Sonoma Valley Hospital keeps obstetrics open, for now

Despite the current lean times for Sonoma Valley Hospital, administrators will be able to keep Sonoma’s one and only maternity ward open, at least for now.

That was the message from hospital staff Thursday night, speaking before the Sonoma Valley Health Care District board of directors. Mark Kobe, the hospital’s director of nursing, explained that the service is still a perennial money-loser, but that losses have been reduced to a manageable level.

“Given our current volume, even though it is decreasing, we believe that we can sustain the service line given a loss of $250,000 per year,” Kobe said during the board meeting.

To make this possible, he said, two important things happened: The hospital “achieved some efficiencies” – i.e. cut expenses – in its obstetrics unit, and Medicare Disproportionate Share funds were restored.

CEO Kelly Mather and other hospital leaders agreed that the Disproportionate Share funds – commonly known as DSH or “dish” funds – were key, and many expressed satisfaction that obstetrics would stay open.

“We seem to be in a different environment than we were a few months ago, which is very heartening for everybody,” said board chair Sharon Nevins.

The low number of births remains a worry for administrators, however, as Sonoma Valley follows national trends in declining birth rates. Kobe said the hospital had 16 births in July – well over the needed number of 12 or 13 per month to break even – but on another month obstetrics might see just six births, leading to an estimated loss of $80,000.

For that reason, board member Jane Hirsch warned that should DSH funds go away again, the hospital might have to reopen the discussion of what to do with obstetrics.

Anna Pier, chair of the board of directors of La Luz Center, thanked hospital leaders for working to keep obstetrics open, adding that its presence in Sonoma “is absolutely critical for the clients of La Luz and the people we represent.”

No vote was cast by the board regarding obstetrics – and in fact very few votes were cast at all during Thursday’s meeting, which was dominated by informational presentations and discussions. In nearly every case, talk centered on the hospital’s difficult financial situation, and how that cut into its ability to provide services.

Along those lines, Dawn Kuwahara, director of ancillary services, gave a presentation on the hospital’s Senior Wellness program, which has received criticism lately after closing its gym.

Senior Wellness maintains a “deep and abiding commitment to seniors in our community,” Kuwahara began.

Though the supervised gym has been closed, with its approximately 60 users shifted to Parkpoint on Highway 12, other programs such as balance classes, pain management and “gentle yoga” will remain available.

“I want to assure our seniors in the Valley, we remain committed to their health and wellness needs. And we will continue to offer no-cost and low-cost health and wellness services,” Kuwahara said. Overall the program serves an estimated 300 seniors in the area.

That didn’t pacify Rosemarie Pedranzini, who complained loudly about a number of changes in hospital services. In response, board member and treasurer Peter Hohorst said, “With the present cutbacks in Medicare reimbursement, our hospital is no longer able to be all things to all people.”

“The financial resources are not there to do it,” he said, noting that 16 full-time positions at the hospital have already been cut. Currently, “We have borrowed somewhere around four-and-a-half million (dollars) on our line of credit to stretch our money as far as we possibly can, and we are now looking critically at everything at the hospital that is not carrying its own weight.”