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E.J. Noble starts fresh

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GOUVERNEUR — E.J. Noble Hospital has a management agreement with Canton-Potsdam Hospital, Potsdam, a new board, a new administrator, an infusion of money and the start of a new vision of how to provide health care in Gouverneur.

“People want clarity. We’re not there yet,” Canton-Potsdam Administrator David B. Acker said. “Hospitals are big, complicated ships and it takes a while to turn them around. From my perspective, the number one issue relative to the hospital is its financial stabilization and to make certain the Department of Health’s concerns about quality are resolved. It will be more clear in the next several weeks how we define services in the future.”

Canton-Potsdam and E.J. Noble were advised Tuesday that their management agreement was approved by the E.J. Noble bondholder, the National Automatic Sprinkler Pension Fund, which paved the way for Marlinda L. LaValley, vice president for administrative services at Canton-Potsdam, to be named full-time administrator at the Gouverneur hospital.

An application for E.J. Noble to change its designation from acute care to critical access was filed Monday, Mr. Acker said. That would allow the hospital to gain increased Medicare reimbursements.

A recently named E.J. Noble board of trustees, consisting of President Michael J. Burgess, a vice president at Kinney Drugs; Mark L. Brackett, Kinney Foundation Board president; Nicholas F. Gardner, a Gouverneur dentist; Stephen E. Knight, United Helpers chief executive officer; and Dr. Andrew Williams, a physician at Cerebral Palsy Association of the North Country and Canton-Potsdam, is continuing to review the hospital’s fiscal situation and its operations, including what services should be kept, and to oversee the eventual opening of a primary-care clinic in the hospital.

“For the foreseeable future, we’re in place,” Mr. Burgess said. “There’s a lot of work ahead of us.”

The size of the board could grow.

“We may need to seek out some other community members that have the same passion that we do,” Mr. Burgess said.

The role of the new board will be much the same as the old board, which resigned, as did former Administrator Charles P. Conole.

“There was a sense that this really needed to be a rebirth, to start afresh,” Mr. Acker said.

The state Department of Health shut down E.J. Noble’s laboratory for deficiencies Sept. 28, then later allowed a partial reopening of services. Already in dire financial straits, the hospital has struggled to stay open as its revenues dropped.

On top of a $2 million loan for the short-term relief of E.J. Noble arranged through the Dormitory Authority by the state Department of Health, Canton-Potsdam Hospital will provide a $300,000 loan, which it will forgive. Canton-Potsdam also will waive its management fee for six months and use that money at E.J. Noble, Mr. Acker said.

The $2 million loan is to be repaid by the end of the year, but Mr. Acker said he hopes to work out terms that are not a burden on E.J. Noble.

“We are working with the state on an ongoing basis to see that there is adequate funding to sustain ongoing operations,” he said.

E.J. Noble is meeting payroll, but has a lot of catch-up in order to make good with all of its vendors, Mr. Burgess said.

Kinney Nursing Home, which is affiliated with E.J. Noble, will remain open under the supervision of United Helpers, and the hospital’s laboratory will be supervised for now by Samaritan Medical Center, Watertown.

About 70 of E.J. Noble’s 245 employees were told not to report to work after the lab closed and acute-care services shut down, and not all have returned to work. The future of the rest of the jobs and the hospital’s satellite clinics remains unknown until the review of operations is complete.

Canton-Potsdam also will furnish an on-site nursing manager, part-time educator Nan Rutledge, to provide oversight. Her role will not be to supplant existing management at E.J. Noble, but to improve processes, Mr. Acker said.

“There will be a deployment of Canton-Potsdam Hospital resources on a steady and ongoing basis,” he said.

Canton-Potsdam’s goal, along with that of United Helpers and Cerebral Palsy, is to provide the community with sustainable high-quality care, Mr. Acker said.

A key part of stabilizing E.J. Noble will be to have a strong primary-care clinic within the hospital, and an architect is looking at the building to determine its best location, Mr. Acker said. Another goal is to keep the physicians that remain.

Gaining critical-access status could benefit E.J. Noble through increased Medicare reimbursements, Mr. Acker said. The status would require the hospital to have no more than 25 beds and have most patients stay no longer than four days, but the hospital’s occupancy of its 37 beds is rarely even at 25, he said.

The only other critical-access hospital in St. Lawrence County is Clifton-Fine Hospital, Star Lake; others do not qualify because of their size.

Mr. Acker said he was at E.J. Noble the night the Department of Health ordered it shut down, sending its patients to neighboring hospitals.

“The panic that people felt that night really struck hard,” he said. “I think our goal is we can’t let that happen again.”

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