Clarence Fanto: No fault in BHS taking their time


LENOX -- Bogged down in bureaucracy and bankruptcy complexities.
On the surface, that would appear to be the cause of the delay in "repurposing" North Adams Regional Hospital into an emergency services facility operated by Berkshire Health Systems.

BHS is the parent company of Berkshire Medical Center in Pittsfield, Fairview Hospital in Great Barrington, Berkshire VNA and seven long-term and senior living facilities under the umbrella of Berkshire Healthcare, a BHS subsidiary.

To meet the need for primary care south of Pittsfield, the new Lenox Family Health Center of BMC will open in early May at the Lenox Commons mixed-use complex, BHS spokesman Michael Leary confirmed Friday.

While it’s understandable that North Berkshire residents are frustrated, anxious and impatient over the delay in restoring urgent care to the now-shuttered North Adams hospital, there’s good reason for Berkshire Health Systems to tread cautiously.

Now, as the sole provider of hospital care and myriad other services countywide, BHS executives have to make sure their bottom line remains protected from the massive debts -- around $50 million -- that forced NARH into liquidation (Chapter 7 of the bankruptcy code) with only three days’ notice.

That huge amount of red ink, an albatross no health care company would want to take on, is the likely reason why the much-speculated potential complete takeover of NARH by Berkshire Health Systems did not materialize.

There’s no doubt that BHS President and CEO David Phelps and his senior leadership team remember all too well the time decades ago when the Pittsfield hospital’s finances were on shaky ground.

In recent years, BMC has won high marks for the quality of its emergency care and a wide range of other services and, from all available evidence, has managed its finances effectively.

Fairview Hospital, which serves a crucial need in South County, was saved from financial collapse a decade ago when it was designated a Critical Access facility -- one of only three in Massachusetts -- so that it receives full reimbursement for its population of Medicare and Medicaid patients.

Under the firm hand of its president, Eugene Dellea, and with the help of state Rep. William "Smitty" Pignatelli, the small hospital is in solid shape after recovering from more than $2 million in annual losses back in 2002 and 2003.

With BHS now assuming responsibility for several medical practices and patient services in North Berkshire, it’s well-advised to make sure its own bottom line remains healthy.

That’s especially the case since, across the state and the nation, the health care landscape is littered with medical facilities teetering on the precipice of financial ruin.

This past week, UMass Memorial Hospital, the largest employer in central Massachusetts, announced it will cut 103 full-time equivalent positions, including 55 nurses, at its two Worcester campuses. According to published reports, the major restructuring will close a medical floor and three out of 17 operating rooms at the system’s site near downtown Worcester.

UMass Memorial will downsize its pediatric intensive care unit and other pediatric services at its other facility near the UMass Medical School, The Boston Globe reported.

Reimbursement reduction from government and private insurers was the culprit, along with a drop in the number of patients, said the Worcester hospital’s president, Patrick Muldoon.

"This volume is gone, and it’s not coming back any time soon," he told The Globe. "It doesn’t take much to start accumulating losses when your volume is falling off. This is the most difficult thing I have to do as a health care leader. But this is what we have to deal with going forward."

Muldoon cautioned that there’s more "restructuring" ahead, telling his managers: "I know in your hearts you want me to tell you it’s over. But I can’t tell you that."

According to the Massachusetts Nurses Association, 179 full- and part-time positions are being eliminated, including 81 full- and part-time nursing jobs.

"We’re heartbroken," said Colleen Wolfe, a registered nurse at the UMass Memorial campus and co-chair of the nurses union’s bargaining committee. "Patients are suffering the consequences of 10 years of gross mismanagement. Now they’re dismantling a medical floor where people are taking care of elderly patients with complex medical needs. It’s really tragic."

UMass Memorial Health Care, the parent company with additional sites in Fitchburg, Leominster, Clinton and Marlborough, posted a $55 million loss last year.

Before the cutbacks announced this past week, the 13,200-employee hospital system had chopped 285 full-time equivalent positions over a four-month period ending in February. It’s selling a medical office building, and its hospital in Palmer is being transferred to a new owner, Baystate Health of Springfield.

In addition to the setbacks at UMass Memorial and the catastrophe at NARH, there are other hospitals across the state with troubled bottom lines.

These are cautionary tales for Berkshire Health System leaders as they study the best options for restoring much-needed emergency care services to North Berkshire. Rather than rush into a potentially perilous situation, it’s wise for BHS to carefully strategize and analyze the best way forward.

There’s too much at stake, so we shouldn’t begrudge BHS the additional time needed to achieve a financially sustainable solution that will stabilize the future of health care for the entire county.

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