Once Again Nurses Union Report Argues Full-Service Hospital Viable In North Adams
A group of Northern Berkshire residents who have been meeting weekly since North Adams Regional Hospital closed 11 months ago have come together under one name. During its founding rally this evening, the North County Cares Coalition also released a report from the Massachusetts Nurses Association arguing for the return of a full-service hospital.The group may be new, but its demands aren’t. The Massachusetts Nurses Association, which represents 100 people who used to work at 120-bed North Adams Regional Hospital, has issued its latest report advocating for in-patient services at the facility now owned by Berkshire Health Systems. The union released a similar report in May. MNA associate director Nykole Roche challenges a state-commissioned report by Stroudwater Associates that BHS is using in determining what services to provide.
“What’s so problematic about the Stroudwater report is that it’s really backward looking,” Roche said. “So it looks at North Adams Regional Hospital and North Adams Regional Hospital doesn’t exist anymore. When it was North Adams Regional Hospital it was in competition with the much larger and more profitable Berkshire Medical Center which had more physicians and greater patient volume. So there was competition there. But now the hospital that is in North Adams is BMC North, a campus of Berkshire Medical Center, so those issues that existed before are gone.”
The MNA’s report from May claims that from 2000 to 2012, patient revenue at North Adams Regional grew by 78 percent, while expenses rose 29 percent. The union argues poor financial decisions, like the 1999 purchase of Sweet Brook Care Centers and Sweetwood retirement community by now-defunct parent company Northern Berkshire Healthcare led to bankruptcy filings in 2011 and liquidation in 2014. Here’s Roche.
“So North Adams Regional Hospital could have been profitable then and it can absolutely be profitable now that it shares resources, doctors and a higher commercial payer level with Berkshire Medical Center,” said Roche.
The Stroudwater report, released in September, argues roughly 20 inpatient beds should be provided at the North Adams site only if it receives federal critical access hospital status, which allows for increased government reimbursement rates. Michael Leary, spokesman for Berkshire Health Systems, says even with the designation Stroudwater’s report raises further concerns.
“The President’s proposed budget and Congressional proposals are all forecasting significant reductions in Medicare reimbursements to hospitals,” Leary said. “State and commercial insurers have echoed those plans to reduce in-patient care in favor of more comprehensive outpatient and preventative services. The government has specifically stated a desire that in the next two to four years at least 50 percent of payments to health providers, especially hospitals, will need to be converted to payment systems that actively discourage hospital admissions and inpatient stays and encourage alternative systems of care.”
NARH’s 2011 critical access application was denied. Leary says no decision will be made on whether to apply for the designation until BHS can review a changing reimbursement climate.
An October 2014 review by financial information firm Fitch Ratings says BHS’s dominant market share of the aging population of Berkshire County and parts of eastern New York is a credit weakness since 66 percent of the company’s gross revenues come from Medicare and Medicaid. While the MNA questions Stroudwater’s estimate that running a 20-bed inpatient hospital would cost BHS an additional $2 million a year, Roche says with $24 million in fiscal 2014 profits, the company can afford it.
“As much as this conversation always goes to money and money is absolutely important, we need to make sure that there’s a hospital there can sustain itself, all the evidence shows that that is the case,” Roche said. “We need to instead talk about what this community needs and what this community needs.”
In less than a year, BHS has invested about $9 million in outpatient services in Northern Berkshire County, on top of the $4 million acquisition of the hospital where it runs a 24-hour emergency center. The company has hired about 250 of the 530 former NBH employees, while its medical center in Pittsfield has seen a 10 percent patient increase since NARH closed. Roche of the MNA argues BHS is also losing 150 annual patient cases to Southwestern Vermont Medical Center in Bennington by not having a full-service hospital in North Adams.
Working with the MNA, the group behind weekly meetings that have at times swelled to hundreds since NARH closed, has formed the North County Cares Coalition to speak with one voice in favor of a full-service hospital. Dick Dassatti says the area wants inpatient access, which BHS provides at Berkshire Medical Center and Fairview Hospital in Great Barrington.
“People need to have medical facilities within their community,” said Dassatti.