HCA Nurses Push Back Against Palantir-Powered AI Scheduling Tool

Timpani was supposed to cut favoritism and save time. Two years in, frontline nurses say it harms care.

Critical care nurse Amber Retzloff requested 50 specific 12-hour shifts over four months at her Florida hospital. The Palantir-powered scheduling software at HCA Healthcare assigned her to different shifts more than half the time—and that pattern now defines daily life at roughly 130 of HCA's 190 hospitals.

What is Timpani, and how does it work?

HCA, the largest hospital chain in the United States, has co-developed Timpani with Palantir since 2023 and rolled it out across most of its network. The tool runs on Palantir Foundry, the data platform Palantir sells to large enterprises for analytics and automation. Named after the beat-keeping drum, Timpani uses algorithmic forecasts of patient volumes and staffing needs to assemble nursing rosters automatically.

HCA's top innovation executive, Michael Schlosser, told WIRED at launch that the tool would save time, cut costs, and remove favoritism from shift assignments. In a July paper, Schlosser wrote that Timpani has drastically reduced the hours managers spend on scheduling each month, lowered reliance on contract nurses, and improved retention. "The efficiency comes from AI generating stronger initial schedules," he wrote, adding that more than 98 percent "include a mix of skill and experiences."

What do nurses say about the rollout?

Retzloff, 34, is a National Nurses United leader with a decade of bedside experience. The half-century of requests she logged shows how often the system overrides preferences. "No one is happy with Timpani," Retzloff says. "Everyone complains all the time."

Lee Barker, an HCA nurse in Missouri, reports the same pattern at her facility. "Everyone checks immediately and every month you hear, 'Man, why did it schedule me like that?'" Barker says.

The complaints extend beyond two voices. WIRED interviewed five nurses at different HCA locations who echoed Retzloff's experience. Other purported HCA workers have voiced similar gripes on Reddit.

How does Timpani fall short at the bedside?

The nurses allege Timpani has compromised patient care by producing understaffed, imbalanced, and exhausted teams. They say it routinely schedules too few nurses or too few senior nurses on shifts, particularly on Sundays. It also frequently ignores preferences about spacing, nights, weekends, or specific days off.

Retzloff recalls recent shifts where all four of her colleagues were junior nurses. She delayed care for the sickest patients to guide the novices through milder cases. "HCA is letting AI dictate," she says. "We are overriding clinical judgment and the human-to-human piece of health care with an app."

A non-union nurse in Texas, speaking anonymously out of fear of retaliation, said the change has been jarring. "I can't remember any issues before," the nurse says. "Everything came out on time."

What is the "red day" problem?

HCA says Timpani schedules nurses for about 1 percent of their requested days off, internally known as red days. For Barker, that figure is misleading. Getting scheduled on a red day was previously unheard of at her facility. Less than a year after Timpani arrived, essentially every nurse there has been assigned to work on a day they requested off.

Barker delayed a long-planned doctor's appointment for a chronic condition after struggling to trade an assigned red day. "It feels like we're being kicked while we're already down," she says.

Before Timpani, managers typically consulted nurses well in advance when overriding their requests. With the new tool, nurses report shorter notice and more reassignments to unfamiliar teams. Appeals now go to a centralized team at HCA's Nashville headquarters with no direct communication or room to explain. Swaps succeed only about 50 percent of the time, according to Barker and Retzloff.

What does HCA say in response?

Harlow Sumerford, an HCA spokesperson, says nursing leaders—not Timpani—make final scheduling decisions. He calls assertions that the tool "is designed to reduce staffing at the expense of patient care" misrepresentative.

HCA's goal, Sumerford says, is "to have the right caregivers, with the right skills and experience, available to meet the needs of our patients while also considering our colleagues' scheduling preferences." He notes that the company continues to refine Timpani based on nurse feedback. HCA's responsible AI policy pledges to protect individuals from "physical" or "emotional" harm. Marketing materials feature nurses praising the tool as easy to use and time-saving.

What is the lawsuit about?

In July, former HCA data science manager Angelique Russell sued the company for allegedly firing her in retaliation for raising concerns about Timpani. She accused HCA of routinely deleting data the tool uses to build schedules, which she said prevented auditing and may have violated several healthcare laws. HCA has yet to formally respond in court. Russell declined to comment.

National Nurses United represents about 10,000 of HCA's roughly 100,000 nurses. Union leaders say the company has rejected their requests for information about the technology. Barker's local union of about 500 nurses at an HCA psychiatric center has filed a grievance arguing HCA is failing to honor scheduling preferences. The matter is likely headed to arbitration.

Where else is Palantir running health care tools?

Rayus Radiology, a large U.S. imaging chain, began receiving complaints earlier this year after it introduced a tool also built on Palantir Foundry to populate scheduling fields from doctors' orders. Internal documents reviewed by WIRED show the software in some cases linked requests to the wrong patient profiles, listed tests that didn't match the orders, or invented patient details. Schedulers at Rayus suspect non-standard forms, illegible handwriting, and insufficient human review contributed.

Rayus spokesperson Kit Crancer said "the broad characterizations" do not reflect its "processes, safeguards, or commitment to safe, accurate, and timely patient care." Rayus, he added, uses technology "to support, not replace, appropriate human judgment and oversight."

A Palantir spokesperson declined to comment using their name but described the company's software as merely presenting information and emphasized that customers own the data, policies, and decision-making.

Why does this matter beyond one hospital chain?

Palantir's sales have nearly doubled to almost $2 billion per quarter as organizations buy its data and automation tools. Soaring costs and staffing shortages have made health care providers especially eager customers. Cleveland Clinic credited Palantir software with boosting patient capacity by forecasting ER discharges and replacing manual coordination.

The deals have also drawn opposition. In the UK, Palantir landed a $440 million contract with the National Health Service to cut appointment wait times. Nurses and activists have demanded its cancellation over privacy and security concerns. Civil rights groups have criticized Palantir's defense and immigration work and the stated political views of cofounders Peter Thiel and Alex Karp.

At HCA, some nurses want Palantir gone. Barker claims several colleagues quit over Timpani and that workplace injuries climbed in the first 12 months with the tool. Three years after Schlosser envisioned frontline nurses actively pushing for more automation—"Then it'll be fun," he said—some see little reason to celebrate. With audits obstructed, lawsuits pending, and a union-led grievance headed to arbitration, the test of whether Timpani delivers on its promises has shifted from hospital IT departments to courtrooms and bargaining tables.