Nurse & Caregiver Concerns

Swedish Surgery Scandal Swedish Surgery Scandal

Swedish Surgery Scandal

“…the aggressive pursuit of more patients, more surgeries and more dollars has undermined Providence’s values – rooted in the nonprofit’s founding as a humble home where nuns served the poor – and placed patient care in jeopardy.”  – Seattle Times February 10, 20176

Swedish Medical Center in Seattle was the center of a scandal in which neurosurgeons were receiving financial incentives to dramatically increase the number of brain and spine surgeries to dangerous levels, including double-booking surgeries. The Seattle Times reported that these hazardous and unsafe practices led to severe, painful complications for many patients and the death of a young woman.7

Investigations by the FBI, Department of Health and Centers for Medicare and Medicaid Services (CMS) led to the resignations of the chief neurosurgeon and the CEO of Swedish8.

Providence executives do not seem to have learned from this experience, and recently they announced cuts to 540 crucial staff, including in the neurosurgery department.9  

Investigators find ‘numerous’ issues related to patient safety at Swedish’s Cherry Hill site
Seattle Times
August 10, 2017

Swedish surgeons were double-booked, and patients didn’t know 
Seattle Times
May 28, 2017

Nurses push to remedy ‘dangerous’ staffing, including ongoing issues at Swedish
Seattle Times
March 26, 2017

U.S. Attorney’s Office launches investigation of Swedish neurosurgery unit
Seattle Times
March 15, 2017

State regulators investigating Swedish’s Cherry Hill hospital, top surgeon
Seattle Times
February 16, 2017

The O.R. Factory: High Volume. Big Dollars. Rising Tension.
Seattle Times
February 10, 2017

A Lost Voice: Surgery was supposed to mean a better life for Talia. But something went wrong.
Seattle Times
February 10, 2017

  1. https://projects.seattletimes.com/2017/quantity-of-care/hospital/
  2. https://projects.seattletimes.com/2017/quantity-of-care/talia/
  3. February 16th, 2017: https://www.seattletimes.com/seattle-news/state-regulators-to-investigate-cherry-hill-hospital-top-surgeon/
  4. https://www.seattletimes.com/business/swedish-cuts-550-jobs-as-part-of-ongoing-reorganization/
Care Problems Care Problems

Care Problems

While FBI and Department of Health investigations of the surgery scandal at Providence’s Swedish Medical Center were ongoing, Providence caregivers in many other facilities were raising alarms about issues with the safety and quality of patient care:

  • Doctors at Providence St. Patrick Hospital in Montana voted “no confidence” in executives who were not listening to their concerns:

St. Pat’s medical staff vote no confidence in ‘decapitated’ leadership
The Missoulian
March 15, 2017

“‘There is, in fact, widespread fear of retaliation and retribution within our physician community,” said the doctor, who requested anonymity because of those fears, but whose speech was obtained and verified by the Missoulian. ‘…There is now a culture of fear and intimidation which is obviously inconsistent with the mission and values of Providence.’”

  • In December 2017, nurses and healthcare workers at all of Providence’s Swedish campuses also voted “no confidence” in executives around patient care concerns, following the submission of Swedish-wide complaints to the Department of Health, resulting in investigations.

Swedish Health nurses and caregivers vote no confidence in leadership
Seattle Times
Dec. 12, 2017

Driving Up Costs Driving Up Costs

Driving Up Costs

There are many indications that Providence St. Joseph Health could be driving up the cost of healthcare for patients, including:

  • Kadlec Regional Medical Center in Richland, Washington brings in more revenue per unit of care than any other hospital of similar size in Central and Eastern Washington.10 In just one full year following Providence’s acquisition of Kadlec, the medical center has seen a 17% increase in revenue per unit of care.
  • The Washington State Attorney General brought a lawsuit against Providence and Swedish Medical Center because they did not notify patients that their lab testing was out-of-network, thereby burdening more than 60,000 patients with up to $7,000 of unexpected charges each. 11 

Providence, Swedish To Pay $1.4M For Failing To Inform Patients About Out-Of-Network Lab Testing Charges 
Washington State Attorney General’s Office
March 29, 2018

  1. Washington Department of Health End of Year Financial reports for fiscal year 2016 and Washington Department of Health Volume report for fiscal year 2016.
  2. August 16 th , 2018: https://www.beckershospitalreview.com/legal-regulatory-issues/providence-health-accused-of-188-1m-upcoding-scheme-6-things-to-know.html
Conflicts of Interest Conflicts of Interest

Conflicts of Interest

David Sabey, President of the Sabey Corporation, is a co-chair of “The Campaign for Swedish” fundraising effort, which asks people to donate money to Swedish. Sabey is also the landlord of Swedish Health Systems’ Cherry Hill campus, collecting millions of dollars a year in rent from Swedish.

As the Seattle Times warned, “While it’s common for hospitals to have close relationships with their top benefactors, prominent experts in nonprofit and health-care law say the Swedish-Sabey alliance has developed an unusual interdependence, setting up potential conflicts and pitfalls that some organizations work to avoid.

“‘I’ve never heard of something like this,’ said Ann Bittinger, a Florida-based lawyer who specializes in business transactions for health-care organizations. ‘It’s weird.’

“Sabey’s company has collected millions of dollars in annual rent from Swedish and embarked on a for-profit venture with its parent organization. He has helped connect device companies with surgeons and propelled a contentious plan for taller buildings in the campus neighborhood where his business now owns $150 million in real estate.”

Swedish Health’s ambitious Seattle plans involved a developer with a stake in their success 
Seattle Times
December 14, 2017

Unaffordable Healthcare Unaffordable Healthcare

Unaffordable Healthcare

It is a sad irony that, even though Providence healthcare workers have dedicated their lives to providing quality care to patients in our communities, they often cannot afford healthcare for themselves and their children:

  • Many Providence healthcare workers have deductibles as high as $1,500 for an individual and $3,000 for families. This means that employees are paying thousands of dollars out of pocket to go to the doctor before their insurance kicks in. These deductibles are larger than many employees’ entire paychecks.15
  • Even after employees pay enough money out of pocket to fulfill their deductibles, many still have to pay Providence other high fees for their healthcare.16
  • If healthcare workers don’t pay up quickly enough, Providence St. Joseph Health has subjected some of their own employees to aggressive repayment collection.
  • Some Providence healthcare workers are not offered any health insurance at all, and 3,000 Providence workers and their children have been forced to rely on Medicaid, costing Washington taxpayers $8.9 million in 2017.17
  1. Employer provided Providence Summary Plan Descriptions
  2. Employer provided Providence Summary Plan Descriptions
  3. Employment Status: Apple Health Care Clients and Non-Client Individuals with Dependents Who are Apple Health Care Clients
    https://www.hca.wa.gov/assets/eshb-3079-employment-status-apple-health-clients-11-15-17.pdf
Staffing Cuts Staffing Cuts

Staffing Cuts

In September of 2018, Providence’s Swedish Health System in Seattle announced 540 staffing cuts14, including vital Labor and Delivery nurses for mothers giving birth. This means that most mothers in the crucial first stages of labor will not receive one-on-one care from a nurse.

Providence St. Joseph Health is also closing a special care nursery in Ballard, Washington and slashing staff throughout other states, leading to what some healthcare workers warn is a “staffing crisis”:

Swedish Health cuts 550 jobs as part of ongoing reorganization
Seattle Times
September 12, 2018

St. Joseph Health lays off dozens of employees in Humboldt, chief executive responds 
ABC News Channel 7, California
September 13, 2018

Providence plans aggressive cost-cutting, layoffs, amid health care high anxiety
The Oregonian
July 10, 2017

  1. https://www.bizjournals.com/seattle/news/2018/09/12/swedish-health-services-job-cuts-layoffs.html
Poverty Wages Poverty Wages

Poverty Wages

Despite Providence’s repeated claims in marketing materials that its chief concern is for the poor, thousands of Providence employees are paid so little that they and their children need to rely on Medicaid.

Providence St. Joseph Health ranked 7th highest out of all Washington corporations for the number of employees and dependents on Medicaid in 2016 and 2017. In each of these years, 3,000 Providence employees and dependents were forced to rely on the state’s Medicaid program.  

Providence’s CEO makes over $4 million a year and the corporation is raking in $23 billion a year in revenue. But Washington taxpayers were forced to pay $8.9 million dollars in just one year because many Providence employees have to rely on Medicaid for their family’s healthcare.13

How does this align with Providence’s core values of Compassion, Dignity, Justice, Excellence and Integrity?

  1.  Employment Status: Apple Health Care Clients and Non-Client Individuals with Dependents Who are Apple Health Care Clients
    https://www.hca.wa.gov/assets/eshb-3079-employment-status-apple-health-clients-11-15-17.pdf
Medicare Fraud Lawsuit Medicare Fraud Lawsuit

Medicare Fraud Lawsuit

The entire Providence system, including Swedish Medical Center in Seattle, is facing a lawsuit for allegedly overbilling Medicare by more than $188 million. Integra Med Analytics, a data analysis firm, says that Providence has been falsely inflating its billing by creating “a culture throughout Providence that promoted increasing Medicare billing without regard for accuracy.”

According to an article in Modern Healthcare: “The lawsuit…claims Providence, with the help of an outside consultant, pushed physicians to add secondary diagnoses when documenting treatment so the health system could qualify for higher Medicare reimbursement… Physicians allegedly received a kickback if they complied with the requests.”

Providence Health sued over alleged $188 million Medicare upcoding scheme 
Modern Healthcare
August 15, 2018

Read the Medicare overbilling fraud lawsuit against Providence 

Union Busting Union Busting

Union Busting

Breaking Federal Labor Law

In the last two years, federal prosecutors have charged Providence with breaking the law multiple times by violating nurses’ and caregivers’ rights under the National Labor Relations Act. Union busting goes against the core social justice teachings of the Catholic Church, and is yet another indicator that Providence has lost its way. Providence’s illegal acts include:

Providence Hospice and Homecare of Snohomish County

The federal government found Providence Hospice & Home Care of Snohomish County committed several unlawful acts during contract negotiations. Among other violations, the National Labor Relations Board prosecutor determined that management illegally implemented a policy that resulted in fewer work hours for employees, barred union members from being at work during non-work hours, made coercive and disparaging comments about the union, and refused to provide the union with information about medical benefits that was necessary for negotiations. Management had to remedy its unlawful acts by paying back wages to workers affected by the policy, rescinding changes not negotiated with the union, providing withheld medical benefits information, and posting a notice affirming workers’ union rights.

Providence’s Swedish Medical Center

At Providence’s Swedish Medical Center, the National Labor Relations Board prosecutor found that Swedish management had illegally terminated a social worker for her union activity, changed emergency department schedules without negotiating with the workers’ union, and implemented other changes to staffing and scheduling without first negotiating with the union. Firing union supporters is an illegal tactic to discourage workers from exercising their rights. Making unilateral changes in working conditions without bargaining is also illegal because it sends a false message to workers that unionization is futile: they will never have a voice at work. The federal government ordered Swedish to make the terminated worker whole, rescind changes that were not negotiated with the workers’ union, and post a notice affirming workers’ union rights.

Providence St. Peter Hospital

The federal government has charged Providence St. Peter’s Hospital with violating workers’ rights and failing to negotiate before making unilateral changes. The charges alleged that Providence management unlawfully retaliated and discriminated against a worker for her union activity. In the other case, management illegally withheld information about workers’ medical benefits, which obstructed fair negotiations.

Ideological Opposition to Unions: Refusing to Reach a First Contact

By using illegal union-busting tactics, Providence demonstrates its ideological opposition to healthcare workers having a union voice to improve the care they provide and the standard of living for their families. Its refusal to bargain in good faith for first contracts is a common tactic by unethical, anti-worker employers. Stalling for years to reach a first contract after workers vote to form a union can defeat unionization through turnover, burnout and demoralization. Providence is very healthy financially and has the resources to address workers’ concerns around safe staffing and fair wages, and provide the same standards it has in place around Washington state. However, Providence executives have refused to negotiate a fair contract with caregivers and instead chosen to waste resources on anti-union campaigns with high priced lawyers that take the focus off of delivering quality patient care.

Tell Your Story

Do you have an experience – as a patient, employee or community member – of how Providence has lost its way and is not adhering to the original core values? We want to hear your story and will keep it confidential, please fill out the form below: