Quick Take
The Pajaro Valley Health Care District board of directors voted 3-2 to close its maternity services, which includes labor and delivery, and its neonatal intensive care unit (NICU). The decision does not mean an immediate closure, and the board could rescind its decision if funding becomes available.
The Pajaro Valley Health Care District board of directors, which oversees Watsonville Community Hospital, voted, 3-2 to close the hospital’s maternity services, including labor and delivery, and its neonatal intensive care unit (NICU).
The decision was met by quiet, deflated reactions from the more than 100 community members and hospital employees who packed the Kathleen King Community Room Wednesday evening.
“I wish we had more time,” said hospital board chair Tony Nuñez. “In this moment, this board, that’s the one thing we don’t have.”
The board’s decision does not mean that the units will automatically close. The hospital will need to give the state a 120 days’ notice. That notice, according to the hospital 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. Interim hospital CEO Moran said the services would remain open during the four-month period, allowing mothers and families to continue accessing care.
The board also directed hospital management to return if funding becomes available, leaving open the possibility that Wednesday’s vote could be rescinded.
Moran told the board that he’s planning to send a letter to Kaiser Permanente, one of its partners, requesting a $5 million annual grant for the next three years to specifically stabilize the hospital’s maternity and NICU services. He’s also sending a letter to the California Nurses Association, the union representing staff at the hospital, requesting the union to designate a year of their dues to help the units.
Hospital management projected that without closing a service or securing additional funding, the facility “will exhaust funds available for payroll within six to twelve months,” according to a hospital report.
The report also identified maternity services and the NICU for closure because the Medi-Cal and Medicare reimbursements do not cover the cost of continuous nursing and physician staffing in both units.
The hospital currently 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.
Community members urged the board to delay the vote in anticipation of potential funding from Measure E, a county ballot tax measure intended to raise funding for safety net services, and other potential funding.
The hospital intends to apply for another distressed hospital grant from the state, asking for $26 million, with $7 million to be used to support maternity services and the NICU. Moran said that the hospital won’t find out if it will receive the money until mid-December.
“We are only six days away from the Nov. 3 election. Why make a significant decision today when important financial developments are just around the corner,” said Watsonville resident Martha Vega.
Outgoing board member Marcus Pimentel had suggested tabling the decision until Nov. 11, when the board was scheduled to hold a special meeting and election results would have begun coming in. While fellow board member Dr. Joe Gallagher, a retired physician, warned that the decision could lead to employees leaving the hospital for other roles and potentially fracturing the relationship with the community.
Nurses, midwives and pediatricians who work at Watsonville Community Hospital shared personal accounts of helping mothers through childbirth emergencies.
“Thankfully, not every birth is an emergency, but that’s why we have hospitals to quickly intervene when things go wrong,” said Sylvia Perez, who works in both units.
Perez told the board that she’s concerned about how the emergency department would handle deliveries if labor and delivery services were no longer available.
“The ED does not currently manage active laboring patients,” Perez said. “They are admitted as quickly as possible to the OB unit in the event that the patient doesn’t get there.”
She also mentioned that an obstetrician tried to transfer a patient last week to Dominican Hospital in Santa Cruz because the patient was in preterm labor with high blood pressure, but was told that Dominican was at capacity.
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.
Throughout the nearly two-hour discussion the board expressed that the decision is a difficult one to make, and a few provided hope that it could be reversed, only if funding is made available.
“No one takes this discussion lightly, at all. And, it’s not an easy decision,” said board member Alexandra Friel. “It’s not a done deal … it’s 120 days plus we could reverse course before that.”
