Rural hospital scorecard

The past few months have been witness to a string of decisions from the Connecticut Office of Health Strategy (OHS) regarding applications from rural hospitals that want to end labor and delivery services.

OHS was created in 2018 and is responsible for developing and implementing a comprehensive health care vision for the state, and requires certain types of providers to obtain state approval prior to making major changes that could alter the healthcare landscape.

The current OHS scorecard shows two proposed denials and one approval. But it’s not over yet.

Sharon Hospital has been at the forefront in our corner. Last August, the state issued a proposed final decision denying the hospital’s request. Citing losses of more than $20 million in a single year, the hospital, part of the Nuvance Health, estimated that closing the maternity unit would save $3 million in large part by enabling the hospital to employ some 18 fewer staff members, and cut down on physician fees incurred by after-hours surgery and anesthesia services. In its proposed final decision denying the request, OHS noted that despite losses in fiscal year 2021, its parent Nuvance Health had an excess of revenue over expenses. Many factors are under scrutiny, including an aging demographic that wants access to primary and preventive care, behavioral healthcare and maternal and child healthcare. Births occur on only 45% of days in the year at Sharon Hospital.

Approval with terms

Last month, the state granted approval to another rural hospital that sought permission to end labor and delivery. Windham Hospital near Willimantic had been denied permission the year before. The Hartford Healthcare hospital’s green light this time came with terms: It must conduct an independent study of the need for a birthing center, and if one is justified, Windham Hospital must find a provider or operate such a facility itself. In addition, the hospital will be required to provide transportation for expectant mothers in addition to providing prenatal and postpartum care.

And just last week, OHS denied Trinity Health of New England’s application to close the labor and delivery unit at Johnson Memorial Hospital in Stafford Springs. OHS noted that the hospital failed to demonstrate that closing the labor and delivery service would improve accessibility and cost effectiveness of health care delivery in the region. Just as in the case of Sharon Hospital’s denial late last summer, Johnson Memorial has a channel of appeal.

In Sharon Hospital’s case, its oral appeal took place in November before OHS’ Executive Director Deirdre Gifford. Lawyers for Sharon Hospital cited four major flaws in OHS’ proposed final decision, and they concluded that the “policy choice that best serves patients is to transform Sharon Hospital into a resource that delivers the right care in the right place at the right time.” (See story on Page A2.)

OHS’ Gifford will have the final say to uphold, reverse or modify the proposed final decision. Her ruling is anxiously awaited in eastern Dutchess County and in Northwest Connecticut, where the Save Sharon Hospital group has been campaigning against the change for years.

Gifford is no stranger to the healthcare world. Prior to her OHS role, she led the state Department of Social Services from June 2019 until January 2023. In May 2020, as the COVID-19 pandemic intensified, Gov. Ned Lamont appointed her acting commissioner of the Department of Public Health. Before serving in Connecticut, Gifford was deputy director for the Center for Medicaid and CHIP Services at the Centers for Medicare and Medicaid Services from 2016 to 2019.