Adirondack Health must keep beds to maintain elective surgeries | News, Sports, Jobs

LAC SARANAC – A new state executive order could potentially limit elective surgeries at Adirondack Medical Center and Lake Placid Medical Health and Fitness Center if the capacity of the health care system to staff beds declines.

Currently, Adirondack Health does not have to limit elective surgeries.

When elective surgeries were cut for three weeks last year, Adirondack Health lost millions of dollars in revenue it relies on to maintain its services. Adirondack Health CEO Aaron Kramer recently said the hospital network was able to recoup some of that revenue – the hospital received funding when Congress passed coronavirus relief programs the year last – but has never been able to make up for this lost time.

A recent increase in COVID-19 cases has also prompted Adirondack Health administrators to again limit visits to some of its facilities.

Elective surgeries face potential cuts again

Governor Kathy Hochul last Friday signed an executive order allowing the state to again limit elective procedures in any hospital that sees an influx of patients and with 10% or less of reserved beds remaining open.

Hochul said she passed the decree to keep bed capacity available if hospitalizations from COVID-19 increase.

Scollin said some details of that order – like what procedures are considered elective – are not yet clear, as the order goes into effect today and the state’s health department is expected to issue guidelines with more details.

Currently, Adirondack Health is not below that 10% threshold, Scollin said. The state has identified 37 hospitals currently eligible for the stay of elective proceedings – including Alice Hyde Medical Center in Malone, Elizabethtown Community Hospital and Champlain Valley Physicians Hospital in Plattsburgh.

Any hospital deemed eligible would see its elective surgeries reduced by an undetermined amount until January 15, 2022. It is not clear in the order whether a hospital could resume surgeries before that date if it again exceeds this threshold. 10%.

Scollin said the percentage of staffed beds available from AMC ranged from 12 to 19 percent this week. This has been close to the threshold at times, and although the week has been busier than normal, Scollin said that with a workforce shortage in the healthcare sector nationwide, it is difficult to find additional staff.

Last week, several Adirondack Health employees resigned as the deadline for a state mandate for the COVID-19 vaccination approached and people with religious exemptions were required to be vaccinated. Seven other employees resigned in September when the mandate went into effect.

But Scollin said those departures had no “pronounced” impact on workforce.

The hospital has also been busier this week than it was last year, Scollin said. This is in part because AMC has had the most COVID-19 positive patients at any given time – 10 – on Monday and Tuesday.

“A lot of times we’ve had a lot more extra capacity than now. “ said Scollin.

Scollin added that the decree also allows the state to limit elective procedures, “As determined by the Department of Health based on regional factors and health care utilization”. He said it is not clear how the DOH would make this decision.

Scollin said this was of concern and that AMC wanted to continue offering elective surgeries.

The state last suspended elective surgeries in March 2020, at the start of the COVID-19 pandemic.

Scollin said during that three week window, Adirondack Health lost about $ 70,000 a day. He said limiting elective surgeries again would make the hospital network’s precarious financial situation more difficult.

“The vast majority of services Adirondack Health and other rural health care facilities provide to the community do not make money. said Scollin. “We rely on other services to make money… and elective surgery is extremely high on that list.”

Scollin said Hochul indicated on Thursday that this limitation on elective surgeries may be less restrictive than last time around, but said they wouldn’t know until they saw the guidelines.

“We are really at the mercy of advice”, he said.

Last time around, Scollin said Adirondack Health had created a surgical review committee made up of doctors, nurses and clinical staff that would review all possible surgeries in the coming days and decide which ones were medically urgent and which were not. were not. He said the hospital could have had big problems with the state if he hadn’t followed his rules about what was urgent and what was not. This committee would be restarted if the state deemed it necessary, he said.

Scollin said regional hospitals have considered sharing patients. If one facility is overloaded, he said other facilities could accommodate patients and ease the burden. He said it was discussed daily.

Suspended visits

Due to an increase in COVID-19 cases locally and within the Adirondack Medical Center in Saranac Lake, Adirondack Health chooses to once again suspend most patient visits to hospital and active treatment settings for short term, starting today, said Scollin.

Exceptions will be made for the visit of a support person in certain cases, he said. These cases include labor and delivery; pediatric patients; people deemed essential in the care and treatment of the patient, such as the caregiver of a person with a developmental disability; compassionate care in end-of-life situations, at the discretion of the medical team; family care conferences deemed necessary by the provider to facilitate important care decisions; emergency room patients; and outpatient surgery patients upon discharge, if deemed necessary for the patient’s continued care and support.

Where exceptions are allowed, he said visitors will be required to wear appropriate personal protective equipment, which will be provided to them, and to adhere to all visitor requirements of Adirondack Health. All authorized visitors must be at least 18 years old, with rare exceptions handled on a case-by-case basis by the hospital and medical team, he added.

Scollin said visits to the Mercy Living Center, a nursing home run by Adirondack Health in Tupper Lake, are still permitted – despite epidemic status – because state and federal guidelines now require all nursing homes authorize interior visits for all residents. times.

Mercy update

The latest round of testing of all residents and staff at Mercy took place on Tuesday and again did not reveal any new cases. The center has been lit “State of the epidemic” for three weeks now. No new cases were found in a previous round of tests last weekend, and only one new resident has tested positive since the outbreak was discovered – a person who had returned to the nursing home after the start of the epidemic and who tested positive.

Scollin said the lack of spread of the virus is a positive sign and the nursing home is on the verge of being released “epidemic” status on December 5, as long as another round of tests on Friday returns with no new positive result.

Scollin said 16 of Mercy’s 51 residents and eight of its roughly 100 staff members tested positive for COVID-19 during the outbreak. Of the 16 COVID-positive residents, Scollin said 14 are vaccinated and two are not. He said all eight staff members were vaccinated.

Two COVID-positive Mercy residents were hospitalized at Adirondack Medical Center in Saranac Lake – one was in the intensive care unit earlier this week.

There have been no deaths from the outbreak in nursing homes.

Ten of the positive residents received monoclonal antibody treatments based on their medical history, oxygen saturation and whether they are showing symptoms.

Scollin said residents who were showing symptoms of COVID-19 are improving and there have been no more hospitalizations.

Scollin said residents dined in their rooms. Activities take place in individual rooms or in socially remote spaces, but he said no gatherings were allowed.

Staff who test positive for COVID-19 must be negative before returning to work.

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