HCA Healthcare hospitals require nurses to work while positive for COVID-19, fail to notify or test workers when they've been exposed, and don't routinely test exposed workers unless they're symptomatic, according to a by National Nurses United (NNU).
The NNU complaint, which accuses the for-profit hospital chain of thereby endangering the health of nurses and their communities, represents thousands of nurses at 17 HCA-owned hospitals in Florida, Kansas, Missouri, North Carolina, and Texas.
"The union has become aware of a constellation of HCA policies and practices that expose NNU members and other frontline healthcare workers to COVID-19, placing them in imminent danger of death or serious physical harm," the complaint reads.
The Aug. 24 complaint asks OSHA to "immediately inspect all HCA facilities, including those enumerated in this complaint, issue citations and require HCA to abate the hazards," . It also asks the agency to impose maximum penalties for violating the worker safety laws.
Even after a nurse tests positive and goes home for the required 14-day quarantine period, he or she is required to return to work at the end of that quarantine "without first testing negative for the virus, so long as they are asymptomatic," NNU alleges.
Debra McKell, marketing director and spokeswoman for the Nashville-based HCA's West Florida division, told MedPage Today that it is "disappointing" that the labor union "seems to ignore the CDC recommended guidelines, specifically in regards to testing," which no longer recommended testing because it too often results in prolonged isolation of patients who are no longer infectious.
McKell also sent a statement from HCA that said, "Since the onset of this pandemic, our focus has been to protect our colleagues – to keep them safe and keep them employed – so they can best care for our patients. Our frontline caregivers have shown unwavering commitment, and our safety efforts to protect them have included screening and testing, universal masking, contact tracing and notification, and other safeguards, in line with guidance from the CDC. We're proud of our response and the significant resources we've deployed to help protect our colleagues."
HCA said the NNU is using the pandemic "as an opportunity to gain publicity by attacking hospitals across the country" and said that filing OSHA complaints is common "especially during membership campaigns."
"No one seems to care"
Its complaint contends that nurses are not always informed when a patient he or she cared for later tests positive, and doesn't let them know they were exposed. "As a result, HCA is effectively causing an unknown number of workers who have COVID-19 to continue working while contagious, unwittingly spreading the coronavirus to their colleagues and patients," according to the complaint.
"No one seems to care," June Phillips, a registered nurse for 13 years at one of the hospitals named in the complaint, Fawcett Memorial in Port Charlotte, Florida, told MedPage Today.
Regularly on duty in the spine and orthopedic unit, Phillips now functions as a floater through various parts of the hospital as elective surgeries have been reduced. Now, she goes all over the hospital, taking care of patients on every floor.
She was surprised when a patient admitted for a non-COVID issue who was under her care was later moved to a COVID unit. She didn't find out until days later, when she was assigned to that COVID unit and found herself facing the same patient.
"I heard this patient call me, 'June, is that you?'" she said. Yet Phillips said no one told her that the patient had tested positive or that she had been exposed, and no one offered Phillips the opportunity to get tested.
The policy, Phillips said, has "probably" caused some patients to become infected while in the hospital. Some patients, after repeatedly testing negative over the course of their stay, a week or so later have tested positive, she said.
"Where did they get it, I ask. They get it from us -- that's my assumption, that they must have," she said.
Second complaint
The NNU complaint comes on top of a in California, by the Service Employees International Union-United Healthcare Workers West, claiming similar lapses in worker safety.
That complaint, on behalf of four workers and many others, alleges that HCA endangers workers by "forcing employees to work without adequate personal protective equipment ("PPE"), including masks, gowns, hairnets, gloves, and facial shields; forcing sick employees to work despite being symptomatic and highly contagious; and pressuring employees not to take reasonable and necessary precautions against exposure to COVID-19 -- such as frequent or effective sanitization of commonly used medical tools and commonly touched surfaces -- if such precautions would harm efficiency and/or productivity."
Chuck Idelson, spokesman for NNU, told MedPage Today that as the "big dog in the industry," HCA has shown "a cavalier attitude" that is leading to health care workers getting infected, getting sick, and even dying.
"They're not giving (workers) proper PPE, they're not testing folks, and they weren't or were rarely testing nurses at all."
He added that these policies are probably happening at non-HCA hospitals as well, because hospital administrators tend to follow HCA's lead. "These are systemic corporate policies within HCA," he said, "but you can bet they are happening in other states."
When you expose nurses, Idelson continued, you're not just exposing them, "you're exposing anyone they come in contact with in that hospital, including coworkers, other patients, and nurses [who] have the danger of carrying [it] back to their home, and increasing the threat of community spread. It's unconscionable, particularly in a pandemic that we are very, very far from being able to confront and contain."
HCA hospital workers have staged numerous labor actions at various hospitals, including one in July at Blake Medical Center in Bradenton, Florida, one of the hospitals named in the complaint.
Idelson and Phillips said that workers are often not provided appropriate or effective PPE.
Phillips said that she has been told to go from patient room to patient room wearing the same gown and mask, even though some of the patients in those rooms are "PUIs" or persons under investigation for COVID, for whom definitive test results have not yet come back.
"As an example, at Mission Hospital in Asheville, North Carolina, several nurses performed aerosolizing procedures without appropriate personal protective equipment (N95 masks) on a respiratory failure patient confirmed to be COVID-19 positive shortly thereafter," the complaint reads.
"HCA and Mission failed to test, or in many cases even notify, all nurses who were exposed to COVID-19 through this patient."
Idelson said that HCA sets "a model that other systems follow because of their size, and political and economic influence...and incredible wealth -- they've gotten a billion dollars in the pandemic relief bills."
The hospitals referenced in NNU's OSHA complaint are:
- Las Palmas Medical Center, El Paso, Texas
- Del Sol Medical Center, El Paso, Texas
- Corpus Christi Medical Center, Corpus Christi, Texas
- Valley Regional Medical Center, Brownsville, Texas
- Menorah Medical Center, Overland Park, Kansas
- Research Medical Center, Kansas City, Missouri
- Oak Hill Hospital, Brooksville, Florida
- Medical Center of Trinity, Trinity, Florida
- Largo Medical Center, Largo, Florida
- St. Petersburg General Hospital, St. Petersburg, Florida
- Northside Hospital, St. Petersburg, Florida
- Blake Medical Center, Bradenton, Florida
- Doctors Hospital of Sarasota, Sarasota, Florida
- Fawcett Memorial Hospital, Port Charlotte, Florida
- Osceola Regional Medical Center, Kissimmee, Florida
- Central Florida Regional Hospital, Sanford, Florida
- Mission Hospital, Asheville, North Carolina
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