinics serving patients in Wisconsin, Michigan, Minnesota and Iowa.

Essentia Health and the Marshfield Clinic Health System

 said in October that they have signed a memorandum of understanding to examine the possibility of creating a regional health system. If they move forward, the combined system would operate 25 hospitals in Minnesota, North Dakota, Wisconsin, and Michigan.

 announced in October it has struck a deal to buy three hospitals in the New Orleans area from HCA Healthcare. 

 said it has reached an agreement to buy two Connecticut health systems, including three hospitals, from Prospect Medical Holdings.

The prospect of more hospital mergers worries some critics. Michael Abrams, a managing partner of Numerof & Associates, a consulting firm, told 

 in July that he feared the Atrium-Advocate Aurora deal would drive other systems to pursue similar deals, and consumers would pay the price.

“The end game is we get to a relatively small oligopoly of healthcare systems that provide care to the majority of citizens in this country,” Abrams said. “They are too big to fail, and too big to care.”

Analysts say some systems may be looking to pursue mergers to find opportunities, while others may be looking to find partners out of necessity. Many hospitals are struggling financially, and 

more than half of the nation’s hospitals could finish the year in negative margins

, according to the American Hospital Association.

Some hospitals may look to mergers to keep their doors open, Anu Singh, managing director of partnerships, mergers and acquisitions at Kaufman Hall, told 

“For some it will be a lifeline conversation, for others it may be a strategic tipping point,” Singh said. “I think we’re going to see financial tipping points for need, I think we’ll see some strategic tipping points for investment.”

The systems say they have now formally merged to create Advocate Health, forming one of America’s largest hospital systems. Analysts have said it could pave the way for  more consolidations.

Atrium Health, Advocate Aurora Health complete merger, and more hospital deals could follow

Former MetroHealth CEO Akram Boutros vowed to pursue legal action after

, and he wasted little time in backing up those words.

Akram Boutros, former CEO of MetroHealth in Cleveland, Ohio. He has sued MetroHealth over his dismissal.

Boutros is suing MetroHealth, saying the Cleveland-based system acted improperly in terminating him Nov. 22. Boutros, who was slated to step down at the end of the year, said the board’s firing was retaliatory and that the board violated Ohio state law in hiring his successor, 

. He said in the suit that the “illegal firing” gives him claims against MetroHealth and its board.

In that court filing in the Cuyahoga County Court of Common Pleas, Boutros said he plans to file a separate lawsuit “to recover damages from this retaliation and other misconduct.”

MetroHealth said the board fired Boutros because he paid himself more than $1.9 million in bonuses from 2017 through 2021 without notifying the board or seeking board approval. Only the board can set compensation for the system’s chief executive, Vanessa Whiting, chairwoman of MetroHealth’s board of trustees, said in a statement.

MetroHealth’s board demanded repayment of the bonuses. On Oct. 31, Boutros repaid $2.1 million, which represented the supplemental bonus money, and more than $124,000 in interest, the system said.

In the lawsuit, the former CEO alleges that the MetroHealth board skirted Ohio’s open meeting law “in orchestrating and executing Dr. Boutros’ discharge.”

The suit also claims that the board acted improperly by “secretly hiring counsel” to investigate Boutros. And he argues that the board moved to fire Boutros without mandatory public notices and deliberation.

Jason Briston, Boutros’ attorney, issued a statement explaining the suit, 

“The suit is the result of an investigation that clearly demonstrates the wanton disregard for Ohio’s Open Meetings Act and the board bylaws by its board and Chair Vanessa Whiting in both the hiring process for the health system’s new CEO and the so-called investigation of Dr. Boutros’ compensation,” Bristol said.

MetroHealth said Boutros was terminated after an outside investigation uncovered that Boutros had secretly paid himself $1.9 million in bonuses.

On Nov. 25, the MetroHealth board released the 

 by the law firm, Tucker Ellis, which investigated the bonus payments.

Boutros, by his own admission, did not involve the board in the payment of the bonuses or the establishment of benchmarks to determine his eligibility for bonus payments. Only the board is authorized to determine the CEO’s compensation, the report stated.

The bonuses approached Boutros’ base salary, according to the report. “The performance bonus compensation Boutros received exceeded 80% of his base salary in each relevant year and in the last two years exceed 90% of his base salary,” the report stated. Boutros never disclosed his payment of bonuses to the board at relevant times, including contract negotiations, the report stated.

“This evidence, at a minimum, establishes the Board’s right to terminate Boutros’s employment for Cause, as defined in the employment agreement,” the report stated. “And, at worse, this evidence suggests that Boutros may face potential criminal liability for Ohio ethics violations, theft in office, and other related statutes.”

Whiting said in a statement Nov. 23 that Boutros’ allegations of improper conduct by the board “are false and a distraction from the facts we have previously communicated about the issue at hand.”

Boutros began serving as MetroHealth’s CEO in 2013. In November 2021, he announced he planned to retire at the end of December 2022.

Airica Steed, executive vice president/system chief operating officer of Sinai Chicago Health System and president of Mount Sinai and Sinai Children’s Hospital, takes over as MetroHealth’s president and CEO on Dec. 5. MetroHealth announced the selection of Steed as the next CEO in September.

MetroHealth operates four hospitals and dozens of sites of care in and around Cleveland.

Making good on a threat to take legal action, Akram Boutros said his termination was improper. The board said Boutros was ousted for paying himself $1.9 million in bonuses without board approval.

Fired MetroHealth CEO sues over termination, claims ‘illegal firing’

Ruth Phillips is vice president of medical affairs at Blue Spark Technologies.

Every day, nurses work tirelessly to ensure patient safety.

It's a challenging profession that requires coordination across care teams, sufficient knowledge of multiple, complex protocols, and unwavering compassion in an ever-changing environment. 

A nursing shortage was evident long before the COVID-19 pandemic but is now of significant concern. While the pandemic tapers, nurses continue to face demanding workloads due to 

 to poor patient outcomes, specifically in sepsis cases. Integrating technology into today’s healthcare system can help buffer the strain of the nursing shortage, with the potential to improve sepsis care–a steady problem for hospitals.

Today’s medical devices can remotely and continuously track a patient’s vitals, including body temperature, which is often a key indicator of infection. This opens the door for rapid fever identification to support early infection detection, intervention, and better patient outcomes.

 in the U.S annually, with one-third of hospital deaths being related. Sepsis occurs when the body has an excessive immune response, typically from an infection. Comorbidities like cancer, advanced age, and obesity increase one's risk of developing this life-threatening condition.

The impact of the nursing shortage on sepsis care is striking, with understaffing linked to the 

The benefits stretch beyond sepsis management, but its use in this setting could make a meaningful difference for patients and healthcare providers.