Nashville, Tenn.-based HCA Healthcare has agreed to a multistate settlement over allegations it illegally required entry-level nurses to repay training costs, according to a July 24 news release from the office of California Attorney General Rob Bonta.
HCA and its subsidiary HealthTrust Workforce Solutions reached a $2.9 million settlement with the attorneys general of California, Colorado and Nevada, as well as the Consumer Financial Protection Bureau, to resolve claims the system used training repayment agreement provisions — or TRAPs — in nurse contracts that violated state and federal laws.
An investigation led by the three states’ attorneys general found that HCA required newly hired registered nurses to sign agreements to complete the specialty training apprenticeship for registered nurses, or StaRN, program. Nurses who left before two years of employment were billed for a prorated portion of the program cost, often sent to collections if unpaid, according to the settlement.
TRAPs are considered a form of employer-driven debt that can restrict job mobility and saddle healthcare workers with unexpected financial burdens.
According to the settlement, five HCA hospitals in California used StaRN agreements: Good Samaritan Hospital and Regional Medical Center in San Jose, Los Robles Regional Medical Center in Thousand Oaks, Riverside Community Hospital, and West Hills Hospital and Medical Center in West Hills, which HCA no longer owns.
As part of the settlement, HCA has agreed to:
– Provide about $83,000 in restitution to affected California nurses.
– Forgive around $288,000 in outstanding TRAP-related debt.
– Pay $1.16 million in penalties to California and additional penalties to Colorado and Nevada, totaling $2.9 million.
A spokesperson for HCA told Becker’s the health system stopped using these repayment agreements in 2023.
Nurses in the program were paid competitive wages while gaining experience in specialty areas such as emergency departments, ICUs and operating rooms. Until 2023, nurses who participated in the program committed to working for HCA for two years. If they did not fulfill their commitment, they agreed to repay a prorated portion of the cost of the training program, according to the health system
“We disagree with the claims made by the states about the repayment agreements, but believe our settlement is in the best interests of our nurses and hospitals, who continue to focus on providing excellent care to our patients,” HCA said in a statement.
