Oregon’s largest healthcare union is asking a state regulatory agency to block Providence’s plan to outsource management of its in-home care and hospice program to a private equity-backed company.
In its proposed joint venture with Compassus, Providence would retain a 50% stake in its home health and hospice operations. The Oregon Health Authority determined the proposed transaction required a comprehensive review on April 18. Since 2022, OHA has had the power to review and reject proposed healthcare mergers. Oregon Nurses Association (ONA) is calling on OHA to block the proposed deal — or at least impose conditions on the transaction.
ONA represents roughly 560 nurses and other providers working for Providence Home Health and Hospice in the Portland and Salem areas.
Providence is the largest provider of in-home health and hospice services in Oregon.
Providence Home Health and Hospice employs nurses and aides, a wound care nursing team, occupational and physical therapists, speech language pathologists, social workers, bereavement counselors, and massage therapists, among others.
Kara Hayden, bargaining committee vice chair at Providence Home Health and Hospice, fears that if a for-profit company like Compassus takes over operations, the new management will whittle down services to the bare minimum.
“We don’t have a crystal ball, but we can look at what private equity has done in other sectors,” Hayden said.
Hayden is one of three speech language pathologists on a team that helps patients with degenerative diseases like ALS or Parkinson’s use technology — from call alert buttons to complex eye tracking machines — to communicate as their verbal abilities deteriorate.
In 2024, Providence closed its 11-nurse Home Health Palliative Care program and its two-person remote monitoring program — and announced plans to cut Hayden’s team, but abandoned that plan after backlash.
Compassus and Providence say they want to expand services, but ONA wants more assurances.
“You can say that you’re going to expand access, but are you just putting a Band-Aid on things and going shallow and wide across more communities? Or are you providing good quality, deep services that actually address patients’ and families’ needs?” Hayden said.
The proposed partnership with Compassus extends to Providence operations in Oregon, Washington, California, Alaska, and Texas. The transactions in Washington, Texas, and Alaska had closed as of March.
As of May 5, OHA had received more than 130 public comments concerning the transaction, with the vast majority opposed to the deal. OHA has until Sept. 1 to complete its comprehensive review.
If OHA doesn’t reject the deal, ONA is asking the state to at least impose conditions, like prohibiting the new entity from switching to a pay-per-visit model, for at least five years. Compassus uses a pay-per-visit model in other states. ONA spokesperson Myrna Jensen said Oregon already banned pay-per-visit for nurses in home health and hospice because it pressures nurses to rush through appointments. But pay-per-visit is legal for other disciplines, like physical therapists.
ONA wants the state to enforce other conditions, including prohibiting the new entity from denying patients treatment because of their diagnosis or reducing visits in any region or specialty for at least five years.
