Office of Health Strategy public hearing: Nuvance faces tough questions

HARTFORD — The Office of Health Strategy (OHS) held a continued public hearing online Wednesday, Feb. 22, for Nuvance Health’s application to replace the intensive care unit at Sharon Hospital with a progressive care unit.

This session of the hearing included OHS questions for Nuvance Health and Save Sharon Hospital’s (SSH) witnesses who testified in the initial hearing as well as closing arguments from both sides.

If Nuvance’s application is approved by OHS, the staff and equipment in Sharon Hospital’s ICU would be relocated to the second floor and combined with the Medical-Surgery unit. Merging these wings would create a new progressive care unit and become the central hub for critical care services at Sharon Hospital.

The bulk of OHS’ questioning was directed at the three witnesses who testified on behalf of Nuvance Health during the initial Feb. 15 hearing: Nuvance President and CEO Dr. John Murphy, Sharon Hospital President Christina McCulloch, and Sharon Hospital’s VP of Medical Affairs, Dr. Mark Marshall.

OHS sought clarification on how Nuvance could justify its claim that all services currently in place in Sharon Hospital’s ICU would remain in place under the proposed PCU, considering these are two distinct levels of care.

During his explanation, Marshall said, “We haven’t been keeping patients for many years that require high level intensive care services.”

OHS Operations Manager Steven Lazarus asked Nuvance when Sharon Hospital last provided ICU level of care.

Murphy responded by saying, “It’s a moving target.”

Marshall stated there are varying levels of critical care medicine and the level of care that qualifies as intensive care has changed over time. “At one point we might have been considered a mid-level ICU, but now the care that we practice is really progressive care medicine,” said Marshall.

Hearing Officer Daniel Csuka requested a side-by-side comparison of the types of acuity cases that can be handled in an ICU versus a PCU as it relates to Sharon Hospital. Additionally, OHS requested updated census data, policies, and transfer statistics from both the ICU and Medical-Surgery unit at Sharon Hospital. Csuka set a Mar. 17 deadline for Nuvance to submit late files.

OHS also inquired about how Nuvance would proceed if this, or its other pending application to shut labor and delivery services, were denied.

Murphy noted the current financial losses at Sharon Hospital and responded by saying, “This model cannot continue. The rate of loss is of enormous concern.” Murphy mentioned a potential alternative that he described as unfavorable: designating Sharon Hospital a Rural Emergency Hospital (REH).

REH is a Medicare provider designation that began in January of 2023. This federal program was designed to compensate rural hospitals that are unable to sustain a full range of services.

REHs receive Medicare funding to provide emergency care, observation care, and additional outpatient services.

“I continue to believe and worry that all inpatient care might go away,” said Murphy. In reference to the application in question, he said, “This is a highly preferable alternative. This preserves care in the community. This preserves jobs.”

During closing arguments, SSH attorney Paul Knag summarized his side’s stance on the issue. He stated the creation of a PCU at Sharon Hospital would result in financial losses, a reduction in quality of care, and a loss of access to care for the community.

Knag noted that all elected officials who spoke during public comment were opposed to Nuvance’s proposal. “This assessment by the community leaders show that there’s a strong need to continue access to Sharon Hospital’s core services,” he said. “We ask that the hospital work with us to find a solution that leaves its core services intact.”

Nuvance’s attorney Ted Tucci closed by stating, “What has been proposed is a transformation plan that not only satisfies all the critical factors you’ve identified, but actually ensures that this hospital remains a critical part of this community.”

Tucci added that if OHS were to deny this application, “essentially what you will be doing is dooming Sharon Hospital to be stuck in the past.”

Tucci’s closing arguments concluded round two of hearings for this application. OHS will await late files from Nuvance to review current data before ruling on the application.