In a rush to get money to medical providers on the front lines of the pandemic, the federal government sent $2.3 million last month to Nix Health — a San Antonio hospital system that had permanently closed months before the city’s first reported COVID-19 case.
The U.S. Department of Health and Human Services distributed $30 billion — from a $175 billion bailout fund for hospitals and other health care providers — to facilities serving Medicare patients based on the previous year’s billings. The grants were automatic; providers didn’t have to request the funding.
That could explain why the shuttered Nix hospitals made the list of recipients.
After several months of staff layoffs, all six Nix locations, including Nix Medical Center on the River Walk, two behavioral health hospitals and a home health care agency, shut down by Dec. 2.
A spokesman for Los Angeles-based Prospect Medical Holdings Inc., the for-profit owner of the Nix Health, said the company already has returned the $2.3 million.
Overall, San Antonio medical providers collected more than $154 million in coronavirus relief funds, the most recent HHS data show.
Congress approved the bailout money through the Coronavirus Aid, Relief, and Economics Security Act and other federal programs. Critics question whether there’s enough oversight of the grants, meant to cover the cost of treating COVID-19 patients and lost revenue.
The biggest shares of the funding in San Antonio went to hospitals that have treated COVID-19 patients: Methodist Healthcare System, $38.6 million; Baptist Health System, $22.8 million; Bexar County’s University Health System, $13.8 million; and Christus Santa Rosa Health System, $7.6 million.
In addition to extra costs stemming from the outbreak, hospitals here and across Texas were hit with major financial losses because of government stay-at-home orders and a state ban — since lifted — on elective procedures. The result was a wave of canceled surgeries and outpatient appointments.
Federal funds also went to a major physician practice called U.S. Anesthesia Partners of Texas, UT Health San Antonio, the START Center for Cancer Care, Post Acute Medical hospitals and many home health agencies.
Southwest General Hospital, a 325-bed facility on the South Side owned by Dallas-based Steward Health Care System, received $1.2 million.
CentroMed, a nonprofit organization that operates a slew of primary care clinics, pulled in just over $1 million.
But some providers in the city received far less — 16 got less than $100 in financial assistance. Acute Vision, a small eye practice on Bandera Road, was granted $4.
Many independent medical practices, which typically operate on tighter margins, reported losing half or more of its revenue because of fewer patient visits.
Nearly two-thirds of doctors said they were forced to apply for small business loans and other financial assistance, according Texas Medical Association, which surveyed 1,548 physicians earlier this month.
But even for hospitals that received much larger sums, the bailout funds probably aren’t enough to bail them out.
The American Hospital Association estimates the four-month financial impact for hospitals and health systems will surpass $200 billion, exceeding the amount set aside for CARES Act grants.
The federal funds will not cover all the revenue lost during the months of the pandemic, said Palmira Arellano, a spokeswoman for Methodist Healthcare System.
Methodist has treated nearly 400 COVID-19 patients, though not all were hospitalized, she said.
The seven-hospital system is co-owned by nonprofit Methodist Healthcare Ministries and Nashville-based HCA Healthcare, a for-profit operator of 186 hospitals that received a total of $700 million in CARES Act grants.
A Baptist Health System spokesperson declined to discuss the grants. Its Dallas-based parent company, Tenet Healthcare Corp., announced this week that it received about $616 million for its 65 hospitals, five of which are in San Antonio.
Baptist also operates several smaller “micro-hospitals” in San Antonio with Houston-based Emerus, which separately received $1.6 million in stimulus funds.
April was a brutal month for U.S. hospitals, said Jim Blake, managing director of Chicago-based hospital consulting firm Kaufman Hall. The company’s new report, based on a survey of 800 hospitals, showed that steep patient-volume and revenue declines led to record-poor financial performance.
“They are serving as the front lines of our battle against this virus, but the pandemic is threatening their fundamental financial viability at a time when we need them most,” Blake said. “The road to recovery will be difficult, and our health care system will be forever changed.”
The provider relief fund grants do not have to be repaid as long as the company meets the federal government’s terms and conditions, which include submitting documents to substantiate that the funds are used appropriately.
An HHS spokeswoman said the agency will monitor the grants for fraud, and they will be subject to oversight by the department’s office of the inspector general.
Still, it’s important for the public to know how stimulus funds are spent in order to hold the government accountable, said Greg LeRoy, executive director of Good Jobs First, a Washington, D.C.-based labor advocacy group.
He said he’s concerned because President Donald Trump fired Glenn Fine, the inspector general who was first slated to head the Pandemic Response Accountability Committee. Trump’s office also has issued guidance that seems to contradict the CARES Act on transparency issues.
LeRoy’s watchdog group built the website covidstimuluswatch.org to pair the CARES Act recipient data with facilities’ regulatory violations, previous government assistance, federal tax avoidance and CEO and worker pay practices.
“Absent full public disclosure of who gets how much money and what they do with that money, we know from too many tragic cases that some companies will lay people off, fail to reinvest, or even move jobs off shore,” he said.
Top 10 San Antonio recipients of bailout funds
More than $154 million in COVID-19 relief funds went to 839 area health care providers.
1. Methodist Healthcare System $38,626,195
2. Baptist Health System $22,814,468
3. University Health System $13,887,313
4. Christus Santa Rosa Health System $7,618,420
5. U.S. Anesthesia Partners of Texas $4,624,690
6. University of Texas Health Science Center at San Antonio $3,126,259
7. South Texas Oncology and Hematology/The START Center for Cancer Care $2,851,692
8. Post Acute Medical at San Antonio $2,643,067
9. Nix Hospitals System $2,363,867
10. The Medical Team Inc. $1,786,502
SOURCE: Centers for Disease Control and Prevention, Data.CDC.gov