Watsonville Community Hospital board to consider closing maternity services, NICU at Wednesday meeting

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The Pajaro Valley Health Care District board of directors, which oversees Watsonville Community Hospital, will decide Wednesday whether to close the hospital’s maternity services, which includes labor and delivery, and its neonatal intensive care unit (NICU).

Interim hospital CEO Tim Moran previously told Lookout that “something significant” needs to happen between now and April 1 or the hospital will not be able to continue operating. 

In September, hospital staff identified several options for the board to consider to prevent a full closure of the hospital. Those options included permanently shuttering the NICU and women’s and children’s services, including labor and delivery; reducing services in both areas; or restructuring staffing in the intensive care unit.

Hospital management projects that, without closing a service or additional funding, the facility “will exhaust funds available for payroll within six to twelve months,” according to a recent report.

“Obstetrics and the NICU were identified for proposed closure because [Medi-Cal and Medicare] reimbursement does not cover the continuous nursing and physician coverage,” the report said. 

The hospital is losing $85,000 a day, according to Moran, who attributed the financial strain to its payer mix – the proportion of patients covered by Medi-Cal, Medicare or private insurance. Nearly 80% of the patients at Watsonville Community Hospital are covered by Medi-Cal or Medicare, whose reimbursements fall short of the cost of providing care, the report said. 

Moran told Lookout that the units lose roughly $10 million a year, or nearly $27,000 a day. Other services, including the surgery and emergency departments, generate more revenue than they cost to operate. 

The NICU and labor and delivery services are labor-intensive, according to Moran. About 58 nurses work across both departments. The hospital also has contracts with nonprofit clinic Salud Para la Gente and Stanford University’s Lucile Packard Children’s Hospital to provide obstetrician-gynecologists, midwives and pediatricians. 

If the board decides on Wednesday to permanently close its maternity services, the hospital will need to give the state a 120 days’ notice. That notice, according to the staff report, will “explain the proposed changes, justification, affected beds and personnel, comparable services and required aggregate patient information.” 

The hospital will also hold a public hearing within 60 days of giving the notice. Moran said the services would remain open during the four-month period, allowing mothers and families to continue accessing care. 

Over the weekend, the nurses union that represents staff at Watsonville Community Hospital hosted a town hall meeting to inform community members about the potential impacts a permanent closure to its maternity services would have on the region. 

“For nurses, the bottom line is always about our patients,” said NICU nurse Heather Brown.

Brown, who works at Watsonville Community Hospital, said that the bottom line has to include the “what ifs,” meaning all the potential emergencies that could happen during a birth. 

“When there is no time to spare, your newborn baby deserves the care they need in the NICU,” Brown said. “Newborn babies, their moms and their families should never have to deal with what could happen when seconds matter.”  

Saturday’s town hall at E.A. Hall Middle School in Watsonville was more emotional than a community meeting organized by hospital leadership just two days earlier. 

The hospital-led town hall gave members of the community an opportunity to hear about the facility’s financial condition and share concerns with hospital leadership. Attendees at both meetings also raised concerns about the potential loss of resources, like Spanish and Mixtec translation for mothers. 

Brown, who was one of four panelists at the Saturday forum, said that the cuts would only lead to more cuts, and added that “nurses know cuts are not good for our health.” 

Dr. Andrew Harkins, a pediatric hospitalist at Watsonville Community Hospital, told community members that his biggest issue is that a decision about the maternity services is being made on what he considers a “rather short timeline.” 

“I don’t want Watsonville to be that place that loses their basic services, especially for families,” Harkins said. “And I think that’s the biggest issue. What we’re asking for is to find a way so that we can pay for families to have the same healthcare as anyone else.” 

Harkins also raised concerns regarding the capacity of surrounding hospitals, like Santa Cruz’s Dominican and Natividad Medical Center in Salinas, to handle additional deliveries when both are already working “at their limits.” 

A Dominican spokesperson previously told Lookout that the hospital is “fully committed to ensuring a seamless transition for the expectant mothers and families of Santa Cruz County.” The spokesperson added that the facility is working with Watsonville Community Hospital leadership to ensure that the community has uninterrupted access to labor, delivery and neonatal care. 

“All these decisions have been happening; it’s come to a head in just the last couple of months. I think without a lot of the community being aware of it,” Harkins said. “I think now is the time to fight for it, and find ways to find some money.” 

Roseann Farris, a WCH nurse and union representative, said it feels as though the hospital leadership is “railroading through a decision” to shutter both the NICU and maternity services. 

Farris also reminded community members that the board considered a similar move involving her department, the intensive care unit, earlier this year. She noted that the NICU remains temporarily closed. 

“We need to have a call to action,” Farris told community members Saturday. “That means that we need to make sure that the community knows what’s going on, what that looks like for our community, and what that looks like as things progress.” 

Farris and other community members also questioned the timing of the vote. The hospital could receive additional funding through Measure E — a county ballot measure intended to help fund safety-net services — if it is approved by voters. Additionally, the hospital plans to apply for another distressed hospital grant through the state. 

“One cut, one day, NICU. One cut the next day, OB. One cut the next day, ICU. What about ER when we’re not making enough money there and things go south because we’re having more patients and less reimbursement?” Farris said. “This community has grit. I know that this community has come together so many times. Now is the time to come together again.” 

The Pajaro Valley Health Care District board of directors will meet on Wednesday, Oct. 28, at 5 p.m. at the Kathleen King Community Room, 85 Nielson St., Watsonville. The meeting is also available to watch via Zoom. 

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