Despite opposition from community members, Northern Berkshire Healthcare will move forward with plans to close its psychiatric and pediatric units.
Due to financial constraints and low patient numbers, Northern Berkshire Healthcare will close Greylock Pavilion at North Adams Regional Hospital in early January. The Massachusetts Department of Public Health held two hearings on the proposed closing in November and about 40 community members voiced their concerns at a public forum Tuesday night. Judy Hopper says her daughter has gotten care at Greylock Pavilion because mental health services at Baystate Medical Center and UMass Memorial Medical Center had up to two-day wait periods.
“It’s appalling that in this country with an acute shortage of mental health facilities anyone is considering closing an already existing one,” said Hopper.
Following the November hearings, the DPH deemed the services necessary and asked the hospital if it could delay closure. Paul Hopkins is a spokesman for Northern Berkshire Health Care.
“Given the un-sustainability of the operation, both in terms of the very low numbers of patients we see and the very high cost associated with providing the care, the simple answer to that question is, no, we can’t keep it open,” said Hopkins.
The DPH also requested Northern Berkshire Healthcare provide information on its restructuring plans following the closing. The hospital will replace its services through existing transfer agreements with Berkshire Medical Center and Baystate Medical Center for patients in need of long-term care. Diane George, an emergency room nurse at the hospital, says plans to establish psychiatric “pods” near the ER for immediate in-patient mental health care are ill-advised.
“There is not enough room,” George said. “There are not enough nurses. Nurses in the ER do not know how to properly facilitate care to a mental health need person.”
Hopkins says over the last seven years, Greylock’s average patient load has dropped from 12 to seven, causing the unit to operate at a loss of $2 million a year. Susan Revotski, a nurse at Greylock, presented a paper she says was posted at the hospital, instructing staff to only admit psychiatric patients from its own ER and from Berkshire County. Jim Gander represents the hospital’s nurses as a representative from the Massachusetts Nurses Association. He says in the past the psychiatric unit admitted patients from Franklin County and southern Vermont.
“This of course limits the ability of the hospital to have a patient census at a level that is necessary in order to make the psychiatric unit at North Adams Regional Hospital viable,” said Gander.
Arthur Turton is on the hospital’s Board of Trustees. He says he can’t speak to the question of turning away patients, but says there is a valid reason for it. He says when the hospital filed for bankruptcy in 2012 it was operating with roughly 12 days of cash on hand. Now, he says, it is back down to 13 days.
“If we continue with the current financial situation we will not be able to make payroll this spring,” explained Turton.
Turton says closing the psychiatric and pediatric units and regionalizing care is part of the hospital’s plan to combat decreasing revenues, steps he says are being taken by providers across the country. He says the hospital treats a high number of Medicare and Medicaid patients which don’t cover as many services as private insurers. Democratic state representative Gailanne Cariddi of North Adams says she is concerned about the financial future of the entire hospital.
“Is this Custer’s last stand?” Cariddi said. “We want to gather together and help our hospital. We don’t just want to see it sink and go out of business. Let’s all gather together and try to help them to stay in business. Help them help us because I don’t want to see this place go.”
Hopkins says the closure will impact staffing levels, but exact figures are not known. He says the hospital has reached agreements with regional ambulatory and taxi services to provide transportation for patients and families to other regional centers. He adds the hospital is looking at outpatient care for early intervention of mental health issues in the community. Democratic state senator Ben Downing says he is working on possible permanent solutions, but hasn’t come across a feasible one yet.
“The ideal solution would be an increased reimbursement for mental health care services,” Downing said. “We don’t have that right now and that would require a significant change in policy.”