Merit Health Central is moving many services from Jackson to the suburbs. Employees wonder what's next

by Kate Royals, Mississippi Today
September 21, 2022

Merit Health Central is struggling: services and units are closing or being moved, and current and former employees say the hospital is unable to maintain safe staffing levels. 

The private hospital, one of nine Merit Health facilities in the state, has already moved or is planning to move its cardiovascular services, neonatal intensive care unit and endoscopy to other Merit Health locations outside of Jackson. The hospital is also planning to “consolidate” its behavioral health beds, according to records with the Mississippi Department of Health, though it is unclear where. 

And the hospital garnered headlines in early September for announcing it would close its  burn center — the only such program in the state.

Meanwhile, several current and former staffers of the hospital interviewed by Mississippi Today said many employees have left or are seeking employment elsewhere, often leading to shifts that aren't fully or properly staffed.

Merit Health Central declined Mississippi Today's request for an interview for the story with someone in administration but provided several emailed statements.

“The five Jackson-area Merit Health hospitals share a commitment to serve residents of Jackson and the surrounding region,” said Jana Fuss, director of marketing at Merit Health. “We regularly review our operations and evaluate how we can best apply our resources to offer needed services and strengthen our operations.”

The hospital's struggles could have an outsized effect on the livelihood of many Jacksonians and those who live in rural parts of Hinds County. Merit Health Central, formerly Hinds General Hospital, has long been a health care and employment hub in south and west Jackson — majority-Black neighborhoods that have a higher concentration of people living in poverty than the rest of the city.

According to U.S. Census data, the neighborhood the hospital is located in is 87% Black and 9% white. The median income for families is $29,500. 

In contrast, Merit Health River Oaks in Flowood, where many services are being moved, is 61% white and 28% Black. Its median income is $46,389 — 57% higher than the south Jackson neighborhood. 

State Sen. Sollie Norwood, D-Jackson, whose district includes Merit Health Central, had not heard about any changes at the hospital other than the closing of the burn unit. He said he fears what a drastic change would mean for the residents he represents.

“We don't need to reduce the accessibility of (health care) at this time,” Norwood said. 

The Jackson hospital reported the largest amount of net uninsured costs, or cost of services for which the patient had no insurance coverage, of any of the Merit Health hospitals in the state for fiscal year 2022. The hospital reported nearly $16 million in net uninsured costs. The next-highest, Merit Health Biloxi, reported just $7.9 million. 

The hospital is owned by the county and leased by Merit Health's Nashville-based parent company, Community Health Systems. Community Health Systems made headlines recently for its financial challenges: the company reported a $327 million net loss in the first half of 2022, and Fitch Ratings downgraded the company's rating outlook from stable to negative. 

Fuss declined to answer questions about how that has impacted Merit Central specifically.

She pointed to the COVID-19 pandemic and the “challenging staffing and recruitment environment” as contributors to the closing of the burn center. They have made it difficult to hire the specialists needed to run the burn program, she said, adding that the hospital has been in discussions with other regional providers interested in potentially establishing such a program.  

On top of the ongoing problems, the hospital, which runs on city water, recently hemorrhaged money bringing in water tankers amid the city's months-long boil water notice.

Mississippi Today spoke with several current and former staffers at Merit Central for this story. None of the employees were willing to speak on the record because they feared retribution from their current or future employers.

One employee said the hospital staff is “dwindling,” and most employees are looking for jobs elsewhere. 

“People in various departments (who) have been told they will likely be impacted are leaving for other opportunities, and it is because they feel there will no longer be opportunities here… We have basically been told since this came to light that it will be predominantly a psych facility,” she said. 

Rumors are swirling at Merit Central that the long term plan for the hospital is to transition to a majority psychiatric facility, and records from the Mississippi Department of Health also show the hospital intends to “consolidate” its behavioral health beds.

The facility currently has 71 behavioral health beds with an occupancy rate of around 80%, according to state health department records from 2020. 

The hospital had been struggling before the pandemic, but things got worse during it, according to three former employees who worked in the emergency department but have since left.

They said staffing levels were, at times, unsafe – so much so that on certain occasions when the next shift's nurses arrived to take over, they would refuse.

“There were several instances where we didn't have – we didn't know how to give reports because you were going to be handing a 20-bed ER to one nurse,” one former employee said. 

The hospital terminated its contracts with travel nurse staffing agencies, including a local agency, the employees said. At the same time, the hospital decreased the remaining nurses' pay and took away incentives – an unusual move at a time when most other hospitals were offering financial incentives to battle the nursing shortage exacerbated by the pandemic.  

The result was severe understaffing, several employees told Mississippi Today, and the nurses who remained were frustrated and overwhelmed. Instead of the six to seven nurses previously covering each ER shift, there were between one and four, they said.  

“It caused frustrations, it caused further burnout, it caused some nurses to retire completely from nursing, and it caused a lot of other nurses who worked at Central to leave,” one nurse said. 

In response to questions about staffing, Fuss said the hospital is “working hard to recruit and retain permanent employees rather than relying on costly contract labor” and, as a result, services have been consolidated as a result. 

“As part of our work to retain employees, in select areas we have implemented market wage adjustments, added a student loan repayment program, increased our education reimbursement program, and covered the cost of any necessary licensure or training that is not already offered to employees at no cost to them,” she said in an emailed statement. 

Before the pandemic, the nurses said, the hospital was taking an inordinate amount of transfer patients – a sign they took to mean the hospital was desperate to bring in revenue.

“They would take every transfer from every outside hospital, utilized every room (in the ER) for admission holds that it got to the point where half of our ER capacity was admissions … We all kind of felt weird about the patients getting an inpatient bill, but they weren't even making it upstairs (to the hospital floor) for 24 to 48 hours,” one nurse said.

Norwood, the state senator, said he plans to reach out to hospital officials this week and hopefully meet with them to “take a deeper dive into exactly what's happening.”

One former employee has a guess as to what's at play.

“I think a lot of it is contributed by business suits that work hundreds of miles away. People who are trying to answer mostly to shareholders rather than trying to treat a community,” the former nurse said.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.