Illinois regulators on Tuesday rejected a plan from the parent company of Chicago’s historic Mercy Hospital to open a new outpatient center.
Leaders at Trinity Health, which owns Mercy, are working to close the Bronzeville hospital and its group of clinics on the South Side by May. They say they’ve been losing patients and money for years.
Instead, Trinity is proposing an outpatient center that would leave them with a foothold on the South Side – a sign that Mercy would not be completely leaving the communities and patients they serve.
But on Tuesday, Trinity’s plans were overrun – both by opponents who say the proposed outpatient center isn’t adequate, and those who argue Mercy shouldn’t be allowed to close at all.
In a 3 to 2 vote, members of the Illinois Health Facilities and Services Review Board shot down Trinity’s plans. Some board members cited concerns about whether the proposed outpatient clinic could ensure patients don’t fall through the cracks. The clinic would not offer primary care, which is a key way doctors prevent people from getting sick in the first place and help manage chronic medical conditions, like diabetes and heart disease. Instead, the clinic would refer patients to doctors elsewhere.
“I don’t understand how … you all think this actually materially improves care,” said board member Dr. Linda Rae Murray. “If everybody switched to this model, we’d see more deaths, and more chronic disease.”
The outpatient center would be located inside Mercy’s existing Oakwood Shores clinic, near the Kenwood neighborhood. It would offer urgent medical care and diagnostic testing, such as mammograms, X-rays and MRI scans. Patients who need follow up care would be connected with physicians who work at other clinics.
Trinity gets one more chance to win board approval. The same board just over a month ago unanimously rejected Mercy’s proposal to close, fearing that patients would have less access to medical care.
Trinity pitches outpatient center to ease health disparities
Before the board vote, Trinity leaders and people who would run the proposed clinic, called Mercy Care Center, gave their pitch. They underscored how much the proposed outpatient center aimed to address health disparities on the South Side, such as higher rates of death from breast cancer among Black women. The majority of Mercy’s patients are Black.
The outpatient center, they said, would be able to screen patients to find cancers early. And it would be cheaper and more convenient than a hospital emergency department for urgent medical needs.
“As a Latina woman myself born and raised in an underserved community in Chicago, I want Black and brown people in our community to get better care, faster, and closer to home,” said Daisy Rodriguez, who said she would be executive director of Mercy Care Center if the clinic is approved.
In this area of the South Side, it can take months to get a mammogram, Rodriguez said. The clinic could screen patients to see if plaque is building up on their arteries, which could lead to heart attacks. Unnecessary emergency room visits could be avoided by going to urgent care, she said.
A Mercy Care Center board member pointed out how many people leave the area for medical care, something she said doesn’t happen as often on the richer North Side.
But some Illinois review board members had some concerns. For one, they complained the hours of the urgent care center weren’t long enough (it would close at 6 p.m. on weekends). Also, the board said it hadn’t received letters of support from local clinics or agreements that these clinics would refer patients to Trinity’s proposed outpatient center for testing.
Fierce opposition to Mercy’s plans
Some review board members also said they were swayed by the strong public testimony earlier Tuesday.
For about an hour and a half, the majority of roughly 30 speakers ticked off a host of concerns. Patients wondered where they would go in an emergency, especially those who don’t have easy access to transportation. And they touted the relationships and trust they’ve built up over years of visits with Mercy primary care physicians.
Many people questioned how the proposed outpatient center can be transformative, as Trinity’s argues, since it would treat only an estimated 65,000 patients a year. Now, Mercy has typically more than 300,000 outpatient visits a year, Illinois public health data show.
“We can’t view this proposal in a vacuum,” said Betty Chang, a first-year medical student at the University of Illinois in Chicago. “It’s not just whether an outpatient care clinic is good. Of course it’s good, but not when it comes with the caveat that the community will lose a hospital.
“What are you going to do when your outpatient clinic with all these imaging machines finds a mass in a patient’s breast,” Chang said. “What will you do then?”
Scott Mechanic, an emergency department nurse at the University of Chicago Medical Center, said he often staffs a part of the ED that operates an urgent care center. And that has given him some insight into the limits of that model.
He patches up wounds and treats strep throat. But he also tells people when they’re not having an emergency and they need to follow up with a primary care provider or specialist.
“At least at University of Chicago we can transition them into those services in-house,” Mechanic said. “The proposed Mercy urgent care center would have none of that available.”
Sally Nuamah, who researches the social and political consequences of institutional closures at Northwestern University, noted how people who live in and around Bronzeville have watched hospitals and schools close over the years, and housing disappear. Mercy’s proposed testing center, she said, would reveal disparities that the public knows already exists, without providing solutions.
“The question then, is how does the care center improve the health care needs of the community?” Nuamah asked.
The financial realities of running a hospital
Many physicians, nurses, patients, politicians and community organizers have been rallying for months to prevent Mercy from closing, especially during the COVID-19 pandemic. Over the years, many hospitals on the South Side have either closed or cut services – especially obstetrics, leaving pregnant women with dwindling options for where they can deliver their babies.
The majority of Mercy’s patients are low-income, elderly and Black. During the pandemic, Black and Latino residents have been disproportionately affected by the virus.
Mercy has one of the busiest emergency departments in Chicago, and the majority of patients who are admitted to the hospital come through the ED. Mercy also is a hub for the community, particularly for people who live in nearby Chinatown.
But Mercy leaders say they’re losing $4 million a month. The hospital routinely staffs fewer than half of its roughly 400 beds.
This emptying out of hospitals was happening around the country before the pandemic, particularly for hospitals like Mercy that treat many low-income and uninsured patients. These so-called safety net hospitals are typically starved for resources.
Trinity and Mercy leaders have one more chance to win the board’s approval to close the hospital, or ultimately could pursue closure in court.
Kristen Schorsch covers public health on WBEZ’s government and politics desk. Follow her @kschorsch.