South County Hospital is losing money and some longtime clinicians – and its top administrators are at odds with a group of doctors about what ails the hospital and how to treat it.
Patients and community members are joining a mounting public outcry over one of Rhode Island’s last remaining independently-operated community hospitals. And they’re calling for state officials and political leaders to intervene to press for leadership changes.
Now, hospital officials are pushing back. They’ve created a website to respond to the negative publicity and enlisted one of the state’s top lobbying firms, Advocacy Solutions.
At a press conference at the hospital on Friday, hospital officials said they have been misrepresented by the doctors’ group. Joseph F. Matthews, chairman of the hospital’s Board of Trustees, praised the hospital, its staff and leaders. He said the previous night the board had given a “unanimous vote of confidence” in the hospital’s CEO, Aaron S. Robinson, and the executive leadership team.
Matthews referred to “these challenging times,” and said the board recognizes the need for “greater engagement” with the public, which it plans to achieve through “interactive public forums” and soliciting patient participation.
The hospital posted a video of the event, where staff photographed attendees before they were permitted to enter. In one case, a patient and her husband who wanted to attend were turned away.
The 100-bed community hospital in Wakefield cares for residents of southern Rhode Island, and its parent, South County Health, operates independently of Rhode Island’s larger hospital systems.
In recent years, South County Hospital has been struggling financially. The hospital reported a $6.3 million operating loss in 2023, according to the most recent audit report. The previous year, it reported an operating loss of just under $6 million.
Nationwide, hospitals are under increasing pressure as the costs of care surge. Workforce shortages exacerbated by the COVID-19 pandemic and inadequate reimbursement rates are making it harder for hospitals to cover the costs of caring for patients, according to a recent report by the American Hospital Association.
Many larger hospitals in cities such as Rhode Island Hospital in Providence, operated by Lifespan, serve large populations of people on Medicaid, the government insurance program which generally has the lowest reimbursement rates.
South County Hospital, however, cares for a relatively affluent population (Washington County’s median annual household income is about $102,000) where nearly half (46%) of its patients are covered by commercial insurance, according to its most recent audit report. Most of the rest (45%) are covered by Medicare, with less than 10% on Medicaid.
Rhode Island’s lower reimbursement rates compared with Massachusetts and Connecticut have “created a barrier for high-quality not-for-profit health systems,” Matt Moeller, the hospital’s director of marketing and communications, said in an email. However, he said, the hospital’s staff turnover rates remain “well below state, regional and national averages.” And all areas of the hospital “are currently open and operational,’’ he said, “which is a testament to our vibrant culture.”
But several doctors and patients said that the hospital has seen an exodus of a number of the hospital’s longtime primary care clinicians and specialists in cardiology and oncology. And the hospital has cut back services such as cardiac rehabilitation, hematology and lactation counseling, doctors said Thursday at a news conference at the public library in Narragansett. The event, billed “Save Our Hospital,” drew scores of local residents, including patients.
“I am afraid because we’re losing all of the doctors and the medical staff and the people who provided this wonderful care,’’ Pamela Matteson, 66, a retired pharmacist who 10 years ago was treated at the hospital for cancer. She said her decision to be treated at South County Hospital rather than traveling to Boston was about more than just travel time. “The people that are treating you are your neighbors and your friends,” she said. “You’re not just a number.”
The public outcry followed an open-letter earlier this month from a group of doctors, nurses and community members to the hospital’s Board of Trustees and state officials, calling for leadership changes at the hospital. The letter said that management is driving clinicians to leave the hospital, eroding its future and quality of care.
In the last two months, four of the five staff in the hematology and oncology group submitted their resignations, Dr. Mark Mancini, the hospital’s medical director of nephrology, said in an interview Friday.
Mancini, who cares for patients with kidney disease, said that he is “on the brink of departure” because of frustrations with operation since Robinson was appointed chief executive officer in 2019, replacing Lou Giancolo.
“We haven’t had an organized meeting with the administration specifically representing the employed physicians in five years,’’ Mancini said. “(That’s a) prime example of an administration that has completely dissociated itself and alienated itself from the individuals such as physicians and advanced practice providers who are the pillars of your hospital.”
Robinson, whose management style was criticized in the open letter to the board, did not speak at the hospital’s news conference on Friday. In an interview with WPRI 12 last week, Robinson defended his record saying, in part, that the departure of the oncology doctors was due to a disagreement over what to do with the department.
Doctors who have spoken publicly about the hospital’s troubles say that the hospital staff departures fit a pattern that goes beyond normal staffing shortages. Doctors and other clinicians are being “driven away by the administration,’’ said Dr. Steven R. Fera, a cardiologist who retired from the hospital in May. “Physicians feel disenfranchised and powerless…There’s an atmosphere of fear and intimidation rather than collaboration and openness.”
Fera founded the hospital’s cardiology program, which last year was taken over by Care New England. The program remains in operation at South County Hospital, he said, but the rehab gym is gone and patients now often have to wait for tests.
Several of the hospital’s oncology staff who left, Fera said, are being replaced by temporary physicians under one-year contracts.
Dr. John O’Leary, who runs a private concierge practice in town, said he has stopped sending patients who need cardiac testing to the hospital because of long wait-times for testing. He said there’s also a backlog to test patients with lung problems. “We have only one pulmonary doctor in town [who works for South County Hospital] who I try to send patients to,’’ O’Leary said, “but there’s about a nine-month waiting list.”
O’Leary said he now sends his patients to pulmonologists at Yale New Haven Hospital in Connecticut or Care New England.
“The recent resignations are obviously not something South County Health wanted to occur,’’ the hospital said in a statement. “As we have previously communicated to patients, whenever a doctor leaves South County Health, we put comprehensive strategies in place to ensure patients do not experience any gaps in their care.”
One thing the group of doctors and hospital administrators may agree on is that South County Hospital’s days as a small, independent operator may be numbered. Asked at Friday’s press conference if the hospital’s independence is sustainable, Matthews, the board chairman, said, “It is not sustainable. Ultimately we will have to find a partner to work with for the benefit of the community to maintain and expand the services.”
Correction: South County Hospital’s CEO, Aaron Robinson, is not a doctor. A previous version of the story incorrectly identified him as a doctor.
Health reporter Lynn Arditi can be reached at larditi@thepublicsradio.org
