GARDNER -Concerns about access to safe maternity care in North Worcester Country have not gone away since last month’s decision by UMass Memorial Health to close its maternity ward in Leominster.
When UMass closed the facility on Sept. 23, it primarily cited falling birth rates and a lack of staff for the move. UMass officials also said Heywood Hospital in Gardner, the closest hospital to the closed Leominster facility, was an option for patients needing maternity care.
But Heywood encountered financial challenges.
The nonprofit community hospital not only filed for Chapter 11 bankruptcy this month, but also saw a 33% decline in the number of births in its maternity ward. In 2022, 304 births took place at the center, compared to 455 in 2016, according to the state Department of Public Health. So far this year, as of October 5, the center has had 241 births.
The 33% drop is a familiar number, because the Leominster facility had a corresponding percentage decline of 511 births in fiscal year 2022, compared to 762 in fiscal year 2017, according to UMass Memorial records with the state .
Now, the convergence between Heywood’s bankruptcy filing and the drop in births has one health policy expert uncomfortable about how pregnant mothers will access maternity care in north-central Worcester County.
It seems to me that this should create anxiety about whether access to maternity services is really hanging in the balance (in north Worcester County), said Paul Hattis, senior fellow at the Lown Institute in Needham, a nonpartisan think tank in the sphere of health care.
Heywood Hospital: ‘Committed’ to obstetric care
A spokeswoman for Heywood said in an email that the hospital’s LaChance Maternity Center remains committed to supporting regional obstetric care in north Worcester County: Maternity services and all core hospital services will continue and will not be affected by the filing for protection under Chapter 11. Chapter 11 allows us to continue to provide essential services to our community.
Reasons cited by Heywood for the 33% drop in births include fewer local family doctors providing labor and birth care.
I would say there is a definite link between the decline in the number of family doctors doing obstetrics and the decline in birth rates here at Heywood, said Lynn Shepard, leader of the hospital’s maternal and child practice. from a hospital spokeswoman.
The shortage of obstetricians is the “biggest problem,” said David Schildmeier, spokesman for the Massachusetts Nurses Association. He explained that fewer doctors mean fewer patient referrals to Heywood Hospital.
Schildmeier also pointed to the mismanagement of former Heywood Hospital CEO Win Brown as a factor in the hospital’s financial problems. Heywood announced in June that he had split from Brown. No reason was given for his departure.
Other reasons for the 33% decline noted by a Heywood spokesperson include:
Impacts of the COVID-19 pandemic.
The hospital does not have a neonatal intensive care unit. However, Heywood joined forces with UMass Memorial Health in 2021 to establish the Tele-NICU. The service provides 24/7/365 connection with a UMass Memorial neonatologist for immediate consultation of premature or critically unstable babies.
Losing patients to Emerson Hospital in Concord. AFA OB/GYN, a private family physician practice with an office in Leominster since 2016, sends its maternity patients to Emerson for births. AFA is affiliated with Emerson Hospital.
Bank run: comparison with Heywood Hospital?
State Rep. Jonathan Zlotnik, D-Gardner, said the public’s perception of Heywood’s financial difficulties could be likened to a run on the banks.
If customers feel that their bank is on the verge of financial collapse, even if the facts don’t support it, they will lose confidence and make a mad dash for their cash deposits. In the case of Heywood Hospital’s bankruptcy filing, Zlotnik does not believe it will close its doors because it has taken steps to bolster its finances.
This is not a cash flow situation,” said Zlotnik. “It’s a structured plan and hopefully the best opportunity to continue with this. I think people can be reasonably confident that the hospital will continue to operate in North County.
In addition to Heywood’s reorganization through Chapter 11, Zlotnick said the hospital is keeping maternity staffing levels reduced to align expenses with the hospital’s births. The team also has dual training, according to Zlotnick. This means they can perform surgeries alongside other maternity wards, he said, so the hospital doesn’t need to hire more staff.
Zlotniks also understands that Heywood absorbed some staff from the closed maternity hospital in Leominster, but he did not know the number. A request for Heywood maternity ward staffing numbers and financial performance for each of the past 10 years was not immediately available, a hospital spokeswoman said.
Difficult Consolidations for Community Hospitals
Zlotnick also mentioned that Heywood is no different than many smaller community hospitals facing financial pressures in an industry that has seen several closures and consolidations over the past 15 years. Heywood could have been dragged into a consolidation, but bad timing was the reason given by Heywood and UMass Memorial Health in January for not moving forward with a merger.
Heywood’s balance sheet is also affected by low government reimbursements, Zlotnik said, because many of its patients rely on Medicare and Medicaid.
Zlotnick supports steps taken by Gov. Maura Healey to get a clearer picture of the state’s maternity care challenges. After the Leominster facility closed, Healey asked the state DPH to do a statewide study of maternal health care in Massachusetts and a second study to evaluate essential hospital services in North Central Massachusetts.
However, it is unclear what will happen to smaller community hospitals in the coming years.
I’m confident it (Heywood Hospital) will remain open, Zlotnik said. But I also recognize big challenges there. There are variables that we don’t yet know and there could be a number of things in the next three to five years that could significantly change the calculation.
This is why the work that begins now with the governor for our region is fundamental. We need a complete review and a solid plan to move towards long-term sustainability.
It’s time for a ‘proactive’ approach
Studies are one thing, results another, said Amie Shei, president and CEO of The Health Foundation of Central Massachusetts. Heywood’s bankruptcy filing and its 33% decline in deliveries highlight the need for Massachusetts to take a more proactive approach, Shei said, in order to identify gaps in healthcare services and develop strategies to close them.
Unless we take a proactive approach to future planning, we will always be too reactive, said Shei. There needs to be a more coordinated effort to encourage the State to carry out more prospective planning.
The Lown Institute Hattis agrees.
It’s time for Massachusetts to take a hard look at its health care system to determine what its needs are and whether current resources can meet them, Hattis said. If this isn’t done, Hattis feels more hospital consolidations will increase prices for consumers. This also means that the state will not know whether a hospital’s shutdown order should proceed or whether taxpayers or third parties should step in to bail out the hospital.
The state needs to do adequate planning, matching projected needs (in Massachusetts) with resources for a variety of different services, including maternity services. We have been negligent as a state in doing this.
Contact Henry Schwan at firstname.lastname@example.org. Follow him on X:@henrytelegram.
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