SARANAC LAKE - Major changes are in the works for Adirondack Health's facilities in Lake Placid: moving a hospital, adding assisted living, senior housing and fitness facilities, and reducing the number of nursing home beds.
At a press conference Monday afternoon, Adirondack Health President and CEO Chandler Ralph announced that the organization's board of trustees voted Saturday to move ahead with a new vision that involves consolidating its services in the Olympic village into one location.
Ralph said Adirondack Health plans to move the services currently provided at its Lake Placid hospital, including its emergency room and doctor's offices, to existing space or a yet-to-be-constructed building on the 13-acre Uihlein Living Center property, which is currently home to a 120-bed nursing home. The former Placid Memorial Hospital property would then be sold.
Meanwhile, Ralph said the organization wants to partner with other organizations to add assisted living and senior housing facilities on the Uihlein campus, as part of a shift away from long-term care at the site. The number of long-term-care beds at Uihlein would be reduced from 120 to 60 over the next one to two years.
A medical fitness center for people of all ages would also be added to the Uihlein property. It would provide adult and senior fitness programs, performance programs for athletes, weight management and may include a pool that would be available to patients, residents and the community.
"This is really a new vision for the campus at Uihlein, and we're tremendously excited about it," Ralph said. "Running two campuses five minutes apart from each other is not terribly efficient. We believe we can gain some efficiencies by moving everything onto one campus."
Ralph said the transition from long-term, nursing home care toward assisted living, where seniors would live in their own apartments but receive some medical and clinical services, is based in part on the financial "struggles" the organization has faced at its two nursing homes - Uihlein in Lake Placid and Mercy in Tupper Lake - since it took them over from the Sisters of Mercy roughly five years ago. Adirondack Health experienced a $1.6 million shortfall last year, $1 million of which was attributed to a shortfall in Medicaid reimbursements. It costs about $220 per patient per day to provide long-term care at Uihlein, but Adirondack Health is only reimbursed $155 per patient, per day. The Medicaid reimbursement is somewhat higher - $188 per patient per day - at Mercy Living Center in Tupper Lake, where no changes are planned currently, Ralph said. Mercy's Medicaid reimbursement had been at crisis point for the Sisters of Mercy but got a boost when the hospital took over.
The other motivation for the change, Ralph said, is community need. Hospital officials convened a focus group of 20 agencies that provide services to seniors in the Tri-Lakes region, and Ralph said the group identified assisted living "as a service that really is not well represented in this community, and also independent or senior housing." The nearest assisted living facilities are the Neighborhood House in Keene Valley and Pine Harbour in Plattsburgh.
"A lot of people can't stay in their homes, but how do you transition them to supervision and care, assisted living, and eventually institutional living?" Ralph said. "Adirondack Health will be going out looking for partners to see if they will partner with us in building those services on the campus."
Ralph also said there's been a nationwide decline in demand for long-term care beds that's being driven by an increased demand for in-home care and other services that allow people to age in place. That demand is expected to increase as more baby boomers reach retirement age.
"We're preparing ourselves for the future," Ralph said. "I think you'll find, five years from now, that this is something that absolutely had to be done in order to keep our senior citizens living in their communities."
But there is still a strong community need for long-term care currently. Ralph said there is demand for the nursing home's 120 beds, all of which are currently full. However, she said, the hospital can no longer afford to "take all comers" and has to cut its losses. Ralph also noted that the facility's administration has identified 29 Uihlein residents it believes would be more appropriate for assisted living than long-term care.
Asked how the number of Uihlein residents will be cut in half over the next one to two years, Ralph said a "natural attrition" will occur at the facility.
She also said Adirondack Health is working with partner agencies to create a "safety net" so senior citizens in the Tri-Lakes can remain in their homes as long as possible.
If, for some reason, the organization doesn't get the level of "attrition" it's seeking in two years, Ralph said that doesn't mean residents will be told to go elsewhere.
"I don't think that's right, and we won't do that," Ralph said.
Cutting the number of nursing home beds by 60 means Adirondack Health won't need as many employees at Uihlein as it has now, which is 182, but Ralph noted that the new services planned for the Uihlein property will create new jobs.
"Positions will change, and new positions will be created," said Adirondack Health spokesman Joe Riccio. "The number of beds is going to be decreased gradually over time, but as those go down, hopefully other services will be added. We also have a high level of (employee) attrition on that campus, so as a position is vacated, we'll ask, 'Do we need to refill it?'"
The planned downsizing of Uihlein comes as Essex County officials consider the potential sale of the county-run Horace Nye Nursing Home in Elizabethtown, which has been operating at a loss of $2 million to $4 million annually. A task force assembled to look at the county's options has recommended selling it to a company based in the Bronx, and the full county board could vote on the deal as early as today.
As for the former Placid Memorial Hospital, which was built in 1952, Adirondack Health officials say it's not configured to provide modern medicine. Ralph said she doesn't think anyone will be interested in the building, which may be demolished, but the property it's located on could be valuable.
The money that would be generated by the sale of the hospital property could provide a big boost to the capital campaign Adirondack Health plans to launch to carry out this vision.
"We've always been fortunate in the past that the community has been extremely supportive of providing new services and what we need to make that happen," Riccio said. "I think that's one thing we can count on with this, is the support from the community."