Closing Skilled Nursing Unit and discontinuing deliveries in Maternity Suite
The ACMC Healthcare System Board of Directors has voted to permanently close the 16-bed Skilled Nursing Unit (SNU). The unit, located on the third floor of the hospital, has been vacant since late-March as part of ACMC’s plan to accommodate a surge of inpatients impacted by the COVID-19 virus.
Several factors contributed to the decision to close the SNU. Those factors include Ashtabula County’s declining population, the number of long-term care facilities in the county, a pattern of volume decreases based on Medicare and private insurers’ requirements, and the reduced need for intensive inpatient care as surgeries like knee and hip replacements continue to move more and more to the outpatient setting.
“Ashtabula County’s population has been declining for several years, and projections indicate that trend will continue,” said ACMC Healthcare System President and CEO Michael Habowski.
“With 16 long-term care facilities in Ashtabula County, skilled nursing care is widely available throughout the county,” said Habowski. “The number of long-term care facilities offering skilled nursing and the declining population trend indicate the need for those services will continue to be met in the future.”
Inpatients who need skilled nursing care will consult with ACMC care management staff to help them choose where to continue their care following their discharge. “We are fortunate to have great relationships with all of the long-term care facilities in the county, including having medical director oversight at many of them. I’m confident that residents who have received care in our Skilled Nursing Unit will be well taken care of at other facilities in the county,” Habowski said.
The ACMC Board also voted to discontinue deliveries in the Maternity Suite. The Maternity Suite will close by August 1, 2020. ACMC’s goal moving forward is to continue to offer prenatal, postpartum and gynecological services (including surgery). ACMC will continue to offer its current scope of Women’s Health services which includes mammography, needle biopsies, and breast surgery.
Ashtabula County’s birth rate has remained relatively flat over the past 10 years. Of the approximately 1,000 births to Ashtabula County residents each year, a five-year average shows that only 34% of those were delivered at ACMC. This amounts to less than one baby per day being born at ACMC. The other 66% of births to Ashtabula County residents take place at hospitals outside of Ashtabula County. In addition to the county’s flat birth rate, other factors contributing to the decision include challenges to maintain state-mandated minimum staffing due to increased difficulty in recruiting experienced obstetric nurses and increased regulatory requirements.
ACMC’s affiliation with Cleveland Clinic has led to a stronger collaboration with Cleveland Clinic Hillcrest Hospital to ensure the highest level of care for our patients who chose to deliver there. The plan is for expectant moms to be seen by an obstetrician at ACMC for office visits – including high-risk OB visits currently offered – then be referred to Hillcrest for their delivery.
“The decision to stop performing deliveries at ACMC was extremely difficult,” said Habowski. “This decision is about ensuring moms and babies have the highest level of care, a level that hospitals the size of ACMC can’t provide,” said Habowski. “ACMC is classified as a Level I nursery. As such, we have very strict criteria established by the Ohio Department of Health that limits our deliveries. The plan to offer the option to deliver at Hillcrest will give expectant moms and babies that higher level of care. Because Hillcrest is classified as a Level III nursery, they meet the additional criteria to deliver higher-risk pregnancies.”
Hillcrest Hospital has a neonatal intensive care unit that is a division of Cleveland Clinic Children’s and has 24/7 coverage by neonatologists, neonatal nurse practitioners, specially trained nurses, as well as dedicated pediatric respiratory therapists and an on-site pediatric pharmacy.
The dedicated caregivers in the Skilled Nursing Unit and Maternity Suite that will be impacted by these changes will be encouraged to apply for positions that meet their skill and experience levels in other areas of the ACMC Healthcare System.
“In June ACMC will conclude our celebration of 115 years of providing care to Ashtabula County. As we plan for the future of ACMC, we are focusing our efforts and expertise to serve the overall healthcare needs of our communities in the most responsible way to ensure ACMC is here for another 115 years,” said Habowski.