Update Feb. 11: Mercy Hospital filed for bankruptcy on Wednesday, saying it has lost about $300 million in the past seven years. In the bankruptcy filing, Mercy acknowledged that the quality of care for patients is “an increasing concern” as financial losses climb and employees leave, which WBEZ reported earlier this week. The hospital still plans to go before Illinois regulators on March 16 to win approval to close two months later. In a statement, Mercy said it plans to keep its emergency department open even after the rest of the hospital closes, until a new outpatient clinic opens. But regulators have not approved that clinic.
More than three months before Mercy Hospital aimed to shut its doors, several lawmakers and physicians fear the Near South Side medical center is closing faster than expected.
Mercy in Bronzeville has one of the busiest emergency departments in the city, with some 50,000 visits a year. But now it’s turning away ambulances and the state is downgrading its emergency room to a “standby” department. That means patients can be treated by on-duty nurses, while physicians are “on call.”
Meanwhile, physicians in Mercy’s emergency department were recently told to transfer patients waiting to other hospitals instead of admitting them to Mercy.
Employees say there’s a staffing crunch. Many nurses and doctors have left without being replaced — potentially creating patient safety issues — while some services have been cut.
All of these moves essentially shrink the number of patients Mercy treats, and signal to other patients to seek care elsewhere.
“They’re trying to shut us down,” said Dr. Ben Saiyasombat, chief ED resident at Mercy.
That has, in fact, been the plan all along. But not so quickly.
Trinity Health, a giant national hospital group that owns Mercy, has said it planned to close the hospital by May 31, after years of losing patients and the money they generate. Trinity has said Mercy loses about $4 million a month, and the aging hospital would need at least $100 million “to maintain a safe and sustainable acute care environment.”
Democratic Illinois State Rep. Lamont Robinson, whose legislative district includes Mercy, said the governor’s office has lined up a local hospital to buy Mercy. But, Robinson said he worries that Trinity is “dismantling” the hospital before someone else could take over.
Mercy sits alongside Interstate 55 just blocks from the South Loop, where development has mushroomed around the McCormick Place Convention Center. In a filing last year, Trinity disclosed to regulators that it would likely sell the hospital building and real estate.
“I think that we all understand that this could happen,” Robinson said of Mercy winding down. “We just thought that in good faith, because of what is going on with the pandemic, that Trinity would work with us and give us more time to be able to get the entity in place.”
A Mercy spokeswoman said Trinity has spoken to 20 potential buyers. None were interested or willing to acquire Mercy as a full-service hospital. She said Democratic Gov. JB Pritzker hasn’t presented any buyers interested in running Mercy as a hospital.
Mercy’s dwindling staff
Trinity announced plans in July to close Mercy and its group of outpatient clinics throughout the South Side by 2021. It was a long transition plan, though initially the hospital considered closing as early as Feb. 1.
Since Trinity announced its plans, some employees on the cusp of retirement have left. Department leaders have gotten new jobs at other hospitals. With fewer patients to learn from, some medical residents in training have moved on to other programs.
During the last few months, Saiyasombat said there haven’t been enough nurses to help treat patients. So in the emergency department, patients who were sick enough to be admitted to the hospital stayed, but were treated by emergency medicine nurses and physicians on other floors upstairs.
Then late last week, Mercy told the emergency department physicians they no longer could keep patients there because there weren’t enough nurses to take care of them on the various floors of the hospital.
At one point, there were just over 20 patients in the emergency department who needed to be admitted to the hospital, and roughly 30 more patients in the waiting room, Saiyasombat said.
Instead emergency room physicians had to transfer them to other hospitals, a time-consuming process. But many hospitals were full. No agency coordinates transfers in Illinois, even when hospitals are overwhelmed with patients, a WBEZ investigation revealed last summer.
“They have to call these hospitals twice per shift and log that they’ve called these hospitals to try to transfer all these patients out,” Saiyasombat said.
To help address staffing issues, the state is paying for about 20 nurses to work at Mercy, Robinson said.
The Mercy spokeswoman said the hospital, like many around the country, is struggling to replace nurses who leave.
“We staff the units at Mercy Hospital to maintain safety for our patients,” she said. “When the census goes down, we reduce nurses, but only when the patient volumes go down.”
On Monday, Mercy was treating just under 70 patients. Before the COVID-19 pandemic, Mercy had on average 162 patients a day, according to Illinois regulators.
The fight to keep Mercy open
There’s been fierce opposition to closing Mercy, which was the first chartered teaching hospital in Chicago, especially during the pandemic. And so far Illinois regulators have rejected Trinity’s request to close Mercy, saying they fear shuttering the hospital would reduce access to medical care for patients. Regulators have also voted down a plan to essentially replace Mercy and its many outpatient clinics with one urgent care and diagnostic testing facility.
Some critics have called the plan racist. The majority of Mercy’s patients are Black, and doctors there also treat many Cantonese-speaking patients from nearby neighborhoods, including Chinatown. During the pandemic, Black and Latino Chicagoans have gotten sick and died the most, public health data show.
Everything from the rate of infant mortality to deaths from heart disease and cancer among people who live in communities that Mercy serves are higher than the citywide average, according to a 2019 report.
And many health care advocates consider the South Side to already be a health care desert. Most of the hospitals in the area are so-called safety nets for their communities, including Mercy. They treat mostly low-income and elderly people of color, but their mission means they struggle financially. And over the years, these hospitals have cut services, particularly obstetrics, leaving pregnant women with fewer options for where to deliver their babies.
Trinity has one more chance to win separate approvals to close the hospital and to open one new outpatient center. Regulators are scheduled to cast their final vote on whether to close Mercy on March 16. If Trinity loses, it could take its fight to court.
Kristen Schorsch covers public health on WBEZ’s government and politics desk. Follow her @kschorsch.