More than half of West Suburban’s 29 resident doctors say the hospital is in “critical condition” and cited several patient safety issues, including a shortage of epidural kits and nonnarcotic pain measures in the labor and delivery unit, under the management of Manoj Prasad.
The unionized residents aired their concerns in an open letter they sent to Growing Community Media, the parent company of Austin Weekly News. In it, they outlined their worries about patient safety that they say are a result of “shortages of vital hospital resources, inadequate building maintenance, and understaffing that have become increasingly prevalent under Resilience Healthcare.”
Prasad is CEO of Resilience Healthcare. In December 2022, Resilience bought West Suburban and Weiss Memorial Hospital in Chicago and inherited $80 million in debt as part of the deal. Since then, West Suburban residents said, the hospital’s conditions have worsened.
“We would not write this unless we felt we had exhausted all direct avenues for change,” residents said in the letter. “Residents and residency program faculty have met with hospital administration countless times to no avail.”
What residents say is “substandard care” has an amplified effect on its patients from Austin, a largely Black neighborhood, which has disproportionately lower income and higher rates of chronic disease compared to the rest of the city. When a majority of West Suburban patients rely on Medicaid to cover costs, residents said, resource shortages and understaffing cause delays that can extend a hospital stay for patients who may not be able to afford it.
“Some of the most vulnerable communities in Chicago are paying the price,” the residents said in their letter. “The crisis at West Suburban reveals how economic and health disparities compound one another, fortifying structural racism in the process.”
Supply shortages
In their letter, residents list of the “most concerning” safety issues, like periodically running out of critical supplies including:
- Vapotherm oxygen tubing, which connects to the patient’s nose for respiratory support
- Nitrous oxide gas, a nonnarcotic pain control option for labor and delivery
- Arterial blood gas kits, which measure levels of oxygen and carbon dioxide in blood
- Tube feeding pumps in the intensive care unit
- Epidural kits for labor and delivery
- Female external catheters
“One night on the labor & delivery (L&D) floor, there were three laboring patients and only one epidural kit in the entire hospital,” residents said in the letter.
As for the catheters, they added, “multiple older women on diuretics languished in diapers with none of their urine output measured for days. One patient’s family member eventually purchased catheters and diaper rash cream with her own money.”
Prasad told GCM that the residents didn’t send him the letter.
“They have chosen to not share this letter or any complaints with me,” he said.
The complaints, however, are not new. Residents voted to unionize last November and asked for better patient safety and investment in their education as part of negotiations. Those negotiations are ongoing.
Prasad, for his part, also said there have been no service or equipment cuts.
“I am happy to tell you again and again that we are not cutting any services and have no plans to cut any service,” Prasad said. “Since we took over, we have added hundreds of pieces of new equipment.”
He added that the hospital has not run out of Vapotherm oxygen tubing and nitrous oxide gas in labor and delivery, arterial blood gas kits and tube feed pumps in the ICU, or female external catheters.
After checking with the hospital’s supply chain team and other leaders – whom Prasad said haven’t seen these supplies run out – he added that sometimes medical supplies aren’t readily available because department heads occasionally don’t place orders in a timely manner. When this happens, Prasad said, West Suburban borrows supplies from Weiss Memorial Hospital or other hospitals. West Suburban has also loaned supplies to surrounding hospitals.
“We might have a delivery glitch that sometimes delays supplies, but we are not cutting supplies,” Prasad said.
“This is a normal part of hospital operation,” he added. “Young doctors in training may not understand this and panic. It happens in every hospital, even the large ones.”
In August, hospital workers were notified by Tiger Connect – the hospital’s paging service that allows staff to communicate throughout the hospital and when they’re on-call – that access would be canceled in a week because of nonpayment.
Prasad said there was a past-due balance of $2,400 that he then paid, but the paging system was never impacted.
Services at risk
The problems, resident doctors said, extend beyond shortages in supplies. They also said there have been gaps in services.
In August, the hospital’s dialysis service was cut because of nonpayment. Without notice to staff, the service was replaced by a company with “far less technician capacity,” according to resident doctors, providing only one dialysis machine operator for scheduled dialysis. Patients requiring urgent or nighttime dialysis are now transferred to another hospital, delaying treatment and increasing the risk of complications, residents said.
Over Labor Day weekend, residents said that doctors redirected heart attack patients to other hospitals because of a scheduling coverage issue with the hospital’s cardiology group.
Prasad said that, because of unfounded rumors in August that West Suburban was closing, its dialysis vendors stopped service overnight. So, the hospital had to change vendors – to one that worked with Rush University Medical Center for 20 years, Prasad said – and it took a few days to get staffed. He added that the new vendor has the same number of technicians at a lower cost.
“We even bought our own three sets of dialysis machines, so no vendor could disrupt services in the future,” Prasad said.
“We have had two occasions when, due to a sudden non-availability of a cardiologist, we have had to divert cardiac patients to another hospital,” Prasad confirmed. “Again, this happens in many hospitals. Several times, other hospitals have to divert their patients to us.”
The cardiologist group, he added, is a private group that organizes its own scheduling.
“In this day and age when hospitals are shutting down departments or laying off large percentages of their staff,” Prasad said, “we are standing tall, recruiting more and more staff and providing services to the community.”
Legal battles
In the letter, residents pointed to a 2002 lawsuit. Louis Cole bought Kern Hospital in Michigan, where Prasad was CEO a year before the purchase. Cole said he discovered the hospital had a medical equipment lease that left him with unexpected financial obligations. He also said Kern officials concealed that the hospital was not in compliance with Medicare conditions. The case was later settled out of court.
“It’s not a Medicare investigation, but a routine survey,” Prasad said. He wasn’t involved with the hospital at that time and said the Medicare survey is a regular process where hospital CEOs can submit their plans of corrections.
The residents also pointed to copies of three lawsuits against Resilience Healthcare for owing money for medical supplies or services.
Prasad said the lawsuits are often for nonpayment of amounts Resilience inherited from previous owners.
The residents said it seems like something similar is happening at West Suburban.
“He’s not paying the bills and he’s slashing staffing and vital resources,” they wrote. “This time, some of the most vulnerable communities in Chicago are paying the price.”
The full residents’ letter can be read here:
