photo by McKenna Schueler
Employees of HCA Florida Osceola Hospital rally outside the hospital over understaffing, which they say is creating unsafe conditions for patients (May 10, 2023)
After months of contract negotiations and a recent rally for better working conditions, staff at 19 Florida hospitals owned by the Hospital Corporation of America, including HCA Osceola Hospital and HCA Lake Monroe in Sanford, have secured a new union contract.
The contract, also known as a collective bargaining agreement, is borne out of a deal reached between their employer, HCA, and the hospital workers’ labor union, 1199 SEIU United Healthcare Workers East.
Subject to union member approval, the agreement — addressing wages, job benefits, and working conditions — was approved nearly unanimously by voting members in late June.
“Caregivers and all our healthcare employees are committed to provide the very best and safest care possible, but we need to be respected, protected and paid fairly,” James Streitenberger, a lead patient care technician and union member at HCA Florida Trinity Hospital, shared in a news release. “This new contract is a solid step in the right direction.”
Altogether, the new three-year contract covers 10,000 HCA hospital employees across Florida, including dietary aides, occupational therapists, certified nursing assistants, patient technicians, and other healthcare workers at HCA hospitals.
HCA Healthcare, based in Tennessee, is the nation’s largest for-profit healthcare system, operating in 20 states. The company owns 40 hospitals and 35 surgery centers in the state of Florida alone.
Approval of the new contract comes just two months after staff at HCA Osceola Hospital in Kissimmee raised the alarm about chronic short-staffing problems they said were putting the health and safety of patients at risk.
“There’s situations within the last two weeks where had multiple units in our hospital close that could be used to serve patients,” Vaughn Benton, a clinical pharmacist at HCA Florida Osceola Hospital, told Orlando Weekly in May.
photo by McKenna Schueler
Vaughn Benton, a clinical pharmacist, shares concerns about understaffing and low pay at HCA Florida Osceola Hospital.
Benton blamed management staff scheduling for the problem, as well as cosmetic updates costing millions of dollars that the hospital had undertaken.
Another worker shared that co-workers reported being sent home, or having their hours cut, further exacerbating the problem.
Staffing concerns in HCA hospitals have regularly been scrutinized, particularly by the SEIU and National Nurses United labor unions.
A reported released by SEIU in January shared that staffing ratios at HCA hospitals, as of 2020, were 30% lower than national averages. In Florida, weighted staffing ratios were 32% lower than state averages for other hospitals.
Understaffing in hospitals is associated with poorer quality of care, employee burnout, as well as more insidious consequences such as patient injury and fatal medical errors.
In 2019, the family of a former HCA Florida Osceola Hospital patient sued the hospital after a patient died “as a result of the severe anoxic brain injury” received following an ovarian cyst surgery.
Despite concerns voiced by hospital employees both within and outside of Florida, however, the company has however repeatedly disputed claims of understaffing.
In a statement, a hospital spokesperson told Orlando Weekly in May that their staffing at HCA Osceola Hospital is “safe, appropriate, and in line with other community hospitals and applicable regulations.”
With the employees’ new contract, they may be better equipped to confirm that for themselves.
To improve “transparency and accountability” in staffing levels, the new contract requires hospital management to provide a copy of the hospital’s staffing matrix upon request, and to “not interfere” with workers who post that matrix inside the facility for employees to see.
The union recently filed a complaint with federal labor officials over HCA’s alleged refusal to provide them with requested information about hospital staffing, as well as patient safety events resulting in permanent harm, severe permanent harm, or death.
The new agreement, per the union, also includes increases in “on-call” and “differential” pay and a new wage scale with no salary caps for the first two years.
It also contains provisions to promote wage equity by ensuring that current staff are paid at least as much as new employees with equal experience who are hired on at higher pay rates.
While Orlando Weekly initially reached a union spokesperson for comment, the union did not provide us with more specifics on the contract’s wage and staffing provisions prior to publication.
Benton, the clinical pharmacist at HCA Osceola Hospital, previously told Orlando Weekly that some hospital staff were making as little as $12 per hour, making it hard for some to make ends meet.
In Osceola County, where the hospital is located, a “living wage” (enough to cover the basics of food and shelter) is an estimated $18.85 for single adults with no kids, according to MIT’s living wage calculator.
Florida’s minimum wage, surpassing the federal minimum wage, currently rests at $11 per hour, but is set to rise one dollar come Sept. 30.
“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?” Jennifer Parker, a hospital employee, asked her fellow workers at a rally outside of the hospital in May.
Understaffing in hospitals is associated with poorer quality of care, employee burnout, and fatal medical errors.
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Benton quipped that staff could make more than what they earned at the hospital working at McDonald’s, driving for Uber or delivering pizza.
And the problem isn’t an employer operating on a tight budget.
Florida is a profitable state for HCA Healthcare. According to an annual shareholders report, combined revenues of HCA hospitals in Florida and Texas (where their facilities are highly concentrated) made up 50% of consolidated revenues in 2022
Although the company saw a slight slide in profits last year — from $7 billion in 2021 to $5.6 billion in 2022 — the company reported $60 billion in revenues, up from $58 billion the year prior.
The company attributed an estimated $50 million in losses to the impact of Hurricane Ian on their facilities in Florida — including a hospital in Port Charlotte that had part of its roof torn off.
The company’s CEO, meanwhile, still made off with a healthy salary of $14.6 million last year, down from $20.6 million the year prior.
After braving the worst of the COVID-19 pandemic, many healthcare workers have expressed intentions to leave the field, or have already. The Florida Hospital Association has warned the state of Florida will be short 59,000 nurses alone by 2035.
Things that can be negotiated within a union contract, such as workplace protections and higher pay, can offer more than just peace of mind for staff working to support themselves and their families.
It also ensures workers can focus on what’s important: taking care of patients in the way that they deserve, with adequate resources made available to those overseeing their care.
Stephanie Shaw, Vice President 1199 SEIU Florida, said in a statement that the union’s new contract with HCA “is a significant step in alleviating the staffing, retention and care crisis we’ve been experiencing in HCA hospitals throughout the state.”
“While it doesn’t include everything our union proposed,” Shaw added, “It’s substantial progress in recruiting and especially retaining the experienced, talented staff who provide direct care and other critical services in communities across the state.”
A spokesperson for HCA Healthcare told Orlando Weekly in a statement that they’re “pleased” to have reached an agreement with the union.
“Now that the negotiation process is complete, we are excited to move forward and want to thank all of our caregivers who are dedicated to providing compassionate care to the communities we serve.”
SEIU-represented staff at HCA hospitals in Texas also recently won gains through their own new agreement, as did workers of HCA hospitals in California after they threatened to strike over “bad faith” bargaining.
Thousands of HCA hospital nurses in Florida, many of whom represented by a separate union, National Nurses United, reached a three-year deal with HCA in 2021.
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