Frisbie CEO explains why hospital is ceasing maternity services; AG reviewing change

ROCHESTER -- The CEO of Frisbie Memorial Hospital laid out a new plan to deal with declining birth services at the hospital for the City Council Tuesday night.

Tim Jones talked about the hospital's decision to discontinue birth services at Frisbie, and the potential intervention by the New Hampshire Attorney General's staff into whether or not that decision violates the agreement reached when HCA took over the former non-profit hospital.

Last week, it was announced that Frisbie Memorial Hospital is facing a review by the New Hampshire attorney general's office over its decision to discontinue labor and delivery services, sending patients instead to Portsmouth Regional Hospital, which is under the same ownership.

More: Frisbie Hospital plans to send baby deliveries to Portsmouth. State AG says not so fast.

NH attorney general reviewing proposed change to maternity services

Attorney General John Formella said Frisbie, which informed the state attorney general last month it plans to stop delivering babies, had agreed in February 2020 to continue labor and delivery services for at least five years after it was acquired by HCA Healthcare for $67 million.

The agreement states the hospital would have to "show proof of extreme financial loss/disadvantage" in order to justify discontinuing labor and delivery services.

Jones called the decision to discontinue births challenging and said they will contract prenatal, postnatal, gynecological and surgical services with Harbor Women's Health. Located in Portsmouth, the private practice does deliveries at Portsmouth Regional Hospital. Former Frisbie patients planning to deliver babies can choose to do so at PRH, or they can choose to change to Wentworth-Douglass Hospital.

Ellen Miller, a spokesperson for PRH and HCA, said they have not yet received a ruling from the AG.

"But as part of our review,  we have to have a plan in place," she said.

More: Frisbie's plan to stop labor and delivery services part of concerning trend in NH

As to Frisbie moving forward, Michael Garrity, a spokesperson for the Attorney General, said, "While the February 3, 2020, Report of the Director of Charitable Trusts on the Proposed Acquisition Transaction involving Frisbie Memorial Hospital does not require that the hospital obtain the prior approval of the Director of Charitable Trusts before discontinuing health care services, the Director is reviewing whether the decision and the notice complies with the terms of the February 3 Report. The review is ongoing."

Why Frisbie's ceasing labor and delivery services

Jones said three factors had gone into the move.

First, Jones talked about the decline in births happening at the facility. He said Frisbie is not the only New Hampshire healthcare facility seeing acute drops in births.

"In 2017, we had 350 births," said Jones. "The volume has steadily declined and this year, it's unlikely we will see 100. In July, we had two. New Hampshire has an aging population, one of the oldest in the country."

Jones said the second issue comes because doctors and nurses are required to take part in a specific number of births in order to maintain their clinical competency status, and they are not finding that at Frisbie.

"I spoke to one nurse recently who had not delivered a baby in two months," said Jones. "The American College of Obstetricians and Gynecologists (acog.org) has a minimum recommendation of 100 births per provider, per year, just to maintain competency."

As a result, Jones said they are having difficulty recruiting doctors.

"At this low a volume, doctors are unlikely to accept a job," said Jones. "We just interviewed one, who asked how many births we saw a year. He turned down the job."

Jones told the council, all staff of the maternity department are being offered ways to keep their employment. He said some can move to other Frisbie departments, or they are in talks with Harbor Women's Health and with Portsmouth Regional Hospital.

"We are committed to our communities," said Jones. "Over the past year, since HCA took over, we have invested over $100 million in the hospital."

This article originally appeared on Fosters Daily Democrat: Frisbie CEO in NH explains why hospital is ceasing maternity services