By Max Friedman
Scrutiny and criticism of cuts and service changes at Windham Community Memorial Hospital by its parent company, Hartford HealthCare, is growing.
Last week, Charles C. Ryan, the editor of the Willimantic Chronicle, published a commentary against these actions, which includes reducing the number of staffed beds from 87 to 32, downgrading the critical care unit and discontinuing programs.
The editor’s commentary is worth the read. It outlines a cautionary tale of hospital consolidation run amok.
Since its integration into Hartford HealthCare in 2009, Windham Hospital has had financial losses every fiscal year. The merger was forged so that the hospital could survive and continue to offer services to an area of the state, which is struggling economically and medically underserved.
The deal has been unsuccessful in achieving such ends.
Thus far, the deal has resulted in many services being shifted to other hospitals in the network, notably Hartford Hospital and Backus Hospital in Norwich. Patient revenue at Windham went from around $81 million in 2008 to $77.5 million in 2015, after a floor of the hospital was closed. This decline was cited by Hartford HealthCare as a reason for further cuts, continuing a death spiral of declining revenue.
Now, many patients are forced to travel long distances to for care, a large burden for those without transportation. Bringing patients to Hartford by ambulance puts the burden on Windham area municipalities, which must also cope with the loss of good middle-class jobs at the hospital. And transport from Windham to Hartford by helicopter only adds to health care costs.
Area medical professionals have spoken out. In July, doctors in Windham Hospital’s Division of Medicine unanimously found the concept of no intensive care unit “completely unacceptable.” Community leaders and health care workers spoke out about the impact of these cuts over the summer and autumn. One doctor noted that losing the intensive care unit is the tip of the iceberg; Windham Hospital now has fewer surgeons and no longer has a full time neurologist.
Hospital mergers and changes in Connecticut must go through a Certificate of Need (CON) application process through the Office of Health Care Access (OCHA) in the Department of Public Health. In their 2008 application, Windham and Hartford HealthCare stated that direct benefits of this integration would include improving the financial stability of Windham Hospital, increased services and technology, offered locally and decreased out-migration of patients. OCHA approved the CON application on the belief that it would improve the quality of care delivered in the region.
The hospitals stated in 2008 that they “will not be terminating any services.” In fact, one condition OHCA placed on the deal was that any change in service availability at Windham would force the applicants to file a new CON Determination Form with OCHA.
Despite the urging of advocates, legislators and medical professionals in the area, including several community forums attended by hundreds of area residents and the collection of over 3000 petition signatures, OCHA determined last fall that these service cuts did not necessitate a formal review and hearing process.
The leadership of Windham Hospital and Hartford HealthCare are not adhering to the spirit of their agreement with the state, even if they are (barely) within its technical bounds. While small community hospitals cannot offer all of the services that large urban ones like Hartford or Yale-New Haven do, residents should be able to receive quality, affordable acute care close to where they live.
State policymakers must work to remedy the significant problems created by Hartford HealthCare’s actions, and ensure that this doesn’t occur at other community hospitals when they are acquired by larger networks. Otherwise, the patients are left holding the bag.