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Concerns Mount Over Private Equity Hospice Care Washington State Partnerships

It wasn’t billed as a takeover. The nonprofit hospice where Washington state nurse Milli Palmer has worked for nearly two decades announced in October 2024 that it was entering a “joint venture” with Compassus, a private equity-backed home health company.…

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2 months ago

July 16, 2026

Randy Breland, Managing Editor

private equity hospice care Washington state

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Last updated: September 1, 2026

Key points

Washington state nurse raises concerns over private equity’s impact on hospice care.
Joint venture with Compassus has led to increased patient visit expectations for staff.
Complaints filed about management practices and quality of care concerns.

NewsWK — In a recent development concerning healthcare in Washington state, a nurse at a nonprofit hospice is voicing serious concerns about a new partnership with a private equity-backed company, Compassus. Milli Palmer, who has dedicated nearly two decades to her role at the hospice, reported that after the joint venture was announced in October 2024, the organization’s priorities changed dramatically.

Washington Hospice Care Concerns Over Staffing and Workload

Initially presented as a 50/50 partnership, the arrangement allowed Compassus to take control of day-to-day operations at the hospice and home health company by May 2025. Palmer stated that management began pressuring staff to increase patient visits significantly, leading to a distressing work environment. “What ends up happening is our staff is so committed to our patients and communities that they will not provide substandard care, so that pushes them into overtime,” she explained.

Palmer noted that the expectations for nurses and case workers have increased from 13-15 patient visits per week to 20-25, which has prompted some staff to leave their positions. The changes have also resulted in fewer patient referrals and a greater reliance on traveling nurses. “It has really limited our ability to make sure that patients are safe in their home,” she said.

The Impact of Private Equity in Healthcare Washington Systems Experience

Joint ventures between private equity firms and nonprofit health systems are becoming more common, yet they can lead to conflicting priorities. While nonprofit organizations are obligated to meet community healthcare needs, private equity firms primarily focus on maximizing returns for investors. As these partnerships proliferate, they may challenge a wave of new state regulations intended to oversee private equity’s role in healthcare.

According to a report by the Private Equity Stakeholder Project, more than 20% of private equity-backed hospitals in the U.S. are now involved in joint ventures with nonprofits. Critics, including Matt Parr from the Private Equity Stakeholder Project, emphasize the need for policymakers to ensure that regulations adequately address these new business models to protect patient care.

Compassus Hospice Complaints Washington Officials Are Reviewing

Palmer and her colleagues have filed complaints with the Washington state attorney general’s office regarding the practices at Compassus. They allege that management has encouraged staff to misreport missed patient visits, raising ethical concerns about the quality of care being provided. “A really big issue is taking on patients and making promises that they can be cared for, and it’s not possible due to lack of staffing,” said April Frazier, a hospice chaplain and Palmer’s coworker.

As the state continues to review the implications of such partnerships, the focus remains on maintaining high standards of care for patients in Washington. Palmer emphasized the importance of accountability in healthcare, stating, “I know our communities are used to a certain standard of care, and if we don’t provide that, we’re not going to have a business here.”

Based on reporting by Anna Claire Vollers originally published by Stateline. Read the original story.