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Nurses, doctors demand change at Eastern Niagara Hospital

LOCKPORT – The doctors and nurses who work at Eastern Niagara Hospital have something to say to the hospital board of directors, but the board won’t hear it first-hand.

Board Chairman George V.C. Muscato, a prominent Lockport attorney, said last week that a committee of the board may meet with the “Save ENH” group, but the full board definitely will not.

They will miss out on the group’s demands that much of the board and the CEO, Clare A. Haar, should be replaced.

Sandra Harmon, a retired Kaleida Health nurse who has taken a key role in Save ENH, said the group’s goal is to protect the future of the hospital. They’ve been gathering petition signatures since this spring to try to get rid of Haar.

“The committee, which consists of health care professionals and community members, have over 6,000 signatures who want Clare Haar removed,” Harmon said. She said the signers also want the board to “work in the best interest of the hospital community inclusive or surrounding rural areas or resign.”

“I am not going to dignify that with a response,” Muscato said. “The board has no intention of replacing Clare Haar.”

Muscato said the hospital is unionized and employees need to communicate through the unions.

The Save ENH group appears closely connected with the nurses’ union at the hospital, which has been feuding with Haar for years. There was a bitter 35-day nurses’ strike at the hospital in 2001 and a strike threat in 2011.

“The board also will not meet with physicians, and that’s a big problem,” said Dr. Jeffrey Schratz, a prominent Lockport surgeon.

A PowerPoint presentation by the Save ENH group shown at little-publicized community meetings, provided to The Buffalo News by an attendee at one of the sessions, claims that “employee morale is at an all-time low.”

The Save ENH group is pointing to negative reports about the hospital from the state Health Department, such as Eastern Niagara ranking 187th out of 192 New York hospitals in “timely and effective care,” and a 61 percent satisfaction rate from patients filling out state surveys.

Also, federal Medicare officials have penalized Eastern Niagara financially three years in a row for failing to improve readmission rates. Under the Affordable Care Act, the federal government is trying to save money on Medicare by forcing hospitals to reduce the number of patients who return to the hospital within 30 days of release for the same problem. In 2014, Eastern Niagara’ penalty was a 1.98 percent cut in Medicare reimbursements. Since the hospital took in almost $19 million from Medicare in 2013, according to its IRS Form 990 filing, that’s a loss of about $376,000 in revenue.

Carolyn Moore, hospital spokeswoman, said the 22.08 percent readmission rate used by Medicare, which placed Eastern Niagara in the middle of the pack in New York, is just a subset of all patients. Medicare’s website says it considered only those admitted for heart failure, heart attacks, pneumonia, chronic lung ailments and elective knee and hip replacements.

Moore said the hospital’s readmission rate for all patients is only 9.55 percent.

Schratz said other hospitals make better efforts to avoid readmission by instructing patients and doctors in how to recover. “There’s no such infrastructure in place at ENH,” Schratz said.

As for the 61 percent satisfaction rate, it exceeded all other Niagara County hospitals except Mount St. Mary’s, and was better than any hospital in Buffalo except Sisters of Charity. It was good enough to earn Eastern Niagara three stars out of five in a state report disclosed in April. The hospital beat or tied the state satisfaction average in eight of 11 categories used to compile the data, Moore said.

Schratz said, “From everything we’re hearing, the hospital is losing millions and millions of dollars.” Moore confirmed the hospital ran in the red in 2014, after turning a $1.33 million profit in 2013. “ENH is currently in the black,” she said.

The 2014 results won’t be made public until the hospital files its next IRS form in November.

“There’s absolutely no transparency. Everything is cloak-and-dagger,” Schratz complained.

Mayor Anne E. McCaffrey wrote a letter to Muscato July 28, asking for a meeting. “I do want the board to consider improved transparency,” McCaffrey wrote. She requested a copy of the hospital board’s by-laws, which have never been disclosed. The mayor said that refusal “creates distrust in the community.” She also called for more openness with employees and the public, including a community forum.

McCaffrey said she got a meeting with Muscato and Haar, but no by-laws. The mayor said, “I’m hopeful their communication with the group that is interested in giving them some information would begin.”

Schratz asserted in an article in a local paper earlier this year that 70 percent of Eastern Niagara County residents head for other counties to receive procedures that are offered at Eastern Niagara Hospital. “There’s an outmigration of thousands and thousands of patients,” he said.

However, data on the Health Department website show that admissions at ENH in the first half of 2015 were higher than the same period a year ago, 2,497 to 2,142. Outpatient services and emergency room visits also were ahead of last year’s figures, but ambulatory surgery was behind the 2014 pace at midyear.

“ENH is adapting to these system changes and is in the process of returning to fiscal health,” Moore said. She said ambulatory surgery and a new urgent care service “are developing well and meeting expectations.”

But Schratz insisted that the hospital needs to align itself with either Kaleida or the Catholic Health System. “We need a new brand at ENH. We need a fresh start,” he said. “My goal is to get the hospital to survive.”