Letter: The real debate in wake of NARH closing


To the editor of THE EAGLE:

I feel compelled to respond to Sunday’s Berkshire Eagle article titled, "Closing of NARH, health study is challenged." The report being challenged is the local MNA’s report on the financial situation of North Adams Regional Hospital over the past decade.

As noted in the article, this report was highly touted in open public forums, both in print and electronic media, and even a positive editorial response by this newspaper. The challenge comes from the Massachusetts Hospital Association, which asserts that the MNA researchers used figures that are not "a recognized measure of hospital operating performance."

MNA spokesman David Schildmeier states that the MNA stands by its report. "Our report is very clear, and they (MHA) misread it, obviously. We used the hospital’s own financials."

Mr. Schildmeier is referring to documents that are in the public domain and are available on the Internet. I, too, could easily access them. In particular, the documents referenced are the tax documents for NARH, Form 990, "Return of Organization Exempt from Income Tax" and reports from the Massachusetts government site, "Center for Health Information and Analysis." (CHIA.) But beyond the truth of the source of the information and contrary to Mr. Schildmeier’s search for clarity for the citizens of North Berkshire, the facts become a little fuzzy.

Let’s look at NARH fiscal 2012. Mr. Schildmeier: "The surplus derived from patient services made the system (NARH) a $23 million profit in 2012." Let’s look at the NARH financial graph prepared by and provided with MNA report and focus on the fiscal 2012. "Program service revenues, $62,752,359, program services expenses, $39,874,267." Looks like a huge windfall.

Now, let’s look at the NARH fiscal 2012 tax filing, the Form 990. The number, "program services revenue, $62,752,359" is correct. That number, however, is actually the total revenue generated. The number, "program service expenses $39,874,267" is correct, but it only pertains to the cost of the clinical services. It does not include the cost of the food service, the cleaning of the floors, the plowing the driveways, the provision of clean linens, the provision of management oversight, and so on. That line item is called "Management and Other Expenses."

That number is $18,144,460. Simple math -- $62,752,359 minus $39,874,267 minus $18,144,460 equals $4,733,632 -- not a $22 million surplus in the NARH fiscal 2012.

Let’s look at the report from the Center for Health Infor-
mation and Analysis, CHIA regarding NARH fiscal 2012. MNA, Mr. Schildmeier: "At NARH, public payers (Medicare and Medicaid) represents less than 65 percent of payer mix." CHIA report regarding NARH fiscal 2012 -- public payers equals 65 percent, private insure reimbursement equals 35 percent, hospital state average equals 38 percent."

And in the end, that is what compels me to write. A horrible wrong was committed on March 28 when North Adams Regional Hospital was abruptly closed. It left the North Berkshire community without easy access to health care services. I can speak from personal experience. Two and half years ago, I suffered a major heart attack and without the nearby NARH emergency room to provide life-saving thrombolytic therapy, I would most likely be dead.

This debate is not about the MNA position regarding the NARH closing. This debate is not about the SEIU position regarding the NARH closing. This debate is not about what local, state, and federal politicians knew about the impending closure of NARH. This debate is not about the opinion of the MHA regarding the closure of NARH. This debate, today, is about the reestablishment of routine, urgent, and emergent medical services in our North Berkshire local community, regardless if that service is rendered by a union or nonunion employee.

And from my observation, Berkshire Health Systems is on task.




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