Burdett closure plans outlined
St. Peter’s argues closing won’t impact patient care; plan’s opponents disagree
TROY — St. Peter’s Health Partners has sent a closure plan for the Burdett Birth Center to the state Department of Health — one that attempts to address a litany of concerns raised by community members, birth professionals and politicians.
In the 43-page document dated Dec. 21, which was obtained by the Times
Union, hospital officials argue that pre- and post-natal care would remain unchanged after the closure and laid out a range of transportation options for Burdett patients whose births would be transferred to hospitals in Schenectady and Albany.
“Samaritan/St.
Peter’s Health
Partners will continue to provide
100% of the services to 100% of the patients we’re currently serving,” the proposal states. “The only thing impacted by this decision is the delivery site; all our patients will continue to receive care without interruption.”
The 16-bed Burdett center is part of the St. Peter’s-run Samartian Hospital in Troy. It is the only maternity ward in Rensselaer County and also serves Columbia and Greene counties, which lack their own birthing facilities. About 900 infants are delivered there each year.
Hospital leaders say the facility has been losing $2.3 million per year and duplicates services already available at St. Peter’s Hospital in Albany.
They claim the center has been operating at a loss since its inception in 2011, but the situation has worsened in recent years due to declining birth rates, an increasing number of patients with Medicaid or Medicare, low reimbursement rates for these public health plans and high malpractice insurance costs.
“If we continue to invest in services that drain financial resources and are impacted by declining demand and staff
“The proposed closure plan … is like a house of cards that can topple over at any moment from the slightest disturbance in the air.” Save Burdett coalition
shortages, it will hamper our ability to deliver the same level of community benefits that are so important and necessary for our region,” hospital officials wrote.
The accommodations outlined in the plan did little to pacify critics, whose advocacy efforts have so far pressured St. Peter’s officials to conduct a health equity impact study and delay the closure of the birth center by several months. St. Peter’s initially planned to close Burdett in December, but extended the timeline for closure, anticipating shuttering delivery services in the spring and no later than June 30. Members of the Save Burdett Birth Center Coalition have written a letter responding to each point in the hospital’s consolidation plan, which also touches on capacity issues and the continuation of the midwifery model of care that Burdett is known for.
“The proposed closure plan … is like a house of cards that can topple over at any moment from the slightest disturbance in the air,” the Save Burdett coalition wrote in a statement to Health Commissioner Dr. James McDonald. “This is not a serious long-term plan for ensuring safe, timely, patientcentered and culturally competent care for the 800 to 900 pregnant people a year who rely on the Burdett Birth Center.”
Hospital unit closures are subject to a limited review, which means the closure will simply be approved or denied by the state health commissioner.
In cases where a hospital construction project’s cost is more than $30 million, it is subject to a full review, coming before a panel of experts who hold public discussions and advise the state Department of Health.
St. Peter’s officials said they have already been forced to transfer an increasing number of births from Samaritan Hospital to their main facility in Albany due to frequent staff shortages at Burdett. It has been especially difficult to recruit nurses and anesthesiologists, which means most cesarean births or attempted VBACs (vaginal births after a cesarean) must be transferred to St. Peter’s in Albany. Premature infants must also be transferred to its Albany site, which has a neonatal intensive care unit.
“This is not best practice for patient care, and it is not what expectant mothers want,” hospital officials wrote. “Reduction of these transfers and redirected cases will improve patient experience and reduce the use of emergency transport resources, which are already strained.”
Transporting laboring patients
Most expectant parents will have arranged for transportation as part of their birth plan, according to the closure plan. For emergencies, there are ambulance services available and emergency room staff at Samaritan Hospital are qualified to assist a walk-in patient who is in labor.
The hospital says it is looking to partner with Roundtrip, a software company that coordinates car service or ride shares for patients and sends the bill to health insurance plans. Patients with Medicaid already have access to free transportation. The hospital has an arrangement with Tech Valley Shuttle, a Cohoesbased company that can provide transportation with advanced notice.
The Save Burdett activists, however, said both companies work with Lyft and Uber, which are dependent on the number of drivers in the area and are generally unreliable, especially in rural areas.
“There is no confirmed and fail-safe plan for providing transportation to St. Peter’s Hospital in Albany from Rensselaer County, especially the farflung rural areas, and from rural areas in Washington and Columbia counties,” they said.
For those with highrisk pregnancies, the Ronald McDonald House in Albany is available to house pregnant individuals and their families ahead of their due dates, the plan states. Ronald McDonald House CEO Kimmy Venter said the lodging facility is frequently used for families of infants in the NICU who qualify. In rare cases, they have housed someone with a high-risk pregnancy who lives far from the hospital.
One criterion for acceptance to the Ronald McDonald House is living more than 30 miles from the hospital. Venter said she was not specifically notified about a potential influx of clients from Burdett.
“We’re close to St. Peter’s, but it’s not like we’re walking distance to St. Peter’s, whereas we are walking distance to Albany Medical Center,” Venter said. “We have had conversations about continuing to build our partnership and being able to support more families from St. Peter’s.”
Is there room for more births?
The closure plan notes that Burdett’s patient base has access to three hospital delivery wards within a 20-minute drive from Samaritan Hospital; Albany Medical Center and St. Peter’s in Albany, and Bellevue Woman’s Center in Niskayuna. Still, St. Peter’s officials claim its Albany hospital has the space to deliver hundreds of additional infants on its own.
The hospital intends to add five multi-use beds to its triage area and one additional birthing suite, according to the plan.
Hospital officials have promised to work with midwives and doulas from Burdett and accommodate birth preferences that are not typically permitted in a traditional hospital setting. According to members of the Burdett coalition, which includes nurses, midwives, doulas and parents, St. Peter’s birthing facility is already overcrowded and under
staffed. The group cites instances where requests for less medical intervention were not honored. Morgan Benson, who was transferred from Burdett to St. Peter’s Hospital early in her labor on Dec. 22, said she was told there were only five nurses on staff for 14 patients.
Benson, a former laborand-delivery nurse herself, decided to hold off on an induction for 12 hours and was put on continuous fetal heart rate monitoring in place of regular checkups from obstetric staff.
“When they were leaving me on the monitor indefinitely, I felt confident to take myself off because I could see the baby was OK,” she said. “I was trying to help them. Over an hour went by and no one came back.”
After 12 hours, Benson reminded the nurse that she was due to start Pitocin, a medication used to induce labor. She was told that no one was available to administer it at that time. She asked to transfer back to Burdett, where she delivered a healthy baby.
“It was an entirely different environment than St. Peter’s. Quite literally, night and day,” she said.
Two midwifery practices cited as additional resources for expectant parents who prefer Burdett’s midwifery model of care said they were not consulted about being included in the closure plan.
“My practice is very small: I attend 30-40 births per year. My practice is thriving: Almost every month is booked,” wrote Michelle Doyle,
Will Waldron / Times Union owner of Local Care Midwifery in Troy. “I simply am not able to take on even a tiny percentage of the 800-1,000 births that have occurred at BCC in recent years.”
Midwife Heidi Ricks of HeartSpace Midwifery objected to the mention of her practice in this section, explaining she is a “solo midwife practicing in the home setting only.”
“I am in no way prepared to fill the gaping hole that is being left by the closure of this stellar facility,” she said of Burdett.
Jim Franco / Times Union