Nurses at St. Vincent Hospital in Worcester, Massachusetts, have been on strike for nearly four months as the hospital, owned by Tenet Healthcare, has refused to negotiate a new contract in good faith. And Massachusetts lawmakers have joined other members of Congress in asking serious questions about just what Tenet used hundreds of millions of dollars in pandemic relief money for.

Sens. Elizabeth Warren and Ed Markey and Reps. Jim McGovern and Lori Trahan sent Tenet a letter last week asking for an explanation. “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,’” the letter to Tenet CEO Ronald Rittenmeyer notes. “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.” Yet the nurses who provide care at Tenet hospitals are on strike not just for themselves but for their patients after, as the lawmakers describe it, “Tenet walked away from a two-year negotiation effort in which nurses asked Tenet ‘to implement desperately needed staffing increases to improve the patient care conditions at the facility.’”

The pandemic has not exactly made things better. “Even at the height of the pandemic, Tenet pursued cost-cutting measures: from April to June of 2020, Tenet slashed hospital spending by 11% or $377 million, while receiving more than $850 million of federal stimulus money,” Warren, Markey, McGovern, and Trahan point out. 

“Tenet failed to safely staff St. Vincent Hospital while exposing nurses and other caregivers to higher risk of COVID-19 due to lack of access to proper personal protective equipment as detailed in testimony (PDF) provided last week by one of our members to a state legislative committee,” St. Vincent Hospital nurse Marlena Pellegrino said in a statement as the nurses prepare to take their campaign to Tenet’s Dallas headquarters. “While Tenet pocketed more than $500 million in profits using pandemic relief money, our patients suffered preventable falls and bedsores, dangerous delays in receiving medications and other treatments.”

Nor is Massachusetts the only place health care workers are protesting Tenet’s way of doing business. At California’s Fountain Valley Regional Hospital, “We are dangerously understaffed on nearly every shift,” nursing assistant Mailinh Nguyen said in a National Union of Healthcare Workers statement. “We want to know how Tenet can afford to pay more than $1 billion for a chain of surgery centers, when it can’t seem to afford to provide safe staffing at its hospitals.”

In May, Reps. Katie Porter and Rosa DeLauro asked the Department of Health and Human Services and the Federal Trade Commission to look into “the potential use of Provider Relief Fund dollars by hospitals and health care systems to finance mergers and acquisitions during the COVID-19 pandemic.”

They pointed specifically to the pandemic relief money Tenet got and its acquisition of those surgery centers, when, “During this time, Tenet failed to provide the care its patients needed or the protections its workers required. Tenet understaffed the emergency room and intensive care unit at Detroit Medical Center’s Sinai Grace hospital so severely that single nurses were charged with treating as many as 20 COVID-19 patients at a time; the emergency room ran out of oxygen and beds and was forced to prop dead bodies upright in chairs; and dozens may have died for lack of basic attention from the overwhelmed staff. The company then fired the staffers who organized to ask for reinforcement and additional support. Tenet also failed to isolate COVID-19 patients from non-COVID-19 patients or dedicate separate staff to each group during an outbreak at Fountain Valley Medical Center in California in July 2020. In the final quarter of 2020, Tenet posted a profit of $414 million.”

This is what a for-profit health care system looks like, and it’s dangerous for patients and workers alike.