Mercy Medical Center on Thursday defended to state regulators its plan to permanently close 50 adult and 24 child and youth inpatient psychiatric beds at Providence Behavioral Health Hospital in Holyoke.
The closure — first announced in February — would take force by June 30, eliminating the only inpatient psychiatric beds for children and teens in central or Western Massachusetts. About 200 employees will lose their jobs out of a total workforce of 466.
Thursday’s hearing was held so the state Department of Public Health’s Division of Health Care Facility Licensure and Certification could gather facts. A decision on whether the beds are an essential service won’t come for up to 15 days. If the state deems the inpatient beds essential, Mercy and parent company Trinity Health of New England will have a chance to come up with their own plan to address those concerns and then get permission to close.
Local advocates, unions and lawmakers said during the hearing that patients — especially children — need to be cared for in their community and that no one should be closing a hospital during the coronavirus pandemic.
One mother, Nicole Desnoyers, said she spent weeks trying to get an inpatient bed for her 9-year-old son so he could get the best treatment close to home. “To send my child to another facility completely out of our region ... it’s just ridiculous,” she said.
Deborah Bitsoli, president of Mercy Medical Center, said the decision to close was not taken lightly, but the hospital simply cannot hire enough psychiatrists to staff the facility properly. She said the hospital’s existing psychiatrists all plan to leave this summer and Mercy can’t replace them.
"Our patients are our top priority," she said.
Donna Stern, a registered nurse at Baystate Franklin Medical Center in Greenfield and member of the Massachusetts Nurses Association, was having none of it.
“Trinity should be ashamed of themselves,” Stern said. “They should be ashamed. This is about money.”
Advocates, including the nurses union, said Providence psychiatrists only decided to leave after the closure was announced.
Bitsoli said reimbursement levels don’t cover the cost of psychiatric care and new standards for physical surroundings are difficult to meet at an aging facility like Providence Hospital.
Dr. Robert Roose, chief medical officer and regional chief of addiction medicine and recovery services at Mercy, said the psychiatrist shortage makes it impossible to deliver care safely and effectively. He said there have been recruitment efforts, but Mercy cannot hire or find psychiatrists to work on a temporary basis.
Roose said it’s harder to staff a freestanding facility because psychiatrists need to be on site 24/7. At a psychiatric hospital embedded in a hospital, other doctors can back up psychiatrists if needed.
Mercy said Providence is licensed for 74 inpatient psychiatry beds, but the hospital has regularly operated at fewer than 60 beds over the past two years due to the psychiatrist shortage.
Roose said Mercy will continue to provide behavioral health care by coordinating with other neighboring hospitals. He mentioned two in Connecticut that are part of Trinity Health: Mount Sinai Hospital in Hartford and Johnson Memorial in Stafford Springs.
State Rep. Aaron Vega, D-Holyoke, called the idea of sending people to Hartford a “slap in the face.”
“The simple idea that you want to send people to Hartford, a half hour to an hour away, is unbelievable,” he said.
Vega also said the first any local lawmakers were told about the inability to recruit psychiatrists was when Mercy announced plans to close the beds at Providence.
“We could have been collaborating on a solution to this,” Vega said.
Both Vega and Stern asked the state to stop the closing process until after the COVID-19 crisis. Vega pointed out that the state of emergency meant that Holyoke didn’t even get a proper face-to-face hearing. Thursday’s event was on the phone only.
Written comments on the closing may be submitted through Friday to the Department of Public Health, Division of Health Care Facility Licensure and Certification, Attn: Closure Coordinator, 67 Forest St., Marlborough, MA 01752, or by email to HFLLicenseAction@MassMail.State.MA.US.
A coalition of unions representing health care workers at Providence and elsewhere, patient advocates and political groups including Western Mass. Medicare for All, wrote a letter opposing the closure.
“Right now, we need to maximize capacity in emergency departments and other hospitals units because of the COVID-19 pandemic, not decrease services,” the letter reads. “No hospital should be allowed to close services while receiving enhanced federal and state funding. No healthcare system should be closing mental health beds when our communities face a mental health and public health crisis.”
Dr. Barry Sarvet, chair of psychiatry for Baystate Health, said he respects Providence’ autonomy in making its own decisions, but called the decision to close the psychiatric beds disappointing.
“We need more beds, not less,” Sarvet said in an interview prior to the hearing. “So the closure of Providence ... is pretty concerning for us. We still have patients that get stuck in the emergency room.”
Baystate has temporarily closed 15 to 20 of its 100 psychiatric beds due to COVID-19. Some beds must be empty to allow for social distancing, Sarvet said.
“We just need beds,” he said. “The expectation is that patients are going to be sent far and wide. Way out of area, which is going to be a hardship.”
Baystate Health and nearby Holyoke Medical Center are planning their own psychiatric hospitals, but both are years away. There is no plan to take up the slack in the meantime, Sarvet said.
He said he understands Providence’ contention that it cannot hire psychiatrists.
“There is a national shortage,” he said. “But that said, it’s not impossible to do so. It’s just hard.”
Baystate has its own residency program for training psychiatrists, Sarvet said, and in July it will start a fellowship program in adolescent and child psychiatry.
Substance use disorder services will continue at Providence Hospital, including its acute treatment service, clinical stabilization service (otherwise known as post-detoxification) and outpatient substance use disorder services such as the methadone clinic there.
Mercy also wants to close a separate methadone clinic in Springfield that serves approximately 600 patients.
Mercy’s national parent company Trinity Health, based in Michigan, has annual operating revenues of $19.3 billion and assets of $27 billion. It had more than $650 million in offshore accounts as of fiscal 2017, according to the Massachusetts Nurses Association.
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