Connecticut health care regulators proposed this week to deny a request by Sharon Hospital to discontinue its labor and delivery services. The Office of Health Strategies found that closing the rural facility’s maternity ward could lead to worse health outcomes for mothers and infants.
In a 40-page proposed final decision issued Monday, the office concluded that the Nuvance Health-owned hospital had failed to satisfy five of the eight statutory criteria necessary to approve a Certificate of Need to stop offering the services. Nuvance has until Sept. 18 to appeal the decision.
The office felt the hospital application failed to demonstrate how the closure would improve the quality, affordability, or access to health care in the rural, western Connecticut region where Sharon Hospital is located.
“All of the available research is clear that even when alternative arrangements are made and emergency department staff is as fully prepared as possible, rural L&D closure results in bad quality and safety outcomes, including premature birth, low-birth weight, maternal mortality, severe maternal morbidity, increased risk of postpartum depression,” OHS hearing officer Daniel Csuka wrote.
Nuvance is one of several Connecticut provider networks which has recently moved to scale back services at its smaller hospitals. Regulators at the Office of Health Strategy have fielded similar requests to close maternity wards from Hartford HealthCare at Windham Hospital and Trinity Health of New England at Johnson Memorial Hospital in Stafford.
In Sharon Hospital’s case, OHS concluded the application did not demonstrate it was consistent with a state-wide health care facilities and services plan and the resulting transportation issues would likely disproportionately impact Medicaid-eligible residents and non-white patients.
The decision notes that Black mothers die from pregnancy-related causes at a rate of more than three times their white counterparts. Meanwhile, infant mortality impacts Black babies at a rate two to three times that of white babies.
“In sum, this termination would negatively affect minority races and ethnicities at a disproportionately higher rate. Accordingly, [Sharon Hospital] has failed to establish this criterion is met,” the decision read.
Like other rural facilities in Connecticut, Sharon Hospital has maintained that declining birth rates have made continuing to operate labor and delivery services unsustainable. Hospital representatives say the facility has delivered an average of fewer than one baby per day over the last decade.
In a statement Wednesday, Andrea Rynn, assistant vice president at Nuvance Health, called the OHS decision “deeply disappointing.” She said the decision ignored serious financial hardships and the considerable costs of operating an under-utilized maternity unit.
“As part of a non-profit health system, Sharon Hospital faces financial and operational challenges moving forward operating a Labor & Delivery unit that sees fewer than one delivery per day,” Rynn said. “We will be considering all options available as we reassess our path forward.”
The Connecticut Hospital Association also released a statement expressing concern over the OHS decision.
“Closing a birthing unit is not a decision that is made lightly,” the hospital association statement read. “Hospitals want nothing more than to provide access to the highest quality care to every patient in every situation. But staffing shortages, decreases in births, and skyrocketing temporary worker costs are serious challenges. Ignoring them doesn’t make the challenges go away and it moves Connecticut further away from our goal to make healthcare more affordable.”
Meanwhile, several state officials and members of the advocacy group Save Sharon Hospital celebrated the OHS decision during a Wednesday morning event held at the Sharon Town Hall.
Lydia Kruge Moore, a member of the group, described giving birth to her third child at Sharon Hospital in July. She praised the care she received at the facility and questioned what would have happened if she had to travel a long distance to receive care somewhere else.
“What if my wonderful but untrained husband had to pull over on the side of the road — in the dark, no less — to deliver our baby?” she said.
U.S. Rep. Jahana Hayes, D-5th District, said that efforts to scale back health care services in rural communities were not exclusive to Sharon Hospital of Connecticut.
“We have seen rural health care attacked all over the country,” Hayes said. “We have seen for-profit ventures where organizations are coming into communities like this and have one purpose in mind and it is to make a profit. You can not do that in a community like this.”
Comptroller Sean Scanlon applauded the Office of Health Strategy decision but noted that Nuvance could still appeal the ruling.
“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 ruling,” he said.