National Nurses United, a nurses union, has criticized hospital chain HCA Healthcare for its $3.75 billion in profits in 2020, claiming that the company instead should have invested that money into public health and COVID-19 safety during the pandemic.
The union called the Nashville-based company's 7.1% year-over-year jump in profits "a clear demonstration of the financial consequences of a year of short-staffing and other cuts affecting patient and worker safety despite a once-in-a-century pandemic."
HCA said it is proud of its response during the pandemic and called the union exploitive.
"This labor union continues to exploit the COVID-19 pandemic and the nationwide nursing shortage, which are both creating significant challenges for caregivers and hospitals across the country, to advance its agenda of adding more dues-paying members," HCA said in a prepared statement.
NNU President Deborah Burger, who is a registered nurse, said it was "a red flag" that HCA could make profits while reporting a drop in admissions during the pandemic and said that was indicative of "how HCA is operating its patient care services."
Burger also questioned HCA CEO Sam Hazen's attribution of the company's "solid cost management" to the year's profits.
"Nurses have seen what 'cost management' means. Throughout 2020, HCA nurses have reported alarming shortages in staffing, the canceling of shifts, a failure to fill vacancies. They've experienced frequent delays in provision of the optimal personal protective equipment, re-use of single use and ineffective 'decontaminated' masks and other inadequate other infection control protocols," Burger said in a prepared statement. "And nurses have experienced and witnessed delays or failure to ensure on-time testing for patients and nurses and other safety cuts that have put patients, nurses and other health care workers at risk."
In the company's earnings announcement, Hazen said, "In the face of the highest surge yet of the COVID-19 pandemic, we finished the year with strong financial results in the fourth quarter. These results were driven, once again, by highly acute inpatient volumes coupled with solid cost management."
HCA said its "focus remains on ensuring the delivery of high-quality care during this pandemic" and noted that the company increased its PPE spending in 2020 by more than $196 million compared with the previous year "to help keep our colleagues safe and to care for our communities."
HCA said it has many safety measures in place, including universal masking, screening and testing, contact tracing and notification, and a PPE steward at each hospital to ensure the proper use and fitting of equipment. The company also said it has used its in-house nurse staffing agency to meet demand and has hired 20% more registered nurses in January compared with last year.
Burger also highlighted that HCA reported a 10.5% increase in hospital patient revenue, despite seeing a 4.7% decline in hospital admissions and fewer emergency room visits.
During HCA's earnings call Tuesday, Chief Financial Officer Bill Rutherford said HCA has "been benefited by the acuity and the payer mix in terms of our commercial volume declined slower than our Medicare volume."
The nurses union called on HCA to "reverse its plans to allocate $6 billion to purchase its own company stock and allocate those funds for improvements in patient and worker safety measures and promotions of public health programs throughout HCA hospitals and communities."
HCA on Monday announced that it would resume its existing share purchase program and authorized a new share repurchase program of $6 billion.
"No one takes the health and safety of our caregivers more seriously than we do. While this labor union continues to attack hospitals across the country, our focus continues to be on protecting our colleagues and caring for our communities," HCA said Wednesday.
This was not HCA's first clash with workers. In October, employees said they sent a letter to HCA investors about lack of PPE and workplace safety concerns during the pandemic, asking them to put pressure on the hospital chain. Employees said at the time that the system's "PPE protocols may be systemically putting lives at risk."
HCA said it believed the letter "was orchestrated by the SEIU as part of their continued effort to attack hospitals across the country" and was meant "to spread misinformation in an attempt to gain publicity."