By Casey Tolan

May 18, 2021

As the coronavirus spiked in Missouri last fall, a wave of cases hit a nursing home in the state’s rural heartland. Robin Bull, a part-time nurse, remembered an ambulance “coming and going constantly” on one especially scary morning, rushing residents to Moberly Regional Medical Center, the local hospital.

But even as Bull was helping send patients to Moberly Regional, the hospital was in the process of suing her and at least one other former employee at the nursing home. They were two of more than 600 former patients that the hospital has sued over medical bills during the coronavirus pandemic, according to a CNN analysis of court records.

Moberly Regional sued Bull last May for $9,281, costs that Bull said came from an emergency room visit for food poisoning several years ago. After a judge ruled in the hospital’s favor late last year, the company filed a motion to start garnishing part of her roughly $850-per-month salary.

Bull, who also receives disability payments, said she and her husband both contracted Covid-19 last summer, and they’ve struggled to pay their bills each month.

“I tried to reason with the lawyers and tell them there’s no way I can pay for this, but nothing worked,” Bull said. “Having this huge bill looming over my head — it’s been stressful, it’s been heart-sickening.”

Bull’s experience is hardly unique. Hospitals owned by Community Health Systems, Inc., one of America’s largest hospital chains, have filed at least 19,000 lawsuits against their patients over allegedly unpaid medical bills since March 2020, even as other hospitals around the country have moved to curtail similar lawsuits during the coronavirus pandemic, a CNN investigation found.

The company’s 84 hospitals, which are concentrated in the South and stretch from Alaska to Key West, Florida, have taken their patients to court for as little as $201 and as much as $162,000. They say litigation is a last resort.

CNN’s review of court filings across 16 states the company operates in found that most of the patients sued by CHS — like Bull — didn’t hire a lawyer or fight the lawsuits, and judges often ruled in the company’s favor by default. In some states, defendants’ debts piled on with attorney’s fees and interest. Elsewhere, the hospital chain’s subsidiaries quickly moved to garnish defendants’ paychecks after a judgment.

Advocates say those hardball collection tactics can leave low-income patients in financial ruin — especially considering the lawsuits were filed in the middle of the Covid-fueled economic collapse.

“I can’t think of a worse thing a hospital system can be doing than suing patients for medical bills during a pandemic and a recession,” said Caitlin Donovan, the spokeswoman for the National Patient Advocate Foundation, a patients’ rights group.

CHS in 2020 enjoyed its most profitable year in at least a decade, even as it was suing patients during the pandemic. The company made $511 million in net income last year, a big swing after four straight years of annual losses. That strong financial result led to the company’s top executives earning millions of dollars worth of bonuses, according to documents it has filed with the Securities and Exchange Commission.

One reason for the success: CHS has been buoyed by taxpayer support. It received $705 million in pandemic-related aid from the federal government’s CARES Act and other state and local programs in 2020, not including additional government loans it will have to pay back, according to its 2021 annual report to shareholders.

In a statement to CNN, CHS said its hospitals only sue a “small fraction” of the patients they treat every year, and that they work to provide assistance for those who can’t afford their bills.