Community with high medical debt questions its hospitals’ charity spending

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Community with high medical debt questions its hospitals’ charity spending
Danmark Seneste Nyt,Danmark Overskrifter
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As 41% of American adults face medical debt, residents of this southern Colorado city contend their local nonprofit hospitals aren't providing enough charity care to justify the millions in tax breaks they receive.

The two hospitals in Pueblo, Parkview Medical Center and Centura St. Mary-Corwin, do not pay most federal or state taxes. In exchange for the tax break, they are required to spend money to improve the health of their communities, including providing free care to those who can't afford their medical bills.

The low levels of charity care have translated into more debt for low-income residents. About 15% of people in Pueblo County have medical debt in collections, compared with 11% statewide and 13% nationwide, according to 2022 data from the Urban Institute. Those Puebloans have median medical debt of $975, about 40% higher than in Colorado and the U.S. as a whole. And all of those numbers are worse for people of color.

IRS guidelines allow hospitals to claim Medicaid shortfall as a community benefit, but many academics and health policy experts argue such balance sheet shifts aren't the same as providing charity care to patients. The second-largest perceived health need was addressing alcohol and drug use. Yet, the only initiative Parkview cited in response was posting preventive health videos online, including some on alcohol and drug use. Meanwhile, the hospital shut down its inpatient psychiatric unit.

Centura also declined to answer questions about its charity care spending. Hospital spokesperson Lindsay Radford emailed a statement saying St. Mary-Corwin was aligning its community health needs assessment process with the Pueblo Department of Public Health and Environment "to develop shared implementation strategies for our community benefit funds, ensuring the resources are targeting the highest needs.

"We’ve made folks now aware that we want to be a part of those processes," Trujillo said. "We're willing to help them reach deeper into the community."

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