PITTSFIELD, Mass. -- Officials spent Monday working on the parameters of a licensing agreement that would allow Berkshire Medical Center to operate parts of North Adams Regional Hospital, according to people with knowledge of the situation.
And Gov. Deval Patrick, during an appearance in Holyoke, stressed that he was working to get the emergency room open as soon as possible, and he offered pointed comments regarding last week’s "abrupt decision" to close the hospital.
Officials from both BMC and the state Department of Public Health spent Monday working on the details of a licensing agreement, according to the Massachusetts Nurses Association.
It is believed there was a parallel effort underway to designate NARH as a Critical Access Hospital, a designation that allows hospitals to receive cost-based reimbursement from Medicare, instead of standard fixed reimbursement rates.
Last Friday, Berkshire Superior Court Judge John A. Agostini approved a request from the state Attorney General’s office that would allow the hospital to close and officials from DPH, BMC and other entities and officials to re-establish emergency services under the direction of BMC.
Also on Friday, BMC said that it would need authority from the DPH to operate a "satellite emergency facility" at NARH under a BMC license. The multi-part application process has been initiated, according to BMC, and once completed will be given an expedited review by DPH. The timeline needed to complete that process remained unclear on Monday.
BMC spokesman Michael Leary said the hospital had nothing to say beyond the comments that it had released on Friday.
MNA spokesman David Schildmeier said the collective bargaining unit had been told that BMC and DPH planned to work out an agreement Monday to keep Northern Berkshire Healthcare’s Visiting Nurse Association and Hospice organizations funded, and that a way to fund NARH’s Emergency Department would be worked out within 48 hours.
Caregivers and community members will hold a community meeting at 5 p.m. today at the North Adams American Legion Hall to discuss the next steps in the campaign to restore services at NARH.
While not privy to what was being discussed or how the talks were taking place, North Adams Mayor Richard J. Alcombright said on Monday that conversations between BMC and DPH are "ongoing."
"I’m not clear on the status," he said, referring to when an agreement might be reached, "but I do know that everyone is pursuing it."
"We thought it would be soon," Alcombright said. "But I don’t know what soon is anymore in this world. It’s very complicated. This isn’t like opening a variety store.
"I do know for certain that there are active ongoing conversations and that they’re doing everything that they can to push this forward, including discussing expedited permitting," Alcombright said.
Representatives of the state Department of Health and Human Services did not return telephone calls seeking comment, while DPH supplied remarks from Gov. Patrick, who addressed the hospital situation Monday at a news conference in Holyoke.
When asked in Holyoke how a hospital could be shut down in three days, Patrick responded, "You should ask the board [NARH trustees] that.
"I’ll tell you that we’ve been working with them for over a week on a solution to keep the hospital open," Patrick said. "We thought we had a deal at the end of last week. It was, frankly, an abrupt decision from our perspective."
Patrick said he understood the Northern Berkshire Healthcare had "legacy debt issues" that needed to be resolved.
"But I think I speak on behalf of all of our team, No. 1, that we’re all over it, (and) doing our very best to, at least, get the emergency room to reopen, and we’re all frustrated with dealing with the outgoing board."
When asked if management issues caused NARH to close abruptly, Patrick responded, "There will be time to diagnose how they got to where they got."
State Sen. Benjamin B. Downing, who cleared his schedule to deal with the situation, said he also has been working with BMC regarding hiring and the licensing issue.
"I personally have been in touch with Governor Patrick and [HHS] Secretary [John W.] Polanowicz, mostly regarding the license to reopen the ER," he said. "I hope both will be out here soon."
A week ago today, NBH, which operates NARH, the VNA and hospice group, and three medical practices, announced that it planned to shut down all of those services within three days because of its "worsening financial situation."
NBH, which filed for Chapter 11 bankruptcy protection three years ago, had posted financial losses in nine of the 12 fiscal years since 2001.
Two days later, Agostini granted a preliminary injunction filed by the state Attorney General’s Office that allowed NARH’s emergency room to stay open temporarily.
But after learning that no funding was available to maintain safe services at the hospital, and that critical staff and supplies were no longer available, Coakley’s office asked Agostini on March 28 to revise the temporary order, and close the hospital’s emergency room over the weekend.
Schildmeier, whose union represents some 100 nurses at NARH, said the union believes more than just emergency services should be re-established at NARH.
"Our position is that not just that the Emergency Department should be opened as a stopgap Band-Aid," Schildmeier said. "A week ago we had a full service hospital."