Nurses and Congress Members Shift Focus to Hospital Owners

WORCESTER – After a seven-week gap in proposals between the Massachusetts Nurses Association [MNA] and Tenet Healthcare,  significant activity occurred in the week leading into the Independence Day holiday weekend.

MNA is the union that represents nurses on strike at Saint Vincent Hospital. Tenet owns and operates St. Vincent Hospital.

Tenet made two separate offers leading up to May 5 before rejecting further meetings. The next seven weeks was a contentious public relations battle with no direct contact revealed to the public until Sunday, June 27.

Timeline of the Week Ending Saturday, July 3

Sunday, June 27

MNA receives a proposal from Tenet. It is the first proposal from either side since May 5.

Tenet releases a statement calling the new proposal a “third alternative” to its proposals in early May. Tenet also criticizes MNA for not making a counterproposal to the previous two offers.

MNA releases a statement saying the proposal “provides no meaningful steps in response to the nurses staffing concerns.”

Wednesday, June 30

Tenet receives a counterproposal from MNA.

Thursday, July 1

MNA announces a delegation of striking Saint Vincent nurses, other caregivers from Tenet facilities in California and healthcare and labor activists will visit Tenet Headquarters in Dallas, Texas. They will attempt to deliver a petition signed by 700 nurses to Tenet CEO Ronald Rittenmeyer.

Friday, July 2

Tenet notifies the Federal mediator they are “ready to respond with our fourth attempt to present a workable offer utilizing parts of previous offers and points the MNA presented in their recent counteroffer,” according to their statement released July 3.

Tenet also says it, “provided availability to meet in person, which the MNA has been requesting, on Monday, July 5; Tuesday July, 6; and Wednesday, July 7. The bargaining committee said they were not available to meet at any time on any of those days..”

Saturday, July 3

Tenet releases a statement which, in part, criticizes MNA’s plans to travel to Dallas:

“Instead of prioritizing an opportunity to negotiate in person, the MNA bargaining committee is focused on theatrics including supporting a faux exorcism in the hospital and a staged visit to Dallas, Texas, on Wednesday, July 7. These actions, which do nothing to further the dialogue so important to ending the strike, demonstrate their lack of a serious commitment to truly resolving the strike and returning Saint Vincent to normal operations.”

Congressional Letter to Tenet

Members of the Massachusetts delegation to Congress wrote a letter to Tenet CEO Ronald Rittenmeyer on Tuesday, June 29. Senator Elizabeth Warren, Senator Edward Markey, Rep. James McGovern and Rep. Lori Trahan have sent prior letters, but this letter asked a series of pointed questions about Tenet’s public funding.

The letter’s second paragraph reads:

“In the early months of the public health and economic crisis, Tenet furloughed staff and postponed the delivery of employee benefits, while seeking over $2 billion in loans and grants from the federal government, an effort you admitted was aimed at “maximizing [Tenet’s] cash position.” Tenet had an extraordinarily profitable year in 2020, despite the COVID-19 pandemic, reporting annual earnings of over $3.1 billion and $2.9 billion in available credit. To date, Tenet has received over $936 million in grants from the Provider Relief Fund and over $1.5 billion more in relief from Medicare Advance Payments and payroll tax match deferrals.”

The letter from the members of Congress also asks for response to five pointed questions; a list of pandemic-related state and federal funding, full accounting of how Tenet spent Provider Relief Funds, an accounting of unspent provider relief funds, explanation of how Tenet transferred grant funds between subsidiaries and pay and bonus details received by Rittenmeyer since January 1, 2020.

The full letter is available here.

Shifting Focus to Tenet

Since the strike began in March, MNA has attempted to highlight issues about the hospital’s parent company in its public statements, including the great success it has had in the last year during the pandemic while attracting funds from pandemic relief efforts.

Tenet’s stock price closed the day on Friday, July 2 at $68.53. Its market capitalization (the sum value of all its stock) is currently $7.318 billion.

The company had over 131,000 employees in 2016. Its employee count declined every year since and reported 110,000 for 2020. Over the last five years the stock dropped as low as $12.25 in October 2017 and $10 in March 2020, at the start of the pandemic.

Much of those gains has come in the last year. A report by Simply Wall St on June 29 said its price has soared 276% in the last year and 29% in the last three months. The following chart represents the value of its stock from January 1, 2020 through the close of business on Friday, July 2.

The three largest owners of Tenet own over 34% of the company. They are Glenview Capital (12.85%), Blackrock Fund Advisors (10.96%) and The Vanguard Group (10.49%). Individual investors own 16.46% of the company.

“Institutional investors hold a majority ownership of THC through the 92.19% of the outstanding shares that they control. This interest is also higher than at almost any other company in the Hospital/Nursing Management industry,” according to CNN Money.

Tenet has had a series of high profile scandals. In 2004 Tenet paid $400 million to patients for performing unnecessary surgeries. In 2006 it paid $900 million to settle charges related to Medicare overbilling. In 2016 it paid $513 million for a kickbacks for patient referrals scheme. In 2020 Tenet paid $1.4 million for one of its hospitals “knowingly charging Medicare for implanting unnecessary cardiac monitors.”

Since 2000, the company has paid just under $1.8 billion in penalties to the federal government and state governments for a range of charges. In May 2018, the Massachusetts Attorney General issued Tenet an assessment for $50,000 for non-payment of wages at Saint Vincent Hospital.