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Larry Robbins wants more changes at Tenet Healthcare. Photo: Adam Jeffery / CNBC/NBCU Photo Bank via Getty Images

The fight between hospital chain Tenet Healthcare and hedge fund Glenview Capital Management has intensified, and Glenview has made it clear it wants to push out four of Tenet's board members.

The bottom line: Glenview, led by billionaire Larry Robbins, owns almost 18% of Tenet and has the power to rally for bigger, quicker changes. The firm most recently took direct shots at Tenet's "chronically underperforming" finances and "shareholder-unfriendly" practices.

The details: A 26-page slide deck made by Glenview lambasted the general direction of Tenet and criticized former CEO Trevor Fetter, who was ousted last year after the fight became public. Some of Glenview's main gripes:

  • Tenet's stock has lagged behind competitors and the broader stock market.
  • Tenet's two major acquisitions haven't panned out.
  • The federal government has sanctioned Tenet several times after finding instances of billing fraud and kickbacks.
  • The board backed Fetter even when Glenview thought the company was making questionable actions.
  • Over five years, the board rejected each of Glenview's ideas to turn the company around. Glenview compared the process to Lucy pulling the football away from Charlie Brown: It was like Fetter "and the board pulled the ball from under shareholders' feet," according to the slide deck.

What's next: Tenet is already looking into selling its medical billing subsidiary, Conifer, as well as a potentially larger sale of itself. With $15 billion of debt, selling the hospitals and surgery centers is highly unlikely, meaning Glenview and Robbins may want to turn this ship around with its own team and on its own terms.

  • Glenview is asking shareholders to vote to allowing the removal or replacement of board directors even if a majority of shareholders aren't present. Tenet's annual meeting is in May.
  • Glenview supports every current board member except Brenda Gaines, Karen Garrison, Edward Kangas and Richard Pettingill.
  • Robbins added in a letter that this latest action is "not a 'campaign' that will be waged daily" and that he is trusting the "informed judgments of each shareholder."

Flashback: The last time Robbins got into a major fight with a health care company, he won. Robbins ripped into the board and executives at Health Management Associates in 2013, leading to a sale of the company to Community Health Systems — a deal CHS now regrets.

Go deeper

Federal judge blocks Biden's vaccine mandate for federal workers

President Biden speaking from Eisenhower Executive Office Building on Jan. 21. Photo: Yuri Gripas/Abaca/Bloomberg via Getty Images

A federal judge in Texas blocked the Biden administration from enforcing its coronavirus vaccine mandate for federal workers on Friday, citing the outcome of last week's Supreme Court ruling that nullified the administration's vaccine-or-test requirement for large employers.

Why it matters: It's a blow to President Biden's efforts to increase the U.S.' vaccination rates, though much of the federal workforce has already been vaccinated against the virus.

Updated 4 hours ago - Politics & Policy

Omicron dashboard

Illustration: Brendan Lynch/Axios

  1. Health: Pfizer and Moderna boosters overwhelmingly prevent Omicron hospitalizations, CDC finds — Omicron pushes COVID deaths toward 2,000 per day — The pandemic-proof health care giant.
  2. Vaccines: The case for Operation Warp Speed 2.0 — Starbucks drops worker vaccine or test requirement after SCOTUS ruling — Kids' COVID vaccination rates are particularly low in rural America.
  3. Politics: Biden concedes U.S. should have done more testing — Arizona says it "will not be intimidated" by Biden on anti-mask school policies.
  4. World: American Airlines flight to London forced to turn around over mask dispute — WHO: COVID health emergency could end this year — Greece imposes vaccine mandate for people 60 and older — Austria approves COVID vaccine mandate for adults.
  5. Variant tracker
Updated 5 hours ago - Economy & Business

Janet Yellen co-opts Reaganomics phrase for new Davos speech

Treasury Secretary Janet Yellen at a speech this week. Photo: Alex Wong/Getty Images

The U.S. needs to focus on increasing its productive potential, Treasury Secretary Janet Yellen told world leaders Friday, calling for what she terms "modern supply side economics."

Why it matters: She co-opted a phrase traditionally used by political conservatives to describe low-tax and deregulatory policies — and framed the Biden administration's initiatives as the best path forward to achieve greater national prosperity.