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Ad’k Health board postpones vote on Lake Placid ER

June 6, 2013

SARANAC LAKE - Adirondack Health's Board of Trustees has postponed for 60 days a decision on whether to convert the emergency room at its Lake Placid hospital to an urgent care clinic.

In an email to the organization's staff Thursday, May 30, Adirondack Health CEO Chandler Ralph said the board was given a summary of public input on the proposal from a series of community meetings held over the past few weeks.

"Upon review, the board has decided there is a need to factor in additional study, community input and give the process more thought in the context of our broader mission and strategic plan," Ralph wrote. "We plan to finalize this discussion within the next 60 days."

The decision came after the hospital's board deliberated behind closed doors for two hours Thursday night in the board room of the Redfield Medical Office Building in Saranac Lake. Reached for comment, Adirondack Health spokesman Joe Riccio didn't provide any additional information beyond what was in the statement. He said Ralph and board Chairman Stan Urban wouldn't have anything more to say for at least a couple of days.

Lake Placid Mayor Craig Randall said after the announcement that he was "pleased that the board listened to the community to the extent that they have and has agreed to step back and look at this more carefully.

"I believe it gives us more time to see if something can be put together that will not only meet the objectives of Adirondack Health but most importantly give our residents and visitors alike the assurance that they're going to continue to have that excellent health care close to home," Randall said.

Adirondack Health officials have said the volume of patients at the Lake Placid ER doesn't justify keeping it open, that it isn't equipped with modern medical technology and that most seriously ill patients already are taken to the Saranac Lake ER. They also say the Lake Placid ER lost roughly $500,000 last year, which is no small sum given some of the financial constraints the organization is facing.

But many Lake Placid residents bitterly oppose the plan to convert the around-the-clock ER to a 12- or 16-hour urgent care clinic, saying it would threaten their safety and that of the area's many visitors and seasonal residents.

Over the last week, pressure had intensified on Adirondack Health's board to either reject the proposal or at least postpone a decision on it.

The state Olympic Regional Development Authority came out against the plan on Monday. In a letter sent to Ralph, ORDA Chairman Pat Barrett said closure of the ER "would have a negative impact on guests, athletes in training and competitors" at its venues, and could also affect its ability to bring conferences and conventions to the community.

Members of the the Lake Placid village and North Elba town boards, in a letter sent to hospital's board this week, said there's been a "rush to judgment by the leadership of Adirondack Health to counteract its poor business choices of the past." Town and village leaders said too many questions remain unanswered, such as the potential impacts to local ambulance squads and the EMS system. They urged Adirondack Health delay the decision and commission an independent professional study of all possible alternatives.

Meanwhile, the New York State Nurses Association has called for an independent financial review of the Lake Placid ER. In an eight-page letter sent to Adirondack Health board members on May 24, NYSNA representative Bill Conley accused senior Adirondack Health officials of putting out inaccurate and misleading statements "in an apparent attempt to bolster their position that the Lake Placid ER should be converted to an urgent care clinic."

Among other things, Conley questioned the hospital's claim that the ER is losing $500,000 a year. The association had asked Adirondack Health officials whether visits by patients who first come to the Lake Placid ER, but are then transferred to the Saranac Lake ER, are recorded as visits to both ERs or just one. It also asked for revenue figures from all patients entering the Lake Placid ER over the last three years.

Conley said the only answer he was provided to both questions came from Michael Lee, Adirondack Health's vice president of human resources, who wrote in a May 6 letter that, "When a patient presents at the LP ER and is transferred to SL facilities, the revenue follows the patient."

"Frankly, Adirondack Health did not do a significant or thorough financial analysis of the Lake Placid (Emergency Department)," Conley told the Enterprise Wednesday. "In my opinion, they omitted revenues that should have been credited to the Lake Placid ED, which caused the revenues to be understated and the losses to be overstated or inflated."

Adirondack Health officials didn't respond to a series of questions the Adirondack Daily Enterprise asked last week about Conley's letter and how the organization credits the revenue from patients who come to the Lake Placid ER. Riccio provided a two-sentence statement that said the organization has received the May 24 letter and that it will "continue in good faith to work with the union, EMS crews, community members and numerous other stakeholders to achieve a shared commitment to excellent care, visionary leadership and sound financial management."

The nurses association sent a separate letter, along with copies of the May 24 letter, to members of the Adirondack Health medical staff on Tuesday. The Enterprise obtained copies of both letters from a local physician who is a member of the medical staff but declined to provide his or her name. The physician, in a letter to the Enterprise, wrote that the examples of misinformation cited in Conley's letter "are true" and said he or she, along with several other members of the board and medical staff, "are disturbed by the obfuscation of the facts" by Adirondack Health's administration.

Riccio said the additional study the board is planning over the next 60 days will be done internally. Asked if there's a need for an independent, outside review of the proposal, Riccio said he couldn't immediately answer that question.



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