Flatline: North Shore Medical Center on Life Support

Located at 1100 NW 95th St., North Shore Medical Center has been serving the diverse clientele of neighborhoods such as North Miami, Miami Shores, El Portal, Little River and the Upper East Side since 1953.

It’s a staple in the community, one where generations of families have been born and sought care, creating somewhat of a legacy on the more than 29-acre lot of land.

“Our hospital has been there for about 70 years,” said Jocelyn, a consultant who worked in women’s services for 11 years and declined to provide a last name. “So even though it’s a for-profit hospital, it’s really a community hospital for that inner-city, multicultural, diverse community.”

Those who know the hospital and know it well have recently been compelled to fear for its future – and for that of surrounding residents. Now that North Shore has officially closed the doors to its behavioral health, labor and delivery, and neonatal units, people are wondering if its owners are on the brink of bankruptcy.

The question remains: Where will everybody go?

Sent Into a Scramble

More than 150 laid-off staff members are transitioning to new positions or new hospitals, if not struggling to find employment entirely. Many feel the rug was pulled out from under them when news of the department closures dropped like a bomb earlier this year with little advance notice.

“This is the only hospital I go to,” said Dr. Christ-Ann Magloire, an OB-GYN whose solo practice has operated out of North Shore for 21 years. “I don’t have another hospital as a backup in order to provide care for my patients, so in one fell swoop they are basically shutting down my business.”

Magloire says the process for another hospital to validate her credentials and allow her to work out of its facilities could take anywhere from three to four months, and even then, space is not guaranteed.

It isn’t just the employees who are lost in transition, however. It’s the patients, too, many of whom may have no idea that their go-to hospital is no longer equipped to provide them with the services they’ve always counted on.

“The community has come to rely upon North Shore as a safe haven,” said Todd Wallace, a behavioral health unit technician who worked at the hospital for more than 21 years.

Since hearing of imminent closures in the hospital, the 1199SEIU United Healthcare Workers East union has been working to make sure that all contracts between the hospital and its laid-off employees are upheld in good faith. Vice president Roxey Nelson says the next step is to reach out to local and state politicians to better understand and mend the impact these closures will have on surrounding residents.

“We’re going to be loudly articulating what this loss means for the community and holding elected officials accountable to answering that question, because that’s whose responsibility that is,” said Nelson.

Where to Get Service

For those who may not know, the most closely situated hospitals to North Shore are Jackson Memorial Hospital and Jackson North Medical Center. Aventura Hospital is much farther away to the northeast and Mt. Sinai is on Miami Beach.

“We have been prepared for this,” said Vicky Sabharwal, vice president and CEO of Jackson Behavioral Health Hospital. “Even before the announcement, we knew that there could be a potential of hospital closures and we’ve been monitoring that, and we have initiatives in place to kind of help the entire health system.”

Joanne Ruggiero, senior vice president and CEO at Holtz Children’s Hospital and the Women’s Hospital at Jackson Memorial, says that her facility and those it partners with are additionally prepared to take on the more than 100 monthly births typically facilitated at North Shore.

“We have the capacity to take the patients,” said Ruggiero. “We have the structures to make sure that the care given to obstetric patients who come from North Shore is done in a way that both supports their original birthing options and in a way that ensures quality to them.”

Jackson Memorial, located about six miles south of North Shore, includes the free-standing acute psychiatric facility Jackson Behavioral Health, as well as a level 4 NICU with 120 beds. Jackson North, located about six miles north, has a level 2 NICU. There is also a 20-bed crisis stabilization unit known as Jackson Community Mental Health Center in Opa-locka, located about five miles north of North Shore.

“Regardless of who you are and your ability to pay, we’re here,” said Marie Sandra Severe, senior vice president and CEO of Jackson North.

Jackson Health System has been able to implement in-demand services that allows it to keep up with an ever-changing market, ensuring its relevance and feasibility. Those include telehealth appointments for patients who don’t have adequate transportation, a 24/7 crisis emergency room, and new-and-improved birthing options – all of which the folks over at North Shore had suggested for their own institution before its department budgets went dry.

Going Under

Despite the required 30-day notice, communicated initially on Jan. 11, staff members say the department closures were a surprise. Those working in the behavioral health unit knew psychiatric care was not proving to be very profitable at North Shore, especially in a vulnerable community with low-income, undocumented or homeless patients showing high rates of recidivism, but the pink scrub ladies – as they’re known over in women’s services – couldn’t believe that their level 3 NICU was suddenly hemorrhaging money.

North Shore did not respond to this publication’s request for comment, although staff members say the reasons provided to them had to do with low insurance reimbursement resulting in a lack of profit. They say the news came only months after having been reassured that the hospital was not at risk of undergoing any closures.

Despite the narrative, some directly blame Steward Health Care, the company that currently owns North Shore, for disinvesting in their respective units.

“They haven’t been improving things,” said a longtime therapist who asked not to have their name shared as they search for new employment. “We don’t have A/Cs running on the psych unit, the water filter was broken, the washer and dryer, the phones haven’t worked for a year for the patients, so we’ve been watching the demise.”

Others working in women’s services say they began to see their resources declining; things like dress tape just stopped getting ordered. They even had to borrow from other hospitals at times and the decline, they say, can all be tied back to when Steward first took over in 2021.

The company purchased five hospitals in South Florida from Dallas-based Tenet Healthcare Corporation in August 2021, including North Shore, Coral Gables Hospital, Hialeah Hospital, Palmetto General Hospital and Florida Medical Center (FMC). A year later, FMC received word that its behavioral health unit would be shut down.

“If you look at what happened when they first purchased the hospitals in South Florida, they immediately started closing the psychiatric units,” said Wallace.

Financial Crisis

Speculation among several employees suggests that Steward may be considering, or even be forced, to eventually close the hospital in its entirety. They see the recent opening of a new private school across the street as a sign of gentrification in the area. They’ve also observed people surveying the hospital campus land in recent months. Most notably, however, they know Steward is in financial trouble.

Formerly headquartered in Boston, the now Dallas-based company reportedly owed $50 million in rent to its owner, Medical Properties Trust Inc., as of January 2024. It is not in good favor with the host of its former home state, Massachusetts Gov. Maura Healey – who has refused to bail the company out and has in fact asked it to take its business elsewhere – and is the subject of more than a dozen lawsuits in the northeast state over unpaid invoices.

“What’s so sad is that Steward bought this hospital and every other hospital that they bought in Florida in underserved communities,” said a five-year assistant nurse manager who also asked for anonymity in fear of retribution from the hospital. “They bought in communities that were mostly on Medicaid and did not have insurance, so they knew exactly what they were getting into.”

Steward currently operates 33 hospitals in the United States across Arizona, Arkansas, Florida, Louisiana, Massachusetts, Ohio, Pennsylvania and Texas.

The company may be in deep waters, but it certainly isn’t alone. Many see Steward’s lows as a sign of the failures that come with a for-profit business model in health care, as well as of a nationwide crisis in mental health and maternity services.