KIM SMITH DEDAM
KEENE — The Adirondack Health Board of Trustees will vote May 30 on whether to convert the Lake Placid hospital's Emergency Department to an Immediate Care Center at its current location on Church Street in Lake Placid
A standing-room-only crowd attended a public forum at this week’s Keene Town Council meeting to learn details of the restructuring that may close Adirondack Medical Center/Lake Placid, including its Emergency Department.
The plan would consolidate the hospital’s wellness programs, along with a new urgent-care clinic, on the Uihlein Living Center nursing-home campus a half-mile away.
AMC/Lake Placid has just two inpatient hospital beds but also offers outpatient services, including sports medicine and rehabilitation, medical imaging and laboratory testing.
Cyndee McGuire, chief operating officer for Adirondack Health, said losses from the Lake Placid Emergency Department have topped nearly $500,000 annually.
The Adirondack Health nursing home — and its sister facility, Mercy Living Center in Tupper Lake — are currently operating in deficit.
To make room for the urgent-care clinic and other AMC/Lake Placid offerings, the number of beds at Uihlein would be cut from 156 to 80 or 60, officials have said.
And inpatient counts are dropping at Adirondack Medical Center in Saranac Lake amid the hospital’s wellness programs and moves to enhance outpatient care.
McGuire said their expansion of Adirondack Home and other programs have been “trying to keep people out of the hospital.”
The emphasis on wellness is working, she said.
But, when combined with loss of federal revenue from sequestration, aid reduction and Medicaid cuts, the financial picture is changing rapidly for the largest health-care consortium in the Adirondack Park.
“The revenue (picture) is very, very different,” McGuire said of the fiscal crisis at Adirondack Health.
“We have to be responsive. We can’t just keep doing business as usual.”
Adirondack Health has shed 36 jobs since December 2012.
The fiscal recovery plan, McGuire said, beyond consolidation, is also adjusting to increase revenue by adding weekend services.
Officials from Adirondack Health have held several public meetings in the past month, gathering input for a final recovery action plan that looks to close the Lake Placid hospital.
In Keene, McGuire was joined by Philip Edie, assistant vice president of Physician Network Services, and Dr. Anthony “A.J.” Dowidowicz, Adirondack Health’s emergency medical director.
Dowidowicz described how services have adjusted for critical care.
AMC/Lake Placid’s emergency room is not seeing the same demand it did 22 years ago when the hospital merged with Saranac Lake’s Medical Center, he said.
“The acuity level has changed,” he said. “People going there (Lake Placid) aren’t as sick as they used to be. People know that when you are really sick, you go to Saranac Lake or elsewhere.”
People who need medical care are “self-selecting,” he said, a fact that is driving the plan to close Lake Placid’s Emergency Department.
Of 65 medical doctors and specialists affiliated with Adirondack Health, Dowidowicz said, “the vast majority endorsed this plan,” finding, in many cases, delay from a stopover in Lake Placid could prove detrimental to immediate treatment.
'DIFFICULT TO SWALLOW’
Rusty Hall, chief of the Keene Valley Volunteer Fire Department, is an emergency medical technician with more than 30 years as a volunteer first-responder.
He said he has traveled with critically ill patients to Lake Placid on occasion.
“The loss of the Lake Placid emergency room will be difficult to swallow,” he said, outlining the challenges for volunteers, who are taking on more and more responsibility for critical medical care.
“A lot of the volunteerism is overlooked with regard to your opinions and statistics.”
Hall said it is a relief to know the Lake Placid hospital is close by when transporting a patient clinging to life.
Lake Placid is about 18 miles from Keene Valley; Adirondack Medical Center is about 29 miles — another 15 minutes or so each way for ambulance trips.
Ambulance crews cannot transport patients to urgent-care clinics.
Keene Volunteer Fire Department Chief Jody Whitney agreed with Hall, suggesting the loss of the hospital would hamper local emergency-response systems.
“They’re (ambulance squads) going to be out of service longer,” he said.
Dowidowicz said mutual-aid agreements could address the change by shifting resources and response plans.
“We are working with emergency medical services in the (affected) communities to make sure you are getting what you need,” the doctor said.
Other Keene residents asked how the influx of summer guests and second-home owners would impact hours of operation at an urgent-care center.
Dowidowicz said the new facility, if built, would staff much the same as the hospital and remain open for 12 or 18 hours a day.
Hours of operation would likely be extended during busy athletic events, such as Ironman or Whiteface ski races, he said, and during the busy summer tourism season.
Others asked if additional cuts would be made to Adirondack Health, which runs Mountain Health Center in Keene.
McGuire said they are looking at 40 areas of medical-service provision, mostly for revenue-enhancing opportunities.
“The bigger picture (is) we don’t want to limit services. The strategy is on the outpatient side,” she said.
There is no plan to close the Health Center in Keene, she said.
“We are committed to maintaining our services here. We’d like to expand it.”
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