Struggling to provide care for a growing and aging population in Plymouth and surrounding towns, Beth Israel Lahey Health is investing more than $116 million to update and expand its facilities at Beth Israel Deaconess Hospital-Plymouth.
The work is aimed at increasing the hospital’s capacity for cancer care, surgical and emergency services. It includes a $50.2 million expansion and renovation of the emergency department at the main hospital campus off Obery and Sandwich streets, $48.6 million to build a hematology-oncology and infusion center at Cordage Park, and $17.6 million for an ambulatory surgery center on Resnick Road, primarily for orthopedic surgeries.
“To take care of the patients in our community, we have to expand. We don’t have a choice,” said Kevin Coughlin, president of BID-Plymouth.
The new emergency department and surgery center are already under construction. The hematology-oncology center plan is still under review by the Massachusetts Department of Public Health, but approval is expected because opening the new cancer center is integrated with the emergency department expansion.
A common theme running through the documents filed by Beth Israel Lahey Health seeking approval for the three projects is the urgent need to address long wait times patients now face for medical services at BID-Plymouth.
Nowhere is that need more acute than in the emergency department. Built in 1993 to replace a smaller ER, it was designed to handle 27,000 patients a year. The department now sees more than 46,000 patients annually. Many wait hours to be treated, often in “hallway beds” – which are just what they sound like – because there aren’t enough treatment rooms to handle the volume.
“We know it’s a hard place for patients and a hard place for all of the staff to work. It’s loud. It’s not private,” Coughlin said.
The emergency department will double in size, growing from 14,434 square feet to 29,000. That includes an 8,000-square-foot addition to the building and reconfiguration of adjoining existing space.
The expanded emergency department – designed to handle up to 65,000 patients a year – will have 37 private treatment rooms and no curtain or hallway beds. It will have a 16-unit secure treatment area for patients who present with behavioral or substance abuse issues.
Building a bigger and better emergency facility is long overdue, but not the full answer to BID-Plymouth’s problems. The hospital also needs to maintain enough staff to care for patients, both in the emergency department and across the hospital.
“Staffing is always a concern,” Coughlin said. “There is a lot of churn in this business and we are constantly trying to pull new people into the organization. Since October, we’ve hired 37 RNs and lots of other staff.”
Questions about inadequate staffing swirled around the death of Rodney Riviello, who walked out of the BID-Plymouth emergency department alone last June after being treated for injuries suffered from a fall near his Manomet home. Riviello’s body was found days later.
But the ER expansion won’t happen quickly. Construction will be done in phases so the facility can stay open 24-7 during the work. It is expected to be completed in 2028.
To free up room within the hospital for the expanded emergency department, the existing cancer treatment clinic will move to Cordage Park in North Plymouth. But it’s more than just a physical move. Instead of being run by BID-Plymouth, the clinic will become a satellite of the Beth Israel Deaconess Medical Center in Boston.
“This will be a massive game-changer for patients,” Coughlin said. “A community hospital like us would never be able to provide access to the level of drugs, clinical trials, and expertise that an academic medical center like BIDMC can.”
The new hematology-oncology clinic will triple in size, growing to 17 exam rooms and 36 infusion chairs for patients receiving chemotherapy and non-chemotherapy infusions, like immunotherapies, monoclonal antibodies, powerful antibiotics, and other drugs that require intravenous administration.
The existing cancer team at BID-Plymouth will become BIDMC employees, with additional physicians and staff recruited by the Boston hospital to handle the growing caseload.
In 2023, the BID-Plymouth hematology-oncology clinic had 14,360 patient visits for chemotherapy infusions, with “schedules consistently fully booked,” according to filings by Beth Israel Lahey Health. “The average new patient appointment wait time to the hematology-oncology clinic in FY23 was 50 days, nearly triple the 18 days average wait in FY21.”
The new clinic at Cordage is projected to handle 15,208 chemotherapy infusions in its first full year of operation, growing to nearly 21,000 patient visits within five years.
In its application to the state for the Cordage clinic, Beth Israel Lahey Health referenced data from the Advisory Board Cancer Incidence Estimator that projects cancer cases in the Plymouth area will increase by 9.6 percent between 2020 and 2025 and by nearly 17 percent between 2020 and 2030, largely driven by demographics, “due to higher incidence of cancer with age.”
“Certain types of cancer that are already prevalent among BID Plymouth patients, such as hematologic cancers and lung and bronchus cancers, are expected to increase by more than 10 percent during this period,” Beth Israel Lahey Health wrote.
According to Dr. Paul Hattis, former senior associate director of the Master of Public Health Program at Tufts University Medical School who is now a senior fellow at the Lown Institute, the extension of BIDMC’s cancer programs into community settings is part of the growing competition between Beth Israel Lahey Health and Mass General Brigham, the two largest health care systems in Massachusetts.
“Across the country people talk about the war on cancer; in Massachusetts there is a war for the cancer dollar,” Hattis said.
A driving force is the Dana-Farber Cancer Institute’s decision to end its long relationship with the Mass General Brigham system and instead collaborate with Beth Israel Lahey Health. That’s a major shift in the cancer care landscape that will boost competition for patients, Hattis noted.
Beth Israel has historically focused its tertiary services like advanced cancer care at its large Boston facilities. But in 2019, when Beth Israel Lahey Health was formed through the merger of Beth Israel Deaconess Medical Center and Lahey Heath, the new system pledged to adopt a different approach.
“Rather than push more people to the mother ship in Boston, Beth Israel Lahey said it would do more with its community hospitals and clinics,” Hattis said. “This project in Plymouth seems to be in line with what they have been preaching, that keeping care in the community is more cost effective and better for the patients who can get care closer to home.”
Furthest along in the Beth Israel Lahey Health construction program is the outpatient surgery center at 43 Resnick Road. Expected to open early in 2026, the 19,000-square-foot, one-story surgery center will have four operating rooms that are projected to handle 2,871 cases in the first full year of operation, increasing to more than 3,200 surgeries within three years.
Organized as the Beth Israel Lahey Surgery Center Plymouth, LLC, it is a joint venture of BID-Plymouth and Plymouth Bay Orthopedic Associates, with the hospital owning a 51 percent controlling interest in the center. (The surgery center will lease the facility, which is being built by Mayflower Landing LLC, a partnership of several Plymouth Bay Orthopedic physicians.)
According to the surgery center application filed with the state, “the current wait time to be scheduled for surgery from the decision to move forward with surgery is approximately 6 weeks. The long wait times are often due to the Hospital’s need to prioritize urgent surgeries so that outpatient surgeries are delayed or rescheduled. For patients in need of treatment for painful, joint-related conditions or injuries, such delays can significantly impact a patient’s quality of life and adversely impact outcomes.”
The new center will not only decrease wait times for orthopedic surgeries but will free up capacity at the hospital’s existing eight operating rooms to expand the surgical services available in Plymouth, including vascular surgery, neurosurgery and more complex general surgeries that now are done in Boston, Coughlin said.
Steven Bolotin, chair of the Plymouth Planning Board and the Master Plan Committee, welcomes the Beth Israel Lahey Health expansion. He said the need for more health care services in Plymouth “has come up repeatedly” in the community meetings hosted by the master plan committee. Bolotin said BID-Plymouth hospital staff are participating in the master planning process, providing data the hospital tracks, as well as the results of its recent community health assessment surveys.
“Our community is growing rapidly, and our medical needs and hospitalization needs have grown accordingly,” Bolotin said.
Beyond providing health care services, Bolotin noted, BID-Plymouth is the largest private employer in Plymouth and health care-related jobs are the fastest growing sector in town.
The hospital says that its total workforce in Plymouth – including primary care and specialty doctors – is about 3,000.
“Beth Israel’s expansion in Plymouth is a remarkably good sign,” Bolotin said. “Having a community hospital is an absolute benefit for Plymouth. It’s a resource many other communities would be desperate to get.”
Michael Cohen can be reached at michael@plymouthindependent.org