Prime Healthcare may ask the state for permission to offer lower-level trauma care at three of the eight Illinois hospitals it bought early this year, compared with what those hospitals were providing before the sale, Prime said in a letter sent to U.S. Sens. Dick Durbin and Tammy Duckworth this week.
Prime’s letter was in response to a correspondence Durbin and Duckworth sent to Prime’s founder and chairman last month, expressing concern about changes Prime has made at some Illinois hospitals since buying them from Ascension in March.
In that letter, Durbin and Duckworth asked if Prime had plans to cut additional services at its Illinois hospitals in the future.
In response to that question, Prime said that Level III trauma designations would be more appropriate at St. Mary’s Hospital in Kankakee, St. Joseph Hospital in Elgin and Mercy Medical Center in Aurora. St. Joseph in Elgin is currently a Level II trauma center. Mercy in Aurora and St. Mary’s Hospital in Kankakee lost their Level II trauma designations in recent months after Prime purchased them.
Level I trauma centers offer the highest level of trauma care, with the ability to treat the most serious injuries in-house 24 hours a day, such as injuries sustained in car crashes or through gun violence. Level II trauma centers don’t offer as many services or have the same staffing, and centers that are Level III – which is a new designation by the state – will offer even fewer services.
Prime wrote in the letter that the hospitals in Aurora, Elgin and Kankakee don’t serve enough trauma patients to justify continued Level II services.
“Level II Trauma Designation in smaller community hospitals with minimal trauma volume (located in Aurora, Elgin, and Kankakee) is likely not sustainable,” Prime said in the 29-page response. “The Level III designation will likely be the more appropriate designation for the hospitals listed below, as those hospitals have minimal trauma volume.”
Prime said it will likely request that St. Joseph Hospital in Elgin become a Level III trauma center once that designation is available. Illinois passed a law last year creating the new Level III designation, but rules are still being created to allow implementation of that law, said Mike Claffey, a spokesman with the Illinois Department of Public Health. Claffey said he did not have a timeline for when the rules might be finished.
St. Mary’s in Kankakee recently worked with the state health department to suspend its Level II trauma designation because of low numbers of trauma patients and because of a loss of on-call OB/GYN coverage, Prime said in the letter.
Mercy lost its designation as a Level II trauma center in April. The Illinois Department of Public Health alleged in a letter to the hospital that Mercy did not have the staff to cover essential services required of a Level II trauma center, at several points both before and after Prime’s purchase. Prime said in the letter Monday that Mercy decided to suspend Level II trauma services “upon further evaluation of the low volume and the need to ensure quality.”
Durbin and Duckworth expressed disappointment in Prime’s response, in a joint statement Thursday.
“Prime knew it was taking on a big challenge when it chose to purchase these hospitals,” the senators said. “But the response we received fails to acknowledge the patient harm that may arise from services being shuttered across several hospitals, and raises new questions about future restrictions on care. As pediatric, trauma, and obstetrics care is being cut, Illinois patients deserve more than hollow promises of potential reinvestment sometime later.”
Attempts to reach the mayors of Elgin and Kankakee for comment were unsuccessful Thursday.
Prime bought the eight Illinois hospitals in March for more than $370 million from Ascension, a large Catholic health system. Six of the hospitals sold to Prime changed from being nonprofit hospitals to for-profit hospitals as part of the sale. St. Mary’s in Kankakee was one of the two hospitals that remained nonprofit, and the Elgin and Aurora hospitals became for-profit.
The other hospitals that were sold include Holy Family Medical Center in Des Plaines, Resurrection Medical Center in Chicago, St. Francis Hospital in Evanston, St. Joseph Medical Center in Joliet and St. Mary of Nazareth Hospital in Chicago.
Since the purchase, Prime has made changes at some of the hospitals, drawing criticism from a nurses’ union and elected officials.
Prime announced in late April that it would suspend inpatient pediatric care at St. Joseph Medical Center in Joliet, citing low numbers of patients. The Illinois Nurses Association decried the move, saying it would be difficult for the community, given that the hospital is the only one in Joliet.
Many Chicago-area community hospitals have closed their inpatient pediatric units in recent years because of low demand, advancements in medicine that make inpatient care less necessary in some cases, and competition from major children’s hospitals in the area.
Prime also decided to suspend obstetrical services at St. Mary’s in Kankakee after the hospital’s “nearly sole obstetrics physician” retired, and because of low demand, Prime said in the letter. Prime said the hospital had been delivering, on average, about 26 babies a month.
The senators had also asked Prime why it made the changes after stating in an earlier application to the state that “at this time, no changes to the scope of services or the levels of care provided at the facility are currently anticipated to occur within 24 months of the proposed transaction.”
Prime said in its response that it filed that application “approximately six months before closing on the acquisition, and in the absence of complete information from Ascension,” and it did note in its application that it would assess and possibly modify services.
In its response to the senators, Prime also emphasized its mission of turning around struggling community hospitals across the country. Prime noted that before it bought the Illinois hospitals, they were losing about $200 million a year.
“After years of turmoil, Prime was the only health system willing and able to commit the substantial resources and effort that will be required to save these hospitals,” wrote Dr. Prem Reddy, the Prime founder, chairman and CEO in a note that was part of the response.
Prime said it plans to expand behavioral health care services for seniors at its Illinois facilities. It said it plans to double the number of beds for geriatric psychiatric patients at St. Mary of Nazareth Hospital in Chicago and create new geriatric psychiatric units at St. Joseph Medical Center in Joliet, St. Joseph Hospital in Elgin and at St. Mary’s Hospital in Kankakee.
Prime has said it plans to invest $250 million in the Illinois facilities for capital improvements, technology and system upgrades.