Rutland Regional Medical Center won’t shutter its inpatient pediatric unit — at least for now, the hospital told state regulators Thursday. The sudden reversal came as the Green Mountain Care Board was preparing to use its newly-enhanced regulatory powers to vote on whether or not to allow the closure to go forward.
Officials at Vermont’s second-largest hospital said they still plan to change how they deliver pediatric care. But they said they would work with the Vermont Agency of Human Services, which is developing a statewide plan for health care delivery, to decide what services should look like in Rutland.
“By advancing our pediatric redesign through this new process, RRMC can enhance our proposal, expand its scope, and ensure it aligns fully with statewide goals and community needs,” Rutland Regional President and CEO Judi Fox said in a statement.
Rutland’s decision to close its five inpatient pediatric beds, which was initially slated to take effect Dec. 21, was highly controversial. In a hearing before the Green Mountain Care Board last week, hospital executives argued that while Rutland Regional would save about $3 million annually by closing the unit, its motivations were not primarily financial.
With an aging population and fewer children being born in the community, the hospital needed to reprioritize, they told regulators. And they argued that quality of care could erode as staff lost practice treating increasingly fewer patients in the low-volume unit.
“I want to be very clear with the Green Mountain Care Board that this decision is driven by quality. While it’s supported by numerous financial and affordability goals both here at the hospital and at the state level, it was really driven by quality,” Fox told regulators at the time.
Pediatric patients could be treated instead in the emergency department, the hospital said, or transferred to the University of Vermont Medical Center in Burlington or Dartmouth Hitchcock in New Hampshire.
But the hospital’s arguments were undercut by its own medical staff. In a letter to the board, RRMC pediatricians wrote that closure of the unit would hurt patient care in a way that disproportionately impacted women and low-income households.
“It’s unsafe. I think it’s poorly thought out. I think it really does a disservice to all of our children and our community,” Rebecca Merrifox, a pediatrician at the hospital, told regulators.
The hospital’s pediatric staff also argued in their letter that while closing the unit might save Rutland Regional money, it would do so by substantially increasing costs to families and the overall system. It would cost thousands to transport a child to other hospitals, they said, and once there, families would likely face higher fees from these tertiary care centers.
Green Mountain Care Board Chair Owen Foster said Thursday he was glad the hospital decided to pursue redesign plans “with a statewide lens,” in concert with AHS. He was preparing to vote “no” on the proposal, and he said he suspected other board members were as well.
“From where I sat, it appeared more likely this would actually cost the system more money and very likely harm access and timely care,” Foster said.
Rural hospitals across the country are increasingly financially strained. And while RRMC is financially healthier than some of Vermont’s smaller hospitals, it is still projected to lose nearly $5 million this year. Foster said he thinks it’s inevitable that more hospitals will come before the board soon with requests to cut services — and that some of those requests will have to be granted.
“There's no more insurance money to bail out the system as it currently is designed. And I don't think the hospitals — some of them — with where their financials are trending, can survive that long without making changes,” he said.
