Signing ER support

LAKE PLACID – An emergency room nurse who works for Adirondack Health spent her day off Saturday collecting signatures on petitions in support of keeping open the emergency department at Adirondack Medical Center in Lake Placid.

Lisa Keegan, who works at both AMC-Lake Placid and AMC-Saranac Lake, stood on Main Street under the awning of the former With Pipe and Book store, talking to passers-by and gathering signatures from both locals and visitors. She is one of several hospital employees and local residents who’ve been carrying petitions around the area in recent weeks. Nearly 1,000 signatures have been collected so far, Keegan said.

“There’s a proposal to close the Lake Placid emergency room, and the hospital wants to turn it into an urgent care,” she said. “The community of Lake Placid and a lot of the staff at Adirondack Medical Center feel that this is not a safe thing for the community of Lake Placid. We’re trying to get the word out so the hospital will give people the opportunity to speak up.”

Keegan said she’s heard a range of responses from the people she’s approached. Some people have seemed flabbergasted by the idea that Adirondack Health would actually close the ER, while others believe it won’t really happen. Some people have told her closing the ER would be a good thing, calling it a “Band-Aid” station where no serious care is provided.

Keegan, who has been a nurse at Adirondack Health since 2002, said there are a lot of misconceptions about the services provided at the Lake Placid ER. Among other things, she noted that it carries blood and can provide transfusions, has a helicopter pad that can be used to transfer patients to other facilities, and can provide initial treatment to patients who have had heart attacks.

Hospital officials haven’t said publicly what they’re proposing to do with the Lake Placid ER, only that a wide range of options are being considered to improve the hospital’s financial position.

In a recent letter to Adirondack Health medical staff, however, Chief Medical Officer Dr. John Broderick said the organization is considering converting the around-the-clock Lake Placid ER to a daytime outpatient urgent clinic. He said it sees few patients during the night, and that the level of service it provides “isn’t needed medically,” noting that patients with serious medical issues being transported by ambulance often bypass the Lake Placid hospital and are taken directly to AMC-Saranac Lake. Broderick also said ambulance traffic would still be able to stop at the Lake Placid clinic for treatment of “appropriate non-life threatening injuries as we do now.”

Keegan said she’s seen the letter. She acknowledged that the Lake Placid ER doesn’t see many patients at night, “but if you’re that one person having a heart attack and there’s no emergency room in Lake Placid, that’s a very scary thing.” She also raised concerns about the impact to EMS response times if ambulances carrying local patients have to travel to the Saranac Lake emergency room instead of Lake Placid’s.

“It’s going to be very difficult on the ambulance services and the community,” Keegan said. “We have a lot of patients that actually just show up at our door, people saying, ‘My dad is having a heart attack!’ or ‘My baby isn’t breathing!’ In an urgent care, I don’t know how that’s going to work out. We’re going to have to say, ‘Sorry, we’re going to have to call an ambulance now because we’re an urgent care.’ The urgent care is not an emergency room.”

Keegan said she was told seven nurses would lose their jobs if the Lake Placid ER closes.

Broderick’s letter says the reason the proposal has come up now is “driven by finances,” but Keegan said their nurses’ union representative told them the Lake Placid emergency department is not in the red. The losses, she said, are coming from the Uihlein Living Center nursing home, the dialysis unit in Tupper Lake and the departure of two surgeons, whose work generates revenue for the hospital.

Adirondack Health officials have blamed their revenue losses, including $1.7 million this year, on declining Medicare reimbursements, the fiscal cliff negotiations, the federal spending cuts known as sequestration, a drop-off in inpatient admissions and other factors. In response, last week the organization laid off 18 full-time employees and reduced the hours of another 15 full- and part-time workers. That came just three months after another 17 employees were laid off as part of a long-term restructuring plan.

Keegan said she wasn’t surprised to hear about another round of layoffs last week.

“The hospital is in a pinch right now,” she said. “I think they’re trying the best they can to preserve what we have, but they have to cut somewhere and unfortunately staff is – that’s where the money is. I understand there will be layoffs, but I still believe the Lake Placid community, surrounding communities and our tourists need to have an emergency room.”

The New York State Nurses Association said last week that Adirondack Health’s board was poised to make a decision last Thursday on converting the Lake Placid ER to an urgent care center. It called on the board to delay the vote.

Adirondack Health spokesman Joe Riccio said Friday that the board didn’t make a decision, but he declined to answer additional questions other than saying the community would have a chance to weigh in on any changes to the Lake Placid ER.

“We’re going to continue to have a thorough conversation with the community,” he said.

Contact Chris Knight at 891-2600 ext. 24 or