On Wednesday, registered nurses protested outside the ability, accusing Good Samaritan Hospital and its parent company HCA Healthcare of jeopardizing patient care. They alleged the health care provider failed to deal with staffing shortages and inadequate meal breaks.

The California Nurses Association said hospital management had not yet adequately addressed greater than 100 cases of unsafe staffing conditions or missed breaks, claiming the health agency was putting profits over people.

“We take care of a lot of sick people, and as a nurse I only have two hands,” said Chris Shulga, a registered nurse on the hospital for greater than 12 years. “I can only do as much as these two hands can do. So when we have seriously ill patients, we simply need more people. We need more bodies, we need more hands and we need more minds just to do all the tasks required for these very sick patients. We are not given the opportunity to care for your family members in this hospital.”

At the guts of the issue is compliance with Title 22, the federal regulations that set the required ratio of registered nurses to patients. The nurses gathered outside the hospital also accused the hospital of attempting to game the system to make it appear that it was complying with regulations. At the identical time, they said the fact reflects that nurses are getting used for other duties since the hospital can also be understaffed in other positions, which has affected the hospital's ability to offer care in a timely manner.

“It looks like they're actually giving their numbers, but that's not the case,” said registered nurse John Pasha. “What I mean by them making their numbers is that they hit everyone and do it in a reasonable amount of time. But they delay treatment for hours and hours, so things like medications are delayed, and then there will be an increase in pressure sores, which are usually caused by things like that. When we start losing bedside nurses, other things fall by the wayside.”

HCA Healthcare denied the allegations in an announcement to The Mercury News.

“Facts matter, especially in healthcare,” said a spokesperson for Good Samaritan Hospital. “We fully appreciate the incredible work our nurses do, so it is disappointing that their union leadership chooses to misrepresent the care they provide. To be clear, Good Samaritan Hospital is 100% compliant with Title 22 requirements, hired 83 nurses in 2024, reduced nursing staff turnover by nearly 7%, and is ranked among the top 100 hospitals in America each year according to Healthgrades. Our hospital, our nurses and our doctors are here 24 hours a day, every day, to care for our community.”

HCA's history in San Jose, particularly because it pertains to operations on the Regional Medical Center, has change into a hot topic amongst nurses and residents.

Earlier this yr, HCA initially decided to shut the trauma center at Regional Medical Center before changing course and downgrading it from a Level II facility to a Level III facility. At the time, doctors and nurses were outraged by the HCA due to its impact on residents in East San Jose, who were forced to travel longer distances to receive treatment for more serious procedures. While Santa Clara County stepped in on the last minute to purchase the hospital and save the trauma center, critics of HCA say its actions are further evidence of its business model and that the corporate is putting patient well-being above profits.

The unresolved concerns facing HCA were highlighted at a recent San Jose Planning Commission meeting, where the advisory panel really useful the City Council deny its request to rezone the Good Samaritan campus to accommodate a brand new facility in compliance with state regulations to ascertain earthquake laws and expand operations.

Several commission members said HCA's profit motive harms residents and wondered what would stop Good Samaritan from cutting more services, because it did when it closed its psychiatric unit.

Although the Planning Commission's decision was purely symbolic for the reason that City Council is the ultimate arbiter, some nurses were pleased to listen to San Jose officials defy the HCA.

“It is a very profitable institution, and if you expand it, it will only become more profitable,” Pasha said. “The problem is that if we can't staff it now and they cut corners now with the size they have now, how are they going to not cut corners over time? They have simply proven that they will do anything to save money, not by innovating more, but by eliminating their work.”

Originally published: October 30, 2024 at 3:13 pm PDT

What is the reason behind the present housing shortage and high housing costs within the United States?

Jessica Trounstine: Most metropolitan areas have seen Housing shortages and skyrocketing prices within the last decade for each rents and mortgages. And as these prices have increased, tax assessments are being raised have also increased, leading to higher property tax burdens. The total amount that residents pay for his or her apartments is subsequently higher than before.

When households spend greater than 30% of their income on housing, the Census calls those households “cost-burdened.” And in keeping with some recent data, even greater than One-third of households within the United States are cost-burdened, and the numbers are even higher for renters than for owners. In some metropolitan areas even greater than 50% of tenants are cost-burdened.

How do local governments influence the provision of housing?

Jessica Trounstine: Local governments could make it tougher to construct housing, which contributes significantly to housing shortages and skyrocketing prices. They do things like charge high fees for development or introduce cumbersome verification processes. You can Implement historical overlays or Create open space requirements.

But crucial way local governments reply to housing shortages is: Prohibit density and only detached single-family homes could also be built. Many cities expressly prohibit multi-family housing. Everything from duplexes to high-rises might be prohibited by a city's zoning or administrative regulations.

You can even do things like: B. Provide requirements for big setbacks from the road. You can set minimum lot sizes for every unit. Since higher constructing density and smaller residential units are cheaper, these regulations limiting constructing density apply associated with higher housing costs.

Many local land use regulations have been in place for a very long time. Why are they causing such problems now?

Jessica Trounstine: It is true that these regulations existed first used 100 years ago, but the present pattern of restrictive zoning didn't really come to fruition within the United States until the Nineteen Seventies. Land use regulations are inclined to turn into more complex over time. Once an area government enacts land use regulations, it will not be inclined to reverse them. As a result, land use regulations often turn into more restrictive over time.

At the identical time, the population has increased in large metropolitan areas for a wide range of reasons. But Housing construction has slowed. The market comes under pressure over time. Only in the previous few a long time have we seen the convergence of all of those events, in order that even housing prices for middle-income families may be very high.

How did zoning and land use policies contribute to racial segregation?

Jessica Trounstine: For a long time, segregation was driven primarily by private market decisions: Racial steeringblockbusters, restrictive clausesand even violence to defend the colour line. But these tactics became no less than technically illegal within the mid-Twentieth century through lawsuits, state laws, etc Federal Fair Housing Act of 1968.

Essentially, restrictive zoning was created take the place of such tactics. The United States is far more segregated today than can be the case if it weren't for the restrictive zoning. Additionally, restrictive zoning freezes segregation patterns that emerged a long time ago through overt racist actions. We have about twice as much racial segregation as we might otherwise have if such regulations didn't exist.

What strategies can municipalities use to combat housing shortages and segregation?

Jessica Trounstine: You can take into consideration having something all types of apartments in every neighborhood – all types of housing to appeal to several types of individuals with different income levels.

For example, you’ll be able to remove parking minimums and expand height restrictions. Even more dramatic, they’ll allocate public funds to low-income developments.

Which strategies make zoning and land use reforms more practical?

Jessica Trounstine: No single reform can work by itself. It is usually not enough to permit the development of semi-detached houses. But we all know that reform packages can work together.

You can allow maisonettes, but at the identical time concentrate to floor space ratios and minimum lot sizes. And addressing all of those different regulatory constraints can expand opportunities within the housing market. There are also indications that something is occurring in California is named “the builders’ remedy.” is working to advance development. It essentially allows developers to override local regulations based on state guidelines.

Some of my work also shows this Lawsuits may be effective in combating patterns of segregation and long-standing regulatory restrictions within the housing market.

How do development and land use decisions affect the environment?

Jessica Trounstine: spread, or The development continues to expand attributable to population density is in itself harmful to the environment. It results in long commutes and alters the built environment in ways in which may be costly for the environment. Increasing density is drawing people back to the middle an environmentally friendly type of politics.

What is the connection between zoning reforms and gentrification?

Jessica Trounstine: Historically, it’s true that when neighborhoods experience economic and racial change, communities turn into marginalized are damaged in the method. So one answer to concerns about gentrification is to make sure that marginalized communities have a seat on the table and take part in the conversation concerning the built environment and development.

What is mostly not clear in gentrification research is whether or not these are latest developments causes gentrification. So before we restrict development to forestall gentrification, we’d like more research and a greater understanding of the interaction between these two mechanisms.