MGH asks state for 94 additional beds

Would expand clinical facility being built

Massachusetts General Hospital is asking the state for permission to add 94 new beds to its massive downtown construction project, arguing that its hospital capacity is growing urgently low.

This is the second time Mass. General has made such a request. The hospital initially asked to add the same number of beds when it first proposed its new, $1.8 billion clinical facility along Cambridge Street, which is currently under construction.

But though state regulators in 2022 approved the tower — largely intended to transition from double to single rooms — they blocked the addition of the beds over concerns that they could increase health care costs. The Department of Public Health said then that MGH could come back with the proposal to add beds later.

In a news release issued Friday, MGH officials said the time for that request is now, and that it planned to file a request with the state in the coming weeks for permission to expand further.

MGH said that nearly every day for the past 16 months, its emergency room has been so full that all the hospital’s inpatient beds and monitored hallway stretchers are full.

On some occasions, the hospital has triggered “capacity disaster” status, a term used to denote that more than 45 inpatients have been admitted to the hospital but are stuck in the emergency department, because there isn’t yet a bed available for them.

In September alone, MGH said, a quarter of patients admitted to the hospital waited in the emergency room for more than 24 hours.

“While hospital overcrowding has significantly affected patient care for many years, COVID-19 and the post-pandemic demand for care has escalated this challenge into a fullblown crisis — for patients seeking necessary emergency care, as well as for staff who are required to work under these increasingly stressful conditions,” said Dr. David F.M. Brown, president of MGH and former Department Chair of Emergency Medicine at MGH, in a statement.

Capacity challenges are not unique to Mass. General. Hospitals throughout the state say they often have more patients than beds.

However state data suggests that the capacity issues aren’t because there are more patients going to state hospitals, but rather that those patients are staying in the hospital longer. Some have suggested that the reasons are outside of hospitals’ control, namely a lack of staffing at nursing home and rehabilitation hospitals that are supposed to accept discharged patients.

Mass. General said it is doing everything in its power to address discharge challenges and other capacity worries. It has dedicated space in the hospital for patients to wait to be picked up once they are discharged, for instance, rather than taking up needed beds. It has leveraged a home hospital service to provide acute-level hospital care out of people’s homes.

The Mass. General Brigham health system also launched a patient transfer center to coordinate where patients should go when they need to be moved among MGB facilities, or when patients are transferred to MGB hospitals from other locations.

“We have improved inpatient throughput and efficiency and developed innovative care models across our health system and yet we still face overwhelming and increasing ED crowding with no end in sight,” Brown said. “That is why adding more beds to MGH will greatly help alleviate this capacity crisis, enhance access for patients and substantially improve the overall working conditions for our clinicians and staff.”