National Nurses United (NNU) supports Bernie Sanders, advocates social insurance, and wants to prevent a private healthcare company from buying the Catholic Medical Center (CMC) in Manchester.
And they hope to put pressure on New Hampshire Attorney General John Formella to block the purchase agreement between CMC and HCA Healthcare.
The nurses union is in a bitter battle with the HCA. More than 10,000 of its members in six states are negotiating contracts with the health care company. The NNU is playing hardball, especially in North Carolina, where it is offering strike classes to its members.
On July 20, that fight came to Manchester when a full-page ad appeared in the Union Leader—an open letter from a nurse at an HCA-owned hospital in Asheville. The letter called on New Hampshire Attorney General John Formella to use his authority and stop the “sale” of CMC.
The NNU has also launched an online petition calling on Formella to intervene, which can be found on the website Medicare4All.org.
But Manchester community leaders and health experts say the HCA is throwing a lifeline to a hospital that is vital to the city’s wellbeing and is in deep financial difficulty.
It’s no secret that CMC is struggling. The historic nonprofit hospital – created in 1974 through the merger of Sacred Heart Hospital (founded in 1892) and Notre Dame de Lourdes Hospital (founded in 1894) – reported losses of more than $45 million in 2023. CMC is currently losing two to three million dollars each month.
For this reason, S&P Global downgraded its bond’s credit rating earlier this month.
“The downgrade reflects several years of significant operating losses that have continued into the interim period of fiscal 2024, as well as a deterioration in balance sheet metrics,” said Marc Arcas, credit analyst at S&P Global Ratings.
The downgrade would have been even more significant, Arcas said, but S&P believes that CMC’s economic future is relatively stable. The reason for this is the “committed efforts of management to find a larger partner that can support the company’s long-term viability. These efforts have led to the purchase agreement with HCA.”
Formella’s role stems from CMC’s status as a nonprofit, charitable hospital. Notice of the intended sale must be sent to the state’s attorney general, who serves as the state’s director of charitable foundations, for review. In the notice to the state, CMC President and CEO Alex Walker describes the hospital’s condition in great detail.
“The healthcare landscape in New Hampshire has changed dramatically and the hospital, as an independent hospital with limited resources, has struggled to meet these changing demands. Providing care to one of the nation’s oldest populations with increasingly chronic and complex conditions while simultaneously addressing one of the nation’s most acute opioid and substance abuse crises has presented the CMC transaction parties with significant clinical, financial, operational and staffing challenges and has overwhelmed the hospital’s ability to respond to patient and community needs,” Walker wrote.
HCA is no stranger to New Hampshire. HCA has been a healthcare provider in the Granite State for 40 years and in 2020 purchased Frisbie Hospital, a 112-bed facility in Rochester that was also facing financial challenges.
Supporters of the sale say NNU’s mission appears to be to attack HCA to gain an advantage in negotiations, rather than to promote a solution that would keep CMC open. NNU criticized HCA as a “billion-dollar Wall Street giant” because of its “size and connections to big money” and accused it of reducing the quality of care.
As of August 2023, HCA Healthcare operates 186 hospitals and approximately 2,400 outpatient care facilities in 20 states and the United Kingdom.
Meanwhile, the NNU remains active in party politics. It endorsed Senator Bernie Sanders over Hillary Clinton in the nation’s first Democratic presidential primary in 2016, spending at least half a million dollars on ads in early states like Iowa and New Hampshire. And it is supporting Vice President Kamala Harris in this year’s race for the White House.
Local politicians say the focus should be on CMC and its role in the community rather than on national political posturing.
“I recognize how important the hospital is to the economic viability of our city, to the 2,000 people who work there and to the people who receive care there,” said State Senator Lou D’Alessandro (D-Manchester) during a hearing on May 31.
“And my main concern is that this service remains at the same level that it has been at all these years.”
