Carney Hospital and Nashoba Valley Medical Center, which are scheduled to close in less than two weeks, each provide “essential services necessary to maintain access and health status” in their areas, health officials concluded this week.
The Department of Health concluded after an abbreviated audit that both Steward Health Care facilities provide “essential services.” That finding has provided further ammunition to politicians and advocates calling for state government intervention to prevent the hospitals from closing later this month.
However, state health officials stressed that their decision does not give the department the authority to order any of the hospitals to open. Instead, DPH asked Steward — which is seeking to sell off all of its Massachusetts hospitals as part of a bankruptcy proceeding — to take a number of additional steps to ease the transition.
Stephen Davis, chief of DPH’s Division of Healthcare Facility Licensing and Certification, wrote a seven-page memo Monday outlining more than a dozen concerns about potential gaps in Steward’s Carney closure plan.
He called on Steward to provide regulators, patients and providers with more information about the location of alternative services, transportation options to health care after the shutdown, access to medical records, ambulance travel times and more.
Based on testimony at public hearings, Davis said, DPH is “concerned that the plan lacks details on what, how and when current patients will receive information about the treatment options available to them, what resources are and will be available to patients to ensure patients can cope with the change, and answer any questions about continuity of care.”
Davis followed up with a similar Nashoba-focused letter on Tuesday, also raising concerns about a lack of details provided by Steward and calling on the system to provide a plan to maintain access to health care.
The “essential facility” designation will likely embolden supporters of Carney and the Nashoba Valley Medical Center, who are frustrated that the Healey administration has chosen to close those facilities while using expropriation powers to support the sale of St. Elizabeth’s Medical Center in Brighton.
State law and regulations do not directly empower the DPH to compel a facility to remain open. If regulators determine that a hospital provides an essential service, they can only require the operator to submit a plan for how to maintain patient access to care after the closure.
Even before the Steward crisis broke out, advocates of reform were calling for changes in the process for closing hospitals.
Senator Nick Collins, a Democrat from Boston, said the essential services declaration makes it “impossible for DPH to say that if Carney were closed it would not be a public health emergency.”
“We know that state health authorities have the power to take over the facility through expropriation, as they are doing with St. Elizabeth’s right now. And state health authorities have made clear that they have the resources to subsidize the necessary investments and operations during a transition period,” Collins said in a statement. “So for DPH to say they do not have the power to do this for Carney is unbelievable and factually incorrect.”
Steward announced on July 26 that it plans to close Carney and Nashoba Valley Medical Center on or about Aug. 31, significantly faster than the 120-day deadline required by state regulations. A federal bankruptcy judge soon approved the shortened deadline.
DPH held an in-person hearing on the Carney closure on Aug. 13, followed by a virtual hearing on Aug. 14. The department held hearings on Nashoba Valley Medical Center on Aug. 15 and Monday.
Governor Maura Healey, Secretary of Health Kate Walsh and DPH Commissioner Robbie Goldstein have repeatedly stated that they are unable to keep the two facilities open.
But her announcement last week that the state would seize St. Elizabeth’s hospital through expropriation to transfer it to Boston Medical Center sparked new pressure from Carney and NVMC supporters, who questioned why the state could take such action at one Steward hospital but not at two others.
Both Carney and NVMC were classified as “small hospitals” by the state in fiscal year 2022 – the latest year with available data – while St. Elizabeth’s was considered medium-sized.
In fiscal year 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 bankruptcy crisis.
Alison Kuznitz contributed reporting.
