Richmond Community Hospital: The Good, The Bad, and The Ugly

by Jack R. Johnson 03.2024

The Good

In the United States, Black lives and the medical profession have always had a fraught relationship. During the ante-bellum period, the assumption among many in the White medical establishment was that Blacks had higher rates of disease and death because of some supposed ‘racial inferiority.’ Not, for example, that they lacked decent medical facilities, decent nutrition or decent income to pay for medical treatment. In 1906, W.E.B Du Bois addressed this issue, publishing one of the earliest descriptions of health disparities between Blacks and Whites pointing out that the disparities were largely matters of environmental and economic conditions—sanitation, education, and economics—rather than racial traits.

The health care field did not become more equal, however. After the Civil War, the vast majority of hospitals created were for Whites only, or were segregated. The medical conditions for Black patients was abysmal compared to those for White patients. In fact, in the early twentieth century, few Southern hospitals even admitted African-American patients. Many White physicians refused to see them at their offices, and those who did, enforced Jim Crow segregation, often forcing African-Americans to wait in separate rooms or to enter through separate doors. Frequently Black patients were relegated to segregated areas of a hospital, like an attic, or the basement, or a supply room, if they were allowed in at all. To get decent healthcare, Blacks soon realized they needed to build their own facilities.

The Freedman’s Bureau in Washington, D.C. was one of the first all Black hospitals designed to address this disparity. They were charged with providing  much needed medical care to slaves freed following the Civil War. The hospital was located on the grounds belonging to Howard University and was the only federally-funded health care facility for African-Americans in the nation.

Later, in the segregated South, one of the first Black hospitals, created in the early 1900s, was the Richmond Community Hospital in Richmond, Virginia. Dr. Sarah Garland Jones, one of the first Black women licensed to practice medicine in the Commonwealth of Virginia, came together with a group of Black physicians to create Richmond’s first Black-owned hospital which opened its doors in Jackson Ward in 1907. In addition to being a hospital where Black doctors could treat Black patients, it also became a teaching hospital for Black nurses when at the time the options were few to none.

The hospital moved to Overbrook Road behind Virginia Union University in the 1930s. It moved again in 1980, with the help of 21 Black physicians who used their own personal capital to relocate the hospital to its current location on North 28th Street. According to Bon Secours which now owns Richmond Community hospital, “by re-establishing Richmond Community Hospital in the East End, these physicians wanted to ensure the members of their community had a designated hospital to go to where they knew they would be treated with dignity and respect.”

The Bad

The shuttered hospital building at Overbrook Road is now slated for demolition. For those who want to honor the history of the institution this is at best a mistake, at worst, a travesty. According to the Richmond Free Press, “Virginia Union University, a historically Black university which owns the former hospital at Overbrook, plans to demolish the historic building and replace it with… a $42 million housing project created through a partnership between VUU and the New York-based company The Steinbridge Group.”

The project is part of Steinbridge’s efforts to help historically Black colleges and universities, and other minority-focused groups, transform underused resources into economic assets. However, former Virginia Delegate Viola Baskerville and others who oppose the demolition, believe that VUU and other HBCUs should not have to destroy the history of a community to attain economic success.

The empty hospital at Overbrook was the focus of a rally on March 3.

“There’s no denying that our city is facing a historic housing crisis, and we need to find innovative ways to increase our stock of accessible [living] units,” First District Councilman Andreas Addison said. “We must also remember that at the root of this crisis is Black displacement, redlining, and the legacy of systemic racism that for too long informed our city’s approach to growth. We cannot repair the sins of our racist past if that means destroying monuments to Richmond’s Black history in the process.”

The Ugly

To be clear, the Richmond Community Hospital did not stop its service after the historic Overbrook location shuttered its doors. The hospital on North 28th Street was acquired by Bon Secours in 1995 to ensure the facility’s survival as an anchor institution in Richmond’s East End. However, it was always hobbled by a lack of resources that only became worse in the 1990s and 2000s, but not because it didn’t generate sufficient revenue. In fact—here’s the ugly part----according to a 2022 New York Times article, “[T]he hollowed-out hospital — owned by Bon Secours Mercy Health, one of the largest nonprofit health care chains in the country — has the highest profit margins of any hospital in Virginia, generating as much as $100 million a year, according to the hospital’s financial data.”

How is that possible? According to the 2022 New York Times article, “The secret to its success lies with a federal program that allows clinics in impoverished neighborhoods to buy prescription drugs at steep discounts, charge insurers full price and pocket the difference. The vast majority of Richmond Community’s profits come from the program, said two former executives who were familiar with the hospital’s finances and requested anonymity because they still work in the health care industry.”

“The Federal program known as 340B after the section of the federal law that authorized it allows hospitals to buy drugs from manufacturers at a discount — roughly half the average sales price. The hospitals are then allowed to charge patients’ insurers a much higher price for the same drugs.” But here’s the rub, hospitals did not have to disclose how much money they made from sales of the discounted drugs. And they are not required “to use the revenues to help the underserved patients who qualified them for the program in the first place.”

According to the Times, “Richmond Community has the feel of an urgent-care clinic, with a small waiting room and a tan brick facade. The contrast with Bon Secours’s nearby hospitals [in the wealthier area] is striking.”

Dr. Lucas English, who worked in Richmond Community’s emergency department until 2018 was quoted in the New York Times saying, “Bon Secours was basically laundering money through this poor hospital to its wealthy outposts. It was all about profits.”

Six months ago, a U.S. Senate committee demanded answers from Bon Secours on the use of its discount drug program, 340B, following accusations of the program’s misuse. 

Meanwhile, despite the protest of local citizens, the old building for the historic Community Hospital in Richmond is slated for demolition.