“It ruins you”

Steward's singular priority of making money caused "horrific suffering and harm to our patients, the people who take care of our patients, and our communities," MacInnis said. The biggest problem was chronic and severe understaffing. She described people seeking care at Steward emergency departments, only to have to wait hours to days for care, some dying before nurses were able to get to them. For instance, an 81-year-old pancreatic cancer patient went to a Steward hospital for his chemotherapy, but "by the time staff got to him, he was dead," she said. There were 95 patients in the emergency department on that shift, but only 11 nurses, a patient-to-nurse ratio more than double what's recommended. In another example, a 28-year-old went to an emergency department with an acute mental health crisis, but there was no one there to provide the close monitoring he needed. "When he went into distress, nobody was there to rescue him, and he's dead."

She also spoke of supply shortages, credit holds keeping supplies from being delivered, and unmaintained equipment, such as IV pumps and computers with only seconds of battery life. Of the six elevators in the building where she worked, only one functioned. In the event of a fire, MacInnis, a 65-year-old, would have been responsible for pulling patients down a stairway on a sled.

When she worked in the emergency department, she said there were several nights when they didn't have diapers, Similac formula, or Pedialyte, and nurses had to run out to 24-hour stores to buy them themselves. The hospital on occasion also ran out of food. "I personally have given my dinner, my meals to patients, and staff has chipped in and sent out and had food brought in for patients."

The hospital also ran out of bereavement boxes used to transport the bodies of dead infants to the morgue. "Steward didn't pay the vendor, and there weren't any bereavement boxes, and nurses were forced to put babies' remains in cardboard shipping boxes," she said, holding back tears. Nurses again chipped in and bought bereavement boxes off Amazon themselves.

Later in the hearing, she spoke of the emotional toll and moral injuries of working as a nurse in these conditions. "It ruins you," she said.

“Health care terrorists”

Audra Sprague, a former nurse at Nashoba Valley Medical Center in Lunenburg, Massachusetts, spoke of similar scenarios. Steward "systematically extracted every possible dollar that they could get out of our hospital, until it led to its closure 12 days ago, on August 31, 2024." Sprague noted subpar equipment and basic things like beds falling into disrepair. "By the time we closed, we probably had around 18 to 20 working beds," out of 57 medical beds the facility was licensed to have. Still, with Nashoba's closure, local residents now face lengthy travel times to overwhelmed neighboring facilities that lack the capacity to care for the additional patients.

Rep. Michael Echols (R-La.) testified about similar situations in his area. In April, state leaders held a hearing after alarmed physicians and providers reported being unable to properly care for their patients at the Steward-owned facility Glenwood Regional Medical Center in West Monroe, Louisiana.

At the hearing, Glenwood’s interim CEO Jon Turton "admitted on the record that Steward was solely responsible for not providing the financial resources that they needed to provide adequate care [in] that hospital. He also, on the record, noted that because of their mismanagement, they killed and maimed patients," Echols testified Thursday. "It is glowingly clear to me that the executives of Steward Health Group are health care terrorists. They are killing our patients, they are killing our communities, and they need to be held accountable."