On Wednesday, March 19, at 8:52 p.m., Scott Carlson, executive director of California Alliance to Advance Nursing Home Care, was apparently in an optimistic mood.
Carlson is a former executive with the Arkansas–based nursing home chain Beverly Enterprises. And until last week he ran the Alliance, a lobbying organization that helped negotiate labor contracts that have discouraged nursing home workers from informing the press, or regulators, about poor conditions for patients.
This was achieved through a pact between nursing home chains and the two-million-member Service Employees International Union (SEIU), the nation's largest union, which represents nurses, orderlies, and other healthcare employees. Under the pact, the union would use its clout with California Democrats to push nursing-home-industry goals such as tort reform, which would limit patients and their families' right to sue in cases of wrongful death or injury; in exchange, the chains selected facilities where the SEIU could absorb workers into union ranks. This was part of national SEIU leader Andy Stern's strategy of collaboration rather than confrontation, and included deals in Washington state, Missouri, and California designed to rapidly add to union ranks on terms attractive to employers.
But in Sept. 2005, the strategy stalled when Sal Rosselli, the leader of the SEIU's California healthcare affiliate, denounced the collaboration on moral grounds. He particularly objected to the union's failed attempt to push California legislation that would have limited patient lawsuits against nursing homes. This was "neither good policy nor politically winnable," the president of United Healthcare Workers-West (UHW-West) wrote in a memo to SEIU's Washington headquarters. "We cannot sacrifice principles such as adequate consumer protection for organizing rights."
The dispute steadily escalated until Rosselli resigned from the union's national executive committee in February, denouncing Alliance-derived labor contracts as stifling the rights of workers and patients. But Carlson saw cause for hope in this public conflict.
"Maybe [the dispute] will be finally resolved by the parent union," Carlson wrote in a March 19 e-mail to Gary Passmore, executive director of the nonprofit Congress of California Seniors, which was obtained by SF Weekly. "That would then create opportunity for all responsible stakeholders to effectively collaborate on behalf of California nursing home residents. If that occurs, I anticipate that a coalition of nursing home companies would seek to join together with stakeholder groups — such as yours — and again seek opportunity for further collaborative action."
Five days later, Carlson's wishes seemed to come true: Stern wrote to Rosselli, announcing legal preparations to take over the California affiliate and throw out its local leaders. Carlson's prescience about Stern's plans seems suspicious — as if he had inside info from his pals over at SEIU.
Carlson, for his part, said anybody familiar with internal SEIU politics could see it coming. Indeed, internal union memos, transcripts, and reports document a growing feud between Rosselli and Stern, who had sought to move thousands of nursing home employees to an affiliate more amenable to the Alliance agreement.
"More SEIU representatives than I can remember — from UHW-West, Local 6434, and SEIU International — have spoken to me about resolving the SEIU internal conflict for many years," Carlson wrote in an e-mail.
I asked Carlson whether a takeover of UHW-West by Stern would mean that negotiations with nursing home chains might be able to move forward, as his e-mail to Passmore suggests.
"No. It means only specifically what it says," he wrote in response. "I believe you have been a leading source of inaccurate news about the California Alliance to Advance Nursing Home Care. Please don't now seek to commit libel or defame me by speculating intent or new facts into my private communication with another person."
In response to my March 31 inquiry, Carlson told me he was resigning from the Alliance, effective immediately. He said this was part of a dissolution plan that had been in the works since December. While nursing home companies wait in the wings in hopes of fulfilling Carlson's March 19 prediction that they'll again "join together with stakeholder groups" in a labor alliance, the conflict within the SEIU may escalate. Union takeovers can be violent, and UHW-West has stepped up security at its facilities in the event that the national union attempts to physically take them over. Rosselli has hired political consultant Eric Jaye to devise media strategy to derail the attempt. Stern, meanwhile, is the labor movement's greatest media whiz.
The resulting coverage might baffle readers accustomed to labor-beat stories about union leaders battling against companies — not among themselves. So it's important to keep in mind that the issues at the heart of this conflict are simple and relevant to everyone. It's about your mom, your former teacher, yourself, and everyone else who will end up in a profit-driven nursing home, now that the government has all but given up on direct care for the elderly. Three years ago, Rosselli took a stand against his Washington union overseers' nationwide strategy of enticing employers rather than confronting them. And in the case of the nursing home industry, these enticements were too morally repugnant to abide.
The ordinarily drab Oakland headquarters of United Healthcare Workers-West was festively jammed last Thursday with a hundred people wearing the union's signature purple T-shirts. "Hey! Hey! Ho! Ho! Andy Stern has got to go," they shouted 30 times in unison.
As one member after another stepped up to a temporary podium to denounce "officials in Washington, D.C.," UHW president Rosselli, a smallish man in neatly pressed shirt and pants and short-cropped hair, rocked on his heels in time with the chanting.
Stern is "trying to intimidate me," Rosselli said in an interview. "He's used to being able to crush people who speak out against him."
This show of force is designed to make the SEIU's national leadership think twice before attempting to take over union facilities, freeze bank accounts, and fire staff loyal to Rosselli.
This procedure, called "trusteeship," was designed to oust corrupt local bosses. In this case, however, the power play appears to have little to do with corruption, despite Stern's strong language. Instead, he appears to be threatening a takeover of this SEIU affiliate as punishment for moves by Rosselli to upend the cozy alliance between the union and nursing home chains. Carlson, for his part, points out that Rosselli had resisted efforts by Stern to move UHW-West nursing home workers into another SEIU affiliate — one whose leaders happen to be more amenable to collaboration, rather than confrontation, with nursing home companies.
Discerning the truth or falsehood of Stern's corruption claims may require a judge. But there's plenty of evidence that something other than corruption has boiled the blood of SEIU's leadership.
"We discovered some top-down deals made between SEIU Washington, D.C. staff with our nursing home employers that ... limit their voice to speak up for themselves and their patients," Rosselli said on the radio show Democracy Now on Feb. 15.
On the same program, Stern ally and SEIU executive board member Dave Regan, who has served as a Stern proxy in this dispute, suggested Rosselli's words constituted treason. "This is the absolute, most despicable kind of behavior that Sal is willing, through his actions on this program, in California and other places, to weaken the strength of members of my union," Regan said.
Reporters rarely cover organized labor anymore unless there's a major strike. So internal union goings-on fit in the public mind somewhere near confusing yet vital topics such as the mortgage-based-derivative instruments that nearly tanked the U.S. economy last month. Both are arcane subjects not worth paying attention to until catastrophe falls.
But the outcome of the SEIU internal dispute could mean life or death for patients nationwide. If Stern succeeds in taking over California's largest healthcare union based on trumped-up charges against Rosselli, it could ensure the success of a cynical view of healthcare labor relations where contracts are the result of self-interested collaboration between union bosses and corporations, to the exclusion of workers' and patients' interest.
To understand the stakes in this feud, it's useful to revisit the tragic death eight years ago of Mary Hochman, a 52-year-old night nurse at Beverly La Cumbre nursing home, a Santa Barbara affiliate of Beverly Enterprises for which Carlson served as California-based vice president of operations.
According to news accounts, Hochman walked onto a beach and shot herself in the heart after a months-long dispute with her employer. Her problems began when she tried to report that a nurse's aide had hit an 81-year-old man with dementia. According to Contra Costa Times reporter Carolyn McMillan, Hochman said in a sworn affidavit that she was told to cover up the information.
"If a nurse cannot protect her patients, I do not want to be a nurse," Hochman wrote in her suicide note. "This has taken all hope away from me."
Hochman's note, along with a journal detailing instances where she was told to cover up incidents of abuse and neglect, helped spur a federal raid on the nursing home. A subsequent investigation revealed patients suffering beatings and maggot-infested bedsores, culminating in a $2 million settlement against Beverly relating to preventable deaths. The investigation also spawned a dozen civil suits, according to press reports.
After the Hochman investigation and settlement, Beverly Enterprises sold off its nursing homes in California and Carlson took on his consulting role as head of the California Alliance for Nursing Home Reform.
As a result of the agreement, nursing homes obtained what some calculate as $3 billion in additional state subsidies thanks to a bill pushed by the SEIU. The union also lobbied to ensure the bill did not include provisions supported by patients' rights groups that would have set standards guaranteeing high-quality care. The union added hundreds of nursing home workers to its ranks. But the labor contracts that resulted included a scandalous detail: The union was discouraged from informing regulators, or the press, in cases of bad patient care. Under traditional contracts, whistle-blowers such as Hochman could report abuses to the union and feel protected. The Alliance contracts, however, seemed to have the opposite intent.
Under California's understaffed, toothless system, lawsuits are one of the few deterrents for-profit nursing home chains face to prevent them from turning their facilities into charnel houses. Tort reform of the type advocated by the Alliance might remove this deterrent.
Under Stern's "modern" collaborative strategy, such protections are apparently worth sacrificing to grow the union. And during the next few weeks, readers will see a confusing account of his efforts to enforce this view.
"Stern is basically declaring a jihad against dissenters," said Jamie Court, president of Consumer Watchdog, a California nonprofit that describes itself as dedicated to "fighting corrupt corporations and crooked politicians."
"This is a do-or-die issue for them," he continued. "Sal Rosselli is a labor leader who stood on principle. He stood with consumers against the nursing home industry."