The D.C. government is suing Providence Health System, alleging the Northeast D.C. hospital violated the terms of its newly renewed license by scaling back many of its services Friday.
The lawsuit, filed Friday in D.C. Superior Court by District Attorney General Karl Racine on behalf of the city, claims Providence and nonprofit owner St. Louis-based Ascension Health ended services without the approval of the State Health Planning and Development Agency, the D.C. Health regulatory body. It throws even more uncertainty upon the already heavily debated closure of a hospital that serves many lower-income residents.
Providence, which had originally intended to close all operations Friday in favor of an outpatient-focused “health village,” pivoted away from that plan in early December after pushback from city and community officials. Instead, it agreed to continue to run its emergency department and 10 inpatient beds for less severe medical cases through April 30 with plans to end ambulance service and inpatient, outpatient, acute and critical care and to transfer more severe patients to other hospitals starting Friday (click here for the list of services it planned to close Friday vs. April 30). But D.C. Health officials, as part of the lawsuit, now say they renewed the license to keep the full hospital running through that time.
In his suit, Racine is asking the court to stop the hospital from closing or winding down any services until it gets SHPDA approval, though that’s also been a point of contention and confusion in recent months. The D.C. Council passed legislation in October that authorized SHPDA, which oversees hospital expansions and openings, to also deny a closure request, but it’s remained unclear whether that law applies to Providence, which was already underway with its closure plans by then.
An initial conference on the lawsuit is slated for March 22, according to court filings.
Providence did not return requests for comment Friday or Saturday. We have also reached out to the offices of D.C. Mayor Muriel Bowser, Racine, D.C. Health and SHPDA and will update this post when we hear back.
At disagreement here is what Providence’s license — renewed Dec. 7 by D.C. Health — requires. It, as before, authorizes the hospital to operate up to 283 inpatient beds with a certain quality of care. Providence’s dwindling patient volume in recent years has meant that only 132, or less than half of those beds, have actually been in use, which coupled with mounting losses led to the hospital’s initial plans to shut down.
But D.C. Health issued the new Dec. 7 license “with the understanding that Providence had agreed to continue to operate as a fully-functioning hospital,” according to a declaration by Director LaQuandra Nesbitt, filed Friday with the lawsuit. She said an Ascension press release issued after the license renewal contradicted its previous representation of what it would operate. “DOH does not issue licenses for free-standing emergency departments,” she said in her declaration.
Further, the law requires hospitals with emergency departments to provide a medical screening exam to anyone who comes and requests it and “prohibits hospitals with emergency departments from refusing to examine or treat individuals with an emergency medical condition,” Nesbitt said. Providence is in violation, she said, “by actively discouraging the arrival of patients by emergency vehicles and attempting to limit patients to those with less serious healthcare issues.”
By late Friday, Providence issued a statement that expanded the emergency services it would offer beyond its original statements earlier in the week.
“This is to clarify a previous communication regarding Providence Hospital operations. Providence’s Emergency Care Center remains open, fully staffed, and available to serve the District of Columbia community, with the same range of services that we have always provided to support our emergency care patients, including an inpatient unit, lab, diagnostic imaging, respiratory care, discharge planning, and other ancillary services and support,” the statement read. It also said the hospital “will continue to operate the emergency care center through April 30, 2019, as previously described.”
“Further,” the statement continued, “Providence will continue to maintain primary care services both on campus and at the Perry Clinic, outpatient behavioral health services, the Center for Infectious Disease, Carroll Manor, and services at the Police & Fire Clinic and Catholic University of America Student Health” — some of which have always been part of the plan, and some of which are eleventh-hour changes that were slated to shut down until Friday.
SHPDA has remained largely quiet through the process, though Director Amha Selassie sent a letter Dec. 5 to Providence that said it found deficiencies in the hospital’s April 30 closure plan, including a lack of information on how the hospital planned to transition patients, transfer them to other hospitals or pay for the closure. He said the hospital must submit a revised closure plan before April 30 to address those issues before it could terminate services.
An extension of Providence’s emergency services into April 30 was welcome news for other D.C. hospitals. “This transitional step will greatly support the city as we approach winter flu season and the increase of patients needing care it brings,” said MedStar Washington Hospital Center President Gregory Argyros in a statement to the WBJ Friday. “It will also provide additional preparation time for all city providers to effectively align medical service offerings, so our community members continue to receive the care they deserve.”
