Sharon Hospital in rural Litchfield County is moving forward with efforts to close its labor and delivery unit despite concerns from advocates and hospital staff that the closure would leave the area as a “maternity desert.”
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The state allowed Sharon Hospital owner, Nuvance Health, to continue its appeal of a decision by the state Office of Health Strategy, which ruled against the plan to close Sharon Hospital’s maternity unit earlier this year.
Nuvance will also get a chance to make its case for the closing at a virtual public hearing scheduled for Nov. 8.
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“This is helpful in clarifying information and points raised in the draft decision with hopes for a more positive final decision,” Nuvance said in a statement.
Nuvance’s efforts to scale back care at Sharon Hospital have met resistance from residents, local doctors and state officials. Births are still happening at the hospital pending a final decision.
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The bid to close Sharon’s maternity ward is part of a strategy by Nuvance to shift patient dollars and profits to the Danbury-based health system’s larger hospitals, said Dr. David Kurish, a Sharon-based physician who has been outspoken about the hospital’s financial woes.
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A spokesperson for a group called Save Sharon Hospital, Kurish said Nuvance has a policy of stripping profitable services from the hospital then using the resulting shortfalls to make further cuts.
“Over the years since they took over, they gradually shifted more services from here to other hospitals,” Kurish said.
“I think the long-term repercussions are that more patients are transferred from our hospital … more expense and inconvenience to families and patients who want to stay in their home,” Kurish said. “I think they care very little about us over here. We're kind of neglected.”
Sharon Hospital could attract more maternity patients if it promoted its services, Kurish added, citing other small hospitals with profitable labor and delivery units.
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Nuvance officials say high-cost services like maternity care are unsustainable in rural areas due to low volume, an aging population and difficulty in finding staff. Sharon-area residents need more primary care and mental health services, while birthing needs and prenatal care can be met at nearby facilities, health system officials argue.
“The closing of its L&D (labor and delivery) service is necessary to position the applicant for a more stable, sustainable future and focus on the community’s greatest need,” Nuvance said as part of its appeal to the state.
Sharon Hospital has lost about $40 million since Nuvance bought the facility in 2017, the health system reported last year.
Nuvance first notified the state regulatory agency of its plans to close the Sharon maternity unit in December of 2021. The state rejected the request in August, finding that Nuvance had failed to make its case for five of the eight criteria needed for approval.
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Nuvance had more success on a second request to shut down Sharon Hospital's intensive care unit in favor of a “progressive care unit,” which provides less intensive monitoring. Sharon’s ICU has been idle for “an extended period of time due to the lack of specialized ICU level services and equipment,” according to state documents.
The state and Nuvance agreed to a settlement agreement on that request, filed on Tuesday, with Nuvance promising to sustain its current level of critical-care services and move ahead with the progressive care unit plan.
“Our teams will move forward with centralizing the services currently offered in our Intensive Care and Medical-Surgical Units into a unified PCU as seamlessly as possible,” Nuvance said in a statement.
State’s rural hospitals cut birthing care
All three of the state’s rural hospitals have either closed their maternity units or have notified the state of plans to close the wards, putting Connecticut high on a national list of potential “maternity deserts.”
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Johnson Memorial Hospital in Tolland County has not recorded a single birth since owner Trinity Health of New England filed with the state to close its maternity unit on Sept. 29, 2022. The decision on a permanent closure to Johnson’s maternity ward at the Stafford hospital is still pending with the state.
Pregnant women in the area can still get care from local doctors and deliver at Hartford’s Saint Francis Hospital, about a 40-minute drive and also owned by Trinity Health, hospital officials say. Johnson Memorial can also provide treatment to mothers in its emergency room.
Windham Hospital in Willimantic, owned by Hartford HealthCare, was the first to announce a plan to close its maternity ward, citing staff shortages and high costs in its 2021 application to the state.
Windham’s maternity ward has been shut for three years, despite an initial denial by the state of Hartford HealthCare’s closure request. The last state action related to the denial was in 2022.
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A community group called Windham United to Save Our Healthcare Coalition plans a vigil on Nov. 13 at the state Capitol building to highlight the closure and urge state action to reopen the ward.
“We were promised in 2010 by Hartford HealthCare that they would enrich our medical services and keep them close to home,” said Willimantic resident Brenda Buchbinder, spokesperson for the group. “This promise never happened.”
Mothers from rural areas around Willimantic now have to travel 30 miles or more via ambulance to Norwich or take helicopters to Hartford to deliver babies.
“We have had (emergency room) births, side-of-the-road births, and no transparency from HHC about the rates of C-section, postpartum depression or adverse outcomes,” Buchbinder said.
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“Windham-area mothers are choosing to have their babies at other hospitals in the region,” reads a statement on the hospital website that offers reasons for the closure.
Financial woes beset maternity units
Connecticut ranks at the very top of a list of states with money-losing rural maternity care, with all of its rural hospitals reporting losses on labor and delivery, according to a July report by the Center for Healthcare Quality and Payment Reform, a Pennsylvania-based advocacy group.
Even in this relatively small state, closure of those maternity wards translates to a median of 33 minutes on the road to an alternative birthing center, the center found.
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“Rural hospitals typically lose money on obstetric care, so if a hospital can’t make enough money on other services to offset those losses, it may be forced to eliminate maternity care in an effort to keep the hospital from closing entirely,” reads the center’s report, titled “The Crisis in Rural Maternity Care.”
Of Connecticut’s three rural hospitals, Sharon seems closest to the financial brink, according to the state Office of Healthcare Strategy’s most recent financial stability report.
Sharon ranked at the very bottom among Connecticut’s hospitals on measures such as annual operating margin, or gains or losses from patient care and related sources.
Compared to a state average operating margin of negative 1.3 percent, Sharon Hospital reported a negative 45.8 percent margin in fiscal year 2022. Sharon also saw a 130 percent increase in bad debts. Its total margin — or income from all sources — has been deep in the red for the last five years.
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Can the hospital stay open while suffering such losses?
“We are not planning to close the hospital, rather we are making every effort toward future sustainability,” a Nuvance spokesperson said in response to a question about Sharon Hospital’s future.