Tenet Healthcare Plans To Turn Over ER Operation Of MetroWest Medical Center To Tennessee Company

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FRAMINGHAM – On Tuesday, January 24, MetroWest Medical Center CEO David Elgarico informed the emergency room doctors that come May 2023,  Tenet Healthcare will use a private for-profit company out of Tennessee as the “Emergency Medicine provider.”

A day later, Tenet Healthcare announced CEO Elgarico had resigned as CEO of MetroWest Medical Center. Elgarico was the 6th CEO at MetroWest Medical Center since 2017.

He replaced Ava Collins, who resigned in April 2022. Collins announced her resignation a week after Tenet Healthcare announced the cancer center at MetroWest Medical Center would close. Tufts Medical took over the Cancer Center earlier this month.

According to an email SOURCE obtained, Elgarico told the Metrowest Emergency Physicians group on Tuesday that Knoxville, Tennessee-based TeamHealth will be the emergency room provider come May of 2023.

“At MetroWest Medical Center we are constantly evaluating our operations to deliver high quality care and an excellent patient experience, while also providing value for our customers. In May, we will be transitioning to TeamHealth as our Emergency Medicine provider. As you are aware, TeamHealth already provides Hospital Medicine services at MWMC.  The decision to also transfer ED services to TeamHealth was made after careful review of anticipated opportunities for a single provider to increase continuity of care for our patients from the emergency department to inpatient services,” wrote Elgarico in an email.

TeamHealth is the nation’s largest staffing firm for ER doctors.

“TeamHealth will be tasked with increased focus on streamlined throughput in the Emergency Department, clinical integration and enhanced communications between the ED and hospital inpatient services. TeamHealth has a track record of delivering high quality ED care at our sister facilities across the country, including at trauma centers and teaching hospitals.  We look forward to coupling TeamHealth’s metric-driven approach with MWMC’s expertise to continue to elevate the care provided in our ED,” wrote Elgarico, who started as CEO at the end of June of 2022.

“We are grateful for the excellent care that you and your colleagues have provided over the years. TeamHealth representatives will be on site tomorrow to answer questions for those of you who would like to continue employment with them, and you will also be hearing from them via email shortly.More information will be forthcoming on transition plans, but please let us know if you have questions in the interim,” wrote the CEO the day before it was announced he had resigned.

“Emergency medicine programs across the country face universal challenges ranging from consistent staffing to fluctuating volumes and everything in between. Not to mention the administrative burdens that often plague teams and disrupt care. TeamHealth’s stable, scalable emergency medicine services take ED efficiency to a new level. Our partnerships transform team performance and improve throughput so facilities can better care for their communities,” according to the TeamHealth website.

However, MetroWest Medical Center’s ER department has been under the leadership of Dr. Lisa Sotir for more than 15 years.

Dr. Sotir has been the chair of Emergency Medicine at MetroWest Medical Center since 2007. Dr. Sotir has been the president of the President of the MetroWest Emergency Physicians group since July of 2007, as well. She is also a member of the hospital’s Board of Trustees since 2018, and had been its chair between January of 2020 and December of 2022. She has been at the hospital for more than 25 years.

Most ER doctors aren’t employees of the hospital where they work. Historically they belonged to doctors’ practice groups.

In the last decade, private investors staffing firms like TeamHealth and KKR-owned Envision Healthcare have come in to take over ER managements and staffing.

On it website, TeamHealth, a for-profit company stated it is (see graphic below)

Revenue from staffing ERs represents the majority of TeamHealth’s revenue from contracted physician services, according to Fitch, which downgraded its long-term rating for TeamHealth in late 2022.

Fitch said the physician staffing firm is expected to face continued pressure on emergency room volumes and pricing.

The credit ratings firm also removed its positive outlook for TeamHealth as it expects the company’s earnings before interest, taxes and depreciation to decline by nearly 30%.

Fitch also raised concerns about TeamHealth’s high debt leverage elevating its near-term risk of default.

SOURCE asked Tenet Healthcare for a statement about the emergency room change.

“I have felt for years now that this hospital has struggled to keep up due to it being owned by an out of state for profit company.  At this point it feels like the struggle has ended and now it is just imploding,” said Framingham at-large City Councilor George P. King jr. “It is frightening for anyone that has to go there and it is sad for our community and particularly for the people who have spent their lives working there.  We have to rid ourselves of Tenet before they rid us of our hospital.  It certainly sounds like the place is becoming almost inoperable.” 

Yesterday, January 25, Tenet Healthcare announced Massachusetts Market for Tenet Healthcare’s Chief Financial Officer John Whitlock will serve as interim CEO for MetroWest Medical Center.

““While the nurses, physicians, and staff of MWMC remain deeply committed to serving the people of Framingham and MetroWest, it has become alarmingly clear that Framingham simply can no longer rely on Tenet’s stewardship of the hospital. Perhaps a Massachusetts-based owner and operator would more effectively meet the standards necessary to operate a thriving medical center in Framingham,” said Framingham City Councilor Michael Cannon, who heads the Council’s economic development subcommittee. “I am hopeful that state leadership and regulators can hold Tenet accountable and develop a plan for a change in ownership, so Framingham residents again have a trusted point of care in their community; and our world-class nurses, doctors, and staff also have an employer they can count on.”

TeamHealth is owned by the Blackstone Group, a private equity firm.

In 2017, Blackstone acquired TeamHealth and its subsidiary Southeastern in a $6.1 billion deal.

The hospital has been having issues since Christmas weekend, when it began diverting ambulances from its labor & delivery department.

It continued to divert ambulances for three consecutive weekends.

The chair of the OB/GYN department stepped down.

In December, short staffed, Tenet Healthcare combined the ICU and CVU units, at MetroWest Medical Center in Framingham.

Dallas-based Tenet Healthcare has been closing services at MetroWest Medical Center since 2020.

In the middle of the pandemic, Tenet closed the pediatric unit.

Last year, the hospital wanted to close the cancer unit, until Tufts Medical agreed to take it over earlier this month.

Staff are worried that Tenet is looking to close labor & delivery at MetroWest Medical Center. The closest hospitals for maternity patients would be Newton-Wellesley Hospital, Milford Hospital or Emerson Hospital in Concord.

The 11-member City Council and the Mayor had a length discussion about the hospital at its first meeting in January.

Dallas-based Tenet Healthcare owns MetroWest Medical Center in Framingham & Natick and St. Vincent Hospital in Worcester, which has 10-month long nurses strike between March of 2021 and January of 2022. MetroWest Medical Center is non-union.

Tenet Healthcare has owned MetroWest Medical Center since 2013, when the Dallas-based company acquired the Nashville-based Vanguard in a $1.8 billion deal.

Tenet had previously owned MetroWest Medical Center and Saint Vincent Hospital in Worcester but sold the facilities to Vanguard Health in 2004 for $126.7 million.

Despite the pandemic, Tenet Healthcare ended 2021 with a net income from continuing operations of $915 million.

The CEO of Tenet-Healthcare, which owns MetroWest Medical Center is Dr. Saum Sutaria. His base salary is $1.15 million, but his total compensation in 2021 was $21.14 million. Total compensation includes salary, bonus, stock and option awards, non-equity incentive plan compensation and all other compensation.


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