HCA Healthcare reports improved nurse recruitment and retention

Nashville-based HCA Healthcare’s nurse recruitment and retention is improving, the company reported in its earnings call last week.

Hiring rates for nurses were up almost 19% compared to the previous four-quarter average, HCA CEO Sam Hazen said. Nurse turnover rates are falling to pre-pandemic levels, he added.

“We continue to invest in our people through compensation programs, increased training, and innovative care models,” Hazen said. “We believe these programs advanced our capabilities to provide high-quality care to our patients.”

HCA relied less on contract labor this quarter; it decreased by 21% from the same period last year, Hazen noted. Contract labor made up 7.1% of Q1’s salaries, wages, and benefits expenses, down from 9.5% in 2022, HCA CFO and EVP Bill Rutherford said. HCA’s fiscal year runs from Jan. 1 to Dec. 31.

Staffing shortages during the Covid-19 pandemic pushed health systems to rely more on expensive contract labor, and total contract labor expenses “skyrocketed 257.9% from 2019 to 2022,” according to a new report from the American Hospital Association and software company Syntellis Performance Solutions—based on data from more than 1,000 hospitals.

Rutherford attributed the contract labor decrease to improvements in HCA’s recruitment and retention.

The company bought a majority stake in the Galen College of Nursing in 2020 to improve the nursing pipeline and increase education opportunities. The college, which has a total of 14 campuses, had more than 3,200 graduates in 2022, according to HCA’s 2023 annual impact report.

Among 11,000 Galen College students, “the number of HCA Healthcare colleagues doubled in 2022 to total 2,400,” according to the report.

HCA also plans to build more hospitals in markets with “high occupancy,” instead of adding on to existing facilities, Hazen said. The company has two hospitals under construction in San Antonio, Texas, and already owns land in Austin and Dallas to build additional facilities.

HCA has 45 hospitals and 632 affiliated facilities across Texas, and has invested ~$6.6 billion over the last five years into increasing its presence in the state, according to a January press release.

This quarter, HCA purchased land in Las Vegas and Salt Lake City for new facilities.

“We need to have sufficient capacity as we build up our staffing over time. We need physical capacity to accommodate what we believe to be the demand for health care,” Hazen said.