HCA Sunrise hospital workers protesting in Las Vegas, Nevada, on 6 August 2026. Photograph: Jason Karsh, SEIU Local 1107View image in fullscreenHCA Sunrise hospital workers protesting in Las Vegas, Nevada, on 6 August 2026. Photograph: Jason Karsh, SEIU Local 1107HCA workers push for higher pay and more staffing amid billions in profits: ‘I’m struggling’Largest for-profit hospital system and operator in the US reported $6.8bn in profits, while employees find it difficult to make ends meet
Union workers with HCA Healthcare, the largest for-profit hospital system and operator in the US, are holding picket protests across the country as they push for pay and staffing increases in a new contract.
The hospital system has over 300,000 employees in the US and the UK, with 22,000 US workers represented by the Service Employees International Union (SEIU) who are in contract negotiations with HCA. Workers are asking for a pathway to a $25 an hour minimum wage, improved wage scales and raises that match the increased cost of living, along with benefits including paid vacation, sick time and bolstered work protections.
Esther Reyes, a single mother of three children, has worked as an environmental services technician at the HCA-owned Las Palmas hospital in El Paso, Texas, for the past two years, and said she constantly struggles to make ends meet on her $16.80 an hour salary.
“Sometimes I need to decide, maybe this month I pay the water bill, then another pay for gas, but most of the time I’m not able to pay for everything,” Reyes said.
Ahead of contract negotiations, Reyes and her coworkers in El Paso are set to hold an informational picket outside the hospital this week, with picket protests planned at over a dozen HCA hospitals in California, Texas, Nevada, and Florida.
Reyes explained prices have been going up but salarieshave remained stagnant, and it’s a constant battle figuring out how to cover basic necessities.
“I’m struggling. I struggle a lot. If they gave us the raise we want, it would be a huge blessing,” Reyes added. “I work for my family. I work for my kids. If I don’t get enough for everything, how am I supposed to cover all they need?”
HCA reported $6.8bn in profits in 2025, a 17.8% increase from 2024. In early 2026, the company authorized a $10bn stock buyback program. Sam Hazen, the HCA CEO, received more than $26.5m in total compensation in 2025, 420 times more than the median compensation for HCA employees at $62,955.
“We also see HCA’s profit reports, and that they are having great returns, and their profit is increasing. Meanwhile, the people doing the work are not being compensated appropriately,” said Jody Domineck, a pediatric nurse with over 20 years at HCA Sunrise hospital and medical center in Las Vegas, the largest hospital in the state, and secretary-treasurer of SEIU Local 1107. “Our work is how they’re making billions. We are just asking for fair compensation.”
Domineck noted that despite the increased profit, the hospitals continue to face staffing shortages that impact both workers and patients.
“There’s been multiple studies that show that the more patients you have, the higher the risk is to all patients,” said Domineck, who joined her coworkers to hold a rally around their contract demands outside the hospital on 6 August.
In 2025, Nevada’s Republican governor Joe Lombardo vetoed a bill that would have established safer nurse-to-patient ratios throughout the state. HCA members are now trying to get similar ratio guarantees into their next contract.
“I personally have had to walk away from a parent when their child was having a procedure, and that parent was crying in the hallway alone,” Domineck said. “I had to walk away from them because I had to see my other patients, and that was one of the kind of moments that broke me, because I, with all of my being, wanted to be there and comfort that parent, but I had to walk away to continue to provide care for the other patients, and those are the decisions nurses have to make when they have more and more patients.”
A spokesperson for HCA emphasized a small number of HCA Healthcare affiliated hospitals are engaged in individual negotiations with local SEIU chapters and shared a statement on the Sunrise hospital negotiations in Las Vegas, Nevada.
“At Sunrise Health System, we value every member of our team and remain committed to reaching a fair agreement through good-faith negotiations,” the spokesperson said in a statement. “While we respect our employees’ right to peacefully demonstrate, portraying this as a patient safety issue is inaccurate. The outstanding issues are about compensation. We believe the best place to reach an agreement is at the bargaining table, and we look forward to continuing negotiations on August 11 and 12.”
