'Extremely challenging for us': Nashoba Valley hospital closure stresses fire departments

GROTON ― Fire Chief Arthur Cheeks was asked how his department is managing since Nashoba Valley Medical Center in Ayer closed Saturday.

His answer told the story of a Groton department struggling to meet the demand for emergency medical calls.

“It’s been fun,” said Cheeks with a laugh, but the sound wasn't one of humor.

Cheeks and other fire chiefs in communities around the shuttered Nashoba hospital lamented that it’s taking more time for their ambulances to take patients to other hospitals versus the quick turnaround when Nashoba was in business.

In some cases, the towns are left with little or no coverage to handle other emergency calls while ambulances are out on the road traveling to other hospitals like Emerson Hospital in Concord, UMass Memorial HealthAlliance-Clinton Hospital in Leominster and St. Joseph Hospital in Nashua, New Hampshire.

“It’s been extremely challenging for us,” said Cheeks.

Bankrupt Steward Health Care closed Nashoba Valley Medical Center because it said no qualified buyers stepped up to take it over. Reports indicate the state is exploring options for some type of health services at the former hospital, but Gov. Maura T. Healey said there was nothing her administration could do to keep the hospital open.

Advocates expressed concern about how the hospital's patients, many of them low-income and on government insurance, would be able to get to other hospitals.

Steward notified state health officials that only 3.3% of patients in Nashoba Valley felt that transportation is a barrier to health care. Travel times to nearby hospitals ranged from a manageable 21 to 45 minutes, according to Steward.

Ambulance trips taking up to two hours

However, in some cases, that time window doesn’t match what fire chiefs are seeing. Cheeks said his department's ambulance used to have a 30-minute round trip to Nashoba, but it can take up to two hours round trip when going to UMass Memorial in Leominster.

Some fire departments have full-time staff while others augment with mutual aid, which means firefighters in other towns can help out in a pinch. Or some departments can supplement with so-called call firefighters who are volunteers in many cases and serve when needed. However, there is no guarantee those backups are available.

Life-or-death proposition

“Time is of the essence,” said Cheeks, because longer travel times can result in life-or-death situations, not only for patients in ambulances but also in cases of understaffed firehouses resulting from longer ambulance trips. What's left behind is staffing that can't adequately respond to calls coming in for fires and other emergencies.

In Ayer, Fire Chief Timothy Johnston said Sunday was a busy day, with both of the department's ambulances out on calls, leaving little coverage back at the firehouse.

With 39 years of service as an Ayer firefighter, Johnston doesn’t remember a time when quick transports to Nashoba weren't the case. That changed when the hospital closed.

“Certainly, for us it’s challenging,” said Johnston, noting that ambulance trips to Nashoba averaged 2.7 miles. Now, the trips are split between 12 miles to UMass Memorial in Leominster and 16 miles to Emerson.

Another change is the loss of Nashoba's helipad, where choppers flew out critical patients to other hospitals for more advanced care. A new helipad is set up at the baseball field at the local regional high school, according to Johnston.

Meanwhile, since Nashoba closed, two ambulances are parked outside the hospital and will stay there for a week, according to Johnston, in case sick patients arrive, unaware the hospital has closed. One ambulance is operated by Steward, said Johnston. The other is run by the state and will take patients to other hospitals, if needed.

Handling emergency calls, for now

In Pepperell, the Fire Department is adequately handling emergency calls, said Fire Chief Brian Borneman. Ten came in Tuesday, and while they were covered, Borneman feels that’s the case because we're in a stretch of nice late-summer weather.

He worries about what will happen when snow and ice hit the scene in winter, when cold and flu season arrives. More emergency calls will arise, and when Pepperell's ambulance is on the road to UMass Memorial in Leominster or hospitals in southern New Hampshire, some emergency calls could fall through the cracks.

“Definitely, the impact of Nashoba closing is going to be felt longer-term,” said Borneman.

There's also the issue of stocking the ambulance. Borneman’s department used to get supplies at Nashoba, but now it’s a longer trip to the Leominster hospital. That takes the ambulance out of service for a longer stretch, potentially risking coverage for other emergencies.

Impacts likely coming

Like Borneman, Devens Fire Chief Timothy Kelly hasn’t seen his department struggling to provide ambulance service. However, Kelly noted it’s only been a few days since Nashoba went offline and the impacts are likely coming.

What concerns Kelly is that his department has only one life-support ambulance, staffed 24 hours daily by full-time shifts. If someone calls out sick, he makes a call to an off-duty staffer, but that leads to significant overtime costs.

The department also has a more advanced life-support ambulance on the way and a decision must be made on whether to keep both ambulances. More emergency calls expected after Nashoba's shutdown could be a major factor in the decision.

What is the solution?

Longer ambulance trips that leave firehouses understaffed is causing local chiefs to think about solutions in the months and years ahead.

The chiefs have held weekly meetings since early August to discuss how to deal with the fallout from Nashoba’s closure. Hiring more firefighters has been a topic of conversation and that presents a budget challenge. Also, finding additional qualified staff won’t be easy because there's not enough supply of paramedics, especially firefighter paramedics.

“Unfortunately, there’s not a lot of folks out there,” said Kelly.

Big picture: A health care challenge in Mass.

More staff in the towns surrounding the shuttered Nashoba could spread out coverage for the area's ambulance trips, said Borneman. However, Nashoba's closure is just the latest example of a health care challenge in Massachusetts, he said, because there’s not enough hospital capacity to meet patient demand.

Borneman's department is living that challenge. Its ambulance recently took patients to the Leominster hospital, where there were delays to get patients admitted because the scene was “mobbed,” according to Borneman.

With Nashoba and the closure of Carney Hospital in Boston, another former Steward hospital out of business, Borneman sees the statewide capacity limits getting tighter.

He also worries that patients will put off their medical appointments because of these inherent problems, much like they did during the COVID-19 pandemic. The result, he said, could be a wave of emergency ambulance calls that will be tough to meet now that Nashoba is closed.

Without an influx of more staff, Cheeks feels there will be more reliance on mutual aid. The problem with that scenario, said Cheeks, is that other towns are in the same difficult boat.

“There may be moments when mutual aid is even delayed,” he said.

Ultimately, more staff will help, but Cheeks noted it comes with added costs for taxpayers.

“The solution is looking at how we as a group of area chiefs can give support to our staff and our towns to minimize delays and give the services we say we do,” he said.

Contact Henry Schwan at henry.schwan@telegram.com . Follow him on X: @henrytelegram .

This article originally appeared on Telegram & Gazette: 'Extremely challenging for us': Nashoba Valley hospital closure stresses fire departments