National Nurses United today called on Georgia Attorney General Christopher Carr to reject HCA Healthcare’s acquisition of Meadows Regional Medical Center in Vidalia, Ga., citing the potential adverse impact on patient care services and care costs for area residents.

The Attorney General’s office is holding a public hearing Thursday, March 25 at 2 p.m. ET to take public comments regarding HCA’s takeover. Access to the hearing is available at www.webex.com Meeting Number: 179 561 2962. Password: hospital2021

Meadows Health Alliance, Inc., parent body of the hospital, signed a letter of intent to sell the hospital to HCA in September, 2019. This January, both the Meadows Health Board of Directors and Toombs County Hospital Authority approved the $73 million sale, reported the Vidalia Advance. As the hospital is community-owned, independent, and non-profit, Georgia’s Attorney General must approve the sale.

In written testimony being submitted for the hearing, NNU notes that it represents 12,000 registered nurses at 19 HCA facilities “who have a deep and unique understanding of HCA’s model of care,” which it says is rooted in “exploitation of its market dominance to limit access, raise prices, and degrade the quality of care.”

HCA, writes the union’s HCA and Southern Region director Bradley Van Waus, “has demonstrated a longstanding pattern of cutting services” after acquiring community hospitals and systems, making “excessive charges, potentially driving up prices,” and “downgrading staffing standards, safety measures and equipment, reducing overall quality of care.”

“The impact of a sale to HCA in Vidalia could reverberate throughout the region,” wrote Van Waus.

“We hope the Attorney General will take a careful, measured look at this proposed sale, and whether it is truly in the best interest of Vidalia and Toombs County businesses and patients — from higher costs to fewer services, and longer waits for care at more distant facilities farther from home,” said HCA RN Marissa Lee.

Examples NNU cites of HCA’s care model include:

• Grandview Medical Center, a rural hospital in Jasper, Tenn., was acquired by HCA in 2014. It then closed all inpatient services, converting the facility to a freestanding emergency department. Emergency patients needing hospitalization had to travel to Chattanooga, 30 miles away.
• Cypress Fairbanks Medical Center in Houston, Texas was acquired by HCA in 2017 as part of a plan to become Houston’s top hospital provider. Just two years later, HCA converted the hospital to a freestanding emergency department and laid off an estimated 600 employees.
• Shands Live Oak and Shands Starke hospitals in north Florida were acquired by HCA in 2020. All non-emergency and inpatient services at the hospitals were shut down to allow HCA to operate the facilities as freestanding ERs affiliated with hospitals more than 20 miles away. Live Oak’s mayor called the move a “gut punch” to the city for its impact on patients and employees.
• HCA’s Regional Medical Center in San Jose, Calif. is the only hospital located in a low-income area of the city. Last May, HCA closed its women's and birthing services, resulting in long waits for expectant mothers and newborns for transfers to hospitals up to 45 minutes away, lack of training for ER staff in handling pregnant patients, and even attempts to transfer mothers and newborns to different facilities. HCA made similar cuts at another California hospital last year.
• Mission Health, in Asheville, N.C. was acquired by HCA in 2019. Last year, HCA shuttered rural chemotherapy services in four towns served by Mission in western N.C., requiring patients to travel as far as 60 miles to Asheville to receive lifesaving care. Amid clinic closures and efforts to renegotiate contracts with physician groups, ABC News 13 in Asheville reported that at least 79 doctors have left or plan to leave Mission Health.

Following the Mission purchase, many nurses have cited problems with insufficient RN staffing while the hospital was also reducing the number of critical support staff. One nurse reported at a meeting of the independent public monitor appointed to ensure HCA compliance with the terms of Mission’s sale: “Every single department in that hospital designed to help the patient is critically and unethically, inhumanely understaffed."

Throughout the pandemic, HCA nurses across the country reported less access to protective equipment than at other facilities. One hospital even told nurses not to wear masks while providing care to avoid “scaring the patients.”

In August, nurses called upon the Occupational Safety and Health Administration to levy sanctions on HCA Healthcare for their dangerous conditions, including failing to notify workers when they’ve been exposed to Covid-19 and pushing those who are or may be Covid-positive to continue working. Several HCA hospitals have been fined by regulators for safety violations.

HCA Healthcare’s High Cost of Care

HCA hospitals are known to be among the most expensive in the country. Hospitals in HCA’s portfolio accounted for 53 of the top 100 hospitals with the highest patient care markups in 2018 and six of the top 10, according to a study by National Nurses United released last November.  

Hospitals use high charges to negotiate higher payments from insurance companies, which results in the insurers passing along the costs to businesses that cover employees, and to individuals, resulting in much higher out-of-pocket costs in premiums, deductibles, and co-pays.    

In Georgia, HCA-affiliated hospitals account for four of the top five and seven of the top ten hospitals with the highest charges for patient care. Cartersville Medical Center, for example, charges $1,152 for every $100 spent on care. Statewide, HCA charges an average of $892 for every $100 of their costs, double the statewide average for all Georgia hospitals. It seems likely that Meadows Regional Medical Center’s charges of $448 for every $100 spent would greatly increase under HCA operation, placing unwelcome pressure on the community.