Ascension (healthcare system)

In April 2016, a class-action lawsuit was brought in federal court, alleging that Ascension subsidiary Wheaton Franciscan Services (in Glendale, Wisconsin), erred by treating its pension plan as though it was a "church plan," exempt from the Employee Retirement Income Security Act ("ERISA"), a federal law governing employee pensions. In January, 2018, the parties announced a settlement, in which Ascension would pay $29.5 million to the plaintiffs.[18][19]

In February 2020, a jury awarded obstetrician/gynecologist Rebecca Denman, M.D., $4.75 million in damages by an Indiana jury, after suing Ascension's St. Vincent Carmel Hospital and its St. Vincent Medical Group for defamation and fraud. The lawsuit arose from a December 2017 incident, in which Denman was accused of smelling like alcohol while on duty. Denman contended that she had been cheated out of the due process, as provided in the company substance-abuse policy, depriving her of a chance to establish her innocence, and retain her position.[20][21]

In 2018, Ascension hospitals abruptly stopped performing tubal ligations and vasectomies, as part of the nonprofit's Catholic belief that all birth control is immoral. Some patients reported not having been informed by Ascension hospitals that their planned tubal ligation or vasectomy was canceled.[22]

This greatly increased costs and risks for those who give birth in an Ascension hospital and then seek permanent birth control, as they must schedule a follow-up surgery rather than having the customary option of having a tubal ligation immediately follow a Caesarean section birth.[23][24]

The ACLU of Michigan has filed multiple complaints against Ascension regarding its practices surrounding birth control, including in 2021 in Michigan when a pregnant woman was denied a tubal ligation post-birth even though the woman's life would be at risk if she were to get pregnant again.[25]

The Wall Street Journal reported on a collaboration between Ascension and Google in 2019 to share health information about its patients with the technology company. Known as Project Nightingale, the stated purpose of the collaboration was to make it easier for physicians to access and search their patient records.[26] The partnership drew criticism over privacy concerns and the potential for violations of the Health Insurance Portability and Accountability Act, and the U.S. Department of Health and Human Services opened an investigation into the project in 2020.[27][28] Cason Schmit, a professor of public health at Texas A&M University, noted that the Nightingale Project could improve health outcomes, especially by gathering data from minorities that are underrepresented in clinical studies, but also raised the lack of a patient opt-out and the Project's unclear transparency and accountability processes as concerns.[29]

In 2021, Stat News reported that Ascension, despite its ostensible mission to prioritize serving the poor,[30] was unusually operating a multi-bllion-dollar private equity fund similar to moneymaking operations on Wall Street.[31] The fund was set up in 2015 in partnership with a firm called TowerBrook Capital Partners, a spin-off of a George Soros-founded firm.

In reaction to this news and other issues reported within Ascension, Democratic U.S. Senator Tammy Baldwin of Wisconsin issued a statement, saying “As a nonprofit, tax-exempt, health system, Ascension is required to provide charitable benefits to the community and operate solely to serve a public, rather than a private interest. Despite these requirements, Ascension has significant for-profit investment activities that dwarf what the system provides in annual charity care.”[32]

A professor of accounting and health policy at Johns Hopkins University, Ge Bai, called Ascension's operation of such a massive fund "aggressive and controversial," noting that "it is not clear how those investment incomes or returns are aligned with Ascension’s charitable mission."[33]

In April 2021, minority shareholders in the medical revenue cycle management company R1 RCM sued Ascension and TowerBrook, accusing them "of teaming up to extract $105 million years before they were supposed to."[34] In October 2023, it was reported that "Ascension Health Alliance and TowerBrook Capital Partners LP will shoulder most of a $45.4 million settlement ending shareholder litigation over their deal to unlock long-term investments in medical billing company R1 RCM Inc."[35]

For several years, the highest paid CEO of any nonprofit in the United States were the CEOs of Ascension Health, Anthony Tersigni and later Joseph Impicciche, who was typically compensated with more than $10 million in earnings per year in the 2010s. Other executives were making millions of dollars a year in direct compensation from the nonprofit.

Reporting of this led to condemnation, as Democratic Wisconsin State Senator Chris Larson called Ascension “a profit machine that punishes the sick and rewards the greedy.”[36] U.S. Senator Tammy Baldwin also wrote an open letter to the hospital, stating "As a nonprofit, tax-exempt, health system, Ascension is required to provide charitable benefits to the community … 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."[37][38]

Two higher-ups in the organization left the healthcare side of the operation in 2019 to lead its investment side of operations, thus earning more income while effectively keeping the same employer.[39]

Near the beginning of the coronavirus pandemic in March 2020, several Ascension-owned hospitals in Wisconsin informed uninsured patients they would not be charged for testing or treatment of COVID-19.[40] Ascension drew considerable criticism for receiving over $211 million in government bailout relief payments despite having $15.5 billion in cash reserves—enough to operate for eight months. Ascension spokespersons responded by saying the payments were justified as the company had not laid-off or furloughed employees during the pandemic.[41]

In December 2022, a multi-part New York Times investigation was published that alleged Ascension was caught "flat-footed" by the COVID-19 pandemic because the health care system had been significantly cutting jobs of nurses and aides prior to spring of 2020, greatly boosting profits in exchange for diminished patient care while adding to an ongoing crisis of nurses leaving the field. The Times reported that, "As recently as 2019, Ascension was trumpeting its success at reducing its number of employees per occupied bed, a common industry staffing metric. At one point, executives boasted to their peers about how they had slashed $500 million from the chain’s labor costs ... During surges in the coronavirus, Ascension repeatedly reduced its capacity by more than 500 beds nationwide because it did not have enough workers." Nurses increasingly were called on to work 16 hour shifts, and in some places hospital aides' jobs were replaced by robotics.[42] This led to nurses and doctors filing hundreds of complaints in 2020, 2021 and 2022, many of them warning that preventable deaths would occur or were occurring because of their lack of capacity to sufficiently care for every patient.

The hospital chain said that it began cutting costs in labor after the passage of the Affordable Care Act, turning an anticipated $5.2 billion loss to $2.7 in profits over a five-year span. The nonprofit continue cutting jobs even after the healthcare market destabilized.[43] Milwaukee Magazine described "chaos" at one Milwaukee hospital, with doctors and other medical staff saying that Ascension's employment decisions were creating unsafe environments for their patients, in part because surgeries were being repeatedly delayed because of limited staff, there not being enough workers on site to answer phones, and doctors fielding phone calls while simultaneously performing surgeries.[44]

In December 2022, unionized health care workers and residents in Milwaukee unsuccessfully protested[45] in opposition to the closure of an urban Ascension-run labor and delivery unit at Columbia St. Mary's Hospital. Ascension claimed the closure was due to a lack of demand in the area because of falling birth rates, although there had previously been "an exodus (of) doctors from Columbia St. Mary's birthing unit."[37]

Also in December 2022, the Wall Street Journal reported that "Of hospitals divested or closed by St. Louis-based Ascension, about half were located in higher-poverty areas."[46]