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Jason Walsh: When maternity wards don’t deliver

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In December of 2013, a notable headline ran in the Sonoma Index-Tribune declaring: “Sonoma Valley Hospital May Shutter Maternity,” with its lead sentence warning that, “There may come a day, in the not too distant future, when the stork no longer visits Sonoma Valley Hospital.”

It looks like nearly five years after the anonymous staff report was written, that day has finally come.

Sonoma Valley Hospital officials announced at a public meeting on July 25 their plans to shutter the hospital’s childbirth center, a move mirroring similar trends among smaller suburban and rural healthcare districts across the country. (The hospital’s skilled nursing facility was also on the chopping block but, perhaps sensing two blows to the district was one too many, SVH officials put skilled nursing’s fate on the backburner and is convening a taskforce to study it further.)

As SVH CEO Kelly Mather put it in a statement to the community, “It’s become clear that a community hospital can no longer try to be all things to all people but must refocus on essential community needs… The reality is that a small hospital today cannot continue to provide services that lose money, no matter how good those services are.”

To put it mildly: Maternity wards are a tough business these days.

And they have been for a long time. As the above headline references, the hospital had serious plans to shutter its OB services back in 2013 for much the same reasons as now – high cost, low use -- but community members in the district urged the hospital to give it another chance. Hospital officials did just that in the hopes of reaching a sustainable 15 births per month. But they’re currently languishing at below 10, and the writing has been on the wall for the past few months, probably a lot longer.

It’s been an up-and-down couple of years for the Sonoma Valley Hospital. They initially lost a crucial vote in 2017 to renew the Sonoma Valley Healthcare District’s 15-year-old parcel tax, but pulled it together in a second ballot attempt that same summer ensuring another five years of a $250-per-year parcel tax that would bring in about $3.85 million in year in revenue. Earlier this year the hospital sealed a promising affiliation agreement with the highly respected University of California at San Francisco.

Now they’re suffering the loss of maternity; and skilled nursing may be on life support.

These are emotional losses for many in the Valley. How many families have brought babies into the world at Sonoma Valley Hospital? How many kids in the school district today breathed their first out along Andrieux Street? Hospital officials point out – rightly so – that most community hospitals this size don’t deliver babies; most people aren’t born in their hometowns. But to many who are, and their parents, it can be something special.

But the baby-bottom line is, well, the bottom line. Hospital officials report a $4.3 million loss last fiscal year, made somewhat more palatable by the $3.8 million in revenue from the parcel tax – giving it a final count of $500,000 in the red. Mather says that by no longer absorbing a cost of at least $60,000 per month to run the maternity ward, the hospital will save more than $720,000 per year.

Among the demands of voters during last year’s narrowly won Measure E campaign to pass the parcel tax was for the hospital to balance its books – find new sources of revenue, and expenses to cut. This fulfills the latter. The healthcare district’s campaign priority was to keep the emergency room running. Hospital officials say that remains their priority.

Major cuts as these are a bitter pill for the community – as well as the hospital, its staff and management. Critics will say it’s evidence of poor financial management; hospital officials say the combination of lowering federal medical reimbursements in an aging demographic – and the move away from inpatient care – are trends they can’t reverse.

What isn’t disputed is that Sonoma Valley Hospital is not alone. Earlier this week, the struggling Sonoma West Medical Center in Sebastopol announced plans to avoid closure by dropping inpatient care and its emergency room. According to industry publication “Patient Flow Weekly,” the hospital, owned by Modesto-based American Advanced Management Group, will transition to a long-term acute-care facility. It threw the baby-ward out with the bathwater long ago.

The Sonoma OB ward is set to close Oct. 31, a day honoring the faithful departed.

Community hospitals are a tough business these days.

Email Jason at Jason.walsh@sonomanews.com.