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Lowville hospital officials expect changes to improve fiscal shape

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LOWVILLE — Despite fiscal woes, Lewis County General Hospital officials are optimistic several initiatives will have the facility back in the black in the coming years.

“In a perfect world, all these things work,” said Eric R. Burch, the county-owned hospital’s CEO, Thursday during a presentation to members of the county Board of Legislators, hospital board of managers and Lewis County Health Facilities Corp.

The facility is eyeing a projected loss for 2012 of up to $2.75 million.

However, several changes are in the works, and their cumulative effect may lead to an operating surplus as soon as next year, hospital officials said.

The biggest boost would come from a proposed switch to critical-access designation, which Stroudwater Associates projects would provide a roughly $3 million annual benefit over the next few years.

“This is the biggest benefit they’ve ever seen in any of their reviews,” Mr. Burch said.

Hospital officials, with assistance from Stroudwater, plan to submit critical-access paperwork to the state by Jan. 15 in hopes of gaining the designation by midyear, he said.

While now licensed for 54 acute-care inpatient beds, the hospital, if designated as a critical-access facility, would be limited to no more than 25 inpatients at any given time. However, hospital officials said they believe that threshold should be attainable, given that the daily average is about 14.

Hospital officials also hope to gain patients through addition of a hospitalist service, which would handle after-hours admissions and initial treatment so family practitioners would not have to come in at night, via a contract with Rural Physicians Group.

The hospital also will contract with NES Medical Services for emergency department physicians.

The county-owned hospital sent out requests for proposals for a combined emergency room physician and hospitalist group in late July.

In response, the four-person ER group North Country Physicians, which has contracted with the hospital for years, submitted its resignation as of Thursday, indicating the group was opposed to the idea of combined coverage and would not have the resources to provide the services requested.

Group members have since agreed to work with the new emergency room group and plan to contract with it on a trial basis for the first three months of 2013, Mr. Burch said.

Through the end of the year, coverage is being maintained by two hospital-employed ER doctors and a few private physicians working on a per-diem basis.

The hospital also expects to reopen a town of Diana-owned clinic in Harrisville, closed earlier in the year by Carthage Area Hospital, as soon as state officials approve of facility upgrades made by the town, Mr. Burch said. While clinics tend not to be break-even ventures, they shift patients to the main facility for ancillary services, he said.

“We’re trying very hard to secure the market,” Mr. Burch said.

A new orthopedic surgeon, Dr. H. John Park, is expected to start in early April, filling a yearlong void in that money-making service, the hospital administrator said.

Temporary physicians may be brought in through February and March to help re-establish an orthopedic practice before his arrival, Mr. Burch said.

While a large uptick in patient admissions could threaten the critical-care designation, Mr. Burch said he expects new government policies aimed at keeping patients out of hospitals and avoiding readmissions will make that a nonissue.

“I think even if we do go up, it’s only going to be a short period of time,” he said.

The hospital also expects to take over certified home health aide and hospice programs from the Lewis County Public Health Agency on Jan. 1.

Given the new policies, Mr. Burch said, the CHHA program may prove useful in supporting discharged patients to limit readmissions.

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