Grievances 101

UMass Memorial Health Alliance in Leominster Plans to Close Pediatric Unit Depriving Children and Families of Access to Care Close to Home

05.29.2018

LEOMINSTER, MA — In the wake of overwhelming community concern about recent service closures engineered by corporate executives at UMass Memorial Health Care (UMMHC), the Central Mass-based health care conglomerate has announced plans to close yet another service, this time it’s the 12-bed pediatric unit on the Leominster Hospital campus of UMass Memorial Health Alliance – Clinton Hospital.  The closure will force families of ill children to travel from Northern Worcester County to Worcester (28 miles away) for care they used to receive close to home. 

The Leominster based pediatric unit provides first rate care to hundreds of children each year who are suffering from a variety of acute medical conditions, undergoing tests or undergoing and recovering from surgical procedures. For example, care provided includes care and observation of children undergoing IV hydration, or infants whose parents have witnessed them either stop breathing or have a seizure at home. Higher acuity patients include infants with respiratory illnesses such as acute asthma and pneumonia who need oxygen and newborns who are having trouble withdrawing from narcotic addiction and children with sepsis (a serious infection).

“We’re angry and disappointed that UMass Health Alliance would consider abandoning the children of our city and surrounding communities,” said longtime Health Alliance nurse Natalie Pereira, bargaining unit chairwoman of the Massachusetts Nurses Association local bargaining unit on the Leominster campus.  “Every day we see the services available to our local community being eroded or eliminated in the interest of further boosting profits for UMass Memorial Health Care corporate.”

“As a pediatric nurse who has cared for the children of this community for years, I am concerned about the impact this will have on our families, particularly the poorer members of our community who lack the resources and access to transportation to travel long distances for needed care,” said Theresa Love, a nurse who has worked on the pediatric unit for more than 17 years.  “The closing of this unit would result in very sick children experiencing delayed access to acute care, in children being boarded in our emergency department, and in children being shipped to Worcester for care they could and should receive here in this community.”

 

Health Alliance management informed the nurses’ union of their intent to seek closure of the unit earlier this month, stating that they would be approaching the hospital Board of Trustees to win their endorsement for the closure.  Once that decision is made, UMass Health Alliance would then be required to appeal to the Department of Public Health for review of the plan, as any closure of an essential service, such as the pediatric unit, is required to go before the Department of Public Health, who will then schedule a public hearing to gauge public support or opposition to the plan, and to determine if this is a service that should be maintained to protect the public health.  Under state law, the service could not be closed for at least 90 days from notification of the DPH. 

 

Background on the Closing Which Is Already in Effect

 

Even without board or DPH approval, nurses report that the pediatric unit has already been closed by the hospital, with patients already being diverted to other facilities.  UMass management cites a low census and the lack of staff available to care for patients at all times as justification for the closure while purposely driving down patient census.  The MNA and the nurses point to the hospital’s refusal to adhere to an agreement negotiated four years ago, that called for the merging of pediatrics with a medical surgical unit and cross training the medical surgical nurses in pediatrics to ensure around the clock coverage so that the unit could remain open. 

 

“The hospital has never followed through on its commitment to work with our nurses to provide the training we requested to maintain this vital service,” Love explained.  “Now, because they never honored their commitment, they want to close this unit.  Their mismanagement and lack of professional integrity has been used to engineer the closing of this service.”

 

While the unit does have a low census during the spring and summer months, Love explained that the unit can be very busy at the beginning of the school year and during the winter flu season. The MNA also points to a similar situation at Cooley Dickinson Hospital in Northampton, which has an even lower census than the Leominster Unit. Cooley Dickinson shelved its proposal to close its pediatric unit by implementing a plan similar to what was negotiated with the Leominster nurses, whereby nurses were cross trained in pediatrics to ensure that the staff were available to keep that unit open for the children of that community.  The difference there was hospital management listened to nurses and community members and made a commitment to save the service. 

 

Other Closures Meet With Strong Opposition

 

In addition to the pediatric unit closure, UMass Memorial Health Care has engineered the closure of a number of other services, all of which have met with strong opposition from the community and local officials, including the closure of:

 

  • The Plumley Village Health Center in Worcester– In April, UMMHC announced that in July it will close this community health center, a 20-year old facility that served the health needs of a diverse, marginalized and underserved population of more than 2,000 patients; 75 percent are Latino, roughly 50 percent are non-English speaking and nearly all are on MassHealth.  The closure has been met with strong opposition from a coalition of community members, public health advocates and local public officials who recently packed a local church to voice their strong opposition to the decision.
     
  • Endoscopy and Other Ambulatory Services at UMass Health Alliance Clinton Hospital – In January, UMMHC announced its plan to close its endoscopy service for the diagnosis and treatment of colorectal cancer and other serious gastro-intestinal conditions that serves several hundred patients each year.  In addition, over the last two years, management has also eliminated the outpatient surgery/operating room; nuclear stress tests; diagnostic mammograms; interventional radiology procedures; and infusion center services such as IV medication administration, IV antibiotics, blood transfusions and phlebotomy, which are essential for providing local treatment for cancer and a number of other conditions. Hundreds of community members turned out to oppose the loss of these services at forums hosted by a local legislator and by the Health Alliance CEO. 
     
  • 13 Psychiatric Beds at UMass Memorial Medical Centers’ University Campus – Last year, UMMHC closed 13 desperately needed psychiatric beds for the care and treatment of patients with serious medical and mental health conditions, at a time when psychiatric patients are waiting days or even weeks in hospital emergency rooms for just these type of beds.  The closure plan was unanimously opposed by the Worcester City Council, nearly every state legislator and the Department of Public Health which ruled that this was an essential service that should have been maintained to meet the mental health needs of the community. UMMHC closed those beds and converted them to medical surgical beds because treating patients with medical conditions is more profitable than treating patients with psychiatric conditions, which are subject to lower reimbursement rates. 

 

Closure Decisions Follow Posting of Enormous Profits

 

All of these decisions are typical of a health care system increasingly being driven by large nonprofit corporate networks and the growing influence of for profit Wall Street firms that are attempting to consolidate more profitable services in larger urban facilities, while cutting access to services in local communities, particularly poorer communities serving marginalized patient populations. 

 

The decisions by UMMHC come at a time when the system has posted enormous profits, paying its executives exorbitant salaries and while stashing millions of dollars in offshore tax havens like the Cayman Islands.  

 

  • UMMHC Profits – Between 2013 and 2016, UMMHC and its affiliated facilities posted profits in excess of $251 million, with total assets of more than $530 million.  They can easily afford to maintain these services.
  • Executive Salaries – According to the most recent available filings, UMMHC is paying its top executives salaries totaling more than $32 million annually, while these executives are making decisions to cut services for some of the poorest residents in Worcester County.
  • Offshore Accounts – UMMHC reports an additional $161 million stashed in the Cayman Islands, keeping in mind that more than half the revenue generated by UMMHC comes from taxpayers in the form of Medicare and Medicaid payments.  They are hoarding our taxpayer dollars offshore while depriving taxpayers in their communities of the care they need.

 

“This level of corporate greed is shameful, particularly when it comes at the expense of access to health care for the most vulnerable,” Pereira said.  “We intend to actively engage with our community and public officials to alert them to this growing public health crisis and to do whatever we can to protect this vital service.”

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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.

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