Abrupt closure of rural Massachusetts hospital creates community outcry

Financially troubled North Adams Regional Hospital, the primary health care provider and employer in rural northwest Massachusetts, abruptly announced plans to close this week, setting of strong union and community protests.

The hospital stopped accepting new patients Tuesday and had only 20 inpatients in its 109-bed facility that day, Paul Hopkins, the hospital’s director of community relations, told the Boston Globe. No mention of the closing was made on the hospital’s website, but late Thursday, it used its Facebook page to communicate its concern about a court order passed earlier in the day that would force Northern Berkshire Healthcare (NBH), the administrative organization for North Adams Regional Hospital, to keep the hospital's emergency room staffed and open past Friday, the day it had planned to close completely.

"NBH had planned to close the Emergency Department in a safe, planned way to ensure patients were treated in appropriate settings. We are now working to assemble staffing and ensure that we have necessary supplies — neither of which is guaranteed. We are also required to keep operating until we exhaust the organization’s funds, raising the possibility of running out of money while patients are in our facility. At this time there has been no offer of additional funding from any source," the hospital wrote. It also added that "we are concerned about safety in the current circumstances, and as long as the order remains in place."

According to the local Berkshire Eagle News, Berkshire Superior Court Judge John A. Agostini issued a temporary injunction to stop NBH from closing the hospital emergency department until it complies with state hospital closure requirements or until Berkshire Medical Center, a hospital about 20 miles away in Pittsfield, Mass., can get an expedited license to operate a satellite emergency facility in North Adams, Mass.

At least two Facebook pages not managed by the hospital and dedicated to organizing opposition to the closure were set up following NBH's announcement that it would shut its doors. By Thursday, the most popular of these pages had gathered more than 5,000 followers. A protest was planned for 9 a.m. Friday outside the hospital, one hour before the hospital was to have closed its emergency department doors.

NBH is a private, not-for-profit health care provider that serves North Berkshire County in northwest Massachusetts and surrounding areas, including parts of southwest Vermont. Along with North Adams Regional Hospital, NBH also will close its Visiting Nurse Association & Hospice of Northern Berkshire and its three Northern Berkshire Healthcare Physicians Group outpatient offices — Northern Berkshire Family Medicine, Northern Berkshire OB/GYN, and Northern Berkshire General Surgery.

According to the Boston Globe, this is the first permanent closing of an acute-care hospital in Massachusetts in over a decade. NBH had sought to keep its facilities open by selling to Berkshire Medical Center in Pittsfield, Mass. However, that deal collapsed.

Officials with the Massachusetts Nurses Association and the Service Employees International Union, which represent a majority of the hospital’s 530 full-time and part-time employees also objected to the abrupt nature of the closing.

“It is totally irresponsible to close a hospital with three days’ notice,” David Schildmeier, a spokesman for the nurses association, told the Boston Globe. “We’re not prepared to accept this closure. We’re going to fight this with everything we can.”

But economic factors may trump community and union activism. According to the Massachusetts Council of Community Hospitals, in-patient care in the state has increasingly concentrated in high-cost teaching hospitals, even though much of this care could be delivered at equal or better quality at community hospital settings. This has contributed to the lower profitability and weak balance sheets for many community hospitals.

Although NBH was deep in the red — in unaudited data filed with the state Center for Health Information and Analysis, the hospital said it lost nearly $9 million between 2009 and 2011 — it had maintained high quality of care by objective independent measures. Last year, it was one of only 18 hospitals in the state to earn Top Performer status from the Joint Commission.