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.”


  • Dee Test

    ? So the maternity services are being subsidized with funds derived from Medicare, which are supposed to be provided to our hospital for services provided to our seniors and disabled?!! How many of the “La Luz clients” – who are apparently the largest group receiving these maternity services- are actually legal residents?!!! Is our hospital “stealing from Peter to pay Paul”? (Are the seniors and disabled of our community being “ripped off” to provide maternity services for women who are foreign nationals and who are receiving “free” medical and hospital care?) Is this the type of decision-making that has caused the collapse of our medical system throughout our state and country?! I believe the members of our community are entitled to a complete explanation and accounting, and are entitled to have a voice in this significant decision. Furthermore, all potential customers for this hospital need to decide whether they want to patronize this hospital or find alternatives in neighboring towns and cities. We can not be sponsoring any unethical type of “redistribution” of our limited resources, especially at a time of shrinking resources.

  • Randy Cook

    What a life it would be if we all lived in suspicion of our fellow residents in the Valley. To assume that the users of the local hospital are not legal residents and therefore should be denied having access to the hospital seems a stretch to say the least.

    One does not have to go back very far in time to a period when public hospitals were shutting down because they had to treat uninsured citizens, much less those who only have “resident” status. Oh wait, that era still exists (e.g. Palm Drive Hospital)! I think the crux of the issue is that the health system in America is badly broken, and Ms/ Mr Test seems to be in the camp that we should only provide services to those who can afford it.

    From my place of observation homeowners have paid for a seismic upgrade and two (2) planning and strategy campaigns with bond measures. Prior to that, bond measures went to just helping the hospital meet its operating expenses, and now they cannot manage Obstetrics or geriatric health. I hate to say it, but that is the state of health care in Sonoma & the US. If you want a hospital Dee, you and I must pay extra for that privilege. As long as I’m paying for it, I prefer to promote community health than to see people giving birth with no pre or post natal care and without having to do so in a clean and sanitary facility.

    • Dee Test

      Our Seniors and Disabled deserve better. The days of pretending that we just don’t notice the large numbers of illegal residents moving into our communities (and utilizing our services without paying) is over. Individuals, like yourself, can not continue to play coy games about who is being drawn to our services and why they are demanding entitlement to them, as represented by “La Luz”. We are overwhelmed. We can not provide for all of the medical needs for all needy and deserving humans on the planet, even if we believe that to be a noble goal. We can not continue to invite more and more exploitation of our system and our country. When we “look the other way” and allow our own Seniors to be denied services, so that medical services can, instead, be provided (at no cost) to foreign nationals, than we are abdicating our responsibilities to our nation and our generations to come. Nobody wants to be honest about this situation, but the persistent draw of “free” medical care ( as well as “free” schools and “free” food stamps, along with lots of illegal employment) acts to perpetuate this untenable fiasco. When we are confronted with the choice of either withdrawing services for our own debilitated and vulnerable citizens, or denying “free” services for illegal residents, than I believe we need to be honest. If our government had done its job, we would not be put in this position. But we are here now, and the difficult choices need to be made, even if they are not “politically correct”.

      • Phineas Worthington

        Half of all medical spending for the average person occurs in the last year of life. The elderly consume far more in costs of services than anyone else. There need to be meaningful limits on those expenses because it is just not fair to burden the young and productive with paying for the virtually unlimited care of the sick and dying.

        • Dee Test

          Remember that when you are older. Be sure to bring a copy of your printed sentiments about not wanting to be a financial “burden to the young and productive” when you require medical attention as you age. Be the first to demand eugenics for yourself.
          The generations before you built this country with their blood and their sweat. They deserve our respect and our compassion and they deserve the medical services that they paid for with steady contributions throughout their working years. You may not get this concept, but it will become very obvious to you when you are the one to be denied services, so that they can be diverted to others.

          • Phineas Worthington

            Where is it written that the young and productive must be forced by law to sacrifice their own needs to the needs of the sick and dying, many of whom are perfectly capable financially to provide for themselves?

            I can’t find those words anywhere in our national contract. Maybe you don’t understand that concept, the concept of property as an inalienable right.

    • Phineas Worthington

      I am a paying customer. Everyone else should be too. Everything has a cost and someone somewhere has to pay that cost. Seems only fair that the people who consume medical services should pay their own costs rather than force others do it for them through legal wealth transfers.