Letter Slams Major Hospital Chain for Poor COVID-19 Protection

Ken Terry

November 02, 2020

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

A group of healthcare workers at HCA Healthcare, the nation's largest for-profit hospital chain, sent a letter October 29 to the company's investors, alleging that the company has procured insufficient personal protective gear (PPE), has required employees to reuse single-use PPE, and has required some employees to keep working even after testing positive for COVID-19.

The letter to investors describes what it calls "the company's management failures in response to the COVID-19 crisis."

The authors, who include HCA employees from across the country, say that the company's PPE protocols may be putting lives at risk. HCA is still not consistently providing the necessary PPE to employees who care for COVID-19 patients or who work in hospital wards where those patients are treated, they contend. In some cases, they allege, HCA is forcing caregivers to use less-reliable masks or reuse single-use PPE for multiple shifts.

In August, some HCA employees in California, backed by the Service Employees International Union-United Healthcare Workers West (SEIU-UHW), sued the company in Riverside County Superior Court, after two employees of the company's Riverside Community Hospital died from COVID-19. The complaint against HCA, its CEO Samuel Hazen, and the hospital charges the defendants with unfair and unlawful business practices, negligence, and public nuisance.

The letter cites some HCA workers who died of COVID-19 as examples of HCA's alleged negligence. At Riverside Hospital, the letter says, housekeeper Rosa Luna and lab assistant Sally Lara — both older people — died "after working without adequate PPE."

Registered nurse Celia Yap Banago, the letter notes, "died days before her retirement after 40 years at Kansas City's HCA Research Medical Center, and other colleagues became ill after treating COVID-19 positive patients without adequate PPE."

Karen Ballentyne, RN, a California nurse who is one of the coauthors, said in the letter, "Asking nurses who work the COVID floor to share gowns and recycle masks is unsafe. We deserve PPE and safe staffing to provide quality care to our patients and our communities."

Jennifer Aguilar, a surgical technician in Texas, said in the missive, "I have to wear the same mask for 12 hours and if I ask for another one it's a ruckus. I need to be careful. I have children at home and an elderly parent. I already had to get my husband and pregnant daughter tested for COVID-19 [and] hope they are negative."

'Not an Easy Situation'

Nate Selzer, a spokesman for SEIU-UHW, the union representing workers at five HCA hospitals in California, told Medscape Medical News that the union has reached out repeatedly to HCA to discuss ways in which labor and management might collaborate to resolve the safety issues.

"We kept on reaching out to HCA to work together to solve the myriad challenges we're facing," he said. "We recognize this is not an easy situation. What was particularly appalling in this case is that we kept reaching out, and they were not collaborating, and then we had our second person die [at Riverside Community Hospital]."

While Selzer stopped short of saying that HCA had refused to talk about the situation, he said, "We don't believe the level of conversation has been sufficient to protect the safety of HCA patients and our workforce."

Harlow Sumerford, a spokesman for HCA, told Medscape Medical News, "We have dedicated significant resources to protect our colleagues throughout the pandemic, and we suspect this letter was orchestrated by the SEIU as part of their continued effort to attack hospitals across the country. At a time when we should come together to support our nurses and caregivers, some unions have chosen to spread misinformation in an attempt to gain publicity for their own benefit."

Among the steps that HCA has taken to safeguard its workers, Sumerford said, are "the screening and testing of our colleagues, universal masking, contact tracing and notification, the assignment of a PPE steward at each hospital to ensure the proper use and fitting of protective equipment and other safeguards, in line with guidance from the CDC.

"Additionally, HCA Healthcare implemented pandemic and quarantine pay programs to help protect the financial security of our colleagues, offered hoteling services to caregivers treating COVID-19 patients, and provided 24/7 counseling services for nurses in need of emotional and mental support."

Sumerford disputed the claim that there are currently PPE shortages at any HCA facilities. However, he added, "there has been a worldwide PPE supply shortage throughout the pandemic and communities across the country are experiencing surges at different times. So it is something we are continuing to monitor to help ensure we can protect our caregivers and meet the needs of our patients."

Contentious History

The union has been attacking HCA's conduct since the pandemic took hold in the spring. In April, SEIU United Healthcare Workers East sent a cease-and-desist letter, according to Becker's Hospital Review, to HCA's Florida facilities after the company established new protocols for the use of N95 respirator masks. Only workers performing the most severe "aerosol-generating procedures" were eligible for the masks, although all workers were earlier supposed to be provided them.

At the time, HCA said the union failed to recognize the worldwide shortage of N95 masks.

In August, according to the Las Vegas Review-Journal, the union asked Nevada hospital regulators to investigate its claims of unsafe conditions at HCA hospitals, including a claim that employees who tested positive for COVID-19 could be called back to work.

Across the nation, Over 1300 healthcare workers have died of COVID-19, according to a joint investigation by The Guardian and Kaiser Health News. It's unclear how many of them contracted the illness because of a lack of sufficient PPE. Some reports have the death of healthcare workers much higher.

The workers' letter to investors contrasted the continuing profitability of HCA with a 17% reduction in spending on supplies in the second quarter. However, it offered no evidence that HCA had decided not to buy PPE in order to increase its profits.

Finally, the letter urges investors to ask HCA about a number of safety-related issues, such as:

  • The number of HCA employees who have tested positive for COVID-19 and how many have died from it

  • The company's infectious disease prevention and control plan

  • An assessment of the company's current PPE supplies and how much PPE it expects to acquire during the pandemic

  • The adequacy of those PPE supplies

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