SRMC officials address concerns at commission meeting

BERNALILLO — Representatives from University of New Mexico Hospital presented a quarterly update on UNM Sandoval Regional Medical Center to the Sandoval County Commission at the May 8 meeting.

UNM Hospital CEO Kate Becker and Jamie Silva-Steele, president of UNM SRMC, gave the presentation, which touched on the acquisition of SRMC by UNMH, labor relations at the Lomas Campus and SRMC, and the recent poor Leapfrog grade SRMC received.

Becker began with updating UNMH’s acquisition of SRMC, showing that 10 work streams have been checked off and SRMC officially became a UNMH campus on Jan. 1.

SRMC now operates under the license of UNM Hospital. The new name will be “UNM SRMC- A campus of UNM Hospital.”

SRMC has always been under the jurisdiction of the UNM Board of Regents as a hospital in the UNM Health System. The UNM Health System is currently compromised by UNM Hospital; UNM SRMC, Inc.; UNM Medical Group; and the UNM Comprehensive Cancer Center.

Becker also announced that Kim Hedrick has been nominated to the UNMH Board of Trustees. Hedrick’s nomination was approved by the UNM Board of Regents Health Science Committee May 2 and will go before the Board of Regents May 16.

“One important part of the acquisition, as you’ll remember, was that a representative from Sandoval County would be appointed to the UNM Hospital Board of Trustees,” Becker said. “Kim Hedrick was the person who was nominated from Sandoval County to go forward to the hospital board. So that will be taken care of before July 1 when our new year starts.”

Labor relations have been a big topic at SRMC with health workers raising concerns about the working conditions at the hospital and pleading with SRMC management to negotiate a contract.

In 2022, the the United Health Professionals of New Mexico moved to form a public employee union as a joint effort by the American Federation of Teachers New Mexico and the International Association of Machinists & Aerospace Workers Lodge #794.

Leading the way for the health care workers is Adrienne Enghouse, a former nurse at SRMC.

“We have filed for our recognition,” Enghouse said in 2022, “and we are just waiting for them to confirm that we have a majority. At that point, we will sit down and negotiate a contract. Today is about celebrating that landmark event.”

The hospital, however, hasn’t gone along with the UHPNM’s move to unionize, the union claims.

UHPNM says that SRMC leadership has been refusing to negotiate for months, despite “dangerously low staffing levels, instances of workplace violence and a failing grade from Medicare.”

“There were two unions seeking to represent the employees at Sandoval Regional,” Becker said. “One was the machinists, the other was AFT. There’s been a lot of litigation involved with these both in front of the Labor Board And in front of the courts. Some of those matters are still continuing.”

UNM SRMC reached a final agreement with IAMAW on Feb. 2 but was unable to agree with AFT.

“We had some issues at the bargaining table, and we ended up not being able to reach an agreement,” Becker said. “We are committed as an organization that when we have positive financial performance to invest in all of our staff. So we have implemented the wage increase in retention incentive for all of our employees to make sure that those are getting the benefits of the financial incentive for hospitals.”

The retention incentive was created after UNM Hospital received $48 million from the Federal Emergency Management Agency from two long-standing claims for COVID-related expenses.

UNM Hospital also received funds from Medicaid reimbursements. The federal government approved a request from the New Mexico Human Services Department to supplement UNM Hospital’s Medicaid reimbursement for new programs that aim to improve rural health, maternal health, substance abuse disorder treatments and increasing access to care.

Nearly 7,000 employees at UNM SRMC and UNM Hospital’s Lomas Campus will each get a $600 retention bonus and a wage increase. Different groups of employees are eligible for different increases, but on average, employees should receive about a 3% pay increase.

“It’s been very challenging for hospitals financially across the country, including ours,” Becker said. “We are so grateful for how hard our teams have been working to improve our financial situation. We are so proud of our teams for their dedication every day taking care of our patients and their families and providing high-quality care.”

Silva-Steele then addressed the Leapfrog rating of a “D” grade SRMC received in November and in May.

“Leapfrog is a nonprofit company that runs data on an annual basis, and they are particularly looking at publicly reported data,” Silva-Steele said. “Plus they look at processes that are occurring within health care facilities. And in November of this last year, SRMC received a D rating for our leapfrog score, and that was primarily related to outcome measures as we had historically not submitted a survey on behalf of the organization. The Leapfrog company also releases a main safety rating, and in that situation, there is not an ability for organizations that have submitted a survey to resubmit a survey that happens once a year. But it is an opportunity to look to see if scores have changed dramatically during that time frame. The important thing about the reported data is that it is for the timeframe of 2020-2022, as many of you know, that was during the pandemic and lots of things were going on obviously in hospitals during that time. So for the main rating that just came out on May 1, we did not expect to see a change in the rating particularly because of the time frame.”

Silva-Steele stressed that SRMC has come a long way since then and the current quality metrics have markedly improved.

“Our team, I feel, is doing an excellent job at recovering from pandemic matters, prioritizing quality and ensuring that we are moving the needle forward as far as getting back to standards and getting back to where we were pre-pandemic,” Silva-Steele said. “All the scores for the Metro hospitals are low. It’s consistent, basically, statewide.”

The May Leapfrog ratings had two “A” grades: Lovelace in Roswell and Christus St. Vincent in Santa Fe. There were six “D’s,” and UNMH Lomas Campus received the only “F.”

Becker and Silva-Steele left after the presentation, but Enghouse spoke during the public comment portion of the meeting.

Enghouse said that Centers for Medicare & Medicaid Services reporting also has a low rating for SRMC, which has lost its five-star Medicare rating.

“Just a couple of things that I wanted to point out that Jamie failed to mention: One is they lost their Medicare five-star rating; they’re now a Medicare one-star rating. So that is a CMS reporting tool that’s based on how well the hospital performs across different areas of quality, such as treating heart attacks, pneumonia, readmission rates and safety,” Enghouse said. “So let me just give you some statistics. That will help you understand CMS if you don’t already. Six percent of patients left the emergency department before being seen at Sandoval Regional. The national average is 3%, and that is a staffing issue.

“On average, patients spent 320 minutes in the emergency department at Sandoval Regional; the national average is 171 minutes, and the New Mexico average is 194. Only 39% of the patients received appropriate care for severe sepsis or septic shock at Sandoval, the national average is 60% of patients receiving the correct care. The New Mexico average is 45%. So every time you add another patient to a nurse’s assignment, that is a cost-savings measure. That is not a patient life-saving measure,” she continued. “They’ve increased the amount of patients that nurses have to six on the fourth floor. The D leapfrog rating, Lovelace just reported they got an A. They also went through COVID. They also went through the pandemic, and somehow they managed to just get an A.”

UNM Health and Health Sciences Communications Director Chris Ramirez responded to Enghouse with the following statement:

“At UNM Sandoval Regional Medical Center (SRMC) — a Campus of UNM Hospital, patient safety and high-quality care is always our highest priority. U.S. News & World Report recently recognized SRMC as a high-performing hospital for pneumonia care (2023-2024). In that same report, SRMC received high marks for patient experience, receiving 4 out of 5 stars related to satisfaction with the hospital overall, willingness to recommend, and satisfaction with doctors’ communications.

“In 2021 the National Committee for Quality Assurance once again recertified SRMC as a Patient-Centered Medical Home (PCMH). A PCMH is a model that puts patients at the forefront of care. SRMC was recognized as having the tools, systems and resources to provide patients with the right care at the right time.

“In addition to prioritizing our patients, the well-being of our employees and providers is also a priority. This year, SRMC received the Platinum New Mexico Family Friendly Business Award in recognition of our family friendly policies for employees — a recognition we are proud to say shows our commitment to our team and their lives outside the hospital. Meanwhile inside SRMC, our leadership team works daily to manage the demand of patient care with staffing to ensure the best care for both our community and our employees. For example, today our daily nurse to patient ratio is 4:1, with some units even enjoying 3:1 ratios.

“We deeply appreciate all our teams who are dedicated to patient care every day and we work hard to ensure they feel that gratitude.”