A group of nurses and community members gathered outside of Providence Hospital in Washington on Dec. 11 to protest the upcoming reduction of services in the hospital’s Pope Francis Emergency Care Center. Though the hospital was originally scheduled to stop all emergency services on Dec. 14, along with the majority of the hospital’s other services, community and government opposition has led Ascension, the Catholic health system that owns Providence, to decide to temporarily keep limited emergency services operating.

“Reflecting its continued commitment to the residents of the District of Columbia, Providence Health System will operate its Emergency Care Center with necessary support services through the current flu season,” confirmed Ascension in a Dec. 10 statement. “The Emergency Care Center will remain open through April 30, 2019 and supported by services needed for emergency care, including lab, diagnostic imaging, respiratory care, discharge planning, and other ancillary services and support.”

WAMU reported on Nov. 30 that according to the District of Columbia Hospital Association, Providence’s Emergency Care Center will continue to serve only low acuity patients and operate just 10-15 inpatient beds to support emergency care services. Though Ascension did not make any public announcement about how they are limiting the services, National Nurses United said in a Dec. 10 press release that hospital nurses have been told that the continuing services will not include an operating room or an intensive care unit.

National Nurses United also reported that nurses at the hospital plan to file an unfair labor practice charge with the National Labor Relations Board this week, because Ascension is providing severance packages to all laid off employees of the hospital, except for the nurses.

The Dec. 11 protest was just the latest of the community opposition over the past few months, after Ascension announced over the summer that it would close all services at the hospital except for primary care and Carroll Manor on Dec. 14. Though community members at the protest celebrated the fact that they would not be seeing a chained link fence going up around the hospital on Saturday, they also worried about what will happen when services are scaled back in just a few days.

“Our victory is not complete,” said Stephen Frum, a labor representative for National Nurses United, noting that Ascension is offering them a small and potentially dangerous hospital, where patients would have to transfer to a different hospital if their condition worsened.

“…We don’t want a situation where if you are sick in this hospital you have to dial 9-1-1 for help,” he said.

Joseph Cassidy; an emergency room nurse at nearby Washington Hospital Center, which will be absorbing many of the patients that would have gone to Providence’s emergency care center; noted that in the type of work he does in emergency care, “minutes are crucial.”

“To travel from here to Washington Hospital could be enough to cost someone their life,” he said.

Defending their decision to close the hospital, Ascension has cited declining hospital revenue and information from D.C.’s 2016 Community Health Needs Assessment.

“To be clear, the decision to close Providence Hospital was not an easy one. For many years, Providence has been performing very poorly financially. Providence is simply not serving this community in a sustainable way: its discharges have been declining over the past five years, and the District of Columbia's data show that the hospital is underutilized,” Ascension said in a statement. “Further, studies have indicated that the highest healthcare needs in the D.C. community include providing place-based care and care coordination. Instead of investing in an underperforming hospital facility, we are committed to transforming Providence into a new healthcare delivery system.”

Opponents of the closure fear that it will further exacerbate already existing socioeconomic and racial disparities within Washington, as 87 percent of the hospital’s patients are insured through either Medicare or Medicaid and 82 percent of its patients are African-American. In an effort to prevent the hospital from closing, the D.C. Council passed a bill on Oct. 16 that requires hospitals to get approval from the city’s department of health before closing.

“The whole reason a lot of us came to work here in the first place is St. Vincent de Paul...giving care to those who need it most,” said registered nurse Bart Barrows, who has worked at Providence for nearly 32 years. As he said this, he pointed at a statue of the saint that loomed over the protest crowd gathered in front of the hospital. St. Vincent de Paul, who is known for his care for the poor, founded the Daughters of Charity, who founded Providence Hospital in 1861.

“The importance of us being here is that this is the hospital where the poor come and it is important that we save the hospital primarily for that reason,” said Brother Brian McLauchlin, who lives near the hospital with his religious community, Divine Word Missionaries. “The Gospel instructs us that we need to take care of the poor and disenfranchised.”

A representative from the Metro Washington Labor Council, who is Catholic, said, “I appeal to the Catholic Church…do the right thing. This is not what we believe in…this is not what the Catholic Church is about.”

A group of local and national Catholic leaders issued a statement on Nov. 29 urging Ascension Health to stop their plans to close Providence Hospital, noting that just three years ago, Cardinal Wuerl dedicated the Providence Emergency Department named for Pope Francis. Given that dedication, the Catholic leaders said they felt, “It would be an embarrassment to His Holiness to see this Emergency Care Center shuttered now.”

The Catholic leaders who signed the statement included Father Patrick Smith, pastor of St. Augustine Catholic Church; Father Kevin Thompson, administrator of the Shrine of the Sacred Heart; and several Catholic orders and organizations, including the Conference of Major Superiors of Men, Discalced Carmelite Friars, the Franciscan Action Network, Franciscan Sisters of Our Lady of Perpetual Help, and Pax Christi USA, a Catholic group that promotes peace.

The statement noted that Ascension was granted public juridical person status by the Vatican in 2011, which means it is bound by the Ethical and Religious Directives for Catholic Health Care Services.

“Those directives include an obligation to ‘distinguish itself by service to and advocacy for those people whose social condition put them at the margins of our society,’” the statement said. “Should Ascension prevail in its efforts to close Providence Hospital, Ascension would be abandoning its core mission as a Catholic health care provider.”

Providence Hospital closed its labor and delivery unit last year, which the Catholic leaders said resulted in “forcing other hospitals to deal with the reverberations.” 

“That this happened in the midst of a maternal mortality crisis in the District of Columbia is all the more galling,” the statement said. “Pregnant African-American women in Washington, D.C. are dying at a higher rate than pregnant women anywhere else in the nation. Infant mortality in Ward 8 in southeast D.C. is more than double the national average, at nearly 15 deaths per 1,000 live births. Notably, the infant mortality rate just a few miles away in the wealthiest of D.C.’s wards is just 2.2 deaths per 1,000 live births.”

Closing emergency care at the hospital will have similar reverberations around the city, they said, noting that between 2014 and 2016, the number of emergency room visits at Providence Hospital increased by more than 25 percent for a total of 142,000 ER visits. 

Though the Emergency Care Center is now scheduled to remain open for a few more months, D.C. Councilmember Kenyan McDuffie said, “While this delay is positive news, the future of the hospital remains precarious. As we await further details, it is imperative that Ascension – the owner of Providence Hospital – better communicate with workers, the public, government officials, and all other relevant stakeholders.”