What will happen to Carney Hospital?

As deals to save five Steward Hospitals are under review, many residents of Boston’s southern neighborhoods are feeling the familiar sting of disregard and disinvestment.  The impending loss of Carney Hospital has opened a painful wound in health care inequities in the city. The abrupt announcement by Steward Health to sidestep normal regulatory procedures and fast track closure of Carney Hospital in Dorchester and Nashoba Valley Medical Center in Ayer is another slap in the face for hospitals serving the most vulnerable and for the communities who have relied on them. 

For 150 years, mission-driven Catholic hospitals formed an essential part of the backbone of our hospital safety net, clinging to the mantra of never turning anyone away and of caring for the “least of these.” 

This ethos has been central to many of the hospitals that make up the Steward hospital chain in Greater Boston (formerly Caritas Christi Health Care), which was sold to private-equity backed, for-profit ownership in 2010. Now Steward plans to discontinue services in Dorchester and Ayer on August 31.

Carney is closing on the heels of dramatic financial mismanagement and bankruptcy – but the trajectory of Carney’s closure is not an anomalous case. Across the country, for-profit systems are buying up struggling hospitals, ostensibly in a last-ditch effort to save them, only to watch them shutter years later. 

In Philadelphia, first Tenet (in 1998), then Paladin Healthcare (in 2018), purchased Hahnemann Hospital, subsequently announcing its closure in 2019. In California, Prime Healthcare bought Centinela hospital in Inglewood, in 2007, closing labor and delivery in 2023.  Purchasing struggling hospitals with the promise of bringing them into solvency, but instead gutting and closing critical service lines, appears to be part of the private equity playbook. 

Along with the Massachusetts Nurses Association, 1199SEIU, elected officials, and community members, we should join the chorus of staunch opposition and disgust at this closure. Carney is a high public payer hospital — over 75 percent of its patient revenue comes from Medicaid and Medicare. The hospital is a vital source of emergency behavioral health services (70 of its 159 beds are psychiatric), at a time when behavioral health resources could not be more needed. With Carney’s closure, the broad swath of Boston’s southern neighborhoods will be without proximate care.   

Adding insult to injury, the Carney closure comes at a time when communities of color are reeling from worsening health issues. Recent data from the Massachusetts Department of Public Health found that while opioid-related deaths decreased in the state in 2023, they increased in Boston, and increased among Black and Latinx communities in particular. 

Between 2016 and 2022, Black non-Hispanic Massachusetts residents had the highest rate of behavioral health ED visits, by far, than any other racial group, reflecting by extension the disproportionate housing insecurity these populations face. It comes at a time when a gaping racial life-expectancy gap, (shaking out along the lines of Boston’s deeply racially segregated neighborhoods) and racial wealth gap are top of mind for city and state officials and community activists. 

The southern neighborhoods of Boston are home to the greatest percentage of Black/Latinx Bostonians (Mattapan, Dorchester, and Hyde Park, for example).  Moreover, the neighborhood of Hyde Park, the most southern neighborhood in the city, lacks a community health center, requiring residents to commute to other neighborhoods or often to the suburban towns of Norwood or Dedham to receive care. In Boston, a globally renowned center for academic medicine, this is unacceptable. 

I commend members of the Massachusetts House and Senate for each chamber’s recent passage of hospital oversight legislation that would begin to reform the regulatory environment that opened the door to Steward.  Unfortunately, the legislation did not make it through the legislative process to reach the governor’s desk. With the Legislature stalled, it will take executive action to see the changes necessary. We must fight like hell to maintain acute inpatient care, emergency services, and behavioral health at the Carney. Swift and compassionate action now is a matter of life and death, especially for our most marginalized communities. 

Alecia J. McGregor is a faculty member in the Department of Health Policy and Management at the Harvard T.H. Chan School of Public Health. She resides in Hyde Park. The views expressed here are her own, and not representative of any institution where she is employed or boards on which she serves.