The Rhode Island Department of Health (RIDOH) approved today Care New England's (CNE's) application to close Memorial Hospital's emergency department in a decision that includes conditions aimed at supporting local emergency medical response capacity, maintaining the state's primary care training infrastructure, and investing in health at the community-level.
The decision will be effective on January 1, 2018.
"We spent weeks carefully weighing CNE's applications to understand how these changes at Memorial Hospital would affect the most vulnerable residents of Pawtucket and Central Falls, and the state's healthcare system as a whole," said Director of Health Nicole Alexander-Scott, MD, MPH. "The conditions included in today's decision seek to ensure that residents continue to have access to the high-quality care they need. In addition, the conditions call on CNE to invest in community-level initiatives that will positively impact the underlying socioeconomic and environmental factors that actually determine the health of people and their neighborhoods."
RIDOH organized two community meetings in Pawtucket in the last month to gather community input, in addition to collecting written comments. This input informed RIDOH's decision and conditions. The conditions include requirements that CNE:
Open a walk-in clinic in Pawtucket, to be open seven days a week.; Provide $300,000 to Pawtucket and $200,000 to Central Falls each year for two years to offset emergency medical services costs associated with transporting patients to other hospitals.; Put in place a transportation plan for patients and patients' families so that individuals with non-emergency chronic conditions won't have to incur additional costs associated with traveling to receive services that are only offered at another hospital.; Maintain Memorial Hospital's Family Care and Internal Medicine Centers in Pawtucket at their current hours and staffing levels.; Invest $100,000 annually in the Pawtucket and Central Falls Health Equity Zones (HEZs). Rhode Island's HEZs are nine distinct areas throughout the state where organizations are coming together to put health programs and policies in place to prevent chronic diseases, improve birth outcomes, and improve the socioeconomic and environmental conditions of their neighborhoods.; Make outplacement and career transition services available to staff through an outplacement firm hired by CNE. CNE will continue to organize job fairs which will include representation from all operating units of CNE, other employers through the state, the Rhode Island Department of Labor and Training, and CNE's Employee Assistance Program.
Although today's decision means that Memorial Hospital will no longer function as a hospital, an application for Memorial Hospital to cease providing primary care services in Pawtucket is still pending. CNE intends to continue to provide these services in the future in Pawtucket under the licenses of other CNE hospitals. (These other CNE facilities are in the process of obtaining the necessary licenses to do so.)
According to statute, in making today's decision RIDOH needed to consider how the proposed changes would affect:
Access to healthcare services for traditionally underserved populations (including Medicaid, uninsured and underinsured patients, and people of color); The delivery of emergency and primary care services in the community; Other hospitals or healthcare providers in the affected community; and Other hospitals or healthcare providers in the state.
The findings of the decision included the fact that there are seven acute care hospitals within a 10-mile radius of Memorial Hospital, and 10 health centers within a 10-mile radius. RIDOH also noted in the decision that while Memorial Hospital's primary service areas include many underinsured and traditionally underserved populations, CNE will continue to serve its large primary care patient population in Pawtucket.
Due to concerns about patient safety, RIDOH issued a consent order on November 30th temporarily halting EMS services to Memorial Hospital, along with new admissions and surgeries at the Hospital. The Hospital's emergency department had remained open for walk-in patients. CNE will be issuing public notifications in English, Spanish, and Portuguese in the coming days about the timing of the permanent closure of the emergency department, effective January 1, 2018.