Why Nurses Leave the Bedside; A Bedside RN Perspective
Kasier Permanente
Part of Subject : Top [most powerful, larges] Hospital CEO salaries
sub text to Topic: The Hospital CEO
part of Chapter: The Health Care Industry and Nurses Within it
See Outside These Pages: Salaries of top execs of HMO's

Kaiser Permanente is a managed care entity with its own hospitals and clinics. It is the "country's largest nonprofit managed care health plan" and their webpages inform they are a not-for-profit health care organization, serving 8.1 million members in 9 states in addition to  the District of Columbia. Currently Kaiser is receiving magnate hospital status as a result of its "Voluntary" innovations regarding nursing involvement in decision making and contractural agreements to maintain RN wage scales above the local norm. These "voluntary" actions gained in the first years of the new millenuim, follow 5 years of fierce RN action and suppression and were, in fact, not voluntary at all. Kasier Permanente does have "a nurse" on its board of directors, but she has not practiced at the bedside, it appears, for nearly two decades, seriously eroding the concept that with her position on the board, the bedside nurse is represented. 
Kaiser CEOs, Board Members and Their Salaries
Kaiser's current CEO is George C. Halvorson, its last, David M Lawrence, MD having made his plan to retire in Dec December  2002 by July 23, 2001. [Health Plan CEO to retire Dec 2002  from Kaiser Permanente's own News Release pages].

" David M. Lawrence, MD, made 2.2 million in 2000.... The Star Tribune.... reports that Halvorson made $814,000 a year at HealthPartners; his Kaiser salary has not been disclosed.  " Meet George C. Halvorson" by Frank Diamond. From Managed Care Magazine; June 2002. George Halvorson also serves on the Board of Directors of The American Asoociation of Health Plans

Kaiser's current Board of Directors includes Jean M. Harris  whom they call, and who indeed is, " a nurse" . However, in accessing more info on her, it does not appear she has practised at the bedside as a staff RN for nearly 20 years, although her role in nursing is impressive from an educational and consultant perspective.  See her entry at Kaiser Permanente's own News Release pages and for Feb 2000

Kaiser's Financial Health:

(Oakland, CA) May 7, 2003óKaiser Foundation Health Plan Inc., Kaiser Foundation Hospitals and their subsidiaries  (KFHP/H) reported net income of $301 million, and operating income of $308 million on operating revenues of $6.2 billion for the first quarter ended March 31, 2003. In the first quarter of 2002 KFHP/H posted net income of $297 million and operating income of $288 million on operating revenues of $5.5 billion. Membership as of March 31, 2003, is over 8.3 million members. Kaiser Permanente: Stable 1st Quarter  from Kaiser Permanente's own News Release pages
Kasier and Its Relationship with Nurses:

Currently Kaiser is receiving magnate hospital status as a result of its "Voluntary" innovations regarding nursing involvement in decision making and contractural agreements to maintain RN wage scales above the local norm. While the term Magnate to define innovative hospitals is one that is now frequently in the news, and seems to imply insight and vision on the part of the management team overseeing hospitals, the actual truth is that the needed, and delayed, changes leading to "magnate" status were in large part initiated by aggresive nursing action and  are a result of nursing's "ain't gonna take it anymore" response to its lack of voice in the hospital hegemony, and management's perception, and manipulation of, a woefully misidentified nursing glut,   during which time Kaiser and other hospitals and hospital systems seriously eroded nursing salaries and work conditions.

While Kaiser fought so strenuously against wage increases for nurses, it appears to have in Georgia alone half a million dollars to devolte to  nursing education to increase the labor pool numbers , NOT addressing the recitivism inherant in the profession itself:

" (Atlanta, Georgia) March 12, 2002óTo help address the severe shortage of nurses in the state, Kaiser Permanente of Georgia has announced $500,000 in nursing scholarships to increase the number of nursing graduates at area colleges." Kaiser Permanente New Release
 The Background:
"Registered Nurses will stage a one-day walkout October 29 [1997] at 54 Kaiser Permanente hospitals, clinics, administrative offices and regional labs in Northern California.....The October 29 walkout will be the RNs' fourth short-term strike since the prior CNA-Kaiser contract expired last January 30 [1997] ......Kaiser has turned its back on RNs and patients by refusing our proposals to make sure RNs can practice nursing in an environment where they can protect patients and not compromise care. Instead, Kaiser is seeking 13 massive concessions that would roll back nursing standards 25 years, " said Rose Ann DeMoro, executive director of the California Nurses Association.... Kaiser's staffing shortages coincide with its business decisions to cut RN staffing by 15% in the past three years in Northern California, a period which coincides with rapid membership growth......While resisting CNA's patient care proposal, Kaiser continues to demand a multi-tiered wage proposal that would mean lower wages for RNs who work in clinics outside the Bay Area, and pay cuts of 19-35% for new hires; reduced health benefits, limits on time off and senior rights, and numerous other contract concessions.....According to news reports, Kaiser has been paying one major firm, McKinsey and Co., $3 million a month for the past five years advising Kaiser how to further slash patient services, shift resources from direct care for Kaiser members in California for national and international expansion, and take a hard line in negotiations with the RNs.....In the past five years, Kaiser CEO David Lawrence has received a 78% increase to a current salary of $1,250,000. In the past four years, Kaiser President Richard Barnaby has collected a 293% hike to $827,715, according to IRS filings. Additionally, 42 other top administrators were paid over $200,000 in 1995."
The Coastal Post - November, 1997 Kaiser Walkout Happening Over Standards Of Care

The Result of RN action:

In 2001, Kaiser Kaiser Permanente "gave" their northern California  nurses  a 14 percent wage increase.  "Kaiser Permanente gives nurses 14 percent wage increase" July 18, 2001  From East Bay Business Times..

Kaiser Permanente-Sunset Medical Center in Los Angeles, nurses  negotiated a provision in their contract to guarantee nurses' salaries   always remain above the community standard. IMPROVING STAFFING AND PATIENT CARE  from SEIU Local 121 RN webpages.

"The California Nurses Association recently ratified a four-year contract that provides salary increases of more than 26 percent, creates a competitive pension and improves retirement health benefits. " Included in the package is "Kaiser Permanente, the only California health care organization to voluntarily adopt minimum nurse staffing ratios, is implementing a 1:4 ratio on medical surgical units. When completed, each Kaiser Permanente nurse will be assigned fewer patients than their counterparts at the majority of other California hospitals." October 22, 2002 "Kaiser Permanente innovations attracting nurses Registered nurses " [Kaiser Permanente California News Bureau]

"Kaiser is using a plan to increase staffing levels to recruit nurses and patients. Nurses on general medical-surgical floors, for example, will be responsible for only four patients. While Kaiser estimates that it may cost $200 million a year to employ the additional people, hospital executives say they expect to achieve savings through better patient outcomes and less turnover among its nurses."
With Nurses in Short Supply, Patient Load Becomes a Big Issue" By REED ABELSON from The NEW YORK TIMES, May 6, 2002