Cutting corners in a crisis: Staffers at Fatima Hospital detail poor working conditions

A new FRONTLINE documentary investigates how some for-profit hospitals are deepening health care disparities in the US

Inside a COVID-19 intensive care unit at LAC-USC Medical Center.Nick Kraus/FRONTLINE (PBS)

PROVIDENCE — The COVID-19 pandemic has put a spotlight on disparities in the American health care system, and highlighted the problems faced by for-profit hospitals as they struggle to serve low-income, working-class communities. Many of these so-called “safety net” hospitals have been in crisis for years.

A new investigative documentary, “The Healthcare Divide,” by FRONTLINE, National Public Radio, and American University’s Investigative Reporting Workshop, examines the widening gaps in the healthcare market. One of the hospitals they focus on is Our Lady of Fatima Hospital in North Providence.

Fatima Hospital and Roger Williams Medical Center in Providence are both owned by Los Angeles-based Prospect Medical Holdings. The two hospitals have had a long history of financial instability, and grueling fights with local lawmakers over ownership changes.

When the hospitals were first purchased by Prospect in 2014, union leaders told NPR correspondent Laura Sullivan, they thought Prospect was the “white knight here to save us.”

“They were going to provide the financial stability that we needed to continue to move forward,” said Lynn Blais, a nurse at Fatima Hospital.

That sense of happiness lasted “not even two months,” said Fatima medical secretary Cynthia Fenchel in the documentary. There were layoffs, hours were cut for management and frontline workers, and critical supplies became less available.

“You were always just used to being able to just walk into the supply closet, reaching for what you need, and knowing it’s there,” said Blais, who was the first president of the United Nurses & Allied Professionals union. “We find now that doesn’t happen. You call down to supply room and say ‘we need more saline.’ [They would say] ‘oh we’re out of stock. It’s on backorder.’”

That never happened before, said Blais. “Even in the worst of times, we always knew we had what we needed for the patients.”

Blais said the new owners told her “this is how the system works. This is how we’re going to survive.” She said she couldn’t get the responses or answers she needed and “went to war,” fighting for safer conditions and a better contract. She and others began researching their owners, and created a video detailing the problems they found coast to coast, all in hospitals owned by Prospect.

Neither Prospect nor the private equity firm that owns them, Leonard Green & Partners, agreed to be interviewed for this documentary, said Sullivan. Instead, they sent a statement calling the hospital staffers’ allegations “untrue” and insisting they had “good relations with the hospitals, unions, and staff.” They also said they invested “more than $100 million” into their hospitals in Rhode Island and “won awards.”

At Waterbury Hospital in Connecticut, which is also owned by Prospect, employees were facing similar, drastic cost-cutting measures.

“They were looking at giving us paper towels to wash patients. Not wash cloths. Paper. I said, ‘How do you charge a patient all this type of money and you give them a paper towel to wash themselves for the day?’ This is unacceptable,” said Romona Barnes, a surgical assistant at Waterbury Hospital, in the film.

Marilyn Anthony, a nurse at Waterbury Hospital, told Sullivan that they were told to change the linens “every third day.”

“This is the worst I’ve seen it in the 30 years I’ve worked for Waterbury Hospital,” said Barnes, who detailed how there was a constant fight for supplies, and not just masks and gloves during COVID-19, but “everything.”

Anthony said she received an email recently that instructed nurses to stop talking in the hallway about being short staffed because upper management didn’t want the patients to think that their care was going to be compromised.

“Their care is compromised,” said Anthony.

“I think we’re on the brink of a precipice,” Dr. Bruce Siegel, president of America’s Essential Hospitals, says in the film. “Even before the pandemic, many of these [safety-net] hospitals were losing money and the pandemic is only going to make that worse.”

State Senator Louis P. DiPalma, chairman of the Senate Committee on Rules, Government Ethics, and Oversight, told Sullivan in the film that he was “extremely concerned” about Prospect’s financials.

According to a report prepared by Pershing Yoakley & Associates PC, an independent consultant and was presented to the Oversight Committee, the two Rhode Island hospitals had accumulated net operating losses of $88.1 million from Fiscal Year 2015 to Fiscal Year 2020. The report also said that health company’s liabilities exceeded its assets by more than $1 billion as of September 2020.

“They have a note coming due in 2022. Not quite certain how they’re going to pay for it,” said DiPalma in the film. He said the company is “heavily leveraged” and recently paid almost $500 million in dividends to shareholders.

Chris Callaci, general counsel of United Nurses and Allied Professionals, said when he heard the news, he thought it was “boundless greed.”

“They go to struggling communities that need these safety-net hospitals to provide care,” said Callaci. “They’re going in there and taking advantage of these communities and these people.”

The Healthcare Divide premieres May 18, at 10 p.m. ET on PBS stations and will also be available to stream on https://www.pbs.org/wgbh/frontline/ , YouTube, and the PBS Video App.