Mass Dept of Public Health to hold Public Hearing on AGH merger

Mass Dept of Public Health to hold Public Hearing on AGH merger

harbordog
Joined: 07 Jun 2008, 11:56

05 Dec 2017, 02:27 #1

The Mass Department of Public Health will hold a public hearing on Wednesday December 6th at 5:00 pm in the GHS auditorium.

This public hearing is on the application for Determination of Need filed by CareGroup Inc, Lahey Health and Seacoast Regional Health System with respect to their intent to affiliate to create a new comprehensive and distributed healthcare delivery system in the Eastern Massachusetts marketplace. The applicant intends to establish and incorporate a new parent organization, NewCo, which will function as the sole corporate member of the entities.

The action will result in a merger of Addison Gilbert Hospital with Beth Israel Deaconess, New England Baptist, Mount Auburn and Anna Jaques (Seacoast Regional Health System).

Once approved, AGH will be one of 8 community hospitals.  Of these hospitals, AGH will have the least amount of services including acute care.  We are asking for equity in services which would include restoration of services and investment in AGH.

For more information you may contact Peg O'Malley at the above email or by calling 978-283-9911.

Thank you for your consideration in the matter of public health and safety.
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DM3194
Joined: 07 Feb 2008, 22:54

07 Dec 2017, 03:28 #2

That was a very good turnout tonight at GHS.
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harbordog
Joined: 07 Jun 2008, 11:56

07 Dec 2017, 03:58 #3

It was pretty disappointing to sit through an hour of listening to hired hospital gun slingers and other obvious plants speak about how beneficial this merger is going to be.  When the public finally did get their chance to speak, Mass DPH seemed more interested in timing the public speeches than hearing what the public had to say.
I was glad to hear Bruce Tarr request the applicants make a presentation to the community with specific details on the merger.  I could not understand how anyone could support the merger without knowing the specifics. 
Is the applicants' merger proposal on line somewhere?
Howard Grant, President, Lahey, spoke of "coordinated services at clinically appropriate facilities" and "keep care in the community whenever possible".    Well that was not very reassuring.  
Someone made mention of the Urgent Care facility to be opened in Gloucester and inferred that would take the burden off people going to the ER.  Do communities with Urgent Care facilities maintain their ER services?
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DM3194
Joined: 07 Feb 2008, 22:54

07 Dec 2017, 06:33 #4

I think that officers of AGH, and many others, made a
great case in support of the proposed merger last night.

Senator Tarr made clear that this plan should progress
further only if a commitment to our community hospitals
is an important part of the mix. Not just to maintain them,
but to improve them.

It is clear that some folks are hard-wired to resent large
organizations, and mergers, even when they improve services.
And even when the survival of the local hospital is much
more likely with a merger!

///
Urgent Care facilities are meant to co-exist with the Emergency Room,
not replace it. UC is a place to go for non-life threatening ailments
... so fewer people are going to the ER with sore throats and bunions.
Way less expensive, too.
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Dun Fudgin
Joined: 21 Jun 2007, 03:54

07 Dec 2017, 10:29 #5

DM3194 wrote:///
Urgent Care facilities are meant to co-exist with the Emergency Room,
not replace it. UC is a place to go for non-life threatening ailments
... so fewer people are going to the ER with sore throats and bunions.
Way less expensive, too.
"Urgent Care" back when I was a kid was "House Calls"!
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DM3194
Joined: 07 Feb 2008, 22:54

07 Dec 2017, 11:00 #6

Dun Fudgin said: "Urgent Care" back when I was a kid was "House Calls"!

I remember my parents calling the doctor to come
over to our house when I was sick. Circa 1963.
I wonder when that sort of nice service totally faded out.
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Damon
Joined: 25 Jun 2007, 22:00

07 Dec 2017, 11:54 #7

These days most families have pickup trucks DM. When we were young physician house calls were essential because not every family could afford their own horse and buggy.
Don't you see that the whole aim of Newspeak is to narrow the range of thought?...   ..........
 George Orwell , 1984
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harbordog
Joined: 07 Jun 2008, 11:56

07 Dec 2017, 12:34 #8

I did not hear any of the proponents of the merger testify to any specifics on how AGH, which is our concern here, is going to gain anything more than buying power.  It may be a matter of fact that independent hospitals can no longer compete in the marketplace and bigger is better - but better for their bottom line.  It is all about statistical outcomes and profits.  It seems local community hospital services are being eroded in favor of centralized care further up the line.  There are longer and longer waits, and patients are bounced from facility to facility.  There was testimony last night about a patient waiting more than a day for transfer to treatment.  Another about an 86 year old woman who was bounced which left her without the ability for her personal support system to be by her side.  These are not isolated incidents, it is the norm of the system now.  
It is critical Mass DPH require contractual agreements from the applicants for a restoration of acute care services and investments be made in AGH.
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Karly
Joined: 20 Feb 2010, 02:12

07 Dec 2017, 12:49 #9

I think Jamie O'Hara, who spoke neither for nor against the merger, made an important point about traffic and emergency services.  Another speaker mentioned that even though there are theoretically emergency surgery services at AGH that it never actualy happens.  I do not know if that is true or not but it seems like a capability we need.  Ann-Margaret Ferrante talked about how AGH saved her mother's life in a situation where she was too ill to be transported even as far as Beverly.

I think there could be big benefits to the merger but I think we also need some local control (someone spoke about that too) and guarantee of services.  I think that would make the people who seem most worried about it feel a bit better.   This same thing is happening where I spend a lot of time in NH now.  I think there are going to be very few small community hospitals or hospital groups.  The merger here would be with some top notch hospitals.   I agree with Bruce Tarr that we need more specifics about the merger.  
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Dun Fudgin
Joined: 21 Jun 2007, 03:54

07 Dec 2017, 12:52 #10

harbordog wrote: I did not hear any of the proponents of the merger testify to any specifics on how AGH, which is our concern here, is going to gain anything more than buying power.  It may be a matter of fact that independent hospitals can no longer compete in the marketplace and bigger is better - but better for their bottom line.  It is all about statistical outcomes and profits.  It seems local community hospital services are being eroded in favor of centralized care further up the line.  There are longer and longer waits, and patients are bounced from facility to facility.  There was testimony last night about a patient waiting more than a day for transfer to treatment.  Another about an 86 year old woman who was bounced which left her without the ability for her personal support system to be by her side.  These are not isolated incidents, it is the norm of the system now.  
It is critical Mass DPH require contractual agreements from the applicants for a restoration of acute care services and investments be made in AGH.
Common sense would say more local medical services would help reduce wait times and patient back ups at major hospitals. 
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Cathy (Admin)
Joined: 13 Aug 2005, 09:30

07 Dec 2017, 19:27 #11

I've been involved in dozens of ER visits and inpatient stays at AGH and/or Beverly, involving relatives, over the last 5 or 6 years.  On more than one occasion, I've thought that we should have just gone to Beverly in the first place, which may very well be what they are going for.

Late night ultrasound needed - no ultrasound tech on duty at AGH, had to wait for one to come up from Beverly.  Early morning appendicitis diagnosis - transported to Beverly at 3:00 a.m. for 8:00 a.m. appendectomy, which they don't do at AGH.  So tech comes from Beverly to perform test, patient goes to Beverly for surgery.

Discussing with a Dr. a potential colonoscopy/endoscopy for an elderly relative -  I asked:  if that were to happen, it could be done at AGH, right?  Well, said the Dr., at that age we like to do a general anesthesia for that procedure and they don't do general anesthesia at AGH.  An ultrasound was scheduled - they hemmed and hawed about doing it at AGH instead of Beverly, but I persisted and it was scheduled there.  Folks need to push to receive services that are available at AGH to actually have them done there.

Transport from Seacoast to Beverly - day trip for blood transfusion, which they apparently don't do at AGH.

Inpatients at AGH are routinely transported to Beverly and back for tests (MRIs for one).

Several times inpatients at AGH were transported to Beverly for a test or procedure and ended up just being admitted there instead of being transported back to AGH for no apparent medical reason.

If a patient needs visiting nurse services after discharge, Lahey (Beverly/AGH/Seacoast) pushes for their own Home Health service.  I had always asked to be set up with the local VNA Care Network.  There was a time when I wasn't present for discharge and another family member was there.  They had no clue about the Lahey/VNA thing and signed on for Lahey Home.  It is more efficient regarding access to records, etc., but I liked supporting the smaller group and was always pleased with their service.

The Addison Gilbert Hospital Citizens' Fund's mission is to support general and orthopedic surgery, 24/7, at AGH.  From their Q&A page:  "By law, the hospital cannot remain open unless an active operating room is available, 24/7."  So, yes, they theoretically need to provide surgery and yes, it does seem to be only theoretical.

http://aghcitizensfund.org/default.aspx?Page=ANSWERS
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harbordog
Joined: 07 Jun 2008, 11:56

07 Dec 2017, 20:58 #12

The stories are all the same.  Patients diverted out of AGH for services elsewhere down the line.  It is difficult for the patients and taxing on their personal support systems and advocates.  Some equipment at AGH is not state of the art (not digital) so not compatible with some Lahey systems.   The need to have intimate knowledge of services such as which after care system to request.  Who would know all this?  Why should we have to know this?  Diversion of patients is a way to control the statistics for the justification of where services go and where investments get made.  
Barbara Collins testified to her experience with an 86 year old patient who was bounced around from AGH to Burlington.  It was very difficult for the health care proxy, Ms. Collins, to carry out her advocacy duties.  Isn't that convenient when patients' personal advocates can not be present.
It is my understanding in order to retain a functioning ER, a hospital must have the ability to perform emergency surgery.   The staffing infrastructure does not exist at AGH to perform emergency surgery.  There has not been an emergency surgical procedure performed there in years.  We are walking a very fine line with the Mass DPH.  When does the curtain get pulled back on this ruse and we loose the ER?
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Dun Fudgin
Joined: 21 Jun 2007, 03:54

07 Dec 2017, 23:50 #13

I've had many kidney stone attacks over the years and on those I had to go to the AGH ER I was treated right away. One time I went directly to Beverly because I was working in Topsfield at the time. I waited over 4 hours to be seen and another hour or so went by after the initial BP & temp readings. The doctor then came in eating a sandwich and asked "What seems to be the problem"! 
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Cathy (Admin)
Joined: 13 Aug 2005, 09:30

08 Dec 2017, 03:00 #14

When was the last time you were there, @Dun Fudgin ?  An ER visit these days is pretty much a 3 hour, minimum, event.  As I type this, my head hurts as I recall the amount of time I've spent in the ER.

It is sinful @harbordog , that people, especially the elderly, need a patient advocate to find their way through the system of services - and I'm not picking on Lahey.  There was that time, at South Shore Hospital, at 4:00 p.m. on a Friday afternoon, when a case manager entered my mom's room and informed her that Medicare had decided that she had no need to return to Braintree Rehab Hospital and denied her return.  She was a couple of weeks post-stroke, getting rehab and being fitted for a custom leg brace when she had a blood pressure issue, fainted, was sent to SSH and definitely needed to continue with her rehab care at Braintree - had not yet even received her brace.  Had my sisters and I not been there at that moment - lordy.  I was on the phone to Medicare within seconds, pleaded my case and prevailed.  Nothing about that is right.  It's my nature to research and question most everything, about anything.  Sometimes to a fault, like a curse, but mostly helpful.

When you mentioned digital, I remembered that was the question from the Dr. about the ultrasound equipment at AGH.

The big hubbub last May was about Lahey's plan to "open a new urgent-care facility in Gloucester sometime this fall, funded in part through a $925,000 grant from the Waltham-based J.M.R. Barker Foundation."  Where the heck does that stand?

http://www.gloucestertimes.com/news/loc ... a84cb.html

In 2012, when Northeast Health Systems (AGH and Beverly) affiliated with Lahey Clinic to form Lahey Health System, there was this:  "We are pleased to announce that Addison Gilbert Hospital is protected in this agreement by a commitment to continue operating as a full service community hospital for the next three years."

http://www.wickedlocal.com/x117257917/C ... hey-merger

http://www.beverlyhospital.org/about-us ... ation-q--a

There was a point, a few years ago, when I considered publishing a review of hospital/rehab cafeterias in the North Shore/Boston/South Shore areas, lol.
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Karly
Joined: 20 Feb 2010, 02:12

08 Dec 2017, 03:10 #15

🙃  When I had my babies in Boston the hospital I chose was in the Best of Boston for some of their food!
Including chocolate chip cookies but their mac and cheese was yummy.   LOL.  Not why I picked them...mostly they were near where I was working and highly recommended by medical professionals I knew.  I have been lucky not to have too much experience with hospital food since but  ate in the cafeteria at AGH a number of times this year when a family member was there...not happy to be there but food was good and outcome was fine for patient.
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Cathy (Admin)
Joined: 13 Aug 2005, 09:30

08 Dec 2017, 03:45 #16

South Shore Hospital has the worst patient care that I've experienced, but the most awesome cafeteria food - go figure.

AGH:  Not even an after-hours-crappy-coffee-but-need-caffeine vending machine.  Tip of the day:  McDonald's drive-thru is open until midnight and 7-11 on Washington is open 24/7.

I'm eternally grateful that AGH had an OB/GYN/Maternity Ward when I was birthin' babies.  My second child most certainly would have been a birthed-on-the-side-of-the-highway-story had I been forced to attempt to get to Beverly in time.
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Dun Fudgin
Joined: 21 Jun 2007, 03:54

08 Dec 2017, 07:59 #17

Cathy (Admin) wrote: When was the last time you were there, @Dun Fudgin ?  An ER visit these days is pretty much a 3 hour, minimum, event.  As I type this, my head hurts as I recall the amount of time I've spent in the ER.
It was last January, As usual I was brought into a room for BP and temp then into an exam room. I waited about 15 minutes for the Dr. then whisked into the ultra sound room. After finding the stone I was given an IV drip until the stone passed. In the past it would have been an IVP while an x-ray was taken. The whole ordeal took about 2 hours. I've had 17 kidney stone attacks with about 12 of them that required a visit to the ER.
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