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Regional hospital planned for Canton

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St. Lawrence Health System is moving ahead with a plan for a central St. Lawrence County hospital in Canton.

“This is a concept,” said CEO David B. Acker, who is also administrator of Canton-Potsdam Hospital, Potsdam. “If it ends up being one organization’s concept, it’s not the best. The question should be, ‘Are we furthering the mission to provide the best health care?’”

While the idea of a regional county hospital is not new, it has never gotten off the ground because of the existence of full-service hospitals in the county’s primary population centers, with the exception of Canton. The road ahead for a central hospital remains strewn with obstacles, Mr. Acker said.

“I don’t think there’s a lot of appetite for it,” he said. “I think you’ll see objections based on the desire to be self-preserving.”

The status quo of the county’s health care system, however, also faces difficult challenges.

Gouverneur’s E.J. Noble Hospital was dissolved and its affiliated Kinney Nursing Home was closed because of financial difficulties accompanied by inadequate care. E.J. Noble became Gouverneur Hospital under the umbrella of St. Lawrence Health System.

Clifton-Fine Hospital in Star Lake became a nonprofit organization rather than a municipal benefit corporation because it feared rising pension costs would make it unsustainable.

Massena Memorial Hospital’s finances are spiraling downward and it is considering privatization.

“I don’t know about this specific plan,” Massena Supervisor Joseph D. Gray said. “I do know we have to take a look at how community hospitals will survive. At this point, no one has the luxury of saying no to anything.”

Claxton-Hepburn Medical Center, Ogdensburg, laid off employees in 2012 as part of a strategy to shore up the medical center’s finances and bring staffing in line with patient demand. Hospital officials are not convinced a central St. Lawrence County hospital is the answer. It is part of the North Country Initiative in partnership with the Fort Drum Regional Health Planning Organization.

“We are interested in collaborating with any health care organization to help reduce duplication of services, find ways to be more efficient and ultimately reduce health care costs,” Claxton-Hepburn spokeswoman Laura C. Shea said. “We have not seen enough data that convinces us that a new facility will address those issues.”

None of the county’s hospitals can continue on its own, Mr. Acker said. Carving the county into pieces eats away at the critical population mass needed to support a high-quality system of care.

“St. Lawrence Health System was an important step because it put together a system for coordinated care,” he said. “The interconnection of care is going to be really important. Everyone has to be talking the same language.”

Canton-Potsdam Hospital made $9.2 million in 2013.

“We’re having a really good year again,” Mr. Acker said. “I think we’re going to hit six or seven million.”

But Canton-Potsdam’s financial gains could fade away because of losses in the operation of obstetrics and intensive care units, along with the uncertainty in regulatory changes.

St. Lawrence Health System plans to proceed with the hope that others will come to share its vision for a 40-bed hospital that would provide broader health care services than individual hospitals can do alone.

A centralized hospital also could satisfy the state Department of Health with reduced numbers of beds overall while cutting duplication of services at the same time it brings in more specialists, Mr. Acker said.

No single current entity would have majority control. Canton-Potsdam Hospital also would lose beds under the plan.

St. Lawrence Health System is negotiating with landowners in Canton for the purchase of about 40 acres that could be annexed into the village.

Mr. Acker would not identify the preferred site but said the purchase could happen by this fall.

There are a number of potential sites on Route 310 near United Helpers Maplewood campus, on Route 68 or on Route 11.

The proposed hospital could cost $60 million, but Mr. Acker said it likely would start with an ambulatory surgery center.

If a regional hospital were established, it could include 20 inpatient surgical beds with needed operating rooms, a 12-bed obstetrical unit and eight to 10 beds for critical care. Unlike the community hospitals, no ancillary services would be open for use by the public, which would remain where they are now.

Community hospitals would retain an emergency room, outpatient services and physician offices, Mr. Acker said.

He made a presentation on the central hospital plan Feb. 18 to the North Country Health System Redesign Commission.

“I don’t have an answer as to whether that is the right thing to do,” said Tedra L. Cobb, a former county legislator who was a member of the commission. “Whether something makes sense is different from getting everyone to the table. Each of the hospitals have their own struggles. The answer to me is that the hospitals work together to serve this area. We need to think regionally.”

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