Three northern Chautauqua County hospitals announced Tuesday they have a plan to coordinate services in a way that should meet a state commission's requirements for restructuring.
The key difference between the new proposal and the recommendations from the Commission on Health Care Facilities in the 21st Century is that the hospital beds at the TLC Network's Lake Shore Health Care Center in Irving will not close.
Other aspects of the new plan include:
* Brooks Memorial Hospital in Dunkirk and the TLC Health Network, which also operates Tri-County Memorial Hospital in Gowanda, will consolidate into one organization that is affiliated with Westfield Memorial Hospital.
* Westfield Memorial will eliminate its hospital and obstetrical beds and convert into a diagnostic and treatment center with a full-time emergency room that includes four "observation" beds for patients who may need transfer to a hospital.
* The TLC Network will close the hospital beds at Tri-County Memorial but keep open beds there for chemical dependency services.
* Brooks will reduce the number of its hospital beds, but obstetrical services will be concentrated at its building.
The commission sought to organize a group of small, rural hospitals more efficiently. But its recommendations to eliminate inpatient hospital beds in Irving met resistance from patients, doctors and hospital officials.
"Most TLC Network patients live in southern Erie County. Their doctors have offices and live there, too. It made sense to have an acute care site near where the patients and doctors live and want services," said Richard Ketcham, chief executive officer of Brooks Memorial.
The organizations plan to seek about $30 million from the state for the changes, roughly half to pay off debts on buildings and the other half for renovations, Ketcham said.
The state is making $550 million in grants available this summer for hospitals and nursing homes to comply with the commission's mandates to close, downsize or consolidate.
The commission's recommendations became law Jan. 1 and affected dozens of hospitals and nursing homes statewide.
State approval of the new plan is likely, given that it is being praised as a model of cooperation.
"The work by Chautauqua County Health Network's Hospital Restructuring Task Force shows the good that can come when hospital leadership reflects on the trend toward outpatient care and focuses on the long-term needs of the community," said Dr. Richard F. Daines, health commissioner.
Brooks Hospital, for instance, could have accepted the commission's report as written, which would have made it the central facility in the area.
"There were mixed opinions," said Ketcham. "But in the end, we thought about the community's long-term needs and not about any one institution."
Only 5 percent of Westfield Memorial's patients are admitted overnight. Under the new plan, it will need transfer protocols to shift those patients elsewhere. To accomplish this, Westfield would retain its affiliation with St. Vincent Health System in Erie, Pa. It also could use Brooks Memorial and WCA in Jamestown.
"We will be the only hospital to have a freestanding emergency department, and the Department of Health is encouraging us to demonstrate its effectiveness in delivering care to our community," said Stuart Williams, Westfield's chief executive officer.