Amid large hospital sell-offs, the large company chain continues to be suing sufferers: gunshots

Vanderbilt University Medical Center bought the hospital in Lebanon, Tennessee, from Community Health Systems in 2019, but the company is still suing former patients over unpaid medical bills. Blake Farmer / WPLN hide caption

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Blake Farmer / WPLN

Vanderbilt University Medical Center bought the hospital in Lebanon, Tennessee, from Community Health Systems in 2019, but the company is still suing former patients over unpaid medical bills.

Blake Farmer / WPLN

Tennova Healthcare-Lebanon no longer exists as a hospital. But it was still suing Hope Cantwell.

There was a knock on the door of Cantwell’s East Nashville apartment earlier this year. She wasn’t vaccinated yet and said she didn’t actually open the door to strangers. So she didn’t.

But then several more attempts were made over the course of a week. Finally she masked herself and opened up. A paralegal served her with a lawsuit; she was summoned to court.

“I couldn’t believe someone – someone? a company? a company? – did this during a pandemic, ”says Cantwell.

It started with a hospital visit in May 2019.

Cantwell was accepted for a brief stint at the Tennova Healthcare Lebanon facility, which was then owned by Community Health Systems, a publicly traded company based in Franklin, Tennessee. Her insurance covered most of the stay, but she still had to pay $ 2,700.

Almost a year later, she was financially able to nibble on the bill. She went online to pay but couldn’t find the hospital or its payment gateway.

Cantwell googled a little and noticed that Vanderbilt University Medical Center had purchased the 245-bed facility around the time of their stay. It is now called Vanderbilt Wilson County Hospital.

Then the pandemic hit. She was given a three-month leave of absence from work. And shortly afterwards a letter came. A law firm representing the former hospital owner demanded payment and threatened to take her to court. She wasn’t sure what to do as she couldn’t raise all the money. She was on hold until the paralegal knocked on the door.

Pandemic Push

An investigation by WPLN News found that Tennova Lebanon Hospital sued more than 1,000 patients, including Hope Cantwell, in multiple counties in the past two years after signing a sales agreement. And hundreds of these lawsuits were filed during the pandemic, at a time when many companies were reluctant to take patients to court over unpaid medical debts. New York State has even banned the practice.

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Community Health Systems is at the end of a downsizing that has shrunk the company from 200+ hospitals to 84. The sell-off helped stabilize the company after it incurred massive debt during a period of rapid growth that briefly gave CHS 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 in court even after they have been sold to new owners who don’t sue medical bills.

When their summons arrived, Cantwell panicked.

“My thoughts immediately went to the incentive payments,” she says. “At least now I have a chance to take care of it.”

When her last pandemic stimulus money fell into her bank account, Cantwell said she sent it directly to the company she sued, despite feeling almost like the victim of a fraud. She wondered if she really owed all of the money or if she had qualified for financial assistance since she had lost income during the pandemic.

But lawsuits are a game of the rich. She couldn’t justify finding a lawyer or battling a large publicly traded company that would pursue her for $ 2,700.

“I don’t have the resources and the emotional and mental capacity to handle anything more than turn around and hand over the amount of money they’re happy with,” she says.

The CHS debt problem

Court records show that Community Health Systems increased its level of patient lawsuits in 2015 while the company’s share price plummeted on concerns about its oversized corporate debt.

Aside from a hospital fire sale, CHS also acted aggressively on patients. And CHS didn’t let the pandemic slow that plan, even though the company received more than $ 700 million from the federal government in its own COVID aid money.

A spokesman for HCA, the country’s largest for-profit hospital chain, says their hospitals won’t sue patients for unpaid medical debts – during the pandemic or otherwise. The Nashville-based company also returned all of its COVID supplies.

An investigation by CNN found that CHS sued at least 19,000 patients during the pandemic, though the number is likely too low given the lawsuits filed on behalf of its former hospitals.

Like Tennova Lebanon, two other CHS hospitals in Tennessee continued to suing patients after recently selling to Vanderbilt. CHS has kept its debt on dealings with Vanderbilt and continues to pursue patients who owe it money.

Vanderbilt University Medical Center spokesman John Howser says Vanderbilt does not sue patients for collecting medical debts.

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

VUMC helps operate a CHS-owned hospital in Clarksville that continues to sue patients, but Howser notes that CHS still has a controlling interest.

“The thing is, these aren’t rich people who don’t want to pay their bills,” says Christi Walsh, a nurse who leads clinical research at Johns Hopkins University. Her team focuses on hospitals that are suing patients and actively pressuring them to stop. “I was in the courthouse on site. These are people who don’t have the money to pay for it.”

In a family in Wilson County, Tennessee, the husband and wife were both sued by Tennova Lebanon Hospital. He works in a distribution center that was closed for months during COVID. She looked after her foster children and delivered meals using DoorDash, told WPLN News they were too busy to get to their court date.

The problem is, it can allow a company to cut someone’s paycheck if they don’t appear in court. It also destroys their financial creditworthiness, and the stress can lead to physical health problems.

“It jeopardizes public trust”

Walsh’s team researched the most controversial hospitals in the state of Texas between 2018 and 2020. The five best were all affiliated with CHS. And most of the lawsuits were filed by the South Texas Regional Medical Center, which was sold to HCA in 2017. However, CHS continued to sue former patients.

Dr. Marty Makary is a surgeon at Johns Hopkins and has written a book on healthcare billing called “The Price We Pay.” He says that most hospitals have changed their tactics because they don’t make a lot of money after legal and court fees suing their patients and it damages their brand. But he says CHS has not raised such concerns.

“Community Health Systems stands out in all of our research on hospital pricing and billing practices as an aggressive institution that is consistently very aggressive billing across the country – suing patients in court for seizure of their wages,” he says.

Even if CHS is willing to accept its reputation, Makary says that patients think of the health system as a whole. And they’ll think twice the next time they go to the doctor.

“It threatens public confidence in our community facilities. And medical facilities should take precedence over these games,” he says.

In a statement to WPLN News, a CHS spokesman said the company had used its COVID relief funds to pay for the pandemic expenses and to offset lost revenue. As of January, the company decided to take patients to court only if they earn at least twice the state poverty line – or about $ 52,000 annually for a family of four.

“We are constantly evaluating changes to our collection practices to help patients struggling to pay their hospital bills,” said spokeswoman Rebecca Pitt in an email.

The change in guidelines should be made retrospectively. CHS will pull the lawsuit for anyone who qualifies, Pitt says. Patients who owe money to CHS and former CHS hospitals will be made aware of the new policy in legal correspondence and can call 1-800-755-5152 to initiate the process, she says.

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