Health Related

Painful cut discussed in Lake Placid

By: KIM SMITH DEDAM Press-Republican

LAKE PLACID — Some with heavy hearts challenged Adirondack Health’s plans to close the emergency room and the hospital here.

About half of about 120 people gathered Wednesday questioned Adirondack Medical Center/Lake Placid staff, doctors and the board chairman, contesting a consolidation move that they believe would leave a void in health-care access for Lake Placid.

Adirondack Health, with two hospitals 12 miles apart, is looking to close AMC/Lake Placid and its Emergency Department on Church Street, establishing an urgent-care clinic at its Uihlein Campus across the road.

The Uihlein Living Center nursing home at that location would be cut from 156 beds to 80 or 60, leaving room for reuse.

Consolidation, hospital administrators say, would help staunch an ongoing — and growing — loss of revenue.

AMC Lake Placid’s Emergency Department lost $582,192 last year and $465,866 in 2011, Adirondack Health President Chandler Ralph said.

Adirondack Health had a deficit of $1.5 million in 2011, with two-thirds of that stemming from federal Medicaid funding cuts. 

Another $500,000 was cut by sequestration earlier this year.

The heath-care provider, with two hospitals, a dental clinic, four health centers and two nursing homes, lost $3 million in 2012.

CAPITAL FUNDING

The urgent-care center established by Adirondack Health would be open 12 to 16 hours each day and employ the nurses, doctors and physician assistants currently working at the hospital, officials said.

Lisa Keegan, a registered nurse at Adirondack Health, asked how the Uihlein renovations would be financed “if closing the emergency room is only going to give you $900,000 this year?”

Adirondack Health President Chandler Ralph said they would look to the endowment for capital funding to retrofit Uihlein.

“We don’t know how much those renovations are going to cost,” she said.

Adirondack Health Board of Trustees Chair Stan Urban explained that redesign at Uihlein would include partnerships with other agencies, for example, for assisted living services.

Lake Placid Memorial merged with General Hospital at Saranac Lake in 1991, and in a cooperative agreement signed then, the property would return to the Town of North Elba if the hospital were to close.

“If you do close 24-hour emergency services,” Keegan asked, “will you be paying rent to the town (for the hospital space)?”

“I would hope we would work out an orderly transition with the town,” Urban responded.

The complex merger in ‘91 carried an agreement to maintain emergency care for Lake Placid residents and visitors, including visiting athletes.

CARE FOR ATHLETES

Over the years, improvements to medical and diagnostic equipment have developed the larger Adirondack Medical Center in Saranac Lake.

And orthopedic services located at the Lake Placid hospital, where there are just two hospital beds, have flourished. 

Orthopedic and rehabilitation therapy centers would eventually move to Uihlein also, if the Lake Placid closure is approved.

Former Lake Placid Mayor and North Elba Supervisor Shirley Seney brought the importance of medical care for athletes to the discussion.

“We are an Olympic village,” she said, standing at the microphone.

“Young people are being prepared to be Olympic athletes. We have got to have a medical facility in this town.”

SARANAC LAKE SPACE

Dr. Herbert Bergamini, who has practiced medicine for decades here, raised concern about outlying communities.

“The Lake Placid hospital also serves Wilmington and Keene,” the longtime doctor said.

“Asking those people to go (12 miles) further isn’t fair. We definitely need an emergency service here 24/7.”

Bergamini suggested Adirondack Health officials hold another informational session in July and August when the summer residents arrive.

Mellissa Furnia, an emergency medical technician with Lake Placid Rescue Squad, asked the hospital leadership team where it would put the additional emergency patients transported to AMC Saranac Lake. 

The emergency department there, she said, has eight rooms and one set aside for mental-health treatment.

Dr. John Broderick, chief medical officer for Adirondack Health, said they would staff the AMC Saranac Lake appropriately to manage the added demand.

“We get a room open pretty quickly,” he said of their response admission time.

“That’s because Lake Placid (emergency) is there to take care of them (first),” Furnia replied.

“If not for the Lake Placid emergency room, my brother would not be here; my mother would not be here.”

‘CONSTANT STRUGGLE’

Lake Placid EMTs said ER closure here would result in fewer transports for their crews, which would harm them financially.

Ambulance companies are not reimbursed for transport to urgent care facilities.

And what, they asked, about Whiteface emergency calls?

“Emergency Medical Service is the lynch pin of how we do this,” Dr. Broderick said, allowing that they have not worked out detailed logistics.

“We are trying to figure out how to put this puzzle together.”

Adirondack Health has not made the absolute decision to close the Lake Placid emergency room or relocate services.

But officials are faced with increasing cuts in federal funding and declining in-patient revenue as people access more outpatient-based care.

Dr. Howard Novick, a radiologist at Adirondack Health, stood up and explained how the health-care industry has changed.

“I don’t think you understand the decimation that has come into medical care,” he told those gathered.

“It’s a constant struggle for the hospital. I ask, as a community — you have to think of the context in which this is happening.”

‘NEED RECOVERY PLAN’

Asked after the meeting how much time they have before revenue loss threatens other services, Ralph said, “we have to take action this year.”

“We need to have a recovery plan,” Urban added. “We can’t let this slide continue.”

North Elba Supervisor Roby Politi said the concern isn’t only about a hospital in Lake Placid.

“None of the citizens want to lose the emergency room,” he said after the meeting ended.

“I’m also concerned about losing a medical center in Saranac Lake.”

Ralph said the Adirondack Health recovery plan would consider all the input from the session.

“We understood it would be very personal for the residents of Lake Placid.”

A second Adirondack Health presentation is planned for 7 p.m. Wednesday, May 8, at Lake Placid Center for the Arts.

Email Kim Smith Dedam: kdedam@pressrepublican.com

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