When Monique Duval arrived at UMass Memorial Health for emergency care last month, she didn’t expect to spend six hours in the waiting room. What followed, she said, was not just a long wait but an experience that left her questioning the quality of patient care at one of Massachusetts’ largest healthcare providers.
Duval’s experience has taken on added significance in light of a recent audit from the Massachusetts Office of the State Auditor, which raises questions about UMass Memorial Health’s operations and its handling of federal COVID-era funding.
“Staff seemed stretched thin,” Duval recalled of her November visit. “There were delays all around for both visits. The staff were in a rush and made me feel unimportant.” She said her experience escalated when she was given medication without prior consultation. “I was given Fentanyl as a pain medication and had a horrible reaction to it. I wasn’t informed that I would be given an opioid until after it was administered.”
Duval said the incident had real consequences. “I was sick as a dog, and for that reason missed a day of work when I wouldn’t have had they not given me that drug,” she said. “I think the public should know that someone was given an opioid without inquiring as to whether that person objected or had any allergies. I felt like I was inconveniencing everyone. I know it is a teaching hospital, but a little more humanity would go a long way.”
The state audit, which covers the period from July 2020 through June 2023, examined how UMass Memorial Health used more than $6.2 million in federal American Rescue Plan Act funds administered by the state. Auditors reported that the health system “did not maintain any documentation” demonstrating how the COVID-19 relief funds were spent.
According to the report, UMass Memorial later provided a spreadsheet indicating that the funds were used to pay one-time appreciation bonuses to more than 13,500 employees. The Office of the State Auditor said the spreadsheet did not meet the standard of detailed accounting records required to verify compliance.
UMass Memorial Health has strongly disputed the audit’s conclusions. In a statement, the health system said it provided extensive documentation and complied with all requirements tied to the funding. “UMass Memorial Health received federal COVID-19 relief funding beginning in 2020 based upon the pandemic’s impact on our community,” the statement said, adding that the funds were allocated to “fiscally strained hospitals designated by the Center for Health Information Analysis as high public pay hospitals.”
Massachusetts Nurses Association President Katie Murphy said the audit’s findings reflect broader concerns about capacity and patient care at the system’s facilities. “We have heard too many stories of mothers delivering in overcrowded emergency departments or in ambulances on highways leading to UMass Memorial Hospital in Worcester,” Murphy said. “We have heard from the nurses at UMass Memorial about the influx of patients from the region and the impact on their ability to provide care at UMass’s flagship maternity facility.”
The timing of the audit is notable given the 2023 closure of the inpatient maternity unit at HealthAlliance-Clinton Hospital in Leominster. UMass Memorial has attributed the closure to workforce shortages and declining birth rates in North Central Massachusetts. The auditor’s report, however, suggested that a different allocation of federal funds might have helped keep the unit open.
“We support any effort by state or Federal authorities to examine how hospitals in our state use or misuse the vast resources they are provided — funds, the vast majority of which come from taxpayers,” Murphy said. “We should expect that those funds are always put to the best use for the core mission of any responsible health care provider, which is to provide first rate care to all who need that care. From this report, it appears UMass has failed to do so and it will be the poorest and most vulnerable among us who will pay the price.”
Through its legal representatives at Ropes & Gray LLP, UMass Memorial has pushed back on multiple aspects of the audit, arguing that key facts were misstated. The health system said it provided grant payment agreements, quarterly reports to the Executive Office of Health and Human Services and documentation related to employee bonus payments. Its legal response characterizes the claim that no documentation was maintained as “false,” noting that auditors did not specifically request the additional accounting records cited in the report.
The audit also raised concerns about birth reporting practices, stating that the health system could not demonstrate whether certain births involving MassHealth patients were reported within the required 10-day window. UMass Memorial responded that all births are documented in its electronic medical record system and that paper logbooks are used only as temporary backup documentation.
Information security training was another disputed finding. Auditors reported that five of 20 sampled individuals lacked proof of required training completion. UMass Memorial said it provided evidence showing that all sampled staff members completed the required training.
Murphy said the issues highlighted by the audit underscore the need for stronger oversight of hospital systems. “On a broader level, this issue points to the need for the state to have greater power over the hospital industry to ensure that services deemed by the DPH to be essential to health of the community are protected from closure,” she said.
In a separate statement included in the audit response, UMass Memorial Health disagreed with the auditor’s assertion that ARPA funds could have been used to maintain the HealthAlliance-Clinton Hospital inpatient maternity unit. “For several years, well-documented workforce shortages exacerbated the challenges of fully staffing the unit consistently, despite our persistent attempts to recruit and retain clinicians in this region,” the statement said.
As of now, the state auditor is standing by the findings, while UMass Memorial continues to assert that it met all federal and state requirements and provided the documentation that was requested. The dispute highlights broader questions about how hospitals document the use of pandemic-era relief funds, how state agencies assess compliance, and how financial oversight intersects with patient care and access to essential services.
Matt Olszewski is a freelance content and news writer who graduated with his MPH from Tufts University. In his free time, Matt enjoys running, hiking or skiing. He can be reached at mattoskier@gmail.com
