In defense of Adirondack Health

I am privileged to serve as chairman of the Board of Trustees for Adirondack Health, an institution with a rich history and tradition of serving the North Country for more than 100 years. AH not only enjoys a well-deserved reputation for providing excellent care and services throughout the region; it is the largest private employer in the Adirondack Park, with 900 employees. It is an integral part of the fabric of the entire North Country, with an annual economic impact of $148 million in the form of payroll, income and property taxes, and purchase of goods and services.

I am compelled to write in part to comment on the letter directed to the AH Board of Trustees from the village of Lake Placid and the North Elba town boards regarding the Lake Placid emergency room. The letter was recently published in the Adirondack Daily Enterprise. I write also to reinforce information I sought to convey during the recent public forums.

The joint letter to the AH board contained repeated reference to AH’s “lack of sound business judgment,” “poor business decisions” and “decisions based solely on money.”

Further, there was a call for the engagement of independent professionals. These statements imply to me that village and town officials believe AH’s current professional staff, including its physicians and executives as well as its trustees, either lacks the knowledge, proper motivation and/or is otherwise not competent to provide sound leadership to AH’s health care enterprise.

Nothing could be further from the truth. AH’s physicians and other clinical professionals seek only the best possible outcome for patients, wherever they present within our system of care. The AH executive team is highly qualified and totally committed to meeting the needs of those we serve in as efficient and effective manner possible. AH’s trustees are appointed only after an in-depth review process to assure the board collectively has the skills, work experiences and competencies necessary to successfully navigate the ever-changing health care landscape and to assure AH’s future success. As a result of strong emphasis on continuing education, AH trustees are extremely well versed in understanding the external environment and the implications for AH. The board is 100-percent committed to and capable of assuring excellent care, visionary leadership and sound financial management.

Some have expressed the belief that the financial challenges currently facing AH are the result of “mismanagement.” Again, nothing could be further from the truth. I serve on the board of another not-for-profit health system which operates 82 hospitals and 89 continuing care facilities located in 21 states. I can say with confidence that what AH is experiencing is similar to what most hospitals are struggling with across the country. The health care industry is facing a time of unprecedented uncertainty and risk in this new era of health reform. All health care organizations are being called to change with the times or risk no longer being relevant or viable.

It is important to note that the AH board has worked for the better part of a year in a thorough and thoughtful process to assure AH’s financial stability and sustainability in these turbulent times. The conversion of the Lake Placid ER is one of literally dozens of initiatives in a Financial Recovery Action Plan necessitated by extensive cuts in reimbursement, both at the federal and state level. The plan contains a wide range of actions, from as simple as changing cafeteria hours to as significant as laying off more than 30 employees. A primary reason the conversion of the Lake Placid ER to a 12-hour immediate care center remains under consideration is medical staff leaders support the change as both “safe and prudent.” Maintaining two fully staffed ERs 24/7, 11 miles apart, especially when one of those ERs sees less than one patient every four hours between 8 p.m. and 8 a.m., can no longer be justified from both a clinical and financial perspective.

With regard to AH’s future commitment to Lake Placid, a reminder: Last year the AH Board of Trustees approved the development of an integrated medical campus on the Uihlein Living Center site. We are presently in discussion with potential partners to build and operate an assisted living facility (a huge unmet need in this area), construct a new medical office building with fitness center and convert existing space within Uihlein to relocate all services currently at the Lake Placid hospital into newer, more patient-friendly space.

In conclusion, I have been coming to Lake Placid since the late 1950s. When I retired after almost 40 years as a health care executive, there was no place my wife and I wanted to live other than Lake Placid. It is indeed a special place. The proposed conversion of the Lake Placid ER to an immediate care center will affect my family and house guests along with those of the many other members of the AH family who choose to make Lake Placid their home. The conversion of the Lake Placid ER is being proposed not because of any self-serving motivation but because in the board’s opinion it is the right thing to do. As board chairman, I do not want to find myself standing in front of the Tri-Lakes communities five years from now, trying to explain why, in 2013, the trustees of AH failed to understand and react to a changing environment and failed to make the difficult decisions that would have prevented AH from sliding toward insolvency. Imagine this region without AH. At that point we would be talking not only about the loss of 900 jobs but also the need to travel 50 miles for hospital services. A proactive approach taken now will best position AH to continue to serve this entire region for generations to come. Will there be challenges as we proceed forward – certainly – but I am convinced that by working together, we will be able to meet those challenges.

Stan Urban lives in Lake Placid.