Credit: Darrow Montgomery

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The bulk of Providence Hospital’s 12-member board of directors was abruptly fired last night via an email sent on behalf of the hospital’s managing body, according to a copy of the email obtained by City Paper

Their firing is the culmination of a weeks-long behind-the-scenes tussle to keep the hospital’s acute care services open, adding another layer of drama to Providence’s fraught transition away from urgent care. The hospital is the longest continuously running hospital in the District of Columbia, and has operated since President Abraham Lincoln signed its charter in 1861. 

Ascension—the largest Catholic health system in the world, and the organization that manages Providence—announced at the end of July that Providence would stop offering acute health services by the end of 2018. Protests on the campus itself by its staff and patients this week highlighted the swiftness of the decision, with doctors telling WAMU that they were caught off guard by Ascension’s decision.

In the organization’s announcement last month, it said ending acute care would make way for other kinds of necessary services like “care coordination, telehealth/virtual care, primary and urgent care, home care, community-based behavioral healthcare, senior care and more.”

A former member of the hospital’s board tells City Paper that Ascension first floated the decision to end acute care at the hospital via a resolution introduced at a July 23 board meeting. The organization’s chief allegedly waited for the meeting’s conclusion to present the resolution to the board, several of whose members had already left the meeting.

“There was no notice of, ‘Hey, stick around, because there’s a pretty big change in how we’re planning to operate,’” the former board member says. The individual adds that decisions of that magnitude would first typically be run through the board’s finance committee before a formal introduction to the board at large. “Maybe we’d even have a special board meeting just to discuss this,” the former member says.

The board nevertheless adopted this resolution, largely because, the former board member says, the body understood it to mean that one facet of the hospital’s programming would end, but that the larger institution would survive. They soon believed that the resolution “was a play to say, ‘We’ll close acute care,’ to downplay the overall closure” of the hospital, the former board member says.

On August 1, Providence’s board sent an email to Ascension chief Anthony R. Tersigni and executive vice president Patricia Maryland, the latter of whom is the new head of Providence’s board of directors. It condemns “Ascension’s decision to close Providence Hospital,” which “resulted in serious concerns among the hospital’s Board of Directors and others.” The email reads, in part:

The Board was informed of the closure as the final agenda item of a regularly scheduled meeting of the Board of Directors, less than 30 hours before Ascension’s public announcement. Prior to this, the Board was not consulted regarding the decision itself, the alternatives that had been considered, if any, or the timing and execution of the final decision. Alternatives to closure, and their financial impact, were never discussed with the board. Ascension never provided a 1, 3, or 5 year plan for the “transformed” Providence or health village, or adequate information which presented a clear vision for the role of Providence once the hospital was shuttered. […]

It was abundantly clear at that moment that Ascension’s decision to close Providence was a fate accompli, one that was inevitable and irreversible. Equally as clear, is the perception of the Board that its lack of inclusion in the final decision making process appeared deliberate, disingenuous, and in bad faith by Ascension leadership, resulting in the Board’s perception that their opinion was of no consequence or value.

The Board is also concerned about the way in which this decision has been presented to the hospital’s constituencies. Ascension should avoid any future reference to the Board as having been part of the final decision making process. To be clear, the Board of Directors was never involved in the final decision to close the acute care services and Pope Francis Emergency Care Center.

The board convened two special meetings, on August 8 and 19, respectively, to discuss the closure of Providence’s acute services. It ended up introducing and passing a resolution to rescind its July approval of the program changes. “We were told by Ascension to keep this [vote] to ourselves, because announcing it would just cause more chaos and pandemonium,” the former board member tells City Paper. “We’ve just kind of been bullied every step of the way.”

At 6:35 p.m. on Thursday afternoon, the board received an email notifying it that its members, excluding three people, were fired.

“Because we understand the difficulty and pressures a local board faces when a decision is made to close a community hospital, Ascension Healthcare has made the decision to downsize and reconfigure the current Providence Hospital Board of Directors. This is consistent with our practices in other markets where we have made the decision to exit acute care. Accordingly, effective as of August 30, 2018, Ascension Healthcare has removed the current Providence Hospital Board members,” the email says. 

When asked about the board’s termination and the August 1 email, a spokesperson for Ascension tells City Paper that the board “has been reconfigured so that a new Board of Directors can advance Providence’s transformation in the community.”

The spokesperson continued: 

The new Board will help guide this transformation under the same three core principles that has served as a foundation throughout this process: commitment to the Mission, that Providence is not leaving the District, and that Providence will be transitioning to best serve the needs of the community.

Providence will have an ongoing presence in the District of Columbia. The new Board will focus its oversight on the collaborative work underway to create a model that will keep health at the center, remove obstacles and barriers to a healthy life for all, and better meet the needs of a changing and growing community.”

The board’s termination email ended with a line thanking members for their service.