Rehab Employees Raise Concerns

Interviews with employees of OHSU’s Rehabilitation Services Department have raised concerns about staffing, patient care, and pervasive contract and labor law violations. In addition issues of internal equity and managerial ethics were also raised. This is the first in a series of reports on these allegations.

All names will be kept confidential in these reports, though more specific information has been shared with OHSU Human Resources and will continue to be shared as we develop it. For now, we are attempting to work with OHSU as we did in the EVS cases, but should grievances and other legal actions become necessary we won’t hesitate to pursue them.

Health Care Benefits

Local 328 Staff were initially contacted by employees who were concerned that they were being unethically denied full time health care benefits by Rehab Services management. According to our union contract there are four classes of represented employees at OHSU – regular FTE employees, relief employees, flex employees, and limited duration employees. In addition, regular FTE employees may be full or part time.

Flex employees do not get health care benefits. Relief employees receive health care benefits based on the number of hours they’ve worked in the previous six months.

Limited duration and regular FTE employees receive health care benefits based on their FTE. LD and Regular FTE employees who are .75 FTE or higher receive full benefits with the maximum employer contribution. Employees between .5 and .75 FTE receive part time benefits which provide the same health plan but with a significantly lower employer contribution, and therefore a much higher out of pocket premium cost for employees.

For the last few years Rehab Services Management has frequently hired therapists as .5 employees, with the notice that extra shifts may be available to be worked. In fact, for many employees those extra shifts were not only available but expected and that extra work resulted in several “part time” employees working full time hours for indefinite periods of time without full time health care benefits. Some employees raised concerns surrounding this without any action from management. Others felt that even though they were losing significant money on their health care benefits, they might face retaliation by losing their extra shifts if they protested about the loss of benefits.

We were given one example of a member who was initially hired on as a flex position in 2015 and was told the flex position would be a way to track hours worked and validate the need for more FTE in the pediatric rehab setting. Her position soon changed to relief and she was able to accrue full time benefits. In September 2017, a .95 employee changed to a .8, making a .15 FTE position available. The relief employee was told if she wanted to maintain her seniority and hours worked, she would have to take the .15 FTE position, otherwise a new hire would have seniority and likely take her hours. In October 2017 she took the .15 FTE out of fear of losing hours worked and routinely worked 30 to 40 hours a week for a year without health care benefits.

Another example is an employee who was a .5 FTE and worked for over a year full time. He requested to receive an increase in his FTE as he needed full time benefits for him and his family. He was told no by management and recently quit to work for Shriners where he now receives full time health care benefits.

Some quotes from union members we interviewed:

“I was hired for Saturday/Sunday and always worked more than that”

“People are being hired under the pretense that these are part time jobs and know they are going to work you more than that and not give you benefits.”

“They don’t hire people with experience because they cost more. They hire new grads because they are cheaper and will put up with not getting benefits.”

“They create unsustainable positions – for example sat/sun only with 10 hours shifts – only desperate people take these jobs and they don’t stay.”

The number of employees working consistently over their FTE has been reduced recently, but for many, in the previous few years, they have lost hundreds of dollars per month in healthcare benefits beginning the day they were hired, with full knowledge by management that they would be routinely expected to work extra shifts. Rehab management frequently frames full time benefits as a privilege and not as a benefit for actual hours worked.

OHSU must end the practice of unethically hiring employees as part time and then working them full time in order to save money on employee health care benefits and must further end the unethical practice of keeping employees who have a demonstrated history of working full time hours listed as part time FTE. It is, perhaps, excusable to hire an employee and not anticipate the number of hours they will actually have to work, it’s an intentional and unethical act to keep them working for months or years in excess of their FTE and not upgrade their FTE status with full knowledge of the negative impact this is having on employee health care benefits.

Next Article: Pervasive Wage and Hour Violations In Rehab Services


16 thoughts on “Rehab Employees Raise Concerns”

  1. As an employee at OHSU, I should start off by saying I absolutely love my job. The families, therapists, doctors, nurses, and staff here are wonderful. OHSU staffs some of the most talented and compassionate people I have ever had the opportunity to work with. When I was hired at OHSU, I worked full time with part time benefits for my first year, it was a financial burden to pay out of pocket for my benefits. By the end of my first year, I started to wonder if staying was sustainable. On a couple of occasions I asked if we could increase my FTE to full time status, since I worked full time hours. It was always denied. I was told that we didn’t have any extra FTE available at that time. Around my 1 year anniversary at OHSU, a couple of my colleagues and I developed an outpatient program. The timing of this program development occurred when one of our therapists left and her 1.0 FTE was divided into a 0.25 position and a 0.75 position. After proving the my outpatient program was successful and generating revenue, management eventually offered me the extra 0.25 to add to my 0.5 position making me a full time 0.75 employee. Though I am thankful for the full time position, my full time status is a consequence of someone else leaving rather than a reflection of my work hours.

  2. As an employee of OHSU, I am very thankful that we are bringing awareness to this issue of OHSU employees working over their FTE and not being fairly compensated for their work. OHSU is the largest employer in the state and a public, university hospital. When I told my friends and families that I work full time here and don’t receive health care benefits, the common responses were, “How can you work in health care at a hospital and not get health insurance?” “That seems wrong!” or “Why are you working there?” The last response is tough to respond to because I love my job. Doernbecher Children’s Hospital is an incredibly inspiring place to work due to the patient population, my rehab colleagues, and the amazing nurses, doctors, case managers, child life therapists, etc., that are passionate about what they do, and care about their patients. The health care providers in this institution are a collaborative team that provide top notch care to pediatric patients and their families, and a team that I am very proud to be a part of. I was willing to work without health care benefits because I’m lucky enough to work at the largest children’s hospital north of San Francisco. That being said, I’ve been taken advantage of. My willingness to work without benefits appears to have saved someone money, since they were unwilling to pay for my employee benefits, or unwilling to advocate for my rights as an employee at this institution.

  3. Thank you for publishing this. I hope the leadership at OHSU steps up to support the change needed. The hard-working and caring employees in the Rehab department deserve to be treated fairly and empowered to focus on patient care above all else.

  4. I support the integrity and bravery of my colleagues in sharing their stories. Having worked at OHSU for 15 years, I was so disappointed to learn that this institution would treat its employees and citizens of our great state in this way. How can an institution reconcile a mission of support for public health with a policy of denial of health care benefits? How can OHSU take advantage of those it SERVES and employs? OHSU can and should do better. Please, OHSU leadership, make this right.

  5. I love my job. But as an employee of OHSU I am continually reminded of just how powerless I feel. Everyday, literally, we are asked about staffing and recognize there is a need, with little to no action. Every week, literally, I am asked if I want to work above my FTE. I continually feel bad for a situation that was created by OHSU. I continually worry that if I don’t work above my FTE I am penalizing my fellow co-workers.
    Instead of valuing their skilled therapists the system looks at them as numbers. Job retention is not built through asking for more hours worked, but instead valuing their input. The patient needs us. Let us provide the level of care our patients deserve.

  6. I stand with OHSU rehab employees! Passionate advocates for our patients and community deserve better treatment from the states third largest employer.

  7. As a retired RN and a proud AFSCME member of 30 yrs the problem of staff working less FTE than required for benefits is a common one in bargaining.
    As a member of the AFSCME bargaining team, we were successful in limiting the amount of time staff could be without benefit status. It seemed a successful strategy and I offer it to you with best regards for success.
    In Soludatity
    Phyllis Smith

  8. It’s a shame that a corporation capable of so much good, decides to take profits over quality of care and employee satisfaction.
    At a time where OHSU are constantly making profit and compensating upper management, it’s only right to compensate those actually making the effort. Running a department, bare bones, in hopes to cut cost and receive a bonus, is no way take care of the people that make OHSU run.

  9. This is very poor practice for such a large institution that brags about its help for others. How can you help others when you cannot take care of the people doing the actual work to care for the patients? These therapists care deeply for their patients, hence why they work above their FTE. They should get recognized for their determination to continue care, even when in a hostile environment.

  10. I stand with AFSCME and OHSU rehab department. Support employees who are passionate about their jobs, patients, and serving the wonderful people of our community.

  11. Thank you for revealing what many do not realize about an institution that publicly prides itself on service to others. My friends, family members, peers, and neighbors are shocked when they hear about such practices from such a well-known and renowned organization. A healthcare company cheating its own employees out of their health insurance benefits??? OHSU: you can and SHOULD do better. I hope this is the start of a new era where staff and management can collaborate in the interest of providing the best patient care possible, foster a transparent and fair working environment, and set an example for other institutions.

  12. I am so grateful to see that this issue is being brought forward by the brave staff in Rehab. This has been common knowledge among employees. These issues have been brought forward to HR but there has been a very real and legitimate fear of retaliation from the director of rehab. The focus in this particular department, adult rehab as well as pediatric rehab, has been the fiscal bottom line. Fiscal growth and responsibility is vital in the growth of the organization. However, the director has directed her managers to make decisions based solely on fiscal growth, has practiced retaliatory behavior, and has regularly practiced cost shifting to other departments. The director has worked tirelessly to attempt to have all rehab employees salaried instead of hourly so that she can maintain (or decrease FTE) but maintain the current workload. To say that HR and her immediate managers were unaware of this practice is false. I raised these issues and more to HR and to her immediate manager. Neither was willing to the do the right thing. This culture is pervasive in the C suite offices. The director’s negative practices are well known throughout the rehab community in the Portland Metro area. Her immediate managers were not willing to do the right thing because she made budget. The staff in adult and pediatric rehab are some of the most skilled and compassionate practitioners I’ve ever worked with. The director of rehab and upper management “hit fiscal targets” on the backs of their employees. It’s disgraceful.

  13. OHSU Rehab management has a horrible reputation locally, these tactics and bullying have been going on for years! Just go ask a current staff member who applies to positions; 1. New graduates or 2. People from out of town = folks who can’t know any better. As B mentioned, higher administrators don’t give a care in the world because the department hits fiscal targets. Administration likes to dream of new ways to schmooze the public, fancy bilboards and commercials stating we’re #1, meanwhile their director of rehab won’t staff occupational therapists on Sundays and holidays and stroke patients get triaged on weekends.

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