While public officials and nurses’ union officials were scrambling to find a way to keep North Adams Regional Hospital and three affiliated medical groups from closing on Friday, Northern Berkshire Healthcare leaders weren’t pitching in. North Adams is a day away from suffering a horrific blow and every effort must be made to prevent it from happening.
It appears that Governor Deval Patrick was blindsided along with everyone else on Tuesday. The governor revealed Wednesday that he and the state Department of Health (DPH) worked over the weekend to find a way to keep the hospital open and thought they had one until "the point that the board of the hospital made the decision" to close. Hospital management is in apparent violation of a law requiring both a 90-day notice and the conducting of a public hearing by the DPH before a hospital is closed. No appeal was made by management for a waiver. Whatever motivated the decision to close, the short notice provided appears to be illegal and is without dispute unfair to employees, patients and the community at large.
North Berkshire residents would certainly welcome the much-rumored merger between Northern Berkshire Healthcare, the parent company of NARH, and Berkshire Health Systems, the county’s largest employer, but BHS can’t be faulted for being cautious about taking on too much red ink. Its responsibility is first and foremost to its employees and patients and to the central Berkshire community. NARH, however, reported just last year that it had successfully emerged from a two-year bankruptcy. The state Center for Health Information and Analysis showed the hospital with a 3.25 percent profit margin as of June 30 of last year, so the concept of a merger was reasonable. By Tuesday, however, the situation was so dire it called for an emergency closing, which should never happen with a hospital.
If the issue is the calling in of bonds issued to NBH then it is incumbent upon state officials to work with bondholders to find at least a temporary solution, such as government backing of the bonds. The governor may have the option of declaring a public health emergency, which would enable the DPH to appoint new management to explore solutions while the hospital stays open. If NBH did not abide by state regulations in closing the hospital it may have opened itself to a lawsuit by the Massachusetts Nurses Association on behalf of the 530 employees who will lose jobs, which could keep the hospital from closing its doors tomorrow.
NBH obviously faces economic problems not of its making given the vagaries of the U.S. health care system, such as poor Medicaid reimbursements. Other small community hospitals, however, are facing these problems without closing their doors. There are options to be explored and NBH management should join in their exploration. The decision to close the hospital Friday has not been adequately defended -- which makes it indefensible.