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Over the past decade, hospitals across the country have used training repayment agreements (TRAPs), forcing newly hired nurses to sign “New Grad” contracts or “RN Residency” contracts as a condition of employment. 

While hospitals tout the extra training and benefits these programs have, nurses report the instruction is minimal. Becky Klatt, an ER nurse at HCA’s Mission Health in Asheville, NC, found the program, “is not designed for patient safety, but instead for dumping nurses on the floor as quickly as possible and as often as possible without any regard for the repercussions,” she said to MarketWatch. 

Hospitals use these contracts to pass the costs of training to nurses, while locking nurses in agreements that financially penalize them if they leave the contract early. In particular, large hospital systems, like HCA, that have control of large portions of health care markets use TRAPs. This makes it difficult for new grad nurses to find work without a training repayment agreement. 

Source: https://www.marketwatch.com/story/they-are-looking-for-other-ways-to-keep-workers-from-leaving-their-jobs-training-repayment-agreements-are-the-latest-corporate-battleground-in-a-tight-labor-market-11662038468

The Federal Trade Commission (FTC) sued to block the sale of four Salt Lake City area Steward Health Care hospitals to HCA, alleging the anticompetitive nature of the deal would lead to higher prices and lower quality of care.

National Nurses United sent a letter to the FTC Bureau of Competition Director Holly Vedova in October 2021, citing similar concerns, urging the FTC to stop the sale. 

“HCA has a well-documented pattern of using its immense scale and wealth to absorb smaller hospital systems,” said NNU President Jean Ross, RN in a statement on the FTC’s decision. “Once HCA is a community’s primary health care provider, it goes into its well-used playbook—slashing and consolidating services, while jacking up health care costs. The FTC’s move to block this transaction, could save thousands of Utah patients from having to endure the profit-orientated and self-enrichment business practices of HCA’s Wall Street executives.”

Just days after the FTC’s announcement, HCA and Steward dissolved their acquisition attempt.

Source: https://www.nationalnursesunited.org/press/nnu-applauds-ftc-decision-to-block-hca-acquisition-of-steward-health-care-utah

In comments to the Federal Trade Commission (FTC) and Department of Justice (DOJ), National Nurses United (NNU) called on the agencies to strengthen federal regulations and guidelines to protect patients and health care workers from the negative effects of monopolistic mergers and acquisitions.

The FTC and DOJ are reviewing and revising their horizontal and vertical merger guidelines, to better protect patients from potentially anti-competitive deals. The agencies invited public comment and testimonies as a part of their review process. 

NNU’s recommendations included, “calling on the FTC and DOJ to expand antitrust scrutiny and other guidelines in reviewing past practices of the buyers, such as higher charges to payers and patients, hospital closures and patient service cuts.”

Source: https://www.nationalnursesunited.org/press/nurses-call-on-ftc-and-doj-to-strengthen-merger-guidelines