DPH determines Nashoba Valley Medical Center provides essential services amid pending closure
Photo I Courtesy of Alison Kuznitz/State House News Service
Nurses from Carney Hospital in Dorchester and Nashoba Valley Medical Center in Ayer demanded action from Gov. Maura Healey on July 31 after Steward Health Care announced it would close the facilities in August.
Carney Hospital and Nashoba Valley Medical Center, which are set to close in less than two weeks, each provide an "essential service necessary for preserving access and health status" in their areas, public health regulators concluded this week.
The Department of Public Health found after an abbreviated review that the Steward Health Care-owned facilities both offer "essential service," a determination that provided more ammunition to lawmakers and advocates who want state government to intervene and prevent the hospitals from shuttering around the end of the month.
However, state public health officials stressed that their determination does not give the department the power to order either hospital to remain open. Instead, DPH called on Steward -- which is trying to offload all of its Massachusetts hospitals amid bankruptcy proceedings -- to take a slew of additional steps to ease the transitions.
Stephen Davis, director of DPH's division of health care facility licensure and certification, wrote a seven-page memo Monday outlining more than a dozen concerns about potential gaps in Steward's closure plan for Carney.
He urged Steward to provide more information to regulators, patients and providers about the location of alternative services, transportation options to get to health care after the closure, access to medical records, ambulance run times and more.
Based on testimony received at public hearings, Davis wrote, DPH is "concerned that the plan lacks detail as to what, how, and when current patients will receive information about options for care available to them, what resources are and will be available to patients to ensure the patients are able to navigate the change and answer any care continuity questions."
Davis followed that up with a similar Nashoba-focused letter on Tuesday, in which he also described concerns about a lack of details provided by Steward and called on the system to submit a plan for maintaining access to care.
The "essential service" designation is likely to embolden Carney and Nashoba Valley Medical Center supporters, who are frustrated the Healey administration opted to let those facilities close, yet intervene with eminent-domain powers to assist the sale of St. Elizabeth's Medical Center in Brighton.
State law and regulations do not directly empower DPH to force a facility to remain open. If regulators determine a hospital provides an essential service, they can only require the operator to submit a plan for maintaining patient access to care after closure.
Reform supporters have been calling for changes to the hospital closure process since before the Steward crisis erupted.
Sen. Nick Collins, a Boston Democrat, said the essential service declaration makes it "impossible for DPH to say that it wouldn't be a public health emergency if Carney were to close."
"We know state health officials have the power to take the facility by eminent domain as they are doing with St. Elizabeth's right now. And state health officials have made clear they have the resources to subsidize necessary capital investments and operations during a transition period," Collins said in a statement. "So for DPH to say they don't have the power to do so for Carney is unbelievable and factually untrue."
Steward announced on July 26 that it plans to close Carney and Nashoba Valley Medical Center on or around Aug. 31, a far quicker timeline than the 120-day period outlined in state regulations. A federal bankruptcy judge soon approved the shortened period.
DPH hosted an in-person hearing about the Carney closure on Aug. 13 followed by a virtual hearing on Aug. 14. The department held hearings about Nashoba Valley Medical Center on Aug. 15 and on Monday.
Gov. Maura Healey, Health and Human Services Secretary Kate Walsh, and DPH Commissioner Robbie Goldstein have repeatedly said they have no ability to keep the pair of facilities open.
But their announcement last week that the state would move to seize St. Elizabeth's by eminent domain to help transfer it to Boston Medical Center triggered a renewed flurry of pressure from Carney and NVMC backers, who ask why the state can take such action for one Steward hospital but not two others.
Both Carney and NVMC were classified by the state as "small hospitals" in fiscal year 2022, the most recent year with data available, while St. Elizabeth's was deemed mid-size.
In fiscal 2022, Carney had 30,919 emergency department visits, 63,172 outpatient visits and 3,119 inpatient discharges, while Nashoba had 16,004 emergency department visits, 38,897 outpatient visits and 1,874 inpatient discharges.
Healey administration officials have said both facilities experienced significant declines in patient volumes during Steward's public bankruptcy crisis.
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