GLENS FALLS — Glens Falls Hospital is in dire financial trouble, CEO Dianne Shugrue told about 60 community leaders and physicians at a presentation Thursday night.
The hospital has so many Medicare patients that it can’t make ends meet, because Medicare reimburses at a much lower rate than commercial insurance companies. The hospital spends about 17 percent more than it gets on each Medicare patient and lost $18 million last year, Shugrue said.
She urged the attendees to come to the hospital for any necessary procedure — from MRI scans to knee surgery — rather than choosing other locations.
When patients pick the “super specialist” in Albany for knee surgery, she said, they don’t realize that procedure would have helped Glens Falls Hospital make up for the losses it takes in running the Emergency Department.
“They think, ‘I’m going to go to the super specialist in Albany,’ but at 2 o’clock in the morning when someone’s having the big one, they’re going to come to Glens Falls Hospital and they’ll expect us to be open,” she said. “We have ORs, ready to go. Anesthesiologists, ready to go.”
To help pay for that overhead, she said, the hospital needs to do more x-rays, gastroenterology procedures, elective surgeries and other services that make money. She also worried that the state and nation may need to structurally change the way it reimburses hospitals that have so many Medicare patients. The hospital isn’t eligible for current assistance.
“Hospitals close every day. Why am I pounding that home? People think the hospital will always be here,” she said. “We gotta figure out how to make ends meet. Hospitals close. We don’t want to be one of them.”
Part of last year’s loss was attributed to the hospital hiring surgical practices to offer more of those services. Shugrue is betting that will lead to more revenue.
She also said the hospital will continue to cut back on services that bring in less revenue than it costs to provide them. She suggested the hospital might need to stop running primary care offices. It has 10 such offices now, including rural locations in Salem, Granville and Whitehall, and has already begun cutting back at some of those offices. Salem is going to two days a week, down from five, and the Fort Edward office is closing and merging with the nearby Hudson Falls office.
“It’s tough decisions, but I think there’ll be more of this,” Shugrue said. “Nobody else is going to have an ED (Emergency Department). Somebody else might be able to do primary care.”
She said her priority is to find a way to keep open the Emergency Department, operating rooms and intensive care unit, which are needed 24 hours a day.
“We’re fighting to keep the ER open. Nobody else is going to have one. So it is crucial,” she said.
But local leaders did not leave with a sense of panic about whether the hospital will be able to remain open.
“I think they’ll figure it out,” said Hebron Supervisor Brian Campbell. “It looks to me like they’re making the changes.”
Queensbury Supervisor John Strough said he and others could work harder to change the “public perception” of the hospital. Residents prefer to go to Albany for knee surgery and other planned surgeries because they think they’ll get the best surgeon there, he said.
He hoped that a potential affiliation with Albany Medical Center Hospital could lead to those surgeons working at Glens Falls Hospital, perhaps once a week.
“Bring the surgeon here. I’d much rather have surgery up here,” he said.
He added that he is confident the hospital will stay open — and that it must.
“The hospital is one of the biggest assets in the community,” he said.
Still, the presentation did not convince some listeners that Shugrue was right to cut services.
Salem Supervisor Sue Clary told Shugrue that she was still unhappy about cuts at Salem Medical Center.
“Rural health is so important,” she said.
Shugrue announced Thursday night that the center will only be open two days a week, beginning this month.
She also gave large metal water bottles to every attendee at the presentation, asking them to use them because the bottles advertise the hospital, and highlighted the new signs, advertising and security measures added last year.
Clary was not pleased, saying the hospital should have spent the money on health care.
“Looking at the water bottles just irked me,” she told Shugrue. “That could be $250,000 for Salem Medical Center.”
Campbell also spoke up for Salem Medical Center, saying that wait times are increasing at other centers as patients have nowhere else to go.
But Shugrue said primary care is not the hospital’s biggest priority and that Salem Medical Center was not bringing in enough revenue to cover its direct costs. She added that she wasn’t even taking into account overhead, just direct provider costs.
“It makes me sad,” she said, but added, “We may not be the best provider of primary care.”
Campbell said after the presentation that he was sure the hospital would keep the medical centers open, if only because the doctors there refer patients to the hospital for treatment.
“I’m optimistic,” he said.