Business & Tech

Somerville Hospital to shutter emergency department, open urgent-care center

Somerville Hospital’s emergency department entrance.
David L. Ryan/Globe Staff/File 2018
Somerville Hospital’s emergency department entrance.

Somerville Hospital, the 128-year-old medical center that serves the diverse population of a growing city, will close its emergency department and open an urgent-care center in its place next year.

The change means Somerville, for the first time since 1891, will have a large outpatient medical complex — but no hospital where patients are treated day and night.

The hospital building includes several primary care and specialist offices but shuttered its inpatient service a decade ago. Since then, the number of patients visiting the 24-hour emergency department has dwindled.

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Officials at the hospital’s parent company, Cambridge Health Alliance, said their decision is warranted because of changes in how local patients use health care services.

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“The patients that are going [to the Somerville emergency department] are for the most part going there for conditions that are urgent-care type conditions, and they’re largely going there at a time when urgent cares are open,” said Dr. Benjamin Milligan, chief of emergency medicine at Cambridge Health Alliance.

The board of the alliance — a public hospital system that also includes hospital campuses in Cambridge and Everett — unanimously approved the emergency room closure at a meeting Tuesday.

The decision follows an unsettling period for the organization.

Somerville Hospital made headlines after the death of 34-year-old Laura Levis, who tried to enter the emergency department early one morning in 2016 but found a locked door. Levis was suffering an asthma attack and collapsed outside the hospital. She was unconscious by the time emergency responders found her and later died.

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Levis’s husband wrote about her death in a Boston Globe Magazine story published last November.

Hospital officials said they have considered the emergency department plan for three years and that it was not related to the Levis case. They said emergency department visits at Somerville Hospital have declined 36 percent since 2008, to about 16,000 annually. Between 11 p.m. and 7 a.m., the emergency room typically sees less than one patient per hour.

As Somerville’s population changes, hospital officials said, younger residents are demanding more convenient and affordable health care options — including walk-in urgent-care clinics that can treat a variety of health problems at a lower cost than emergency rooms.

Patients usually pay lower co-pays to use urgent-care centers instead of emergency departments.

The urgent-care center that opens in place of the Somerville Hospital emergency department will be staffed by doctors and nurses, hospital officials said. It will open 9 a.m. to 9 p.m. and will be able to treat patients with minor ailments and those who need stitches, X-rays, blood tests, and IV fluids.

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After the change, the Highland Avenue facility will no longer receive ambulances or treat patients with emergencies such as heart attacks.

Mayor Joseph A. Curtatone of Somerville said he was disappointed by the decision and argued that hospital officials didn’t do enough to improve and expand emergency services for the city of more than 80,000 residents.

“They’ve made no major investments,” Curtatone said. “It was set up not to succeed.”

State Senator Patricia D. Jehlen said in a statement that Cambridge Health Alliance should have delayed the decision until after the appointment of a new chief executive. Its previous chief executive, Patrick Wardell, stepped down in June and Dr. Assaad Sayah is serving as interim chief.

The Massachusetts Nurses Association, a labor union that represents nearly 900 nurses in the Cambridge Health Alliance network, also opposes the closure.

Somerville emergency department nurse Lisa Valley-Shah said she’s worried that vulnerable patients — including the undocumented and the homeless — will suffer if they have to travel to Cambridge or Boston for emergency care.

“Taking away services, especially for these types of people, is such total disregard. People who come to us, it’s hard for them to navigate health systems,” said Valley-Shah, who is also a union official.

About 20 people work in the Somerville emergency department; hospital officials said all of them will be offered other jobs within the organization.

Cambridge Health Alliance must notify the Department of Public Health of its plans. The department can demand information, but it cannot stop a hospital from closing services.

After the circumstances around Levis’s death became public, Cambridge Health Alliance hired a law firm to investigate what happened. In a report in March, the lawyers’ report highlighted communication failures but stopped short of blaming any individuals. It also found a “lack of cohesion” at Cambridge Health Alliance, with finger pointing among staff, management, and board members.

Levis’s husband, Peter DeMarco, is promoting state legislation to help improve access to hospital emergency departments.

“I don’t know whether Laura’s death contributed to this decision in any way, but I hope the message to other hospitals out there remains the same: whether your ER sees 1,000 patients a day or 10 patients a day, it must have proper signage and lighting, security has to be in place 24/7, and staff must be properly trained on all aspects of patient safety,” DeMarco said in a statement.

“Regardless of whether an ER is struggling,” he said, “if you cut corners on any of those elements, someone could needlessly die.”

Some hospitals are seeing growing numbers of patients in their emergency departments while others are seeing fewer patients. Statewide, the number of annual visits across all emergency departments has been steady for the past three years, at about 3.1 million, according to data from the Center for Health Information and Analysis, a state agency.

A few miles from Somerville Hospital, Lawrence Memorial Hospital in Medford also recently closed its emergency department and expanded urgent-care hours in its place, after a sharp decline in patient numbers.

Priyanka Dayal McCluskey can be reached at priyanka.mccluskey@globe.com. Follow her on Twitter @priyanka_dayal.