The merger is expected to be approved Wednesday, June 10.
WESTFIELD - The Massachusetts Nurses Association, a union that represents about 100 of Nobles 750 employees, is cautiously optimistic on the eve of Noble's purchase by the much larger Springfield-based Baystate Health.
"Noble has always prided itself on going alone," said Paul Dubin, a 27-year nurse at Noble and co-chair of the nurses local bargaining unit. "But to be honest, in this health-care climate it makes sense to have a support system. A lot of hospitals are moving toward at least affiliating with another network. Baystate seems to be someone we can work with."
The Massachusetts Health Policy Commission is expected to approve Baystate's purchase of Westfield's Noble Wednesday at the commission's regular June meeting. It's the last of a long series of regulator hurdles and real changes at Noble which are expected to start at in July.
Neither Noble management nor Baystate executives are talking specifics now, but Baystate has promised to keep inpatient care at Noble and to add specialties from its Springfield headquarters to Westfield operation.
The purchase price has not been disclosed.
Noble and Baystate announced back in March that their boards were contemplating an "affiliation". The word "acquire" is being used now.
Health care providers are consolidating across the state, said David Schildmeier, director of public communications for the Massachusetts Nurses Association/National Nurses United.
Medicare and Medicaid reimbursement rates do not cover the cost of care. New payment systems encourage providing quality health care to populations and preventative care, not payments based on procedures or tasks performed.
All this makes it tough for independent hospitals and encourages operators to seek out economies of scale.
In September 2014, Baystate took over Wing Memorial Hospital in Ware from the UMass Memorial System.
Northampton's Cooley Dickinson affiliated with Boston's Massachusetts General Hospital in 2013. Partners HealthCare, of which Mass. General is a part, also has plans to take over Harbor Medical Associates on the South Shore.
Lahey Hospital and Medical Center in Burlington recently bought hospitals on the north shore.
The wave of mergers means that only Holyoke Medical Center will remain as an unaffiliated hospital in Springfield.
The union's contract with Noble, which won't expire until March 2016, has a successor clause meaning Baystate must honor it, Schildmeier said.
Baystate's relationship with the Nurses Association suffered during contract talks at Baystate Franklin in Greenfield which were settled in 2014. But things are improving in recent years.
Dubin said he met with union-member nurses from both Baystate Franklin and Baystate Mary Lane in order to learn more about the current working relationship. He came away satisfied of a cooperative environment.
"Our goal in all of these situations is to preserve hospital services in these communities," Schildmeier said. "Our problem with all of this is that in that process of consolidation, poorer communities tend to suffer. North Adams is a perfect example."
North Adams Regional Hospital, which had 121 beds, shut down abruptly in March 2014, leaving 40,000 residents in northern Berkshire County without access to a local hospital and 500 people out of work.
Westfield is more prosperous than hard-hit North Adams, Schuildmeier, a Westfield State University alum, said.
The Census Bureau said the average household income in Westfield was $59,588 from 2009 to 2013. That's less than the statewide average of $66,860 for the same time period but much better than North Adams which averages a household income of $38,317.
But Westfield has its challenges, the union told the State Department of Health at a recent hearing concerning the purchase. Westfield has 40,000 residnets and there are thousands more in surrounding towns. There are 8,000 people aged 60 or more in Westfield.
Westfield also has a growing population of immigrants including Nepali refugees and those of Iraqi, Afghan, Burmese and Ukrainian origins, the union said. There is a growing population of Spanish speakers as well.
More than 25,000 patients visit Noble's emergency department each year, and they average over 4,000 inpatient discharges and 44,000 outpatient visits each year.
Documents on file with the Massachusetts Attorney Generals Office show that Noble has been struggling. In 2013, the most recent year for which an audit report is available, it listed $64.6 million in revenue and $67.1 million in expenses to make an operating loss of $2.4 million.
IRS documents, also on file with the state Attorney General's Office, say Noble's land and buildings were worth $12.69 million in 2012, the most recent document available.
The same document lists Noble CEO Ron Bryant's compensation as a total of $387,127, also in 2012.
Baystate Health has a total of 11,500 employees at Baystate Medical Center in Springfield, Baystate Mary Lane in Ware, Baystate Franklin in Greenfield, Baystate Wing in Palmer and other assorted operations. Of those, 6,100 work in Springfield, the 761-bed hospital that also serves as Western Massachusetts' only Level 1 Trauma Center, and has the second-busiest emergency room in all of Massachusetts.
Baystate Health's planned purchase of Noble Hospital agenda
