NORTH ADAMS -- Nearly a month after North Adams Regional Hospital abruptly closed, the three North Berkshire ambulance services are feeling the effects of long transport times to emergency rooms in Pittsfield and Bennington, Vt., as well as other headaches.
And while they have beefed up their staffs and their fleets to meet the demand, the companies report that the additional workload is causing financial hardship and operational challenges.
"We are incurring overtime, the crews aren't getting any break time, the fuel costs are higher, the maintenance costs are increasing, and we're not getting any of the hospital transfer business we used to get from [NARH]," said John Meaney, general manager of North Adams Ambulance Service.
NARH closed on March 28, leaving Northern Berkshire with no emergency services. Negotiations are ongoing for Berkshire Medical Center in Pittsfield to operate an emergency satellite center at the former North Adams hospital.
In the interim, all three of Northern Berkshire ambulance services say the increased drive time -- from the average of 30 minutes for an ambulance to respond to a call and be back in service, to as much a two-hour turnaround time -- has resulted in a significantly higher cost of doing business.
Meaney said that his company has transported more than 200 patients in the month since the hospital closed. Ten of them went to Southern Vermont Medical Center in Bennington, and the rest went to Berkshire Medical Center.
Staffers say the increase in traffic at the emergency department of Berkshire Medical Center has, at times, tested the capacity of the ambulance arrival area. At the more busy times of the day, a queue of three or four ambulances may be waiting to drop off patients.
"We do see a bit of an increase in wait time," said Michelle Sawicky, operations manager at Village Ambulance in Williamstown. "It just depends on how busy their emergency room is."
Michael Leary, a spokesman for Berkshire Medical Center, 313 patients have been transported to BMC by the three Northern Berkshire ambulance services, or an average of about 12 per day.
"Since the closure of North Adams Regional Hospital, we have considerably increased staffing and resources in the BMC Emergency Department to accommodate the expected influx of patients from North Berkshire," said Leary, noting that the emergency department is by its nature a busy place.
"BMC has comprehensive systems in place to ensure that the most critical patients are seen first, and this is coordinated through EMS and all ambulance services that have patients en route to our facility," Leary said. "If the ED is experiencing a heavy patient volume, it's possible the ambulance bay will see some stacking, but that is the exception rather than the norm and is not related to patients coming from one section of the county or another."
Despite the increased traffic, ambulance staffers said BMC has been up to the challenge.
"They're very, very busy," said Daniel LaPlante, manager of Adams Ambulance Service. "But they're helping us as much as possible and sometimes there's a little bit of a wait. But so far they've been quite good at moving us through. I think they're at about capacity but they've been handling everything we've brought in."
LaPlante has seen some familiar faces recently in the emergency department at BMC.
"They've added staff," he said. "We've seen a few docs and nurses at BMC that used to work up (at NARH)."
Berkshire Medical Center has confirmed it has hired a number of former NARH employees.
Meaney said the loss of hospital transfers from NARH also has had an impact on its bottom line.
In addition, he said, North Adams Ambulance had to lease another ambulance to handle the load, resulting in an additional $3,200 in overhead every month. And for nearly three days after the hospital closed, North Adams Ambulance was required to have an ambulance fully staffed and standing by at NARH in case of emergency patient arrivals.
"That was an expensive weekend for us," Meaney said.
Managers of all three services said the Massachusetts Department of Health sought information on their increased costs, with an eye toward formulating some sort of relief package to help the nonprofit agencies survive what they hope is a temporary period of increased workload.
There has been no word on any relief package thus far.
In a prepared statement, DPH spokes person Anne Roach said "DPH recognizes the importance of EMS services as local employers and vital components of the health care system for the greater community. DPH has been working with local EMS services to transition patients safely to other facilities and will continue to monitor the situation to provide all support possible to ensure patient care needs are met."
But if a new emergency center were to open, the workload would likely shrink back down.
"Things should get better when they open a satellite [emergency facility] in North Adams," Meaney said.
The long ride to Pittsfield was a factor in another recent incident involving a North Adams man who suffered a cardiac event last week, Meaney said.
The man's condition was critical enough to require someone to perform CPR during the 35-minute trip to BMC. But because CPR is a strenuous process for the caregiver, they needed a CPR-certified EMT to provide relief.
Through the Sheriff's Office radio dispatch center, they arranged to pick up two Cheshire Fire Department EMTs on the way down Route 8, who were then able to continue to administer CPR.
The man's condition could not be learned.
"Our crew was quick on their feet and made that call," Meaney said. "And we're thankful for the help. But it's a smack in the face that shows us what we're up against: People can only sustain this for just so long. This needs to end now."
To reach Scott Stafford:
or (413) 663-3741, ext. 227.
On Twitter: @BE_SStafford