The pain in Dolores Wilson’s stomach was so bad in May that she got a ride to Mercy Hospital, less than a mile from where she lives in Chicago’s Dearborn Homes public housing in Bronzeville, and spent a few days there on a liquid diet.
Wilson, a sweet and spry 92-year-old, started writing down a song she wanted sung at her funeral.
“When they took me in, when I thought I was going to die, they saved my life,” Wilson said of the staff at Mercy. “It was close, and at the time when I really, really needed it … it was open.”
Wilson said weeks after her Mercy stay, the pain in her stomach returned. This time, she called 911.
“And I said, ‘Well, just take me to Mercy,” Wilson recalled, her voice rising to a shout. “They said, ‘We can’t take you to Mercy.’ I said, ‘But I was at Mercy before!’”
But she wouldn’t go this time. The historic hospital, which had served Chicago for 170 years, was being sold. It was losing millions of dollars, losing scores of patients, losing staff. The nursing shortage, in fact, had gotten so bad that Mercy had been turning away city ambulances for months.
So paramedics took Wilson to University of Illinois Hospital, a teaching hub about five miles away from her Near South Side home. The ER was slammed.
After 14 hours, Wilson walked out of the hospital without seeing a doctor. She ran out of patience.
Wilson would tell this story to illustrate Mercy’s vital role in her community. She was among dozens of people who fought for nearly a year to keep the hospital open. They argued that the South Side already had few health care options as other hospitals, clinics and medical services vanished over the years. That if Mercy closed, already grim disparities would get worse. That people could die.
But they were up against a brutal reality: Mercy was hemorrhaging money, losing at least $4 million a month, yet needing at least $100 million in upgrades. Mercy’s CEO announced in July 2020 that the hospital would close the following year.
The community campaign to save Mercy that followed was an angry, emotional battle that formed on the heels of George Floyd’s murder by a white Minneapolis police officer, and during a global pandemic that disproportionately killed and infected Black and Latino patients.
In the end, the hospital was sold for $1 to an out-of-state owner called Insight and the name changed, ending Mercy’s reign. It was the oldest chartered hospital in the city.
Mercy’s near death took a toll – on its patients, employees and other hospitals where the sick and injured had to be sent instead. It also illustrates why access to health care is so unequal in Chicago and across the nation. So-called “safety net” hospitals like Mercy have a mission to serve the poor and uninsured, but often have the least amount of resources to do so.
“People were right to fight for Mercy to stay open,” said Dr. Linda Rae Murray, a longtime community health practitioner in Chicago who is on a state board that voted against Mercy’s closure.
“The reality is there was probably no way for Mercy to stay open, and we’re going to lose other community hospitals unless we change the underlying medical system in this country,” Murray said. “These hospitals cannot survive financially because we set up a structure that makes it impossible.”
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Mercy Hospital is a hulking, white rectangular building located in the historic Bronzeville neighborhood just south of downtown.
Perched along bustling I-55 with a view of Lake Michigan, Mercy’s location straddles the edges of poverty and plenty. Walk just a few blocks north, and signs of gentrification and money are apparent: soaring shiny condo buildings, new hotels and Wintrust Arena buttressing the renowned McCormick Place Convention Center.
Mercy was a Catholic institution founded by the Sisters of Mercy around 1852, and was housed in a few different locations, before ultimately landing where it stands today.
The hospital survived the Great Chicago Fire 150 years ago. Mercy was in what was considered the country then, far from the flames near the center of the city, and treated victims from the fire in the middle of the night.
The hospital trained generations of physicians, and was considered a pioneer in medical treatment. Many celebrity or politically connected patients and donors cycled through: former U.S. President Teddy Roosevelt, Congressmen, governors, famed boxer Muhammad Ali. All of former longtime Chicago Mayor Richard J. Daley’s seven children were born at Mercy.
“It is deeply interwoven into the history of this city,” said Sister Joy Clough, who wrote a book about the history of the hospital.
The majority of Mercy’s patients were Black, low-income or elderly. But it served a stew of surrounding communities.
Dr. Alan Jackson was a cardiologist at Mercy and grew up across the street from it, skateboarding in the shadow of the hospital as a kid.
“I might have a guy from streets and sans, a Bridgeporter who might be related to one of the politicians,” Jackson recalled. “I may have someone from Chinatown that speaks … Taishanese, which is rare, but there it is and we have nurses who can speak that.
“We have Latino patients from the Near West Side, and then we have our Black population, and not just the underserved Black population, but middle class, upper middle class people. You just see, I think, a slice of real Chicago at Mercy.”
Mercy is also a place where employees tended to work for years, if not their entire careers. Many former employees describe Mercy as “family,” and many found jobs there after nearby Michael Reese Hospital closed in 2009.
It’s where Dr. John Patterson’s parents and his aunts and uncles went when they were kids, and where as a young medical resident in training he met his wife, Maryclare. She was a nurse in the emergency department. He spent his entire career walking the halls of that hospital, and trained future generations.
“It’s always been my desire to go back to my neighborhood and practice medicine,” said Patterson, who became an obstetrician and gynecologist and retired in 2019. “Which is exactly what I did.”
In Chicago, your ability to see a doctor depends on where you live. If you can actually get to a clinic given the lack of easy transit in some areas. If there’s even a clinic to get to. If you have insurance.
Most of the hospitals on the South Side are struggling safety nets, like Mercy was. There are some neighborhood clinics as well — Mercy had several — but mostly this pocket of the city is considered a health care desert. There’s a massive drought of doctors — specialists like OBs and psychiatrists in particular.
Earlier this year, a local study called out the “alarming access gaps” on the South Side compared to the rest of Chicago and laid out just how much the lack of money safety nets brought in threatened their survival.
Yet people here are sicker and die earlier than in other parts of Chicago, which has the biggest life expectancy gap between neighborhoods of any big city in America, according to the NYU Grossman School of Medicine.
Dr. Ben Saiyasombat watched this play out as chief resident in Mercy’s emergency department.
“If patients come in sick, a lot of times it’ll be because they have no other choice,” Saiyasombat said. “They haven’t seen a doctor. They don’t have the resources to see a doctor. And they’ve come in by ambulance, or they’ve come in because they have nowhere else to turn.”
Mercy’s ER was one of the busiest in Chicago, with some 50,000 visits a year. The hospital was also one of the few places on the South Side still delivering babies.
“You got patients that aren’t seen till the third trimester because they don’t have options, and they’re finally being shuttled to Mercy at the end,” said Dr. Pierre Johnson, an OB-GYN who was born at Mercy and later delivered babies there.
Losing Mercy would mean shrinking access even more, a fact that a coalition of organizers that fought to save the hospital hammered time and again.
But being beloved didn’t help the bottom line.
Safety nets like Mercy bleed money. Their buildings tend to be old and expensive to maintain.
Fewer and fewer patients are going to them. Of the patients who do come through the doors, many either have no health insurance, or they’re poor and they have Medicaid. And that insurance sometimes covers just 50 cents for every dollar spent on a patient. Then there’s the battle for the hospital itself to get reimbursed from insurance companies.
All of this financial strain puts Mercy and other safety nets in the worst position to take care of people who need it the most.
“Nearly half of the hospital beds on the South Side remain empty; yet 60% of patients in that area leave for the care they need,” Trinity Health CEO Michael Slubowski wrote in a letter to Illinois Gov. JB Pritzker earlier this year.
Trinity is a vast national Catholic nonprofit health system that owned Mercy. While the hospital made a $4.1 million profit in 2020, Mercy had been losing money for years, totaling nearly $300 million in losses the previous five years, records show.
Trinity said it invested more than $124 million on infrastructure updates into old Mercy, and spent another $112 million for other operating needs. Still, Mercy would need at least another $100 million in dire repairs. Rust covered the entire frame of the hospital, and leaky windows “bring winter precipitation into patient use spaces,” state records show. Interviews with at least half a dozen former employees and others who provided medical care at Mercy revealed the deterioration of the hospital over the years.
“One of the operating rooms in labor and delivery where I did so many C-sections, it was just broiling hot,” said Patterson, the OB-GYN who was at Mercy for about 45 years.
Rooms facing east had great views of Lake Michigan, but when temperatures soared outside, they also soared inside. Sweating patients would be mistaken for having fevers, a former resident said.
Norma Rolfsen, a veteran nurse practitioner, recalled treating a patient in the last days her clinic was open at Mercy. Supplies had already been removed from several exam rooms. She soaped up her hands but had to go to three different rooms before she found water to rinse. The other faucets appeared to be turned off.
“It felt like you were in one of those fun house things where it sort of shrinks around you,” Rolfsen said. “Like, ‘Wait, wait, wait, don’t push my arms in yet. I still need to move around.’ …. It was a challenge just to finish seeing people.”
Despite Mercy’s physical and financial challenges, there was a lot of skepticism from employees about how much money Mercy was actually losing.
Trinity has some 90 hospitals from coast to coast and roughly $20 billion in revenue. There was money to spend.
But the giant hospital group had already tried to close Mercy in 2019 when it instead agreed, at the behest of the state, to a sort of medical Hail Mary. Mercy would merge with three other safety net hospitals on the South Side: St. Bernard in Englewood, Advocate Trinity in Calumet Heights and South Shore in that community.
“It was a hugely bold plan, because those four institutions were contributing all their assets, and they were giving up their identity,” recalled St. Bernard CEO Charles Holland.
The hospitals would have been closed, and at least one new modern one opened, along with several outpatient clinics. But the merger plan was pricey, totaling about $1 billion. The hospitals wanted the state to pick up $520 million of the tab. Legislators said no.
Trinity had also tried shopping Mercy around to more than 20 potential buyers. The hospital group said no one wanted it.
By December, Mercy was before the Illinois Health Facilities and Services Review Board — the main hospital regulators in the state — looking for approval to close.
“We looked at many, many different ways to change our services, to change the levels of service,” Mercy CEO Carol Schneider told the board.
But it was tough to compete, she said, with bigger, richer teaching hospitals that were wooing patients with new, modern facilities.
Trinity’s new pitch: to close the hospital and its outpatient clinics. Then open one new clinic with urgent care on the South Side. Board members weren’t convinced. They unanimously voted no, that Mercy could not close, not in the height of the pandemic, anyway.
In reality, the board had little power. It couldn’t force a private business to stay open.
As Mercy kept moving toward closure, a fight to keep it open was growing.
The drumbeat against Mercy’s demise was relentless. Letters and petitions poured in. Patients, politicians, and community organizers testified for hours at public hearings, laying out the stakes.
That Mercy saves lives.
“I treated three cardiac arrests in an hour and a half two weeks ago, where time was of the essence. People showed up dead. They did not leave my emergency department dead.” — Dr. Anudeep Dasaraju
That the next closest hospital is too far, especially considering Chicago’s wall-to-wall traffic and endless construction.
“For the population I represent, Chinese immigrants, many of whom are limited English proficient, senior citizens who are transportation challenged, and low-income families that rely on the services of this community safety net hospital. Five miles may as well be a different planet.” — Illinois State Rep. Theresa Mah
That their lives weren’t valued, and that closing a hospital in a Black community was racist.
“All we hear every day is people doing press conferences where racial justice is coming out of their mouths, where Black Lives Matter is coming out of their mouths. … When it counts, our lives really don’t matter.” — Jitu Brown, national director, Journey for Justice Alliance
Banned by the hospital from speaking out, Mercy’s employees could only watch from the sidelines, listening to public hearings on their cell phones while filling out patients’ medical charts, peering out windows to watch protests for their hospital being taken up by others.
One of those was Dasaraju, a medical resident at the University of Illinois who worked in Mercy’s ER and intensive care unit as part of his training. He wasn’t on Mercy’s payroll, so he wasn’t silenced.
“We want to treat these patients. We care about these patients,” he would cry out during a protest to keep Mercy open. “We sit at the bedside with these patients. We stay up for 24 hours and longer with these patients to make sure they get through the night.”
Later, Dasaraju described how extreme it was to close Mercy, at that time.
“You have a billion-dollar corporation trying to shut down a hospital in the middle of a global pandemic,” Dasaraju said. “Something about that seemed evil.”
Trinity’s CEO declined an interview request. In response to questions, a spokeswoman cited many of the reasons safety nets struggle, including aging infrastructure costs and treating patients who mainly don’t have better-paying private insurance.
No matter the protests on the streets, Trinity’s plan kept churning.
The letters to patients started to arrive, telling them that Mercy was going to close, that they needed to find new doctors somewhere else. The outpatient clinics would shutter first, followed by the hospital.
Etta Davis, 67, received a handful of those letters, one for each doctor she had at Mercy. She saw a physician at least every three months, helping her manage kidney disease, diabetes, arthritis and other ailments.
This happened to her before — the scramble to find new doctors and get her medical records — when she was a patient at Michael Reese and that hospital closed. She found a haven at Mercy. She lives close by, a 10-minute walk from the hospital.
“This whole thing is like a nightmare all over again,” Davis said.
Some of Davis’ doctors helped her find new ones at other hospitals, including the University of Chicago Medical Center, a prominent teaching hospital about five miles south of Mercy. But it would take time to build trust, she said, like it took time to build trust with her doctors at Mercy.
“Like my rheumatologist, sometimes I would try to go even if I was in pain and just say, ‘I’m fine,’” Davis said. “She would be able to notice on those days and say, ‘Ms. Davis, you always come in in a happy mood, but I can tell you’re not fine today.’”
Davis would deliver one fiery speech after another at news conferences and protests, imploring someone to step forward to save Mercy. She was used to fighting for causes she believed in. The words just came, she said.
“I’m so angry about it,” Davis said on a bench over the summer near her home, the letters from Mercy on her lap. “I speak from my heart.”
Hospital leaders had promised they would arrange for some patients to go to other hospitals. But there were many fears.
Would other hospitals take them in? And would those providers speak Chinese, like many of the staff at Mercy? How many patients would simply fall off the radar, and just get sicker?
“So basically, you’re releasing these patients, and you really don’t have any place for them to land,” said Patterson, the former longtime Mercy OB-GYN. “It’s like pushing them out of a plane without a parachute.”
One of Mercy’s doctors took to giving his clinic patients a small card that fit into their wallets. It listed their medications, illnesses and last screenings and immunizations. The idea was to help patients transition easier.
So many were on their own.
With the hospital’s future so bleak, the staff at Mercy began leaving for new jobs.
The staffing shortage was enough to prompt Alivio Medical Center, a group of clinics for low-income, uninsured and undocumented people in predominately Mexican neighborhoods near Mercy, to stop delivering babies there last October.
“There were not enough nurses. There were not enough staff. It was just a little bit scary for us and legally we felt it was a better idea if we moved,” said Susan Ward, a nurse midwife who coordinated the midwifery service at Alivio from 2010 until she retired in June. “None of us wanted to do that.”
Alivio shifted to another hospital, but many of Alivio’s patients speak Spanish, and some told their midwives they felt their language wasn’t valued during their deliveries. Some of Alivio’s patients stopped showing up altogether.
Maria Argumedo, 26, is an Alivio patient who delivered her first baby at Mercy, a boy who is now 4 years old. But around Christmas, when she was six months pregnant with her second child, Argumedo learned she would have to deliver elsewhere.
She grew worried. At Mercy, she said she got good, attentive treatment. They had her medical history. Delivering at a new hospital, during the pandemic?
“I got really nervous,” Argumedo said of Mercy in Spanish. “I didn’t know what was going to happen.”
In the end, she said the experience of delivering her baby girl turned out fine.
For Ward, the nurse midwife, the change was nonetheless painful.
“I’m still hurting,” Ward said. “I love that hospital. … The relationship that we had with the nurses, with the residents, with the doctors, with the clerks, the clean-up staff. It didn’t matter who was there. It was a family, very much like Alivio.”
The staffing crunch only worsened.
For 15 days in late January to early February, there weren’t enough nurses in Mercy’s busy ER. At times they were short up to six nurses during shifts, according to an inspection report from the federal Centers for Medicare & Medicaid Services. At one point, there were dozens of patients waiting to be treated or waiting for a bed upstairs because they needed to be hospitalized.
“The deficiencies are so serious they constitute an immediate threat to patient health and safety,” CMS branch manager Anna Olson wrote to Mercy’s CEO on Feb. 10.
Mercy’s ER was no longer allowed to accept ambulances from the Chicago Fire Department when someone called 911. The next closest hospital is at least a 10-minute drive depending on traffic.
City ambulances were estimated to make up almost 25% of the patients who came to Mercy, the inspection report said. They stopped coming in the late afternoon on Feb. 5, according to city ambulance transport data. Within days, the number of patients showing up at Mercy’s ER sharply fell.
Records show Mercy brought on expensive agency nurses, who have been in high demand across the country during the pandemic, to help. A Trinity spokeswoman said patient care was not compromised.
Mercy’s doors were closing — fast. Patients would have to go elsewhere, and nearby hospitals would soon see that crush.
Spend some time with Dr. Janet Lin, and the impact of Mercy’s wind down on other hospitals and the Chinese-speaking communities it served becomes strikingly clear. The University of Illinois Hospital’s emergency department is the closest to Mercy, about five miles northwest.
Lin stood outside U of I’s emergency room on a warm afternoon in early August, wearing a crisp white blazer and hot pink pants instead of scrubs. Tucked away on Taylor Street, the ER is almost hidden from view and underneath L tracks where trains roar every few minutes.
Lin had just walked through the ER, and said it was packed. In fact, the entire hospital had been full for at least the last three to four months.
“I think we have something like 63 plus patients physically in the waiting room,” said Lin, who has worked at U of I for more than two decades. “We technically have a 30-bed ER. You can probably do the addition. It doesn’t quite add up.”
Patients were waiting longer to see a doctor to get treated and go home. Others were getting medical care in hallways while waiting for a bed upstairs, in some cases 24 hours or longer. Many ERs, like U of I’s, already were slammed with COVID-19 cases and people who had delayed care during the pandemic. Add to that the closure of Mercy’s ER to city ambulances in February.
To understand the impact, WBEZ traced the rush of ambulances that, forced to steer clear of Mercy, made their way to other hospitals through early August. Before the pandemic, there were three ambulances stationed in fire houses from Chinatown to Bronzeville that transported the majority of patients to Mercy.
When Mercy shut its doors to city ambulances, U of C, a highly specialized trauma center, received the most from those three ambulances — nearly 2,100 transports compared to around 600 in 2019 during the same months. That’s a more than threefold jump.
U of I has an ER half the size of U of C’s, but took on the second highest volume from the three ambulances, a nearly six-fold increase.
U of I’s patient walk-ins surged too, particularly from Chinatown — a neighborhood that some consider an extension of Mercy.
Mercy was long part of the fabric of Chinatown and other surrounding Chinese-speaking neighborhoods. It’s a heavily immigrant community where many people work low-wage jobs — local cooks and hotel housekeepers — without health insurance. For many who only speak Chinese, their neighborhood is their world.
Fenny, 43, of nearby Bridgeport, became a Mercy patient more than a decade ago when she delivered her son and daughter there. There was always an employee who spoke her language, she recalled. Signs throughout the hospital were in Chinese.
“I feel comfortable and relaxed because they can explain,” Fenny, who didn’t want her last name used to protect her privacy, said through a translator. “It really is full of mercy, and full of love.”
In February, Fenny drove her father-in-law to Mercy when he was having a stroke. A Chinese-speaking physician in the ER helped treat him. Her father-in-law spent more than 20 days hospitalized at Mercy.
“Good thing it was so close to home,” Fenny said.
Behind the scenes as Mercy was unwinding, Gov. Pritzker’s administration raced to buy time — and find a new owner.
According to a WBEZ review of hundreds of emails and other documents, the state questioned Trinity about how much money Mercy was really losing.
By February 2021 — two months after state review board members rejected Mercy’s request to close — the hospital filed for bankruptcy. That prompted a terse exchange between Pritzker and Michael Slubowski, Trinity’s CEO.
“I find it inexcusable that Trinity decided to close Mercy Hospital without ensuring there is a plan in place to provide care for those who need it most,” Pritzker wrote in a Feb. 11 letter.
The health disparities for Mercy’s patients would get worse, Pritzker warned. Slubowski shot back, and blamed Illinois lawmakers for not helping to pay for the proposed merger with three other hospitals on the South Side. He said the losses at Mercy were getting worse, now totaling nearly $9 million a month.
Slubowski suggested revisiting a proposal Trinity previously offered the state: to transfer Mercy, including the real estate it sits on, to the state for $1. The state declined.
A few days later, Slubowski wrote to Pritzker again, this time offering to connect him with a potential buyer. He reiterated that Mercy would be closing by May 31.
A week after this back and forth, Mercy started issuing layoff notices to those who had hung on. Ultimately, more than 1,000 employees would lose their jobs.
Then came the moment so many fighting had been waiting for — Mercy had found a savior.
Mercy CEO Carol Schneider emailed her dwindling staff on March 3. There was a non-binding deal to sell the hospital to Insight Chicago, a new nonprofit affiliated with a biomedical technology company in Flint, Mich.
“It is not our intention simply to have a functional hospital,” Dr. Jawad Shah, Insight’s founder and a neurosurgeon, said during a virtual public hearing on March 12 where he introduced his company. “We want to make this a world-class institute that attracts people from all over the world and the state.”
Shah touted Insight’s deep ties to the Flint community, financial turnaround expertise given Mercy’s financial struggles, and an ability to transform a sprawling 600,000-square-foot former General Motors building into Insight’s campus.
Many people vouched for Insight during the hearing, including former patients and Flint’s mayor.
A coalition of Chicago community organizers, patients and others took a brief victory lap for likely preventing Mercy’s closure. The state still needed to approve the deal. The organizers also demanded seats on Insight’s board with voting power so they’d have a say in what happened in their community.
Still, the reception from Chicagoans was icy. Insight wasn’t from here. They ran a tiny 20-bed hospital in another state, no match for a hospital the size of 400-bed Mercy.
There was suddenly a push to vet other potential buyers, to delay the vote on Insight’s potential purchase. Why Insight?
Dr. Adele Cobbs, who worked in Mercy’s emergency department, was among the skeptics.
“I have watched my colleagues’ morale suffer as this hospital is rapidly being deconstructed,” Cobbs said during a public hearing about Insight’s potential purchase.
“Mercy is not just an empty building and a plot of land for auction. She has a life and a soul,” she said. “She is historic and resilient. She serves the community and is part of the community, and that community belongs to me and countless others.”
Just over a week later, the Illinois review board held a meeting to consider Insight’s bid for Mercy. A local alderman asked for a delay so the community could vet other potential buyers, with complaints that Insight still hadn’t divulged how it could even afford to run Mercy.
“What are we saying?” asked Ald. Sophia King, whose ward includes Mercy. “That anyone can come in a Black community and take over without due diligence?”
This would never happen to richer, bigger hospitals like Northwestern Memorial Hospital or U of C, King suggested.
But there were concerns, too, that Mercy was running out of time. Mercy attorney Edward Green didn’t mince words.
“Every day that goes by, the less and less likely you are going to have a hospital to save,” Green said.
In the end, regulators had no choice.
“We already have our hands tied because we can’t really make a judgement on whether we think the … answers were adequate,” Dr. Linda Rae Murray, a member of the state review board, said of the questions the board had for how Insight would pull this off.
But all the deal required was the new owner filling out paperwork correctly.
On March 22, the board approved the sale. The price tag: $1.
On Memorial Day around 11 p.m., a small group of Mercy employees gathered in the parking lot of the hospital to say goodbye.
Music blared. There was a table heavy with food. Drinks all around. It felt in part like a celebration, in part like a wake.
“One day we’re sitting in the breakroom and decided we need to just toast – toast her out,” said Cobbs, who was the assistant director in the ER, an alcoholic drink splashed with pink lemonade in her hand.
Insight was officially taking over at midnight. Mercy would get a new name, and a new identity.
Cobbs looked over the small crowd that was mourning, the nurses, doctors, technicians and secretaries. Many of them were moving on to new jobs, including Cobbs.
“There was no signs of Mercy in this plan,” Cobbs said. “Mercy’s not a building. It’s the people. I just didn’t feel like it was going to be represented in this plan.”
At one point, the crowd watched a small team from Insight walk inside the hospital.
There, the Insight team would find just over a handful of patients. The lobby was dark. The halls were empty and quiet. Insight largely took over a shell of what Mercy used to be.
Insight’s journey to buy Mercy was somewhat kismet. Insight founder Dr. Shah was visiting family in Chicago and found himself on a bike ride along Lake Michigan, looking out at Mercy and wondering about its fate. He’d heard about the intense public pressure to keep the hospital open.
“It didn’t make sense to me given our own history of the turnarounds that we’ve done in several different situations,” Shah said. “That also sparked our interest.”
On June 1, just after midnight, Shah and a dozen Insight employees fanned out across Mercy. They had little access to the building before then.
Atif Bawahab — Shah’s chief strategy officer in Flint — is the new CEO of the hospital, now called Insight Hospital & Medical Center. Inside an empty corner office, Bawahab sank into a chair. He was wearing a dark suit, and flew in hours before from his home in Houston, replaying events over the last year on the flight.
“We weren’t even sure until probably 12 hours ago the situation we were walking into,” Bawahab said.
He jiggled keys to the hospital. There was a constant knocking at the door by new and old staff. Around 1 a.m., he greeted some new physicians coming in.
“I always ask myself if this is the right thing for us and we’re meant for this, then it naturally will happen,” Bawahab said. “Trinity … for whatever reason they had a choice to make and it was a tough decision, but it led to us now here in this moment.”
He reflected on the stakes and the work ahead. He wants to make Mercy an “engine for economic development,” a research hub, but Bawahab acknowledged it wouldn’t happen quickly.
He would need to rebuild trust with the community. He didn’t expect the process of buying Mercy to be so political.
“We also weren’t looking for high fives,” Bawahab said. “I guess maybe I was naive that we just assumed that this was a hospital that was about to close, and we were kind of coming in with sincere intentions to make it work.”
Even as they ramp up the return of services, there are significant looming costs — Insight has to infuse the hospital with $50 million over two years, a promise pushed by Chicago Mayor Lori Lightfoot.
Many people are rooting for Insight to succeed, hoping the connection the community had to its flagship hospital will be restored. By late October, signs of life were slowly returning.
Insight restored the intensive care unit for the sickest patients, and has resumed surgeries. Still hamstrung by a nursing shortage, the ER isn’t accepting city ambulances yet.
But the fight to save Mercy was about more than reviving one hospital. It highlighted the larger health disparities that exist throughout Illinois.
If people care about the health of the state’s population, there needs to be better planning for what kind of medical services people actually need, health care advocates say, and where they can get them, because more hospitals will likely close.
In Chicago, a dozen safety nets (which then included Mercy) are on the brink, and expected to lose at least a combined $1.8 billion by 2024. And these hospitals are emptying out, filled with vacant beds.
But the near death, then sudden rescue of Mercy proved the government can’t force safety nets to stay open, or make better-resourced hospitals fill in the gaps where there’s little access to care. Hospitals are still private businesses, in the end.
Meanwhile, a patchwork of efforts are aiming to bring back medical services to the South Side.
Other hospitals have taken on some of Mercy’s former outpatient clinics. Trinity is opening an urgent care center in the former Oakwood Shores clinic. Cook County plans to bulk up services at Provident Hospital, a safety net across a vast park from U of C.
And there’s a big collaboration in the works, buoyed by at least $26 million from the state. St. Bernard, U of C and several other safety nets and clinics are teaming up to woo more than 100 doctors to the area. The focus is on ramping up preventative care, for hospitals to be the last resort.
But a wary watch remains, the wait to see who might close next.
Holland, St. Bernard’s CEO, looks out at marble floors in the hospital’s original building. It’s 117 years old and houses administrative offices, not patient rooms. There’s a small chapel around the corner, where light pours through arched stained glass windows.
But here’s the dilemma.
“This building … is not a usable hospital building,” Holland said. “What do you do with it?”
It’s expensive to maintain, but just as expensive to demolish.
Over the first five months of this year, St. Bernard had lost some $3.6 million, which could spiral to a nearly $9 million deficit by year-end if the trajectory continues.
Holland quietly mentions perhaps a controversial idea: drastically downsizing the hospital, but keeping St. Bernard’s busy ER.
This hospital’s struggles were Mercy’s struggles. They’re the struggles of all safety-net hospitals.
“It’s not sustainable. So help us figure out what we need to do to make it sustainable,” Holland said.
“Not only my partners on the South Side, but also the state of Illinois,” he said. “We just have to look to the future and make plans so that we don’t go the same route as a Mercy Hospital went.”
This story is part of a reporting fellowship sponsored by the Association of Health Care Journalists and supported by The Commonwealth Fund.
Kristen Schorsch covers public health on WBEZ’s government and politics desk. Follow her @kschorsch.
WBEZ’s Adriana Cardona-Maguigad contributed. Charmaine Runes produced the data visualizations. Courtney Kueppers produced this story for digital.