As the coro­n­avirus con­tin­ues to bat­ter the U.S., the hor­ror sto­ries still sound the same: basic med­ical sup­plies nowhere to be found, new patients keep show­ing up gasp­ing for air, nurs­es with impos­si­ble work­loads and back-to-back-to-back shifts, hos­pi­tal staff with inad­e­quate per­son­al pro­tec­tive equip­ment (PPE) get­ting sick.

It might even sound like no one with any pow­er in Amer­i­can health­care has learned much since March, but that’s not true, accord­ing to Saum Sutaria, chief oper­at­ing offi­cer of Tenet Health­care, a mas­sive, for-prof­it hos­pi­tal chain. ​“We’ve learned a tremen­dous amount,” Sutaria boast­ed to Wall Street ana­lysts dur­ing a con­fer­ence call in mid-June. The McK­in­sey alum and fea­tured Aspen Ideas Fes­ti­val speak­er was talk­ing about how to lim­it Covid-19 ​“costs on a unit basis of managing.”

Of course, hos­pi­tals can low­er their costs in a lot of ways that make patient care worse. Tenet, for exam­ple, fur­loughed an aston­ish­ing 10% of its staff in March and April. It also stopped con­tribut­ing to 401(k) retire­ment accounts, rationed PPE(and threat­ened to fire employ­ees who brought their own), and slashed hours for its nurs­es. Some nurs­es were sent home mid-shift, leav­ing oth­ers to watch sec­tions as big as 20 patients. At a Tenet hos­pi­tal in Mass­a­chu­setts, nurs­es filed more than 50 reports over two weeks in April, doc­u­ment­ing spe­cif­ic instances of how the down­siz­ing jeop­ar­dized patients. One declared she had “[nev­er] been more ashamed to work” somewhere.

Tenet’s pan­dem­ic man­age­ment style has been espe­cial­ly har­row­ing at Detroit Med­ical Cen­ter (DMC), Detroit’s major hos­pi­tal group (with 2,000 beds) and the city’s biggest employ­er. Near­ly 3,000 peo­ple have died from Covid-19 in Wayne Coun­ty, where Detroit is. Mean­while, a law­suit filed by four for­mer DMC nurs­es claims that, at one point, DMC was so short-staffed that a stag­ger­ing num­ber of the deceased were in rig­or mor­tis before any­one noticed they weren’t breath­ing. The staffers allege hos­pi­tal admin­is­tra­tors active­ly increased the death toll by instruct­ing nurs­es not to revive patients sus­pect­ed of hav­ing Covid-19.