The New York Times reports on how Ascension, a non-profit hospital chain operating in 16 states and serving millions of patients a year, created its own staffing crisis while building an $18 billion reserve and paying its CEO $13 million in 2021. The for-profit hospital chains are behaving no better and could be worse. What’s going on?
Most hospitals in the US are non-profit. They don’t pay taxes. In exchange, they are supposed to offer charity care and community assistance. But, many are not providing the charitable services expected of them. Staffing is inadequate, often at the poorest hospitals, and charity care is hard to come by.
Ascension operates 139 hospitals. It has been cutting its staff for several years now. Even though it’s a non-profit hospital system, its executives worked to improve its “profits.” Consequently, patients at some of its hospitals have needed to wait a day just for a hospital bed, and the ratio of patients to aides at one of its hospitals was 32 to one!
Ascension executives used to boast about its staff-cutting, reducing labor costs by $500 million. Despite thousands of complaints from nurses about understaffing, executives refused to hire more staff. Sometimes, nurses were not available to clean or turn patients who were bed-bound or to treat their open wounds.
When the pandemic hit, Ascension was unprepared. It could not take all the patients that needed care. More than a thousand nurse positions were vacant. Emergency rooms were not equipped.
Ascension is not alone among non-profit hospital systems in its desire to limit labor costs in an extreme way. It is one among many non-profit hospital systems that have turned their backs on patient care. The New York Times reports that Providence hospital system also cut staffing significantly, as has CommonSpirit Health, forcing patients to wait extended periods to get needed care.
The New York Times investigation focused on two Ascension hospitals that nurses reported put patient safety at risk. Nurses complained formally day after day to no avail. Independent health inspectors cited Ascension for failing to care for patients with bed sores appropriately. At the same time, Ascension’s former CEO was earning $11 million a year to run Ascension’s investment division.
To keep costs down, Ascension executives gave CEOs at its hospitals financial goals. If they could not meet them, they would not receive bonuses. At the same time, Ascension tried to keep Illinois and Michigan legislators from setting nursing to patient ratios at hospitals. Needless to say, staffing levels at Ascension hospitals were often inadequate to meet patient needs; surgeries needed to be delayed and ambulances could not bring patients to the Ascension hospitals because there was not enough staff to treat them.
Ascension went so far as to replace staff at dozens of its hospitals with 450 “telesitters,” robots with video cameras monitored off-site. Off-site staff speak to patients through the telesitters. To make up for inadequate staffing levels, Ascension often expected nurses to work 16 hour shifts and care for more patients than permissible under their contracts.
No one knows how many patients are dying needlessly as a result of Ascension’s cost-cutting and inadequate staffing levels. Why would Ascension keep track? Are Ascension’s executives looking to sell out to a private equity firm? My bet is that the executives are planning for Ascension to convert to for-profit status and expecting a whopping payout.
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