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Consultant bullish about Lowville hospital, while workers air concerns

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LOWVILLE — A consultant at Wednesday’s Lewis County General Hospital Board of Managers meeting painted a rosy picture of the facility’s future.

However, several workers at the county-owned hospital continued to complain about administration and a perceived communication gap about several issues, including the recent departure of the interim chief financial officer.

“I would suggest you guys are perfectly positioned right now,” said Eric Shell, principal at Stroudwater Associates, Portland, Maine.

Operating losses over the past four years were caused primarily by the hospital’s strategy of bringing in primary care physicians as employees, Mr. Shell said.

While the current fee-for-service system does not reward that strategy, with larger facilities recouping much better returns by employing specialists, recent reforms will shift that in the next several years, he said.

“In five years, it’s going to penalize the specialists,” Mr. Shell said. “We’ve got a delivery system here that everybody is going to be envious of.”

Initiatives like seeking critical-access designation, with which Stroudwater is assisting the hospital, should help turn around the financial situation, increasing Medicaid and Medicare reimbursements, he said, noting most rural hospitals are making that switch.

Some employees expressed concerns that the designation change, dropping the facility’s inpatient limit from 54 to 25, could result in limiting services or transfers to other facilities. Even with a 24 percent increase in inpatients this month following addition of a hospitalist program, the average inpatient census is around 16 or 17, leaving plenty of wiggle room, Mr. Shell said.

The hospital also has a strong market share and relatively high marks for quality of service that should draw more people, he said.

Mr. Shell recommended the hospital continue seeking ways to improve efficiency, increase services and align with primary care doctors; he suggested that current staffing levels seem appropriate. However, hospital managers did go into executive session with the stated intent of discussing specific personnel matters with him.

In contrast, a public comment session earlier in the meeting focused on worker concerns, with 27-year employee Susan Ross presenting a laundry list, including poor communication, insufficient responses to past concerns and “erosion of trust” with administration. “The key to good leadership is integrity,” Mrs. Ross said.

Emergency room doctor Daniel R. Cappon read a letter from Dr. R. Brian Shambo, who serves at the hospital’s Copenhagen clinic, suggesting that he won’t be renewing his contract when it expires at the end of November, partly because he feels concerns raised by doctors were not addressed adequately. The letter also questioned the reasoning for the loss of interim Chief Financial Officer Richard Borschuk, who was hired in early November for 12 weeks with the option to extend the term.

Board President William H. Wormuth said only that it was a mutual decision and that Mr. Borschuk had left a “voluminous” report on hospital finances for hospital leaders.

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