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Sonoma Valley Hospital Delays Final Recommendation To Close Obstetrics Program

Sonoma Valley Hospital announced it will ask the Health Care District Board to delay acting on the Administration’s recent recommendation to close the Hospital’s Obstetrics service. The main reason for the delay, according to Hospital CEO Kelly Mather, is that the Hospital has learned that the Medicare funding supporting the program, which was cut in October 2013 and precipitated a reassessment of this program, has been restored.

Hospital Administration had recommended to the District Board at its January 9, 2014 meeting that the Hospital’s Obstetrics service be closed this year due to low use that made it financially unsustainable. The Hospital projected the service would lose $86,000 each month during 2014.

“Now that Medicare Disproportionate Share (DSH) funds, which have underwritten a large part of the cost of the Hospital’s Obstetrics program in recent years, have been restored, this gives us some breathing room to explore options to continue the services,” Mather said.

“A number of community members at the board meeting shared stories about how important giving birth here in Sonoma is to them,” she said. “We too would prefer not to close the service, but it is unfortunate that there are so few births in our valley and that many prenatal patients choose to deliver elsewhere.  We are always faced with some hard choices because our community is so small.  Many small hospitals have already eliminated Obstetrics because of low volume,” she said.

“We could not recommend a delay unless Medicare reinstituted the funds because our hospital cannot sustain a loss of over $1 million,” Mather noted. “Hospitals across the nation fought for this delay throughout 2013 and it sure would have been nice if they would have made this decision before expiration on September 30, 2013.  We now have a bit more time to assess the situation and exhaust all options that may make this service financially sustainable.”

Mather stresses that this is only a delay, and not a final decision. She said the Hospital will continue to lose money on its Obstetrics program even with the restored DSH funds, and the low volumes are of great concern. She reported that Hospital Administration plans to regularly update the District Board this year on the financial situation regarding Obstetrics services, and if the trend continues to demonstrate low demand for this service, it will likely have to make a final recommendation for closure.

The Hospital reported it has seen a steady decline in annual births since 2000, consistent with national and country demographic trends. Births at the Hospital have dropped from an average of 21 per month in 2000 to around 12 currently. The Hospital estimates it needs at least 25 deliveries each month to cover its costs for this program.

Dee Baucher January 18, 2014 at 04:30 PM
There are many different options for obstetric deliveries, and women giving birth have different priorities. Some women want home deliveries. Some women choose to deliver in high-volume birth centers where sophisticated technology and highly trained experts are available. Some women want a specific doctor who may utilize a specific birth center. Others may choose a midwife and midwifery center. Some young families use Kaiser insurance for their comprehensive and affordable coverage, and are committed to delivering in a Kaiser hospital. Thus, there are many explanations for the low volume of deliveries in this small hospital. The low volume of use (only 12 deliveries/month) can not sustain this very expensive service, and the large loss of revenue associated with this underused program will ultimately jeopardize the entire hospital. This town can not afford to loose the whole local hospital for the sake of retaining an unused service.

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