Uniontown Hospital’s pending closure of Fayette County’s only birthing center at the end of June comes with officials citing similar death knells as other facilities already shuttered around Western Pennsylvania — rising costs, challenges of recruiting doctors to rural locales, declining birth rates and other changes in the health care industry.
The hospital is closing its Family Beginnings Birthing Center as it reevaluates services while transitioning from its partnership with UPMC to an affiliation with West Virginia University Health System in Morgantown, said Josh Krysak, Uniontown Hospital spokesman. For women due to give birth after July 1, hospital staff will work to find alternative birthplace facilities, Krysak said.
The hospital also intends to close its inpatient pediatric department, as most children treated there are released or stabilized and then moved to UPMC Children’s Hospital of Pittsburgh.
“This (closing obstetrics units) is definitely a trend, and it’s not just in Western Pennsylvania. It’s a national trend as well,” said Patricia J. Raffaele, vice president of professional services for the Healthcare Council of Western Pennsylvania, a trade organization representing hospitals and other health care providers.
In 2004, 55% of rural U.S. counties had hospital-based obstetric services. A decade later, only 46% did, according to a study published last year by the University of Minnesota Rural Health Research Center and other researchers. Those service losses were associated with an increase in out-of-hospital and preterm births, particularly in counties not located next to urban areas, the researchers found.
Pennsylvania has lost 50 obstetric units since 2000, primarily in smaller communities and rural areas, Raffaele said. That includes units in Westmoreland, Somerset and Washington counties.
The obstetrics unit at H.C. Frick Hospital in Mt. Pleasant closed more than 15 years ago, before its merger with Westmoreland and Latrobe Area hospitals to form Excela Health, spokeswoman Robin Jennings said. The obstetrics unit at Excela Latrobe Hospital closed several years ago and consolidated operations at Greensburg’s Excela Westmoreland Hospital, where more than 1,300 babies were born last year.
Having births at a single location gives staff at one place more experience, Jennings said.
“Everyone wants that level of expertise,” she said.
Somerset Hospital closed its obstetrics unit in September 2016, citing some of the same issues as Uniontown officials — rising costs, trouble recruiting physicians and a drop in the number of births, said Sara Deist, a UPMC Somerset Hospital spokeswoman. The obstetrics unit was closed before UPMC acquired the hospital, Deist said.
The Monongahela Valley Hospital in Carroll Township also no longer has an obstetrics unit.
Uniontown Hospital’s decision comes as the number of annual births there fell 20% in five years, from 1,000 in 2013 to 800 last year, Krysak said.
This coincides with the 4.5% decline in Fayette County’s population this decade. To make matters more challenging, 20% of Fayette’s population is 65 and older, according to the U.S. Census Bureau.
“It’s not likely to get back” to 1,000 births a year, Krysak said.
Rising costs coupled with insurance providers reducing reimbursement rates for obstetric services factored in the decision to close, Krysak said.
Liability insurance premiums have increased for obstetrics, and the cost of keeping up with advancing technology is expensive, Raffaele said.
Steve Handy, Uniontown Hospital chief executive, said these decisions “are never just about the bottom line or the short term, but what options are available to us to provide the best care and sustain that level of care long term.”
The closure will impact 50 employees, including 30 nurses, Krysak said. Those employees will have an opportunity to take another job in the hospital, such as on the medical/surgical floors, Krysak said. For those who want to remain in pediatrics, the hospital will work with other facilities such as WVU Health System, Jefferson Hospital in the South Hills and Magee-Womens Hospital in Pittsburgh, to find jobs.
WVU Health System, which operates J.W. Ruby Memorial Hospital in Morgantown, announced in January it was affiliating with Uniontown Hospital. WVU Health continues to have “positive discussions” about the ways in which the two health systems can clinically align, said Angela Jones-Knopf, WVU Health System spokeswoman.
WVU Health System did not say if it would open an obstetrics unit in Fayette County.