LYNWOOD — Alicia Ambriz, RN, has worked as a nurse at St. Francis Medical Center, in Lynwood, for 30 years. And since the purchase of her hospital by Prime HealthCare in August 2020, she has seen things go downhill. 

St. Francis had 384 beds for patients when it closed its acquisition. Currently, the facility famous for its rhomboid-shaped façade operates about 330 beds, including those at the family life care center. 

Ambriz — a senior nurse on the bargaining team representing nearly 600 union nurses affiliated with the United Nurses Associations of California, Union of Health Care Professionals — blamed Prime Healthcare’s decision to cut 20% of the nursing staff since the facility changed ownership, for the decline in the quality of care. Fewer nurses means lower morale, tougher working conditions, longer hours, and fatigue — and that leads to failures.

Mounting stress and a lack of a new labor contract — the current contract expired Aug. 14 — pushed Ambriz and hundreds of her colleagues to picket in front the hospital on Aug. 29, at Imperial Hwy. and MLK Blvd., to demand training and retention programs, wage increases to match what competing hospitals pay, and improve ratios of nurses caring for patients.

Better working conditions and salary raises are recurrent themes embraced by striking workers in the hotels and hospitality industry, unionized Starbucks employees, Hollywood writers and actors, UPS truck drivers and Los Angeles city workers in protests that spread as part of the hot labor summer. Across industries workers have complained over overwork due to short-staffing.

“The hospital is putting nurses in danger all the time. If something happens, the nurses are the ones to blame,” said Ambriz. 

Scott Byington, a mobile clinician nurse acting as the president of the St. Francis Registered Nurses Association, or SFRNA, said labor conditions began to deteriorate when Prime Healthcare acquired the facility — purchasing it from a Verity Health System, a nonprofit affiliated with the Catholic Church, for $350 million, after the charitable group filed for bankruptcy. Byington says that Prime Healthcare (a for-profit corporation) then began firing advanced nurses and immediately imposed a freeze on wage increases with the goal of bringing the facility to profitability. St. Francis is no longer a Catholic hospital.

Elizabeth Nickels, vice president of communications and public relations with Prime Healthcare, declined to answer allegations of deaths at various units at St. Francis Medical Center in the last three years, and referred questions from LAPP on the matter to spokesperson Fred Ortega.

In a statement Ortega, a spokesperson for Prime Healthcare, said the company “will continue to bargain in good faith with UNAC-UHCP nursing leadership to reach an agreement in the best interest of the hospital, our caregivers and most importantly, those we serve.” 

He insisted that St. Francis has spent more than $36 million in improvements to infrastructure, equipment, technology, clinical resources and staff, and countered claims of lack of training — though the exact nature of those expenditures, and their relation to baseline maintenance cost are unclear.

Prime Healthcare said St. Francis remained open during the protest.

Nurses held a one day picket demanding better working conditions at St. Francis Hospital — saying conditions have declined since purchase by a private company. (Alfredo Santana / LAPP)
Nurses held a one day picket demanding better working conditions at St. Francis Hospital — saying conditions have declined since purchase by a private company. (Alfredo Santana / LAPP)

A decline in working conditions

Jeff Rogers, a representative with the union, said that prior to the recent purchase St. Francis had 120 to 130 full-time nurses assigned to the ICU, compared to 70 currently staffing the unit 24 hours a day, seven days a week.

Now, between six and seven nurses work per shift, taking care of 30 to 40 patients on average, according to Ambriz.

The ICU has 36 beds, and often experiences overflows.

Recently, the understaffed unit has caused backlogs at the reception area, with paramedics often waiting three to four hours to remove patients from their gurneys. 

Union members said nurses fresh out of college get anxious, or “freak out” while attending women about to give birth, causing them to feel uncomfortable and stressed. 

“We have had very negative outcomes. People are dying due to lack of staff. But that doesn’t seem to make a dent on the administration’s view to encourage hiring,” underscored Ambriz. 

Since the 2020 purchase, Prime HealthCare has laid off about 300 nurses, downsizing their staff from a peak of 850 to 900 nurses, three years ago, to between 550 to 600. 

In addition, nurses at St. Francis earn lower entry-level salaries as compared to other hospitals offering similar services in Los Angeles County. That situation has contributed to a turnover rate of more than 50% among nurses with less than two years of experience. 

Salaries for recently graduated nurses start at $40,000, whereas hospitals such as Torrance Memorial Center pay up to $50,000, union members said. 

Title 22 of the California Code of Regulations says the nurse-to-patient ratio at critical care units should be one to two at all times, meaning St. Francis is non-compliant, according to Sandra Marquez, a nurse who works in the catheter lab. 

Ratios are different for each unit. For example, the state code calls for 1 to 4 ratios in pediatric clinics, and 1 to 2 in anesthetic and post-anesthetic units all the time.

Marquez complained the hospital flouts the ratios “almost daily,” and refuses to add, train and educate new nurses in the trauma, maternity, emergency and heart care units. 

Ratios at the ICU ballooned to three to four patients per nurse “on a consistent basis,” following layoffs starting Aug. 15, 2020, said Marquez. 

“Our emergency unit should have a minimum of 14 people. We only have seven,” said Marquez, a registered nurse with 36 years of experience. “The state knows about these complaints, but we are short staffed. This is not sustainable every day.”

Marquez attested to Ambriz’ comments that disinvestment on nurses and lack of training had led to an increase of deaths in several departments.

Nurses who stick around a few years gain experience setting IVs on patients’ arms and hands, monitoring their heart rates, installing catheters and managing their overall health and become assets to the hospital.

But when these nurses find better jobs, they create hard to fill voids. 

“We don’t have any people to replace them with. When they leave, or when people die, we are typically the last persons to see them,” said Byington amid a cacophony of sounds from chants of nurses clamoring for justice mixed with cars and trucks driving on the street sounding their horns.

Scott Byington at St. Francis (Alfredo Santana / LAPP)
Scott Byington at St. Francis (Alfredo Santana / LAPP)

Recent legislative efforts

In a related matter, the Lynwood City Council passed an ordinance earlier this year to raise minimum wages of healthcare workers to $25 an hour, only to pause it following pushback from the California Hospitals Association, a group that mounted a signature campaign to overturn the measure. 

The council agreed to let Lynwood voters decide the initiative’s fate — it’ll be on next fall’s ballot Nov. 5, 2024. 

In Sacramento, a similar measure with statewide implications is being debated in the California Assembly. 

Already approved by the Senate, SB 525 would increase wages in two steps, the first at $21 an hour by June 1, 2024, and then to $25 an hour by June 1, 2025. 

At St. Francis, Ambriz said licensed vocational nurses are doing the job of RNs to make up for the staff shortage, prompting delays in services and risking the patients’ wellbeing. 

Bargaining members expect to receive a proposal for a new contract with the hospital’s administration on Sept. 14. 

Unionized nurses are scheduled to gather and discuss a strike authorization on Sept. 12, but it’s likely they would hold off until all the members learn where the company stands, said union leaders.

If a vote backing a strike is recorded, the union would have to notify the National Labor Relations Board at least 10 days before a stoppage date is inked. 

“This hospital would be a great hospital if they do the right thing,” said Byington, the nurses representative. “This is what happened when they made it for profit.”  

The hospital serves residents from Lynwood, Compton, South Gate, Paramount, Downey, unincorporated Walnut Park and Florence-Graham.