Rural hospitals are in grave danger in Connecticut

Rural hospitals in Connecticut are having essential services eliminated, putting the health of Connecticut residents at risk. Recently, the labor and delivery unit at Windham Hospital closed and the same unit at Johnson Memorial Hospital was suspended, following closures of more units at Milford and New Milford hospitals. The latest victim is Sharon Hospital — the pending closure of its labor and delivery unit was announced in September 2021 by its parent, Nuvance Health.

Nuvance, created in 2019 pursuant to a merger, filed a Certificate of Need (CON) application to Connecticut’s Office of Health Strategies (OHS) for approval in which it stated that the purpose of the merger was to enhance the focus on primary care and expand local access to specialty care, with no planned reductions in healthcare services.

On April 1, 2019, OHS approved the merger in an Order directing that Nuvance maintain for five years, among other services, Sharon Hospital’s emergency room, inpatient obstetrics/gynecology and critical care unit services in order to meet the needs of the community. Nuvance’s pending closure of Sharon Hospital’s labor and delivery unit within three years is in direct violation of OHS’s 2019 Order. Nuvance is proceeding to close the unit without waiting for OHS to conclude its formal investigation into the propriety of the closure.

Nuvance’s closure of Sharon Hospital’s labor and delivery unit is based primarily on two false premises. The first is that the number of births at Sharon Hospital has steadily declined in recent years. This is false: the number of births at Sharon Hospital has increased since OHS’s 2019 Order, from 197 in 2019 to 216 in 2020 and 210 in 2021. Moreover, in a recent submission to OHS, Nuvance described an  anticipated 1.4% increase in the number of local women of child-bearing age over five years.

The second false premise is that hiring and retaining qualified medical staff at Sharon Hospital has become impossible. In fact, the community OB-GYN group recently hired a new full-time obstetrician; physician coverage is not an issue. A nursing shortage has only occurred following Nuvance’s announcement, causing most of Sharon Hospital’s full-time birthing unit nurses to leave or announce their departures. Nuvance refuses to replace full-time nurses and, instead, is employing expensive and temporary “travel nurses.”

The closure of Sharon Hospital’s labor and delivery unit will put mothers and their unborn children at unacceptable risk. Pregnant mothers will have to travel long distances to give birth and for emergency care. Given inclement weather conditions, especially during winter months, travel to distant hospitals is sometimes impractical, forcing women to give birth at home or en route to a hospital. As Connecticut Attorney General William Tong stated concerning the closures at Windham Hospital: “[A]sking these parents to travel an additional 25-45 minutes in order to undergo a major medical procedure at another hospital is not a mere inconvenience; it creates additional burden and risk for an already vulnerable mother and baby.”

The American College of Obstetrics and Gynecology conducted a complete review of Sharon Hospital’s labor and delivery unit in 2021 and determined that it was highly qualified to provide obstetric care and that everything should be done to preserve its labor and delivery unit. Sharon Hospital also has received a Five-Star rating from the Center for Medicare and Medicaid Services. However, Sharon Hospital will no longer be a full-service hospital and doctors may leave.

Nuvance is also eliminating the Intensive Care Unit (ICU) at Sharon Hospital — in the middle of a pandemic — and cutting surgical services so that emergency surgeries cannot be performed after regular business hours or during weekends, again in violation of  OHS’s 2019 Order requiring Nuvance to maintain Sharon Hospital’s ICU for five years. Nuvance’s new policy requires that ICU-level patients be transferred to other facilities for admission and has caused multiple ICU nurses to resign.

These closures will have detrimental effects on the community at large. The inability to provide healthcare services could cause residents to leave and discourage young families, the elderly, and people with health conditions from moving to the area. Recruiting new businesses to the area, or their expansion, will become difficult as firms consider quality of life, quality education and access to healthcare.

If Nuvance is permitted to use its dominance to forcibly close Sharon Hospital’s labor and delivery unit and ICU — and it should not — large swaths of Connecticut residents will be denied access to the healthcare they need and deserve.

David C. Singer is an attorney, arbitrator and mediator. He is also on the Board of Save Sharon Hospital, Inc., and is representing them here.