The state’s proposed final decision issued last week denied Sharon Hospital’s request to close labor and delivery services at the hospital. (See story here.) The Office of Health Strategy, an agency created in 2018 responsible for developing and implementing a comprehensive health care vision for the state, requires certain types of health care providers to obtain state approval prior to making major changes in the health care landscape. In its proposed final decision, OHS included “Findings of Fact” containing more than 100 statements. In themselves, the statements provide a portrait of our hospital that puts the issues in perspective from both sides of the argument. The findings and the state’s proposed final decision also stand as a snapshot of our time, illustrating in some ways how Sharon Hospital shares issues facing rural hospitals across the country.
Those issues include low labor and delivery volume, difficulties in recruiting and retaining staff, a problem further exacerbated by a nationwide health care worker shortage. From January to December 2021, Sharon Hospital had deliveries on approximately 45% of the days during the year; there were approximately 202 days (55%) where no obstetrical delivery occurred. Yet full staffing for a birthing unit and 24/7 surgical and anesthesia support is required. A 2022 Community Health Needs Assessment indicated health needs of the community, which has an aging demographic, include access to primary and preventative care, behavioral health care and maternal and child health care.
Rural hospitals also struggle with travel times, and the request to close Sharon’s labor and delivery unit has raised concern about alternatives for women in the Northwest Corner and in eastern Dutchess County. The lack of adequate access to labor and delivery facilities and services for women in rural areas has led to documented increases in out-of-hospital births, births in hospitals without obstetrics services, and poorer birth outcomes. Travel time of 20 minutes or more is associated with an increased risk of mortality and adverse outcomes. Travel times from Sharon Hospital to area hospitals capable of serving patients in need of labor and delivery services range from 37 minutes to 60 minutes.
Seven percent of residents in the hospital’s primary service area have incomes below the federal poverty level, but an additional 31 percent have incomes that fall below a threshold necessary to meet all basic needs. The Findings of Fact state that the hospital’s proposal would have a negative impact on access to Medicaid recipients and indigent persons and would exacerbate racial and ethnic healthcare inequities at the state, county, and town levels.
As part of Nuvance Health, a not-for-profit organization, Sharon Hospital anticipates $3 million dollars in annual savings by shutting labor and delivery. The Findings of Fact state that despite Sharon Hospital’s losses in fiscal year 2021, Nuvance made approximately $75 million, had an excess of revenue over expenses of $105 million. OHS concluded that Nuvance appears to be financially stable.
The proposed final decision can be appealed. Sharon Hospital has until Sept. 18 to do so.
To read OHS’s proposed final decision, go to: portal.ct.gov/OHS/Pages/Certificate-of-Need/CON-Portal and search for CON status of Vass
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