By Jeanne Sager
HARRIS — June 9, 2006 – Art Brien feels like a character in the center of a George Clooney movie.
“Ever see ‘The Perfect Storm’?” the CEO of Catskill Regional Medical Center asked. “That’s sort of what’s brewing here.”
With the official pull-out last week of Crystal Run Healthcare’s physicians, the Harris hospital has had to face the very real risk of heading back into the red.
“We were expecting something like 1,000 admissions from Crystal Run this year,” Brien said.
At about $7,000 in profits per patient, that’s a potential $7 million missing from the CRMC coffers.
Added to that is the recent cutback in Medicaid funding from the state – at least $1.5 million less will come in from the state this year.
“That’s definitely rock solid serious,” Brien said.
He said the only option will be to cut costs at the hospital.
And although he skirted around the word “layoff,” when the question was raised, Brien admitted, “It is a possibility.
“But it will be the very last thing we do,” he quickly added.
There are 1,080 staffers working for Catskill Regional Medical Center in Sullivan County – that includes both hospital facilities and the hospital’s clinics.
Of that, 913 are full-time, making CRMC one of the county’s largest employers.
But Brien said Crystal Run CEO Dr. Hal Teitelbaum’s allegations of quality care issues at Catskill Regional are unsubstantiated – and the negative publicity drummed up in the metropolitan press (The New York Times carried a story on the pullout last week) and in local papers could have serious ramifications for CRMC.
Besides the possible reduction in admissions from Crystal Run is the possibility of patient loss due to lack of confidence.
Summer is traditionally the hospital’s busiest time – and thus the most profitable.
But if visitors take concerns to heart after reading the papers, the hospital stands to lose profits this summer.
And those losses could translate to job losses, Brien said.
“The most important thing is, the people who will be affected,” he said, “the patients and the employees.
“Anything that happens will affect people, not statistics,” he noted. “It’s not a good place to be.”
Teitelbaum placed the blame for any layoffs or cuts on the hospital’s management, fingering Brien, Board President Richard Baum and former Board President Joyce Salimeno (who is still a trustee).
“A prudent management course, whether they agreed with us or not, would have been to sit down and speak with us,” he said. “The board of trustees, which has the ultimate fiduciary responsibility of the hospital, literally refused to meet with us.”
Teitelbaum said the board has instead pumped more hospital money into Brien’s salary and into costly exclusive contracts with private practitioners who have relationships with the hospital.
“The bottom line is, they’ve had financial problems for a long time . . . in the spring of 2004, as we were coming in, they announced 70 layoffs,” Teitelbaum recalled. “The only thing they got since we’ve been there is busier.”
But when the hospital announced it was finally in the black in 2005, Teitelbaum said there was no pat on the back for Crystal Run.
“If we weren’t responsible for the good times in 2005, how can we be responsible for the bad times in 2006?” he asked.
Teitelbaum said Catskill Regional is a hospital without competition – there’s no reason for financial woes.
“If it was a hospital with a reputation as good as the hospital in Orange County, people wouldn't want to drive a half an hour,” he said.
But this is a rural community, a place where a non-profit hospital is vital, Brien said.
“We’re the safety net for the community,” he explained. “We provide roughly $13 million of free care every year.
“People who are in the business of healthcare won’t see them,” he said of patients who are uninsured or have only Medicaid.
Crystal Run has long been criticized for accepting only patients with insurance – although Teitelbaum said “14 percent of our patient base has some sort of Medicaid.”
“He cherry picks,” Brien said of Teitelbaum, relating the problem back to the state’s Medicaid funding cuts.
“He takes the profit out of what we get here at the hospital,” Brien said, noting that Crystal Run is competition for Catskill Regional.
Teitelbaum said the hospital receives higher reimbursements for serving Medicaid patients than a private practice.
“They’re not doing it as a charity, they’re doing it because they get paid for it,” he said. “When money became an issue with the Woodridge clinic or Livingston Manor, they shut ‘em down!”
Brien returned again to the quality care issues that Teitelbaum has been alleging since announcing the pullout of Crystal Run physicians.
“A woman who’s pregnant, who lives in Loch Sheldrake in February ... she has to deliver and has a Crystal Run physician, and now she has to get in a car and drive to Orange Regional in the snow.
“Is that safe?” he asked.
Catskill Regional is needed in this community, he said, and profit losses at the facility will affect patients.
But Teitelbaum said there’s a vast difference between healthcare and good healthcare.
Traveling an extra half hour (the time he said it takes to travel at a high rate of speed from Catskill Regional’s Harris facility to Orange Regional in Middletown) is worth it in 90 percent of the cases if the patient is going to receive better care at the other end, he said.
Dr. Lewis Broslovsky, who has maintained an obstetrical practice in Liberty since the early 1980s, left Catskill Regional in 1992 and has since been delivering babies in Middletown.
In the 10 years between leaving Catskill Regional and joining up with Crystal Run in 2002 (when OB/GYNs in the practice resumed deliveries in Harris), women managed to safely deliver their children, Teitelbaum said.
“With a little bit of planning, the majority of women can deliver safely an hour away,” he said.
That said, Teitelbaum admitted the better option is for women to deliver at a Catskill Regional that has quality care.
“I’m not the guy who wants to shut Catskill Regional down,” he said. “I’m the guy who wants to fix it.”
In the meantime, Teitelbaum said if layoffs happen, Crystal Run is hiring – in Sullivan and Orange counties.
And for Catskill Regional, there is some good news.
With the pullout, the hospital has begun receiving phone calls from Crystal Run patients.
“They’re asking what doctors on our staff they can use,” Brien said.
That will factor into the board’s decision about budgeting, as will admissions numbers.