NEW YORK NURSE: July/August 2008
by Mark Genovese
The deadline for hospitals and nursing homes in New York State to meet the Berger Commission’s mandate to merge or downsize passed on June 30. Yet the healthcare industry is still struggling to make all the pieces fit.
The commission ordered Erie County Medical Center (ECMC) and the Kaleida Health system to form a single, nonpublic entity affiliated with the medical school at the University at Buffalo. But strong differences in philosophy led to several months of lawsuits and adversarial advertising. ECMC, where NYSNA represents the RNs, was concerned that the larger Kaleida system would have too great an influence over the new network’s supervisory board and wanted to protect its financial reserves from being raided by the cash-strapped private entity.
To force a resolution, the county executive filed a legal action to compel the state to close either ECMC or Kaleida’s flagship, Buffalo General Hospital, unless an agreement was reached. After a State Supreme Court justice overseeing the case stepped in to mediate, the parties agreed in June that the two would remain separate, but under management of a state-appointed board of representatives. The agreement was approved by the state health commissioner on June 30.
Ellis Hospital in Schenectady took over Bellevue Women’s Hospital in November 2007 and St. Clare’s Hospital in June 2008. Ellis planned to hire nearly all the staff from the two facilities. Bellevue will now house all of the new network’s reproductive services. St. Clare’s, renamed the “McClellan campus,” will handle outpatient care. Its emergency room remains open for now, but will eventually become an urgent care center. NYSNA represents the RNs at Ellis. Nurses at the other two facilities did not belong to any union.
NYSNA has been meeting with nurses from both St. Clare’s and Bellevue to acquaint them with the association and its services. Nurses expressed concerns about the future of emergency services in Schenectady, as the Ellis ER is expected to handle nearly all of the 37,000 ER patients per year that previously went to St. Clare’s. Ellis nurses said that their ER, which handles 34,000 visits each year, is already overburdened.
St. John’s Riverside Hospital is awaiting state approval to close Dobbs Ferry Community Hospital and reopen it as “St. John’s Dobbs Ferry Pavilion.” NYSNA represents RNs at St. John’s and has been representing Dobbs Ferry nurses since St. John’s assumed operation of that facility last fall.
St. John’s plans to keep the Dobbs Ferry emergency department and observation beds open, and will have the facility focus on primary and cancer care and management of chronic conditions. The facility’s highly-regarded breast-care center will be expanded. Local elected officials supported the merger, noting that there is a demonstrated need for an emergency room and a primary healthcare facility in the Westchester County’s river towns. On July 10, RNs approved an agreement that adds the Dobbs Ferry RNs into the St John’s contract.
A parent company, called the “Lake Erie Regional Health System of New York,” was created to manage Brooks Memorial Hospital in Dunkirk and the TLC Health Network in southwestern New York. Bertrand Chafee Hospital and Home in Springville agreed to collaborate with the new system. Brooks Memorial professional staff are represented by NYSNA.
The financial impact of complying with the Berger recommendation is in queston. The hospital has contended that the $3.8 million it received from the state isn’t nearly enough to relieve its debt and cover legal and consulting costs.
Three financially strapped hospitals in eastern Long Island agreed to put aside years of competition and affiliate, as required by the Berger law. Under the new “East End Health Alliance,” Peconic Bay Medical Center in Riverhead, Southampton Hospital, and Eastern Long Island Hospital in Greenport hope to eliminate unnecessary duplication and pool their resources and buying power. Each will retain its executives and boards for day-to-day operations, but a system-wide board made up of representatives from the three facilities will make strategic decisions. NYSNA represents RNs at Peconic Bay and Southampton.
The Berger Commission had ordered that Community General Hospital in Syracuse take over the deficit-ridden Van Duyn Home and Hospital, which is operated by Onondaga County. After outrage by community leaders and lawsuits by the county and employee unions, the State Health Department agreed in October 2007 to let the two develop an alliance. Under the new, nonprofit “Onondaga Hill Corporation,” representatives from both facilities will handle joint planning. Community General closed its nursing home unit in January and is converting those beds to acute care. Van Duyn also decommissioned some of its beds. NYSNA represents RNs employed by Onondaga County, including those who work at Van Duyn.
Two facilities in Elmira were the lone exceptions in meeting the commission’s mandate. In October 2007, after nine months of heated discussions, Arnot Ogden Medical Center and St. Joseph’s Hospital informed the state health commissioner that they were unable to merge. This cleared the way for St. Joseph’s, where RNs are represented by NYSNA, to resume affiliation talks with the Guthrie Healthcare System in nearby Pennsylvania, which had started well before the Berger Commission was formed. Both hospitals agreed, however, to establish primary care clinics to serve Medicaid patients.