Rutland hospital Backs Down From Pediatric Bed Closure After Public Outcry
Vermont’s Rutland regional Medical Centre (RRMC) has withdrawn its proposal to close five pediatric inpatient beds following meaningful opposition voiced during a public hearing and through over 150 submitted comments. The hospital now intends to collaborate directly with the Vermont Agency of Human Services (AHS) on a redesign of its pediatric services,shifting away from the state’s Green Mountain Care Board (GMCB) regulatory process.
The GMCB held its first-ever hearing to evaluate a potential hospital closure last friday, a proceeding that revealed deep concerns about the impact on families and the state’s healthcare system. Regulators expressed frustration with the hospital’s decision to pursue the closure independently, particularly given the state’s ongoing hospital transformation efforts.
The debate highlights the tension between balancing access to essential services that are needed in communities with the reality that some of these services are fairly low volume, and we have very few options for admitting pediatrics in Vermont?”
This move by Rutland is not isolated. A recent study published in the journal Pediatrics revealed a nationwide trend of hospitals drastically reducing thier pediatric inpatient services over the past two decades, with the number of hospitals offering only emergency department pediatric care more than doubling. Had RRMC closed its beds, children in the region would likely have faced extended stays in the emergency department or required transfer to the University of Vermont Medical Center in Burlington, approximately two hours away.
The potential closure served as a test case for Vermont’s Act 68, recently signed into law, which grants the GMCB the authority to block hospital service cuts. RRMC’s withdrawal came before the board could formally vote on the matter. The hospital’s evolving strategy raises questions about which state entity should lead hospital transformation efforts.
The AHS is currently spearheading broader hospital transformation initiatives, empowered by the same legislation that bolstered the GMCB’s oversight capabilities. throughout the summer and fall, the agency has worked with hospitals to develop transformation plans and allocate grant funding. However, the AHS’s transformation plan was initially unclear to RRMC leadership when the hospital first announced its intention to close the pediatric beds in late October. At that time, hospital leaders stated they were coordinating with both the care board and the state agency.
The AHS released its statewide transformation template on November 24 – the same day RRMC submitted its full closure intent report. In a letter to the GMCB, Mitchell Baroody, RRMC’s chief legal officer, argued that the board’s authority had “become moot” following the AHS guidance. However, Judi Fox, RRMC’s CEO, presented a differing perspective during a December 5 GMCB hearing.
During the hearing, GMCB chair Owen Foster repeatedly asked hospital administrators why they chose to pursue the closure independently, rather than through the agency’s transformation planning process. “While finances were a piece of the equation, again, it’s really in trying to understand how we were going to continue to staff the unit when we had and have fairly low (occupancy),” Fox explained. “So it wasn’t led with necessarily transformation in mind, but we certainly wanted to consider how this change in care delivery would impact and support goals that we believe the state of Vermont was looking for all hospitals to engage in.”
Fox further clarified that,based on her conversations with the AHS,the pediatric bed closure would be considered “hospital optimization and not necessarily a transformation,” though the distinction between the two terms remained ambiguous.
Now, as RRMC engages with the AHS on a more comprehensive transformation effort, hospital administrators have also expressed interest in expanding its labor and delivery services to establish a regional hub for obstetrics.
“RRMC recognizes the strong community interest and diverse perspectives since we announced the pediatric proposal,” Fox wrote in a Thursday press release. “Advancing the redesign through AHS’ statewide transformation framework will allow for a more comprehensive plan that reflects both community needs and long-term sustainability.”
She added, “Our responsibility is to do what is best for our patients, our workforce, and our community.”
This story was republished with permission from VtDigger, which offers its reporting at no cost to local news organizations through its Community News Sharing project. To learn more, visit vtdigger.org/community-news-sharing-project.
