The Massachusetts Nurses Association report released Tuesday on the causes of the demise of North Adams Regional Hospital didn’t reveal much that was not already known or assumed. It does, however, indicate that a properly run hospital will succeed in North Adams.

In the absence of any word from Northern Berkshire Healthcare management or trustees since the hospital was closed on three days notice March 28, the MNA stands as the lone autopsy report on the hospital. In citing "poor management" decisions, the MNA report cited the 1999 purchase of the Sweet Brook Transitional Care and Living Centers and the Sweetwood Continuing Care Retirement Community in Williamstown for $25 million (The Eagle has reported that the price was $19 million). NBH sold the businesses for $7 million four years ago.

The resulting debt burden caused management to cut staff and end viable services, the report says, weakening the hospital’s foundation. The report also asserts that reimbursements for patient services were better than for many other community hospitals. In an open letter to the community in March, the NARH trustees claimed that declining reimbursements were contributing to the hospital’s precarious financial position, and while reimbursements were undoubtedly not what they should have been, other community hospitals in the state receiving similar or worse reimbursements were not and are not on the verge of closing their doors.

That open letter, the last word heard from the trustees, expressed puzzlement that "for whatever reason" patient volume had declined in nearly all of the hospital’s operations. The reason may well have been the cuts in services made in response to the considerable debt burden and staff cuts that made the hospital less responsive to patients and families.

The MNA concludes that with the debt addressed and better management installed, a full-service hospital remains viable in North Adams. Berkshire Medical Center wants to set up a satellite emergency center at the hospital this month and has bid $4 million for the hospital building and its assets. Under bankruptcy law, other bids must be taken for the property, but under the purchase agreement, should BMC be outbid it will be granted a one-year lease while it looks to set up business elsewhere. This condition may discourage outside bidders.

Assuming BMC ends up with the hospital, it has indicated it will invest $10 million in the facility. BMC has not said what services it would provide, and indeed, nothing should be specified in advance of a state-funded study to determine what medical services will be sustainable in North Adams. A different NARH may emerge, but it is clear that North Berkshire County, which must have its own hospital, can and will support a well-managed medical facility.