by Justin Glowacki  with contributions from Rasheed Ambrose, Javion Henry, McKenna Klamm, Matt Martin and Aidan Tarrant

BILOXI – On Feb. 1, Memorial Health System officially took over Merit Health Biloxi, solidifying its position as the dominant healthcare provider in the region. According to Fitch Ratings, Memorial now controls more than 85% of the local health care market.

This isn’t Memorial’s first hospital acquisition. In 2019, it took over Stone County Hospital and expanded services. Memorial considers that transition a success and expects similar results in Biloxi.

However, health care experts caution that when one provider dominates a market, it can lead to higher prices and fewer options for patients.

Expanding specialty care and services

One of the biggest benefits of the acquisition, according to Kristian Spear, the new administrator of Memorial Hospital Biloxi, will be access to Memorial’s referral network.

By joining Memorial’s network, Biloxi patients will have access to more services, over 40 specialties and over 100 clinics.

“Everything that you can get at Gulfport, you will have access to here through the referral system,” Spear said.

One of the first improvements will be the reopening of the Radiation Oncology Clinic at Cedar Lake, which previously shut down due to “availability shortages,” though hospital administration did not expand on what that entailed.

“In the next few months, the community will see a difference,” Spear said. “We’re going to bring resources here that they haven’t had.”

Beyond specialty care, Memorial is also expanding hospital services and increasing capacity. Angela Benda, director of quality and performance improvement at Memorial Hospital Biloxi, said the hospital is focused on growth.

“We’re a 153-bed hospital, and we average a census of right now about 30 to 40 a day. It’s not that much, and so, the plan is just to grow and give more services,” Benda said. “So, we’re going to expand on the fifth floor, open up more beds, more admissions, more surgeries, more provider presence, especially around the specialties like cardiology and OB-GYN and just a few others like that.”

For patient Kenneth Pritchett, a Biloxi resident for over 30 years, those changes couldn’t come soon enough.

Pritchett, who was diagnosed with congestive heart failure, received treatment at Merit Health Biloxi. He currently sees a cardiologist in Cedar Lake, a 15-minute drive on the interstate. He says having a cardiologist in Biloxi would make a difference.

“Yes, it’d be very helpful if it was closer,” Pritchett said. “That’d be right across the track instead of going on the interstate.”

Beyond specialty services and expanded capacity, Memorial is upgrading medical equipment and renovating the hospital to improve both function and appearance. As far as a timeline for these changes, Memorial said, “We are taking time to assess the needs and will make adjustments that make sense for patient care and employee workflow as time and budget allow.”

Unanswered questions: insurance and staffing

As Memorial Health System takes over Merit Health Biloxi, two major questions remain:

1. Will patients still be covered under the same insurance plans?
2. Will current hospital staff keep their jobs?

Insurance Concerns

Memorial has not finalized agreements with all insurance providers and has not provided a timeline for when those agreements will be in place.

In a statement, the hospital said:

“Memorial recommends that patients contact their insurance provider to get their specific coverage questions answered. However, patients should always seek to get the care they need, and Memorial will work through the financial process with the payers and the patients afterward.”

We asked Memorial Health System how the insurance agreements were handled after it acquired Stone County Hospital. They said they had “no additional input.”

What about hospital staff?

According to Spear, Merit Health Biloxi had around 500 employees.

“A lot of the employees here have worked here for many, many years. They’re very loyal. I want to continue that, and I want them to come to me when they have any concerns, questions, and I want to work with this team together,” Spear said.

She explained that there will be a 90-day transitional period where all employees are integrated into Memorial Health System’s software.

“Employees are not going to notice much of a difference. They’re still going to come to work. They’re going to do their day-to-day job. Over the next few months, we will probably do some transitioning of their computer system. But that’s not going to be right away.”

The transition to new ownership also means Memorial will evaluate how the hospital is operated and determine if changes need to be made.

“As we get it and assess the different workflows and the different policies, there will be some changes to that over time. Just it’s going to take time to get in here and figure that out.”

During this 90-day period, Erin Rosetti, Communications Manager at Memorial Health System said, “Biloxi employees in good standing will transition to Memorial at the same pay rate and equivalent job title.”

Kent Nicaud, President and CEO of Memorial Health System, said in a statement that the hospital is committed to “supporting our staff and ensuring they are aligned with the long-term vision of our health system.”

What research says about hospital consolidations

While Memorial is promising improvements, larger trends in hospital mergers raise important questions.

Research published by the Rand Corporation, a nonprofit, nonpartisan research organization, found that research into hospital consolidations reported increased prices anywhere from 3.9% to 65%, even among nonprofit hospitals.

The impact on patient care is mixed. Some studies suggest merging hospitals can streamline services and improve efficiency. Others indicate mergers reduce competition, which can drive up costs without necessarily improving care.

When asked about potential changes to the cost of care, hospital leaders declined to comment until after negations with insurance companies are finalized, but did clarify Memorial’s “prices are set.”

“We have a proven record of being able to go into institutions and transform them,” said Angie Juzang, Vice President of Marketing and Community Relations at Memorial Health System.

When Memorial acquired Stone County Hospital, it expanded the emergency room to provide 24/7 emergency room coverage and renovated the interior.

When asked whether prices increased after the Stone County acquisition, Memorial responded:

“Our presence has expanded access to health care for everyone in Stone County and the surrounding communities. We are providing quality healthcare, regardless of a patient’s ability to pay.”

The response did not directly address whether prices went up — leaving the question unanswered.

The bigger picture: Hospital consolidations on the rise

According to health care consulting firm Kaufman Hall, hospital mergers and acquisitions are returning to pre-pandemic levels and are expected to increase through 2025.

Hospitals are seeking stronger financial partnerships to help expand services and remain stable in an uncertain health care market.

Source: Kaufman Hall M&A Review

Proponents of hospital consolidations argue mergers help hospitals operate more efficiently by:

• Sharing resources.
• Reducing overhead costs.
• Negotiating better supply pricing.

However, opponents warn few competitors in a market can:

• Reduce incentives to lower prices.
• Slow wage increases for hospital staff.
• Lessen the pressure to improve services.

Leemore Dafny, PhD, a professor at Harvard and former deputy director for health care and antitrust at the Federal Trade Commission’s Bureau of Economics, has studied hospital consolidations extensively.

In testimony before Congress, she warned: “When rivals merge, prices increase, and there’s scant evidence of improvements in the quality of care that patients receive. There is also a fair amount of evidence that quality of care decreases.”

Meanwhile, an American Hospital Association analysis found consolidations lead to a 3.3% reduction in annual operating expenses and a 3.7% reduction in revenue per patient.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

When Judi Cox was 18, she began searching for her biological mother. Two weeks later she discovered her mother had already died. 

Cox, 41, was born in Gulfport. Her mother was 15 and her father didn’t know he had a child. He would discover his daughter’s existence only when, as an adult, she took an ancestry test and matched with his niece. 

It was this opaque family history, its details coming to light through a convergence of tragedy and happenstance, that led Cox to seek stronger legal protections for adopted people in Mississippi. Ensuring adopted people have access to their birth certificates has been a central pillar of her advocacy on behalf of adoptees. But legislative proposals to advance such protections have died for years, including this year.  

Cox said the failure is an example of discrimination against adopted people in Mississippi — where adoption has been championed as a reprieve for mothers forced into giving birth as a result of the state’s abortion ban. 

“A lot of people think it’s about search and reunion, and it’s not. It’s about having equal rights. I mean, everybody else has their birth certificate,” Cox said. “Why should we be denied ours?”

Mississippi lawmakers who have pushed unsuccessfully for legislation to guarantee adoptees access to their birth certificate have said, in private emails to Cox and interviews with Mississippi Today, that opposition comes from judges.

 “There are a few judges that oppose the bill from what I’ve heard,” wrote Republican Sen. Angela Hill in a 2023 email. 

Hill was recounting opposition to a bill that died during the 2023 legislative session, but a similar measure in 2025 met the same fate. In an interview this month, Hill said she believed the political opposition to the legislation could be bound up with personal interest.

“Somebody in a high place doesn’t want an adoption unsealed,” Hill said. “I don’t know who we’re protecting from somebody finding their birth parents,” Hill said. “But it leads you to believe some people have a very strong interest in keeping adoption records sealed. Unless it’s personal, I don’t understand it.”

In another 2023 email to Cox reviewed by Mississippi Today, Republican Rep. Lee Yancey wrote that some were concerned the bill “might be a deterrent to adoption if their identities were disclosed.”

The 2023 legislative session was the first time a proposal to guarantee adoptees access to their birth certificates was introduced under the state’s new legal landscape surrounding abortion.

In 2018, Mississippi enacted a law that banned most abortions after 15 weeks. The state’s only abortion clinic challenged the law, and that became the case that the U.S. Supreme Court used in 2022 to overturn Roe v. Wade, its landmark 1973 ruling that established a nationwide right to abortion.

Roe v. Wade had rested in part on a woman’s right to privacy, a legal framework Mississippi’s Solicitor General successfully undermined in Dobbs v. Jackson Women’s Health Organization. Before that ruling, anti-abortion advocates had feared allowing adoptees to obtain their birth certificates could push women toward abortion rather than adoption.

Abortion would look like a better option for parents who feared future contact or disclosure of their identities, the argument went. With legal access to abortion a thing of the past in Mississippi, Cox said she sees a contradiction.

“Mississippi does not recognize privacy in that matter, as far as abortions and all that. So if you don’t acknowledge it in an abortion setting, how can you do it in an adoption setting?” Cox said. “You can’t pick and choose whether you’re going to protect my privacy.”

Opponents to legislation easing access to birth certificates for adoptees have also argued that such proposals would unfairly override previous affidavits filed by birth parents requesting privacy.

The 2025 bill, proposed by Republican Rep. Billy Calvert, would direct the state Bureau of Vital Records to issue adoptees aged 21 and older a copy of their original birth certificate.

The bill would also have required the Bureau to prepare a form parents could use to indicate their preferences regarding contact from an adoptee. That provision, along with existing laws that guard against stalking, would give adoptees access to their birth certificate while protecting parents who don’t wish to be contacted, Cox said.

In 2021, Cox tried to get a copy of her birth certificate. She asked Lauderdale County Chancery Judge Charlie Smith, who is now retired, to unseal her adoption records. The Judge refused because Cox had already learned the identity of her biological parents, emails show.

“With the information that you already have, Judge Smith sees no reason to grant the request to open the sealed adoption records at this time,” wrote Tawanna Wright, administrator for the 12th District Chancery Court in Meridian. “If you would like to formally file a motion and request a hearing, you are certainly welcome to do so.”

In her case and others, judges often rely on a subjective definition of what constitutes a “good cause” for unsealing records, Cox said. Going through the current legal process for unsealing records can be costly, and adoptees can’t always control when and how they learn the identity of their biological parents, Cox added.

After Cox’s biological mother died, her biological uncle was going through her things and came across the phone number for Cox’s adoptive parents. He called them.

“My adoptive mom then called to tell me the news — just hours after learning I was expecting my first child,” Cox said.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

by Anna Wolfe, Mississippi Today
February 21, 2025

Neighbors could hear yelps from inside a 10-by-10-foot shed behind a house on Grand Avenue in west Jackson on an October afternoon in 1982.

The location was a known unlicensed personal care home — facilities meant to care for adults, often with mental illness, who cannot live on their own, but which have never been regulated by any state agency.

Local police said they couldn’t enter without a warrant and called Mendal Kemp, then-chief of licensing for the Mississippi State Care Commission, the precursor to the Mississippi State Department of Health.

Kemp arrived and, finding the property locked, borrowed a ladder from a neighbor and scaled an eight-foot wooden fence.

He made it past two vicious guard dogs, opened the storage room door and found eight severely emaciated individuals sitting on a cot and on the floor around the dark, unlit room. There was no running water or electricity, and the owner had given the residents a bucket to use as a bathroom. One had sores all over his back, another was completely blind. 

Kemp, his colleague from the Mississippi Department of Mental Health named Janne Patterson Swearengen and others spent four hours at the scene rescuing the individuals, who were transported to licensed facilities.

But the health officials were no strangers to these conditions. A few years earlier, the U.S. Supreme Court found state mental health hospitals could no longer hold nondangerous patients against their will, and thousands of patients from the nearby Mississippi State Hospital wound up in Jackson.

To answer, unlicensed personal care homes started cropping up, especially along West Capitol Street in large multi-story houses that had otherwise been abandoned, absent safety assurances like fire extinguishers or appropriate staffing.

“We couldn’t license them. So what do you do?” Kemp told Mississippi Today in a recent interview. “They couldn’t comply with any kind of standards. And these people were so helpless. They had been treated like dogs — ‘go lay down, stay in your room, don’t do this’ — and they’d been institutionalized for all this time, so they obeyed.”

Kemp’s office often received anonymous complaints about these facilities. His workers would go door to door and issue letters: get a license or close down.

“We’d go back, it’d be an empty house. She’d just moved down the street,” Kemp said.

The Grand Avenue discovery by Kemp and his colleagues made national news, resulted in the creation of the Coalition of Boarding Homes, and led to the passage of the Vulnerable Persons Act in 1986, which strengthened laws around protecting abused or neglected vulnerable adults.

READ MORE: In a city without a plan, anti-public sleeping bills pop up at Jackson City Hall and state Capitol

Forty years later, an underground network of unlicensed personal care homes in Jackson — and the horrors perpetuated against vulnerable residents living in some of them — persists.

In 2010, a woman living in an unlicensed personal care home in west Jackson died of hypothermia after being kept in a room with no heat and a broken window. In 2017, the health department raided three illegally-operating homes, finding that residents were living with no heat, toilets or bed linens, according to news reports. That home operator still has an active home health care business license. In 2021, three residents died after a man set fire to another unlicensed personal care home in north Jackson.

In January, Disability Rights Mississippi, a nonprofit and the state’s designated legal advocacy agency for people with disabilities, released a report detailing widespread misconduct in the industry of unlicensed personal care homes across Mississippi, where, unlike in other states, these facilities “have the ability to comfortably engage in illegal practices without the threat of licensing agencies penalizing them.”

State law requires that any home caring for more than four individuals not related to the homeowner be licensed by the Mississippi State Department of Health, adhering to a set of often costly safety requirements and inspections. Residents of these homes typically don’t need the level of care offered by a nursing home, but still need assistance to stay fed and bathed, take medicine, or get to and from appointments.

The health department licenses 11 of these homes in Jackson, according to an agency directory — down from 17 in 2017, according to the Clarion Ledger. The health department said in that time, smaller homes have been replaced with larger ones, so the reduction only accounts for a net loss of 15 beds.

Then there are unlicensed homes operating legally with fewer than four residents and those operating illegally with more than four residents – same as forty years ago. Disability Rights found that some owners try to skirt this rule, such as by placing residents in tents on their property, “to claim that only three people are ‘actually inside the house.’”

The Legislature saw a bill this session to get rid of this distinction, requiring homes with any patients to be licensed, but it quickly died. 

There’s no way of knowing for sure how many of these homes are operating under the radar, but Disability Rights estimates there could be two to three times as many unlicensed homes as licensed.

Individuals living in these facilities often have nowhere else to go. They sometimes sign over their monthly SSI checks, $900 of federal assistance for people with disabilities and often their only income, to the homeowner in exchange for paltry services and little to no allowance. Disability Rights found a home caring for six individuals pulling $4,800 per month in rent, far above the market value for the property, and it did not have a smoke detector or sprinkler system.

“Operating these homes does cost money, but the inconsistency and lack of oversight for ensuring residents are receiving adequate care and provisions, after handing over most or the entirety of their limited funds, creates a breeding ground for financial exploitation,” the Disability Rights report reads.

Aurora Baugh, who spent most of her career at the Department of Mental Health, retiring several years ago as the Coordinator of the Division of Recovery and Resiliency, said her agency long quit discharging folks from the mental hospitals to unlicensed personal care homes — but low housing stock is one of the sector’s largest challenges. The agencies that transition people from institutions to the community, like the Department of Mental Health, but also the Department of Corrections, have a stake in the conditions of these facilities.

“They’re the ones who make the difference if people go to licensed or unlicensed, but if you only have (11 in Jackson), what are you going to do? Put them in a hotel?” Baugh said.

And to make matters more complicated, some residents may prefer the lax rules offered in the unlicensed homes, such as the ability to come and go as they please or smoke cigarettes, as opposed to strict conditions in place at some licensed facilities or nursing homes.

“They wanted the freedom, you know, after being housed (in hospitals) for so many years,” Swearengen said.

In exchange, the Disability Rights report identified what residents inside some of these homes are enduring: plastic coverings or boarded up windows, deadbolted doors, no electricity, exposed wiring, bathrooms ill-equipped for disabled residents, no washer, dryer or stoves, locked food pantries and improper cooling and heating to the point where one resident’s body temperature decreased to 78 degrees. Disability Rights found residents that had not been bathed, wearing the same clothes for days, and residents receiving only one meal a day.

Typically, the conditions inside these facilities aren’t brought to light until an incident involving law enforcement occurs or someone makes a complaint, like in the case of Grand Avenue in 1982. 

But licensing officials aren’t exactly scaling fences today. 

Frances Fair, director of health facility licensure and certification at the Mississippi State Department of Health, said the department’s surveyors – “current day superheroes” – hit the streets every week in tough circumstances to examine conditions and investigate complaints inside the homes licensed by the department.

“But we do need to do it legally, within the framework of our authority,” Fair said, which does not include the same treatment for unlicensed homes.

When the health department receives word of a home operating illegally, Fair said it turns the information over to the Office of the Attorney General, whose responsibility she said it is to investigate.

Michelle Williams, chief of staff for Mississippi Attorney General Lynn Fitch, said the office has received at least 10 of these complaints from the health department since January of 2024, and that the office does investigate in these instances to determine if abuse, neglect of exploitation is occurring. But Williams also said a home simply operating without a license isn’t a crime, that the attorney general’s office doesn’t pursue licensure, and the health department should seek administrative relief in those cases.

The AG’s office investigates thousands of cases of alleged adult abuse, neglect or exploitation each year — most of which do not rise to the level of criminal prosecution — but Williams said the office does not capture data to show how many of those incidents occurred inside personal care homes, licensed or unlicensed.

In the gap, Disability Rights has taken the steps it can, filing civil court complaints to force illegal homes in Jackson to become licensed or close down: four in 2022 and one in 2024.

“Even when these homes are closed, there are no safeguards in place to prevent operators from reopening a new UPCH (unlicensed personal care home) in a different location, leaving residents vulnerable to continued exploitation and neglect,” reads the Disability Rights report.

Fair said solving the issue of predatory unlicensed personal care home owners will require stakeholders to “follow the money.” In the case of residents signing over their SSI checks to the personal care homes, the business owners become the official “representative payee” in the federal government’s records.

“As long as people can make money off of vulnerable adults and say they’re going to take care of somebody, but then they take their checks and commingle those funds with their own personal funds and there’s not a lot of oversight on that, then that can be a problem,” Fair said.

Fair said several agencies have a role to play, such as the U.S. Social Security Administration, which administers the funds ultimately going to these business owners and should be auditing to ensure residents are treated fairly.

The descriptions of the unlicensed homes found today in Mississippi — “inhumane living conditions”, “neglect by other residents and staff”, “unsafe, unsanitary, and uncaring” — mirror language from Kemp’s old papers.

“They were in deplorable conditions and in great need of attention,” Kemp wrote after the incident on Grand Avenue, according to an Oct. 20, 1982, Mississippi Health Care Commission memo obtained by Mississippi Today.

“Things must be a lot better,” Kemp mused during his interview with Mississippi Today.

“I don’t know that they’re better,” Swearengen, his former colleague, responded.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.