Call on for-profit owner Community Health Systems to reinstate critical service

The California Nurses Association/National Nurses United (CNA/NNU) called on Community Health Systems (CHS), the giant for-profit healthcare corporation based in Franklin, Tennessee that operates Fallbrook Hospital, to reinstate labor and delivery services, which were hastily suspended with little notice on September 3, 2014.

Providing fewer than fourteen days’ notice of closure despite the availability of registered nurses and a doctor to continue to staff the unit, CHS ignored the demands of RNs and doctors to keep the unit open at least until an adequate transition plan could be formulated.

The nearest hospitals with labor and delivery units, Tri-city Medical Center in Oceanside, and Palomar Hospital in San Diego are at least a 30-minute drive from Fallbrook.

The RNs patient safety concerns are detailed in a letter to the hospital’s chief executive officer.

They say that the CHS plan to triage and transfer maternity is deeply flawed. Maternity patients who walk-in to the emergency room for care, especially those who are in active labor or who are critical cannot be safely transferred to other facilities. Without preserving the unit, vital services such as emergency C-sections will be unavailable.

Nurses raised further concerns about nurse staffing, equipment, and patient care protocols. With only one maternity RN available only as a resource, staffing will be insufficient for critical mother-baby couplets that require one-to-one obstetrics nursing care. Vital equipment, such as fetal heart monitors will not be available in the emergency room according to hospital officials.   

In a meeting with the nurses the day after the closure, CHS representatives admitted that they did not have a comprehensive plan to care for walk-in patients or projections on the number of patients likely to present, and described the care plan as a "work in progress."    

RNs also expressed alarm at the cavalier attitude to patient safety expressed by CHS administrators in a meeting with the nurses the day before the closure, where the chief nursing officer told nurses to "pray that doesn’t happen" when confronted with an emergent situation.  In the same meeting, a women's center unit manager responded to concerns about appropriately prepared delivery space by observing that patients deliver in many different places, “including their cars.”

"The Fallbrook community deserves better.  “A 'work in progress' is not a good enough plan for a patient who presents in need of an emergency C-Section, “said Fallbrook Hospital labor and Delivery RN Michele Caiola.  "We have the staff and equipment to operate a fully functional maternity unit - there's no need to take these kinds of risks with patient safety.”

"The decision by CHS to suspend labor and delivery services presents a clear and present danger to the health of this community, and should be reversed" said Fallbrook Obstetrician Dr. Lawrence Peterson.

Community Health Systems is the largest for-profit health system in the United States with 206 hospitals in 29 states.  CHS has recently been under the subject of a number controversies, including the recent $98 million settlement with the United States Department of Justice,  several  Medicare and Medicaid fraud claims, and its failure to protect the personal information of more than 4.5 million CHS patients.