Niagara Falls Memorial Medical Center has lost nearly $4 million over the last two years, despite cuts in some salaries and the elimination of the equivalent of about 100 full-time jobs since last August.
But the hospital, which serves a poor community with high numbers of uninsured patients and Medicaid recipients, is still bleeding money.
Because of financial troubles going back more than a decade -- Memorial had $38 million in losses between 1996 and 2002 -- hospital leaders have asked state lawmakers for $5 million in aid.
That amount would cover a portion of the $12 million in uncompensated care the hospital provided in 2007 and so far in 2008, officials told The Buffalo News.
It would be an infusion of cash they said would help a facility that's in the middle of a cash crunch, which has made borrowing more difficult.
"It's a shot in the dark, but it's certainly worth the fight," said hospital President and Chief Executive Officer Joseph A. Ruffolo.
Hospital officials said Thursday they're planning to "reinvent" the facility, and look to focus on core services in order to make their operations sustainable.
"When you're giving away 25 to 35 percent of your work, you can't stay in business long," said James C. Roscetti, president of the medical center board. "And that's where we're at."
Hospital officials provided several figures they said illuminate the medical center's troubling financial situation:
The hospital typically loses about $300 each time a patient on Medicaid or who has no insurance visits the emergency room.
*About half of all emergency room visits are by patients who are unable to pay full charges or are on Medicaid, while about one-third of all hospital patients fall into that category.
*The total number of patients who visit the hospital's emergency room each year has been increasing significantly since 2006, partly due to the opening of a new emergency facility.
This year alone, 16,052 patients have been treated in the emergency room.
The financial woes related to emergency care also have led to trouble retaining surgical specialists willing to work in the emergency room, officials said.
Because of tough economic times, officials said they expect to accrue additional hardship for at least the next six to 12 months.
The medical center already has tightened its belt, officials said. This year, Memorial closed its Bridges adolescent mental health unit, which took away 30 jobs, and as of last month, there were the equivalent of 874 full-time employees. "We can't cut any more," Roscetti said.
Officials also revealed that they want to renegotiate agreements with local HMOs.
Despite the existing struggles, which follow a five-year period where the hospital was in the black a little more than $1 million, hospital officials plan to move forward with several projects, including improvements to the adult behavioral health unit, as well as a 17-station kidney dialysis unit.
In the future, officials believe, the hospital's focus will be on cardiac, stroke and renal care, along with primary and preventative care.
State Sen. George D. Maziarz, R-Newfane, said he has met with hospital officials about their request and has told them he's not overly optimistic, given the state's fiscal status.
Regardless of whether the cash boost comes, hospital officials want the state to recognize the increased need at inner-city, "high-need" medical centers.
In particular, they want the state to increase reimbursement levels for "safety net" facilities such as Falls Memorial.
Hospitals are unique by nature, said Kenneth Raske, president of the Greater New York Hospital Association.
If a person went into a grocery store and filled the shopping cart with $100 worth of food, but got to the checkout counter and didn't have enough money, Raske said, the customer would be told to put the items back on the shelf.
But hospitals can't do that, he said. "I've seen this story get played out across these communities," Raske said. "Particularly vulnerable are these 'safety net' facilities."
Raske's solution: federal government action to reduce the number of uninsured people in this country.
"That would go a long way," he said, "in solidifying the resource base."