Worcester Business Journal

wbjournal.com | September 2, 2024 | Worcester Business Journal 9 for the facility isn't found, Dickson hopes UMass Memorial can work with the state to eventually utilize Nashoba Valley's emergency room space and still provide some healthcare services for the region. Perhaps, it could turn it into an urgent care or a skilled nursing facility, but it's not a short-term solution. "is isn't going to be fixed in a day or two. is is going to have to be an intense recruitment effort to staff up and really then look at every area, every nook and cranny that we have to be able to take care of patients," said Dickson. "e emergency departments will be busier. e waits to be seen will be lon- ger. e hospital will be more crowded. But the real part of this that sometimes people fail to consider is what happens to the EMS system." EMS system challenges e average Ayer ambulance turn- around time to and from Nashoba Valley is about 20 minutes, said Ayer Town Manager Robert Pontbriand. With Nashoba Val- ley closed, he said the average hos- pital turnaround time will grow to 60-90 minutes. For residents of Pepperell, which is north of Ayer, wait times will be longer. About 60% of Pepperell Fire Depart- ment transports go to Nashoba Valley and 90% of calls are turned around in about an hour, said chief Borneman. With the hospital's closure, he anticipates turnaround times increasing 50%-100%. Nashoba Valley could have made a difference in those emergency situations, said Sprague, the hospital's ER nurse. "Lives will be lost because seconds count," said Sprague. "We're not a big medical mecca and a big trauma center, but where we're located, we can stabilize anything and get [patients] the immedi- ate care they need." is increase in distance to health care won't solely affect those utilizing the ER. Sprague foresees the distance most im- pacting seniors and those with chronic illnesses who frequent the hospital on a regular basis. With the distance to hos- pitals now doubling or tripling, Sprague said patients will postpone care. "You think that everybody has a car or has somebody that can drive, and that's not the case in a lot of places. I mean, I've given patients rides home from the emergency room that came by ambu- lance because they had no ride and then they have no way to get home," she said. Alternative transportation options such as community shuttles or paying for Ubers are infeasible with the situation in which the town is headed, Pontbriand said. For example, the Ayer Council on Aging senior center brings senior residents to healthcare appointments via its one van holding 10 to 12 people, but when Nashoba Valley closes, he said it won't be possible to bring everyone in need to their appointments. e extra expense that would come with paying for ride services might deter patients further from accessing care. "Here is a traditional middle America, hard-working, traditional blue collar community. e people in these towns, they don't have all kinds of disposable income to begin with so increasing the distance is increasing their cost," said Pontbriand. e fear of patients postponing care is shared by Borneman and his peers. He said they foresee a similar situation to COVID when people delayed care because they were avoiding hospitals, but in this case, it will be because they lack an accessible hospital. In turn, Borneman said patients will be calling for an ambu- lance having developed acute conditions, but the availability of that ambulance may be up in the air. "We still do firefighting. So if we're all tied up on ambulance calls and a fire comes in, in this area, we just don't have the staffing like bigger places and cities that can handle all this," he said. Service gaps Massachusetts State Rep. Margaret Scarsdale (D-Pepperell) fears the services specifically provided by the region's fire departments will be lost. While first Robert Pontbriand, Ayer town manager Nashoba Valley alternatives Once NVMC closes, the Town of Ayer's emergency response will need to transport patients to another hospital at minimum an extra 9.1 miles away, drastically increasing wait times in and for ambulances. Hospital Distance from Ayer Fire Department Nashoba Valley Medical Center, in Ayer 2.4 miles UMass Memorial HealthAlliance-Clinton Hospital, Leominster campus 11.5 miles Emerson Hospital, in Concord 16.8 miles Southern New Hampshire Medical Center, in Nashua 18.6 miles Lowell General Hospital 19.7 miles Source: Ayer Select Board's "Offical Resolution Requesting Emergency Declaration Regarding the Proposed Closure of Nashoba Valley Medical Center" Governments shouldn't do more to prevent hospital closures Over the loud protests of hospital personnel and officials, Steward Health Care is moving forward with closing Nashoba Valley Medical Center in Ayer, along with Carney Hospital in Dorchester, following a July 30 announcement from the Dallas-based health system. Even though she's opposed to Steward's decision, Gov. Maura Healey said there's nothing she can do to stop the hospitals from closing in a statement in which she admonished Steward CEO Ralph de la Torre. Healthcare companies, particularly large hospitals, have been in a protracted financial and workforce crisis for years, exacerbated by the COVID pandemic. When polled online, WBJ readers were almost evenly split on the issue of whether governments should do more to prevent hospital closures, with the slight majority of readers saying no. Should governments be doing more to prevent hospital closures? F L A S H P O L L Yes, federal and state governments should support struggling systems by increasing Medicaid and Medicare reimbursement rates. Yes, governments should provide direct public assistance to struggling hospitals, as well as additional tax breaks. No, hospital closures are a natural consequence of the free market. No, private organizations shouldn't receive government handouts. 27% 29% 22% 22% State Rep. Margaret Scarsdale (D-Pepperell) responders are unavailable during longer turnaround times, she sees the potential for other vital aids to fall by the wayside. "at means the services that our fire departments offer: inspection safety programs, fire prevention services, life safety education, those are all going to be in jeopardy because there'll be no one there to perform those services because they're sitting in traffic at the Concord Rotary," said Scarsdale. In addition, she said dispatch staff are going to have to learn to understand and navigate more complex scenarios re- garding where to transport people amid higher demand for mutual aid within the Nashoba Valley. Pepperell and surrounding towns have a robust mutual aid system, Borneman said, but if all towns are experiencing longer turnaround times, their collec- tive ability to deliver an ambulance will diminish drastically. As it is, Borneman's department had to scramble to secure the use of Pepperell's singular staffed ambulance since Steward announced Nashoba Valley's closure. e Town needs an affiliation agreement with a hospital in order to operate an ambu- lance, and Pepperell would have been without a license had it not acquired a new agreement with Clinton Hospital's Leominster campus. State of uncertainty Although there are plenty of known and predictable challenges ahead with Nashoba Valley's closure, there are a number of unknown factors officials have expressed have the potential to fur- ther derail the region's healthcare system. ough the public health impact is of first and foremost concern for him, Pontbriand added Nashoba Valley's closure may increase costs for towns to provide additional emergency services. With municipal budgets already set, the towns might not have the resources allocated to pay additional personnel, added fuel costs, or for a new ambulance, the last of which Ayer did to the tune of $400,000 with 18-month order lag, said Pontbriand. Scarsdale is trying to identify pitfalls before they happen, such as what will happen to Nashoba Valley Medical Center's helicopter landing zone used to transfer patients via helicopter. "It's a whole region full of dominoes that are about to start falling, and the patient outcomes and the health of our towns are going to be severely impacted from that," said Scarsdale. EDITOR'S NOTE: is story was sent to the printer on Aug. 28, ahead of the planned Aug. 31 closure of Nashoba Valley Medical Center. W

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