Nurses Blast Steward Health Care’s Greed: ‘It Ruins You’

Witnesses described the impact that Steward Health Care’s greed and mismanagement has had on patients and healthcare workers during a Senate Health, Education, Labor, and Pensions (HELP) Committee hearing on Thursday.

Ellen MacInnis, RN, a former Steward nurse at St. Elizabeth’s Medical Center in Boston, said she was present at hundreds of staffing and labor management meetings over the last 12 years that detailed “unsafe” and “untenable” conditions.

As a board member of the Massachusetts Nurses Association, “we represent hundreds of nurses who just sometimes struggle to come into work, to put one foot in front of another,” she said. “It ruins you.”

“The way they deliberately — and it almost feels malicious — deprived me of my colleagues, my support system, my supplies, my equipment, I’m just worn out,” MacInnis added.

According to Committee Chair Sen. Bernie Sanders (I-Vt.), multiple studies have shown that when private equity firms take over a hospital or healthcare facility, prices increase, quality declines, and workers are forced to do more with less.

Sanders called Ralph de la Torre, MD, the CEO of Dallas-based Steward Health Care “the poster child for this outrageous type of corporate greed.”

In November 2010, the global private equity firm Cerberus Capital Management bought six Massachusetts hospitals in an $895 million deal through the newly formed Steward Health Care. By 2017, it had taken over 37 hospitals in 10 states, according to the Private Equity Stakeholder Project, a nonprofit watchdog organization.

Sanders said that de la Torre loaded the hospitals with billions of dollars in debt; sold the land underneath them to Medical Properties Trust, a real estate investment group; and charged them “unsustainably high rents.”

Steward has also closed six hospitals since 2018, laid off at least 2,650 workers, and has cut vital services across hospitals, including obstetrics, behavioral health, and oncology.

In May, Steward Health Care filed for bankruptcy and announced plans to sell its more than 30 hospitals.

Meanwhile, de la Torre had spent $160 million on a yacht, two private jets, a luxury fishing boat, and a donation to an elite preparatory school.

In July, de la Torre was subpoenaed to testify before the committee during the hearing. He announced last week that he would not attend.

Understaffing Harms Patients, Overwhelms Nurses

An estimated 15 patients in Steward’s hospitals have died due to lack of medical equipment or staff, and thousands more were put in danger, Sanders said.

MacInnis, who has worked for more than 26 years at the Boston hospital, recalled the “horrific suffering” of patients caused by severe understaffing and supply shortages at Steward hospitals.

At one hospital in Brockton, Massachusetts, an 81-year-old man with pancreatic cancer died waiting for care in an emergency department that was understaffed. At another, a 28-year-old patient in an acute mental health crisis “went into distress” and died. A 39-year-old woman who had a normal childbirth then bled to death; her life might have been saved by an embolism coil used to stop serious bleeds, only the coils had been repossessed by the vendor weeks earlier.

Audra Sprague, RN, a former nurse at Nashoba Valley Medical Center in Lunenburg, Massachusetts, brought her 18-year-old son who was in diabetic ketoacidosis to her hospital. He had been newly diagnosed with type 1 diabetes and was admitted to the intensive care unit. Due to staffing shortages, he stayed in the emergency department overnight where there were 18 patients and two nurses.

No matter how hard or fast they worked, there is no way for two nurses to care for 18 patients, Sprague said. The hospital’s local leadership asked for a third nurse for night shifts, but corporate negotiators repeatedly rejected the request. So, “I had to be his nurse that night and not his mother,” Sprague said.

Other challenges persist, MacInnis added. Only one of six elevators in her building worked. Nurses were given sleds to drag immobile patients on in the event of a fire. “I’m 65 years old. Do you think for one minute I can haul a patient down a flight of stairs on a sled?” she said.

There is no nursing shortage in Massachusetts, MacInnis noted, only a shortage of nurses willing to work in unsafe conditions.

Lack of Transparency

Staci Albritton Mitchell, mayor of West Monroe, Louisiana, described the impossible situation that state officials found themselves in after investigating Glenwood Regional Medical Center there.

Even as a hospital board member, Mitchell was kept in the dark about Glenwood’s financial problems. “It was always presented that Glenwood was profitable,” she said.

In the summer of 2023, rumors about local vendors not being paid surfaced, but it wasn’t until the fall that the gravity of the situation was realized. “And then all of a sudden … we were in immediate jeopardy,” Mitchell said.

In written testimony, Louisiana State Rep. Michael Charles Echols (R) noted that “this is how both private equity and these facilities get away … with these schemes, because they put your facility in jeopardy. They shut them down, [and then] your community has nothing. So they suffer even more.”

Then, they demand “bailout money” from politicians, which in itself is criminal, he argued.

He urged the committee to hold de la Torre accountable. “Put him in jail, because that’s where he deserves to be for stealing this money from all of our communities.”

He added that Medical Properties Trust, the real estate investment group, should also be held accountable, noting that they operated a “Ponzi-like scheme,” moving billions of dollars through private equity and transforming healthcare systems into “criminal enterprises.”

If nothing is done to stop these groups from funding “other bad actors,” someone else will take Steward’s place, Echols said, calling for new federal legislation or increased oversight to rebalance the industry.

In August, Steward said it entered into a “definitive agreement” to sell its Stewardship Health business — which includes about 5,000 physicians in Massachusetts and nine other states treating about 400,000 patients — to Rural Healthcare Group, an affiliate of Kinderhook Industries LLC, a private equity firm.

The HELP Committee will meet to discuss a contempt resolution for de la Torre on September 19.

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