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A tale of two hospitals

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This is a tale of two hospitals.

Both are in the north country, and they are the only two municipally owned hospitals left in the state. Massena Memorial Hospital is owned by the town of Massena, and Lewis County General Hospital is owned by Lewis County. Both are struggling to find a working model that will allow them to survive. They face the same challenges: declining federal insurance program payments and rapidly escalating state pension system costs. The rising costs of equipment, supplies, salaries and almost everything else are not being met with rises in revenue.

At that point, however, despite the similarities, the hospitals diverge widely. While Massena Memorial officials are working as hard and as fast as they can to turn the hospital into a private nonprofit facility, Lewis County General Hospital is not even taking a serious look at privatization.

In Massena, the hospital reported a record net operating loss in 2013 of $3.3 million. It lost $2.3 million in 2012. Its state pension system costs rose from $124,200 in 2002 to $4.4 million in 2013; it will be $4.8 million this year.

Everyone at Massena Memorial who has looked at the numbers seriously sees a facility that cannot continue on the present path. While employees are rightfully concerned about the potential loss of membership in the state pension system, many of them are starting to understand they have a great deal more to lose if the hospital shuts down.

Hospital CEO Charles F. Fahd has seen the handwriting on the wall and has led the movement to privatization. Reluctantly, town officials are now agreeing that the hospital cannot stand as a municipal facility. And the state Health Department has affirmed that it, too, supports privatization.

Then, there is Lewis County General Hospital. It, too, has seen plunging federal program reimbursements and rocketing pension costs. There, the pension bill has gone from $1.6 million in 2009 to $4.8 million in 2013, and is projected to reach $5.6 million this year. It posted a $5.2 million operating loss and “owed” the county $6.1 million in late 2013 in money the county has fronted the hospital.

Yet, as we reported a couple of months ago, the hospital board of managers took a deep drink from the Kool-Aid bowl and passed a feel-good budget that shows a solid profit this year, based on a number of revenue enhancements that as yet have no basis in reality.

The county Legislature acts like someone sneezed in the salad bowl if the word privatization is brought up. And yet...

Just last week the hospital agreed to pursue an affiliation with St. Joseph’s Hospital, Syracuse, in an acknowledgement that perhaps it cannot get by all on its own.

While all this is going on, a regional health-care study commission is working on a plan that would rearrange the seating chart for north country health-care facilities. Many of the most at-risk hospitals — Carthage Area Hospital immediately comes to mind — will be told firmly what the future will hold. Since all the hospitals in the state operate under the authority of the state Health Department, this commission’s report is likely to carry the full weight of the state.

And what will happen? It’s impossible to tell. But it’s safe to predict that in Massena, privatization will be part of that hospital’s rescue plan. As will some type of affiliation with another facility.

That would leave Lewis County General Hospital as the only municipal hospital in the state. The last one. And there is a reason all the municipal hospitals that used to exist, do not anymore. The reason is, the model is broken.

Lewis County legislators can thump their chests and proudly promise to keep the hospital county-owned. But change is coming, whether those legislators want it or not. And it seems to me that a goal that would far better serve the people of Lewis County is keeping the hospital open — even if it means swallowing pride and stepping into the 21st century.

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