Health giant sold dozens of hospitals, but continued to sue patients


Tennova Healthcare-Lebanon no longer exists as a hospital. But he still sued Hope Cantwell.

There was a knock on the door of Cantwell’s apartment in Nashville, Tennessee, earlier this year. She said she had not yet been vaccinated against covid-19 and was not answering the door to strangers. So she didn’t.

But then several more attempts took place over the course of a week. Finally, she masked herself and opened. A legal assistant served him on trial; she was subpoenaed to appear in court.

“I couldn’t believe anyone – anyone?” a society? a company? – was doing this during a pandemic, ”Cantwell said.

It all started with a hospital visit in May 2019.

Cantwell was admitted for a short stay at Tennova Healthcare-Lebanon, then owned by Community Health Systems, a publicly traded company headquartered in Franklin, Tennessee. Her insurance covered most of the stay, but she still had $ 2,700 to pay.

Almost a year later, she was able to start cutting the bill. She went online to pay but couldn’t find the hospital or its payment portal.

Cantwell did a bit of Google research and noticed that Vanderbilt University Medical Center had purchased the 245-bed facility at the time of his stay. It is now called Vanderbilt Wilson County Hospital.

Then the pandemic struck. She was put on leave from work for three months. And soon after, a letter arrived. A law firm representing the hospital’s former owner demanded payment and threatened to sue her. She didn’t know what to do because she couldn’t find all the money. She was on hold until the paralegal knocked on the door.

Pandemic outbreak

A WPLN News investigation found that Tennova Healthcare-Lebanon has sued more than 1,000 patients, including Cantwell, over the past two years in several counties after reaching a sale agreement. And hundreds of those lawsuits were filed during the pandemic, when many companies have given up on suing patients for unpaid medical debt. New York State has banned this practice.

Community Health Systems is at the end of a company downsizing that reduced the company from more than 200 hospitals to 84. The sale helped stabilize the company after it took on massive debt during a period of rapid growth that briefly gave Community Health Systems more hospitals than any other chain in the country.

But now many of these institutions are like zombie hospitals – little more than a legal entity that sues patients even after being sold to new owners who don’t sue over medical bills.

When his summons arrived, panic set in at Cantwell.

“My mind immediately turned to the stimulus payments,” she said. “‘At least I have a way to deal with this now.'”

When her last pandemic stimulus money fell into her bank account, Cantwell said, she sent it directly to the company that had sued her, even though it almost felt scammed. She wondered if she really owed all the money or if she was eligible for financial assistance since she had lost income during the pandemic.

But trials are a rich man’s game. She couldn’t justify trying to find a lawyer or fighting a large for-profit company that sued her for $ 2,700.

“I don’t have the resources and the emotional and mental capacities to handle anything other than just rolling over and handing over the amount of money they would be happy with,” she said.

Community health systems debt problem

Court records indicate that community health systems stepped up lawsuits against patients in 2015, as its share price plummeted amid concerns over its outsized corporate debt.

Aside from a hospital fire sale, Community Health Systems has also aggressively attacked patients. And the company hasn’t let the pandemic slow down that plan, even though it has received more than $ 700 million in relief money from the federal government.

A spokesperson for HCA Healthcare, the country’s largest for-profit hospital chain, said its hospitals are not suing patients for unpaid medical debt – during the pandemic or otherwise. The Nashville-based company has returned all of its aid funds to Covid.

A CNN investigation found that Community Health Systems had prosecuted at least 19,000 patients during the pandemic, although that number is likely underestimated given lawsuits filed on behalf of its former hospitals.

Like Tennova Healthcare-Lebanon, two other hospitals in the Tennessee community health system have also continued to bring patients to justice after selling to Vanderbilt more recently. Community Health Systems has retained its debt in the agreements with Vanderbilt and continues to sue patients who owe it money.

Vanderbilt University Medical Center spokesman John Howser said Vanderbilt does not sue patients to collect medical debt.

“Community Health Systems and its subsidiary Tennova Healthcare are a private company that is not owned or operated by Vanderbilt University Medical Center,” Howser wrote in a statement. “As such, VUMC is not involved in these lawsuits.”

Vanderbilt University Medical Center helps run a Community Health Systems-owned hospital in Clarksville, Tennessee, which continues to sue patients, but Howser noted that Community Health Systems has the majority stake.

“The point is, it’s not rich people who don’t want to pay their bills,” said Christi Walsh, a nurse practitioner who heads clinical research at Johns Hopkins University. His team is focused on hospitals chasing patients and pushing them to quit. “I have been on the ground in courthouses. These are people who have no money to pay for it.

In Wilson County, Tennessee, a husband and wife have both been sued by Tennova Healthcare-Lebanon. He works at a distribution center that has closed for months during the pandemic. She looked after their adopted children and delivered meals with DoorDash, telling WPLN News they were too busy to show up in court.

The problem is, failure to show up to face a debt in court can allow a business to take part of someone’s paycheck. It also destroys a person’s financial credit and stress can lead to health problems.

“It threatens public confidence”

Walsh’s team searched for the most contentious hospitals in Texas from 2018 to 2020. The top five were all affiliated with community health systems. And most of the lawsuits were filed by South Texas Regional Medical Center, which was sold to HCA in 2017. But South Texas Regional Medical Center has continued to sue patients.

Marty Makary, a surgeon at Johns Hopkins who wrote a book on health care billing called “The Price We Pay,” said most hospitals have changed tack. Prosecuting their patients doesn’t earn them a lot of money after attorney and court fees, and it hurts their brand image. But he said community health systems had not expressed such concern.

“Community Health Systems, in all of our research into hospital pricing and billing practices, stands out as an aggressive institution that uniformly across the country engages in very aggressive predatory billing – chasing patients ahead. the courts to seize their wages, ”he said.

Even though Community Health Systems is prepared to damage its reputation, Makary said, patients are thinking about the health system as a whole. And they’ll think twice the next time they need to go to the doctor.

“It threatens public confidence in our community institutions. And the medical institutions are supposed to be on top of these games, ”he said.

In a statement to WPLN News, a spokesperson for Community Health Systems said the company used its relief money to cover expenses related to the pandemic and make up for lost revenue. In January, the company said it would only sue patients if they earned at least double the federal poverty line, or about $ 53,000 a year for a family of four.

“We are continually evaluating changes to our collection practices to help patients who are struggling to pay their hospital bills,” said spokesperson Rebecca Pitt.

The policy change is supposed to be retroactive. The company will withdraw the litigation for anyone who qualifies, Pitt said. Patients who owe money to the community health systems and its former hospitals are informed of the new policy in legal correspondence and can call 800-755-5152 to begin the process of dropping a lawsuit. , she said.

This story is from a reporting partnership that includess WPLN, NPR and KHN.

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