West Suburban Medical Center has not made any payments toward its $71 million debt to the State of Illinois, $2.6 million of which the Illinois Department of Healthcare and Family Services has recouped.
Instead, West Suburban CEO Manoj Prasad said that, like other financially strapped safety net hospitals, West Sub is using its cash to “provide care to the community, instead of pay assessments to the state.”
In an email to Growing Community Media, Prasad added that many safety net hospitals financially struggle to provide care for uninsured or under-insured patients.
“We are one such hospital and, if you recall, were to be permanently closed in December 2022 until we stepped in to save it and keep it operational,” Prasad said. “Now three years later, we continue to welcome all patients from the community who we observe are sicker and more complex, due to not being able to afford care early due to funding cuts and reimbursement cuts.”
Resilience Healthcare bought West Sub, along with its sister hospital Weiss Memorial in Chicago’s Uptown neighborhood, from Pipeline Health for $92 million in 2022. Before selling the hospitals, Pipeline filed for bankruptcy, reporting nearly $70 million of net losses between West Sub and Weiss from Aug. 2021 to 2022 alone.
According to documents provided to Growing Community Media by the Illinois Department of Healthcare and Family Services under a Freedom of Information Act request, in Jan. 2023, the department gave West Suburban a $20 million advance payment to help get Resilience Healthcare out of some of the debt it inherited, but the hospital hasn’t paid any of it back.
FOIA documents also show that West Sub hasn’t paid any assessment payments — which are state fees that help cover the cost of patients with Medicaid or who are uninsured — since August 2022. The state approved the sale to Resilience Healthcare that June and ownership officially changed by December. As of Feb. 3, 2026, West Suburban owed $51.8 million to the department in assessment fees and late penalties.
In the 2023 fiscal year alone, West Sub incurred $10.5 million of debt to the IDHFS for not paying the monthly assessment fees, nearly $1 million of which were late penalties. The hospital racked up another $13.5 million in missed assessment fees the following fiscal year and $18.5 million in the 2025 fiscal year.
The IDHFS told Prasad in October that it would enter into a payment plan agreement of 36 monthly installments, Jan. 2026 through Dec. 2028. The hospital was instructed to pay $50,000 or $100,000 monthly through this year, $200,000 or $300,000 monthly next year, $600,000 monthly the first half of 2028, and over $5 million a month through the rest of the year. While on the payment plan, West Sub would still have to pay subsequent hospital assessment payments.
If West Sub doesn’t comply with the agreement, the IDHFS can either: deduct 25% of total payments to the hospital for services rendered from future payments; recoup the remaining amount of the outstanding assessment balance; or withhold increases in payment upon federal approval of updated hospital assessment payments beginning last year.
To date, the IDHFS has recouped $2,600,353 from West Sub in outstanding debt.
In December, Prasad submitted a request for an administrative hearing with the IDHFS. According to the request, Prasad is “challenging HFS’ recovery of unpaid assessments because it is against the public interest, more specifically, the public residing in the Austin and surrounding neighborhoods, for whom West Suburban Medical Center, a safety net hospital, provides critically needed acute healthcare services almost exclusively,” Prasad said in the request.
“HFS is aware that for the past eight months, West Suburban Medical Center has been struggling with a forced transition to a new Electronic Medical Record System that has crippled our billing and collection capabilities, forcing the hospital to survive on a small fraction of its normal revenues while continuing to provide needed services to the impoverished neighborhoods,” Prasad said in the request. “This enforced recovery, on top of severely diminished revenues, will most likely force the hospital to end services, creating a healthcare desert in the region, negatively impacting the community’s health, the very thing that HFS is charged with improving.”
During a press conference in August, Prasad said, since before Resilience Healthcare bought the two hospitals, they have averaged a loss of $20-50 million annually. The press conference was the same day Weiss closed, after the federal government cut its Medicare program because of violations relating to emergency protocols, nursing services and the hospital’s physical condition.
“HFS is aware that a number of hospitals are facing financial difficulties that will be exacerbated by changes implemented by HR 1,” or the Trump Administration’s Big Beautiful Bill, Melissa Kula, a media relations officer for the IDHFS, told Growing Community Media in an email. “HFS is currently considering steps to ensure a sustainable healthcare safety net for the State of Illinois.”
State has funded West Sub
In Jan. 2023, the IDHFS gave a $20 million advance payment to Resilience Healthcare for both West Suburban and Weiss.
Resilience requested the payment from the IDHFS after it bought the two hospitals from Pipeline Health. According to the payment plan agreement, Pipeline accrued nearly $60 million of debt to vendors in 2022 alone, which Resilience inherited and needed help paying off in order to make the hospital financially stable.
In the 18-month payment plan, Resilience was expected to pay $1.1 million monthly in 2024 and for half of 2025.
To date, the IDHFS has not received any scheduled advance payments and is establishing measures to ensure West Sub’s compliance with advance repayment agreements.
According to the agreement, if Resilience fails to pay, the IDHFS will immediately start taking collection action to recover the outstanding balance, including penalties. And Resilience wouldn’t be able to get approval for another advance payment until it pays off the first.
West Suburban has not been without financial assistance from the state, receiving about $19 million since 2022. The Illinois Department of Public Health (and some federal funding) has provided the following grant agreements between the department and West Suburban:
- $4.2 million, one-year grant starting July 2022
- $4.8 million federal, one-year grant starting July 2022
- $3.45 million, one-year grant starting July 2023
- $4 million, one-year starting July 2024
- $2.4 million, one-year grant starting July 2024
Prasad told GCM that each grant has requirements for what it must be spent on, like hiring more staff or buying equipment.
“We are required to provide evidence of completing those actions or activities that we have consistently and timely done,” Prasad said.
West Sub visited by state public health department
The last week of January, the Illinois Department of Public Health visited West Suburban. An IDPH public information officer told Growing Community Media that the department’s visit to West Suburban last month “is a pending matter, and therefore we are unable to comment.”
Prasad said the visit wasn’t unusual, and that the IDPH was at other hospitals in the area in prior weeks.
“They typically investigate complaints and monitor care delivery, which they also did for us,” Prasad told Growing Community Media. “There was nothing newsworthy that came out of it. We were pleased with their approval of our care delivery and operations that they reviewed at length.”
