CharterCARE Health Partners remains hopeful of its bid to restore the recently shuttered Memorial Hospital emergency room, but Pawtucket officials may try for a state waiver allowing some rescue runs to be directed to local clinics rather than to Providence to keep care speedy and local, while relieving pressure on other facilities.
The impact of Memorial’s loss has stung the city and nearby hospitals. Officials at Lifespan Corp., which owns The Miriam Hospital and Rhode Island Hospital, say traffic that might otherwise have gone to Memorial is only driving part of recent high patient demand.
Patient volume and wait times at hospitals near Pawtucket are spiking even as flu season winds down, said Dr. John Miskovsky, an internist who served on Memorial’s medical executive committee.
Miskovsky, whose private practice is across the street from the defunct Memorial Hospital, said his patients are finding it difficult to care for their health without nearby hospital services, and finding long waits at The Miriam Hospital and Rhode Island Hospital when they do make the trip.
Two and a half miles away at The Miriam Hospital, colleagues tell Miskovsky that half of their hospital beds are often taken by people waiting from the previous evening, he said.
David Levesque, director of communications for Lifespan, said Lifespan hospitals have seen a decline in flu cases in recent weeks, although the height of the flu season contributed to a busy few months. Recent reports of high volume at their hospitals are the result of a combination of a short-term flu season spike, patients that would ordinarily have visited Memorial and a separate, long-running trend of rising demand at the hospitals, Levesque said.
“The emergency departments at Rhode Island Hospital and The Miriam Hospital continue to experience significant demand at certain times. This is indicative of a yearslong trend of increasing visits to these two ... Lifespan emergency departments. Over the last year, both Rhode Island Hospital and The Miriam Hospital have also absorbed many patients previously served by Memorial Hospital’s emergency department. The physicians, nurses and staff in our emergency departments triage patients based on the urgency of their medical needs. ... We strive to treat all patients in a timely manner,” he said.
Pawtucket Mayor Donald Grebien had firsthand experience with a recent long emergency room wait following Memorial’s closure. On April 14, he said, he and his wife were involved in a car crash, and his wife suffered a minor head injury. They went to Rhode Island Hospital for her treatment, he said, at about 10:30 that night where they waited to be seen by a doctor for five hours.
“We did not get discharged until 9 a.m.” the next day, Grebien said.
‘[Memorial’s closure has] become incredibly disruptive to the medical care of my patients.’
DR. JOHN MISKOVSKY, Pawtucket internist
“It’s become incredibly disruptive to the medical care of my patients on many levels,” Miskovsky said of Memorial’s closing. There’s no infectious disease specialist nearby to refer his patients to, for instance, he said. That’s more significant than some realize, since many of his patients rely on public transportation, he said. Many who can’t get care in Pawtucket are likely to delay or skip important screenings, he said.
CharterCARE’s proposed restoration of Memorial’s emergency room faces two roadblocks; one inherent, one imposed by CharterCARE. State law requires a new certificate of need filed by any company seeking to bring services back to the location, according to Joseph Wendelken, spokesman for the R.I. Department of Health. CharterCARE has yet to submit anything to that effect, he said.
CharterCARE has imposed its own condition on its $10 million commitment to restore Memorial’s emergency room, making it contingent on renegotiating reimbursement rates with the state. Doing that requires an application for a waiver from the R.I. Office of Health Insurance Commissioner, according to OHIC Regulation 2.
Cory King, principal policy associate at OHIC, reports CharterCARE hasn’t applied for a waiver.
Several calls and emails to CharterCARE officials seeking an update were not returned.
A stakeholder group that includes Care New England officers, city and RIDOH officials that Care New England established as a RIDOH condition of Memorial’s closure is exploring sending ambulance runs to local clinics, said Grebien, a member of the group.
Grebien said they would either need a permanent change in state law allowing all communities in the state to direct rescue runs to clinics, or a waiver from the General Assembly for Pawtucket. He said a decision will have to come soon to pass the solution during this legislative session.