By Kathleen E. Carey
Daily Times
RADNOR, Pa. 鈥� Waiting time for ambulances has doubled, resources including a Tuesday stadium job fair are set up for Crozer employees and a health provider locator map has been established in the wake of Crozer Health hospital closures.
Information on these and a presentation on how Prospect owners took $658 million out of its system were shared at Delaware County Council鈥檚 recent meeting.
鈥淭his is not a situation we should be in,鈥� Delaware County Executive Director Barbara O鈥橫alley said. 鈥淭he mismanagement of this system and the resources that were taken from it for the profit of others have devastated a community.鈥�
Last year, she said the county convened a Hospital Contingency Planning Group after Prospect closed Delaware County Memorial Hospital and Springfield Hospital in 2022 and efforts to sell Crozer Health fell apart.
The group鈥檚 focus, O鈥橫alley said, was to respond if Crozer Health were to fail and to try to prevent that from occurring.
In February, the county established an internal Emergency Operations Center planning team after Prospect declared bankruptcy in January.
Various work groups were established to address what the greatest needs would be upon a Crozer system closure.
Delaware County declared a state of emergency on April 21 when Prospect announced and began its closure of Crozer Health facilities, as did 26 municipalities in the county. O鈥橫alley said this gives the county flexibility in its EMS dispatching.
鈥淭aylor closed within a week,鈥� she noted, adding that it was shuttered four days after the announcement was made. 鈥淐rozer-Chester Medical Center closed on Friday, May 2.鈥�
She said Prospect agreed to leave two ambulances at Crozer-Chester Medical Center through the end of May, although the county had asked for 16 weeks of coverage.
鈥淧rospect is gone from this community,鈥� O鈥橫alley said. 鈥淭here will be no one at the hospital 鈥� Do not go to that emergency room.鈥�
When Crozer-Chester Medical Center and Taylor Hospital were open, 95% of Delaware County鈥檚 576,000 residents were within five miles from a hospital. When they closed, 13% of county residents are not within 5 miles of a hospital, O鈥橫alley said.
Jobless number spirals
Kate McGeever, executive director of the Delaware County Workforce Development Center, spoke of the impact and what鈥檚 being done.
鈥淗ere in Delaware County, for the last several years, we have had anywhere between 10,000 and 12,000 people who were unemployed, giving us a quite low unemployment rate,鈥� she said. 鈥淲hen Crozer announced their layoffs, we are anticipating a total of 3,200 individuals will be impacted, so this is quite a shock.鈥�
She said unlike other scenarios, their team was not able to meet with impacted employees prior to the closure.
McGeever said a Crozer Transition Center opened Monday at the Chester Police Station at 160 E. Seventh St. in Chester for Crozer employees.
It is open 8:30 a.m. to 5 p.m. Monday through Friday to provide career counseling, resume writing, unemployment guidance, job search assistance and health insurance enrollment.
Appointments can be scheduled at Pa.CrozerTransitionCenter.info@edsi.com. However, walk-ins are welcome. The phone number is 610-876-4855.
In addition, a Crozer Job and Resource Fair will be held from 10 a.m. to 2 p.m. Tuesday, May 13 at Subaru Park, 1 Stadium Drive, Chester.
More than 200 employers have registered to attend the event and hundreds of job titles will be available. For more information, call 610-447-3350 or email Pa.CrozerTransitionCenter.info@edsi.com.
Delaware County has also set up a health care provider map on the Prospect portion of the county website.
Residents can type in their address and then be shown what hospitals, urgent care facilities, minute clinics and test-and-go kiosks are near them with addresses, phone numbers and hours of operation.
EMS wait times
Also at the meeting, Patrick O鈥機onnell, Delaware County鈥檚 Regional EMS Director spoke of the effect he鈥檚 seeing.
鈥淭he greatest impact of this crisis is the EMS wait times,鈥� he said. 鈥淭he wait times were the ambulances are waiting in the hospital emergency room to transfer the care of the patient to their staff 鈥� These delays cause the delay in readiness for EMS to respond to the next urgent call.鈥�
Using state data for this area, he said it showed April 2024 was a 22-minute wait in these facilities and hospitals.
鈥淟ooking forward to April 2025, those times increased to 49 minutes,鈥� O鈥機onnell said.
An audience member in the county council room, shouted, 鈥淧eople will die.鈥�
Through Independence Blue Cross Foundation, AmeriHealth Caritas Foundation, and Jefferson Health, Delaware County has been able to have four ALS vehicles for three months bridge the gap left by the Crozer closures.
O鈥機onnell said that four regions have been established and that this ALS coverage is being provided by Keystone Quality Transport, Main Line Health out of Riddle Hospital and VMSC out of Lansdale, Montgomery County.
Region 1 includes Eddystone, Glenolden, Norwood, Prospect Park, Ridley Park and Tinicum and is covered by Keystone Quality Transport out of Norwood Fire Company. Region 2 includes Morton, Swarthmore, Rutledge and the Garden City section of Nether Providence and is serviced by VMSC out of the Swarthmore Fire Company.
Region 3 includes Brookhaven, Chester Township, Parkside and Upland and is covered by Main Line Health 鈥� Riddle, serving out of the Middletown Fire Company and Region 4 includes Lower Chichester, Trainer and Marcus Hook, being served by VMSC out of the Marcus Hook Fire Company.
He also noted that some municipalities are contracting with services to provide ALS for their residents.
O鈥機onnell listed challenges as increased coverage area, cost of this service, vehicles and equipment, staffing, training and asset availability.
Those who got rich off it
Mary Bugbee, health care director for the Private Equity Stakeholder Project, gave an overview of what led to the Crozer Health hospital closures at the meeting.
鈥淭he short answer of why we鈥檙e here is because of private equity extraction,鈥� she said, adding that while devastating, these practices are legal even as profit is prioritized over patients.
Los Angeles-based private equity firm Leonard Green & Partners controls about $75 billion, Bugbee said, adding that among the companies they鈥檝e owned included J. Crew, Joann Fabrics and Petco.
In 2010, Leonard Green bought Prospect Medical in a $205 million leveraged buyout, 77% of which was leveraged by debt, according to Bugbee.
鈥淭hey extracted approximately $658 million in fees and dividends from the safety net hospital chain, in part, by saddling it with debt and using the proceeds of the loans to pay themselves,鈥� Bugbee said of Leonard Green owners Samuel Lee and David Topper. 鈥淪o, they just used debt placed on the hospital to pay themselves hundreds of millions of dollars.鈥�
She added, 鈥淭he investor group collected this money out of Prospect even as many of its hospitals were suffering, deteriorating financial conditions and quality issues.鈥�
In 2021, Leonard Green exited its stake in Prospect after selling it to Lee and Topper.
鈥淥f the $658 million, 鈥� $437 million of that went to Leonard Green and the remaining went to Samuel Lee and David Topper,鈥� Bugbee said.
She said that Prospect was able to pay off the $1.1 billion of debt it had accrued through selling off the bulk of Prospect real estate to a real estate investment trust, likening it to hospital landlords, in this case the for-profit Medical Properties Trust.
That action left Propsect with long-term lease liabilities as they had to pay rent for properties they once owned.
鈥淚t often contributes to financial distress at the hospital,鈥� Bugbee said of this transaction. 鈥淭here鈥檚 less money for operating costs, leading to reduced quality of care and sometimes, unsafe working conditions 鈥� and that fact that Prospect hospitals don鈥檛 own their own real estate has factored into the major difficulties that these hospitals are facing right now in trying to find buyers.鈥�
The wider picture
Bugbee received applause when she said that Massachusetts Gov. Maura Healey used eminent domain last year to seize the real estate of one of the Boston hospitals.
She also warned that these private equity maneuvers are not isolated to the health care industry, although she said not all private equity firms participate in this, as it doesn鈥檛 add value.
鈥淚t鈥檚 literally siphoning value out of it,鈥� she said, noting the impact of private equity extraction in health care leads to understaffing or unsafe staffing, layoffs, poor quality of care, unpaid vendors, unpaid taxes and hospital closures.
She noted that the first hospital Prospect closed was in San Antonio, Texas, in 2019, impacting almost 1,000 employees.
The Private Equity Stakeholder Project is a nonprofit watchdog group that focuses on the impact of private equity on people, the economy and the planet.
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