State denies closure of Sharon Hospital maternity unit

UPDATE:  On Friday, September 8, the OHS granted Sharon Hospital an extension to appeal the OHS's Proposed Decision. The hospital, and its parent company Nuvance Health, now has until October 18, 2023 to file a brief and exceptions seeking a Certificate of Need to close the hospital's Labor and Delivery Unit.

SHARON — Sharon Hospital’s application to close its Labor and Delivery Unit was denied by Connecticut’s Office of Health Strategy (OHS) on Tuesday, Aug. 29.

The “proposed final decision” granted Sharon Hospital and its parent company, Nuvance Health, 21 days to appeal the decision. An appeal would continue a five-year battle between Sharon Hospital and members of the local community, led by Save Sharon Hospital, over maintaining the hospital’s labor and delivery services. 

Sharon Hospital filed a Certificate of Need to close the maternity unit with OHS in January 2022, citing financial concerns, declining birth rates in Litchfield County, and underutilization of its obstetrics unit.

The hospital, which has cited losses of more than $20 million in a single year, 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.

The hospital also described a decline in births at Sharon Hospital, citing fewer than one delivery per day in 2021, and difficulty attracting and retaining trained staff in a rural community.

At an OHS hearing in December 2022, doctors, advocates, and local families rebutted the hospital’s claims that closing the maternity unit would not impact access to adequate care in the region, and raised questions about the hospital’s claim that underutilization of the unit was causing irresolvable financial and safety concerns.

In its Aug. 29 decision, OHS found that Sharon Hospital had not adequately met five of eight applicable criteria to qualify for a Certificate of Need, repeatedly citing testimony from the December hearing, as well as supplementary materials provided by Save Sharon Hospital and others. 

Primarily, the decision to reject Sharon Hospital’s application rested on concerns about the closure’s impact on the accessibility of adequate care for pregnant women in the region. OHS emphasized the disproportionate effect this closure would have on people of color, the fastest-growing demographic in the region, and indigent people (more than 48% of Sharon Hospital’s labor and delivery patients paid through Medicaid in 2021).

The decision stated repeatedly that the burden of proof rested with the hospital and that the hospital had not succeeded in providing adequate evidence of either financial or safety concerns, nor adequate plans for alternatives for women in labor seeking care, especially for high-risk and emergent deliveries.

Though the hospital is non-profit, OHS took care to point out that its parent, Nuvance Health, provides financial support to Sharon Hospital, and, having ended 2021with a net increase in assets of $242 million and $1.7 billion in net assets, Nuvance is “by all accounts financially stable,” despite its operating losses at Sharon Hospital.

While there are other five other hospitals within an hour from Sharon, all able to accept women in labor, these options would require patients to make longer drives (the nearest hospital is Charlotte Hungerford in Torrington); OHS also cited concerns about these hospitals’ higher costs and lower safety ratings.

Gregg Pulver (R), Chairman of the Dutchess County Legislature, said that OHS’s decision was responsive to arguments from “representatives on both sides of the state line.” Patients at Sharon Hospital are more often from Dutchess County than from the Northwest Corner.

“Access to rural health care here is in crisis or at risk across the board,” said State Rep. Maria Horn (D-64). Though “it will always be a battle,” she said, “[We need] to keep this thriving hospital alive and vibrant and and helping all of us.”

Andrea Rynn, spokesperson for Nuvance Health, called the decision “concerning and disappointing.”

Sen. Richard Blumenthal (D-CT), State Sen. Stephen Harding (R-30), U.S. Rep. Jahana Hayes (D-5), Rep. Horn, and State Comptroller Sean Scanlon all spoke in support of OHS’s preliminary decision at a press conference in Sharon Town Hall on Wednesday, Aug. 30.

Blumenthal called on Nuvance not to appeal OHS’s “well-reasoned, fully researched decision.”

“Nuvance has an obligation to listen to its customers, its patients, its community,” said the senator. “I am hopeful that meetings like this one will convince [Nuvance] that it can and should do the right thing.”

Horn drew a contrast between the diverse, fact-based testimonies provided by local healthcare professionals, and Nuvance’s “one single argument, that ‘this is just unsustainable,’ and ‘we can’t afford it.’”

Harding said, “I want to applaud the Office of Health for taking the time, not only with reading the testimony, but the whole process in general. I think they did a great job of listening to all sides of the story.”

Hayes noted that the threatened closure is indicative of national trends in rural and women’s healthcare access. “We have seen women’s reproductive health attacked all over the country,” she said. “So I am excited about today, but also looking forward and committed to […] bringing this 20 year battle [over the future of Sharon Hospital] to an end.”

Nearly all of the speakers thanked the local 501(c)(3) Save Sharon Hospital (SSH) for its instrumental work in preventing the closure of Sharon Hospital’s labor and delivery unit by marshaling skilled testimony from health care workers.

SSH President Lydia Moore, who gave birth to her youngest daughter in Sharon Hospital about two months ago, acknowledged the community for contributing “almost 12,000 pages of public comment,” overwhelmingly in favor of keeping labor and delivery open, as critical to the movement’s success.

Acknowledging that Nuvance can still appeal the OHS decision, Scanlon said, “We’re here today to say that this is good news, but the fight to maintain access to affordable, quality health care, especially when it comes to labor and delivery, is going to continue beyond this morning.”

As of Sept. 4, Nuvance has not yet announced if it will appeal the decision.

“As part of a nonprofit health system, Sharon Hospital faces financial and operational challenges moving forward,” said Rynn in a statement. “We will be considering all options available as we reassess our path forward.”