Travel Nursing at HCA Hospitals

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The Hospital Corporation of America (HCA) is the largest for-profit hospital operator in the United States. HCA boasts a whopping 162 hospitals and generates over $33 billion in annual revenue. HCA is also one of the biggest users of travel nurses in the nation. In this blog post, we’ll provide some detailed information about travel nursing with HCA so that you will know what to expect.

Are HCA hospitals good for travel nurses?

Of course, the first question that every nurse considering a travel nursing job with HCA wants answered is whether or not HCA is a good place for travel nurses. Are HCA hospitals “travel nurse friendly?” Unfortunately, this question is too general to provide an all encompassing answer.

HCA hospitals are stretched across the country. And while it’s true that corporations tend to have an overall culture, the culture within each hospital is largely influenced by the people who work there. Therefore, you will find differences between hospitals, between units in the same hospital, and even between shifts on the same unit.

However, this doesn’t mean that you will be unable to obtain any idea about the hospital’s working conditions prior to accepting an assignment. Many nurses turn to social media groups and message boards in an effort to lock down an answer. Be careful with this approach. Like everyone else, nurses have differing opinions on what constitutes a good work environment. When using this approach, be sure to ask for specifics and do not rely on vague, uninformative answers.

Checking hospital rating services is another potential avenue that nurses can explore when attempting to determine whether or not an HCA hospital is traveler friendly. Again, please be careful with this approach. Standard hospital rating services are largely devoted permanent employees. The experience can vary greatly between permanent employees and travel employees.

Meanwhile, even the most active hospital rating services dedicated to travel nurses have very few ratings, so their validity is questionable at best. For example, Travel Nursing Central has been collecting hospital ratings since 2005 and the hospital with the most ratings only has 11 ratings. The vast majority of hospitals on the site have less than 2 ratings. It may be best to utilize all the methods listed above to piece together a picture of what it might be like to work a travel nursing contract at the HCA hospital in question.

Having placed nearly 40 travelers at HCA facilities throughout the country, I can offer the following anecdotal observations. Most of the nurses I worked with had no complaints about the HCA facilities they worked with. For example, I placed an ICU nurse at Bayshore Medical Center in Houston, Texas. She absolutely loved it. She commented glowingly about the orientation and how she was made to feel a part of the team from day one. She accepted an extension and was hoping to get hired permanently.

In another case, I placed a PACU RN at the Woman’s Hospital of Texas. He loved it and returned for several contracts over the years. I also had a positive experience with an L&D nurse who loved her contracts at Rose Medical Center in Denver, CO.

On the flip side, I worked with several nurses who had less than desirable experiences with HCA facilities. I placed a Med/Surg nurse at Sunrise Hospital and Medical Center in Las Vegas, Nevada. She complained of receiving a less than adequate orientation and being overwhelmed with the work load. She left the contract and went on to accept and successfully complete several assignments with me at various other hospitals.

I also placed three ICU nurses together at Regional Medical Center Bayonet Point in Hudson, Florida. All of them complained about orientation and caseload. One of them cancelled their contract early. The second completed their contract but wasn’t happy about it. She went on to accept several contracts with me and enjoyed every one. The third completed the contract and accepted an extension because she liked the area so much.

What are the most common complaints travel nurses have about HCA?

My experience and research indicate that there are some common complaints that travelers have about HCA hospitals. First, HCA uses Meditech which tends to be unpopular among nurses. It’s often described as clunky and anything but user-friendly. The learning curve can be steep and travelers have a short period of time to get up and running. There was talk of HCA piloting Epic. However, I have yet to hear that they are making a transition.

Additionally, travelers express concern about the workload at HCA hospitals. This also appears to be a common complaint among permanent employees of HCA hospitals. In fact, this New York Times article explains that HCA’s move to a flexible staffing system had several interviewed nurses complaining about inadequate staffing levels throughout the hospitals.

Many travelers and permanent HCA employees also cite old equipment as a major concern. I’ve also seen complaints about supply rationing. This link has complaints about both! At the same time, you’ll also see some positive comments on the same page.

Do you care if it’s an HCA Facility?

It’s important to note that many nurses go unaware that the facility they’re considering is an HCA facility. It’s not like Kaiser, where every Kaiser hospital includes “Kaiser” in it’s name. HCA facilities have names that leave them undistinguished from HCA.

Moreover, recruiters may not inform their candidates that the facility in question is an HCA. Sometimes this is an honest oversight. For example, the recruiter may not know that it’s an HCA facility or may not realize that it maybe important to the nurse. In other cases, the recruiter may shy away from telling the nurse for fear the nurse might decline the assignment simply because they’ve heard negative things about HCA.

Therefore, if it’s important for you to find out, then be sure to ask your recruiter if the facility in question is an HCA facility. You can also check the HCA website to see if the hospital in question is on their list.

Travel nursing agencies that work with HCA

If you decide that you want to be submitted for an assignment with an HCA facility, then it’s important to know that Parallon is the Managed Service Provider (MSP) for HCA. It’s also important to know that Parallon is a subsidiary of HCA. Up until 2011, All About Staffing  was the MSP for HCA. They were also owned by HCA and were merged with several other HCA units into Parallon.

As the MSP for HCA, Parallon has an exclusive contract to meet all of HCA’s staffing needs. However, Parallon works with a large number of healthcare staffing agencies to assist them with this endeavor. These staffing agencies are called sub-vendors.

This relationship has several implications. First, it’s important to know that Parallon has first crack at filling all HCA jobs. If they are unable to fill jobs in a timely fashion on their own, then they’ll release them to their sub-vendors.

Parallon works with a very large number of sub-vendors. Therefore, the market for HCA jobs that are released to sub-vendors is highly competitive. It’s not uncommon for jobs to be closed for new candidates within 1 hour of the job being released to sub-vendors. I recall one instance in which a Parallon Account Manager released a list of nearly 100 job openings and closed them for new candidates the following day stating that he had received over 900 profiles.

It stands to reason that you will maximize your exposure to HCA jobs and increase your chances of consideration by using Parallon. However, it’s difficult to tell how much effort Parallon puts in to filling HCA’s job openings on their own. Our cumulative agency ratings for 2014 reveal only 9 ratings across the three most popular agency rating services. This could be an indication that Parallon doesn’t really staff that many travelers.

This could be a result of the fact that Parallon focuses almost exclusively on HCA job orders. However, they still have over 700 jobs, 987 per diem jobs, and 156 permanent jobs posted on their website as of the writing of this blog post. Additionally, their website indicates that they have over 20 recruiters, which would make them a fairly decent sized agency.

Parallon is rated a little less than average by travelers. Our cumulative rating score has them at 67.78 on a 100 point scale. By contrast, American Mobile comes in with a paltry score of 44.07. However, Parallon only received 9 rankings, so it’s difficult to tell if their rating is truly reflective of their service. Finally, I’ve seen several complaints that Parallon doesn’t stand up for healthcare professionals when disputes arise between the HCA hospital and the healthcare professional. The indication is that Parallon is biased as a subsidiary of the hospital.

Again, you’re not required to work with Parallon to land HCA jobs. And rest assured that the most revered agencies in the business are able to land HCA jobs for you.

What’s the Pay for HCA travel nursing jobs?

Parallon advertises that they “offer the best pay rates and packages in the industry.” However, almost every agency advertises that. The truth is that the pay rates for HCA facilities vary greatly across the country.

My former recruitment experience was with a Parallon sub-vendor. Unlike some MSPs, Parallon doesn’t charge their sub-vendors a billing fee for doing business with them. Instead, Parallon’s sub-vendor bill rates already have the cost of doing business with Parallon subtracted out.

I’m explaining this because this approach to sub-vendor fees makes it difficult for sub-vendors to know what the true bill rate is. For example, American Mobile charges its sub-vendors  a fee equal to 2% of the bill rate for the job in question. As a result, sub-vendors can see the actual bill rate that Kaiser pays American Mobile. Knowing the actual bill rate allows the sub-vendors to have an idea of how much American Mobile is able to pay their own employees. This isn’t the case with Parallon.

That said, Parallon breaks sub-vendor bill rates into regions and there are a very large number of regions. In some of the regions, the bill rates for sub-vendors seemed quite low. In those regions, it was fairly consistent for me to hear Parallon nurses express that they were making about $2 more per hour than what I was able to offer. In other regions, it seemed as though my rates as a sub-vendor were equal or better than what Parallon was offering.

I found that HCA bill rates were very good in Northern and Southern California where they were among the highest, if not the highest in the regions. The bill rates were solid in San Antonio, Houston and Colorado. They were fairly low in Dallas and Austin. And they seemed horrendously low in most parts of Florida. Again, these observations are all relative to bill rates for other facilities in the area.

Again this is from a sub-vendor’s perspective. I regularly heard from nurses who explained that pay rates through Parallon were the best they could find in Florida. So it’s possible that Parallon charged a larger fee to sub-vendors on their Florida bill rates than they did for other regions throughout the country.

It’s important to remember this when comparing pay packages with other nurses. For example, you may find yourself comparing pay packages with a Parallon employee while working an HCA contract through a sub-vendor. If the Parallon employee expresses that they’re making more money than you, it’s not necessarily an indication that your agency is ripping you off. Your agency most likely has a lower bill rate.

Travelers should also be aware that specialty unit bill rates, like ICU, tend to be about $3-$5 per hour higher than standard unit bill rates, like Med/Surg. Additionally, overtime and holiday bill rates tend to be about $7 to $1o per hour higher than the regular bill rate. Finally, HCA hospitals will sometimes offer completion bonuses of between $2000 and $5000. On the rare occasion that bonuses are offered, they are typically for hard to fill specialties like CVOR and L&D.

Qualifications for travel nursing at HCA facilities

HCA has some fairly stringent qualifications by industry standards. They typically require a minimum of 2 to 3 years of recent experience in the specialty applied for. They have a stated policy requiring all travel nurses to have an ACLS certification. This includes specialties that don’t routinely require this certification. It’s fairly rare for them to overlook or bend on this requirement. Some HCA hospitals also require Stroke and Trauma certifications for applicable specialties.

HCA frequently requires Meditech experience. This is probably because they know that the learning curve for Meditech can be steep. Moreover, they often require that travelers have experience working in HCA facilities.

Contracts and per diem for travel nurses with HCA

HCA engages in traditional travel contracts. They commonly have 13 week contracts for 36 hours per week. They also have 8 week contracts on occasion.

However, HCA also engages in a lot of per diem and “local” contracts as well. So you may find Parallon and many sub-vendors offering “Hybrid” contracts. With hybrid contracts, the nurse must make themselves available to work a particualr number of days per week, usually 5, and the agency will guarantee 36 hours per week. As soon as the nurse reaches 36 hours they are not obligated to remain available for the remaining days. It’s a hybrid between travel and PRN.

With all of this variability, you should be extra mindful of asking about what you’re signing up for. Travel contracts, hybrid contracts and local contracts all have different aspects from bill rates to guaranteed hours clauses. So it’s especially important to ask about the guaranteed hours clause that Parallon has with your particular contract.

Travel nurse submission process with HCA

Unlike many MSPs, Parallon does not conduct their interviews in-house. Instead, the profile is sent directly to the Unit Manager responsible for the job requisition. In the vast majority of cases, the travel nurse will have an interview directly with the unit manager. This is the best case scenario for travel nursing interviews because it gives travel nurses the opportunity to get all of their interview questions answered.

There are a couple more things to note about the HCA submission process. First, if you’re getting submitted by a sub-vendor, it maybe highly competitive and you may wind up waiting quite some time for an interview or to hear that the assignment has been filled by another candidate.

Second, you should NEVER contact an HCA hospital directly, even if your recruiter tells you to. Parallon and HCA have a strict policy prohibiting travel healthcare candidates from contacting the hospitals directly. Often times, rookie travel healthcare recruiters are unaware of this policy and tell their candidates to call the hospital directly. This will definitely result in your profile being pulled from consideration and could result in your agency losing their sub-vending contract with Parallon.

Onboarding for travel nursing jobs with HCA

If you decide to take an assignment with an HCA hospital, then there are few things you should know about the onboarding process. First, the onboarding process can be unstable. That is, sometimes it goes smoothly and sometimes it’s a train wreck.

Many sub-vendor agencies complain that Parallon doesn’t use a Vendor Management System (VMS). They cite this as resulting in poor communication between the agency and Parallon as to a candidate’s progress through the onboarding process.

For example, VMS’s allow agencies to upload the candidate’s required documents and receive updates through the system as to whether or not the documents are acceptable. They also get notifications from the system on missing documents. With Parallon, the documents are emailed or faxed and there is no way for the agency to track the documents. Instead they must wait for email communication from Parallon.

Agencies cite many other examples of poor communication between themselves and Parallon that result in a shaky onboarding process. It’s important to understand this so you don’t end up blaming your agency for the potential poor service during onboarding at an HCA facility.

Thankfully, HCAs tend not to have overly burdensome onboarding paperwork requirements. However, some HCAs require a PBDS exam prior to starting a assignment. Some HCAs will cancel the contract if the PBDS exam is “failed”. We’ve discussed the issues to consider with PBDS exams in a previous blog post, so we won’t rehash them here. However, it’s extremely important for all nurses to ask the facilities they interview with if such tests are administered!

Travelers will typically be required to visit the local Parallon staffing office prior to starting their assignment. There you’ll fill out some standard paperwork. It’s also a good idea to bring your licenses, certifications and medical documentation just in case. Different local offices handle this meeting in different ways. Some require travelers to come in on the Saturday before their start date. Others have the traveler come in on Monday or Tuesday of their first week.

Finally, it’s important to request your computer access code from your recruiter prior to starting your contract. Neither the hospital or the local staffing office has the ability to set this up, so it must be obtained from your agency’s Parallon contacts. At least this is how it worked in the past and I assume it still does. Many recruiters are unaware that they must request this from Parallon and sometimes it slips through the cracks.

We hope you find this information helpful. And as always, your feedback, questions and comments are welcome in the comments section below!

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17 replies
  1. Jaime says:

    Former HCA and Parallon employee, now a traveler trying to get back to my family in FL. I interviewed 2 weeks ago with Margate, still no contract in writing. After 5 days of nothing and multiple emails from my recruiter, Healthtrust (their new name) told the mgr I declined it, then told my recruiter they filled the position but opened a new one to extend to me. I happily took the offer, because I have a daughter in FL and had to leave HCA for 12 mo in order to travel with them. Now I’ve been sitting in rural NorCal unable to leave because they are still “checking” my credentials. But of course they want me to complete all their online learning still. After reading the reviews on here, I’m terrified that if they finally give me the green light and I sign the contract I’ll be stranded on the 3600mi drive back because they will cancel. It’s now been 3 weeks I’ve been done with my previous contract, still waiting to start driving, and they have this hold on my credentials. I’m about to be stranded in NorCal with no place to go because of them dragging their feet. I’ve never experienced this problem with other ones. As a staff member they were terrible, I’m only trying to get back to my little girl and unfortunately hca owns most of the hospitals in FL. What is so hard for them to check? I worked there for 10 years!

  2. Anonymous says:

    I wish I would have researched all of this information about HCA and Parallon before taking on my first travel experience. I got up and moved excited to have my first travel assignment. The day before I started the hospital cancelled my contract. My agency eventually found another assignment but it was an hour away from where I moved. From the beginning the assignment at RMC of Bayonet Pointe was terrible. I was given the worst assignments and would be tripled with 3 ICU patients. In my interview the manager stated that I would “ocassionaly” be tripled but only if one was waiting to be transferred out! My second week in the unit I walked by a male nurse and lightly brushed his shoulder to say hello. He yelled at the top of his lungs not to touch him and that he was taking me to HR! Huh!! I was traumatized! I discussed the issue with the charge nurse and she said she would talk to him. When asked later on she said she never talked to him! I told the manager and her response was, “did you do an incident report!” She stated he had done this before to another female nurse. Every shift I was tripled. There was no help from staff nurses sitting around! I stuck it out for 6 weeks until I couldn’t take it anymore! I cried going into work and hoped to GOD I would be floated out of CCU! I finally called my recruiter and expressed my concerns and asked to possibly finish out my contract in a different unit. There was no need in other units. Per “protocol” an email was written up and sent to the facility. The facility responded to the concerns and terminated my contract saying I had an attitude etc. The HR personnel in my agency said, its kind of bizarre that the unit has these complaints only AFTER my concerns were expressed!? The unit manager was obviously told who made the complaints about the safety of the assignments to suddenly have complaints about me that were she never brought to my agency attention. Now as I am trying to find another assignment my recruiter submitted my profile to another HCA hospital and it was rejected because Parallon has put me in as “unhirable” in all HCA-HealthTrust facilities! Are you kidding. I was harassed and given unsafe assignments and finally brought my concerns to the agency; the agency tried to fix the problem, instead MY livelihood, my career, my name…everything is affected. How is this possible? I was scared of providing unsafe care to my patients and now I am “unhirable” because one hospital in all of my career complained that I had an attitude only after hearing my agency reached out about MY concerns!! The hospital said they had no complaints about my clinical performance it was all attitude!! Bayonet is using that as their. defense because I brought their unsafe practices to the table.

  3. Stephanie crutchfield says:

    I work at HCA,yes, meditech is outdated; but once you understand it not so hard. It reminds me of computers before mouses. It’s keyboard heavy. Everything is f9 lookup, you have to type in caps, -f5 or f1 shows you the last entries to compare/ contrast. You can find most everything you need to chart and lookup labs etc under process interventions. If you wish to add more you can just click on nurse notes (under process int), choose any note then type. Yes it’s different but once you use it it’s actually very repetitive and not so bad. Once I show the agency nurses the basics and short cuts they are usually fine on the unit I work on. It reminds me of the “Oregon trail game”. It’s old school computer w no mouse. Hope this helps anyone experiencing meditech stress! Good luck!

  4. Anonymous says:

    I would NEVER recommend HCA facilities to nurses or patients. They are all unsafe, they expect you to do whatever it takes to get patients in and out regardless of care. They are an unsafe company, CANNOT BELIEVE THEY EVEN FUNCTION AND ALLOWED TO OPERATE ACCORDING TO JAYCO STANDARDS… RUN AWAY TRAVELERS RUN AWAY!!!

  5. Zino says:

    All About Staffing, Parallon is now HEALTHTRUST. This God-forsaken agency staffs HCA hospitals across the U.S.A. The worst agency ever. The recruiters pretend to work in your favor, but actually work against you. They fail to provide housing and give you a blended rate which is always a RIP – OFF. If housing is provided, you lose $2000 or more per month and hourly rate drops to $18 to $20. This agency is all about money and will never give you all you need to work with. You have no access to charting or Med adminstration. You can’t get a hold of the recruiters and will always find negative reviews about your performance circulating from one manager in one facility to another without your knowledge. No reviews, no feedback, no communication whatsoever. You are just to be used to make money for them and be dumped at will. Their assignments are the worst you can ever encounter. HCA facilities are very unsafe. I will never work for Parallon aka HealthTrust or any of their affiliates. I’d rather starve to death.

  6. Bobby says:

    OH.MY.GOD! HCA is the worst of the worst! Please don’t work there as an employee and please don’t go there for a travel assignment. The stories you hear about HCA are true – run far away from ANY hca hospital you come across.

  7. Jason says:

    I would never work as a staff employee for HCA as I have in the past, and yes, Meditech is old and outdated. When I became a nurse in 2004, I started at an HCA facility in San Antonio. It was the first hospital that hired me. I really don’t remember it taking all that long to learn the charting system, and after going to other hospital systems (Tennet) was one of them, Meditech isn’t that bad. HCA hospitals or the ones I’ve worked at were extremely understaffed, but all hospitals are. I’m fairly new at the traveling thing, but as long as you have your days off, max amount of patients specified in your contract, you should be fine. When I was staff at an HCA hospital, I worked alongside Parallon employees, and it seemed as though their recruiters were always behind them. I tried traveling with different agencies, and they were awful. The recruiter I have now with Parallon is really good, and the process is going smoothly. Keeping my fingers crossed.

  8. Anon says:

    Thanks for cancelling a contract on a family that was enroute and being inflexible with two deadlines. The communication between your top to bottom staff is horrible and full of sad lies! You’ve stranded a family with two children under 5 in Colorado! Communication was always open with the recruiter that the deadlines couldn’t be met due to road travel. Since you’re heartless and inflexible the family is stuck! You’re a sad company! From the reviews we’ve found all over the web maybe that family was saved by your pathetic lack of communication and inability to be flexible. Hope your “profit” is worth the awful situations you put humans in!

    • Kyle Schmidt says:

      We’re really sorry to hear about this experience and thank you for sharing so our readers can benefit. Just to be clear, this website is not affiliated with HCA in any way. We wrote this article because HCA is a large employer of travel nurses so we wanted to provide our readers with some background. We hope you’re able to find another assignment soon!

  9. Anonymous anonymous says:

    I will never work for a Parallon facility ever again. The hospital in Smyrna, TN is a terrible facility to work in, also a HCA facility. Very unsafe practices, lack of orientation, poor management, no access to policies etc. this was my first travel assignment as a l&d nurse and it makes me consider if traveling is something I want to continue. WORST company ever!!

  10. S says:

    I’m currently working a parallon contract but with a different company (at an HCA hospital)…. never again!! I don’t care if it decreases the assignments available to me, parallon is unprofessional and demanding and I’m over it. The first time I went through them it was okay but I must have had a great company/recruiter that buffered the stupidity and protected me from dealing with parallon as much. I’ve worked with cross country contracts several times and even though the hours weren’t as greatly gauranteed, I found CC to be easier to work with and WAY less red tape.
    As far as HCA- not only did the supervisor lie about the unit I would be on and my job description, it is the most run down unit that needs updating badly. Half paper charting half EMR, no respect for nurses from anesthesia or physician support (NP’s & PA’s), freaking out about hours and constantly hounding the nurses about budget like it’s their fault, old equipment or lack of adequate equipment, on and on and on. When they have unit meetings with admin you can actually SEE the beurocratic BS floating through the air.
    And a side note…. I’m making TERRIBLE money here. They quoted me the weekly rate of 40 but come contract time the assignment was 36, and it was personally too late for me to turn back.
    Never again. Please let this next 7 weeks go by fast. I’m outta here.

  11. Lucia says:

    Parallon are the worst !!! very demanding, Management takes everything personally, you have no freedom of speech with them and they take their good nurses for granted. Maybe reason why HCA gets such a bad reputation. Management has to leave the ego at the side and treat Nurses more respectfully. WITHOUT NURSES THERE IS NOT HCA HOSPITALS…WE ARE NOT REPLACEABLE !!!!

  12. lynn says:

    Capital Regional Medical Center in Tallahassee, FL . The most awful experience. Very unprofessional staff. Management is more unprofessional than the staff. No training of the computer system – so if you dont know Meditech prior to contract you are out of luck. They will not help you if you have questions while charting.

  13. Margaret says:

    I will not work a HCA contract because of Parallon. I am an experienced labor nurse (8+ years, 3 of them as a travel nurse) and parallon is demanding an intermediate fetal monitoring class. Won’t accept advanced. Makes no sense. I don’t know a labor nurse that renews intermediate we just renew advanced every couple of years. Parallon is clearly run by idiots. And HCA is losing out by using them.

  14. Shad Barden says:

    I have only worked one contract with an HCA, Kingwood Medical Center. It was an awful experience. Bounced around constantly to different units, high patient workloads and unfriendly MD’s. Meditech is not nurse friendly, the way you have to chart on it forces you to choose options that may not accurately depict the situation, but there usually isn’t a free text area where you can chart what really happened. Please research thoroughly before you contract at an HCA.
    The one upside to the hospital was the nurses there seemed willing to help each other, I guess you become that way when everyday is a train wreck….


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