REPORT: October/November 2006

Ethical issues swirl around Montefiore joint venture

by Rolando Tomas Infante and Mark Genovese

NYSNA has initiated a legal review of a joint venture between Montefiore Medical Center and two groups of gastro-intestinal (GI) physicians to open two free-standing GI-endoscopy facilities.

“This deal has serious ethical flaws,” said Michael Hertz, NYSNA nursing representative. “This institution is using revenues generated under its tax-exempt, non-profit status to provide investment capital to a direct competitor so that they can take away lucrative business from the hospital. Something is wrong with a business model that exploits taxpayer funds for private gain.”

This fall, management at the Bronx medical center announced that state approvals had been secured for the joint venture.

The deal poses two major concerns: Has Montefiore created a two-tier delivery system that would allow outside facilities to drain resources from the hospital? What are the implications of a “non-profit” hospital creating and outsourcing to a “for-profit” facility?

NYSNA is also concerned that when the outside facilities become operational, GI/endo RNs could lose their jobs due to a reduced demand for these services inside the hospital.

“Although NYSNA had requested details about this plan for a year, there was no response,” said Karen May, NYSNA nursing representative. May said management provided the information after NYSNA filed an unfair labor practice charge.

One RN from the GI/endo unit described the nurses’ feelings. “We feel badly betrayed by management,” said Tom Gurry. “When we heard about Montefiore’s plan from a group of talkative doctors, we confronted management. We were told that this was not going to happen. Now that they have admitted it, they are telling us it’s just business. Nothing personal.”

But for the unit’s RNs, it’s all personal.

“While we were working without a nurse manager, basically running the unit ourselves,” said Gurry, “management was secretly planning these new facilities and outsourcing our jobs.” He fears that the hospital’s creation of a for-profit partnership will become a trend, resulting in an elimination of RN positions throughout the hospital.