Report Provides Valuable Data and Information for Use by the Pending Legislative Commission to Determine the Long-Term Future of Pappas and the Care of the State’s Most Vulnerable Children with Disabilities
CANTON, MA — The Massachusetts Nurses Association, which represents more than 45 RNs and Healthcare Professionals at Pappas Rehabilitation Hospital for Children (PRHC), has served as member of the Governor’s Pappas Working Group, which was established following the Governor’s pause of the proposed closure of facility, and is issuing this statement in response to the release of its long awaited report. The document details options and issues governing the future of PRHC and the other aspects of care for pediatric patients with complex needs in the Commonwealth. To view the full report go to: www.mass.gov/doc/pappas-working-group-final-report-2025/download
Founded in 1904 on a 160-acre campus, The Pappas Rehabilitation Hospital for Children (PRHC) provides state-of-the-art medical, rehabilitative, educational, recreational, habilitative, transitional, and complementary alternative medical services to children and young adults (ages 7 – 22+) with multiple disabilities. PRHC assists them to achieve their optimal level of independence in all aspects of life.
As stated in the Pappas Working Group report: “PRHC excels in its therapeutic care, arguably providing an unmatched level of service due to the quality, experience and dedication of the staff as well as a unique set of physical amenities including dedicated rehabilitation rooms, an aquatic center, a stable for horses and other animals, garden/farmlands, an adaptive play park, and an athletic center including a bowling alley… PRHC delivers on the pillars of therapy by developing physical abilities, helping kids get out of wheelchairs when possible, building social relationships, and connecting with community resources outside the hospital.”
The report provides essential data on the more than 2,000 children in the Commonwealth with complex disabilities, medical and rehabilitative needs, many of whom are languishing in the emergency departments of our acute care hospitals, sometimes for months at a time, children in need of specialized care, including a significant number who could and should have access to care at Pappas.
It also identifies specific barriers that exist including current regulatory, infrastructure needs and sources of reimbursement that prevent the admission of children to Pappas who could benefit from the care, education and expertise provided by the facility.
It is important to note that there was broad consensus by members of the working group that the closure of Pappas, or the maintenance of Pappas in its current state, would not be acceptable for meeting the needs of this vulnerable population.
The report lays out a number of options regarding the future development and expansion of Pappas to meet those needs, including two options the MNA strongly supports. These options call for a multiyear, phased program of investment in the facility, with needed infrastructure improvements, as well as expansion of service offerings over a number of years.
In addition to outlining future options for Pappas, the working group report identified the need for the creation of additional pediatric beds in other regions of the state, including the creation of a 21-bed unit at Western Mass Hospital in Westfield. These beds would be to augment pediatric services in the state, but not to replace beds and services provided at Pappas.
The completion of the report concludes a year of intense advocacy and activism by a broad-based coalition of patients, families, caregivers, labor organizations and policymakers who mobilized to oppose the Governor’s plan to close the facility. That activity initially resulted in the Governor’s decision to pause the closure and form the working group. In addition, as stated in the report, “intervening legislative action through the budget process has resulted in continued operations for PRHC with service level reporting requirements” for 2026, as well as calling for the creation of a legislative commission charged with exploring options for the future of Pappas.
The PWG report positions its data and findings as a valuable resource to support the legislative commission in its work next year.
Armed with these findings, the MNA looks forward to our work with the legislative commission to establish a plan and funding to ensure the future of Pappas as a state-of-the art provider of comprehensive long term care to meet the needs of the state’s children with disabilities for years to come.
With the Working Group Disbanded, MNA Has Serious Concerns About the Administrations’ Continued Efforts to Discharge and Failure to Admit New Patients to Pappas
While the MNA is grateful for contributions of the Working Group, we continue to have serious concerns about the actions of the DPH and Pappas administration since the announcement of the pause in February. Over the objection of Pappas staff, families and patients, there has been a relentless effort by the administration to pursue the discharge of patients at Pappas, discharges that prior to the announcement of the Governor’s closure plan, would never have occurred. In recent months, this effort has only accelerated, with families reporting being pressured to discharge their loved ones, and with staff reporting that in all but a few cases, patients are being discharged to settings that fail to provide the same level of care patients receive at Pappas.
In response to these developments, staff and families will be holding a demonstration outside Pappas on Thursday, Oct. 23 from 11 a.m. – 2 p.m. calling for an end to inappropriate discharges and for the admission of children in need of Pappas Care.
MNA staff also report that since the pause was announced, there has been no concerted effort to recruit and admit new patients to Pappas, decreasing the census, and the failure to fill important positions, which we belies efforts by advocates, policy makers and the working group to ensure the survival of Pappas to meet the needs of this vulnerable population.
“We continue to discharge our patients to residential schools or other hospitals that cannot provide the same level of care our patients receive at Pappas, but have not admitted patients at the same rate in the past six months,” explained Michelle Sweeney, Pappas’ Supervisor of Physical Therapy and co-chair of the Massachusetts Nurses Association local bargaining unit for Pappas. “The clinical staff have approved multiple admissions, but we have been blocked from admitting these patients to our care for one reason or another. We know that there are as many as 100 children currently boarding in acute care hospitals, and I’m unclear why none of them have been admitted to Pappas. There is already a shortage of acute beds in the state, especially for pediatric patients, and we would welcome the opportunity to care for so many of them at Pappas.”
In the coming year, as part of our work on the new legislative commission, we hope we can stop these inappropriate discharges and begin to admit children who need first-rate care that Pappas can provide.
MNA Also Raises Concerns About the Discharge of Vulnerable Elderly Patients at Western Mass Hospital as Part of Plan to Expand Pediatric Care in the Region
This effort to pursue premature and inappropriate discharge of patients is not limited to Pappas, but staff and families at Western Mass Hospital report similar efforts occurring at WMH, where comprised adult patients with serious neurological conditions are being discharged out to inadequate alternative settings to make way for the creation of the pediatric unit. While we support the creation of pediatric beds at WMH, we cannot support doing so at the expense of the safety of the adult patients currently receiving care at the facility.
###
MassNurses.org │ Facebook.com/MassNurses │ Twitter.com/MassNurses │ Instagram.com/MassNurses
____________________________________________
Founded in 1903, the Massachusetts Nurses Association is the largest union of registered nurses in the Commonwealth of Massachusetts. Its 25,000 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.
