UPDATE: Dec. 10, 2018: Ascension confirmed Monday that Providence will keep its emergency room open until April 30 for the duration of the current flu season. The ER will be supported by lab services, diagnostic imaging, respiratory care and discharge planning in a victory for community interests. Less positive for health access advocates, however, was ancillary confirmation that all other acute care services will close Friday as previously reported.
Dive Brief:
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The fate of an Ascension-managed northeast D.C. hospital that stoked controversy remains unclear, after an initial report from a councilperson and the local hospital group said a decision to close its ER had been reversed. The hospital group later deleted its blog post breaking the news and declined to comment on Providence hospital's status.
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However, Ascension said Wednesday it will keep Providence's walk-in emergency room services open through April 30, confirming initial reports. "Providence Hospital is continuing to work with DC Health — including applying to renew its hospital license so it can continue to operate Emergency Services through April 30, 2019 — and will provide additional communication as to any future healthcare services when such services are approved by the appropriate regulatory agencies," an Ascension spokesperson told Healthcare Dive via email.
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Providence Health System, located near the Maryland border, had planned to shut down its emergency room walk-in service beginning Wednesday and all other acute care services by Dec. 14 in a controversial move that caused widespread concern in the historically-underserved area.
Dive Insight:
The decision to elongate the life of Providence’s ER for four additional months comes following discussions between Ascension, elected officials, community members, the D.C. Department of Health and the D.C. Hospital Association.
“Providence and Ascension remain committed to the District and are pleased to be able to respond to the community need for this extended period,” Patricia Maryland, president and CEO of Ascension’s care delivery arm, said in a statement stressing Providence’s shift to wellness and community health as opposed to traditional healthcare.
"While this delay is positive news, the future of the hospital remains precarious," said Ward 5 councilmember Kenyan McDuffie, in a statement. "It is imperative that Ascension … better communicate with workers, the public, government officials, and all other relevant stakeholders," he said.
The Providence emergency room did appear to be open Wednesday, when it was originally scheduled to close. But ER staff answering the phone couldn't say what the status of the hospital's acute care services would be moving forward.
The 283-bed Providence Health System announced in July it planned to transition away from acute care services to focus on population health efforts. When Ascension clarified this meant closing all services at the hospital except for a primary-care operation and a skilled nursing facility, workers and political advocacy groups were outraged.
D.C.'s Ward 5 is already underserved, community groups say. Though Ascension says it's transitioning Providence to best meet the needs to the community, critics say it's protecting its margins.
Ascension reported drops in operating income, revenue and volume for the first nine months of fiscal year 2018, which likely contributed to its decision to scale back Providence and brick-and-mortar facilities in favor of outpatient and telehealth services.
Providence staff protested the move over fear of losing their jobs, and patients joined in over concerns of care access.
More than 500 members of medical staff and roughly 1,300 employees overall could lose their jobs under the restructuring. Providence, one of Ascension's more than 2,600 healthcare facilities country-wide, defends the restructuring by citing the large number of providers in the area and that what the community needs more are population health programs, not another hospital.
In October, the D.C. Council voted unanimously to advance a bill requiring hospitals and other providers to get regulatory approval before being allowed to close. But it's unclear whether Mayor Muriel Bowser's administration intends to use the bill.
Providence's website and voice mailbox system do not reflect the change, which could be confusing for patients. Both maintain Providence will be closing Dec. 14, but Carroll Manor and primary care related services such as geriatrics and outpatient behavioral health will remain open.
Moving forward, Ascension “will be transforming the services Providence provides with a focus on the specific needs of the community, including primary and behavioral health, senior living and health services, community outreach and engagement; and access to care,” Maryland said in the Dec. 10 statement.
Ascension also reiterated its initial promise to invest over $30 million in Providence.