Amid Massive Sell-Off of Hospitals, Corporate Giant Chain Still Sues Patients : Shots - Health News As Community Health Systems has downsized, what remain are like zombie hospitals – little more than legal entities still taking patients to court even though the new owners don't sue.

A Health Care Giant Sold Off Dozens Of Hospitals — But Continued Suing Many Patients

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SARAH MCCAMMON, HOST:

Many hospitals have been publicly shamed for suing patients over medical bills, especially during the pandemic, and many have stopped that practice. But one major hospital chain has been aggressively pursuing patients, even as it sells off its facilities to pay down its debts. As Blake Farmer of member station WPLN in Nashville reports, the company is taking patients to court well after no longer owning the hospital.

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BLAKE FARMER, BYLINE: I'm standing on the helipad of the hospital in Lebanon, Tenn., which was sold two years ago to Vanderbilt University Medical Center. But since then, we found through county court records that the former hospital owner has sued more than a thousand patients like Hope Cantwell.

HOPE CANTWELL: I could not believe that someone was - someone - a corporation was doing this during a pandemic.

FARMER: It started in 2019. Cantwell was admitted for a short stay at this midsized hospital in a Nashville suburb. At the time, it was owned by Community Health Systems, known as CHS, a for-profit hospital chain operating in 16 states. Nearly a year later, she'd saved up some money to start chipping away at the $2,700 her insurance left as her part of the bill.

CANTWELL: And went online and could not find the name of the hospital for the portal (laughter).

FARMER: She did a little Googling and read the facility was sold a few months after her stay, one of more than 100 hospitals unloaded to help CHS avoid going under. Then the pandemic hit. Cantwell was furloughed from work. And soon after, a letter arrived - a law firm representing the former hospital owner. CHS demanded payment and threatened to sue. Then, a few weeks later, there was a knock at her apartment. She masked up and answered the door. A legal assistant handed her a summons to appear in court.

CANTWELL: My mind immediately went to the stimulus payments. I was like, well, I guess at least I have a way to take care of this now.

FARMER: At this point, it was no longer a question of whether the charges were correct or whether she really owed the former owner of the hospital. Lawsuits are a rich man's game. She couldn't justify hiring a lawyer. She was trying to avoid ruining her financial credit or having her paycheck garnished. So when her final pandemic stimulus money dropped into her bank account, she paid up.

CANTWELL: I don't have the resources and emotional and mental capacity to handle anything more than just, like, kind of rolling over and handing over whatever amount of money they'd be happy with.

FARMER: Other patients who were sued just can't afford to pay. I talked to a woman who was sued by the same hospital, and so was her husband for a separate hospital stay. He works at a distribution center that shut down for months during COVID. She cares for their foster kids and delivers meals ordered online.

CHRISTI WALSH: The thing is, these aren't rich people who don't want to pay their bills.

FARMER: Christi Walsh is part of a research team at Johns Hopkins University that's been pressuring hospital systems like CHS to stop taking patients to court.

WALSH: I've been on the ground, in the courthouses. These are people who don't have the money to pay it.

FARMER: The company has made suing patients part of its corporate debt-reduction strategy since 2015. And the pandemic didn't stop that behavior, even though the for-profit chain received more than $700 million from the federal government in COVID relief money, helping the company turn its first profit in years. Dr. Marty Makary leads the Johns Hopkins team and says most hospitals have changed tactics, since suing their patients doesn't bring in tons of money, and it hurts their brand.

MARTY MAKARY: Community Health Systems, in all of our research of hospital pricing and billing practices, stands out as an aggressive institution that across the country engages in very aggressive predatory billing - suing patients in court to garnish their wages.

FARMER: Makary says he's concerned these patients will think twice before going to any hospital, not realizing that most are more flexible on payment.

MAKARY: It threatens the public trust in our community institutions.

FARMER: In a statement, a CHS spokesperson says that the company used its COVID relief money to pay for pandemic expenses and make up for lost revenue. This year, the company also decided to take patients to court only if they make at least twice the poverty level - or about $52,000 - for a family of four. The exemption is meant to be retroactive, though many sued patients might only learn of the policy change if they hear this story.

For NPR News, I'm Blake Farmer in Nashville.

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