CANTON, Mass. – Hospital executives have closed or are threatening to eliminate essential services from Greenfield to Taunton, prompting patients, nurses and advocates to push for legislation that will strengthen the existing hospital closure law, shine a light on hospital profits and offshore tax havens, and limit excessive CEO pay.
What: Hearings on An Act Relative to the Closing of Hospital Essential Services (S. 672/H. 1139), sponsored by Senator Julian Cyr and Representative Ed Coppinger and The Hospital Profit Transparency and Fairness Act (S. 714/H. 1144), sponsored by Senator Michael Moore and Representative Josh Cutler.
When: Tuesday, May 28, 10:30 a.m. to 1 p.m.
Where: Room A-1, State House, Boston
Strengthening Hospital Closure Law
Massachusetts hospital corporations such as Baystate Health, Partners Healthcare, UMass Memorial Health Care and Steward Healthcare have closed at least 27 hospitals or hospital units over the last 10 years. At least nine of these were deemed “essential services” by the state Department of Public Health, but executives closed them anyway.
Right now, Baystate Health is planning to close inpatient mental health beds at community hospitals in Greenfield, Palmer and Westfield, along with its intensive care unit at Noble Hospital. Patients, nurses, advocates and elected officials have come out strongly against the closures.
Cambridge Health Alliance recently proposed closing its emergency department at Somerville Hospital and turning it into an urgent care clinic. In Taunton, where Steward Healthcare closed its maternity unit in 2017 despite enormous public opposition, mothers have been giving birth under risky and inappropriate conditions because of the loss of those essential services.
“Hospital executives are operating our hospitals – paid for by our tax dollars – like Wall Street banks and real estate holding companies rather than vital community resources,” said RN and Massachusetts Nurses Association President Donna Kelly-Williams.
“Patients face losing mental health care in their communities or are forced to give birth in an emergency department,” Kelly-Williams said. “In Massachusetts, in 2019, this is a disgrace. Patients should be getting more high-quality care near where they live, not less care 30 miles away because a hospital CEO decided that for executive pay to keep skyrocketing the most vulnerable members of our society have to suffer.”
- Extend the official notice period to the DPH in advance of a closure or discontinuation of health services.
- Require any hospital proposing closure or discontinuation of health services to provide evidence of having notified and provided the opportunity for comment from affected municipalities before the notification period begins.
- Instruct the Attorney General to seek an injunction to maintain the essential services for the duration of the notice period.
- Prohibit the hospital from eligibility for an application for licensure or expansion for a period of three years from the date the service is discontinued, or until the essential health service is restored, or until such time as the DPH is satisfied with a modified plan.
Nurses, health care professionals, lawmakers and advocates will attend the hearing in favor of a strengthened hospital closure law. They will represent patients who have been affected by closures, or threatened hospital closures, in communities throughout Massachusetts.
Donna Stern, RN in the mental health unit at Baystate Franklin Medical Center:
“These closures will have a ripple affect, impacting thousands of people. Any one of us can be a hospital patient at any time. Any of our loved ones can end up in the ICU or in a mental health bed. Many people in our communities work and volunteer with patients who require these services. If the care we need is not local, it will limit access and hinder recovery.
“That is why we are fighting to keep care local. But we need better tools. Executives should not be able to close local services while expanding throughout Massachusetts, out of state and around the world. Hospital corporations should not be able to pile up profits, stash them in tax havens, pay their executives millions and close essential services.”
Lisa Valley-Shah. RN in the emergency department at Somerville Hospital:
"To take away services, especially for people where this is their only means of care, especially non-English speaking people, not only is it disrespectful, this is such total disregard for people that already find it hard to navigate a health care system. To now disregard them and basically tell them they can no longer come here for things they get from us is dangerous for their health and welfare. It's such a burden."
Jacqui Fitts, RN who used to work in Morton Hospital’s maternity unit:
“Last year, Steward Healthcare executives callously closed maternity services at Morton Hospital even though the state Department of Public Health deemed them essential. Our maternity unit had been serving families in the Taunton area for more than 100 years. The closure devastated many of the most vulnerable people in our communities, especially mothers struggling financially or with addiction.
“Unable to access hospital maternity care close to home, mothers are giving birth in our emergency department. These births are happening in an unsafe and inappropriate setting because these mothers have no other options and Steward has not provided them the support they need. Morton ED doctors have had to call obstetric physicians at other hospitals to talk them through births. Nurses like myself have been called from other hospital units into the ED to assist in these sudden, risky deliveries.”
Hospital Profit Transparency and CEO Pay
When hospital corporations making tens or hundreds of millions of dollars in profits each year keep closing essential health care services, policy makers have the right to know if our tax dollars are being spent to benefit patients or hospital CEOs.
Massachusetts hospitals have a least $1.5 billion in offshore accounts in places like the Cayman Islands and Bermuda, according to IRS 990 reports from 2015, 2016 and 2017. Baystate Health and Partners Healthcare, for example, each have more than $100 million in the Cayman Islands. UMass Memorial Health, which closed pediatric and mental health beds in recent years, has $171,000,000 in the Cayman Islands, according to its 2017 990 form.
To address this issue, The Hospital Profit Transparency and Fairness Act (S. 714/H. 1144) will:
- Require hospitals to be transparent about their financial holdings and other activities.
- Assess any hospital receiving taxpayer dollars that has an annual operating margin above a specific, predetermined cap.
- Assess any hospital receiving taxpayer dollars that provides a compensation package for its CEO that is greater than 100 times that of the hospital's lowest paid employee.
- Deposit assessments in a newly created Medicaid Reimbursement Enhancement Fund to increase Medicaid reimbursement rates to eligible hospitals as a way to claw back excess profits and ensure that taxpayer dollars are dedicated exclusively to safe patient care and necessary services for all communities in the commonwealth.
Mansfield RN and MNA Vice President Karen Coughlin:
“Because of the opaque way hospital executives move money around their corporations, stashing it in tax havens like the Cayman Islands and pouring it into new corporate entities as they expand around the state, the country and the world, the public does not know how its tax dollars are being spent. We can improve our health care system by shining a light on hospital finances, limiting excessive CEO pay and ensuring that the public has a stronger voice in shaping how our health care dollars are spent.”
Bill Co-Sponsor Senator Michael Moore:
“Given the high cost of health care, the public deserves to know what hospital executives are doing with public funds. Many people do not realize that many of the Commonwealth’s multi-billion-dollar hospital corporations are largely funded by taxpayer dollars. Transparency in regard to the use of those funds is critical to maintaining public trust.”
Bill Co-Sponsor Representative Josh Cutler:
“Our Medicare, Medicaid and other state tax dollars fund hospital corporations, but what those corporations do with our money can be at odds with public service. This bill will allow the public to see exactly where our tax dollars are going – especially if they end up in the Cayman Islands – and limit excessive hospital CEO pay. We should instead spend that money helping our most vulnerable patients.”