MORE THAN A year after Steward Health Care’s bankruptcy shuttered Carney Hospital in Dorchester and Nashoba Valley Medical Center in Ayer, the communities that depended on them are still trying to process why the state decided to save the other Steward community hospitals and leave theirs to close.  

This week on The Codcast, CommonWealth Beacon reporters Jennifer Smith and Hallie Claflin discuss Claflin’s long-read into the fallout for residents and health care providers trying to navigate system strain and longer travel times post-closure. 

Both in the Dorchester neighborhood of Boston and the more rural Nashoba Valley region, “the issues in health care that already existed in these communities were really exacerbated,” Claflin said. “They’re really drowning in it. And these hospitals were vital to them. Whether they had a declining patient volume or not, they were really vital to those people.” 

What once was a trip of just a few blocks to the Carney for Jane McInerney, a 69-year-old Dorchester resident who is wheelchair-bound with multiple sclerosis, is now a cross-city voyage. Getting care at multiple facilities across Greater Boston involves scheduling transportation through her insurance days in advance, and that’s after about a year of nailing down her array of new providers. 

“She told me, ‘I think that I’m probably just gonna start going to the doctor less,’” Claflin said. For older adults and those with mobility issues, delaying care can be life-threatening, Claflin noted. 

McInerney took Claflin to the shuttered Carney – doors boarded, trash accumulating. “Walking by a community hospital that served you your entire life and seeing those boards up, it kind of feels like walking by a gaping hole,” one local activist told Claflin. 

One rationale for the closures was lack of demand. But Steward’s reported census numbers excluded outpatient surgeries, medical imaging, and emergency room patients who weren’t admitted. Steward had been pulling staff and resources for months before closure, forcing patient transfers. 

And the system is feeling the pressure, Claflin said. The Carney saw 30,000 annual emergency visits that had to be absorbed somewhere. Boston EMS has seen a 20 percent increase in transport times. The Codman Square community health center now has a five-month wait for new primary care patients. 

Between rural Ayer, which has just two dedicated ambulances, and the surrounding Nashoba Valley region, 17 small municipalities lost their hospital. The strain on EMS has been severe. Fire departments operating with skeleton crews now transport patients one to three hours away instead of 15 minutes to Nashoba Valley.  

“If anything else happens in the town of Ayer, there is no ambulance,” Claflin said. 

Audra Sprague, an emergency room nurse at Nashoba Valley for 17 years, told Claflin the closure weighs on her constantly. “I think about this all the time,” she said. “Where are people going? Are they not going to the emergency room because it’s 40 minutes away?” 

What struck Claflin most was the residents’ sense of betrayal. After all this time, she said, “a lot of people still don’t understand why five hospitals were saved and the other two weren’t.” 

On the episode, Smith and Claflin discuss the immediate aftermath of the closures (10:00), EMS strain in rural communities (13:40), and how communities feel about the state’s lack of action (20:00).