BOSTON, Mass. – Nurses and advocates will testify at the State House on Tuesday in favor of legislation to strengthen state and community oversight of essential hospital service closures, such as Steward Health Care’s plan to stop offering maternity care at Morton Hospital in Taunton and instead divert vulnerable mothers and their babies to Brockton.
“Maternity services are critical to our community,” said HollyAnn Shea, an RN who works in maternity at Morton Hospital. “Taunton has been hit hard by the opioid epidemic, and has the highest rate of children born to addicted mothers. Many of our patients also struggle financially and either take cabs or walk to the hospital. Sending them outside of our community to receive care is a huge disservice to patients and their families. This law requires community oversight of proposed closures and means stronger enforcement of existing laws.”
The hearing will also feature legislation backed by the Massachusetts Nurses Association that calls for improved safe patient handling programs at all health care facilities.
What: A hearing before the Joint Committee on Public Health.
When: 1 p.m. on Dec. 19, 2017.
Where: Room A-2 at the State House, Boston.
Bill Information: An Act relative to the closing of hospital essential services (H.1143/S.1199) sponsored by Sen. Jennifer Flanagan, D-Leominster and Rep. Edward Coppinger, D-Boston. An Act relative to safe patient handling in certain health facilities (H. 1144/S.1167) sponsored by Rep. Claire Cronin, D-Easton and Sen. Harriette Chandler, D-Worcester.
Closure of Essential Hospital Services
The proposed closure of maternity care at Morton Hospital and Steward’s past failure to maintain essential services in Taunton and elsewhere highlights the need for An Act relative to the closing of hospital essential services (H.1143/S.1199). The bill makes a few simple improvements to existing law, including:
- Extending the notification period to 120 days and requiring community input in advance;
- Directing the Attorney General to seek an injunction against the closure of any essential services for the duration of the notice period;
- Barring a hospital from eligibility for licensure or expansion for three years if DPH deems the service proposed for closure “essential”;
- Requiring community oversight of any approved plans for access to necessary services following a closure or discontinuation of services.
Earlier this fall, Steward temporarily closed its maternity unit because of its inability to negotiate a dispute with the Massachusetts General Physicians Organization. Since then, Steward has proposed shutting down the unit permanently. It is diverting Morton maternity patients to Good Samaritan Medical Center in Brockton, also a Steward facility.
There is no public transportation from Taunton to Brockton and many of the patients seen at Morton have serious hardships. Morton Hospital also has the highest rate of drug-addicted newborn babies, according to a report by the Health Policy Commission, at 75.2 out of every 1,000 live births. That compares to 65.5 per 1,000 at the next highest at Charlton Memorial Hospital and 17.6 per 1,000 at Good Samaritan, the second lowest rate.
In response to the proposed closure, Sen. Marc Pacheco, D-Taunton, sent a letter to Attorney General Maura Healey on December 1 asking her to look into whether Steward is living up to the commitments it made “to the public health of our community” when it purchased Morton in 2011. When Steward purchased Morton Hospital it made a commitment to keep all services open. The company already broke that promise once when it previously closed Morton’s pediatric unit.
In 2013, the state Department of Public Health found that Morton’s pediatric unit was an essential service that should be maintained. Yet Steward still pursued the closure, promising the creation of a dedicated pediatric observation unit in the hospital. That observation unit does not exist. A year later, Steward closed Quincy Medical Center in direct violation of commitments it made to DPH and the Attorney General.
Paula Ryan, a former Quincy Medical Center nurse, embodies the idea that a community hospital should provide a lifetime of health care to residents. She was born at Quincy Medical Center and gave birth to her children at the hospital.
“Quincy Medical Center is also where I thought I would one day seek care in my later years, but that will not happen,” Ryan said. “After a half century as a nurse at the hospital, I was forced into retirement when Quincy Medical Center closed. Over the past several years, my colleagues and I have raced across the state in an attempt to prevent the closure of essential health services. This has included everything from full-service hospitals, like Quincy Medical Center and North Adams Regional Hospital, to inpatient psychiatric units like UMass Memorial to pediatric and maternity units like Morton Hospital.”
“In every instance, the DPH has agreed that the services or facility slated for closure were essential and should remain open. And in every case, the recommendation has been ignored. This is unacceptable. It is just another example of the transformation of our health care system from one dedicated to meeting the needs of patients to one dedicated to maximizing financial gain for massive corporate health care networks.”
Safe Patient Handling
As health care workers in Massachusetts move patients – each lifting 1.8 tons during an average shift – they are being injured at precipitous rates. Solutions have been proposed by both a state task force and the MNA, and yet the hospital industry refuses to take action. In fact, as documented in an alarming report by WGBH News, the Massachusetts Health & Hospital Association actively worked to suppress a Department of Public Health report detailing safe patient handling recommendations for more than a year.
Once published, the task force's findings made clear both the scope of the patient handling problem and the hospital industry's unwillingness to implement comprehensive injury prevention programs. Massachusetts hospital workers suffer back and other severe patient handling injuries at a rate 70 percent higher than for hospital workers in other states. In 2010 alone, an estimated 1,000 Massachusetts health care workers suffered patient handling injuries so severe that they resulted in 59 years of missed days of work.
Yet most Massachusetts health care facilities have done little or nothing to address this problem according to the report. Only 44 percent (37) of the 88 hospitals surveyed by the task force reported having a written safe patient handling program in practice.
“The epidemic of worker and patient injuries attributed to patient handling has been well-documented, as have the successes of comprehensive safe patient handling programs,” Donna Kelly-Williams, RN and President of the Massachusetts Nurses Association. “There is no reason to use 19th century patient handling protocols in 21st century hospitals.”
The components of An Act relative to safe patient handling in certain health facilities (H. 1144/S.1167) match virtually every recommendation made by the DPH task force, including:
- Development of a written Safe Patient Handling policy
- Undertaking a comprehensive needs assessment
- Procurement of Safe Patient Handling Equipment
- Training at all levels and the involvement of direct care personnel (at least half of a Safe Patient Handling Committee shall be comprised of “frontline, non-managerial employees who provide direct care to patients”)
- Ongoing evaluation of program effectiveness
Dan Rec knows what it is like to work at a hospital that is taking the right steps to protect health care workers. At Brigham & Women's Faulkner Hospital, where Rec is a registered nurse, staff members use HoverMatts that allow patients to float on a cushion of air, so caregivers can safely transfer them throughout the hospital without lifting or straining. Other SPH equipment at Faulkner includes ceiling lifts, slide boards and "sit-to-stand" devices.
"Proper, ergonomic equipment will not only benefit caregivers," Rec said. "In addition to the decrease in injury to the nurses and other bedside staff, obtaining these tools has also increased early mobility for patients – providing them with a shorter healing time and decreased hospital stays. This in turn can provide additional cost savings to the health care system."