NORTH LAWNDALE — Saint Anthony Hospital in North Lawndale is being pushed to its limit.
In recent weeks, the Intensive Care Unit has been at 120-140 percent capacity. Patients with respiratory failure are being intubated and hooked up to ventilators in other units in the hospital because there simply are not enough beds in the ICU and nurses have left for McCormick Place’s field hospital, said Dr. Eden Takhsh, chief quality officer at Saint Anthony Hospital.
It’s one of the top-performing hospitals in the city, but Saint Anthony, 2875 W. 19th St., is also a safety net hospital serving a patient population that is especially vulnerable to exposure to coronavirus and to developing severe complications once infected.
As the number of COVID-19 cases rises toward a peak, local hospitals will be stretched thin. But safety net hospitals serving vulnerable communities like Saint Anthony may face a bigger burden than they can bear without more help from public officials.
“Before the epidemic came upon us, we’re already under-resourced,” said Jim Sifuentes, senior vice president of mission and community development for the hospital. “Now we’re really in a fight for keeping the doors open to continue to serve the community. … If you look at the numbers we are disproportionately impacted in a way that others aren’t.”
Takhsh said about 20 percent of people who get tested statewide are confirmed to be infected with coronavirus. But at his hospital, it’s around 50 percent.
So far, 264 confirmed or suspected COVID-19 patients have been treated at Saint Anthony. As of April 23, 51 people with COVID-19 were being treated there, placing a tremendous burden on a medical center with only 15 ICU beds and 151 beds across the entire hospital.
More than 70 percent of people who died from COVID-19 in the city have been Black. Even without coronavirus, a Black West Sider will die an average of 16 years earlier than a more affluent white Chicagoan, studies show.
On top of that, residents in some communities of color are more likely to be exposed to the infection.
“Our community are essential workers,” Takhsh said. “They don’t have the luxury of sitting at home. If they did, and they had to self-isolate, there is no place for them to self-isolate because they’re not living in three-, four-bedroom houses. They have co-morbidities, whether it’s obesity, diabetes, hypertension and so on. So it hits them much, much harder.”
Safety net hospitals treat patients regardless of their ability to pay, and many coming to Saint Anthony are uninsured or can’t pay at all. About 70 percent of patients at the hospital are insured through Medicaid, compared to an average of only 19 percent statewide. Only 4 percent of patients at Saint Anthony use commercial insurance, Takhsh said.
But the profit-driven managed care organizations that pay out Medicaid reimbursements to hospitals pay only a small fraction of what commercial insurers would pay. On top of that, the reimbursements are often delayed or denied, leaving hospitals struggling to pay for vendors, clinicians and medical equipment.
“Managed care organizations have been dysfunctional in a way that there are tremendous delays and denials of payments over the last few years. So Saint Anthony Hospital is owed in the region of $30 to $40 million,” Takhsh said.
Those deficits make it impossible for the hospital to secure advanced testing resources that are needed to keep the community safe, like the 15-minute turnaround tests better-resourced hospitals may have. Other hospitals also have their own lab facilities on site, cutting down wait times for test results. Until recently, Saint Anthony relied on an outside lab company that had a two-week turnaround time, making it hard for clinicians to offer effective medical advice to patients who have been exposed or infected.
One of Saint Anthony’s most essential resources — its nurses — are also in short supply.
Some nurses are unable to work because they are vulnerable to developing severe illnesses from coronavirus or because they have been infected. But at least 15 Saint Anthony nurses have also been poached to work at the medical center built at McCormick Place for COVID-19 patients, Sifuentes said. Thirteen of those lost were ICU nurses lured away by public money that allows McCormick Place to pay two to three times more than a safety net hospital like Saint Anthony, Sifuentes said.
These experienced nurses are now treating patients who aren’t as sick as those at Saint Anthony’s ICU, Sifuentes said.
“The McCormick Place isn’t up and running in full capacity. Yet they lured all these nurses away,” Sifuentes said.
Sifuentes wants public officials to be mindful of how their efforts will impact the most vulnerable and to consider allocating nurses and equipment to hospitals already embedded in communities rather than investing so much capital into opening treatment centers.
“If they’re putting resources in these other areas, why are they not looking at the places that are impacted the most?” he asked.
Saint Anthony is not the only low-income hospital losing staff to McCormick Place. Roseland Community Hospital’s CEO also claimed it was losing nurses to better-paying gigs at McCormick Place and other hospitals.
Mayor Lori Lightfoot has denied allegations McCormick Place is poaching nurses.
“We did not want to cannibalize staffs at surrounding hospitals,” she said during a news conference last week. “We were very conscious of making sure that the staffing agency that was initially hired by the state put in specific provisions to ensure we weren’t hiring anyone away from area hospitals.”
Pascal Sabino is a Report for America corps member covering Austin, North Lawndale and Garfield Park for Block Club Chicago.
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