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Low inpatient volume is one reason for Carthage hospital’s restructuring plan


CARTHAGE — Administrators at Carthage Area Hospital aren’t considering its recent restructuring and service alignment plan as a hospital down-sizing.

They’re calling it a “right-sizing,” an adjustment of staff and services that blends well with current utilization.

“The hospital will remain exactly how it’s provided for today,” said Richard A. Duvall, chief operating officer.

Services won’t be slashed, rather presented in a more efficient manner, he said. Although hospital Chief Executive Officer Adil Ameer reported to the Times last week 90 of a total 451 hospital and Meadowbrook Terrace assisted-living facility jobs would be cut, Mr. Duvall said the actual number is 73.

Administrators said the layoffs, a reduction of a combined 20 beds in the hospital’s critical care, medical/surgical and pediatric units and sharing dietary services with Meadowbrook Terrace are necessary because the hospital cannot afford to keep staff when the number of inpatient visits, in particular, have declined during the past couple of years.

The average daily census for the hospital’s total 48 acute care beds has been only eight. Meadowbrook Terrace, a year-old, 60-bed facility, has only 28 residents.

Mr. Duvall likened the situation at the hospital to a car repair shop that has 10 mechanics, but only one car coming in for work daily. At some point, he said, there needs to be an adjustment. That is the purpose of Carthage Area Hospital’s restructuring and service alignment plan, Mr. Duvall said.

The same story has affected surrounding north country hospitals: low reimbursement rates, the shift from inpatient stays to more outpatient visits, increased regulations and other factors have made hospitals in Jefferson, Lewis and St. Lawrence counties reduce staff, consolidate services and look into collaborations with other hospitals and health organizations.

Carthage Area Hospital and five other local hospitals, have been that survival mode in the past couple of years since they joined to come up with collective ways to become more efficient and reduce unnecessary Medicaid readmissions.

The newly formed North Country Health Systems Redesign Commission is also looking at ways to reshape health care delivery.

“One goal is to maintain Carthage Area Hospital as a viable organization,” Mr. Ameer said.

Mr. Duvall called the restructuring and service alignment plan proactive.

“Our plan’s been supported not only by the state Department of Health, but our regional partners,” he said.

He blamed local media reports, including “the newspaper” on people’s confusion about whether the hospital would close. The Times never reported that. Mr. Duvall said all services, including laboratory, X-ray and surgical, will remain intact.

“We are not closing,” he said.

Expanding outpatient surgical services is something Mr. Ameer said the hospital is exploring. Carthage Area Hospital recently hired general surgeon Marcia Chung, who will work out of the hospital’s surgical center at 3 Bridge St.

The organization’s “commitment to quality still remains our number one priority,” Mr. Ameer said.

To ease the community’s mind, Carthage Area Hospital will hold community forums next month. Specific times and dates will be announced soon.

However, it is unlikely any of the recent decisions will be reversed, including the layoffs.

“No time is a good time, so to speak,” Mr. Ameer said. “We thought this was the right time to do it.”

As many as a dozen employees who were given a layoff notice may remain employed by the hospital, as 10 to 12 positions will be available as part of the reconfiguration of the three units with bed reductions.

While dietary services will be shared with Meadowbrook Terrace, Mr. Ameer said there is no truth to a rumor that a Subway sandwich shop will be coming to the 1001 West St. hospital. Outside vendors approached the hospital about expanding their businesses there, he said, but no commitments or plans have been made for such an arrangement.

As for empty physical space the changes will create in the hospital, Mr. Ameer said, he is unsure what the nonprofit will do with that. He said the hospital also continues to look for new residents for Meadowbrook Terrace.

“We had a slow ramp-up to it,” he said. “At this point, it’s being subsidized by the hospital. We’ve looked at trying to consolidate expenses.”

Meanwhile, New York State Nurses Association spokeswoman Eliza Bates said the priority of the union for registered nurses is making sure Carthage Area Hospital remains viable. The group has been in contract negotiations with hospital representatives for eight months, but no new meetings have been scheduled since the restructuring plan was announced last week.

By the numbers
Here is a look at a breakdown of layoffs announced last week at Carthage Area Hospital:
• 73 total layoffs
• 41 are members of Service Employees International Union Local 1199, which represents in dietary, housekeeping, licensed practical nurses, certified nursing assistants, phlebotomists, respiratory therapists, pharmacy technicians and unit coordinators.
• 19 are registered nurses, whom are members of the New York State Nurses Association.
• The remaining 13 are non-union employees, some of whom hold manager positions in the purchasing and patient accounting departments.
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