Why is the California Nurses Association swimming in money?

Since the year 2000 CNA has grown from about 30,000 members to 90,000 a 300 percent increase. In the same time period their total assets exploded from 7.4 million to over 238 million, a 3116 percent increase. By any measure this is a phenomenal rate of membership growth for any Union in an era of declining membership and a OMG rate of increase in financial strength. Some of the increase is due to Real Estate holdings and appreciation of Bay Area real estate but most is cash, including 108 million of cash on hand at the end of the reporting period.

Let’s follow the money and see if we can answer this question while we examine how CNA and its parent organization, National Nurses United (who share the same leader) receive and spend members dues monies. We will look at various disclosure reports from the Labor Department known as LM2 reports as well as public interest websites that track campaign donations as the source of information. The Union look-up tool at the Department of Labor website can be viewed at the link. Department of Labor Union look-up tool

Membership and dues

20. How many members did the labor organization have at the end of the reporting period?	94,659
21. What are the labor organization's rates of dues and fees? Rates of Dues and Fees Dues/Fees Amount Unit Minimum Maximum (a) Regular Dues/Fees 138.84 per Month 69.42 138.84

Assets and investments

ASSETS	Schedule Number	Start of Reporting Period (A)	End of Reporting Period (B)
22. Cash		$90,029,013	$108,088,355
23. Accounts Receivable	1	$6,715,017	$6,524,695
24. Loans Receivable	2	$7,233,776	$0
25. U.S. Treasury Securities		$20,857,328	$23,465,615
26. Investments	5	$30,502,364	$29,099,225
27. Fixed Assets	6	$70,539,574	$70,093,092
28. Other Assets	7	$1,085,375	$1,199,302
29. TOTAL ASSETS		$226,962,447	$238,470,284

Interesting note on line 24 references the 7.2-million-dollar loan CNA made to another labor union, NUHW, 5 years ago and. That relationship was severed last year and NUHW has not paid one dime. In the footnotes of CNA’s 2016 LM2 report they list that loan as uncollectable. Another red flag here is why does a labor union need to sit on 108 million in cash. Read about the CNA NUHW history and split here. CNA - NUHW Split and Loan

Executive Salaries – Keeping it in the Family

Rose Ann Demoro has been the Executive Director of CNA and NNU for many years. Both Rose Ann and her husband Robert, who is Director of Research, command nice salaries from CNA and NNU. Combined they pull in 567 thousand in the last year.

Demoro ,  Rose Ann   Executive Director None		$182,370	$672	$4,500	$0	$187,542
I	Schedule 15 Representational Activities 30 % Schedule 16 Political Activities and Lobbying 20 % Schedule 17 Contributions 0 % Schedule 18 General Overhead 20 % Schedule 19 Administration 30 %

Demoro ,  Robert   Director Research None		$192,102	$1,345	$0	$0	$193,447
I	Schedule 15 Representational Activities 80 % Schedule 16 Political Activities and Lobbying 0 % Schedule 17 Contributions 0 % Schedule 18 General Overhead 20 % Schedule 19 Administration 0 %

From NNU’s LM2 report – Many of CNA’s officers draw salary from both CNA and NNU which reports out of the same address in Oakland. If one did not know to look in both they would grossly underestimate the compensation of many CAN/NNU officers. Curious why Rose Ann’s salary is identical under both organizations. There are other relatives rumored to work for CNA.

Demoro ,  Rose Ann   Executive Director None		$182,370	$672	$4,500	$0	$187,542
I	Schedule 15 Representational Activities 15 % Schedule 16 Political Activities and Lobbying 40 % Schedule 17 Contributions 0 % Schedule 18 General Overhead 20 % Schedule 19 Administration 25 %

 Liabilities

CNA purchased in early 2015 a 66-million-dollar Lake Merritt tower 10 story building with a view of Lake Merritt which is considered prime Real Estate in Oakland. They recently sold their 2000 Franklin St address for 13 Million. Most members have yet to see this new building from the inside and most meetings are held away at other properties or hotels. The membership was not told about this purchase until well after it was reported in the media and little has been said since. Eyebrows are being raised about the perceived secrecy around the need for and use of this high priced piece of Real Estate. Read about that purchase here CNA purchases Lake Merritt Tower - Business Journal

LIABILITIES Schedule Number Start of Reporting Period (A) End of Reporting Period (B) 30. Accounts Payable 8 $4,008,020 $4,131,699 31. Loans Payable 9 $66,000,000 $51,545,000 32. Mortgages Payable $0 $0 33. Other Liabilities 10 $5,806,567 $7,307,118 34. TOTAL LIABILITIES $75,814,587 $62,983,817
35. NET ASSETS $151,147,860 $175,486,467

CNA California State Political Activities

SUMMARY INFORMATION - CALIFORNIA NURSES ASSOCIATION PAC (CNA-PAC) (ID# 780657)
CURRENT STATUS	ACTIVE
LAST REPORT DATE THIS SESSION	09/29/2016
REPORTING PERIOD	07/01/2016 - 09/24/2016
CONTRIBUTIONS FROM THIS PERIOD	$217,472.27
TOTAL CONTRIBUTIONS 1/1/2016 - 09/24/2016	$837,022.38
EXPENDITURES FROM THIS PERIOD	$369,511.66
TOTAL EXPENDITURES 1/1/2016 - 09/24/2016	$1,085,089.59
ENDING CASH	$50,181.17

It’s very interesting to drill down into the detail of contributions. CNA contributed to many ballot measures mostly Proposition 61, nearly every Democratic Candidate for state races, many local board of supervisors, local city or county measures dealing with a variety of items from campaign finance to local energy development to schools. To say they spread money around is an understatement. See for yourself at the link.

CNA Contributions filed with Secretary of State 2016 YTD

The SOS data is much lower than even CNA’s self-reporting of political contributions on their LM2 likely due to different reporting periods and monies still in the pipeline as we approach the election.

National Nurses United

Founded in December 2009, NNU brought together the California Nurses Association/National Nurses Organizing Committee, United American Nurses, and Massachusetts Nurses Association. Its purpose is to give registered nurses a national voice and organizing power. Since additional registered nurses in Florida, Illinois, Iowa, Missouri, Nevada, Texas and Washington, D.C. have been organized under NNU. The clear dominate force of the 196,000 member NNU is the 95,000 members from CNA.

NNU lists an address in Maryland but for reporting it lists the same CNA address in Oakland and many of its officers / directors work out of the Oakland Office. It shares the same website. NNU is much more modest in their assets. Monies are funneled in from the various State Unions, again, mostly from CNA in a back and forth flow that is very confusing to analyze without additional information.

ASSETS	Schedule Number	Start of Reporting Period (A)	End of Reporting Period (B)
22. Cash		$25,634,802	$26,675,560
23. Accounts Receivable	1	$2,372,287	$2,746,704
24. Loans Receivable	2	$0	$0
25. U.S. Treasury Securities		$0	$0
26. Investments	5
27. Fixed Assets	6	$124,699	$77,050
28. Other Assets	7	$435,440	$449,999
29. TOTAL ASSETS		$28,567,228	$29,949,313

NNU Political Spending

National Nurses Super Pac is named National Nurses for Patient Protection. The link below shows you where they are spending their money in 2016. You can see the summary in the table below or go to the link and drill down on any of the candidates to get a list of everything they spent either to or on the behalf of their candidate. Uncle Bernie comes in first with almost 5 Million of the 6.6 million raised by the NNU Super PAC followed by a few House Candidates getting pocket change.  NNU/CNA is all in for Bernie hosting him at their conferences and plastering his insignia everywhere.  http://realtime.influenceexplorer.com/committee/2016/national-nurses-united-for-patient-protection/C00490375/

SANDERS, BERNARD (D)	N	US President	Support	$4,787,271
CANOVA, TIMOTHY A. (D)	N	US Rep. (FL-23)	Support	$43,464
TEACHOUT, ZEPHYR (D)	N	US Rep. (NY-19)	Support	$21,732
JAYAPAL, PRAMILA (D)	N	US Rep. (WA-07)	Support	$21,732
KINGSON, ERIC R. MR. (D)	N	US Rep. (NY-24)	Support	$5,882

So who funds this Super PAC, individual contributors or members’ dues. Most CNA contracts allow members to designate money to go directly to the CNA PAC. Almost none do in my experience. At the link you can go down and see who contributes and its almost entirely contributions from National Nurses Association minus a handful of small contributions. So, members dues transferred from the various subsidiary Unions mostly CNA are what funds NNU’s Super PAC as far as I can tell.

In Summary

The purpose of this post is to enlighten CNA members on some of the ways their Union sends and receives their money without offering much commentary on if it is justified. It’s also done to educate Union Members everywhere that their Unions finances are public record accessible to them with a simple search.  After looking at the numbers one thing was clear to me. CNA can do their job on a whole lot less of members’ dues money. Perhaps a look at the dues structure is in order.  A more in-depth analysis of the flow of money between CNA and NNU and how much of the money is really being spent on the representative versus political causes. Why are they hording money and buying expensive properties and being secretive. Time to shine a little light and find out.

Who are the real Villains in the Nataline Sarkisyan case.

Ever hear the expression, Don’t let the facts get in the way of a good story. In the case of the well publicized death of a 17 year old from LA who while being treated for Leukemia went into Liver failure and was “denied” a transplant by CIGNA Insurance, that appears have happened. I won’t rehash the entire story as it is all over the media and has entered the health care debate at State and National levels. One candidate, John Edwards, has made it part of his campaign and advocates of “Single Payer” which is code for “Government run and taxpayer financed Health care” are using Nataline’s case as their poster child for the cause. The father appeared at a rally the other day and was quoted as saying “CIGNA killed Nataline”. The family has retained infamous looser lawyer, Mark Geragos, in their almost certain lawsuit against CIGNA. He and others are requesting that CIGNA execs be charged with murder.

Maggie Mahar has written one of the most balanced pieces on this issue titled “Bad cases make bad law” its an eye opener for those who haven't looked at this in depth.

“The fact that Nataline’s case had gone sour on her doctors’ watch might have made them less than objective. I’m not suggesting that the doctors were worried about a malpractice suit: following bone marrow transplants, patients are very susceptible to complications. There is no indication that the physicians caring for her did anything wrong. Nevertheless, at least one prominent palliative care specialist has told me that sometimes she has to protect patients from surgeons who want to try to repair a failed procedure —with yet another surgery. “They can’t bear the failure—they want to make it right. This is what they have been trained to do.” But they are not necessarily thinking about what is best for the patient”.

Two things stood out to me in this story. Those being were, is this patient even a candidate for a liver transplant and if she was why did not UCLA do the operation rather than wait for insurance approval. CIGNA had approved her bone marrow transplant which was unsuccessful. UCLA certainly did not need CIGNA’s approval for the transplant operation, only for the payment. Looking over the exclusion criteria for liver transplants from 2 other facilities that have good reputations in the transplant area I noted that this patient was not a candidate. Sanford who’s criteria is listed here and California Pacific Medical Center in San Francisco who’s criteria is listed here both exclude patients with non-hepatic malignancies. I could not find UCLA’s criteria in any searches.

I nominate the following as the Villains in this case

1. UCLA medical center for raising this families hopes when she would not of been a candidate for the operation at most transplant centers. They get a double nomination for not performing the operation if they felt it could of saved this girls life. A hospital does not need approval from a 3rd party insurer to perform a lifesaving operation. Considering the narrow window of availability of livers and this patients grave condition If UCLA felt she could have benefited they should have performed the operation immediately upon the availability of a donor liver and appealed the denial. Instead UCLA asked the family for a $75000 deposit to do the procedure which they did not have. Most appeals eventually end up getting paid. Even if they were not paid UCLA could have performed the case as charity care and been the good guys. UCLA is infamous for its excessive end of life care with no better results than more conservative like institutions. This is likely being driven by their excess bed capacity and a high percentage of specialist. Its all well documented here in this study by Drartmouth University.

2. The organizations promoting single payer who are exploiting this case and the family for the cause. In particular, one that I am a member of, the California Nurses Association. They have done a lot for nurses at the bargaining table and getting Nursing Ratios but their political agenda is way to Micheal Moorish. I cannot remember CNA ever soliciting its members on whether they even support single payer before devoting our dues money to that cause. Emails to their leadership expressing an opposite point of view are ignored. CNA members are some of the highest paid nurses in the country. That would not of happened under single payer where government sets the reimbursement.

3. Politicians and slimball lawyers led by slimball in chief John Edwards. Politicians do not normally piss me off, Edwards is an exception. He made his millions by suing OB doctors in cerebral palsy cases for not doing c-sections. He used junk science and courtroom theatrics imitating a fetus stuck inside the mother yelling to get out to sway juries. Note to Edwards, most recent research has shown that CP is not related to delayed C-sections but lets not let facts get in the way of a good story, especially when big money is at stake. Edwards, the champion of the poor, is well known for giving speeches on poverty in America for 50,000 a pop. One recently for none other than the University of California at Davis. You’d think the University of California would have better things to do with taxpayers and students money, apparently not.

I hate to be in a position defending an Insurance company. I generally despise them and as Maggie Mahar states

“Meanwhile there are so many clear-cut problems in our for-profit private insurance industry that should be investigated in a court of law. I would like to see states take insurers to court for the way they “cherry-pick” their customers, shunning the sick, and raising premiums on customers who become seriously ill. Often, insurers scour their records looking for some scrap of evidence that the patients’ illness may have been caused by a pre-existing condition. Insurers also write policies in such a way that it is very difficult to know, for certain, what will be covered—and they advertise “super-saver” policies that contain so many holes that they don’t even deserve to called “insurance.”

Another tip for the single payer crowd would be pick your battles. Being wrong and going public with it in such a high profile case and trying to capitalize on other peoples tragedies ruins your credibility for legitimate issues.