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Class action lawsuits allege anticompetitive activity.


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It seems counterintuitive that, in the midst of a nursing shortage, employers would lowball nurses' wages. But recent antitrust litigation in U.S. courts alleges that some are doing just that.


In May the U.S. Department of Justice and the State of Arizona sued the Arizona Hospital and Healthcare Association (AzHHA), charging that it conspired to set mandatory billing rates for temporary and travel nurse staffing agencies doing business with member hospitals. On the day the charges were filed, the AzHHA agreed to stop setting uniform bill rates.


Nurses placed in member hospitals by those agencies allege that they lost thousands of dollars in wages. A nurse who wishes to remain anonymous and is a plaintiff in a pending class action lawsuit related to the Arizona case told AJN that his own earnings were affected by the AzHHA's wage fixing, which he said had been routine during his 20 years as an agency nurse. He said that he's lost $30,000 to $40,000 in wages "siphoned off the top" by his agency employers.


In four nearly identical cases filed in June 2006 on behalf of nurses in Albany, New York; San Antonio, Texas; Chicago; and Memphis, Tennessee, plaintiffs alleged that human resources staff at many hospitals in those cities exchanged detailed, nonpublic compensation information, agreed not to compete when recruiting or setting compensation rates for nurses, and paid nurses at the same or nearly the same rate. In fact, the Chicago suit says: "Human resources employees have been evaluated by their superiors on their ability to accomplish this RN compensation coordination." The defendants, which include the University of Chicago Hospitals; Ascension Health, Seton Health, and Albany Medical Center in New York; and Baptist Memorial Healthcare in Memphis, are seeking to have the cases dismissed.


Attorney David Balto, who represents one of the nurses in the Arizona case, said that such conduct is likely in response to rising costs, with hospitals and hospital associations seeing nurses' wages as an easy target for budget cuts. These are among the first cases of their kind, he said.


"Nurses need to look at what's going on in the marketplace to figure out whether there might be some kind of anticompetitive conduct [occurring]," he said. They don't need proof to pursue legal action-just suspicion. An antitrust attorney can, on a contingency-fee basis, investigate the validity of the claim and prepare a case if warranted. When employers' actions are judged illegal, further anticompetitive conduct is prohibited and plaintiffs can seek the awarding of "treble damages"-three times the amount lost.


Cathy Singer-Glasson, RN, president of the Nurses Alliance of the Service Employees International Union (SEIU), attributes the timing of these cases to the 2006 publication of Solving the Nursing Shortage Through Higher Wages, a study by the Institute for Women's Policy Research commissioned by the SEIU. The report, available at, identifies wage stagnation, inadequate staffing, and mandatory overtime as reasons for the nursing shortage and linked increases in compensation with improved staffing levels.


"The lawsuits raise nurses' awareness of this issue," Glasson said, "and represent the hope that we can bring nurses back to the profession."


Sibyl Shalo



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