BELLEVILLE, Ill.—Nearly as old as the railroad that slices through this southern Illinois city just east of the Mississippi River, St. Elizabeth’s Hospital has been a downtown bedrock since 1875.

Started by three nuns from a Franciscan order in Germany, the Catholic hospital still seeks “to embody Christ’s healing love” to the sick, the aged, and the poor, according to its mission statement. It is so tied to the city that when the local economy slumped in 2009, the nonprofit St. Elizabeth’s gave $20 to every employee to spend on Main Street, sending hundreds of shoppers out to the mostly mom- and pop-owned stores.

But St. E’s, as locals call it, now faces its own financial troubles, largely a result of the costs of maintaining an obsolete facility and of treating more low-income and uninsured patients from Belleville and neighboring East St. Louis, one of the poorest cities in the Midwest.

After a decade of losing money, St. Elizabeth’s officials are taking a radical step: Like a small but growing number of hospitals around the country, they plan to close the 303-bed hospital and move elsewhere. They are seeking state approval to build a $300-million facility seven miles northeast, in O’Fallon, a wealthier city that is one of the fastest-growing communities in the St. Louis region with new subdivisions, proximity to a regional mall, and quick access to Interstate 64.

"I think they are putting profit motivations over the mission of serving the poor. I am embarrassed for them."

Describing plans to leave behind some services, including a walk-in clinic, St. Elizabeth’s CEO Maryann Reese insists the hospital is not abandoning the city or the poor.

But that’s exactly how many residents, community leaders, and clergy see it. If St. Elizabeth’s leaves downtown, they say, it will limit care for many poorer residents, especially those dependent on public transportation, and lead to overcrowding at the city’s one other hospital, which is downsizing. Many also worry about the loss of jobs and of the visitors to the hospital who patronize local shops and eateries.

Geri Boyer, who runs a bed and breakfast and an engineering firm on Main Street, said that as a Catholic, she’s “appalled” by the hospital’s plan. “I do think they are putting profit motivations over the mission of serving the poor. I am upset and embarrassed for [them].”

“Communities can be tipped by the loss of a vital medical institution,” the Belleville police captain John Moody II wrote in a scathing letter about the plan to a state review board. “There is too much at stake and the loss will be catastrophic and I fear unrecoverable.”

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Hospitals have moved to follow population migrations before, but the relocations are becoming more common. That’s partly due to the aging of many facilities built in the 1950s and 1960s, and the desire to attract better-paying patients. A 2012 Health Affairs study found that hospitals in 12 markets used geographic-expansion strategies, including building new hospitals or adding freestanding emergency departments, to “capture” well-insured patients.

Source: http://www.theatlantic.com/health/archive/2015/04/when-hospitals-move-who-gets-left-behind/391412/