Tuesday, October 11, 2022

Statement from Adirondack Health on planned closure of Lake Placid emergency room

lake placid health center

An open letter from Adirondack Health:

Six months ago, spirits at Adirondack Health were running high. We seemed to be on the right side of the COVID-19 pandemic, with things looking up for the first time in a long time.

But then, with the onset of inflation, doing business began to get very expensive, very quickly. Staffing challenges, exacerbated by the pandemic, have forced us to rely much more heavily on costly contract labor – traveling doctors and nurses working on temporary assignment for third-party staffing agencies. At the same time, the cost of necessary supplies – everything from gloves and masks to medications, surgical instruments, and utilities – has gone through the roof. And demand for healthcare services, thrown out of whack by the pandemic, has not returned to pre-COVID levels. To make a long story short, we are spending more money than ever before to provide the same high-quality care to relatively fewer people than ever before. This is a problem, and things are coming to a head.

On Thursday, Oct. 6, Adirondack Health submitted a closure plan for the part-time Lake Placid emergency department to the New York State Department of Health. This action was unanimously supported by the health system’s board of trustees and medical-executive committee.

With Adirondack Health on pace to lose upwards of $10 million this year alone, we are forced to examine every service we provide and see what we can do – or not do – to right the ship. One of our current loss leaders, unfortunately, is the Lake Placid emergency department. Emergency departments are the most expensive care setting in the healthcare industry and, in Lake Placid, we have been averaging fewer than eight emergency department visits per day. We analyzed all Lake Placid emergency department visit types for the first six months of 2022, based on the patients’ presenting concerns, and found that 89% were non-urgent or semi-urgent, 9% were urgent, and 2% were truly emergencies. These low patient volumes translate to a loss of over $2.2 million per year. Put another way, Adirondack Health spends about $8,800 per day to staff and operate the Lake Placid emergency department, while only generating about $2,700 per day in revenue. While we’re not a small business, we’re still a business – a nonprofit business with a legacy and mission we take very seriously. The hard truth is that these numbers are unsustainable, by any measure. We could choose simply to ignore the problem, but that would end up endangering, in short order, the viability of the overall health system.

So here we are, and we’re certainly not alone. Hospitals and health systems across the state – and country – are in the same unenviable position. As the American Hospital Association framed things in an April 2022 report, “these expense increases have been severely detrimental to hospital finances, leading to billions in losses and over 33% of hospitals operating on negative margins.”

We need to make some really tough decisions in order to ensure that access to quality, personalized hospital care remains available in the Adirondacks. In collaboration with our partners in state government and community stakeholders, we intend to reimagine the Lake Placid emergency department and transition it to a model that meets the needs of the community, rather than doubling down on a duplicative service line just because “that’s the way we’ve always done it.” We also want to stress that, at this juncture, no layoffs or elimination of permanent positions are part of the conversation. The Lake Placid emergency department’s full-time and part-time clinicians and staff members will have the opportunity to continue working at Adirondack Health, bolstering capacity where it makes the most clinical and financial sense.

With the 2023 Lake Placid World University Games just around the corner, Adirondack Health is working with the organizing committee, regional emergency medical service providers, and state partners to ensure there are no major disruptions. Regardless of the current financial headwinds, our core philosophy remains unchanged: We honor a mission of excellence, healing, and compassion close to home that goes back more than a century and goes forward just as far. If there’s one thing we’ve learned over the course of these past few years, it’s that you can fear change, or you can manage change. We’re choosing the latter because that’s the only productive option. This is unlikely to be the last hard decision, as we navigate out of this storm and back into calm waters. Nevertheless, we’re committed to getting there with your continued understanding and support.

Change is hard. But change can be good – especially if you manage it carefully and confidently. We promise always to shoot straight with you, because, in addition to being the right thing to do, it is what you expect and what you deserve. We’re making you aware of an acute challenge that poses systemic risk to Adirondack Health because we need you – along with our state partners – to be part of the solution. We need to do things differently in the Lake Placid emergency department space. What we’re currently doing is not working. But something else could, and something else must. Change is coming either way. Adirondack Health has an opportunity to transform the way we care for residents and visitors in and around the global sports capital of Lake Placid. We have made the decision to adapt and overcome, rather than peddle in excuses while access to quality healthcare in the North Country bleeds out.

As we consider the shape this new model takes, we welcome the community’s input and feedback.


Aaron Kramer, President & CEO, Adirondack Health

Sue Delehanty, Chair, Adirondack Health Board of Trustees

Glenn Keet, Vice Chair, Board of Trustees

Irwin Lieb, M.D., President, Adirondack Health Medical Staff

Bartlomiej Szczech, M.D., Vice President, Adirondack Health Medical Staff

Daniel Kelleher, Chair, Adirondack Health Foundation Board of Trustees

Darci Beiras, M.D., Chief Medical Officer

Dianna Bryan, M.D., Medical Director – Emergency Department

Michael Bettmann, M.D., Board of Trustees

Elizabeth “Betsy” Buck, M.D., Board of Trustees

Jeannie Cross, Board of Trustees

Rebecca Leahy, Board of Trustees

Jon Plehn, M.D., Board of Trustees

Randall Quayle, Ph.D., Board of Trustees

Tim Reilly, Board of Trustees

Harris Semegram, Board of Trustees

Craig Sheldon, Board of Trustees

William Smith, M.D., Board of Trustees

Ernest Stretton, Ph.D., Board of Trustees

Kathy Woughter, Board of Trustees

Amy Corliss, M.D., Medical Executive Committee

Robert “Duncan” Douglas, M.D., Medical Executive Committee

Thomas Green, M.D., Medical Executive Committee

Michael Hill, M.D., Medical Executive Committee

Thomas McBride, PA, Medical Executive Committee

David Strauss, M.D., Medical Executive Committee

Emily Szczech, D.O., Medical Executive Committee

Anthony Tramontano, M.D., Medical Executive Committee

Olga Voronel, M.D., Medical Executive Committee

Elizabeth “Beth” Bartos, M.D., Lake Placid Primary Care Physician

David Garrison, M.D., Lake Placid Primary Care Physician

Michele Mannion, M.D., Lake Placid Primary Care Physician

Howard Reinheimer, M.D., Lake Placid Primary Care Physician

Lindsey Wilhelm, D.O., Keene Primary Care Physician

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The Adirondack Almanack publishes occasional guest essays from Adirondack residents, visitors, and those with an interest in the Adirondack Park. Submissions should be directed to Almanack editor Melissa Hart at editor@adirondackalmanack.com

5 Responses

  1. Nathan says:

    there should be some way to help support the ER in lake placid, those suffering from true trauma are much more likely to die in the surrounding region as they have to be run sometimes an hour or more away. the crisis of deminishing ambulances and hospitals across every rural areas in the united states are leading to emergency responses of hour to 3-4 hours, how many will survive a bad heart attack or severe car accident, agricultural, industrial, ect with severe bleeding, trauma. there are already cases of emergency service being 200 plus miles away. Are the Adirondacks going to be a 100 mile death ride for accidents, emergencies?
    LAke Placid as olympic center/resort/ skiing, boating, biking, snowmobile, cars, triathelons, ect going to loose proper emergency care? when will events, taurism start deciding on other places?

  2. Worth Gretter says:

    This is a tough decision for everyone, I know that.

    But I just want to say that the statement from Adirondack Health is very well written. It is full of facts and solid reasoning. There is none of the usual business buzz words, double-talk, and gobbledegook that we so often get from corporate America.

    They have taken a good first step by clearly laying out the case, for all to discuss.

  3. Frank Krueger says:

    Over the past 20 years, I have received some very high quality care at the Lake Placid emergency room. I am sorry to see it closed. As an alternative, I hope Adirondack Health will convert it to an urgent care center. Most of my visits were for urgent care, with several exceptions. Often when one gets sick, you cannot get an appointment with a care giver. An urgent care facility would fulfill this need. Another possibility would be to convert the space for a pharmacy. It would be great convenience for patients as well as the practitioners for Adirondack Health to operate its own pharmacy.

  4. Vanessa B says:

    This is good, but yeah per the above they should commit to an urgent care center. Many of the services provided by urgent care will save lives in the same way you’d have life saving care at the ER.

    That said, the state has more of a role here imo. For true emergencies, it’s not just the tri-lakes region that has a problem. In fact the tri-lakes have a lot more infrastructure and health care options than many other parts of the NoCo.

  5. Ivana says:

    I hope and pray that those that advocate the closure of the Emergency Services at that facility are never in need of emergency care where time is of the essence. Its another 15 minutes from Lake Placid ER to Saranac Lake ER. Sometime minutes make a difference. May God in his eternal wisdom provide our rescue crews with safe roads, capable staff and the speed of angles to save to transport those who for lack of a closer ER have to go an extra mile for treatment. If Lake Placid’s ER saves but one life, have they not fulfilled their purpose? I, for one say yes for that life could be mines or one of my loved ones.

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