HCA, a for-profit hospital chain, has been accused of chronic understaffing. For the hospital profiled in the NBC News report, Mission Hospital in North Carolina, staff positions have been cut by 37% since HCA took over. Nurses interviewed in the piece said that more "Code Blues" (a call for help for a patient that has suddenly taken a nosedive,) are more common now than before. They feel that their licenses are being put at risk (nurses are required to refuse patients if they feel that the staffing ratio is unsafe, but obviously it can be a tough call when you are dealing with your employer.)

https://www.nbcnews.com/nightly-news/video/hca-healthcare-low-staffing-levels-accused-of-endangering-patients-159830085859

I lurk on the nurse's Reddit, and *by far*, the most complaints come in about HCA.

In Utah, HCA runs six hospitals -- Brigham City Community Hospital, Cache Valley Hospital, Lakeview Hospital, Lone Peak Hospital, Mountain View Hospital, Ogden Regional Medical Center, St. Mark's Hospital, and Timpanogos Regional Hospital. Staffing at these Utah hospitals has been 22% less than comparable Utah hospitals from a 2020 report.

For Idaho (with three HCA hospitals,) that figure is -41%. For California (six HCA hospitals,) -34%.

California is the only state with safe staffing ratios mandated by law, but a dozen other states have certain safeguards in place. Given the California law, I'm not sure how or why HCA continues to run their hospitals "lean and mean" there.

Given what the nurses say over on Reddit, I personally would not go to a HCA operated hospital given a choice in the matter.



Edited 1 time(s). Last edit at 03/04/2023 09:06AM by summer.

It used to be that he would have patients in the hospital and he would see them everyday. Now, hospitalized patients may see a different doctor every day. He also mentioned that the younger doctors today don't have the same commitment regularly seen in his younger years; with these hospitalists expecting to work a "9-5" and nothing more. This friend said that his son, also a doctor, has been traveling around the country, working in different locations, because there are some hospitals that have "no doctors and no nurses".



I've recently had a close relative hospitalized a few times over the past year in a Northwell hospital and a Catholic Health Services hospital. These are large, modern hospitals, newly renovated with all the latest equipment. Still, there were serious care-related issues in both of them.

notmonotloggedin

Understaffing increases profits.

Yep.

A for-profit enterprise sets output at the point where demand equals supply, meaning that all demand over that point is not met. Surge capacity is minimized because it is unprofitable.

Imagine what that does for public services. Fire departments would ration their service and let some fires go uncontained. (There's a hint in there for residents of California and other states where utilities are run on a for-profit basis.) The same happens in healthcare and insurance: commercial realities dictate that supply must be rationed and some patients go underserved.

The old rule is that society must decide which services are so important that they should not be tossed to the market. Thoughtlessly saying "the market is always better" means, in short, 80% of roads will never be built and 30% of Americans must lose their postal service.

But these decisions are not receiving public debate. They are being made on emotional impulse.

It doesn't help that the general public went gung ho attacking nurses and teachers recently based on political views. Then they wonder why there aren't enough nurses left to bother with roaches and blood on the floor.

Both professions are in big trouble right now, due to shortages of people willing to do the job. With teaching, you can put any warm body in a classroom if you are desperate enough, but with nursing, there are no shortcuts other than bringing in workers from overseas.

Because of this, hospitals are hiring temporary nurses on travel contracts (from what Notmo is saying above, at least some physicians are being hired this way as well.) Travel nursing pays substantially better than hospital-based nursing. But it is a costly way to staff a hospital. On the Reddit forum, nurses have stated that some departments are staffed solely by newbies. Nurses with only six months or a year's experience are being promoted to Charge Nurse (a supervisory position.) Nursing is not something that you learn in a day, a week, or even with several months of experience. Hospitals are losing employees with a solid knowledge base.

I know in Maryland, our emergency rooms are overloaded. This is not due to an unwillingness to hire, but instead to a lack of staff and probably capacity as well.

Our U.S. healthcare system is in crisis, and not many people are aware of that.

There are plenty of health care centers around the USA that are doing quite well on staffing of physicians, nurses, and other necessary health care professionals. Who is hurting are those where a sizeable portion of their revenues come from government funding sources. This outcome was easy to predict with the nature of the "reforms" of over a decade ago. There's no such thing as a free lunch. Somebody always ends up paying for it.

Eventually someone is going to come up with an idea to scare the physicians, nurses, and these health care centers that are doing alright to go offshore outside the USA by trying to make sure that the health care centers that are doing alright have to have it as bad as those who get a sizeable portion of their revenues from government funding sources. A big issue for all health care facilities/workers in America is that the Medicaid/Medicare reimbursement rates don't even compensate for the costs of services and any facility that provides services for Medicaid/Medicare patients must rely heavily on non-government sources of revenues.

If they succeed in getting health care professionals to flee the USA in huge numbers then we'll start seeing restrictions placed on them using their Passports like how the Russian Federation won't let their soldiers take vacations abroad right now very easily. And then we'll start seeing more Americans who want to be health care professionals needing to leave the USA for college/training. Finally, we'll have millions of ambulance chasers with no ambulances to chase in America. But there will be plenty of social workers whose jobs will be to get paperwork signed so people can more quickly be pushed into morgs and then the crematory ovens.

The most obvious solution to this will be for people to realize that there's no such thing as a free lunch. But too many people are hooked on a belief so much stronger than most TBM's feel about the religion. This belief is that somebody else ought to pay for whatever they want. You see this in America by how there are more people getting federal handouts than people paying federal income taxes. Thus, the craziness continues and gets much worse :(

Did you support the Trump or any other tax cuts?

Of course. Then who are you to complain about entitlement culture when you voted to increase you material wealth by making future generations pay the bill.

Welfare queen.

Trump was a buffoon. His fiscal numbers speak for themselves. I presume he still is a buffoon. He will be out of the race for 2024 within 14 months. He'll be dead within a few decades. But his legacy of increasing the national debt and leaving behind a huge bill to pay will live forever :(

Taxes? There has never been a year where federal revenues exceeded 21% of GDP. So yeah we can try to raise tax rates but if we could only get over 19% three times in 1944, 1945, and 2000; but never over 21%; then its unrealistic to ever think it'll get over 21% of GDP. In the meantime the federal spending (not counting interest on the debt) is well over 25% of GDP and now the interest expense on the debt is on path to skyrocket to over 6% of GDP. It's a disaster.

Now if you are willing to be honest and truthful then please let's focus on the facts. And please show your numbers analysis. Otherwise, this is a pointless discussion.

> Taxes? There has never been a year where federal
> revenues exceeded 21% of GDP.

Below you call for "analysis." But you've provided none.

In the first place, it's nonsensical to measure tax revenues over GDP because if you are measuring government you must include state and local levies. (You're not familiar with the word "levy" in this sense, are you?)

Overall government revenues over GDP have not been below 20% of GDP since the early 1940s. In the last 43 years the figure has bounced around between 32 and 34%. Even in the Great Recession it only fell to 25.4%.


---------------------
> Now if you are willing to be honest and truthful
> then please let's focus on the facts.

"Honest?" You keep throwing that word around like disagreement with you implies dishonesty. But since you measure the wrong variable aren't you the one who, by your standards, is "dishonest?"


-----------------
> And please
> show your numbers analysis.

You provided no "analysis." You focused on the wrong data series. If you had any analytical capacity, that would not have happened.


------------------
> Otherwise, this is a
> pointless discussion.

Oh, I think you've proved that is the case. Without question.

>> There are plenty of health care centers around the USA that are doing quite well on staffing of physicians, nurses, and other necessary health care professionals.

Yes, that's true, but I'm going to bet that most of those hospitals are non-profits. And I agree with you that Medicaid and Medicare reimbursements most likely need to be raised.

Some regions of the country, i.e. the South, have really lagged behind in terms of pay for medical professionals. What they pay their R.N.s is laughably low, even given a generally lower cost of living. That's why a number of hospitals are struggling to find employees.

Yes, I do think it would be good if Medicaid and Medicare reimbursements rates could be raised. But I have to be honest about the dire federal fiscal situation. I just don't see any realistic possibility anymore that the federal finances will allow for this to happen anytime soon without huge curtailing of the sizes of those programs. That ship probably sailed trillions of dollars of debt ago. I presume you are aware that CMS is running a shortfall of well over 100 billion dollars every month as they spend around 140 billion per month while bringing in revenues in the range of 35 billion per month? That's hardly a situation where reimbursement rates can go up much.

IHC is not much better, one time while in the ER they put my wife in a room with blood on the sheets and floor, and then I had to take the needle away from a nurse trying to put in an IV and call down the hallway for someone to come and do it who knew how.

And this is just the tip of the iceburg with them. I avoid them at all costs. St. Marks is on my never go to list of scary places.

I was fired from a medical company for not having a temple recommend. The company's initials are IHC.

Interesting....Were you smoking in the nurses lounge or respiratory therapy dept.? I didn't get asked for a temple recommend in either hospital.

Had heart surgery at St.Mark's some years ago. They had one of the best heart surgeons in the country at the time and everyone was terrific. Hard to think it may have gone downhill. Had two visits to the small regional hospital here in Mesquite this week's. Slow labs but the emergency room people were great.

IMC in South SLC last spring. Well, he started in Logan Regional. They only had 2 techs who did EEGs and only one EEG machine. My son had been having seizures. He ended up being diagnosed with viral meningitis. When I was there they were doing an EEG and the nurses kept saying he was still have seizure activity. His legs were shaking. By the time I got home, "husband" called to tell me that they were life flighting him to SLC as he was still having seizures. We got there and his legs were still shaking, BUT IMC had people who followed the EEG hookups 24/7 and he didn't have any seizures in IMC. His leg shaking as not seizures. Could have saved Medicaid A LOT of money, but then they have a flat fee and can't charge any more than that.

IHC has moved the specialties to SLC so it costs you more than it did in prior years as they send everyone to SLC by ambulance or life flight.

There weren't very many people working in the behavioral health unit when he was in in early February in Ogden Regional. He's been in a BHU at IHC and he said it was much better.

From what my "husband" has seen having worked there over 40 years, but outside, but they were cutting costs everywhere except salaries for the bigwigs.



Edited 1 time(s). Last edit at 03/04/2023 02:41PM by cl2.

HCA has always been understaffed---Especially so when Rick Scott was running the show. That is the way they make money for the stockholders. That's capitalism they say. Management and CEO's make bonuses for cutting costs. Which means someone will be understaffed. HCA has a sticker on everything in order to charge the patient a lot. At Nursing staff meetings the first thing that is talked about is overruns in costs. Patient care is talked about afterwards..if at all.

The people working at the bedsides eventually leave with permanent PTSD.I am not joking (So yell at administration instead of the nurses.) HCA have a fixed legal cost because they hire a large firm to take care of all lawsuits. There is a word for that--it isn't coming to me. The only shift that actually gets a lunch break is the day shift because they have more staff.

IHC (Intermountain Health Care) used to be a MUCH better staffed hospital and nurses were treated well. They used to have child care too. I have heard that IHC has changed completely in order to compete.with HCA.(Hospital Corporation of America)

At HCA everything has to be entered as an amount. So you will pay for the IV or butterfly, the IV tubing, the IV bag and also for the insertion of the IV by an RN. If it takes two tries to hit a vein--too bad--the patient pays for both. The pt will be charged for an "admission kit"---tooth brush,lotion & a washbasin. The patient will also be charged for a pillow.And a plastic bedpan. This way they can charge $1.50 for an aspirin and that makes the un-educated patient HAPPY.. they will go through pages and pages of unknown charges until they find the aspirin charge.

The responsibility for these stickers/charges falls to the RN or care giver.Putting all these stickers on a card takes time away from patient care. Okay--- even if done by a computer swipe now days, it is still a process the RN is responsible for.

IHC used to have a basic room charge and an IV charge. but in order to compare apples to apples they had to go to an item charge. Plus they have had to also understaff RN's.just like HCA does.

I have worked at both companies and I would still pick IHC in a heart beat.esp. if it was an abnormal heart beat.

Yes, nurses have complaints about other health systems, but HCA is in a league of its own. They have mentioned the endless charges.

MARIN COUNTY USED TO HAVE A PUBLIC HOSPITAL SYSTEM UNTIL QUENTIN C(R)OOK GOT HIS GRUBBY LITTLE MITTS ON IT!!!!!!!! NOW HE IS A SPECIAL WITNESS OF THE NAME OF CHRIST!!!!!!!! AND I USE THE TERM GRUBBY PRECISELY- HIS HANDS ARE DIRTY!!!!!!

There used to be some excellent county ran hospitals. They have disappeared because of either mismanagement or corruption. What can you say. Everything is ran by Bozo the Clown these days.

Healthcare is very corrupt. Where you have corruption you have poor service and high costs. Going to a single payer system won’t fix it when the government is corrupt. The only real solution is to have decent people running it that aren’t tied to Wall Street or the government. That’s a local solution. There used to be really good locally ran hospitals. My doctor started a clinic out of frustration with other doctors and the big goal is to build a hospital but as soon as you take it public it just becomes completely profit driven.

Dear church leaders: providing poor health care while charging your patients their life savings is a moral issue. I just thought you would want to know, since you have such a hard time understanding the concept.