The Register Citizen (Torrington, CT)
Hospital affiliation draws support
TORRINGTON >> The future of a long-standing community institution — Charlotte Hungerford Hospital, in operation for more than a century in Litchfield County — was ushered into the public eye during a hearing Monday.
CHH and Hartford HealthCare are seeking to enter into an affiliation, and have submitted a Certificate of Need application, which was considered by officials with the Office of Healthcare Access Monday.
CHH officials described a series of issues, including financial strain, difficulty recruiting physicians, a falling number of patients, and capital needs, among
others, as reasons behind the decision to seek the proposed affiliation.
The operating margin for the hospital fell to a loss of 1.19 percent in fiscal year 2015, with a loss of 5.65 percent in the 2016 fiscal year, according to documentation filed with the state.
“Our financial results have always been a very low margin, but in 2016, we hit an all-time low. We had an operating loss of over five percent,” said CHH Vice President Finance & Treasurer Susan Schapp. “We cannot sustain operating margins at this level. We have not made improvements and investments that are needed.”
Revenue fell by almost $3.5 million between FY 2015 and FY 2016, Schapp said.
This was driven, in part, by a falling number of patients seeking services at the hospital, according to the documentation and the testimony Monday, which, in turn, was prompted by difficulty recruiting physicians to replace those retiring or leaving the institution.
Other factors in this drop in revenue, Schapp said, included payer mix changes and the shift from in-patient to out-patient.
“For the long-term stability of this hospital and health care in my community, I ask you to please approve this application,” said Schapp.
Forty-six medical and other staff have retired or resigned at CHH since 2013, Charlotte Hungerford President and Executive Director Dan McIntyre said.
“This is a huge problem for a community hospital, in trying to recruit,” said McIntyre.
A lack of critical care support systems, McIntyre said, and technology at hand also have proven to be barriers to recruiting.
The aging population, McIntyre said, is also projected to be an issue for the hospital in the future, as it does not have the resources to manage the health of this population as a standalone hospital.
“For reasons concerning changing demography, and therefore payer mix, for reasons related to physician recruitment and the replacement of retiring physicians, for reasons pertaining to our ability to care for the population and nurture the health of the population of Northwest Connecticut, for reasons of capital investments and expenditures,” said McIntyre. “(W)e ask you to consider our application for affiliation to Hartford HealthCare, so that we can continue with our mission in (and) on to the future,”
Hartford HealthCare Chief Executive Officer Elliot Joseph said the affiliation would allow patients access to additional resources.
Charlotte Hungerford could be restored to profitability within four to six years, Hartford HealthCare Chief Financial Officer Charles Johnson III said.
An initial investment of $73 million is planned in the hospital over seven years, Johnson said, $50 million of that for capital projects, including a renovation and expansion of the emergency department.
Services offered by the hospital are not set to diminish as a result of the proposed application. An assessment of community needs will be conducted if the affiliation is approved, Hartford Healthcare President and COO Jeffery Flaks said, to guide further expansion of services.
This would include focus groups, a statistical survey, and open sessions with community partners.
The organization has a department that serves to recruit physicians, officials said Monday, to aid with that need at CHH.
Public comment offered Monday was overwhelmingly in favor of the proposed affiliation, as local officials, residents and CHH staffers, among others, came forward to speak.
Torrington Mayor Elinor Carbone pointed out the importance of the hospital as an employer.
“Charlotte Hungerford Hospital is a major employer in the city of Torrington, and as a distressed municipality with an unemployment rate that exceeds the state average, we are reliant on the stainability, and pray for the resiliency, in our leading employer,” said Carbone.
Other speakers focused on the care the facility provides.
“We need to keep our community hospital here. Having an acute care hospital in Torrington, one that offers full services, is critical to the health and safety of the surrounding communities,” said Heather Cappabianca. “Some patients will travel 20 miles to reach this hospital, and they must have access to state-of-the-art medical care and technology to ensure positive outcomes.”
“The staff at Charlotte is committed to remaining connected to our community. This proposed affiliation will not change this commitment, but only enhance our partnership. We will be able to offer more services and advancements,” said Ann Vilhotti, a CHH employee since 1990. “It is important, in this tumultuous time in health care, we all stand in support of each other and our local hospital community.”
Officials with OCHA asked a series of questions of the applicants, touching on the importance of addressing community needs, the makeup of the Board of Directors that would be formed after an affiliation, dealing with the loss of physicians at CHH, and the planned use of the $73 million investment, among other topics, during the hearing.
Charlotte Hungerford and Hartford HealthCare signed a memorandum of understanding regarding the potential affiliation in February 2016.
Standards to be considered for a Certificate of Need as laid out in state statute, include “whether there is a clear public need for the health care facility or services proposed by the applicant” and “whether the applicant has satisfactorily demonstrated that the proposal will not negatively impact the diversity of health care providers and patient choice in the geographic region.”
A decision is expected, according to Office of Health Care Access official Steven Lazarus, within 60 days of the official closing of the public hearing, which is expected soon after May 19, when final documentation is due to be submitted by the applications and considered.