July 24, 2025
Carson City, NV — Today, Nevada Attorney General Aaron D. Ford announced a settlement with HCA Healthcare, Inc. and Health Trust Workforce Solutions, LLC (together, HCA), resolving allegations that HCA, one of the nation’s largest hospital systems, unlawfully required entry-level nurse employees to repay the cost of a mandatory training program if they did not remain employed with the company for two years.
“The debt that HCA saddled its prospective employees with was unlawful and hindered the ability of Nevadans to thrive early in their vital careers in the health care industry," said AG Ford. "I am proud of today’s settlement, which includes full available restitution for the impacted nurses and penalties paid to our state. I will not allow bad actors to saddle Nevadans with destructive, unlawful debt as they attempt to develop the skills they need to help make the Silver State safe and healthy."
Today’s settlement is the result of a lengthy investigation by AG Ford and the attorneys general of California and Colorado, who worked in partnership with the Biden administration’s Consumer Financial Protection Bureau.
The states’ investigation found that HCA violated Nevada’s consumer protection laws and possibly federal consumer financial protection laws by using training repayment agreement provisions (TRAPs) in nurses’ employment contracts. These TRAPs are a form of employer-driven debt, or debt obligations incurred by individuals through employment arrangements.
As a condition of employment at an HCA hospital, HCA generally required that entry-level nurse employees complete the Specialty Training Apprenticeship for Registered Nurses (StaRN) Residency Program. The company advertised StaRN as an avenue for entry-level RNs to get the education and training they need to land their first nursing jobs in an acute-care hospital setting, although the states’ investigation found the benefits of the StaRN program to be overstated.
Until spring 2023, HCA required that RNs hired through the StaRN program at facilities in several states, including Nevada, sign a TRAP agreement in their new-hire paperwork, but the repayment commitments in these agreements were not always adequately disclosed. The TRAPs purported to require nurses to repay a prorated portion of the StaRN “value” if they did not work for HCA for two years. If a nurse left HCA before the end of the two-year period, then the TRAP loan was often sent to debt collection, or the balance of the TRAP obligation was deducted from the nurse’s final paycheck.
In Nevada, HCA owns or operates Mountain View Hospital, Sunrise Hospital and Southern Hills Hospital, and Nevada nurses eligible for restitution will be notified later by HCA pursuant to a redress plan that is subject to review by the attorney general. Today’s settlement resolves the state’s claims that HCA’s conduct violated consumer protection laws in NRS 598.092(8) and 598.0923.
Under today’s settlement, HCA will:
- Pay approximately $75,776 to provide full restitution to Nevada nurses who made payments on their unlawful TRAP debt to HCA.
- Be prohibited from imposing TRAPs on nurse employees and attempting to collect on any outstanding TRAP debt incurred by Nevada nurses who signed TRAPs with HCA.
Pay $786,500 in penalties to Nevada. HCA will pay a grand total of $2,900,000 in penalties under settlements filed in California, Colorado and Nevada today.
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