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Ralph Nader > In the Public Interest > Fighting Back to Keep Hospital Open

Economic mismanagement, lack of accountability and secrecy are working their insidious will to destroy the non-profit, full-service, acute care, community hospital in Winsted, Connecticut that has been the pride of this small town (pop. 11,000) for 94 years. Winstedites are fighting back to save their health care institution that serves about 30,000 people in semi-rural northwestern Connecticut. Therein lies the conflict — between the forces of community destruction vs. the forces of community preservation — that is going on all over the country.

Winsted is my home town so I have heard the many accolades that residents and summer camp people have given to the physicians and staff at this intensely courteous and competent hospital. From across the Massachusetts border, fire fighters and other emergency volunteers rave about the emergency room services at Winsted Memorial Hospital (WMH).

When I hear these stories I recall the time when my father was operated on there -¬≠excellent — or my mother was treated there — excellent. I remember my observations of many big city hospitals — their impersonal often brusque nature. One of my friends was having a heart attack and was rushed in mid-day to the emergency room of a major Washington, D.C. hospital. He waited for five hours and died before anyone ever attended to him.

In Winsted, while the hospital on the hill was getting better professionally, management started making mistakes, starting some eighteen years ago with closing down obstetrics. The slippery slope commenced with the loss of many young families who followed pediatrics and related specialities elsewhere.

Then came a hairbrain holding company idea with a larger hospital ten miles away in Torrington in the late Eighties. Before this blunder was repealed, the Winsted hospital was paying about $1 million a year for bureaucracy and subversion of its independence. In both cases, citizens objected but were ignored by the management and hospital board.

Then came a state law for an uncompensated care pool that hurt smaller hospitals in smaller towns. The state is finally phasing this levy out.

More pressing are managed care contracts between insurance companies and nearby hospitals that trade discounts for exclusivity. This has led to Winsted area residents being sent to Torrington’s hospital because Cigna, for example, has signed such an agreement. The State Attorney General’s office is presently investigating this tying arrangement.

The Torrington hospital, ever eager to put its smaller competitor out of business, requires physicians, who also work at WMH, to become active staff, rather than courtesy staff, members. This status bends these physicians to send Winsted-area patients to Torrington instead of Winsted.

Notwithstanding mismanagement mistakes and unfair external squeezes, WMH has not been gushing red ink in past years. It has little debt to speak of. In mid-February of this year, WMH board chairman, Hartford attorney, Herbert Isaacson, said that “Winsted Memorial is in good shape and doing well under the current management arrangement it has with Sharon Hospital.” James Sok, who is president of both WMH and Sharon — a troublesome dual allegiance situation regarding hospitals with partially overlapping territories — echoed similar positive statements.

Then suddenly a mere two months later, the stealth president, Mr. Sok, unveiled a plan, approved by the Board, that, in effect, would shut down the Hospital’s acute care services and move its non-profit outpatient and emergency care into a for-profit subsidiary that would build a separate standing facility some miles away.

The news struck the community like a bolt of lightning. The community, which helped build the hospital, then enlarge the hospital; the community which volunteers and raises money for the hospital; the community which viewed the hospital as its heart was not consulted. The community was just TOLD by a president, who refuses to disclose management contracts, other data and policies crucial to an informed public, and by a Board that is self-perpetuating.

Losing too much money, says Sok and the Board. So unlike other small Connecticut hospitals that fought successfully their predicaments, Sok and company cave. Twelve thousand people signed protest petitions demanding that the Hospital’s governors strive to keep the Hospital open. The citizens secured proposals by volunteer specialists on how to make the hospital survive and thrive.

First, collect its bills (it is nearly five million dollars behind), second, subcontract with a larger city hospitals in ways that help both sides, open up needed specialized outpatient care such as cardiac rehabilitation and major physical therapy, tap the state’s distressed hospital fund to return some of the monies unfairly assessed against WMH by the state (this is about to occur), be more price competitive, and develop a skilled nursing facility using available bed space.

There are other ideas and higher morale among the staff which a management and board, that really wanted to save the hospital, could generate. A new board and new management are needed.

The six or more “towns” served by WMH can create a not-for-profit corporation, adopt the hospital and place it under new management dedicated to keeping the Hospital open and improved. Instead of wallowing in all the excuses to close it and turn its remnants into a for profit ambulatory care clinic, this municipal initiative can become a last line of defense against profiteering, anti-patient priorities and giant HMO domination over physicians and nurses.