Ascension Well being introduced it could shut its Bedford hospital solely days after posting a fiscal 12 months, system-wide lack of $1.8 billion that got here largely on account of funding losses that exceeded $1 billion.
Whereas a hospital business spokesman stated the Bedford hospital’s closure was prompted, no less than partly, by a decent labor market, a well being care business critic and a few neighborhood members laid no less than a part of the blame at Ascension’s toes, saying the Catholic nonprofit didn’t make correct investments and cared extra about cash than mission.
Ascension, primarily based in St. Louis, declined requests for interviews to debate why it determined to shut St. Vincent Dunn Hospital, which previously served because the county hospital and dates again to 1941.
The well being system in September stated it misplaced $1.8 billion for the 12 months that ended June 30, in comparison with a revenue of practically $5.7 billion the prior 12 months. Ascension misplaced practically $900 million from its well being care operations, partly as a result of wages and salaries rose by $1.2 billion from the prior 12 months. Nevertheless, the well being system additionally noticed a roughly $7 billion swing in its non-health care-related investments: Ascension misplaced about $1 billion on its investments this 12 months. Final 12 months, the investments generated a revenue of practically $6 billion.
Put one other method: Ascension within the final 12 months misplaced extra money on investments than on its well being care operations.
Ascension amenities closing after loss
The chain has reacted by closing hospitals and clinics in Indiana and elsewhere. It stated this 12 months that it was closing its kids’s intensive care unit in Tulsa, Oklahoma. It introduced in June that it was closing 11 fast care clinics in Indiana. It closed a kids’s most cancers heart in Detroit in October.
In response to inquiries from The Herald-Instances, Lauren Nelson, Ascension Indiana’s senior director of selling and communications, lately emailed a months-old assertion that stated the Catholic nonprofit made the choice to shut the Bedford hospital after a “thorough evaluation of the hospitals.” ‘present working surroundings and the healthcare panorama.”
Nelson didn’t reply to follow-up emails and telephone messages.
Leaders of the Bedford hospital weren’t within the facility on a current afternoon and they didn’t reply to telephone inquiries. Staff within the hospital and others working in close by Ascension-affiliated workplaces stated they might not speak as a result of that they had signed non-disclosure agreements and risked dropping their severance pay.
‘An accident of historical past’
Brian Tabor, president of the Indiana Hospital Affiliation, stated he was not shocked to listen to in regards to the hospital closing, partly as a result of Bedford is one of some communities — and maybe the one one — within the nation with two Vital Entry hospitals, which function outposts of care in rural communities. Federal guidelines restrict such hospitals to 25 beds and require that the amenities be no less than 35 miles from the closest acute care hospital.
Tabor stated Indiana has 35 such amenities and it was “a little bit of an accident of historical past” that two such hospitals serve Lawrence County.
Operating a hospital with around-the-clock emergency care in a small, rural neighborhood — a lot much less two amenities — was difficult earlier than the pandemic, Tabor stated. Sharply rising staffing prices made these challenges even larger.
He stated that in a current survey by the IHA, Indiana hospitals reported wage prices have been rising as much as 30%, and money balances for a lot of hospitals have been declining, constraining their capacity to acquire financing.
“Hospitals are undoubtedly feeling some actual monetary headwinds,” Tabor stated. “I’m involved that might result in closures.”
Tabor stated Ascension’s assertion additionally hinted that its cross-town rival, Indiana College Well being Bedford, had captured a better share of the market, making operations for St. Vincent Dunn much more difficult.
Ascension stated in its assertion that it explored different choices however concluded “different suppliers with a bigger presence within the area are higher positioned to effectively serve the residents of Bedford and neighboring communities.”
Certainly, IRS data present that whereas St. Vincent Dunn was within the black, the IU Well being hospital has generated way more income within the final decade.
Bedford hospital posted a revenue in 2020
In line with reviews Ascension filed with the Indiana State Division of Well being, St. Vincent Dunn produced a revenue of $2.4 million for the 12 months ended June 30. It had a revenue of $1.4 million the prior 12 months. In line with Inner Income Service data and filings with the Indiana State Division of Well being, the hospital was worthwhile most years and within the final three years generated a mixed revenue of practically $8 million.
Nevertheless, IRS data present that IU Well being Bedford in 2020 had a revenue of practically $21 million, roughly equaling the mixed income St. Vincent Dunn has generated within the final decade.
Matt Bell, chief coverage strategist for Hoosiers for Reasonably priced Well being Care, acknowledged that hospitals, like different companies in Indiana, are coping with staffing challenges, however he stated Ascension, regardless of its current loss, nonetheless had vital monetary assets.
The nonprofit’s most up-to-date annual report exhibits long-term funding exceeding $22 billion. That is sufficient, even with none funding return, to run St. Vincent Dunn Hospital for about 900 years.
“Given the big assets they’ve, it is troublesome for me to grasp why there’s not a extra concerted effort to offer high quality care at an inexpensive value,” Bell stated.
Hoosiers for Reasonably priced Well being Care advocates for insurance policies that decrease well being care prices in Indiana. The group says that Hoosiers pay between the fourth- and seventh-highest costs for hospital providers within the nation.
Neighborhood sees lack of funding
Ascension stated in its assertion that it performed an “unsuccessful search” to discover a purchaser for its Bedford hospital, however some neighborhood members stated the well being care system didn’t strive very laborious and has, through the years, didn’t make the sorts of investments that will make the hospital extra aggressive.
Dr. Deborah Craton, a household practitioner who retired from the hospital in July, stated Ascension routinely failed to interchange docs who left the power. She recalled a doctor colleague who left through the pandemic who was not changed. An inside drugs physician retired this 12 months and was not changed. One other household physician left and was not changed.
Ascension by no means gave the hospital the assets needed to supply all of the providers that have been wanted, particularly within the final 5 years, Craton stated.
“They by no means labored to ensure that we have been viable,” she stated.
At any time when physicians left the hospital, Craton stated Ascension would inform employees that the docs would get replaced, however they by no means have been. She stated when she challenged leaders on that time, she could be instructed they’re engaged on it.
Lawrence County Council member Janie Craig Chenault, a former hospital board member, stated hospital operations started shrinking when Ascension took over. The hospital system failed to interchange staff who left or have been let go. It appeared each determination they made included fewer staff.
“And fewer. And fewer,” Chenault stated.
She additionally stated whereas IU Well being Bedford took care of COVID sufferers and was allowed to exceed its 25-bed minimal, St. Vincent Dunn needed to switch COVID sufferers to different amenities, although she suspects that lack of kit and destructive stress hospital rooms performed a task.
Chenault stated Ascension leaders additionally made too many mistaken choices from Indianapolis.
“They by no means understood southern Indiana,” she stated.
Kierra Weaver, a supervisor on the Courtroom Room Sports activities Grill, on the west aspect of the Lawrence County courthouse sq., stated from a sentimental perspective, the hospital means lots to individuals. Weaver was born there, as have been her two kids from her.
However she stated she’s not sorry to see the hospital shut.
“It was type of going downhill,” she stated.
The hospital was not paying a lot and never paying a lot consideration to employees, she stated.
Weaver stated she had a nasty expertise on the hospital a couple of years in the past and has been going to the IU Well being facility since.
John Crane, proprietor of Crane’s Leather-based & Shoe Store, simply off the sq., stated he “wasn’t shocked in any respect” when he heard the hospital was closing.
He seen quickly after St. Vincent took over the hospital the well being system was making investments in different amenities, however not in Bedford, the place docs left however weren’t changed.
“They weren’t making any enhancements right here,” he stated.
Ascension has owned hospital since 2010
St. Vincent, which has been a part of Ascension since 1999, purchased the previous neighborhood hospital in 2010 for $7 million. On the time of negotiations — Clarian, now IU Well being, additionally was within the working to purchase the power — St. Vincent leaders promised nice care at low costs.
“Our high precedence is to serve the well being care wants of Lawrence County residents,” Kevin Speer, chief technique officer of St. Vincent Well being, instructed the Bedford Instances-Mail in 2010.
“Having an method of partnerships, we look ahead to working intently with native employers and colleges to assist decrease their well being care prices. Households ought to count on native well being care from a neighborhood accomplice with the perfect fame,” Speer stated.
With the power closing in a couple of month, the other is prone to occur, in keeping with Bell.
Ascension’s determination to shut the Bedford hospital was “disappointing,” he stated, and finally will value Lawrence County sufferers extra money.
“After we see competitors disappear, we see increased costs,” he stated.
Boris Ladwig might be reached at email@example.com.