Johnny Kotcher has worked as a surgical technician for over 40 years, first while serving in the United States Army and then as a travel technician, taking jobs across the country. In 2019, a friend told Kotcher about an opening at Saint Francis Hospital in Hartford.

“My contract was finishing in Missouri, so I said, ‘Okay, cool, let’s do that,’” said Kotcher. “I think I did three contracts, and they said, ‘Look, we like your work, we like what you do, you caught on super quick, why don’t you stay permanently?’ I said, ‘Okay.’”

Kotcher worked for five years at Saint Francis’s Spinal Institute, eventually becoming the neurosurgery coordinator, the lead technician tasked with training other techs and nurses and testing the department’s equipment. In 2024, Kotcher was diagnosed with pulmonary fibrosis, a terminal condition that can only be treated with a lung transplant. Determined to work as long as he could, Kotcher was eventually given the job of biological tissue coordinator, in which he managed, received, purchased, and kept records on all of the hospital’s donor organs. 

“Basically, I could have bought my own lungs and had them put in,” said Kotcher. 

Before he can get his lungs, Kotcher must go through a long and extensive testing schedule to be placed on the organ recipients list. On October 24, 2024, Kotcher had one last test to do before he could be placed on the list. Unfortunately for him, that same day, he received a letter from David Ceder, a human resources representative for Saint Francis.

“According to our records, you have been out of work since July 21, 2025 and have exhausted all leave benefits,” reads the letter. “Thus, we contacted you on October 24, 2025 to notify you that per this conversation we are unable to hold your position, and your employment record will be updated to reflect the administrative separation of your employment as of November 1, 2025.”

Kotcher’s termination disrupted his health insurance coverage, setting him back to the beginning of the testing schedule required to get his new lungs. While his termination was legally sound, Kotcher and one of his old coworkers, Andrea, who spoke with Inside Investigator on the condition of anonymity, believed his firing was morally reprehensible and goes against the six core values that Trinity Health, the Catholic non-profit health system that owns Saint Francis, claims to adhere to.

“I just think it was ethically stinky,” said Andrea. “Those six pillars went out the window when it came to an employee.”

Kotcher’s Story

Prior to his diagnosis, Kotcher was “a very athletic” and “energetic” person. He said he noticed his health started “slowing down a lot” when he took his position as the neurosurgery coordinator, around May 2024.

“At one point, one of the doctors said, ‘You should go see a pulmonologist,’ because they heard me breathing really hard one day,” said Kotcher. 

A CAT scan revealed that he had pulmonary fibrosis, a condition in which lung tissue stiffens and scars, typically in middle-aged or older adults. The condition progressively worsens, reducing lung function as more tissue is affected, making it harder for patients to catch their breath. While Kotcher, now 64, speculates that his 40 years of cigar smoking played a role in his development of the disease, the root cause of the condition is typically unknown. Pulmonary fibrosis can be treated with medicine and therapies, but a full lung transplant is the only known cure.

Kotcher started taking medication and doing treatments every two months, but he still started “slowing down even more,” struggling to walk thirty feet down the hall without having to sit down to catch his breath. Last summer, Kotcher underwent another CAT scan and round of X-rays, and decided to ask his Chief of Anesthesia at Saint Francis to take a look and give his professional opinion.

“He looked at them and his jaw hit the ground,” said Kotcher. “He called our pulmonology surgeon that was there that day and said, ‘Come in here and look at these X-rays,’ and  [the surgeon] immediately got on the phone and called his friend at Massachusetts General Hospital in the lung transplant division and said, ‘I’ve got someone for you that you truly need to see, it’s not good.’”

Kotcher was told that he had “one-third function of one lung and one-half function of the other lung,” and he continued to work until he couldn’t anymore. In July 2025, Kotcher said his manager and co-workers understood the severity of his condition and that he kept them in the loop as he left for various appointments. His manager was “really cool with him,” and Kotcher said everyone was “okay with me going to Boston” to get evaluations and tests done. 

“I’d miss a day here, I missed a day there, then I would go back to work, and I would do my job every day,” said Kotcher. 

Eventually, his disease progressed to the point where he started carrying a portable oxygen machine with him to work. It was then, in August 2025, that Kotcher knew he had to stop.

“Walking around in an operating room with a portable oxygen machine, it’s not feasible,” said Kotcher. “So I said, ‘Look, I have to stop right now.’ All my intentions were getting my transplant, rehabbing, and going back to work.”

At this point, Kotcher said the wheels were fully in motion for him to get his lung transplant. He was in constant contact with the lung transplant team in Boston and had the transplant, as well as all the prerequisite appointments, scans, and treatments, approved by his insurance. Unfortunately for him, his employer was unwilling to accommodate him.

“My FMLA was 12 weeks, and at the end of those 12 weeks, I get a letter from my HR department saying, ‘When are you coming back to work?’” said Kotcher. “I said, ‘I just, you know, I need a new set of lungs before I go back to work.’ Well, okay, that was October 24. They said, ‘Okay. Well, effectively, on November 1, your position is terminated.’”

Kotcher’s insurance through Saint Francis offered short- and long-term disability. After receiving his doctor’s approval, he qualified for short-term disability and still had two months left at the time of his firing.

“But as soon as those 12 weeks were up for FMLA, they didn’t even wait, mention, or offer anything long-term until I got my lung transplant,” said Kotcher.

From day one, Kotcher said he wanted to beat his diagnosis so that he could return to work. 

“I loved my job,” said Kotcher. “My whole thing was, ‘I’m gonna get my lungs, I’m gonna go back to work.” 

Instead, he was terminated.

“They took everything from me,” said Kotcher. 

Kotcher lost his insurance in December and had to scramble to enroll in state-provided insurance. He went from making $100,000 a year to making $2,500 a month on disability, before taxes. In his termination letter, Ceder recommended Kotcher enroll in COBRA, which allows recently fired employees to temporarily retain their employer-sponsored health plan, with the caveat that the employee must pay the full premium without any employer assistance. In his email, Kotcher argued that COBRA was far too expensive to afford without income.

“I was told I could get COBRA for $800 a month,” wrote Kotcher in his email. “With no income, that was impossible for someone in my situation. That was not feasible.”

As a result, Kotcher applied for HUSKY D in December 2024, which didn’t go into effect until January 2025. The lapse in insurance caused him to miss his December appointments because he couldn’t afford to pay for them out of pocket. Since getting on HUSKY D, Kotcher said he’s had issues getting telehealth appointments with his team at Massachusetts General approved, forcing him to drive to more appointments.

“I have to drive to Boston, which is brutal on my body,” said Kotcher.

While his insurance has covered “most of what I’m doing,” Kotcher said he has had to have everything pre-approved, a burden he did not have to carry while on his Saint Francis plan. He has also had to battle with his insurance to cover certain bills that he didn’t have to before.

“I got a bill from Mass General and they said, ‘Well, we sent it to your Connecticut insurance and they denied it,’” said Kotcher. “It’s like one of those ‘he-said she-said’ on both ends.”

It took Kotcher three months to get his disability payments approved, and he has not been reimbursed for the period in which he was waiting. 

Furthermore, because of his temporary lapse in insurance, Kotcher, who was only a few weeks away from completing the rigorous schedule of testing required to be put on the organ donor list, has since had to start the testing process all over again. Kotcher still hasn’t been put on the list, as additional health problems have since caused him to put his testing on pause. 

Adding insult to injury, Kotcher spoke to a friend at Saint Francis’s cardiac surgery department about his situation, who told him the hospital had accommodated a surgeon with the same diagnosis in the past.

“She says, ‘You know, we had a surgeon a year before you found out that you had this disease, had the exact same disease, needed the exact same surgery, and they let him go out on leave, do all his tests, get his lungs rehabbed, and return to work in a minimalistic capacity,’” said Kotcher. “They let him do all this. Me? They went, ‘Your FMLA is done,’ opened the door, ‘Get the fuck out.’”

Inside Investigator spoke to the surgeon in question, who wished to remain anonymous. He said Saint Francis’s staff was “excellent” but graded the administration a “B-minus.” While the surgeon confirmed that Saint Francis held his job during his lung transplant and recovery, he said he was ultimately laid off in late 2025, after further medical complications kept him from returning to his normal duties in the operating room. He recalls being “surprised, and not surprised” when he was laid off, and said that although he was “bummed,” he ultimately understood the decision.

“I wasn’t generating work that they could bill for, and so, you know, I guess it wasn’t a huge shock that they decided to let me go,” he said. “They were struggling financially, so they were trying to cut excess expenditures.”

Andrea wondered why the hospital didn’t offer to extend his leave, recalling that when she had to get a hip replacement, she was offered an extension.

“I had my hip replaced, and I took eight weeks, and when I thought I could be back at eight weeks, they said, ‘Are you sure? Wouldn’t you want to extend that?’” said Andrea. “They offered it to me, but I don’t know — part of me thinks that they saw his potential transplant as a big money drain, and that could save a whole lot of money just by cutting their own.”

While Kotcher acknowledges that firing him was entirely legal, as he was an at-will employee who had exhausted his FMLA leave, he felt it was the wrong thing to do.

“To take somebody that’s fighting for their lives, waiting for a lung transplant, [and] go ‘All right, see you later, out the door you go,’” said Kotcher. “What they did — it was just morally reprehensible.”

The Impact of His Termination

Andrea said that Saint Francis’s termination of Kotcher was a “tremendous loss, not only for him, for the hospital.”

“It’s like cutting your own nose off to spite your face, and thinking you still are the same,” said Andrea.

After his termination, Kotcher said he “emailed like 35 different people,” starting with his direct manager and operating room director at Saint Francis, to the C-suite of its parent company, Trinity Health of New England, and eventually the C-suite of Trinity Health, which is based in Michigan.

“Not one single reply from anybody,” said Kotcher.

The day he was fired, OR Today, a trade magazine for operating room staff, published a profile piece on Kotcher. When he was asked to be interviewed for the story, Kotcher said he “was really excited,” making his termination feel even more like a betrayal.

“Then I turned around and they [Saint Francis] just shit me out and didn’t even wipe their ass,” said Kotcher.

Andrea also worked as a surgical technician and described Kotcher as an “excellent teacher” with a “very varied background,” which made him a “very valuable employee to keep.” As coordinator of the neurosurgery department’s surgical techs, Andrea said Kotcher was uniquely qualified to teach nurses.

“We were always onboarding new nurses,” said Andrea. “Nurses are not trained to work in the operating room, so he was always onboarding somebody new who had never seen a brain, or a spine, or any of the instrumentation needed.”

She said that new nurses rarely know what to do in an operating room, and that it’s “totally not what you expect, nothing like on TV,” but that Kotcher could “put them at ease and keep them on the right path, to prevent harm to themselves or to the patient.” 

“He was a tremendous, tremendous employee there; even if he didn’t work side by side with somebody, people would come to him with a question, and he could answer it for them,” said Andrea. “They’ve lost a valuable trainer, they’ve lost a valuable person who could orient new people. His knowledge base is so vast.”

Andrea, who worked 36 years as a tech before retiring in March, said that even she learned from Kotcher. Surgical techs must familiarize themselves with each procedure beforehand to ensure they present surgeons with the proper tools for the job when the time comes, explained Andrea. She compared it to setting a dinner table.

“If you know what you’re going to have for dinner, you know you need a knife and a fork, right?” said Andrea. “Well, there’s 28 different forks and there’s 22 different knives, and Surgeon A doesn’t like five of those knives, but Surgeon B loves those, so having a person who can read the surgeon and say, ‘You need these 12 things, you don’t need these eight things,’ that’s the kind of person he would be, he would be training to understand those things.”

Kotcher forwarded Inside Investigator a copy of an email he sent to 18 different employees of both Trinity Health and Trinity Health New England on Dec. 1, 2025. The email recounted his journey from a travel technician to the hospital’s biological tissues and preference card coordinator. Tissue coordinators must receive, maintain, and keep precise and up-to-date records for every donor organ in the hospital’s possession.

“When I took on the Tissue Implant Program, there were 4 people doing the same job in 4 different ways,” wrote Kotcher. “I built a new database from the hundreds of implant logs that were scattered around. I also retrieved what was put into storage. I compiled all of these Implant Records into 1 system. My actions made a system which was ready for auditing from The Joint Commission.”

The Joint Commission is a medical accreditation group whose certifications allow hospitals to receive Medicaid and Medicare reimbursement. Andrea vouched for his ability as a tissue coordinator, saying that he did it “absolutely better than anyone had previously.” She explained that past tissue coordinators frequently accrued Joint Commission audit violations, but that when Kotcher was audited, his “books were perfect.” 

“Everyone was impressed, even the managerial people who had to let him go were impressed,” said Andrea. “They said to everyone that ‘He’s doing a fabulous job with it, thank goodness he’s taken it over.’”

After Kotcher’s dismissal, she says hospital administrators engaged in a “mad scramble” to find replacements for the tissue coordinator and the lead neurosurgical tech positions. She recalls there being a “bunch of unhappiness and disgruntlement” after two techs were “voluntold” into the two positions.

“They should have planned better, and they shouldn’t have let him go; it ran very well with him,” said Andrea. “Even surgeons said, ‘Well, why did they do that?’”

As a tech, Kotcher “knew every little nuance, every little detail of what needs to be done,” said Andrea, who used craniotomies, surgeries where a portion of the skull is temporarily removed to allow access to a patient’s brain, as an example. Andrea said Kotcher could look at any craniotomy surgery on the schedule and immediately know what tools would be required, while other techs would be lost, calling it a “big learning process.” In his email, Kotcher said he was “one of only very few” people who know how to do craniotomies after the hospital split its spinal team from the main operating room. 

“I single handedly built the framework to teach the rest of the main OR,” said Kotcher. “I arranged all the instrumentation and made instructional binders for people to follow along. I did running in-services on how to use the specialized equipment. I helped train anybody that was put in the Neuro Rooms for cases.”

He also shared the OR Today article noting that he was “proud to say I was part of St. Francis Hospital” when he was interviewed for the piece. Kotcher appealed to the company’s stated core values of reverence, commitment, stewardship and integrity. 

“I’ve worked for the last 6 years with these Core Values as the center of my employment,” said Kotcher. “The minute I’m in dire need of life saving care; you have cut all ties. How does this stand up to your Core Values?”

Andrea also cited the hospital’s core values and called their dismissal of Kotcher “ethically stinky.”

“They promote integrity and compassion, and they have these five pillars of what drives them as a business, and I don’t see any compassion for this individual who is an employee,” said Andrea. “Those five pillars went out the window when it came to an employee.”

Kotcher believes it all came down to money. After he was terminated, he investigated the price of a double-lung transplant, landing on a figure of $1 million. The true costs may actually be even higher. According to Milliman, an actuarial services company, the average cost of a double-lung transplant in 2025 was $2,346,500.

“The surgeon made the hospital money; they were paying me money to be an employee,” said Kotcher. “In my eyes, the hospital saved themselves a million dollars by firing me, and then they gave the bonus to the CEO.”

Saint Francis’s Financial Struggles

According to the Connecticut Office of Health Strategy’s latest annual report on acute care hospital finances, Saint Francis operated at a $54.974 million deficit in 2024. The hospital brought in an estimated $859.174 million in revenue, while accruing $914.148 million in expenses. 

The hospital has undergone corporate leadership changes; earlier this year, it was reported that Trinity Health New England would shed its old CEO, Montez Carter, and that its hospitals would fall under the supervision of Trinity Health New York, Dr. Steve Hanks. After Connecticut’s Department of Health discovered struggles with staff retention and care, Saint Francis was placed under a consent order, and DPH staff have monitored the hospital since September 2024. Since then, at least three patients have died of delayed care due to the hospital’s high nurse-to-patient ratio. In June, another woman sued the hospital, alleging inadequate care led to the death of one of her newborn sons.

Kotcher is not the only disgruntled ex-Saint Francis employee, either. In January, 40 radiologists left the hospital after their employer, Advanced Imaging Services, a radiology practice group contracted by Saint Francis, sued the hospital for alleged mismanagement of its radiology department. 

When he started back in 2019, Kotcher said employees could earn “as much overtime as we wanted,” but that “over the last few years,” they barred employees from working overtime entirely.

“You started to see them not hiring as many people,” said Kotcher. “You know, one of the big complaints in the operating room is we’re short-staffed, but the surgeries keep coming in.”

Because the hospital avoided overtime, Kotcher said that when employees inevitably worked longer shifts than they were supposed to, they would be told to miss however many hours later that week, but that they had to take PTO to do so. Making matters worse, Kotcher said that while they used to have separate banks for PTO and sick days, “now it’s all just one thing and they don’t even want to give you that.” Kotcher saw morale dip considerably, as more and more people began to call out and those who remained at work consistently “got blasted all day long.”

“Little by little, I see Saint Francis going down the tubes,” said Kotcher. “I just don’t get it.”

A Pattern of Profit over Patients and Providers

Andrea believes Saint Francis has gone steadily downhill since Trinity Health purchased the hospital in 2015. When Trinity took the hospital over, the company told employees that “they were gonna be supportive,” said Andrea, but “suddenly we could not get the supply that we had been getting for 15 years.”

“I went to budgetary meetings, where they said, ‘You know, this thing costs $8, this other one costs $4, you can use this for’ – No!” said Andrea. “They’re not the same thing. People who have a finance degree don’t understand how something is used in the human body.”

Andrea sat on the hospital’s Purchasing Committee for a period, allowing her to see firsthand the cost-cutting measures considered by hospital administrators, many of which she believed were ill-advised or counterintuitive. As an example, Andrea recounted conversations she had with hospital administrators around their proposal to purchase cheaper retrieval bags, a tool used by surgeons to grasp and remove gallbladders.

Andrea said the tool surgeons had used at the time automatically deployed; it was fed through the patient’s incisions and, upon the press of a button, a net would open, allowing surgeons to scoop the gallbladder and easily remove it. Hospital administrators, however, proposed they use a different tool that was “a lot cheaper,” but didn’t automatically deploy.

“They [would] have to use more instrumentation and more time to deploy this thing, to open it up big enough and hold it open to put this gallbladder in,” Andrea explained. “So, you’re going to spend 15 minutes deploying this — and before, you could just do it in about four seconds — so how much time are you going to save? Because time is charged in seven-minute increments, you’re not going to save any money by using this different device.”

There were “all kinds of reasons” it’d be a bad idea and, ultimately, she had to write an “18-page why-it’s-a-bad-idea thing” before administrators agreed to reject the proposal. Andrea said she was asked to be on the committee because of her experience and was told they valued her input, but that she struggled to get administrators to listen to her.

“They are looking only at the cost and the numbers; they’re not looking at why [or] how it’s used, why it would be a better choice,” said Andrea.

Andrea felt Saint Francis’s “corporate mentality” prioritizes profit over patient outcomes. Additionally, she believes that administrators treat hospital staff as “fodder” to “look good for a patient.”

“I don’t think they treat staff as well as they want us to treat the patients,” said Andrea. “I still know a lot of people who work there, and they say their morale is so low because they feel they’re not supported by their manager.”

Since retiring, Andrea said she has kept in touch with some of her former co-workers who still work as techs, and that one of them believes Saint Francis is consciously trying to replace its techs with nurses. Andrea said the hospital used to have 15 techs on staff, but now only has seven.

“I don’t know if there’s anything to that,” said Andrea about the downsizing theory. “But I know that surgeons, especially surgeons who do very detailed procedures, really want a surgical technologist who has the background and training.” 

Kotcher’s dismissal was one of several Andrea witnessed that reduced her view of the hospital. She recalled several surgeons being notified within a week of their contracts’ expiration that the hospital didn’t intend to renew them. One surgeon who “worked there for years,” was reduced to tears after administrators notified him of their intent to let him go a day before his contract expired, said Andrea.

“They just told him, ‘No, we’re not renewing you and by the way, your last day is tomorrow,’” Andrea said. “The ethics of the approach — instead of saying, ‘We need to renegotiate your contract and we’re to do that on X day,’ they just said ‘Nope, we’re not even going to talk to you, bye.’”

These experiences, especially Kotcher’s dismissal, left “a really bad stain” on her view of the hospital and led to her having “trouble trusting the whole institution,” said Andrea. Seeing how the hospital dismissed its staff members played an integral role in her decision to retire. 

“I don’t want you to slowly mistreat me, you know?” said Andrea. “You say you appreciate me, but I’m not feeling appreciated at this point, so I’m kind of done with you guys, and — yeah, I’m no longer working there.”

Kotcher’s Future

The phenomenon of local hospitals being purchased by larger, out-of-state healthcare systems, many of which are backed by private equity firms, has become a hot-button issue in recent years, especially in Connecticut. Earlier this year, Gov. Ned Lamont signed Public Act 26-22, which requires hospitals to attest that private equity firms hold no controlling stakes in their business or interfere with their clinical decision-making. 

Furthermore, the bill bars hospitals from entering into “sale-leaseback” agreements, in which the hospital sells its property and then enters into a lease agreement with the property’s new owner, unless approved by officials at the state’s Department of Public Health. Critics of the practice say it allows private equity firms to turn the value of hospitals into liquid cash for the short-term benefit of investors, while strapping hospitals into lease agreements that financially burden them long-term. 

The bill was spurred by the 2016 purchase of three Connecticut hospitals – Waterbury Hospital, Manchester Memorial Hospital, and Rockville General Hospital – by Prospect Medical, a healthcare group backed by the private equity firm Leonard Green & Partners. Prospect executed sale-leasebacks on each property before filing for bankruptcy in 2025.Critics 

Connecticut’s experience with private equity has led its U.S. Senator, Chris Murphy, to attack the issue at the national level as well. In March, he and Pennsylvania Congresswoman Mary Gay Scanlon co-authored a bill to ban private equity firms from owning hospitals and skilled nursing facilities.

Murphy issued a report last August that examined Prospect Medical’s practices in Connecticut, concluding that they worsened patient outcomes and lowered staff morale before ultimately bankrupting the hospitals. The report interviewed numerous staff members at Prospect hospitals while citing several studies and reports on private equity in healthcare.

“When Prospect came into these hospitals, they cut corners, squeezed staff, eroded patient care and drove these hospitals into bankruptcy, leaving economic uncertainty for these communities in its wake,” said Murphy. “Prospect didn’t invent the private equity playbook, but they followed it to the letter – buy the hospitals, strip them of their assets, flip them for a quick profit, and leave the mess for someone else to clean up.”

While Trinity Health is not a private-equity-backed health system, the phenomena found in Murphy’s report and the phenomena reported by Kotcher and Andrea share similarities: initial promises of increased investment, followed by a stripping of resources, and a decline in provider morale and patient outcomes.

As for Kotcher, he is still waiting to be put on the transplant list. He said a bout of pancreatitis has further delayed him from getting approved.

“I’m kind of just in a limbo land,” said Kotcher. “But I’m still here, fighting for my lungs. I’m tethered to my house on an oxygen machine that runs constantly all day long. I have these little tanks I have to drag along everywhere when I go to my doctor’s appointments and my pulmonary rehab, but that’s basically the gist of what I’m dealing with right now”.

Kotcher has had to dip into his savings, as he only makes $2,500 a month on his Social Security Disability Insurance, and has to pay $800 a month for his insurance and $2,200 for rent, not including his utilities. He is nervous about what will happen when he switches over to Medicare in September, as he will turn 65 then. 

Kotcher has a friend who has been “a blessing,” who takes him to appointments and does “all these things for me,” he said. She recently sold her condo and bought a house in Arkansas, but has moved in with Kotcher, vowing to stay and help him until he gets his new lungs. Despite it all, Kotcher still yearns to return to work someday.

“She wants me to move down to Arkansas with her, you know, so we can both retire together down there,” said Kotcher. “But I don’t want to retire; I just want to go somewhere and have a different job.” 

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