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October 23, 2024

State: Rockville General halting surgical, psych services may violate state law

SHAHRZAD RASEKH / CT MIRROR Rockville General Hospital is one of three hospitals in Connecticut owned by Prospect Medical Holdings. Yale New Haven Health has signed a deal to acquire the facilities, but state approval is pending.

State health regulators say Rockville General Hospital and/or its owners may have violated state law by terminating “all medical/surgical” and psychiatric services at the hospital without approval.

The state Office of Health Strategy (OHS) sent a letter last week to Prospect CT Inc., the state arm of Prospect Medical Holdings that owns Rockville General and two other hospitals here. The letter states that “Prospect CT Inc., Prospect ECHN Inc. and/or Prospect Rockville General Hospital may be in violation” of state Certificate of Need (CON) regulations by terminating the services without permission.

The three-page letter, dated Oct. 17 and signed by OHS Staff Attorney Craig A. Sullivan, is addressed to Deborah K. Weymouth, president and CEO of Prospect CT Inc. and Prospect ECHN Inc. 

Prospect ECHN Inc. operates Eastern Connecticut Health Network, which includes Rockville General in Vernon and Manchester Memorial Hospital. Prospect CT also owns Waterbury Hospital, and has been mired in a protracted and litigious effort since November 2022 to sell the three hospitals to Yale New Haven Health Systems.

The letter states that OHS granted a COVID-19 waiver on or about March 25, 2020, that allowed Rockville General to close its operating rooms and gastroenterology procedure room for surgeries and procedures, “elective and otherwise,” as well as to close its preoperative and postoperative anesthesia care unit (PACU) areas. 

The letter also notes the closure “was the subject of a prior civil penalty proceeding.” That proceeding began in May 2022, when OHS notified Rockville General that it had received information stating that the hospital had failed to resume “surgical and procedural services” after the waiver had expired. 

In his decision issued on May 2, 2023, hearing officer Daniel J. Csuka ruled that Rockville General did not willfully fail to restart the services and recommended the civil penalty of $118,000 — based on $1,000 per day for 118 days — be “waived in its entirety.”

The Oct. 17 letter from OHS, however, claims Rockville General went far beyond what that COVID-19 waiver allowed.

According to the letter, “it appears that in actuality, (Rockville General) ceased to provide all medical/surgical services around this time, did not seek a waiver for the cessation of these other services, and to date has yet to restore these other services.”

In addition, the letter states, “it also appears that (Rockville General) may have ceased providing all inpatient psychiatric services (both adolescent and adult) … in or around June 2020 and has yet to restore those services as well.”

Under state law, hospitals must apply for a CON to terminate inpatient or outpatient services. A footnote in the letter states that the medical/surgical services cited refers to intensive care unit (ICU) and critical care unit (CCU) services.

The letter poses six questions to Prospect CT about the services, when they were halted, and whether other services have also been halted. It also requests “an explanation and/or justification for each occasion on which the identified services were stopped.”

The sixth question raises a separate issue. It cites a hospital reporting system report that “indicates that Prospect Manchester Memorial Hospital Inc. (MMH) ‘leases’ beds from (Rockville General)” to increase its ability to treat more psychiatric patients. 

The letter seeks an explanation for how the leasing process works, asking whether the state Department of Public Health is aware of the practice, where the “leased” beds are physically located (at Manchester Memorial or Rockville General), on what date the leasing began and whether the leasing practice is still in place.

The letter asks Rockville General to submit responses and any supporting documents by email to Sullivan no later than Oct. 31.

Prospect CT did not immediately respond to a request for comment.

On Tuesday, Gov. Ned Lamont said during a news conference following a meeting of the state Bond Commission that his administration had asked Prospect Medical Holdings to agree to hire an independent monitor to oversee patient care at all three of its hospitals in the state.

In September, Lamont hosted Yale New Haven Health and Prospect Medical Holdings officials to discuss the stalled purchase by YNHH of Prospect’s struggling hospitals.

YNHH has asked the state Superior Court to be let out of its contract with Prospect Medical Holdings to buy the hospitals for $435 million, claiming Prospect breached the contract by defaulting on rent and tax liabilities, allowing its facilities to deteriorate, mismanaging assets, “driving away” physicians and vendors and engaging in “a pattern of irresponsible financial practices.”

Prospect Medical Holdings, meanwhile, last week issued a statement blasting YNHH’s board of directors, its board Chairman Vincent Calarco and Vice Chair Marry Ferrell, stating they have waged “an aggressive campaign in both the courts and via the media to denigrate” Prospect’s hospitals and employees in the state.

“Prospect has made numerous concessions to try to move the deal forward and stands ready to close the transaction,” the statement adds. “Unfortunately, the direction for YNHHS set by Calarco, Ferrell and the other trustees seems to be focused on beating down the purchase price, and ignoring the collateral damage caused to the communities that rely on the facilities.”
 

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