Worcester Business Journal

December 11, 2023

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wbjournal.com | December 11, 2023 | Worcester Business Journal 15 Dickson said Heywood is not the only hospital on the verge of having to file for bankruptcy. "I don't believe this will be the last one," he said. Dickson does not foresee a scenario in which Heywood would not remain open aer the bankruptcy proceedings. In its bankruptcy filing, Heywood said a merger with UMass Memorial is still possible, and Dickson said UMass Memorial might be involved with Heywood post-bankruptcy. Heywood's importance to North Central North Central Mass. cannot afford to lose the hospital, particularly its emergency departments, said Dickson. "is is a region of the state that is pretty underserved already," he said. "e thought that these could be taken off the map: We can't let that happen." e Heywood bankruptcy has not been the only jolt to the North Central region this year. In September, UMass Memorial closed its labor and delivery unit at its HealthAlliance-Clinton Hospital in Leominster, aer months of community pushback. e closure, due to workforce shortages and declining births resulting in unsustainability of the unit, according to UMass Memorial, came as a blow. In November, the state issued two reports on healthcare access indicating maternity care was already precarious in North Central Massachusetts. Ensuring continued access to labor and delivery services is a priority for Heywood as it seeks to emerge from the bankruptcy in a more viable state. "We remain focused on serving as the regional provider of labor and delivery services. e LaChance Maternity Center is a hallmark of Heywood Healthcare," said Casavant. e go-forward for Heywood will have to be a multipronged approach, as with every system trying to navigate the financial state. "With challenging payment rates, increasing costs and changing demographics, we must continue to take account of our resources and focus on services that are in the best interest of the community," Casavant said. What services it may have to dial back have not been determined. W L A W & A C C O U N T I N G F O C U S Top creditors in Heywood Healthcare bankruptcy Creditor Amount owed Commonwealth Of Massachusetts $6,000,000 Heywood Green Street LLC, Needham $2,945,097 Stryker Orthopedics, Chicago $2,339,337 Medefis Inc., Omaha, Nebraska $1,181,675 Cardinal Health Pharmaceutical Distribution, Peabody $1,151,787 Labcorp Of America, Burlington, North Carolina $1,099,500 Medline Industries, Mundelein, Illinois $627,803 TMX Healthcare Technologies LLC, Indianapolis $519,527 B.E. Smith LLC, Chicago $496,051 National Grid, Pittsburgh $465,653 Source: Court documents filed in Heywood Healthcare's bankruptcy proceedings Worcester. is is the worst health care in the region has ever been, he said. "I've never been as worried about health care as I am right now," said Dickson. All solutions are long term, Dickson said. Addressing root causes, like extended hospital stays and staffing shortages, must be coupled by coordination between healthcare systems, akin to the level that propelled the industry through the pandemic. Restructuring through bankruptcy Heywood filed for protection with a petition to the U.S. Bankruptcy Court for the District of Massachusetts under Chapter 11 of the Bankruptcy Code, oen dubbed a reorganization bankruptcy, where businesses oen emerge financially stronger aer the bankruptcy by shedding debts and reaching new agreements with stakeholders. e two Heywood hospitals will remain open and operational throughout the resulting proceedings as it proposes a plan to reorder affairs and pay creditors back over time. "To become financially viable, we must negotiate fair rates with payors, right-size operations, and reduce expenses. Rising labor costs and supply costs, increasing costs of living and operating in a small market makes it difficult for a small independent hospital to remain competitive," Dawn Casavant, vice president of strategy and external affairs at Heywood Healthcare, wrote in an email to WBJ. Heywood has $76.7 million in outstanding debt obligations, mostly owed to state agency MassDevelopment, according to its bankruptcy filing. e hospital system owes another $31.3 million to its top 20 creditors. Separately, Heywood and related parties have been sued for $9 million over unpaid work at the now-paused surgical pavilion project. "Chapter 11 allows us to address historical and out-of-market contracts and reduce expenses while optimizing services," said Casavant. e hospital is committed to staying open, but that may require the dialing back of some services, said Casavant. The merger that never was When UMass Memorial elected not to go through with the merger in January, it was because Heywood was significantly worse off financially than UMass had previously believed. UMass ducked out before the step that would require it to guarantee Heywood's debts, said Dickson, but they remained heavily engaged with one another to try to ensure access to care for people across Central Massachusetts, he said. Hospitals like Heywood rely on Medicare and Medicaid payments from a significant portion of patients have extra challenges in a difficult financial landscape, because unlike with private insurers, hospitals can't raise rates for public insurance reimbursements, Dickson said. "ey were kind of doomed," he said. At Heywood, more than 67% of patients are covered by Medicare or Medicaid, said Casavant. Heywood is consider by CHIA to be a High Public Payor hospital, meaning 63% or more of charges come from public payers. "As a High Public Payor community hospital, we cannot be everything to everyone and expect financial stability. We continue to evaluate the needs of our community while simultaneously right sizing operations. Ensuring every patient we touch receives the highest quality care is the highest priority," Casavant said. Dr. Eric Dickson, CEO of UMass Memorial Health Heywood Healthcare stopped construction on its planned $29-million surgical pavilion after construction costs escalated, resulting in increases in projected rent, according to Heywood's bankruptcy filing. PHOTO | CHRISTINE PETERSON

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