Windham Hospital weighs saving money, lives in closing of critical care unit

For resident Jody Parent, Windham Hospital in Windham, Connecticut was more than a medical care center – it provided services that kept Parent from living on the streets.  

A few months before the birth of her daughter, Parent lost her job, her car and her apartment. The Access Agency, a federal nonprofit that works with low-income people at Windham Hospital, provided baby formula that Parent would not otherwise have been able to afford.

Windham hospital also provided transportation services for Parent after she had to get her tonsils removed.

Despite the need for those crucial services, Windham Hospital, located in the poorest county in the state and owned by Hartford Healthcare, is closing its critical care unit due to budget cuts, which will eliminate over 100 jobs and force patients to travel miles to get critical care.  

“I guess the plan for Windham Hospital would mean people would have to travel to Hartford for procedures and facilities,” Parent said. “Twenty-five percent of our community is living below the poverty level. They do not have transportation.”

Hartford Healthcare (HHC) announced service cuts at Windham Hospital in June. These cuts include reducing patient beds from 87 to 32, cutting 119 positions as part of the 418 positions being cut across the state and replacing the 12-bed critical care unit (CCU) with a four-bed progressive care unit (PCU).

The difference between a PCU and a CCU, John Brady, a doctor at Norwich hospital, said at a forum to discuss the plans for cutting the CCU, is that a CCU is for “acutely ill patients” who are unstable or in critical condition, while a PCU is a more intermediary facility that often has a higher patient to nurse ratio.

“Hartford Healthcare would like for us to believe that a PCU provides the same services as the CCU. That is not the truth,” Brady said.

Since HHC is not removing their CCU, just replacing it with a PCU, the Office of Health Care Access (OHCA) is not requiring them to file a certificate of need, which would mean a full review process for the proposed changes, said Mansfield State Representative Gregg Haddad.

Haddad said that people in Windham believe that a PCU does not offer the same services as a CCU because it is smaller, so they are fighting for OHCA to require a certificate of need. The review process for the certificate could alter the changes that HHC is planning.  

The magnitude of the cuts has drawn concern from many residents about their access to critical care units, as well from the Windham Hospital Memorial Hospital (WCMH)  Employees United and AFT Local 5099. To urge the HHC leadership to drop the facility cuts.

“We’re particularly worried about what that will mean for the patients who do not have the ability to travel to Norwich or more likely Hartford,” nurse at Windham Hospital Lee Johnson said. “We cannot allow Hartford Healthcare to outsource patients, their families and their care. Nearly 2500 residents have already signed our petition telling Hartford Healthcare to put patients before profits.”

In June, the state legislature passed a measure  28-15 to protect Hartford Healthcare hospitals from these cuts.

“We passed a really meaningful piece of information to overhaul our health care in the state of Connecticut to protect local community hospitals, to protect local doctors, small physician practices, to make sure that entities like Hartford Healthcare can’t just roll in and take over our community hospitals, can’t just roll in and steamroll our community,” Sen. Mae Flexer said referring to the bill that was passed.

Hartford Healthcare, however, argues that Windham Hospital cannot afford to keep expensive services like the CCU because average patients per day have fallen from 53 to 35 in the past 10 years and cannot afford to continue running such expensive services.

“Statements in the media say that we will become nothing more than a glorified emergency department and our plan is as close to closing Windham Hospital as we could be without closing the doors,” Vice President of clinical services and operations for Hartford Healthcare Cary Trantalis said during the public forum. “This is simply not the case. The only consequence of this kind of miscommunication is that it will drive already low patient volumes even lower.”

Additionally, Windham Hospital already experiences fewer surgeries than other hospitals across the state. According to Windham Hospital’s website, in 2014 the hospital had 12,582 surgeries, while Hartford Hospital had 26,442 surgeries.

David Whitehead, senior vice president of the east region of Hartford Healthcare, wrote in a letter to Mansfield Mayor Elizabeth Paterson that a PCU would allow for more efficient use of staff and hospital space without changing the services provided.  

In response, community members at a public forum argued that HHC employees are being paid millions to cut services.

“Hartford Healthcare top executives are raking in millions plus bonuses. They should cut compensation instead of cutting services at this not for profit hospital,” president of the WCMH Employees United and employee for patient access services at Windham Hospital Heidi Kolle said.

According to 2014 IRS reports, East Region president David Whitehead earned $1.09 million in benefits in the past year.

According to the financial records of the hospitals’ 990 forms, which hospitals are required to fill out by the state, Windham Hospital had a positive fund balance of over $12 million before it was taken over by Hartford Healthcare. In 2009, Windham Hospital was more than $21 million in debt. By 2012, the reported balance was a loss of $44 million, resulting in a net loss of $56 million in three years.

“To be fair to Hartford Healthcare, I’ll share that it justifies its decision by claiming that Windham Hospital loses close to $11,000 a day,” Haddad said in a press release. “But we must put that in perspective. The salaries of just the top three Hartford Healthcare executives combined is over $11,500 a day.”

These changes will also affect other services in the community. The Windham Fire Department is in charge of critical care transports, which is initiated when a patient at the critical care center needs services beyond the capacity of Windham Hospital, said Willimantic fire chief Marc Scrivener. The changes in services at Windham Hospital will tax the fire department’s service abilities, Scrivener said.

“Right now the Windham fire department is operating on the upper level of our capacity. We have a daily struggle to meet the demands placed on our services.  If critical care imports were to increase, so would the burden of the fire department in this community,” Scrivener said. “If we are called upon to transport more patients out of town due to service reduction at Windham Hospital, it will have a detrimental affect on our service delivery model and our ability to care and provide in our services.”

Scrivener said that out of town transports can take up to two hours. If there is another emergency in town, such as a fire, it would take much longer for the fire department to respond if they are busy making critical care transports.

“What is happening here is emblematic of what is happening all over the state,” said Frances Padilla of the Universal Healthcare Foundation, a non-profit which promotes access to quality health care in Connecticut.

However, Windham cannot stand to lose a local care facility because of the limited public transportation and fewer hospitals in this part of the state, said Padilla.

“My relationship with Windham Hospital started 49 years ago,” Haddad said. “It is where I was born and it is where I take my daughter when she wakes up sick in the middle of the night. Windham Hospital is a vital member of our community and I will not allow it to collapse without a fight.”

Maggie McEvilly is a staff writer for The Daily Campus. She can be reached via email at maggie.mcevilly@uconn.edu.

Emma Krueger is a staff writer for The Daily Campus. She can be reached via email at emma.kruger@uconn.edu.