The Office of Health Strategy issued an initial denial of Trinity Health of New England’s application to close the labor and delivery unit at Johnson Memorial Hospital, according to a proposed final decision published Tuesday.
The decision found, among other points, that Johnson Memorial failed to sufficiently demonstrate that the closure would improve accessibility and cost effectiveness of health care delivery in the region.
Trinity Health of New England now has 21 days to appeal and request an oral argument. At that point, the application would appear before the executive director or deputy director of OHS, who then would have the final say to uphold, reverse or modify the decision.
Trinity Health of New England issued a statement Wednesday.
“We are disappointed that the Office of Health Strategy (OHS) has denied our application for a Certificate of Need (CON) regarding the elimination of labor and delivery services at Johnson Memorial Hospital. This decision comes after Johnson officials fully participated in a lengthy and detailed information gathering process and a public hearing on the matter,” the hospital said. “We are currently deliberating our next steps regarding the CON denial. We are committed to continuing to work with state officials to resolve this issue and further our common goal of providing safe, high-quality care to the greater Stafford community.”
“This decision is good news for the residents of our district,” Sen. Jeff Gordon, R-Woodstock, wrote in a press release on Wednesday. “Expectant mothers, and families, rely on Johnson Memorial’s maternal care because of its accessibility in our rural area and its quality.”
However, the initial denial doesn’t mean the unit won’t face closure. In the past, proposed decisions have been modified and even reversed.
Johnson Memorial stopped delivering babies in April 2020, though it briefly resumed services for a few months later that year. The hospital applied to close its labor and delivery unit in September 2022, and OHS held a public hearing in July 2023.
The hospital cites recruiting challenges as one of the reasons it’s seeking to terminate services. In its application, hospital executives stated that the only obstetrics doctor on the hospital’s medical staff stopped performing deliveries at the hospital in 2020, and that they’ve also faced issues recruiting sufficient nursing staff to retain a full labor and delivery unit.
During the July 2023 public hearing, Robert Roose, Johnson Memorial’s chief administrative officer at the time, revealed that Johnson Memorial faces financial challenges that go beyond the hospital’s labor and delivery unit.
“Is [Johnson Memorial Hospital] considered at risk of closure? Financially?” asked Annaliese Faiella, a planning analyst with the Office of Health Strategy.
“I was not prepared to answer that question today. I’ll be honest,” said Roose with a nervous laugh. “The sustainability of hospitals in the current health care environment is one that is being considered. Right now, there are many hospitals, Johnson Memorial Hospital included, for which financial sustainability is a concern.”
Roose then confirmed that labor and delivery is not the only unit at Johnson experiencing financial problems.
“Does JMH anticipate closing any other departments?” Faiella asked.
“I don’t have any comment on that at this time,” Roose responded.
Rural labor and delivery
Over the past several years, OHS has received three applications to close labor and delivery units in rural parts of the state.
On Dec. 1, 2023, OHS announced the approval of a plan to terminate labor and delivery services at Windham Hospital, which is owned by Hartford HealthCare, after initially denying the proposal the previous year.
Under the terms of the settlement, Windham Hospital must hire an independent third party to assess the need for and feasibility of establishing a birthing center in the area. If the study concludes that it is necessary and possible to do so, the hospital will have to either find a provider to operate a birthing center or operate it themselves.
The hospital will also be required to provide both emergency and non-emergency transportation for the expectant mother, as well as any support people, to and from the hospital for pre-delivery exams, labor and delivery, and post-delivery visits. Windham Hospital will continue to provide prenatal and postpartum care.
Sharon Hospital, which is owned by Nuvance Health, applied to close its labor and delivery unit in January 2022 as part of a broader effort to align services to the aging population it serves, said Andrea Rynn, a spokesperson for the health system.
In August 2023, OHS initially denied Nuvance’s application. The hospital appealed the decision and, last month, presented oral arguments. Per the certificate of need process, OHS should issue a final decision within 90 days. Sharon Hospital has continued performing deliveries while it awaits the state’s decision, the only hospital of the three to do so.
This story was originally published by The Connecticut Mirror Jan. 17, 2024.