Kramer says he feels “privileged” to lead this medical institution and he’s proud of his staff and the work they do. He said the job is challenging and rewarding, and he’s glad to live in a place where he can “de-stress naturally.”

“It’s a big responsibility,” he said, of his job. “But I think my career up until this point has prepared me for it.”

He’s worked on the back end of many of the company’s operations.

Kramer joined Adirondack Health in September 2015 and has moved through a variety of positions — starting as the assistant vice president of information systems, then chief information officer and chief operating officer. When Sylvia Getman retired from her role as president and CEO in July after five years in the position, he became the company’s acting CEO during the search for Getman’s replacement.

Kramer and his wife Amy, a teacher in the Lake Placid Central School District, live in Saranac Lake with their two children. They moved here from Poughkeepsie six years ago for a change of scenery. He was an IT director at a hospital in Hudson Valley and had previously worked at IBM. He said he got into hospitals because he fell in love with the health care mission.

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Staffing

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Kramer said the biggest challenge the hospital faces now is recruiting and retaining staff.

Staffing is hard in many industries right now, he said, but, “it’s especially difficult in health care.”

“I wouldn’t say that we are understaffed, but we continue to recruit for open positions,” Kramer said.

Kramer said he’s proud Adirondack Health did not lay off anyone or cut benefits to employees during the pandemic.

Adirondack Health did offer some employees voluntary furlough options during the pandemic last year and a few employees did take them.

Kramer said in September, the company raised its minimum wage to $15 an hour.

“It’s a way to recognize the hard work that everybody in this organization puts in,” Kramer said. “It’s also a retention and recruitment tool for us.”

He’s thankful for the hospital’s committed employees, but said Adirondack Health is relying on contract labor more now.

He said certain areas — specifically Mercy Living Center — have more severe staffing issues.

To become a certified nursing assistant to work at long-term care facility like Mercy, someone needs to take classes and find an approved testing site. Kramer said he’s trying to remove their barriers and recently AMC became a certified testing site to test new potential hires in-house.

One of Kramer’s long-term goals is to expand primary care access at Adirondack Health facilities. He said he’s looking to hire more primary care providers, and Adirondack Health spokesman Matt Scollin said the hospital recently hired two local doctors, who are returning to their hometown to practice medicine.

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Pandemic

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Kramer took the reins at Adirondack Health during the largest public health crisis in decades — the coronavirus pandemic. He said it’s been a difficult time, but that it’s also allowed him to see the best people have to offer.

Kramer said he’s proud of Adirondack Health’s vaccination rate. He said 98% of the staff at Adirondack Medical Center and the Lake Placid Health and Medical Fitness Center are vaccinated; 95% of staff at Mercy are fully vaccinated and 97% have at least one dose.

When the state mandated that all health care workers get vaccinated this fall, he said there were a few resignations. A few staff are still working with religious exemptions.

“It has been a challenge, but our employees got vaccinated for a number of reasons — to protect themselves, to protect their patients and their families,” Kramer said.

Kramer said Adirondack Health follows the laws and regulations of the state, but said he’d appreciate more clarity from these mandates, too.

The pandemic has weighed heavily on hospitals like AMC.

“The financial environment has always been challenging, especially for rural health care providers,” he said. “In many cases it was exacerbated by the pandemic. … We operate on thin margins.”

Adirondack Health has spent close to $1 million so far this year on pandemic-related expenses, he said. Last year, the hospital got $8.3 million in provider relief funding. While elective surgeries were unable to happen for several weeks last year as the hospital prepared for a possible surge of COVID-19 patients, the hospital missed out on a lot of revenue.

Now, Kramer said Adirondack Health’s financial position is “good, but certainly not great.”

“The stopping of elective surgeries hurt, financially,” he said. “We’ve been able to recover some, but there’s lost time that you can’t necessarily make up for.”

Kramer said he was glad Adirondack Health didn’t have to permanently reduce or cut any services as a result of the pandemic.

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Telehealth

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Kramer said a lot of the hospital’s services moved to telehealth during the pandemic, but as things have opened up, it’s continued to be a “good fit.”

He said doing behavioral and mental health visits over the internet results in less travel and more access. And not requiring people with contagious illnesses — even ones less serious than COVID-19 — to come to the hospital keeps the rest of their patients safer.

Adirondack Health is preparing to partner with the Saranac Lake Central School District to embed telehealth services in the school nurse offices. Kramer said anytime they can increase access and keep kids in school, that’s a good thing.