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News: 08/15/2018

Sonoma Valley Hospital to shutter OB department in October

Board will discuss transfer of home health care, closure of skilled nursing facility at upcoming mee

The last baby to be delivered at Sonoma Valley Hospital will have to be due before Halloween, as the Sonoma Valley Hospital (SVH) will close its obstetrics (OB) department on Oct. 31. At its July 25 meeting, the Sonoma Valley Hospital District Board of Directors voted 4-1 to approve closure of the department, in response to a dramatic decrease in births at the hospital and a shift in which services are in demand and profitable.

The hospital now averages two births per week, which is too low to sustain the department, said CEO Kelly Mather during her presentation to a standing-room-only crowd. The hospital has seen a 50 percent decrease in babies delivered at the hospital since 2010, and a 35 percent drop since 2015. Operation of the OB department resulted in a $597,000 loss for the 2018 fiscal year. The hospital has been absorbing the losses of the OB department for the last three years, said Mather.

Nearly every public speaker – from pregnant women and expectant dads to concerned community members – was opposed to the closure, but Mather reminded the audience that the hospital’s number-one priority and importance to the community was to keep the emergency department open. Eighty-four percent of the hospital’s patients come in as emergency patients, said Mather, who said the emergency department admits 10,000 patients annually.

“We want to make our investment into our emergency department and our physicians – and with a limited amount of resources, you have to decide,” said Mather.

“This is uncomfortable, it’s not easy, but at some point we have to make some difficult decisions.”

Mather said this is part of a bigger shift as the hospital reinvents itself to face a new reality of a decreasing inpatient census – the number of patients who stay in the hospital while under treatment – and a growing demand for outpatient services – like rehabilitation, surgery, ultrasound imaging, lab tests, etc. The hospital has also seen a change in patient mix – the number of patients on Medical or Medicaid – and patients avoiding elective procedures because of high deductibles, physician reduction in testing and managed care, or performing procedures in their own clinics that they used to do in the hospital. Also, the closure of the Sonoma Developmental Center and a drop in patient referrals from Napa State Hospital has had an affect.

Seventy-five percent of services are outpatient and that keeps going up, said Mather.

“I truly believe we have done everything in our power to keep OB and make it viable,” she said. This included creating A Woman’s Place, which brings together specialists offering comprehensive health care and preventive screening services specifically for women. A Woman’s Place will continue operation with gynecology and breast surgery services.

The hospital plans to move the Medical-Surgical department to the space once occupied by the OB department to help improve efficiency, since the Intensive Care Unit shares the same floor. The C-section room will become another operating room due to the high volume of surgeries. Seven full-time equivalent positions, staffed by 12 individuals, will be affected by the OB department closure.

For 2019, the hospital is moving forward with the design of a cardiology center, a master plan for the campus that will likely include a new medical office building, and will start a Rural Health Center at Sonoma Family Practice.

Mather also gave an update on the transfer of the hospital’s Home Health Care service to nonprofit Hospice By The Bay. Seventeen full-time equivalent positions, staffed by 27 individuals, will transition to the new organization. The board will discuss the transfer of Home Care to Hospice by the Bay at a special meeting on Aug. 15, 5 p.m., in the Community Room on First Street West, Sonoma. It will make its decision about the transfer at the regular board meeting on Sept. 6. Both meetings are open to the public.

The board will also consider a recommendation to close the hospital’s skilled nursing facility. A board-appointed task force will deliver its report no later than Oct. 4.

With the closure of the SVH’s OB department, Petaluma Valley Hospital and Queen of the Valley Hospital in Napa will be closest hospitals where Sonoma women can deliver babies. Women currently scheduled to deliver at SVH are being notified. In case of an emergency, handling an emergency delivery is a required part of every ER physician’s training and something SVH’s emergency physicians and nurses are already trained to handle.

Sonoma Valley Community Health Center will continue to practice prenatal care and is working with its patients to ensure they will find a hospital to deliver their babies.

Sarah Phelps is an editor and reporter. She was raised in Kenwood and has a BA from Loyola Marymount University.

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