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Flanked by business and community leaders, officials of Memorial Medical Center announced an all-out war Thursday to combat an alarming decline in use that threatens the struggling hospital's existence.

Officials cite misperceptions about the hospital's inner-city location and lack of awareness about the services available as prime causes for the decline.

Their battle plan is a series of community forums and on-site wellness programs. No specific programs have been scheduled, but the main location already is selected. Most will be at the hospital, said Thomas A. Sy, chief executive officer, because officials believe that if they can get people in the door, they will return.

"For us it's the challenge of getting someone in the (parking) ramp to see how safe it is, getting someone in the building to see how clean it is, getting someone on the floors to see the quality of care," he said.

For a while in 1998 and 1999 after dissolving an alliance with Mount St. Mary's Hospital in Lewiston, Memorial experienced some "upward reversals," Sy said.

"We're not seeing them now. We have to address that," he said.

In July, the hospital announced the layoffs of 57 employees and the closing of several clinics. In 1998, Memorial had a loss of $5.3 million. That was brought down to about $2.8 million last year. The goal, Sy said, was to reduce that to about $1.6 million this year. Instead, this year's projected loss is $3.7 million.

If the $2.3 million in expense reductions announced in July are fully implemented, he said, this year's loss would probably be between $1.5 million and $2 million.

During the merger attempt, Memorial also accumulated a $20.5 million debt to the Daughters of Charity, now Ascension Health, the owner of St. Mary's. And the hospital has an outstanding debt of $428,000 to the city for water and sewer bills. Sy said the decline in use is showing in ambulatory surgeries and, to a lesser degree, in in-patient stays for medical and surgical treatments. All outpatient services are experiencing a slight growth of 1 to 2 percent, he said. He said the hospital has asked its physicians to poll patients on why they choose another hospital. He said the patients say the quality of care at Memorial is outstanding.

"It's always the same thing. Location, location, location," Sy said. "Our concern all along has been how many people are going to Buffalo and, in the last year or two, to St. Mary's, where they would have gone to Memorial," Sy said.

Having said that, though, Sy said the strategy is not a "Memorial vs. St. Mary's campaign."

"The bottom line," said Carolyn A. Van Schaik, co-chairwoman of the coalition, "is that Memorial Medical Center is a vital community asset. Mount St. Mary's is a vital community asset. We cannot and should not let another community asset leave our area and Niagara County."

At St. Mary's, spokeswoman Marcia M. Traverse said the hospital's patient counts are "up across the board."

Sy said he believes Memorial and St. Mary's have two distinct markets. He said the medical center isn't trying to cut into St. Mary's markets, such as Grand Island and Youngstown. He said the goal is to lure back the residents of the city, particularly the LaSalle section, and the Town of Wheatfield.

Memorial serves primarily city residents, 70 percent of whom rely on Medicaid or Medicare. Cuts in reimbursement rates from those programs have threatened the hospital's balance sheets, officials said.

Officials said the medical center also will try to improve its marketing, in the belief that the community doesn't understand the seriousness of the financial situation the hospital faces or the many services available.

Don J. King, a board member and chairman of the coalition, said that if the hospital closed, the local economy would lose 1,000 jobs and an annual $36 million payroll.

"Most alarmingly, our most at-risk citizens and our neighbors would lose access to health care. Where would they turn?" he said.

King said Memorial is the only hospital in the county with a linear accelerator that provides radiation therapy to 8,500 patients a year.

He said the hospital provides the only comprehensive mental health services in the county, which served more than 20,000 patients last year plus nearly 8,000 children through Memorial's behavioral school-based programs. He said it is the only teaching hospital in the county through its residency program, which is affiliated with the University at Buffalo School of Medicine and Biomedical Sciences.

The coalition will begin meeting next week to plan the programs.

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