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Thursday, April 25, 2013

Lawrence and Memorial completes final hurdle before buy-out of Westerly Hospital

Deal to be closed on June 1
By Will Collette

I am happy to see that Westerly Hospital has been saved from imminent closure, now that they have received all of the state agency approvals they need. Lawrence & Memorial (L&M) Hospital of Stonington will sign all the final paperwork to get the keys to Westerly Hospital on June 1

That’s the same day that Westerly Hospital will close its obstetrics department, now that the RI Health Department has closed the door on retaining that service.

While this is a welcome bail-out, it does not mean that Westerly Hospital is out of trouble. Under the terms of the deal, L&M is only pledged to keep clinical services going for two years and to keep Westerly Hospital in operation as an acute care hospital for five years.

Two years and five years are not very long. Plus, as the unions who represent hospital workers at L&M can attest, the new owner of Westerly Hospital is not a stickler for honoring its contracts.

RI Attorney General Peter Kilmartin was the last official to sign off on the deal, setting multiple conditions for the ownership transfer that include retaining the name, “Westerly Hospital” and that L&M will raise money to be used to improve Westerly Hospital. $30 million is expected to be spent on capital improvements and L&M is supposed to inject $6.5 million in working capital.

The hospital worker unions at Westerly Hospital were an integral part of the coalition to save Westerly from closure. Unfortunately, L&M brings a lot of baggage with it as its own unions have filed unfair labor charges against L&M management for unfairly cutting staff – telling their own workers that they don’t have money to retain already overworked staff while telling the RI Health Department that they have lots of money – and for shifting jobs out of the unionized hospital into non-union subsidiaries.

This has prompted the AFT’s health care workers division to launch a new organizing drive that targets those non-union subsidiaries. The union says it is hopeful that the National Labor Relations Board will rule in their favor in the charge that L&M committed an unfair labor practice by shifting hospital jobs to the subsidiaries, but decided to start organizing because “these folks don’t want to wait.”

The AFT also said in a statement that workers at L&M Physician Associates, the non-union subsidiary, say they were "kept out of the hospital's unions despite providing the same excellent care" as hospital workers.

The state of Connecticut declined to sanction L&M for moving its obstetrics and outpatient mental health departments out of the hospital and into the subsidiaries, ruling that those changes did not require prior state approval. However, they also said that L&M needed the state’s approval to change the management of those services – which L&M has not received.

 In my earlier reports (here and here in particular), I raised concerns about L&M’s low ratings for patient satisfaction and quality of care – ratings that are lower than Westerly Hospital’s have been, even in its distressed circumstances, and for sake of comparison, far lower than South County Hospital’s exemplary ratings.

These problems did not escape the attention of Dr. Robert Crausman, the consultant hired by the RI Health Department to review the deal. In 2010, the Connecticut Department of Public Health cited L&M for multiple violations that led to a corrective action plan, consent order and close health department attention.

In March, the Public Health Department did an inspection on behalf of Medicare and notified L&M on March 28 of more deficiencies that are being reported to Medicare. Among the defects were inappropriate, potentially dangerous, equipment in the dialysis unit, improper use of restraints on patients, incomplete medication orders and other patient safety issues.

Dr. Crausman reported to the RI Health Department that these findings were serious, but "are of the type commonly identified on hospital inspection surveys and should be readily corrected." He noted that the Connecticut health department’s oversight was "somewhat reassuring."

I guess that when you’re a seasoned professional in the medical business, you get used to things that might make us laypeople less than comfortable. However, I also think Dr. Crausman probably also got the memo that the L&M-Westerly buy-out deal needed to happen.

Look, I’ll say again that I’m glad Westerly Hospital is being saved. However, given the issues that L&M Hospital brings with it, the community’s job is not over. The coalition that saved Westerly Hospital will now need to turn its attention toward making sure that L&M doesn’t just bleed Westerly Hospital to death.