Skip to Content (press ENTER)
2018-09-12news-articleNews<p>Spaulding Rehabilitation Hospital Cape Cod (Spaulding Cape Cod) today announced the negative impacts mandated nurse staffing ratios would have on its ability to provide safe, quality care to patients across Cape Cod and the South Shore and to its viability.</p>

Spaulding Rehabilitation Hospital Cape Cod Projects Devastating Impacts of Ballot Question One

September 12,  2018

Government mandated nurse staffing ratios would increase costs, reduce access to care

Spaulding Rehabilitation Hospital Cape Cod (Spaulding Cape Cod) today announced the negative impacts mandated nurse staffing ratios would have on its ability to provide safe, quality care to patients across Cape Cod and the South Shore and to its viability. Slated to be Question 1 on the ballot this November, proposed rigid staffing ratios will devastate community hospitals and behavioral health facilities across Massachusetts.

“Our nurses are on the leading edge of efforts to deliver quality care in the rehabilitation setting, and the hospital needs to ensure they have every tool and resource they need to care for our patients,” says Stephanie Nadolny, MHA, Vice President of Hospital Operations at Spaulding Cape Cod. “This ballot question will hinder, not support, our care teams’ ability to provide the high quality care Massachusetts patients experience.” In fact, Massachusetts hospitals rank #4 in patient safety, according to Leapfrog’s 2018 report, the national database that tracks patient safety. California, the only state to have implemented universal nurse staffing ratios, ranks #25.

The costs associated with the nurse staffing ballot question are unfunded and will set Spaulding Cape Cod back $1.9 million per year. The resulting budget deficits will ripple through the hospital, and the community, impacting cost of care, staffing, and the ability to expand or develop services to meet patients’ needs. Most alarmingly, an inability to hire additional nurses could mean reducing admissions by up to 40% to be in compliance with the mandate. This would result in closing beds, restricting access to Spaulding’s expertise, which is unique on the Cape, extended wait times for patients and families, and travel off-Cape for many patients needing immediate access to hospital-level rehab care.

According to an independent study by MassInsight and BW Research Partners, the ballot question will cost the Massachusetts health system $1.3 billion in the first year, and $900 million every year thereafter. The Cape’s three hospitals alone would need to hire more than 260 full-time nurses just to maintain existing services.

“As a nurse who is proud to have had the honor of caring for patients for 31 years, in long-term care, intensive care, and now in the acute rehab setting, I’m stunned by the unintended consequences of a proposal that treats every patient in every setting the same,” says Deborah Byrne, RN, CRRN, Chief Nursing Officer at Spaulding Cape Cod. “Nurse staffing decisions are complex and cannot be reduced to a simplistic formula without putting at risk our commitment to put patients’ needs first. Such a bill would absolutely constrain our nurses’ ability to give the excellent, compassionate care our patients expect from us every day.”

The ballot question would require hospitals across the state, no matter their size or specific needs of their patients, to adhere to the same rigid nurse staffing ratios within all patient care areas at all times. The petition does not make allowances for rehabilitation hospitals, which do not perform surgeries, deliver babies, or run emergency rooms, holding them to the same staffing ratios as major acute-care teaching hospitals.

The ballot question is opposed by the American Nurses Association of Massachusetts, the Organization of Nurse Leaders, the Massachusetts Medical Society, the Massachusetts Health and Hospital Association, the Massachusetts Council of Community Hospitals, the Conference of Boston Teaching Hospitals, and other healthcare and business leaders across the state.

“No studies evaluating nurse staffing ratios reported a magic number as the single factor to affect patient outcomes or job satisfaction,” said Donna Glynn, President of the American Nurses Association and a Nurse Scientist for the VA Boston Healthcare System. “This ballot question is ignoring scientific fact around what is best for nursing practice, decision making and quality patient care.”

About Spaulding Hospital Cape Cod

Spaulding Rehabilitation Hospital Cape Cod is a Medicare-certified acute rehabilitation hospital with 60 beds, the only hospital-level rehabilitation provider serving the Cape Cod and Plymouth areas. A member of Spaulding Rehabilitation, it provides advanced inpatient rehabilitation care at the main hospital in Sandwich and comprehensive outpatient rehabilitation physician and therapy services at outpatient centers in Sandwich, Yarmouth, Orleans, Plymouth and a dedicated pediatric outpatient center in Sandwich. Its specialty programs include stroke, Parkinson’s disease, brain injury, orthopedic conditions and injuries, cardiac rehabilitation, complex medical conditions, multi trauma, and an array of specialized outpatient services for adults and children. Information at