State launches investigation into noncompliance by Nuvance Health

SHARON — The state Office of Health Strategy (OHS) is investigating allegations against Nuvance that claim the nonprofit hospital group, owner of Sharon Hospital, has not lived up to promises made to the state in 2019.

Although an Oct. 29, 2021, letter from OHS is addressed to administrators at Norwalk Hospital, a list of six requests for information covers the three Connecticut Nuvance hospitals in Norwalk, Danbury and Sharon.

One of the requests very specifically touches on reductions in services that Nuvance has announced are planned for Sharon Hospital. These reductions are in the labor and delivery unit, the intensive care unit and the hours that surgical services will be available.

Nuvance is based in New York state and was created by joining Health Quest with the Western Connecticut Health Network. To get permission from the state, the health organizations had to submit a Certificate of Need, which was completed in November 2018. There were multiple conditions the state required before approving the new name (Nuvance).

The letter from OHS to administrator Sally Herlihy at Norwalk Hospital explains that, “On Oct. 22, 2021, OHS received an inquiry alleging possible noncompliance with several conditions of the Order and requesting that we investigate Nuvance’s compliance with these conditions.”

The first of the six requests for information asks about the amount of charity care provided at each of the three hospitals.

Second is a request for information on “interruptions, closures, reductions or other deviations”  to services that had been offered by the three hospitals at the time the state gave its approval.

Maternity and obstetrical services

The third request asks about “Nuvance’s efforts to recruit and retain clinical staff for the provision of services including but not limited to maternity and obstetrical services, medical/surgical units, intensive care unit and surgical services, including any reductions in access to or availability of operating rooms.”

The fourth request asks for  “activities and progress towards Nuvance’s plan to recruit and retain physicians, as detailed in its Nuvance Health Strategic Plan 2025.”

Sixth is a request to “describe strategies that Nuvance has considered and pursued to address any professional staffing issues at Sharon Hospital utilizing resources available within the Nuvance system, including but not limited to clinical providers at other Nuvance facilities.”

The final request refers specifically to “Condition 18 of the Order,” and asks “how Nuvance has determined the obstetric and gynecological needs of each community served by each Connecticut hospital in the Nuvance system and its efforts to align these services with the professional standards for high quality gynecological and obstetric care.”

The original request to Nuvance was for a detailed response by Nov. 5. Tina Kumar, who is Manager of External Affairs at the state Office of Health Strategy, said that the deadline has been extended to Nov. 22.

Attny. General Tong weighs in

Meanwhile, Hartford HealthCare, one of the region’s major health-care networks (it includes Charlotte Hungerford Hospital in Torrington), announced last week that it plans to close the labor and delivery unit at Windham Hospital in Windham, Conn.

The medical group is offering reasons in its application to the Office of Health Strategy that are similar to those Nuvance is offering in its request for the changes at Sharon Hospital. They are claiming low patient counts in the labor and delivery unit, and struggles with getting medical staff.

If the Hartford HealthCare request is granted, mothers who would have delivered at Windham Hospital will have to go to hospitals in Norwich, Manchester or Hartford instead.

The Hartford HealthCare request was submitted on Wednesday, Nov. 10.

The day before the presentation to OHS, Connecticut Attorney General William Tong sent a two-page letter to OHS Executive Director Victoria Veltri.

In the letter, he said, “I understand that the applicant has provided a number of reasons for closing the obstetrics unit. These include the choice of patients to have their babies in larger hospitals and the concern that a low volume  of births will put patient safety at risk, and other local and national workforce challenges.”

Tong continued that, “the fact remains that permanently closing the birthing unit will leave vulnerable families in the region — those  who do not have the choice of driving to Norwich, Manchester or Hartford in order to give birth — without an essential health-care service.”

Tong says in his letter that Windham Hospital serves a low-income community and that it is particularly difficult for mothers in this community to drive an additional 25 to 45 or more minutes to get to a hospital that has a labor and delivery unit.

An eye on use of charitable donations

Tong also notes that, “the  statutes  charge  my  office  with  ensuring  that  charitable  gifts  are  used  for  purposes  consistent with donative intent. Should OHS ultimately approve this application, we will ensure any charitable  funds  intended  to  support obstetric  services  at  Windham  Hospital  continue to  serve the  Windham service area in a similar capacity.”

When contacted for comment on the similar situation at Sharon Hospital with Nuvance, a spokesperson for the attorney general said, “We are watching that issue closely and expect to be similarly engaged.”