Nuvance defends hiring efforts, decision to close unit

SHARON — Nuvance administrators responded to questions on staffing and hiring practices at its three Connecticut hospitals — with special emphasis on the labor and delivery unit.

The state Office of Health Strategy contacted Nuvance at the end of October about allegations that the nonprofit hospital group, owner of Sharon Hospital, has not lived up to promises made to the state in 2019.

OHS sent six questions to Nuvance about its hospitals in Norwalk, Danbury and Sharon. The responses were due on Nov. 22. Nuvance responded on that date with a 17-page document in which it defended its hiring and recruitment practices; and justified its decision to close the labor and delivery unit in Sharon.

About its recruitment efforts at all three hospitals, Nuvance Vice President for Strategic Planning and Business Development Sally Herlihy gives a detailed description of “competitive compensation and comprehensive benefits” offered to entice medical staff;  retention bonuses and relocation bonuses; and a $2,500 referral fee for anyone who recruits “an eligible full-time registered nurse.”

Two new nurse practitioners in Sharon

Nonetheless, Herlihy says, “There are currently over 1,600 open positions across the Nuvance Health system, of which approximately two-thirds are clinical positions. These include openings at Danbury Hospital, Norwalk Hospital, and Sharon Hospital for maternity and obstetrical services, medical/surgical units, intensive care units, and surgical services staff.”

The “competitive compensation and comprehensive benefits” have attracted a total of 26 new primary care clinicians across the Nuvance system, Herlihy says. That includes four physicians and one nurse practitioner in the Norwalk Hospital service area and five physicians and four nurse practitioners in the Danbury Hospital service area.

In the Sharon Hospital service area, Herlihy says, “two new primary care nurse practitioners will be joining the Millerton and Sharon offices.”

Sharon also now has a mobile health van in its parking lot two days a week, a collaboration with the Community Health & Wellness Center in Torrington.

Herlihy says that, “As of September 2021, Sharon Hospital had a total of 244 physicians and advanced practice providers on its medical staff, while Norwalk Hospital had 768 providers, and Danbury Hospital had 1,079 providers.”

To help keep the hospitals functioning, Herlihy says, Nuvance “pays a staffing agency partner significant fees to fill specific, hard to recruit positions at Sharon Hospital. Although this option is currently being utilized in an effort to fill open positions at Sharon Hospital, the nationwide health care worker shortage has also impacted the availability of clinical providers through staffing agencies.”

Can’t fill labor and delivery nurse jobs in Sharon

She referred specifically to challenges faced in staffing the labor and delivery unit in Sharon, where there are now three open registered nurse jobs that need to be filled.

“Nuvance Health has historically encountered challenges recruiting for these positions and has regularly resorted to utilizing its staffing agency partner…. “

Herlihy says the staffing agency has “approximately 1,100 requests for Labor & Delivery Registered Nurses for which they have approximately 56 individuals available, resulting in a very low likelihood that the agency will be able to fill these positions.”

Herlihy says there is a national shortage of labor and delivery nurses.

Nuvance  tried to grow new staff with an obstetrical registered nurse residency in 2019. “To date five nurses have completed the residency.”

No success in attracting OB-GYN doctors

Herlihy then described “extensive recruiting efforts aimed at attracting obstetrics and gynecology physicians to the Sharon community.”

This “multi-faceted recruitment approach via professional recruiting channels, advertising, and locum tenens searches” has so far not succeeded in attracting new doctors.

Herlihy says in her letter that, “Sharon Hospital and Nuvance Health have sought to support the hiring of physicians by community obstetrics and gynecology practices by offering financial support and incentives for recruitment and on-boarding, in accordance with federal guidelines, but efforts have been unsuccessful.”

She then blamed  “the instability of community providers” for exacerbating “the strain on the remaining providers and service.”

Nuvance might have considered “shifting clinical staff from other Nuvance Health facilities to Sharon Hospital” but the remote location makes it hard for doctors “to assume call coverage, or cover in-person shifts while managing shifts in another location.”

Also, some of the doctors employed by Nuvance, which is based in New York State, are not licensed in Connecticut.

At any rate, Herlihy says, there aren’t really any extra doctors anywhere in the Nuvance system, where “there are currently more than 1,600 open positions across the health system, including 50 clinical positions at Sharon Hospital.”

Decrease in deliveries statewide

Herlihy’s letter then refers to Nuvance’s consistent claim that “Nuvance Health’s continuous, dedicated efforts to develop a long-term, sustainable staffing plan have been unsuccessful to date, due in part to the combination of decreasing birthing volume and the rural location.”

The Sharon Hospital labor and delivery unit “is currently adequately staffed to meet the needs of the community,” with one Nuvance-employed and one “community-based” obstetrics doctor.

Even though there is a decreasing need for obstetricians, Herlihy says that the two now delivering babies at Sharon Hospital have “a demanding call coverage schedule” and have had to sometimes “rely on general surgeons to assist with C-sections (which increases the burden on the general surgery practice and makes it more difficult to recruit surgeons).”

In closing, Herlihy reiterates that Nuvance has tried to recruit new doctors without much success.

Some doctors recruited to Sharon have left “for busier practices in other markets, forcing Sharon Hospital to re-start recruiting efforts in the midst of a workforce shortage,” Herlihy says.

Two other hospitals in Connecticut (neither of which is owned by Nuvance) have also announced this year that they will close their labor and delivery units, for similar reasons. They are Windham Community Hospital, which is part of the Hartford HealthCare network; and Johnson Memorial Hospital in Stafford Springs, which is part of Trinity Health of New England.

Tina Hyde, manager of external affairs for the Office of Health Strategy, said, “OHS is reviewing the [Nuvance] responses and a timeframe for a decision of the Certificate of Need is unknown at this time.”