Ascension (healthcare system)
Ascension is a large private Catholic healthcare system in the United States. Ascension had 142,000 employees, 90 hospitals, and 40 senior living facilities operating in 17 states and the District of Columbia as of July 1, 2025. Ascension is one of the largest nonprofit and one of the largest Catholic health systems in the United States. It also operates a number of for-profit firms, including subsidiaries involved in private equity, venture capital, insurance, medical software, and pharmacy delivery.
Formed in 1999 from the merger of two Catholic healthcare organizations, Ascension is bound by the Ethical and Religious Directives for Catholic Health Care Services. Ascension had an operating revenue of $27.2 billion at the end of fiscal year 2021. The president and CEO is Joseph R. Impicciche, one of the highest-paid nonprofit CEOs in the United States.
Ascension has faced a number of investigations and controversies. A 2022 investigation by The New York Times alleged Ascension hospitals instigated a staffing crisis via system-wide layoffs, leading nurses and doctors to file complaints about possible preventable deaths. National Nurses United has alleged that Ascension has increased maternal mortality by consolidating and then closing obstetrics units.
In 2024, Ascension was a victim of a severe cyberattack that affected operations for several weeks.
Overview
Ascension was the largest nonprofit and Catholic health system in the United States as of 2021. It operates more than 2,600 health care sites in 19 states and Washington, D.C., including 142 hospitals and 40 senior living facilities. It employed more than 142,000 people as of 2021. Ascension had an operating revenue of $27.2 billion at the end of fiscal year 2021. The company is led by president and CEO Joseph R. Impicciche and is headquartered in St. Louis, Missouri, at 4600 Edmundson Road.In addition to health and senior care facilities, Ascension also operates several subsidiary companies, including an investment management firm called Ascension Investment Management, Ascension Care Management, an insurance holdings company, and Ascension Technologies, a healthcare information technology services company. Ascension also operates a for-profit venture capital subsidiary called Ascension Ventures, which invests in medical startups. Ascension runs a pharmacy and drug delivery system under the name AscensionRx.
Hospitals
In 2025, Ascension had 90 hospitals. Several of them have been recognized for care, including cardiovascular by Fortune magazine and maternity by Newsweek. Among them, Ascension St. Vincent in Indianapolis and Ascension Sacred Heart Hospital in Pensacola.History
In 1999, the Daughters of Charity National Health System and Sisters of St. Joseph Health System merged to create Ascension Health. In 2010 the Catholic congregations that had sponsored Ascension ceased to do so. They were replaced by a sponsoring group of "both religious and lay persons" whose identities Ascension has declined to share.In 2012, the company underwent a restructuring and rebranding, dropping the "Health" moniker and going forward as Ascension. In the process, the company brought its subsidiaries under a national umbrella and renamed all its hospitals to include the Ascension name, which the company hoped would improve clients' understanding of the system.
In 2014, the company partnered in opening the $2 billion Health City Cayman Islands project, and sold its stake in 2017.
Ascension announced plans to make changes to its business model in 2018, shifting away from a hospital-oriented business to one prioritizing outpatient care and telemedicine. The move was made in response to decreased government reimbursements, reduced profit margins, and higher costs of care.
In December 2018, the Attorney General of the District of Columbia brought suit against Ascension in an attempt to prevent the closure of the Providence Health System hospital, which served a low-income population but was financially unviable. Though the D.C. city council specifically passed an ordinance to give the city the power to block the closing, the suit was ultimately withdrawn by the Attorney General after reviewing plans for the hospital's closure.
In 2021, Ascension opened a pharmacy hub in Austin, Texas. The hub fills 5,000 prescriptions per shift and houses a "patient engagement center" designed to offer patients assistance with understanding their medication. Officials with the company have said they hope to reduce hospitalizations by improving at-home prescription management through the hub. In October that year, Ascension and AdventHealth announced the planned dissolution of their joint venture AMITA Health in 2022. Each system will retain the hospitals they originally contributed to the partnership.
It became public on May 8, 2024, that Ascension was a victim of a massive cyberattack that made it impossible to access thousands of patients' records. Mandiant was tapped to assist in the investigation. Russian ransomware operator Black Basta, a.k.a. "Conti." was blamed for the attack, CNN reported. Patient medical records were restored by June 11, after more than a month of inaccessibility, a period that saw delayed appointments and patients' health allegedly being put at risk. Class-action lawsuits were filed amid the attack against Ascension because the hack was "foreseeable and preventable," according to those bringing the lawsuits.
Following the cyberattack and financial losses during fiscal year 2023, Ascension began to sell hospitals. It sold three Michigan hospitals and an ambulatory surgical center in March. In August 2022, it was announced that Ascension St. Vincent's Health System would be taken over by the Alabama Health System Authority.
On March 1, 2025, Prime Healthcare acquired eight Chicago-area hospitals and seven senior living and care facilities from Ascension.
Controversies
Pension lawsuit
In April 2016, a class-action lawsuit was brought in federal court, alleging that Ascension subsidiary Wheaton Franciscan Services, erred by treating its pension plan as though it was a "church plan," exempt from the Employee Retirement Income Security Act, a federal law governing employee pensions. In January, 2018, the parties announced a settlement, in which Ascension would pay $29.5 million to the plaintiffs.OB/GYN defamation and fraud lawsuit
In February 2020, a jury awarded obstetrician/gynecologist Rebecca Denman, M.D., $4.75 million in damages by an Indiana jury, after suing Ascension's St. Vincent Carmel Hospital and its St. Vincent Medical Group for defamation and fraud. The lawsuit arose from a December 2017 incident, in which Denman was accused of smelling like alcohol while on duty. Denman contended that she had been cheated out of the due process, as provided in the company substance-abuse policy, depriving her of a chance to establish her innocence, and retain her position.Birth control
In 2018, Ascension hospitals abruptly stopped performing tubal ligations and vasectomies, as part of the nonprofit's Catholic belief that all artificial birth control is immoral. Some patients reported not having been informed by Ascension hospitals that their planned tubal ligation or vasectomy was canceled.This increased costs and risks for those who give birth in an Ascension hospital and then seek permanent birth control, as they must schedule a follow-up surgery rather than having the customary option of having a tubal ligation immediately follow a Caesarean section birth.
The ACLU of Michigan has filed multiple complaints against Ascension regarding its practices surrounding birth control, including in 2021 in Michigan when a pregnant woman was denied a tubal ligation post-birth even though the woman's life would be at risk if she were to get pregnant again.
Refusal to treat ectopic pregnancy
A patient named Kyleigh Thurman filed a complaint with the Department of Health and Human Services claiming that, in February 2023, Ascension Seton Williamson Hospital in the Austin suburb of Round Rock refused to treat her ectopic pregnancy or to transfer her to another hospital; she was instead discharged. She says the hospital again denied her treatment when she returned with vaginal bleeding, days later, a delay which caused her fallopian tube to rupture.As a Catholic hospital, Ascension is required to follow the Ethical and Religious Directives for Catholic Health Care Services which stipulate that doctors may never perform an abortion, even to save a woman's life in the case of extrauterine pregnancy. Intentionally allowing the rupture of the fallopian tube, risking the patient's death, is historically a common practice at Catholic hospitals in accord with the requirements of Catholic bishops.
Death of Yeniifer Alvarez-Estrada Glick
In early 2022, a pregnant woman named Yeniifer "Yeni" Alvarez-Estrada Glick came to the emergency room of Ascension Seton Edgar B. Davis, in Luling, Texas, reporting breathing problems, diabetes, hypertension, and a history of pulmonary edema. She came back and multiple times thereafter with increasing problems. She was never offered the option of terminating her pregnancy, which is a common procedure in a situation like Glick's. She died of hypertensive cardiovascular disease on July 10, 2022.Her death was the subject of a 2024 exposé in The New Yorker.
National Nurses United report
A 2024 report by National Nurses United claimed that "Ascension is one of the nation's worst offenders for closing obstetrics units" because it closed 26 percent of its labor and delivery departments since 2012, particularly in low-income, Black, and Hispanic neighborhoods and in concentrated health care markets. This increased maternal mortality, particularly in Bay County, Florida where the maternal death rate in the county more than doubled. The report concluded that "Ascension Betrays its mission by gutting care for pregnant patients and babies."The United States Conference of Catholic Bishops declined to comment on the closures. Charles Bouchard, a former director of the Catholic Health Association and vice president of theological education at Ascension, observed the bishops would be incapable of solving the problem: "They can keep hospitals from doing something if it's seen as at odds with Catholic teaching. But they can't, unless they're going to pay for it, they can't go out and say, 'you've got to keep this hospital open.'"
Ge Bai at Johns Hopkins University said that the cuts were likely made to maximize profitability; obstetrics and gynecology services are low-margin units, especially in locations where many patients are on Medicaid. In an essay about the closures and the death of Glick, author Jessica Valenti disparaged Ascension as "the Catholic hospital system killing women."