Last week, the U.S. Senate’s Health, Education, Labor, and Pensions (HELP) Committee held a hearing for which it had subpoenaed Steward Health’s CEO, Ralph de la Torre. However, Mr. de la Torre’s lawyers sent a letter to the Committee refusing to attend (potentially earning a Contempt of Congress charge). Despite this, the HELP Committee decided to proceed with the hearing, inviting a panel of former Steward employees and leaders from the private equity-backed, for-profit system. During the hearing, legislators highlighted the need to increase oversight of private equity within the health care sector and bolster workforce safety.

Private Equity Oversight

Several senators on the panel recalled anecdotal evidence of worsening patient outcomes in Private Equity (PE)-owned facilities. Recently, the Journal of the American Medical Association (JAMA) published a study which found that the rates of adverse patient events in PE-owned facilities increased by 25% when compared to non-PE-owned facilities.

While there is no current federal legislation that would impact PE health care investments, federal agencies have been working to gather data on the investments being made. Last year, CMS finalized rules instituting public reporting of PE and other investor relationships and early this year, several agencies released a Request for Information (RFI) on the increasing investments from PE and other corporations in the health care sector.

Workforce Safety

When asked what can be done to address nursing shortages, Ellen MacInnis, a former nurse at Steward Health, said, “We need legislation. We need safe patient staffing legislation. We need safe patient handling legislation […] and we need safe environment legislation that would make it a crime to harm a medical worker.” She quipped that there is no nursing shortage; instead, there’s a shortage of nurses who want to work in unsafe situations.

While several pieces of legislation before the 118th Congress seek to establish nurse staffing ratios, none have made any progress. CMS established nurse staffing ratios through rulemaking for skilled nursing facilities but that ruling is being legally challenged. Congress also has multiple bills to address violence against health care workers, including the SAVE Act (H.R. 2584/S. 2768), but with the upcoming federal funding deadlines and the national elections, Congress is not expected to pass anything beyond what is absolutely necessary.