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RIDOH Issues Decision on Memorial Hospital Obstetrics Proposal With Patient-Focused Conditions

Today the Rhode Island Department of Health (RIDOH) approved Care New England's proposal to transfer obstetrics services from Memorial Hospital to Kent Hospital and Women & Infants Hospital in a decision that includes conditions aimed at ensuring access to care for patients and communities served by facilities throughout the Care New England system. The conditions of approval were informed by a series of public meetings and hundreds of comments from Rhode Islanders across the state.

The decision with conditions requires Care New England to provide transportation for patients to other hospitals within the network, and to submit a plan to replicate Memorial Hospital's unique, alternative birthing experience at another Care New England hospital. Care New England, a health system that employs thousands of Rhode Islanders, has a financial standing that has grown increasingly unstable since 2013.

"Care New England's current financial situation has serious implications, not just for Memorial Hospital, but for patients, communities, and employees throughout Rhode Island," said Nicole Alexander-Scott, MD, MPH, Director of Health. "We listened carefully to the community throughout this process. Our decision is responsive to those who expressed their preference for Memorial's unique birthing environment, while at the same time helping to ensure that people throughout Rhode Island continue to receive quality, affordable care."

Care New England is not authorized to begin transferring obstetrics services from Memorial Hospital before August 1st, 2016.

The conditions of the decision include: Memorial Hospital shall execute a transportation plan for a minimum of nine months that includes expanded shuttle service with multiple scheduled stops at each Care New England facility; preferred arrangements with a taxi company; and the provision of vouchers to patients for supplemental transportation services. Women & Infants shall maintain its alternative birthing services, and within six months Care New England shall submit a plan to RIDOH for replicating Memorial's obstetrics unit's unique, birthing center experience within another Care New England hospital. In developing this plan, Care New England will be required to convene an expert group of consultants who are familiar with, and who helped implement, this model at Memorial Hospital. Care New England shall engage an outplacement services firm for displaced staff, and shall notify staff of this career transition service; and Care New England shall cover any additional out-of-pockets costs for current Memorial obstetric patients with commercial health insurance whose obstetrical care is transferred to other Care New England hospitals. Rhode Island law calls for the decision to consider the impact of the change on the following four criteria: access to care for traditionally underserved populations; healthcare delivery in the community; other healthcare facilities in the local community; and other healthcare facilities in the state. The decision issued by RIDOH today is based on the potential impacts on patients, the community, and other healthcare facilities.

RIDOH conducted public meetings in Central Falls and Pawtucket in March to gather community input on the proposal and collected written comments from hundreds of Rhode Islanders, many of whom expressed their preference for Memorial's alternative birthing environment. Care New England representatives cited steady declines in births at Memorial and expressed concerns about how declines in volume can affect quality of care.

As part of its review, RIDOH collected aggregate patient data and audited financial statements from Care New England. An independent financial analyst was engaged by RIDOH to review the financial documents. Some of the findings from the information received were: The majority of women in Memorial Hospital's service area receive obstetrical care at Women & Infants Hospital. In 2015, more than 92 percent of the 3,687 children born to women who lived in Central Falls, Pawtucket, and Providence were delivered at Women & Infants. There are five other birthing hospitals in Rhode Island, including Women & Infants, seven miles away. The current financial situation at Care New England is unsustainable, and further deterioration in Care New England's operating margins increases the risk of a bond covenant violation. This could have serious implications on the entire Care New England system. Care New England facilities include Butler Hospital, Care New England Wellness Center, Kent Hospital, Memorial Hospital, the Providence Center, VNA of Care New England, and Women & Infants Hospital. This decision relates only to obstetric services at Memorial Hospital. On April 22nd, Care New England submitted a complete application to RIDOH for the transfer of obstetric services from Memorial Hospital to Kent Hospital and Women & Infants Hospital.

A copy of the full decision is available online.

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