More than 60 hospice and home health workers have left Providence at Home with Compassus in Everett since a private-equity-backed joint venture took over operations in May 2025, and the state is now investigating 47 labor complaints from the facility.

The Washington Department of Labor and Industries confirmed Saturday, Aug. 8, that it opened investigations into complaints filed by 38 workers at the Snohomish County and Lacey locations, the Everett Herald reported. The complaints allege paid sick leave violations, mileage reimbursement problems and meal and rest break violations, according to department spokesperson Matt Ross.

The Everett facility on 75th Street has historically employed about 200 people. Since Compassus assumed day-to-day management, patient visit expectations have jumped from 13 to 15 per week to 20 to 25, according to April Frazier, a chaplain whose territory stretches from Edmonds to Index. Time per patient visit has shrunk from roughly an hour to about 20 minutes, she told the Herald.

"You can't just walk out on a patient's family that are in tears because their loved one is dying," said Milli Palmer, a licensed practical nurse and SEIU 1199NW executive board member at the Everett location. "You have to be there and be present."

Palmer said workers began filing state complaints around October 2025 after concluding operational problems were not improving. Staff also allege Compassus's automated mileage-tracking system rejects employee corrections for detours, and that incentive pay for nurses has been inaccurately tracked.

Beyond labor violations, employees have filed complaints with the state health department, federal health agencies and the state attorney general's office alleging inadequate patient care and Medicaid and Medicare fraud, according to SEIU 1199NW senior member program director Stacey Opiopio. Frazier told the Herald she filed a complaint after management asked her to document in patient charts that patients had declined visits when no staff member was available.

Compassus, based in Brentwood, Tennessee, is jointly owned by Ascension Health and private equity firm TowerBrook, based in London and New York. A Compassus spokesperson said broad claims that the company does not maintain high standards of care, regulatory compliance or support for caregivers are inaccurate. Providence spokesperson Ed Boyle said the health system has confidence in Compassus as its partner and expects concerns raised by caregivers to be taken seriously.

The Washington State Investment Board has invested more than $1 billion in TowerBrook funds, including $450 million in the fund that financed the joint venture. Board spokesperson James Aber told the Herald on Thursday, Aug. 6, that the board is in "ongoing discussions" with TowerBrook and Compassus about concerns raised by the union.

State Sen. June Robinson, D-Everett, who sits on the investment board, told the Herald that the board's reputation could pressure TowerBrook into changes. Robinson has sponsored legislation in the last two sessions to restrict corporate involvement in medical care decisions, though neither bill cleared committee. She told Cascadia Daily News in June she is rethinking the bill entirely.

At the federal level, U.S. Rep. Pramila Jayapal, D-Seattle, and Sen. Edward Markey, D-Mass., reintroduced the Health Over Wealth Act on July 23. The bill would require private equity-owned healthcare entities to disclose financial information and establish escrow accounts covering five years of expenses in the event of service reductions.

The Everett bargaining unit of SEIU 1199NW is negotiating its first contract with Compassus. After roughly nine months at the table, no complete economic package has been offered, Palmer said.