FALMOUTH, Ma – The Department of Public Health has issued its ruling regarding the proposed plan by Cape Cod Healthcare to close its Obstetrics, Pediatric and Nursery Care Program at Falmouth Hospital, stating “the Department has made a finding that the services provided by the Hospital are necessary for preserving access and health status within the Hospital’s service area.” The full text of the letter can be found here.
The DPH based its finding on its review of the issue and the testimony at a virtual public hearing held on May 28, where dozens of community members, former patients, public officials, nurses and other advocates called in to voice their opposition to the closure, expressing concern that elimination of these services will result in longer waits and extended travel times for expectant mothers to access a maternity unit for a safe delivery.
The nurses on the unit, who are represented by the Massachusetts Nurses Association (MNA), were alarmed when Cape Cod Healthcare CEO Michael Lauf pursued closure of the unit, as part of the hospital’s COVID-19 surge plan back in April, with the aim of permanently closing the unit. He did this before the DPH had a chance to conduct its hearing and the lawfully-required review of the closure. The nurses on the unit were laid off last month, while no plans were announced or implemented to improve staffing at the lone remaining maternity service on the Cape — at Cape Cod Hospital in Hyannis. Since the closing, maternity nurses at Cape Cod Hospital have seen an increase in deliveries, with no extra staff support, and last week the MNA has received reports of two potentially dangerous deliveries at Falmouth Hospital, one which occurred outside the hospital, requiring follow up care in the hospital’s emergency department, and the other requiring care in the operating room — a result predicted by nurses and residents opposing the closure at the DPH public hearing.
“We greatly appreciate DPH’s findings that this is an essential service, and that the loss of this service will deprive families throughout the region access to essential care they need, but it is too late,” said Eileen Sardinha , RN, a nurse in the maternity unit and co-chair of the MNA local bargaining unit at Falmouth Hospital. “Unfortunately, our employer has already closed the unit, placing our patients and our community in danger, while taking no steps to prepare for the change at Cape Cod Hospital, and making no effort to communicate his plan to the dedicated nurses who have given so much to this community and who have now been forced to find work at other facilities.”
The closure of the maternity unit at Falmouth Hospital takes on added significance for the entire Southeast regions as it follows the recent closure of maternity services at Morton Hospital in Taunton and at Tobey Hospital in Wareham, which has resulted in the March of Dimes classifying this region of the state as a “maternity desert” for the lack of access to adequate obstetrical care. In fact, the March of Dimes also submitted testimony to DPH opposing the closure.
“As happened at both Tobey and Morton hospitals, I have little real hope that there will be continued obstetrical care available at Falmouth Hospital,” Sardinha explained. “Unlike those two hospitals, there was time to prepare the remaining healthcare workers – doctors, nurses, and respiratory therapists – and develop a plan for emergency situations. The abruptness of the closure left little to no time for us to prepare and little to no time for women whose due dates were imminent to prepare and alter their delivery plans, or to arrange childcare plans for their other children.”
MNA President Donna Kelly-Williams, RN, who was a maternity nurse, testified about the impact on the region at the DPH hearing, stating:
“In 2018, I was at a packed hearing in Taunton, when Steward’s Morton Hospital closed its maternity unit. Last year I was before you during another packed public hearing testifying in opposition to the closing of the maternity unit by Southcoast Health at Tobey Hospital. In both those previous instances, you agreed with us that those were indeed essential services that should not be closed. Both did, and the result has been devastating for the Southeast region as a whole. We have seen mothers in Taunton and the Southcoast delivering babies on the highway, we have seen maternal child deaths, specifically due to understaffed and overburdened maternity units at hospitals forced to absorb these excess deliveries. By the way, Falmouth Hospital was included in the alternative care plans you endorsed as part of the DPH process for essential service review of those closings.”
As part of the DPH ruling, the hospital has 15 days to provide DPH with its plan to maintain access to this vitally important service, and if it proceeds with a closure, how alternative sites can meet the needs of the community. Given the testimony at the hearing and the DPH findings, the MNA believes there is no viable alternative to keeping the service open that will not deprive this community of the maternity services it needs.
Kelly-Williams closed her testimony before DPH highlighting the key weakness in our state’s public health system, which is the inability of the DPH, or any agency for that matter, to prevent the closure of health services, even those that are deemed upon review to be essential for the protection of that community. Across the state, we have seen hospital systems close a number of services including psychiatric units for adults and children, pediatric and maternity services, even hospital intensive care units, all deemed by DPH to be absolutely necessary; yet there is nothing to stop those hospital systems, most or all of them highly profitable, from closing those services.
“I must tell you I am tired of coming to hearings like this, providing the same testimony, seeing you agree with our position, yet still, nothing is done to stop these closings, “ Kelly-Williams testified. “A plan is filed with empty and ineffective substitutes, with the only outcome being that more mothers and families have their health and safety jeopardized. How is this protecting the public health of anyone?
That is why our organization is working to help you in this process, to promote legislation to provide you with the power to do more than listen and validate, and to actually have the power to stop these closings to truly protect our communities.”
Founded in 1903, the Massachusetts Nurses Association is the largest union of registered nurses in the Commonwealth of Massachusetts. Its 23,000 members advance the nursing profession by fostering high standards of nursing practice, promoting the economic and general welfare of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Legislature and regulatory agencies on health care issues affecting nurses and the public.