Kaleida Health last week announced a smart and thoughtful plan to reposition DeGraff Memorial Hospital not just for success, but for survival. The hospital will no longer serve as an inpatient facility – it’s barely one now – but that will come as no surprise to anyone who has been paying attention to the forces that have buffeted health care over the past 20 years.
The fact is that the North Tonawanda hospital is failing. It lacks the patient base to continue as it is now structured. It can change into something more useful or it can close completely. The leaders of Kaleida Health have chosen the former. If anything, the change is coming later than hospital economics suggest it should have.
On Oct. 1, DeGraff will stop performing surgeries and will close its intensive care unit.
It’s the inevitable acknowledgement of declining usage: Just 12 to 15 of the hospital’s 66 beds are occupied on any given day. Surgeries are down 60 percent over the past five years, while inpatient admissions are down 33 percent over the same period.
The cost has been substantial. In 2013, the hospital lost $1.5 million; in 2015, the loss reached $3 million; and this year, without changes, it would hit more than $6 million. That kind of financial bloodletting would threaten all services at the hospital and weaken the rest of the Kaleida system.
The decline in usage is not surprising, given the increased ability to handle many conditions on an outpatient basis and the increasing number of high-tech inpatient facilities, such as the Gates Vascular Institute and the soon-to-open John R. Oishei Children’s Hospital. DeGraff will send patients who need more sophisticated care to facilities such as those while retaining 10 beds for low-acuity patients.
There is a price beside money in declining numbers of surgeries. Patient confidence relies to a notable extent on the number of successful surgeries any doctor or facility performs. DeGraff is doing too few to engender much confidence.
But Kaleida isn’t planning to cease offering health care at DeGraff. Instead, it will break ground next month on an upgraded $7.8 million emergency department at the facility. That makes sense: Demand for that service at DeGraff has increased from more than 14,000 visits in 2013 to nearly 15,500 in 2015. It will also provide wound care, chemotherapy, GI services and geriatric primary care. The hospital may lease some of the vacated space to area nonprofits.
The change will certainly create stresses among DeGraff’s 104 employees, but Kaleida hopes none will be laid off. Instead, the company wants to place those workers in some of the system’s 400 vacant positions. It’s the right approach.
Buffalo has been through this before and survived. The Catholic Health System closed Our Lady of Victory Hospital in Lackawanna 18 years ago, converting it into what has become the Our Lady of Victory senior neighborhood. Sheehan Memorial Hospital closed in 2012, the same year that Kaleida closed Millard Fillmore Gates Circle Hospital. Those closures caused community stresses, especially at OLV, but the fact is that the community’s health care was not undermined. Indeed, with reinvestment, it has become more sophisticated.
The same will surely be true of the changes coming to DeGraff Hospital. It will be stressful, but that doesn’t change the arithmetic. DeGraff has been on life support for many years. It was necessary to make a change.