Long tradition of care, service by St. Clare’s Hospital ending

PHOTOGRAPHER: Michael Lamendola

The Christian crosses are gone and the nuns and priests who walked the floors have or will soon disappear as well. St. Clare’s Hospital is slowly losing its identity as a Catholic health-care facility.

On Friday, the 59-year-old hospital will surrender its operating license, becoming a nondenominational health-care provider. At that point, Ellis Hospital will take over St. Clare’s assets and buildings and will rename it the Ellis Hospital McClellan Campus.

The Ellis subsidiary will cease operating as a full-service hospital open 24 hours a day, seven days a week. Only its emergency room will remain open constantly.

Instead, the McClellan Campus will convert to a primary care and urgent care service provider, offering same-day surgery, medical imaging, sleep disorder care, primary and dental care, laboratory services, wound care, infusion therapy and physical and rehabilitation services.

St. Clare’s maternity services — one of its bedrock services — will transfer to Bellevue Woman’s Health Care Center, which became an Ellis subsidiary in October 2007. Bellevue will then become the only maternity hospital in the county. Ellis discontinued maternity services in 2000.

St. Clare’s will also transfer its medical-surgical beds, critical care, pediatric, stroke and cardiac care services to Ellis.

The state Department of Health mandated the Ellis and St. Clare’s merger. The mandate came through the Commission on Health Care Facilities in the 21st Century, known as the Berger Commission after chairman Stephen Berger. The recommendations became state law Jan. 1. The Berger Commission also ordered the closure of Bellevue Hospital. Ellis took over its operations instead, keeping the campus open for maternity services.

Ellis has remodeled three floors in its C wing, at a cost of $1 million, to add between 50 to 70 beds. The Berger Commission said the Schenectady community should have 264 beds total, a decrease from the combined 458 beds the two hospitals currently have.

The mandates are designed to end duplication of services, improve efficiency and, in the long run, save money. A big savings will come by not having to operate St. Clare’s 24/7.

The decision to close St. Clare’s came from its board of directors and Bishop Howard Hubbard of the Albany Roman Catholic Diocese, which sponsors St. Clare’s.

St. Clare’s CEO Robert Perry said in an earlier interview the option to continue operating independently was no longer possible. The hospital consistently lost money pursuing its mission to help the community’s poor and uninsured. It also had unfunded employee pension obligations totaling $28.5 million, debts and other costs.

‘medical mall’

The state provided a grant to cover these costs and more. Ellis will assume a debt-free St. Clare’s, as it did with Bellevue.

Perry will leave St. Clare’s at the end of June; Ellis is planning to hire almost the entire St. Clare’s staff, as it did with Bellevue’s staff.

Up until its surprise announcement in January to surrender its license, St. Clare’s had been working with Ellis Hospital on a merger agreement. Ellis CEO James Connolly said the long-term plan is to turn the McClellan Campus into a “medical mall,” a one-stop center for people seeking urgent and primary care services.

The mall would incorporate St. Clare’s family practice and dental residency programs as well as its newly established pediatric program. In addition, insurance providers would be there to sign up people for an applicable medical insurance program, such as Child Health Plus or Medicaid.

Ellis would own the mall, but other medical providers in the community would be allowed to lease space to offer their services. The Schenectady Free Clinic, Schenectady County Public Health, which offers a number of clinics, private providers and Hometown Health are among those under consideration as tenants.

Also under consideration is a plan to develop a network of primary care providers who would go into the community to service people with little or no insurance.

Connolly believes this medical model, which would take several years to bring online, will serve as a relief valve for the over-burdened emergency rooms operated by Ellis and St. Clare’s. Both emergency rooms see more than 70,000 patients per year; they were designed to handle half that capacity.

millions lost

“If you have a medical home, where people can get care so that they show up at the ER only when they need it, you will reduce the need to go to the ER,” Connolly said.

The community has a large population of people with little or no insurance. Estimates put the number at more than 12,000. They go to emergency rooms for their care because they lack primary care physicians, and they arrive often sicker than the average ER patient, therefore requiring extensive, and expensive, medical care.

Ellis and St. Clare’s especially provided the care whether the person could pay or not. Each hospital lost millions in uninsured care coverage.

By channeling the patients into an urgent care setting, they can receive regular, comprehensive care before their health becomes critical to the point of an ER visit. “We need to invest money to take care of this community because one way or another, we will end up taking care of them,” Connolly said.

He called the medical mall “a unique opportunity. We could become a model for other communities.”

Ellis is seeking a $5.7 million grant from the state to help establish the medical mall. It also has plans to build a new medical tower as well as a 500- to 600-car garage on its Nott Street campus. The tower would contain obstetric, gynecological and maternity services, pediatric services and neonatal services.

Ellis will use money raised through fundraising, state grants and bonds to construct the tower, estimated to cost about $50 million.

Once the tower is built, which Connolly expects to occur in 2012, Ellis will move women’s health services there from Bellevue. The Bellevue campus, on Troy Schenectady Road in Niskayuna, could become a nursing school or an education and training center, Connolly said.

community support

Connolly also plans to move some medical imaging services from Ellis to St. Clare’s. This would free up space to expand the Ellis emergency room and establish an urgent care center.

The Ellis model has the support of the Schenectady County Medical Society and other groups in the community. But it also has detractors. A newly formed group called Schenectady County Citizens for Hospital Choice opposes the closure of St. Clare’s and the transition of its maternity services to Bellevue.

Group spokeswoman Connie Ciervo said Ellis and St. Clare’s should go back to the plan to develop a joint operating agreement. “We feel the administration from Ellis jammed things down the throat at St. Clare’s without an option,” she said.

The group’s goal is to make the community aware so that St. Clare’s remains open and keeps its specialties. “We need to have the option to go to whatever hospital we want to,” she said. The group, which consists of about 20 people, wants St. Clare’s to keep its full-service emergency room open and to operate a small critical care unit for people having outpatient surgery and a small birthing unit.

costs of moving

Ciervo said St. Clare’s should offer these services “for the simple reason Ellis doesn’t have [a birthing unit] and if you go to Bellevue and something happens, you have to be shipped elsewhere. Why do that if they have a perfectly good place at St. Clare’s?” Ciervo asked.

Connolly said the reason to move St. Clare’s maternity services to Bellevue is a matter of economics. “It would cost us $150,000 to move St. Clare’s services to Bellevue, whereas it would cost $2.7 million to move Bellevue’s services to St. Clare’s,” he said.

Bellevue has the beds and capacity to handle an additional 700 to 800 births, which St. Clare’s handles annually. St. Clare’s would require a major redesign of the facility to handle the 1,700 to 1,800 births that Bellevue handles annually, he said.

Also, Ellis does not intend to maintain St. Clare’s as a 24/7 hospital, which would be required to operating a birth center.

“In either case, it is short-term investment. We are absolutely committed to getting the tower built on the Ellis campus,” Connolly said.