U.S. Sen. Tammy Baldwin on Monday called on Ascension Health to invest some of its billions in cash into struggling hospitals in Milwaukee and questioned whether the national health system was putting its bottom line before patients.
In a letter to Ascension chief executive Joseph Impicciche, Baldwin, D-Wisconsin, wrote that she is concerned Ascension Health, based in St. Louis, Missouri, is not putting the money it earns from investments back into hospitals in Wisconsin, some of which are struggling with severe staffing challenges.
“In fact, I am concerned that the opposite is occurring – that by operating like a private equity fund, Ascension is squeezing staff, closing facilities and extracting cash from its member hospitals for dubious ‘management fees’ all to advance its investment activities and provide compensation to its executives,” she wrote, referring to multimillion-dollar fees that Ascension charges its hospitals.
The letter comes as Ascension is under fire from health care professionals, patients and regulators for staffing and patient care concerns at Milwaukee-area hospitals.
The Milwaukee Journal Sentinel and Milwaukee Magazine separately have reported on staffing shortages at Ascension Columbia St. Mary’s Hospital in Milwaukee that have resulted in disruptions to patient care, long wait times in the emergency department, delayed surgeries and staff concerns about patient safety.
The Journal Sentinel’s reporting found that nurses at Columbia St. Mary’s were often assigned more patients than they considered realistic, or even safe. Nurses interviewed by the Journal Sentinel also complained about a lack of nursing aides. Without more help, nurses were at times slow to answer patients’ calls for help. Overstretched nurses spent less time with individual patients and worried they might miss something that could result in a medical emergency.
State regulators recently opened an investigation into a complaint filed by the widow of a Milwaukee high school principal, Keith Carrington, who died of septic shock in August while hospitalized and recovering from a surgery at Columbia St. Mary’s.
Baldwin’s letter also comes after Ascension St. Francis Hospital abruptly closed its labor and delivery unit in December, the only such unit on Milwaukee’s south side, which drew criticism from the surrounding, largely immigrant community.
Ascension reports $900 million loss, $18 billion in cash reserves
Many hospitals have reported financial losses in the last year, driven in part by inflation and increased labor costs. Ascension, a nonprofit that operates hospitals and health care sites across 19 states, reported nearly $900 million in operating losses in its last fiscal year. The health system has reported trying to bring down labor costs by relying less on staffing agencies that provide nurses and other health care workers on a temporary basis at high rates of pay.
At the same time, the health system reported having nearly $18 billion in cash reserves in its latest quarterly filing. In her letter, Baldwin called on Ascension to reinvest that money in hospitals that serve vulnerable communities and to increase pay and improve working conditions for its “burned out and overextended health care workforce.”
“Ascension’s hospitals in Wisconsin have struggled to maintain basic services and are putting patients at risk by not having enough nurses or support staff to provide care,” she wrote.
Nonprofit status called into question
Baldwin also questioned whether the health system was living up to its obligations as a nonprofit organization that is tax-exempt.
“Cutting essential service lines, charging excessive fees, shuttering hospitals in high-need areas, reducing staff to unsafe levels, and suing patients that cannot pay their bills does not serve the community. It serves only your bottom line,” she wrote.
Ascension Health, which has hospitals and health care sites across 19 states, has been found to charge its hospitals management fees that can be in the tens of millions of dollars per year, fees that critics question as opaque and potentially excessive.
A 2018 investigation by Washington, D.C.’s attorney general into fees Ascension charged a hospital in the district found that some fees were “likely excessive.” In response, Ascension forgave $130 million in debt the hospital owed the health system.
Baldwin requested that Ascension provide a list of all management fees charged to Columbia St. Mary’s and to St. Francis. Among other things, she also asked for information about Ascension’s investments and details about how investment returns were used to provide charity care.
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This article originally appeared on Milwaukee Journal Sentinel: Sen. Baldwin calls on Ascension to help struggling Milwaukee hospitals