State agency says Nashoba hospital is ‘essential;’ Select Board weighs effects of Aug. 31 closing

 

The Harvard Select Board added its voice Tuesday night to the growing chorus of local leaders and politicians calling on Gov. Maura Healey and her administration to save Nashoba Valley Medical Center, scheduled to close Aug. 31.

In a unanimous 5-0 vote, the board requested that Healey declare the closure of Nashoba hospital a public health emergency and that Department of Public Health Commissioner Robbie Goldstein take action to keep the facility open and operational.

The board’s action came just hours before the Department of Public Health released its finding that Nashoba is essential and “necessary for preserving access and health status within the hospital’s service area.” The finding is stated in a seven-page review of a closure plan submitted by Steward Health Care to the agency on Aug. 13. The report incorporates the views heard from local leaders, health care workers, and area residents in public hearings held in Devens Aug. 15 and online Aug. 19.

In spite of the determination, DPH does not have the power to keep the hospital open, but it does have the power to mandate that Steward submit a plan that ensures continued access to the services the hospital currently provides.

The DPH review, which asks Steward for more details than its current closure plan provides, will give those pushing the state to keep the hospital open beyond Aug. 31 additional ammunition for their cause.

Harvard’s position will be stated in a letter that asks Healey to require that Steward Health Care, the hospital owner, adhere to the state’s requirement for a 120-day closure period and that the governor work with federal, state, and local leaders to find a way to keep Nashoba open and transfer ownership to “a responsible operator.” The letter’s text draws on a similar resolution passed by the Ayer Select Board Aug. 6.

Healey has said repeatedly that the state can do nothing to stop the closure—a “shoulder shrug,” in the words of board member Rich Maiore—which has angered local leaders, health care workers, and residents, more than 450 of whom turned out for the DPH hearing in Devens last Thursday, Aug. 15. (See story.)

Healey’s announcement last week that the state had found nonprofit operators for five of Steward’s hospitals in eastern Massachusett and would provide $80 million over three years to support them has only increased the frustration of area leaders who say her administration is ignoring the needs of Central and Western Massachusetts communities.

While praising the governor for intervening on behalf of those hospitals, including the taking of St. Elizabeth’s Hospital in Brockton by eminent domain, central Massachusetts officials and other stakeholders are asking why her administration hasn’t been as aggressive on behalf of Nashoba Valley Medical Center and Carney Hospital in Dorchester.

In a statement released shortly after Healey’s announcement, Ayer Town Manager Robert Pontbriand observed that less than 15 hours after DPH Commissioner Goldstein had told a packed DPH public hearing in Devens that there is nothing the state can do, Healey had done the opposite for other regions of the Massachusetts.

“We have been consistently pleading with Governor Healey to work with us to find a solution to keep Nashoba Valley Medical Center open, and she has demonstrated at her press conference this afternoon that she has no regard for the Nashoba Valley region,” said Pontbriand.

In reply to a reporter’s question at her press conference last week, Healey said the difference was the absence of qualified bids for either Nashoba or Carney. “If one were to miraculously appear, that would be another thing. But where we are today, this is all we can do today.” Without a bidder, she said, the state had no options. “The state doesn’t operate hospitals,” she said.

‘Morally unconscionable’

The Harvard Select Board’s action Tuesday night reflects a growing awareness that the closure of Nashoba will have consequences for Harvard.

Among those who spoke at Tuesday’s board meeting was Dr. Paul Harasimowicz, chief of surgery at Nashoba and an orthopedic surgeon who has practiced there for 33 years. He said, “Make no mistake, closure at this hospital is going to affect the health care in Harvard as well.”

He said the closure will cost some patients their lives, an inevitable consequence of longer drive times to area hospitals. “There are going to be deaths associated with [the closure], and I think that’s going to be on the administration’s head,” Harasimowicz said. He added, choking up for a moment, “I think that for the governor and our administration to have the ability and the resources to keep it open and not do so is morally unconscionable.”

Prior to the meeting, the Council on Aging, Police Department, Ambulance Service, and Board of Health each submitted assessments of the impact their departments can expect from the closures. Many are the consequence of the longer distances and drive times needed to reach Emerson, Leominster, or other hospitals.

Harvard’s Emergency Services Coordinator Jason Cotting predicted an average increase of seven minutes for the 45% of calls that would normally have gone to Nashoba. “Some patients may have worse outcomes,” Cotting said, citing an incident where the additional time would have led to the death of one of the service’s own workers.

Council on Aging Director Debbie Thompson wrote that the increased distances would require as many as 2,500 additional hours behind the wheel for its van drivers and an additional $45,000 to pay for it. There would be more wear and tear on the agency’s two vans, higher costs for fuel, and with a growing senior population the potential need for a third van.

Police Chief James Babu wrote that the closure of Nashoba Valley Medical Center would pose significant challenges for the Police Department, particularly in the areas of psychiatric evaluations and prisoner medical care. Nashoba’s proximity has allowed his department to efficiently manage psychiatric evaluations, ensuring that people in mental health crises receive timely and necessary care.

“If we are forced to transport these individuals to more distant facilities like Emerson Hospital or Leominster Hospital, the increased travel time could delay critical assessments and interventions,” he said. “This not only heightens the risk to the individuals in crisis but also to our officers and the community at large.”

Nashoba is also the Police Department’s go-to facility for prisoners requiring medical attention. Its closure would mean that officers would need to transport prisoners to more distant hospitals, which would increase the time they are off the streets, reducing their availability for other calls, he said. This added travel time also increases the risk of incidents during transport, especially in emergency situations where a prisoner’s condition could deteriorate rapidly. “Longer transport times and the need to rely on busier, more distant facilities could delay critical care, putting both the prisoners and the officers at greater risk.”

Board of Health Chair Libby Levison listed many of the same consequences cited by other departments, but also noted the closure of Nashoba will overload other hospitals struggling to provide timely care. That will result in additional time crews spend waiting for someone to talk to in the emergency room, said EMS Coordinator Cotting. “As hospitals become busier absorbing Nashoba’s patient load, we’re going to have to wait longer.”

In an interview earlier this week, Harasimowicz stated flatly, “People are going to die.” The Healey administration has to know that by closing this hospital, longer drive times to other facilities will lead to additional deaths. “It’s inevitable,” he said. “If you talk to any of the emergency services in any of the communities they will agree with that.”

But the greatest loss is the loss of the people who work at Nashoba, some of whom have spent their entire careers there, he said. “It really is a family … When we go out … we see everybody at the grocery stores, we see people in the ball fields … You’re able to smile and say, you know, we took good care of you, and we will always take good care of you.”

“For me, one of the things I’ve learned over the course of time is, the secret of patient care is caring for the patient. The care that this community, this hospital community, gives to the 15 communities that we serve is unparalleled.”

Editor’s note: This is a developing story. Watch for updates and breaking news at harvardpress.com.