Aspen Valley Hospital, with more than 30 full-time positions to fill and its employees feeling overworked, underpaid or both, will issue across-the-board raises of 5% after staffers aired their concerns at a series of town hall-style meetings with executives last week.
CEO David Ressler notified the staff in a Nov. 18 email that hospital board directors will be asked at their next monthly meeting, scheduled Dec. 13, to approve the raise as part of their adaption of the 2022 budget. All full-time employees on AVH’s payroll on or prior to Nov. 1 also will receive a $1,000 bonus on their Nov. 26 paycheck, while the amount will be pro-rated for non-full-timers.
Ressler, in a telephone interview Tuesday, said the process of addressing the employees’ concerns moved quickly. The issue was raised at an AVH board of directors meeting Nov. 8 where Ressler referred to a letter sent to the board from employees. The letter suggested staff exits without pay raises.
“The difficult truth for Aspen Valley Hospital is, in order for it to retain its valued staff members, we must be paid a more proportionate wage to the cost of living,” said the letter, which the hospital provided to The Aspen Times this week. “Aspen Valley Hospital once provided some of the most competitive wages in Colorado, but that is no longer the case.”
Ressler expressed confidence this week the board will approve the raises. And at this month’s board meeting, members Greg Balko and Mindy Nagle, who also are physicians, said the issue was not a new one and it was being taken seriously.
“I would think that I speak for everyone,” Nagle said, “and I look forward to what will be done and what can be done to support our dedicated staff through what is a very hard time in not even just getting the numbers to fill the positions but making sure we’re taking care of our long-term staff.”
“We’re not in the dark and we’re aware of the issue,” said Balko. “We appreciate the letter. It’s something that obviously staff has already been working on and discussing with us, and we obviously don’t have the answers yet and we’re in the process of working with some consultants to help us try and wrap our heads around this — because it’s a problem happening nationally — and figure out how we best deal with this problem. We’re definitely aware of the issue, we feel for everybody, and we’re looking into it, and I’ll just leave it at that.”
The letter said employees had not received a cost-of-living adjustment to their pay since the spring of 2019, while most of the hospital’s staff commute to Aspen from 20 to 65 miles away during a time of rising gases prices, inflation and a global pandemic.
“There is no longer the same pool to draw from and contrary to this organization’s belief, we are not easily replaceable,” said the letter. “Burn out and moral fatigue are plaguing staff who have worked through the pandemic. This is only placing more strain on an already stressed and dire system.”
The hospital froze wages for six months 2020 due to the pandemic. And raises eyed for July didn’t happen, partly because there wasn’t adequate market information on health care compensation, Ressler said. The hospital has a consultant who bases compensation for all positions using the most current market trends available, Ressler said.
Now with more clarity about industry pay and AVH’s own financial situation, hospital authorities carved out room in the 2022 budget for the pay increases, Ressler said.
“As soon as we felt our cash was stable, then we implemented our pay raise,” he said.
The situation at Aspen Valley Hospital, as both Balko and Ressler noted, is one being experienced nationally as well.
“Employment in health care is down by 460,000 since February 2020,” according to a news release Nov. 5 from the Bureau of Labor Statistics.
The health care industry added 37,000 jobs last month but most of them came in home health care services (more than 16,000) and in nursing-care facilities (more than 12,000), according to the bureau.
AVH as of Tuesday had openings for 31 full-time positions, three half-time positions and five seasonal positions, and 16 openings for PRN employees, who are used on an as-needed basis, according to Jennifer Slaughter, the facility’s director of community relations.
Multiple employees or people close to the hospital contacted The Aspen Times in recent weeks expressing concerns about AVH’s staff morale and the potential fallout.
“For two years the frontline workers at AVH have been there for the community, to keep everyone safe and healthy. That may no longer be the case. The hospital can not function without frontline workers,” said one email to The Times. “There may come a day very soon where someone who breaks a leg going down Ajax will have to take a 60 minute ride down to Glenwood to get it fixed because there is no longer a hospital in Aspen.”
That email was sent last week. Yet the mood apparently had shifted after Ressler’s announcement.
“They’re taking measures to make it better for employees,” said a nurse speaking anonymously. “They have listened.”
Housing employees only exacerbates the issue. AVH owns 66 worker-housing units, and about two-thirds of those are occupied by contract employees known as “travelers” or those coming from seasonal agencies, Ressler said.
“Like all employers,” Ressler said, “we’re utilizing our own inventory of housing as best we can can, and we’re aggressively looking to expand that inventory.”
Traveling nurses, while necessary to help shore up staffing shortages, can also create resent among the long-timers at AVH, according to people close to the hospital. Those nurses, in Aspen on a temporary basis, can make three or four times as much per hour than longstanding, full-time AVH full-time employees. The amount of money they’re making, Ressler noted in his email, is due largely to paying competitive wages at a time when some hospitals with full ICUs are struggling to keep up due to high cases of COVID-19.
“It is not uncommon to see hospitals paying $150 or more per hour for agency or traveler staff, or $5,000 per week to temporarily fill vacant positions,” said Ressler’s email. “All of these dynamics result in wage inflation across all positions and shortages that, in some cases, are causing hospitals to reduce services.”
The concern among staff was significant enough for town hall staff meetings to be held last week in Aspen, Snowmass Village, Basalt and Glenwood Springs, drawing about 150 people.
“Some of what we discussed was difficult for you to hear, and some of it was difficult for us to hear,” Ressler’s email to employees said. “But it had to be said, and we appreciate that we were able to be open and honest with one another. It has been a long time since we have been in person together, and our organization is built upon a shared sense of community and purpose that is best served when we work as a cohesive team. That is hard to do when we don’t see each other face-to-face regularly, and it is particularly important when we have important topics to discuss that affect all of us.”
In 2020, AVH’s patient revenue fell short of budget by 13.6%, generating $136.1 million compared to the projected $157.6 million. AVH had to suspend elective surgeries for six weeks in 2020 due to the pandemic, and also had $96.3 million in total operating revenue against $110.2 million in total expenses.
This year is shaping up to be a different story.
Through September, or the first three quarters of 2021, the hospital had reported $124.5 million in revenue, 7.6% better than budget projections. Net patient revenue from January through September was $82 million, 8.7% better than the budget forecast.
Staff salaries paid out amounted to $33 million and physician compensation totaled $5.4 million during that period, and were part of AVH’s $79.4 million in expenses the first nine months of the year, 7.6% ahead of budget. Overall, AVH ran $14.1 million ahead of budget during that time. Those figures are based on a presentation given to the board at its November meeting by hospital CFO Ginette Sebenaler.
Ressler’s email said “2021 has exceeded our expectations for surgical volumes and hospital activity levels,” noting AVH’s partnership with the Steadman Clinic, which took effect Dec. 1, 2020, “has had the effect of building our cash reserves in advance of what will surely be several difficult years ahead.” Upcoming challenges include moving 70% of the hospital’s orthopedic surgical cases to the new Steadman Philippon Surgery Center in Willits, spending $15 million on the roll-out of the Epic patient-records system, and the uncertainty of the pandemic.
“All of these will be impacting our cash reserves that we hold for these and other unforeseen reasons,” Ressler’s email said.
The hospital did not lay off any full-time employees because of financial constraints due to COVID-19 in 2020, said Ressler in this week’s interview.
“It was our priority to not have any layoffs or have any mandatory down-staffing,” he said.
AVH historically has based its pay on national models, with its midpoint salary range for positions in the 75th percentile, according to Ressler’s email.
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