This city has had a hospital for 92 years. That may not be true much longer.
As part of a sweeping series of recommended New York State health care reforms, the State Commission on Health Care in Facilities in the 21st Century has recommended that DeGraff Memorial Hospital cease hospital services and become a nursing home.
Currently, 80 of the 150 beds in the Tremont Street facility are skilled nursing, or nursing home, beds. But a petition drive that has gathered more than 2,000 signatures in opposition to the state-directed closure illustrates that many believe the loss of hospital services would badly damage the city.
"I think it would be a crucial blow to North Tonawanda," said State Sen. George D. Maziarz, R-Newfane, who has lived most of his life in the Lumber City. "I'm not giving up on DeGraff. The recommendation doesn't make sense."
Donna Zellner Neal, director of the North Tonawanda History Museum, is one of those who spearheaded the petition drive.
"Our hospital is profitable," Neal said. "Why are they closing hospitals that are profitable and leaving hospitals open that are unprofitable?"
The commission plan released late last month promises to reorganize the region's hospital system to improve quality, control rising costs and help recruit new physicians.
Commissioners pointed out that nearly half of the hospital beds in the region sit empty because of the decline in population and changes in health care. They say underused hospitals duplicate expensive services in a medical arms race - including heart surgery programs at five locations - and that facilities, many aging and in debt, have spread rising fixed costs over fewer patients.
No Niagara County hospital went untouched in the so-called Berger Commission report. Commissioners recommended Newfane Inter-Community Memorial and Lockport Memorial hospitals continue down a path of joint management and that Niagara Falls Memorial Medical Center and Mount St. Mary's Hospital in Lewiston restart joint operating talks that ended abruptly in the 1990s.
Both the Assembly and State Senate would have to vote to kill the merger and closing plan before the end of this month or it automatically takes effect. The recommendations must all be accepted or rejected as a whole.
The state health commissioner will be given wide latitude to enforce the plan, including the power to withdraw hospital and nursing home operating certificates.
In North Tonawanda's hospital, the commission report is a tough pill to swallow.
Christopher Lane, hospital president, said it hurt employee morale to see erroneous data about the hospital's track record cited in the report. It asserts, in part, that "DeGraff Memorial performed poorly on quality, viability and availability of services."
Lane, who works for Kaleida Health, the hospital's owner, said the commission lumped in DeGraff with other Kaleida hospitals on performance measurements and arrived at incorrect results.
"It was hurtful to our staff to hear that. They know in their hearts what kind of hospital we are," Lane said. He said 15 of the the 16 major quality indicators at DeGraff are higher than national standards.
Judith Kuhn has been an office support clerk at DeGraff for 27 years.
"They say good things come in small packages," she said. "You don't get any better than DeGraff. People from Wilson, Pendleton, Sanborn, Lockport, Niagara Falls, all over the place, come to DeGraff because of the special service we provide the patients."
"We've put a great deal of emphasis on quality," Lane said.
DeGraff has more than 500 full- and part-time workers.
Although Kaleida lost more than $100 million from 1998 through 2002, it has been in the black since 2003. The health group, which also is threatened with the closure of its Millard Fillmore Hospital in Buffalo, has pledged that no jobs will be lost as a result of the commission's mandates.
>Pulling for DeGraff
Neal hopes Kaleida is able to keep that promise.
"It's the largest employer in North Tonawanda," the North Tonawanda History Museum director said, adding that job losses at DeGraff "would be an economic disaster."
A changeover would have its challenges.
"It would be very difficult to convert the hospital workers to nursing home workers," Lane said.
The commission report says DeGraff's hospital patient load "could be readily absorbed by the hospital's coverage partners, which include Kenmore Mercy, Millard Fillmore Suburban, Buffalo General, Mount St. Mary's, Erie County Medical Center, Sisters of Charity, Millard Fillmore [which is to be closed] and Women and Children's hospitals."
Neal said the closest out-of-town hospital depends on which part of North Tonawanda you are in. It could be Kenmore Mercy, Niagara Falls Memorial Medical Center or Millard Fillmore Suburban.
Not having a hospital in North Tonawanda could cost lives, its advocates said.
In 1965, Neal said, she almost lost her life when she suffered a hemorrhage in her First Avenue home while pregnant with her fifth child. She was rushed to DeGraff and saved.
"Had they not gotten me there when they did, I might not have made it," she said. "Having that hospital so close gave me another 41 years of life, and I had two more kids."
Kuhn echoed Neal's thoughts.
"Fifteen years ago this week," she said, "my infant son became ill while we were visiting my parents in Sanborn. On the ambulance ride to Children's Hospital, the ambulance crew didn't think he would make it to Children's. The ambulance crew decided to stop at the ER at DeGraff. If it wasn't for DeGraff, my son would not be here now."
County Legislator Peter E. Smolinski, a retired North Tonawanda assistant fire chief, said the loss of DeGraff's acute care facilities would create extra risk in case of a terrorist attack or bioterrorism outbreak.
"The commission's report and the people involved with it never went to the Homeland Security agency," Smolinski said at a Dec. 1 rally. "We are planning how to deal with epidemics, bioterrorism, even natural disasters. With any type of mass casualty situation, we have found our area woefully short of emergency rooms and hospital beds.
"Here we don't even have the facilities that can handle it now, and they want to take away more. It's just unbelievable."
Second Ward Alderman Kevin Brick Jr. said the commission clearly didn't consider the increasing proportion of elderly residents in the city.
"When it comes to strokes and heart attacks, seconds and minutes can mean the difference between life and death," he said at the same rally. "It's utterly ridiculous they would want to take away the fact that you can come to DeGraff instead of having to drive all the way to another hospital when your life is on the line."
Neal said the hospital is named for James DeGraff, a banker and lumberman in North Tonawanda in the late 19th century. On June 17, 1913, his son, LeGrand S. DeGraff, appeared before the North Tonawanda Common Council to propose constructing a hospital on land the DeGraff family had bought, if the city would agree to support it. The Council approved the arrangement, as did the City of Tonawanda Council a few days later.
The rules of the bequest were that indigent residents of the Twin Cities had to be treated for free and, if the property was no longer used as a hospital, the land would revert to the family.
Neal said $40,000 was spent to build and equip the hospital, and although 67 donors gave $100 or more, most of the money was from the DeGraff family. None of James DeGraff's descendants live in the Tonawandas, she said, and it's unclear whether the reversion clause would kick in if the hospital becomes a nursing home. She said attorneys for the hospital and its unions are looking into it.
Even if the State Legislature upholds the commission findings, Maziarz noted it will be up to the incoming administration of Gov.-elect Eliot L. Spitzer to implement them. Maziarz said he serves on the Senate Health Committee and will scrutinize Spitzer's nominee for state health commissioner.
"I intend on grilling the next health commissioner, whoever that may be, at their confirmation hearing about their recommendations for Niagara County that don't make sense," Maziarz said.
Frank Budwey, owner of a North Tonawanda supermarket, was another voice at the rally earlier this month and maintained that the city and its hospital are in a battle worth fighting.
"This is like David versus Goliath," Budwey said, "and you've got to remember, David always wins."
Coming in next week's Niagara Weekend: The challenges that will come with trying to build joint management at Niagara Falls Memorial and Mount St. Mary's hospitals.
>DeGraff Memorial Hospital
Address: 445 Tremont St.
Beds: 70 in hospital, 80 in skilled nursing facility
Average occupancy: 74 percent in hospital, 98 percent in nursing home
Ownership: Kaleida Health