Hospital employees, represented by the 1199 Service Employees International Union, say staffing continues to remain at “crisis” levels, to the detriment of patient safety, health outcomes and hospital staff.
“Within the last few weeks, we’ve had situations where we have the ER overwhelmed with ICU patients,” said Vaughn Benton, a clinical pharmacist who’s worked at the Osceola hospital for five years. “But, because we don’t have enough nursing staff, or enough staff in general to place them into ICU, they just closed the ICU down,” he said.
A January report published by SEIU found that staffing ratios at HCA hospitals, located in 20 states nationwide, were 30% lower than national averages. In Florida, weighted staffing ratios were 32% lower than state averages for other hospitals, according to data obtained by the union.
Worker pay, staffing levels and workplace protections are key issues on the minds of staff at the hospital, operated by the Hospital Corporation of America, the United States’ largest for-profit health system.
Jennifer Parker, a hospital employee of 23 years, said HCA has been cutting their hours, despite the short-staffing, and sending workers home.
“We all have bills to pay, we all have families to feed, and how can we feed those families if they're not paying us what we should get paid?” asked Parker.
“The patients are suffering,” she added.
Profit over people
HCA Healthcare, the nation's largest healthcare system, owns and operates over 180 hospitals nationwide, with 46 of those located in Florida.
According to a January financial report, HCA Healthcare reaped $5.6 billion in net profits last year, and $7 billion the year before that.
The company’s CEO since 2019, Sam Hazen, saw his total compensation dip somewhat last year, admittedly, from $20.6 million in 2021, to a measly $14.6 million in 2021.
Hazen’s 2021 earnings were equal to 368 times the median employee’s pay, according to a corporate tracker from the AFL-CIO.
Benton said it’s “sad and unfortunate” that, as it is, hospital staff can earn more than they do currently by jumping ship to work at McDonald’s, for instance, or a nearby restaurant. “[They can] get paid more to deliver a pizza than they get paid to deliver medications to your family member.”
Benton told Orlando Weekly that some of the lowest-paid workers at the hospital earn as little as $12 per hour.
In Osceola County, where the hospital’s located, a living wage is an estimated $18.85 per hour for a single adult with no children, or $25.38 for a household with two working adults and two children.
But change could be coming.
The workers’ labor union, 1199 SEIU, is in ongoing negotiations for a new union contract with HCA that will cover 10,000 certified nursing assistants, dietary aides, occupational therapists and other hospital staff at the Osceola facility and 18 other HCA-affiliated medical centers across Florida.
About 800 employees at HCA Florida Osceola alone will be covered, according to Roxey Nelson, executive vice president of 1199 SEIU United Healthcare Workers East.
Meanwhile, registered nurses at the Osceola hospital are represented by National Nurses United, a trade union boasting a membership of nearly 225,000 nationwide that exclusively represents RNs.
Back in December, registered nurses protested HCA’s plans to shutter its nursery unit at the hospital, in favor of what’s known as a “rooming-in” model.
Hospital executives said this move to house babies and mothers together, instead of separating them at birth, would align the hospital with evidence-based practices that can improve mother-infant bonding.
But nurses feared it would put patients at risk.
“The newborn nursery and its staff provide essential services that patients need — especially our high-risk population,” Cassandra Gomes, a RN, told Spectrum News 13 at the time. “Those patients in particular need more services, not less.”
The risks of understaffing
While the registered nurses union was not part of the rally on Wednesday, both unions have called out HCA for chronic understaffing, which they say is putting both patients and staff at risk.
And they have the receipts.
In 2019, for instance, the family of a former HCA Florida Osceola Hospital patient sued the hospital after the patient died “as a result of the severe anoxic brain injury” she received following ovarian cyst surgery, according to SEIU’s report.
That same year, a patient of HCA Florida Citrus Hospital in Citrus County died after medical technicians — working short-staffed — failed to monitor the patient’s “life-threatening heart rhythm change,” with a communication delay between themselves and nursing staff.
Earlier this year, U.S. Sen. Marco Rubio and U.S. Rep. Gus Bilirakis wrote a letter to the CEO of an HCA hospital in Pasco County, “in response to troubling allegations of unsanitary and unsafe practices” that were reported by NBC News.
“As a leading healthcare provider in the community and a recipient of American taxpayer dollars, it is critical that HCA Florida Bayonet Point prioritizes the health and safety of their patients and staff and is transparent about these standards with the public,” the letter reads, with the signatures of both Republican members of U.S. Congress.
1199 SEIU says that understaffing saves HCA billions of dollars per year, even as the hospital system continues to expand throughout Central Florida.
HCA in January, for instance, broke ground on a $12 million dollar ER in Lee Vista, near the Orlando International Airport. An independent ER in St. Cloud — a $15.5 million dollar expansion of HCA Florida Osceola Hospital — is also in the works.
“We have this brand-new lobby, which costs millions of dollars, but we don't even have technology to send medications to every unit on the floor as quickly as possible,” Benton, an evening-shift pharmacist, told Orlando Weekly of his hospital.
“There are people who have to physically deliver medications throughout this hospital, because they [HCA] refuse to put money into the things that actually improve safety and quality, as opposed to the things that make them look good,” he added.
Staffing within his unit, and across the hospital, he said, only got worse during the pandemic.
Today, there’s just one pharmacist for the hospital’s 400-bed trauma center, he said. “There is one pharmacist taking care of this entire hospital from 7 at night to 7 in the morning.”
Maria Campbell, a patient technician at HCA Florida Osceola Hospital, said she believes that “profit is being put over patients,” as well as over their care and safety.
Campbell said she’d like to give the care to patients that she would want for herself or her loved ones, “But at this point, we can’t,” she said. “Our hands are tied.”
State Sen. Victor Torres, a Democrat and vocal proponent of organized labor, told workers at the Wednesday rally that he plans to meet with the hospital administration and open a dialogue.
“How can you not provide for your workers? How can you cut their hours in a time where inflation is so high?” said Torres, a former union cop from New York and former bus driver.
“I cannot make promises,” he admitted candidly. “But I can fight for you.”
Workers at other HCA hospitals in Florida this week also rallied to raise the alarm on chronic understaffing, and how it can lead to unsafe patient conditions.
The rallies come during National Nurses & Hospital Week, as well as just one day after Florida Gov. Ron DeSantis signed into law a bill designed to undercut the state’s public sector unions, with exemptions for unions representing cops, firefighters, and corrections staff.
Hospital staff hope, if they stand together united, HCA will be forced to meaningfully address their concerns, not just for themselves and their families, but for the community that turns to them for care.
“Ultimately, if we stand together and we’re all saying the same things, there's nothing that can be ignored, and no one can be singled out,” said Benton.
The hospital's response
HCA Florida Healthcare Public Relations Director Trip Farmer shared the following statement with Orlando Weekly when asked about Wednesday's rally and concerns voiced by the Osceola hospital's employees:“At HCA Florida Osceola Hospital, we believe a strong culture of respect and collaboration among our colleagues is critical to our mission. We value all members of our care teams and we provide a safe environment for our patients.
“Today’s demonstration is part of this labor union’s normal tactics during collective bargaining, which happens every three years at HCA Florida Osceola Hospital. During those negotiations, our goal is the same: to secure a fair agreement that continues to support a culture of colleague safety, care excellence and compassion.
“We strongly disagree with SEIU’s allegations. Our staffing is safe, appropriate, and in line with other community hospitals and applicable regulations, and we are proud that Osceola has been recognized by Healthgrades for being among the Top 5% in the nation for patient safety in 2022 and 2023. This union has a history of attacking and bullying community hospitals with misleading information and staged events designed to garner media coverage.”
