(RNS) — One of the largest Catholic health care systems in the U.S. will likely have to pay 33,000 of its Washington state employees more than $200 million after a Seattle jury found on April 18 that the system had illegally underpaid workers for years by rounding down their compensated hours and denying meal breaks that were nonetheless deducted from their time sheets.

The verdict, the latest in a series of legal troubles for Providence Health & Services, is part of a broader pattern of Catholic hospitals being accused of undermining their mission by shortchanging patients and staff. 

Two lead plaintiffs, a certified nursing assistant and an ultrasound tech, filed the class-action suit in 2021 against Providence, which operates 51 hospitals throughout the western U.S.

The jury awarded Providence hourly employees in Washington about $98 million in damages, but King County Superior Court Judge Averil Rothrock, finding that the violations were willful, doubled the total, following state law, with interest.

Providence did not respond to multiple requests for comment by Religion News Service, but in an emailed statement to The Seattle Times and Fierce Healthcare, the health system indicated that it intends to appeal the decision.

Monsignor Robert Siler, the episcopal vicar and chancellor in the Diocese of Yakima, told RNS by email that the diocese was limiting its comments due to Providence’s appeal but said that “overall we believe Providence cares deeply for its employees” and noted that Providence’s employees benefit from “robust union representation.”

“Given the many challenges facing Catholic health care, we pray for a just outcome, and a continued focus by both labor and management on Providence’s mission to serve everyone, especially the poor and vulnerable,” Siler wrote.

The Archdiocese of Seattle and the Diocese of Spokane did not respond to multiple requests for comment.

The president of SEIU Healthcare 1199NW, a union representing 8,000 health care workers at Swedish Providence, Kadlec Regional Medical Center and Providence St. Peter Hospital, told RNS in an emailed statement that the union is “elated by the legal victory achieved by these workers.”

While the union was not involved in bringing the class-action suit, Jane Hopkins, the president and a registered nurse, said that the union has fought for recent laws on overtime, breaks and staffing because “we’ve watched multibillion-dollar healthcare corporations like Providence prioritize profits above the well-being of their workers.” 

Hopkins said the class-action suit “demonstrates the need for persistent enforcement.”

Providence has also faced scrutiny from attorneys general in Washington and Oregon around its charity care practices. 

In February, the system agreed to repay or forgive about $158 million in medical bills to nearly 100,000 patients who likely qualified for free or reduced-cost charity care. Washington Attorney General Bob Ferguson had filed the suit two years ago alleging that “Providence trained staff to aggressively ask for payment from patients who were likely eligible for financial assistance, or simply billed them without determining if they qualified.” 

Ferguson also said that “In thousands of cases, Providence knowingly sent low-income patients — including Medicaid enrollees — to debt collectors.”

In September 2022, The New York Times found that Providence had relied on consulting firm McKinsey & Co. to create an aggressive strategy to press patients, even those with very low incomes who ought to have qualified for financial aid, to pay their medical bills, sometimes asking them to pay at the bedside and sending repeated bills before sending the cases to collections, resulting in drastic financial consequences such as depriving the patients of heat in their homes.

In Oregon, where Attorney General Ellen Rosenblum is investigating the health system’s charity care practices, she asked a state judge to force Providence to turn over documents in her investigation, which the health care system has called “highly burdensome.” 

Shortly after last week’s wage violation verdict, about 500 technicians represented by the United Food and Commercial Workers International Union 3000 at Providence Sacred Heart Medical Center in Spokane began a strike scheduled to last more than a week because of what the union says are unfair labor practices during contract negotiations.

“Ethical and Religious Directives for Catholic Health Care Services,” a document created by the U.S. Catholic bishops with “authoritative guidance” for Catholic health care, stipulates that a “Catholic health care institution must treat its employees respectfully and justly,” including providing “just compensation and benefits.”

While Catholic bishops have devoted time and attention to enforcing the directives’ guidance on abortion and creating new guidance on transgender health care, they have rarely publicly spoken up when Catholic health systems have been accused of mistreating their employees or failing poor patients.

In January, a nurses’ union report raised concerns that another Catholic health giant, Ascension, was closing labor and delivery units at higher rates than all U.S. hospitals, with closures in poorer neighborhoods and Black and Latino communities. More than 15 U.S. Catholic bishops did not respond or declined requests for comment on that report from RNS.