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E.J. Noble Hospital makes strides but remains in fiscal trouble

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GOUVERNEUR — E.J. Noble Hospital has jumped a lot of hurdles to stay open but remains in a financial bind while it looks at controlling expenses, becoming more efficient and improving its bottom line.

“We are continuing to look at all aspects of the hospital and make adjustments. Our plans are rather fluid at the moment, but they should be solidified in the not-too-distant future. I think the important message is we’re optimistic,” said Administrator Marlinda L. LaValley. “E.J. Noble is open for business. Virtually everything continues to be done here that was done before.”

The hospital was already struggling financially when the state Department of Health shut down its laboratory for deficiencies Sept. 28. The closure forced the hospital to curtail many of its essential services, including its emergency room, until the Health Department allowed a partial reopening of the lab — under the supervision of Samaritan Medical Center, Watertown — in October.

A management agreement with Canton-Potsdam Hospital, Potsdam, was finalized in March, so E.J. Noble’s most recent administration has been able to make decisions about a direction for the hospital only over the last few weeks.

One of the early moves was to prioritize the hospital’s unpaid vendors so that those essential to operations would be worked with first, said Ms. LaValley, who had been vice president for administrative services at Canton-Potsdam Hospital. The hospital also wanted to pay down its debt with local vendors who have been E.J. Noble’s support system.

“These are the individuals upon whom we rely to keep our doors open,” Ms. LaValley said. “We did make a commitment to bring them up to date.”

The hospital also promised to keep those vendors current on any future bills, she said. Kinney Drugs agreed to hold off on accepting money for its unpaid bills, and many of the other local merchants converted the debts owed them to contributions to the hospital.

“We are grateful for their generosity,” Ms. LaValley said. “Some of them were shocked because they thought they would never be paid.”

The hospital’s survival would not have been possible without the Health Department, said board President Michael J. Burgess. The department has provided the hospital with a loan to help it restructure and may provide grant funding in the future.

“I think there were some misconceptions about the role of the Department of Health,” Mr. Burgess said. “Without the Department of Health, we wouldn’t be here right now. They have been incredibly supportive.”

The department’s closure of the laboratory was necessary because of quality issues the hospital is working to resolve, he said.

E.J. Noble’s blood bank remains closed, meaning the hospital cannot perform most surgeries or have a maternity ward, but the administration is not pressing that issue with the state, Ms. LaValley said. Instead, it is focusing on establishing processes that show it can handle routine tests with speed and accuracy. Even with lab restrictions, most tests can be handled either on site or through an external lab and treatment is seamless for most patients, she said.

The state has approved E.J. Noble’s initial application to become a critical access hospital. Under that designation, the hospital would reduce its bed count from 37 to no more than 25 and have most patients stay no longer than four days, but it would gain through increased Medicare reimbursements.

That application has been filed with the federal government, which has 60 days to respond. If it is approved, the state would move on to its next step.

Community Health Center of the North Country, under the Cerebral Palsy Association of the North Country’s umbrella, has applied for permission to open a primary care clinic in the hospital into which E.J. Noble could wrap some of its services. Community Health Center of the North Country enjoys higher reimbursement rates, and a strong primary care clinic could help stabilize services, Ms. LaValley said.

The emergency room remains a critical part of the plan, along with continued operation of Kinney Nursing Home under the oversight of United Helpers.

Meanwhile, many of the roughly 70 workers who lost their jobs when the hospital’s lab was shut down have not returned to work. Four have been called back recently, but the hospital also laid off one full-time and two part-time employees because of shifts in services, Ms. LaValley said.

The hospital has requested permission to close its health clinics in Harrisville and Russell but plans to keep others open in Edwards, DeKalb and Antwerp.

A physician’s assistant is in the works to reopen the DeKalb clinic. The hospital is also close to an agreement for a full-time women’s health nurse practitioner who could provide basic ob/gyn care.

A physician’s office that had been at the Pine Grove housing complex in Gouverneur will move to the hospital next week, Ms. LaValley said.

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