Tenet is unethical-hit with 2 fines over about 15 years-one for about 800 million and the most recent one at around 400 million for kickbacks, etc. I have realized that the hospital is fading, loosing its luster. In a very competitive environment San Ramon falls behind so many. Its relying upon the past, cost cutting to survive. It does not plan for the future, provide motivation-its just a day to day negative; very negative environment. How can we cut should be the mission statement. Corporate Tenet in all their wisdom came from Texas and cut " the nice coffee cups" in the cafeteria and I believe the chocolate cake.....no kidding. The rooms and equipment are old, carpets dirty, leaks in the roof-. I could go on , but I will not. Poor wages compared to many others, poor night shift differential.