A report released Jan. 7 by a U.S. Senate committee investigating the practices of private equity-owned hospitals and prompted by a sexual assault investigation in Iowa names Community Medical Center in Missoula.
On page 102 of the report detailing incidents at Ottumwa Regional Health Center, owned by Lifepoint Health — a co-owner of Community and backed by the private equity firm Apollo Global Management — the report states:
“ORHC may not be the only hospital in the Apollo portfolio where patients have been sexually assaulted by a medical provider. At Community Medical Center in Montana, a contracted physician has been accused of sexually assaulting at least 15 female patients while he treated them in the hospital’s ED between 2017 and late 2023.”
The report’s referring to the case against Tyler Hurst, a contracted doctor who worked in Community’s emergency department. A lawyer for several of the accusers confirmed they are pursuing legal action against Community and told The Pulp her clients are also considering action against Apollo.
Last year, Hurst was charged on eight counts of rape or sexual assault of patients at Community, including six felonies, according to charging documents. He pleaded not-guilty.
Hurst was contracted to work at Community, but was employed by Clark Fork Valley Emergency Physicians Group. Alleged assaults in the charges occurred between April and December of 2023; additional alleged assaults in the prosecution’s affidavit occurred as far back as 2017. Court documents confirm there are allegations from 15 women in the case, and there are seven alleged victims among the eight criminal charges filed. Hurst could face life in prison if found guilty. The criminal case is pending with an omnibus hearing scheduled for Jan. 23.
At least 14 of the women who accused Tyler Hurst of rape or sexual assault have since filed claims against Community Medical Center with the Montana Medical Legal Panel.
Two civil suits have been filed against Hurst for sexual abuse as well, each representing at least two plaintiffs.
At least 14 of the women who accused Hurst have since filed claims against Community Medical Center with the Montana Medical Legal Panel, a state board that evaluates malpractice claims.
Kasodie West, an attorney for AVA Law firm in Billings, said the 14 accusers also seeking to file complaints against Community have individual hearings with the medical panel scheduled in February and March.
West said that the panel is the necessary step before a malpractice lawsuit can be filed against Community, and she intends to move forward with a lawsuit against CMC, Hurst and Clark Fork Valley Emergency Physicians regardless of the panel’s decision.
“We also intend to bring Apollo Global Management into that as well,” West said.
Apollo — which manages roughly $700 billion in assets — didn’t immediately respond to a request for comment on this claim.
West said that John Heenan, another Billings attorney who earlier filed a civil complaint on behalf of alleged victims of Hurst, has also filed claims with the Montana Medical Legal Panel and at least one claimant he represented has already had a hearing. Court documents show the complaint originally included two plaintiffs, and in September Heenan attempted to amend it to add two more. The Pulp reached out to Heenan but hasn’t received a response. West said the two firms are collaborating as they move forward with the complaints.
West is aware of the Senate Budget Committee’s January report and claims, as the investigating senators have, that the ownership companies have mismanaged hospitals and created safety issues for patients.
In a statement sent to The Pulp, CMC spokesperson Megan Condra said she’s aware of the inclusion of Community Medical in the Senate’s report “and can affirm that it does not reflect our experience with Lifepoint Health.”
“Lifepoint has been a great partner to our hospital, working with us to enhance quality care across our region, grow our team and invest in our facilities and services,” she said.
In regard to the claims filed with the Montana Medical Legal Panel, Condra provided the following statement: “When Community Medical Center was notified last year of a patient allegation regarding Dr. Tyler Hurst, an independent physician, we immediately removed Dr. Hurst from the facility. We have zero tolerance for inappropriate conduct towards our patients. To the extent the allegations against Dr. Hurst are true, he took advantage of the trust placed in him by our patients, our staff members and our community. When a predator evades policies and procedures and takes advantage of the access they gain in healthcare settings, they should be prosecuted to the fullest extent of the law. We are fully cooperating with those efforts, and our team continues to work closely with all relevant agencies to ensure full accountability.”
An affidavit shows at least two accusers allegedly reported inappropriate behavior by Hurst to CMC staff in 2023. The affidavit also contains the allegation one of the accusers, after a June 2023 visit to Community’s ER, made this complaint to the hospital in a text message: “I came into the ED and saw Dr. Hurst. He did an abdominal exam, and, I feel, placed his hands a bit too low as well as too high. On a second occasion [he] reached into my pants to feel my hip.”
An application for an order of protection included details from an incident dated Dec. 31, 2023, when a woman who thought she might have a kidney infection went to Community’s emergency room. In the application’s narrative, the woman states: “I chose Community ER because I had previously worked there years ago as an ER secretary and I had in the past felt comfortable with the staff and care I had received.” She detailed claims of being repeatedly groped, listening to Hurst say he was “excited” and wanting to tell a nurse, but missing opportunities to do so because Hurst would follow the nurse into the exam room. She stated she later contacted police and is a named plaintiff in court documents.
Dwight Schulte is Hurst’s defense attorney in the criminal case. The Pulp requested comment from Schulte by email and didn’t receive a response after five days. The Pulp also left a phone message with his office on Tuesday.
Court documents state Hurst underwent pre-trial treatment at Pine Grove Behavioral Health and Addiction Services in Hattiesburg, Mississippi, and was also treated more recently at a facility in the Bitterroot Valley. He was denied a request to travel to Washington state to visit family over the recent holidays.
Senate investigations
The U.S. Senate Budget Committee’s report, “Profits Over Patients: The Harmful Effects of Private Equity on the U.S. Healthcare System,” is the result of a year-long, bipartisan investigation led by Budget Committee Chairman Sen. Sheldon Whitehouse, a Democrat representing Rhode Island, and Sen. Charles Grassley, a Republican from Iowa. Grassley got involved after reviewing details at Ottumwa, where police investigating an overdose death of a male nurse practitioner, Devin Michael Caraccio, discovered alleged video and photographic evidence on Caraccio’s cell phone that he sexually assaulted nine female patients, two under 18, local and national news sources reported. The incidents occurred in 2021 and 2022.
Grassley, who serves on the budget committee, advocated to widen the scope of the criminal investigation to look into whether higher-level transactions caused problems in his state.
“When I see the type of tragic lapses that occurred at Ottumwa Regional … it raises serious questions as to whether these hospitals have the right resources or if they are being loaded with overwhelming amounts of debt to the point where they are forced to shift money away from patient care,” Grassley wrote in a press release last March.
The Pulp received comment from both Grassley and Whitehouse as part of its reporting for an upcoming series looking into the past decade of Community Medical Center as a for-profit hospital. Whitehouse sent The Pulp a statement in October.
He wrote, “As private equity firms increasingly take control of essential health care and leverage it to get rich quick, they are treating patients and communities as collateral damage. We’ve seen it before: Private equity buys a hospital, sells off the assets and saddles it with debt, and reduces costs by cutting staff and services. Any situation that puts the health and safety of Americans at risk warrants our attention, and that’s why Senator Grassley and I are demanding answers.”
Ottumwa, like CMC, was a nonprofit community hospital until it was bought out by RegionalCare Hospital Partners and later merged into Lifepoint Health.
In the budget committee’s report, investigators said they uncovered “unfulfilled promises and underinvestment, which eroded the hospital’s culture of safety. While (Ottumwa Regional Health Center) deteriorated, Apollo received millions of dollars a year.”
The report specifically alleges several commitments made when the hospital was sold to RegionalCare that weren’t fulfilled by RegionalCare or its successive owners, including Lifepoint Health, but notes some short- and long-term commitments were honored and that recent improvements have been made. The investigators aimed to tie various shortcomings at the hospital to the profits gained by Apollo. The company, in a letter to investigators, said it charges $9.2 million annually in management fees to Lifepoint Health. Investigators allege Apollo makes many millions more off the arrangement via loan financing and investor fees, the details of which investigators say Apollo refused to reveal.
The 162-page report is based on thousands of pages of documents, including Apollo and Lifepoint’s responses to the senators’ inquiry letters, Lifepoint’s financial statements and statements from employee satisfaction reports alleging unsafe staffing around the time of the sexual assaults at Ottumwa Regional.
There is plenty of back-and-forth in letters between the senators and Apollo over how much control Apollo has over Lifepoint’s hospital operations. The report found that six of 12 of Lifepoint’s corporate board of directors are Apollo employees.
Lifepoint, via its response, said the company provided $43 million in charity and uncompensated care services over the past five years at Ottumwa. “That commitment … has allowed Ottumwa Regional to remain open in the face of the widespread national closures of rural and regional hospitals,” the statement reads.
Nationwide, nearly 200 rural hospitals have closed in the last two decades, and currently more than 700 are at risk of closing because of serious financial problems, according to a 2024 report from the Center for Healthcare Quality and Payment Reform.
The Pulp asked representatives from both Lifepoint and Apollo for a response to the report and the Senate investigation and did not receive a response from Apollo.
Lifepoint spokesperson Emily Serck sent The Pulp a statement regarding the budget committee’s January report:
“Lifepoint is dedicated to providing quality healthcare to people around the country, often serving as the only provider in many of our nation’s rural and underserved communities. In the face of many challenging industry and community circumstances, we have worked diligently to expand access to care and bring quality providers, caregivers, and technology to address our patients’ needs.
“We are proud of the progress we are making at Ottumwa Regional Health Center and of how we have partnered with the hospital team to make broad facility updates, improve quality, support employees, invest in new equipment and technology, and expand local access to services in areas including cardiology, women’s health, behavioral health and imaging. Lifepoint remains steadfast in our commitment to continuous improvement and to providing the best possible care to all the people we serve in Ottumwa and beyond.
We appreciate the Senate Committee’s attention to these issues, and we share the Senators’ commitment to ensuring that all American communities have access to the healthcare services they need.”
NBC News reported statements from Apollo, including a dispute of the Senate committee’s findings. “Apollo Funds have invested billions of dollars in Lifepoint and its predecessor companies, which has been used to improve facilities, expand local healthcare services, recruit care providers, build new centers of care and upgrade technology across Lifepoint’s network,” the Apollo spokesperson said. “As a result of these investments, quality of care at Lifepoint hospitals has improved, according to third party ratings like Leapfrog as well as CMS Star Ratings. … At a time when many rural hospitals are under pressure and at risk of closing, Lifepoint has not had to close a single hospital and is committed to providing critical services in underserved areas.”
Another separate U.S. Senate investigation into Apollo and Lifepoint is underway from the Homeland Security and Governmental Affairs Committee. Apollo is a key subject of both and Lifepoint is the only hospital group named in the Homeland Security Committee probe.
The Homeland Security Committee in April 2024 began investigating Apollo and two other major private equity firms that own hospital staffing companies, along with Lifepoint. The inquiry is focused on impacts to hospital emergency departments in the U.S., a third of which are overseen, staffed or managed by companies owned by private equity firms, according to a Senate press release. Investigators interviewed more than 40 emergency department physicians, revealing significant concerns related to patient safety and care at ERs funded by private equity and sent inquiry letters to Lifepoint and Apollo in April.
Lifepoint and Apollo did not respond to a request to comment on that investigation from The Pulp, but NBC News reported a statement from Apollo saying it was cooperating with the investigation.
The Pulp’s four-part series, “Community for Profit,” will begin publishing Monday, Jan. 20.
