Lower RN hours, operating losses, and negotiated nursing support

Florida Avenue acute campus: 394 licensed beds. The annual financial reporting unit includes 394 acute and 67 psychiatric beds, with psychiatric patient days separately reported. Its staffing and finances are presented at that combined reporting scope.

Each column retains the actual fiscal period and filing status. Dollars are reported amounts. Nursing FTEs cover the reported nursing workforce; they are separate from calculated productive RN-only FTEs.

Operating margin = income from operations ÷ (net patient revenue + other operating revenue). Purchased services include more than contract nursing; education expenses cover more than bedside RN education. Those fields cannot establish dollars spent on travelers or nurse educators.

• 2022 preserved HCAI source · API record 103 · Audited
• 2023 preserved HCAI source · API record 102 · Audited
• 2024 preserved HCAI source · workbook row 103 · Audited

Quarterly HCAI filings are shown as filed and may be revised. They are not audited annual accounts. Operating income is calculated as net patient revenue + other operating revenue − total operating expenses. Quarter-to-quarter changes can reflect timing, settlements and accounting adjustments.

• 2025-Q1 preserved primary API · record 104 · HCAI endpoint →
• 2025-Q2 preserved primary API · record 104 · HCAI endpoint →
• 2025-Q3 preserved primary API · record 103 · HCAI endpoint →
• 2025-Q4 preserved primary API · record 103 · HCAI endpoint →
• 2026-Q1 preserved primary API · record 103 · HCAI endpoint →

Annual accounting departments expose differences hidden by hospital totals. These values were assessed from CNO’s collected extract; original complete filing rows remain queued for independent recheck. Census-day ratios are calculated only where a positive adult/pediatric census denominator is present. ED, surgery, nursery and labor/delivery have different service denominators and are shown as hours.

Adult psychiatric cost-center rows at Doctors retain the combined financial filing’s scope; they do not describe the Florida Avenue acute campus.

Exact CDPH ELMS facility 030000122 matched to HCAI 106500852, CMS 050464 and 1441 FLORIDA AVE, MODESTO. This is the July 30, 2024 extract, whose resource is titled 1997–2023 and includes 2024-issued records. It does not provide complete 2024–2026 complaint or enforcement coverage.

The API returned 30 matched rows; 15 exact duplicate penalty records were removed. Distinct penalties can concern the same incident. Reporting failures, privacy breaches and immediate-jeopardy penalties are separate categories.

A coded category names the event class; the original deficiency report is needed for the clinical narrative, unit location, correction plan and later outcome. A burn adverse-event category does not establish that an event occurred in the burn center.

17 service records for the matched parent facility. This inventory lists supplemental services and authorized locations; it is not a complete list of bedside units or a staffing roster. Start dates are licensing-record dates.

1. 2022-04-22

   Union reported RN departures

   CNA/NNU stated that Doctors Modesto had lost 160 RNs since the pandemic began. This remains an attributed historical union claim; an HR denominator, gross-versus-net separations and unit distribution were not supplied.

   Source record →
2. 2023-09-26 / 2023-12-08

   NLRB charge and withdrawal

   Case 32-CA-326941 names the Modesto employer, alleges bargaining and coercive-statement violations, and lists a December 8 letter approving withdrawal. The case is closed. The docket establishes allegations and a withdrawal, not an adjudicated violation. Related cases located in Manteca and Turlock are excluded from this hospital’s case count.

   Source record →
3. 2026-03-27

   Union announced contract ratification

   CNA/NNU included Doctors Modesto among six Tenet hospitals in its ratification announcement. It reported rapid-response and orientation commitments and 11%–18% wage increases over the agreement covering July 2025–June 2028. This is the union’s description of the agreement.

   Source record →
4. 2026-09-16

   Current licensing inventory assessed

   The state facility record identifies an open, licensed 394-bed acute parent at 1441 Florida Avenue, with Level II trauma recorded. The supplemental-service inventory is shown below. Licensing entries establish authorized services, not the number of staff on a shift.

   Source record →

• How are RN hours, nursing FTEs and staffed beds allocated between Florida Avenue and the behavioral campus?
• Have the dedicated rapid-response nurse and minimum-orientation provisions been implemented locally? Obtain the executed agreement and implementation dates.
• What are the current unit-level vacancies, separations, break-relief hours and educator FTEs? The earlier ER-educator job link now returns 404, so it is not evidence of a current vacancy.
• Obtain the original deficiency findings and corrections behind enforcement entries and newer 2024–2026 complaint outcomes; the recovered extract is historical.
• Obtain explanatory schedules for unusual quarterly revenue or expense changes and revised filings; quarterly totals do not identify the underlying accounting transactions.

The September 2026 complete annual financial release for FY2024–25 was identified. Its download returned 403 and its resource has no accessible datastore response here; those newer annual figures are not substituted for the assessed 2022–2024 series.

Staffing-ratio and staffing-response requests in the collected planning workbook are marked “Ready to submit,” not submitted. No response or finding is inferred from those drafts.

Site-matched OSHA injury summaries, nurse-specific injury denominators, educator staffing, vacancy and turnover records are not yet assessed. Hospital-level outcome figures cannot supply those missing workforce records.