PITTSFIELD - Emergency services at North Adams Regional Hospital will remain closed through the weekend while officials wade through the morass of financial, legal and regulatory issues left in the wake of Friday's shutdown.
Possibly for the first time in its 129-year history, the institution's doors were closed to patients and hospital staff.
Attorney General Martha Coakley issued a release that acknowledged the hospital's fiscal health "was even more precipitous than previously understood," and that a temporary injunction against the closure that her office obtained Thursday in Berkshire Superior Court had to be revised.
Those changes, approved Friday afternoon by Judge John A. Agostini, allow the hospital to close and for the state Department of Public Health, Berkshire Medical Center and other entities and officials to re-establish emergency services under the direction of BMC in Pittsfield.
"We have asked the court to enter a revised order that will maintain the ability for Berkshire Medical Center to access the hospital and help facilitate a prompt transition to BMC's provision of emergency services at NARH," Coakley said in her statement.
She added that her office "is currently working with all stakeholders to reopen emergency services as soon as possible." Coakley also directed her Non-Profit Organizations/Charities Division "to conduct a full investigation into the actions of the board of trustees that led to this rapid closure with little notice to employees or the community."
A statement released by the trustees on Tuesday afternoon announced that the financially troubled institution would close as of Friday.
Michael Leary, spokesman for Berkshire Health Systems, said in a statement Friday night: "BMC must first receive from the state Department of Public Health authority to operate a 'satellite emergency facility' under the Berkshire Medical Center license. The multi-part application process has been initiated, and once the application has been completed the Department of Public Health has stated it will be given an expedited review. The timeline for completing that process is not clear at this time. BMC will remain engaged with the state DPH to keep the process on track."
Leary added: "A senior leadership and clinical team from BMC met at North Adams Regional Hospital this morning to begin determination of what personnel, equipment and resources will be needed from BMC to reopen emergency services in Northern Berkshire once the hospital is authorized to do so."
BMC intends to engage NARH staff members to re-establish emergency services, helping to ensure as smooth a transition as possible, Leary said.
BMC has also extended job offers to emergency department physicians at NARH and physicians in Northern Berkshire's internal medicine and obstetrics and gynecology practices, he said.
David Phelps, the Berkshire Health Systems president and CEO, said in the statement: "We made these offers and are expediting credentialing at BMC because we want to assure the residents of Northern Berkshire County that core healthcare services will remain available in their communities."
The revised temporary court order signed Friday by Agostini includes provisions enjoining NBH from preventing access to its medical records system, emergency department, equipment, books and records; appointing BMC "as temporary provider of emergency services and medical record support services," and allowing BMC to address the threat to public safety for residents "from the abrupt cessation of operations."
The revised order also requires NBH to provide records to allow BMC to be licensed by the DPH "on an expedited basis" to operate a satellite emergency facility, and to provide notice of the order to staff members, hospital vendors and the public concerning steps to take to receive emergency services.
The order likewise orders NBH to turn over to BMC, once it obtains DPH authorizations, access to relevant portions of the facility and equipment and records necessary to provide emergency services.
BMC would have authority over employees and the operation of emergency services, according to the order, and to "expend such funds as may be made available for the commencement and provision of emergency services and electronic health record support."
BMC and DPH also are directed to evaluate the long-term feasibility of emergency or other services at the hospital site and file monthly reports with the court, the DPH and the AG's office.
Possible sources of funding - whether public, private or a combination of both - have not been identified, a spokesman for Coakley's office said Friday. Leary declined to comment on funding aspects, saying the prepared statement would be the only comment issued by BHS.
At a community meeting at the North Adams American Legion on Friday, state Sen. Ben Downing, D-Pittsfield, tried to shed some light on why the state hasn't been able to provide funding to avert the closure.
"One of the frustrations was if you make a grant directly to NARH, there was concern that the money would go directly to the bondholders or it would go directly into a bankrupty filing," Downing said.
In the court order, BMC's "obligation to perform its duties ... is expressly conditioned upon the timely availability to BMC of funds necessary to perform such duties."
Creditors of NBH also are barred from interfering with utility services without authorization from the court, and all persons are enjoined from taking possession of any part of or interfering with the facility.
Past and present officers of NBH are directed to cooperate with BMC and the DPH for access to records or information and enjoined from interfering or impeding the provision of emergency services by BMC. To reach Jim Therrien: firstname.lastname@example.org, or (413) 496-6247 On Twitter: @BE_therrien