Home Care In Sharon, CT

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.

This letter expresses concerns about the recent budget discussions involving the Sharon Board of Education (BOE) and the Board of Finance (BOF).

The BOE’s failure to identify efficiencies or savings at the beginning of their budget cycle is troubling, especially considering that the only reason the budget may be lower this year is due to savings in the Region 1 budget, not in the local Sharon Center School budget. A flat budget does not indicate savings.

It is important to note that the Net Current Expenditure Per Pupil (NCEP) in Sharon, for the 2021-2022 school year is $53,217, according to the document provided by the Connecticut State Department of Education. This figure highlights the significant investment made in our student’s education and reveals that Sharon has the highest NCEP in Connecticut. The extremely high NCEP makes it even more crucial that the school board consistently looks for saving and efficiencies every budget cycle. Sharon Center School’s consistent drop in resident students means the BOE review, while lowering the budget and asking the Commissioner of the Department of Education for reductions, is crucial.

It is equally alarming that the BOE is only now researching efficiencies after a town hearing and the board of finance’s imposition of stipulations for budget approval. One cannot help but wonder why these potential savings and efficiencies were not explored and identified earlier in the process. The Board of Education’s apparent lack of initiative is concerning. It suggests a disregard for the responsible use of taxpayer money and the importance of maintaining a balanced budget for our community.

Moreover, the BOE has not provided quotes for roof leak repairs nor requested additional funding for this issue. As elected officials, it is their responsibility to ensure that our schools are safe and well-maintained. Their apparent lack of urgency on this matter raises questions about their commitment to the welfare of our students and the efficient use of taxpayer money.

Our local government must operate with transparency and accountability. Unfortunately, the school board’s actions, or lack thereof, seem to be hindering this process. It is disheartening to hear that some members complain about additional meetings, stating they “have lives, too.” However, elected officials must serve the public, which may require attending more meetings than they initially anticipated. If this becomes a burden for them, perhaps they should reconsider their positions and make way for new members more dedicated to the task.

It is time for a change on the Sharon Board of Education. Sharon needs officials dedicated to providing accurate and truthful information, prioritizing the needs of our schools, and working collaboratively with other boards to ensure the best outcomes for our community.

In addition, given that Sharon has the highest NCEP in the state, it is even more critical that we have a board of education committed to transparency, efficiency, and accountability. If the current BOE members are unwilling or unable to meet these expectations, then it is time for them to step aside and allow new blood to take the helm.

Cody O’Kelly lives in Sharon.

SHARON — There are more cows, cornfields and grain silos than shopping centers and apartment buildings in this northwest corner of the state, but that doesn’t mean women in labor should have to drive an hour to deliver their babies, state and federal lawmakers said Wednesday.

“To have women seek care locally but at the point where it is time to deliver have to go outside to a brand new team with people they don’t know … (who) are just relying on medical charts is just not fair to the people in this community,” said U.S. Rep. Jahana Hayes, D-Conn., standing with a coalition of legislators and community supporters here to celebrate a draft decision by a state agency to deny a request by Nuvance Health to close the labor ward of Sharon Hospital. “It is not how we should be delivering health care.”

Nuvance, the health system that manages Danbury, Norwalk and five other hospitals in Connecticut and New York, said the draft denial by the state Office of Health Strategy that would bar Nuvance from closing Sharon Hospital’s labor and delivery ward was “deeply disappointing” and “very concerning.”

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“It ignores the fact that (Sharon) Hospital faces serious financial hardships and a very under-utilized maternity unit with declining births and considerable operational costs,” said Andrea Rynn, Nuvance’s assistant vice president, community, government and public relations.

Nuvance stopped short of saying whether it would appeal the decision by the Sept. 18 deadline, except to say, “We will be considering all options available as we reassess our path forward.”

At stake is the fate of a rural hospital near the borders of New York and Massachusetts with one of the only three 5-star safety ratings in Connecticut. Movie stars Liam Neeson and Meryl Streep made video appeals during the height of the coronavirus crisis in 2020 to help raise money for the hospital.

U.S. Sen. Richard Blumenthal was among the state and federal leaders assembled at Sharon Town Hall Wednesday to call on Nuvance to “do the right thing” and accept the state decision to keep the labor and delivery ward open.

“Work with us, not against us. Make the right decision. Don’t appeal,” Blumenthal said during a mid-morning press conference. “To appeal … would be a travesty and a tragedy for you as a health care institution.”

Nuvance responded that over the last decade, Sharon Hospital has averaged fewer than one delivery per day and at times has gone multiple days without a birth in a fully-staffed ward.

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In December, Nuvance’s top executive told the state Office of Health Strategy during a public hearing that Sharon Hospital was in “serious financial distress,” losing more than $20 million total in 2020 and 2021. And in one month alone — October 2022 — Sharon had lost $1.9 million.

“Since 2019, the losses have been more than $50 million. It’s about $450,000 (in loses) a week,” said John Murphy, president CEO of Nuvance. “The bottom line is that the current model of providing care and the services that we provide and the manner in which they are provided is simply not sustainable.”

The Connecticut Hospital Association said in a statement on Wednesday that the state should not turn a "blind eye to the issues that threaten hospitals' ability to sustain exceptional care and slow the rate of cost growth."

“It’s concerning that OHS’s proposed final decision disregards declining births, recruitment challenges, and financial pressures that pose significant challenges to maintaining birthing services," the association said. "Closing a birthing unit is not a decision that is made lightly. Hospitals want nothing more than to provide access to the highest quality care to every patient in every situation. But staffing shortages, decreases in births, and skyrocketing temporary worker costs are serious challenges. Ignoring them doesn't make the challenges go away and it moves Connecticut further away from our goal to make healthcare more affordable."

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The state disagreed in a 39-page “proposed final decision” on Monday.

“Despite Sharon Hospital’s losses in 2021, Nuvance made approximately $75 million, had an excess of revenue over expenses of $105 million, had an increase in net assets of $242 million ending the year with over $1.7 billion in net assets, and by all accounts appears financially stable,” the finding reads. “Moreover (Nuvance) … does not anticipate any financial losses resulting from the termination of the (labor and delivery) services. In fact, (Nuvance) anticipates a financial gain of approximately $3 million per year.”

State Comptroller Sean Scanlon called that a bad trade for Connecticut.

“What this boils down to is (Nuvance) was trying to close labor and delivery for $3 million in revenue,” Scanlon said during Wednesday’s press conference. “We do not think as a state that is a good trade — $3 million more profit to jeopardize the health and safety of the women and children of this area.”

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Blumenthal agreed.

“Nuvance makes a lot of money. Profits are not a problem for Nuvance. Obviously, what they are trying to do here is squeeze more profits out of Sharon Hospital by trying to profiteer on the backs of pregnant women,” Blumenthal said. “To say women can travel 30-to-60 minutes ain’t gonna cut it. Nuvance knows healthcare…and Nuvance knows forcing travel is wrong to do.”

SHARON — Celebrity residents like Kevin Bacon and Kyra Sedgwick may add sparkle, but the heart of the Litchfield County town of Sharon is its hospital, residents say.

“We’re a hospital town — everything’s interconnected,” said Brent Colley, outgoing first selectman of Sharon. Colley’s wife works at a medical office linked to Sharon Hospital and his two kids were born there. His wife has also been treated for cancer there twice.

Sharon Hospital is also the town’s largest employer and draws visitors from throughout the region to the upscale shops and cafes that dot Sharon’s main streets.

And now that the hospital’s owner has attempted to cut back on key services like its birthing center and intensive care unit, townspeople are worried.

“It’s a scary time for everyone,” Colley said. He compared the impact of the hospital’s downsizing to the slow decline of the Gilbert & Bennett wire factory in his Fairfield County hometown, Redding.

“We really suffered when we lost the heart that provided so much to the community, so it could be a similar situation like that,” Colley said.

In the latest chapter in Sharon Hospital’s downsizing, owner Nuvance Health of Danbury is appealing a decision by the state to reject its bid to close the birthing center.

Nuvance is losing $3 million a year staffing the labor and delivery unit at Sharon Hospital due to staffing difficulties and declines in demand, an attorney for the health system told officials from the state’s Office of Health Strategy at a Nov. 8 hearing.

Amid the stats illustrating Nuvance’s losses from Sharon Hospital was a clear message: Keeping the birth center open could endanger the survival of the entire institution.

“This decision threatens Sharon Hospital’s ability to continue delivering care in northwestern Connecticut,” Nuvance attorney Ted Tucci said.

The state will issue a decision on Nuvance’s appeal within 90 days of the Nov. 8 hearing, an OHS representative said.

Deep roots in town

Walk past the columns into Sharon’s 1875-vintage town hall and you’ll see a framed photo right outside the first selectman’s office: The “new hospital” built on site of the current one on Hospital Hill Road in 1916. That building took the place of the town’s first hospital, founded by Dr. Jerome Chaffee in 1909.

When Colley started his first of five terms as Sharon First selectman in 2013, Sharon Hospital was owned by for-profit Essent Healthcare of Connecticut and making $2 million a year in profit. But a shift in tax structure and a steady decline in patient volume began taking its toll.

By the time New York-based nonprofit system Health Quest bought the hospital in 2017 it was reporting annual losses of $2.5 million. Citing those deepening losses, Health Quest proposed closing the birth center in 2018 sparking a community outcry, according to the Poughkeepsie Journal.

Health Quest merged with Western Connecticut Health Network in 2019 as part of a $2.4 billion deal to form Nuvance Health, an alliance that brought Sharon into a network with Danbury, Norwalk and New Milford hospitals, along with New York’s Vassar Brothers Medical Center in Poughkeepsie and Putnam Hospital Center in Carmel.

Sharon now has 78 available beds and operating losses that ballooned to $23 million in fiscal 2022. Nuvance formally petitioned the state to close the birthing unit in January of 2022, citing its financial woes along with declining births and the aging demographic in the area.

But town and state officials pushed back, citing the popularity of the hospital in communities in neighboring New York towns with a younger and more diverse demographic.

Connecticut’s northwest corner — and Sharon Hospital’s service area — extends across borders due to the area’s rural and remote landscape, Colley said. In addition, the pandemic has brought new younger families to the area who prefer not to drive more than 30 minutes on hilly roads for maternity services, he said.

Most of all, the birthing center represents a continuity of care for local residents, Colley said.

“The doctors that we have here are great, not only are they delivering babies, but they’re helping the women throughout their life,” he said. “We’re just kind of pleading with them to reconsider this,” he said of Nuvance’s bid to close the unit.

'Corporate medicine’ comes to town

With its faded children’s artwork on the walls, family photos and copies of Yankee Magazine piled up in the waiting room, Dr. David Kurish’s office across the street from Sharon Hospital could be a set from a nostalgic TV show like “Leave it to Beaver.”

But Kurish acknowledges that the old-school medicine he has practiced in Sharon for decades may be a thing of the past.

“It used to be 36 hospitals in Connecticut 40 years ago, now it’s (four) big chains. And it’s such a shame because it’s denying care to people in more remote areas,” Kurish said.

Nuvance’s fight to close the maternity unit at Sharon Hospital has already impacted the town’s medical community, which is down to one obstetrician-gynecologist from three several years ago, Kurish said.

“Unfortunately, the hospital is litigating this and delaying it, and it just makes it more difficult for women,” Kurish said.

Even as Kurish fights to keep Sharon Hospital central to town life, Nuvance seemed to push back at that vision of health care at the Nov. 8 hearing.

“We don’t live in a ‘Leave It to Beaver’ world,” Nuvance attorney Tucci told the OHS at the Nov. 8 hearing. “The days of small community hospitals being what they once were are simply over.”

Patients across Connecticut in both big cities and small towns will increasingly encounter what he terms “corporate medicine,” Kurish said, with consolidation and profit-based decisions that impact both cost and convenience.

“To me a hospital doesn’t have to be a profit-making venture — it shouldn’t be. It’s supposed to serve the community,” Kurish said.

An attorney for Sharon Hospital blasted state regulators on Wednesday for their decision to keep its labor and delivery unit open against its owner’s wishes.

Birthing services at Sharon are a costly drain on the struggling hospital and are not needed by Litchfield County residents, argued Ted Tucci, a Robinson and Cole attorney representing the hospital.

“There’s an overwhelming basis to conclude that refusing to close the (labor and delivery) unit is both wrong on the facts and incorrect on the law,” Tucci said, marshaling an array of slides on Litchfield County’s demographics and the hospital’s financial performance.

“This decision threatens Sharon Hospital's ability to continue delivering care in northwestern Connecticut,” Tucci said.

Tucci spoke at a hearing held via Zoom as a last-ditch bid to overturn an Aug. 28 decision by the state’s Office of Health Strategy to reject hospital owner Nuvance Health’s plea to close the labor and delivery unit at Sharon.

Sharon-area doctors and patient advocates have argued that closing the unit would require mothers to travel long distances on rural roads and disproportionately impact the poor and people of color.

The state agreed, finding that closing Sharon Hospital’s birthing services would negatively impact patient access, choice, and outcomes in the region. Birth rates are holding steady in the area and the hospital’s unit would benefit from a stronger marketing campaign, state auditors said.

Nuvance Health’s subsidiary Vassar Health Connecticut first asked the state in December 2022 to close down the birthing unit, which Tucci said cost the hospital $5 million a year to operate while taking in only $2 million in revenue.

Costs related to staffing the labor and delivery unit are contributing to a nearly $24 million annual loss at Sharon Hospital, threatening its survival, Tucci said. Only an average of two births a week currently take place at the hospital, sited in an area of the state marked by an aging population, he added.

Tucci took a harsh tone in criticizing the state’s decision on Wednesday, calling it a “clear error” and accusing regulators of violating their own guidelines.

“We’re facing a situation where the future of another small hospital in Connecticut is in peril,” Tucci said. “The days of small community hospitals being what they once were are simply over. We don’t live in a ‘Leave It to Beaver’ world.”

OHS Executive Director Deidre Gifford said that the agency would issue a finding on Nuvance’s appeal based on relevant state laws, but did not announce a timetable for a decision.