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Ignored, Mistreated, Overcharged

Virginia Woman's Experience Illustrates Abuses Perpetrated by Non-Profit Hospitals

By Joseph S. Enoch
ConsumerAffairs.com

October 11, 2006

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Karen Chaffraix was at one of the lowest points in her life when a nonprofit hospital in Northern Virginia took advantage of her.

Karen's story is similar to countless others who are poor, sick and taken by the same hospitals that are given tax breaks so that they may -- at least in theory -- provide services to those who otherwise could not afford it.

Chaffraix of Middleburg, Va., was making about $7,000 annually four years ago doing odd jobs while trying to get her realtor's license. She was taking care of an infirm elderly man in exchange for room and board.

She could only afford three months of health insurance. Soon after her insurance expired, she awoke in the night to tremendous pain in her kidneys.

An emergency room doctor at the nonprofit Inova Loudoun Hospital in Leesburg, Va., told her she was probably passing kidney stones. He gave her a few days worth of painkillers and said if the pain didn't subside to return in two days for more treatment.

Two days later, pain continuing, Chaffraix returned to the hospital.

"This time a punch-drunk doctor laughed at my MRI," Chaffraix said. "He said he'd never seen so much gas."

The doctor accused her of only being there for painkillers, but put her on a drip anyway.

"I was left alone in the dark for many hours," Chaffraix said.

Without having heard anything from the doctor or nurses for hours, Chaffraix pulled the IV out and staggered into the nurses' station, hoping to get some answers as to why she was in so much pain.

The nurses told her that there was no doctor who could speak to her and that they didn't have any answers for her.

A confused and broken Chaffraix burst into tears and decided to take a taxi home.

Pain Passes, Bill Doesn't

Chaffraix's kidney pain passed, but her $3,000 hospital bill did not.

"Since I had no insurance and such a low income, I should have been eligible to have my bill waived," Chaffraix said.

Unfortunately, the hospital insisted that the chronically ill man she was living with and taking care of was her boyfriend. He made too much money so they refused to waive her bill.

Karen said she could only afford to pay $100, so she did and then never heard from the hospital again until four years later when a $5,000 bill arrived in the mail.

"I went to court and tried to explain that no one in their right mind would pay for being not only ignored but abused in a hospital; and furthermore, that I was denied indigent status by a woman who insisted the man I was caring for was my boyfriend," Chaffraix said.

Unfortunately, the judge could only knock off $,1000 of her bill and even though Chaffraix has a better income now, she said she could not possibly meet the six-week deadline to pay her bill.

The hospital is now garnishing her wages. The 49-year-old Chaffraix was forced to end the lease on her new apartment and move in with her mother.

Loudoun Hospital is part of the Inova Health System, a not-for-profit health care system that operates hospitals throughout Northern Virginia, the wealthy region inhabited by federal government employees, contractors and lobbyists.

Loudoun Hospital spokesmen failed to return repeated calls seeking comment on this story.

Senate Probe

In September, Senate Finance Committee Chairman, Chuck Grassley, (R-Iowa) released a study of 10 nonprofit hospitals. The study showed that the hospitals took advantage of many of the nation's poorest individuals by charging them more than insured patients, using aggressive tactics for repayment and not informing patients of special programs to waive or decrease bills.

"Federal, state and local governments give nonprofit hospitals tens of billions of dollars each year in tax breaks," Grassley said in a prepared statement.

At a Senate Finance Committee meeting last month, Grassley recognized Diane Insco, a Cincinnati, Ohio resident who was making $14,000 a year when she was hospitalized due to problems related to her Type II diabetes.

Insco was charged more than $4,639 by the nonprofit hospital -- far more than if she had had insurance.

No one told her about financial assistance or charity care at the hospital. The tax-exempt hospital went after her for the debt and ultimately put a lien on her house. Mrs. Insco almost lost her home.

"Mrs. Insco's story fortunately has a happy ending. After many lawyers and many phone calls, the hospital did the right thing and tore up the bill," Grassley said in the statement. "But I believe this committee needs to think about whether we're comfortable with a system that works only if you have every lawyer in the yellow pages getting in on the act."

The Senate Finance Committee held the meeting last month to discuss whether Congress needs to step in to regulate these hospitals.

Heartless Hospitals

The Commissioner of Internal Revenue, Mark Everson, told The New York Times that tax officials often found little difference between nonprofit and for-profit hospitals "in their operations, their attention to the benefit of the community or their levels of charity care."

Many attorneys general in the Midwest are examining the aggressive billing tactics and other questionable actions of nonprofit hospitals.

Kansas Attorney General Phil Kline is currently investigating the billing practices of nonprofit hospitals.

"While most of these institutions conduct business in a professional and ethical manner, we must work diligently to ensure that those who can least afford quality healthcare aren't subjected to unconscionable practices by those who do not," Kline said in a prepared statement.

"We are still working on the final report of that investigation," Kline's spokesman, Jan Lunsford said, Some nonprofit hospitals and health systems in Minnesota have provided "lavish gifts" and "grossly excessive" compensation to top executives while providing "paltry levels" of charity care, Minnesota attorney general Mike Hatch told The New York Times.

Catholic hospitals in the U.S. are making strides toward governing themselves so Congress won't have to.

"The broad adoption of the guidelines is a clear signal of the Catholic health ministry's ongoing commitment to be accountable to our communities and to effectively demonstrate how the ministry carries out its mission of service, especially outreach to those for whom the health care system is not always readily available," Sister Carol Keenan, president of the Catholic Health Association said in a prepared statement.

Grassley hopes more nonprofits adopt the Catholic system of accountability so Congress won't have to standardize the industry.

"The new voluntary guidelines for community benefits for nonprofit hospitals developed by the Catholic Health Association are a good step forward and will bring real benefits to many in need," said Grassley in a prepared statement.

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