It's very hard for health care facilities to break-even in their operations. Making a profit is unheard of. Everything seems to suffer from catch-22. They have poorly staffed and supported facilities due to their poorer clientele.
Their clients just do not have disposable income to spend on health. Poor families gamble with their health. They wait until the last minute or until conditions are beyond worst before going to the doctor or nurse. They believe it will get better tomorrow. Unfortunately, they die before tomorrow comes.