Crozer-Chester Medical Center is one of the Crozer Health's four hospitals. (Kenny Cooper/WHYY News)
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When patients fail to pay medical bills, hospitals often aggressively seek payment through lawsuits and negatively reporting to credit rating firms.
But what happens when a hospital doesn’t pay its bills? Patients still pay the price.
Crozer Health, the struggling four-hospital system in Delaware County, and its parent company Prospect Medical Holdings, have at times been unable to pay vendors and contractors who provide vital services to patients at Crozer-Chester Medical Center in Upland, according to staff.
“Trident is a company that inserts something called a PICC line, and IV lines for us. It’s not a central line. It’s not that invasive, but it’s just not your standard peripheral IV line. It really is beneficial to patients. We weren’t able to get that service, because that bill had not been paid and that was pretty significant,” said Peggy Malone, president of the Crozer-Chester Nurses Association.
TridentCare declined to comment. While the hospital has since paid that particular bill, Malone pointed to a recurring pattern: one bill gets paid while another gets ignored.
Judy Ramos, president of the Crozer-Chester Society of Pharmacists, said “credit holds” are a frequent obstacle to staff. For example, pharmacists have previously run out of equipment to package drugs and eventually find out they are on credit hold with a supplier.
“We finally got to a point where we had to use little Ziploc bags and package things like that and put a label on them — not very professional looking. And then eventually they get around to paying a bill and then something else comes in. But from day to day, you don’t really know what equipment you have to work with,” Ramos said.
Ramos, who has worked at Crozer for 35 years, said these issues, when compounded, can negatively impact patients.
“The harder that it gets to package drugs, the longer that it takes to do it. And then there are patients who are ordered a drug. The drug is not available to them. They have a delay in getting their medicine. It’s just not the way that we’re used to practicing pharmacy,” Ramos said.
Prospect’s inability to pay some of its bills has impacted more than just Crozer’s flagship hospital’s supplies and equipment.
Normally, the Upland Borough Police Department would have an officer permanently stationed at the hospital. But that’s recently changed.
“We ended up pulling out of the agreement and we no longer have an officer on site,” said Michael Irey, the police chief of Upland Borough.
Irey said Prospect owes the borough just short of $70,000 since missing payments for the months of December, January, and February — a growing figure the borough couldn’t “sustain.”
The police will still respond to calls at the hospital. And the hospital still contracts with an outside security firm. Irey, however, said it was essential to have an officer on site due to the sheer call volume.
In 2016, Irey said calls to the hospital — which includes a crisis center — accounted for roughly a third of all of the police department’s dispatches. Irey said the number has only risen following the pandemic and its overwhelming Crozer-Chester’s emergency room.
“Rather than having to call 911 and have a delay, that officer is right on the radio. So it cuts down on response time. It cuts down on officers having to fly around all over the place for a call that may not require something like that,” Irey said.
Malone called the lack of a constant police presence at the county’s largest mental health facility “extremely concerning.”
Prospect’s financial issues extend beyond the hospital doors. A local car dealership seized two of Crozer’s ambulances due to a lack of payment for desperately needed repairs in December.
On top of that, Malone said the company has suspended its match of 401k contributions to employees. Crozer has promised staff that they would be made whole by March 31. Malone said there have been quite a few empty promises made to staff.
“We hear them saying all the talk, but on our day to day, we’re not seeing it. It has caused a lot of anxiety and all of the staff. It creates all kinds of chaos. And a lot of staff still are continuing to look for positions and to leave the system because of the uncertainty. We hear ‘bankruptcy’ all the time. Staff is very afraid that this hospital is going to declare bankruptcy,” Malone said.
WHYY News reached out to both Prospect and Crozer for comment but did not receive a response.
Crozer, previously a nonprofit system, is Pennsylvania’s poster child for private-equity investments in health care. When Prospect, a California-based company, made the decision to shut down Delaware County Memorial Hospital and turn it into a behavioral health facility in September, the belief was that the shift would allow the hospital system to focus more attention on Crozer-Chester.
But since then, the financial outlook of the company does not appear to have improved, even with Prospect’s intention of transitioning Crozer back into a nonprofit system.
“I know that the CEO and the medical director [of Crozer] are really working toward getting us to nonprofit status, which will help a lot. But I think as long as Prospect has a member on that board and is charging a fee to advise that board, I just don’t think all the money is going to be sent to the places it needs to go,” Ramos said.