Last night, dozens of employees, patients, community members, and elected officials held a rally outside of Columbia Memorial Hospital in Hudson. Many were members of a group called the Save CMH Coalition, which has formed in opposition to proposed changes at the hospital. WAMC's Sam Dingman was at the rally.
INTERVIEW TRANSCRIPT
Lucas Willard: Hi, Sam.
Sam Dingman: Hey, Lucas.
Willard: So before we talk about what happened at the rally, what are these proposed changes?
Dingman: So, Columbia Memorial Hospital wants to change its classification to something called a critical access hospital. This is a governmental classification, and it's designed to ostensibly benefit rural hospitals. By qualifying as a critical access hospital, the facility gets, among other things, cost-based reimbursement for Medicare services. CMH leaders say they are doing this in part to align with the community's "actual needs." They say that, for example, the vast majority of their surgeries are outpatient procedures, and that while the hospital currently has capacity for 147 medical surgical beds, the average overnight bed usage at the hospital is much lower - about 40 to 50 patients, according to them. And if they were to achieve this critical access hospital classification, they would go down to 25 medical surgical beds.
Willard: So tell me about some of the pushback. What did you hear from employees, patients, and other folks at the rally last night?
Dingman: Well, I think generally speaking, there's a fear that by shrinking the hospital's footprint and services, CMH is on a pathway to closing. Which, to be clear, the hospital says is not part of this plan. But CMH employees, many of whom are members of the Service Employees International Union, see this drastic reduction in bed count as a ploy for the hospital to make more money, which they say should not be its goal. Albany Med Health System, which CMH is part of, is a nonprofit, and many of the employees I spoke to see a disconnect between the goal of trying to get higher reimbursement levels and serving the community. I think those sentiments are pretty well summed up by Sara Dragula, who is an ER nurse at CMH. I spoke to her at the rally last night.
Sara Dragula: They don't pay taxes, and respectfully, if you can afford to pay your CEOs over half a million dollars, I think you can find a way to invest in their in your hospitals. Healthcare access should not be something that is questioned about if it's worth it or not.
Dingman: Dragula also disputes those numbers from CMH about the average number of overnight patients. She says she and her colleagues are frequently facing long waits to get patients out of the ER into beds, sometimes having to stash people in hallways, which she says is dangerous for a whole host of reasons. Many CMH staffers have also pointed out that the hospital has the only ER between Kingston and Albany, and that straining its capacity even further would be, again, dangerous for employees in the community.
As an example of this, Lucas, I heard one story about a woman in Athens who was having a medical emergency. She went to the ER in Hudson at CMH for treatment. It took her about 20 minutes to get to the hospital, where she went into septic shock. They were able to save her, but as they put it, if she'd had to go all the way to Albany, she likely would have died.
Willard: So obviously, the employees are against these changes in classification. Have any counter proposals been offered here?
Dingman: Yes, many of the folks I talked to say they want to see Albany Med invest in growing CMH's offering. I spoke to an X-ray technician named Rob Anderson, and one thing he said was that he feels like the hospital is viewing the changing demographics in the city of Hudson as a challenge rather than an opportunity. For example, he pointed out that a lot of the new folks who move to Hudson are younger, affluent people - people with private insurance, generally speaking, who he thinks CMH is assuming they can't make as much money off of. A significant number of those folks are gay men, and Rob has an idea.
Rob Anderson: We have a big population of HIV-positive gay men, younger gay men who want to be on PrEP. They have to go back to the city, or they have to go to Albany to get a simple prescription, to get monitored for their viral loads. We could have a gay men's clinic, or a man's clinic, here in Hudson. It would be a fantastic.
Dingman: One of the other things Rob emphasized is the role CMH has historically played in the community. In a literal sense, it's one of the biggest employers in the city of Hudson. There are about 1,500 people working at CMH, and this is a city of between five and six thousand residents. But also, Rob told me there was a time when CMH was a real community gathering place.
Anderson: We had a cafeteria that had these wonderful cooks, and they made great meals. We had a salad bar. We had like two or three wonderful entrees every day. Hot, you know, food, sandwiches. People would come from town to eat at our cafeteria because it was good!
Dingman: These are people who were coming and paying out of pocket to eat at the cafeteria?
Anderson: Yeah, because we had the best mac and cheese in town at one time!
Dingman: Rob said that since Albany Med took over CMH, they have pretty drastically scaled back the food services. But I thought it was interesting that he was sketching out this vision of it as a place that can both make money in new ways and also maintain its role as kind of an anchor in the city.
Willard: And Sam, have you reached out to Albany Med about all of these concerns?
Dingman: Yes. As a matter of fact, Lucas, just before we started talking, I received a reply to my request for comment from them. I will read that to you now. This is from Tony James, who is Albany Med's Executive Vice President for Strategy, Transformation, and Corporate Partnerships. He writes, "A lot of misinformation has been spread about Columbia Memorial Hospital's application to become a critical access hospital. This federal designation would make CMH eligible for significantly greater federal reimbursement for the care it already provides. It will help CMH close large annual operating deficits caused by factors beyond our control. This federal designation would not diminish CMH, as some fear it will."
They have also publicly addressed some of these concerns in statements on their website. Again, they say they have no plans to close the hospital. They also say they have quote no plans for layoffs - although, as Rob, the X-ray technician, pointed out in my conversation with him, there is a difference between "no plans for layoffs" and "no layoffs." CMH also counters the idea that the region will be losing services if this proposal goes through, because they are planning to open a new outpatient surgical facility in Catskill - Greene Medical Arts. They're currently doing a multi-million dollar expansion on that facility. And as I mentioned, Lucas, CMH says the vast majority of surgeries at CMH are outpatient. That number, they say, is 84%. So they think this new facility will help serve what they see as the main need.
Willard: And that's WAMC's Sam Dingman. Sam, thanks for your reporting. I appreciate it.
Dingman: Thanks, Lucas.
