Crozer closure crisis could catalyze new state oversight of hospitals

Several years ago, the inpatient drug and alcohol treatment facility at Crozer-Chester Medical Center abruptly shut down. “That was the first sign for me – they were choosing profit over patients,” says Yahaira Turner, who joined the Upland hospital as a social worker seven years ago. 

Last week, Turner – along with the rest of the Delaware Valley region – received more bad news: Having failed to secure the necessary financing to remain open, the bankrupt Crozer Health system was shutting down, starting with the emergency room where Turner had most recently worked. The announcement, while crushing to many, was hardly a surprise, coming as it did after months of failed efforts by various government and nonprofit stakeholders to save Crozer, which had been acquired by Prospect Medical Holdings, a Los Angeles-based private equity firm, in 2016.

It is the latest in a string of closures that have left Pennsylvania communities without critical health resources. Many are hoping that the episode’s silver lining will be momentum for greater state oversight of hospitals, including long-stalled legislation aimed at preventing more devastating closures. 

In Westmoreland County, Jeanette Memorial Hospital closed in 2011; another Jeanette hospital, Monsour Medical Center, had closed five years earlier. In 2009, Northeastern Hospital, which had served Philadelphia’s Port Richmond community for a century, terminated its hospital services and became an ambulatory care location for Temple Health.

More recently, the long-troubled Penn Highlands system shuttered its Elk County maternity care unit in 2024, leaving residents of that rural community without nearby labor and delivery services. And earlier this year, Sharon Regional Medical Center was closed down by its private equity-backed parent company, Steward Health, before re-opening – under new nonprofit ownership – several months later. Still, the closure temporarily left western Mercer County without a cardiac catheterization lab, an intensive care unit, specialized cardiac services, inpatient child psychiatric care or public-transportation drug testing. 

In Philadelphia, residents are still smarting from the 2019 closure of Hahnemann Hospital, a storied circa-1848 teaching institution that, like Crozer, fell victim to the fortunes of private equity. That shuttering remains the nation’s largest-ever displacement of physicians-in-training.

On April 29, the Philadelphia Inquirer reported that 16 state lawmakers had sent a letter asking state Attorney General Dave Sunday to intervene to recover the $40 million cobbled from various sources to keep Crozer Health hospitals fully operational until late April. The legislators also want Prospect to pay for standby ambulance service at the hospitals’ shuttered emergency rooms, so that patients seeking care can be seamlessly transported to the next-closest facility.

The push for greater state involvement comes after State Rep. Lisa Borowski, who represents her native Delaware County, said she plans to reintroduce a bill she sponsored in a previous session – which passed in the House, but languished thereafter – that would mandate review of major proposed hospital transactions by the state Attorney General’s office. 

Such a measure would not only give the state leverage to intervene in proposed sales or closures of hospitals above a certain financial threshold, but would also alert the Attorney General’s office of brewing hospital issues earlier on, allowing for earlier intervention.

The legislation “would call for additional documentation – giving the attorney general an opportunity to do a little more of an in-depth look as to who (a potential hospital) buyer is,” explained Borowski. “What have their intentions been in other places? What is their track record?”

Borowski suggested that Prospect may well have failed that test. “I think they saw a system ripe for profit-taking,” she said of the bankrupt outfit, which is struggling to manage its network of financially troubled hospitals elsewhere across the U.S. “They sold the land that hospitals were on … They took over $400 million of profit and gave that to their shareholders, as opposed to, if you have a struggling health system … reinvest that money back into the system. As I understand it … it was always their intent to close the system and sell off the parts for profit.”

Neither Prospect nor Crozer Health responded to requests for comment.

Borowski, who gave birth to her first child at a Crozer hospital 27 years ago, acknowledges that the system’s troubles were multifaceted. “A lot of our nonprofit health systems are struggling,” she said. “It’s a challenge to deliver health care in this environment, with reimbursement rates as they are, people being sicker a lot of times when they present to the hospital, an aging population.”

Still, the closures of Crozer-Chester and Taylor Hospital in Ridley Park leave Delaware County without a single trauma center or burn unit. This week, local officials were scrambling to contract with ambulance outfits to fill the void left by the loss of Crozer's emergency medical services. More than 2,600 Crozer employees are losing their jobs. 

And residents of the commonwealth's fifth-most-populous county are facing the prospect of driving farther – and waiting longer for care – at Delco’s two remaining hospitals. Chester residents, who could previously access trauma care a 5-minute ride away at Crozer-Chester, will now have to travel at least 20 minutes to the next-closest hospital – Riddle Hospital in Media – which is not equipped to handle the most complex cases. The nearest Level 1 trauma centers and burn units are now more than a half-hour away, in Philadelphia.

“With trauma, time lost is lives lost,” said Maureen May, the longtime president of the Pennsylvania Association of Staff Nurses and Allied Professionals, a fast-growing statewide health workers’ union. Emergency workers talk about the “golden hour” – the precious minutes when it is often possible to resuscitate a victim after the onset of a stroke, heart attack or traumatic brain injury. It is a brief window, and when it closes, recovery may not be possible. 

“We will watch people die,” said May, who led months of union protests against the impending Crozer closure. Health care workers “aren’t sitting behind a desk, saying, ‘Oh, we feel bad.’ We are the ones on the ground, absorbing the pain. When they just shut down the hospital and patients die because they don’t get their care, there is no liability for private equity.

“It’s pure devastation and confusion and chaos. I know that from Hahnemann,” added May, who worked for years in critical care and is currently at Temple Health’s neonatal intensive care unit. 

Bankrupt hospitals are nothing new, of course, but the veteran nurse has watched the 20-year rise of for-profit health care structures with alarm. “Before that, the typical model was nonprofit community hospitals,”  May explained. The financial pressures of private equity introduce new tension into a system already beleaguered by fast-rising costs, she said: “It’s a profit-driven system … until it’s no longer profitable.”

May still shudders when she remembers the agony of Hahnemann’s stranded transplant patients, who scrambled to obtain the records essential for vital follow-up care. In Delaware County, she fears for the heart attack and stroke victims who will inevitably lose precious time traveling farther for emergency care.

“Every health system should have a crisis plan, a backup plan,” May added. “(Borowski’s) bill is too late for Crozer, obviously. But in any disaster, you pull together and you try to figure out how to mitigate it in the future.”