NORTH ADAMS -- The impending closure of North Adams Regional Hospital's inpatient psychiatric and pediatric units in early 2014 will be the subject of two public hearings held by the state Department of Public Health on Nov. 1.
The hospital's critical care unit, which is slated to be merged with the medical/surgical unit into a single 16-bed unit, could also be subject to a public hearing. Discussions between hospital and Department of Public Health (DPH) officials about whether the merger will change current services are still ongoing.
Photo Gallery: NARH unions share concerns about planned changes
At each of the scheduled hearings, DPH representatives will hear testimony from local providers and community members about the impact the closures and the hospital's plan to help facilitate those services in the future will have on the community.
Although the goal of the hearing will be to determine whether or not the units are "essential services" and should remain open, DPH currently does not have the regulatory authority to prevent the units from closing.
Northern Berkshire Healthcare, the hospital's parent company, announced its plans to close the Greylock Pavilion, its inpatient psychiatric unit, and inpatient pediatric unit in late September. Both services are being transitioned to outpatient programs. Officials also announced the closure of the critical care unit and the opening of the unit dedicated to the hospital's Joint Rehabilitation Center at the same time.
NARH officials say the closures and restructuring are part of a strategic plan to keep the hospital fiscally viable and are in response to changing needs in the community, while members of
NARH's Chief Nursing Officer Leesa-Lee Keith, a registered nurse, said declining inpatient numbers at the Greylock Pavilion and inpatient pediatrics were part of the reason the hospital's senior staff and administration identified the units for closure and a transition to out-patient care models.
"All of our [psychiatric] resources are invested in inpatient care. Our census at the Greylock Pavilion hovers around 7 patients, a number that worries us for two reasons -- when the census goes that low or even lower, it creates a therapeutic milieu, which impacts some of our elements of care such as group sessions. It also isn't ever financially viable," she said.
By changing to an out-patient program, Keith said the hospital will be able to expand therapy offerings, while still providing coordinated care for patients in need of longer-term solutions coming into the emergency department. Talks with Berkshire Medical Center's behavior health services unit and the Brien Center are currently ongoing.
MNA member Susan Revotskie, a psychiatric nurse who has worked at the Greylock Pavilion for 18 years, and 1199SEIU Chapter Chair Debbie Poplaski, who's served as the pavilion's unit secretary for 25 years, believe discontinuing inpatient services will be detrimental and that census numbers in the psychiatric ward could be improved.
Revotskie said the closure of psychiatric wards around the state has created a shortage of beds for patients, many of whom also have opiate or other drug addictions, and that closing Greylock Pavilion would only further escalate shortages in the county.
"We want our patients on our floor. We want to take care of them. We can be full. We need to change the unit to do this, so let's do it," Poplaski said, adding that the unit's staff has yet to be consulted about any changes.
As for changes to the critical care unit, Keith said the closure and merger with the medical/surgical unit will allow the hospital to continue caring for the population served by both units, and also increase the number of beds with cardiac monitors.
"We want the community to know that the patients and families we serve today are the families and patients we'll still be serving tomorrow," she said.
Staffing of the new unit, Keith said, will include nurses from both departments, with medical/surgical nurses receiving increased education in the area of intensive care patient management.
Angie Lingner, a registered nurse who's worked in the critical care unit for 25 years, criticized the consolidation of the units, saying the increase of patient-to-nurse ratios for critical care patients, from 3-to-1 to 4-to-1, had the potential to create safety issues.