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Catskill Regional Medical Center

Fixing What Ails CRMC

By Jeanne Sager
SULLIVAN COUNTY — December 8, 2006 — When you’re sick, you go to the hospital. But where does a hospital go when its down in the dumps?
Catskill Regional Medical Center is in what many residents are calling the worst state in its history – 72 employees were laid off last month and hospital officials say they’re hemorrhaging $500,000 a month.
But the hospital’s still there.
Ask around the community.
Residents are still using the hospital.
They still need the hospital.
“People would lose their lives if we lost this hospital,” said one White Sulphur Springs woman – who asked her name not be used because of the intimate details of her medical background.
She’s had major surgery at Catskill Regional Medical Center, saw her husband die after years of care at CRMC.
And he got only the best care, she said.
“Their ICU unit, I can’t say enough about them… totally dedicated…” she said. “I’m not afraid of them… 10 years ago I was afraid to go to Harris, but I’m not now.”
She visits a primary care physician at Crystal Run Healthcare in Rock Hill – an institution that’s been blamed for much of the financial trouble at CRMC – but she still uses the hospital for everything else, ironically at the orders of her Crystal Run doctor.
“I’m getting older,” she said, “I can’t travel to Horton.”
Tilly Calkin of Youngsville says she owes her life to CRMC.
After years of traveling to Cooperstown to consult with doctors at Imogene Bassett, Calkin said her colon cancer was caught right here in Harris.
The oncology department at CRMC made cancer treatment bearable.
“They make you feel so welcome and special,” Calkin said. “For anyone having to go through this experience… it wasn’t bad.”
She sees people leaving the area for care these days, and she asks “why?”
“You feel lousy,” she said, “why leave?”
But Calkin is afraid of losing the hospital.
“I know there’s problems at the top,” she said. “You read someone’s making $5,500 a week and they’re laying people off.
“Those people being laid off, that’s our community,” Calkin continued.
If something isn’t corrected, Calkin sees a community without a hospital.
“Someone needs to take management and smack their heads together,” she said. “They’re not telling us anything.
“I don’t know what as a hospital we’re entitled to know about the decisions that are made,” Calkin continued, “but we have a great unit right here and a great support system.
“When you send people to Middletown, that sends money out of our county… and when I see $5,500 a week, I know something’s wrong.”
Dr. Marc Hudes is a member of the CRMC medical board – a private practitioner at the Family Footcare Group, he’s been practicing medicine in Sullivan County for more than 30 years.
Something is wrong, he said, and that something is the board of trustees.
“The board, as far as I’m concerned, has not been attuned to what the needs of this community are,” Hudes said.
But, he hastened to add, this isn’t about the particular people currently serving on the board – he’s been saying this for years.
“It’s a $125 million business, number one, and number two it’s a hospital,” he said. “You need good business acumen to run it.”
Looking back to the early 1990s when Dr. Lewis Broslovsky and Dr. Randy Cohen left then Community General Hospital, Hudes said he recalls the hospital stood to lose as much as $7 million a year with the reduction in OB/GYN patients.
An emergency meeting was called by the hospital’s administration, Hudes said. They wanted to know what to do.
“I raised my hand, and said, ‘Well, I think you should resign,’” Hudes recalled. “When the CEO of a large organization doesn’t know what to do, they either resign or they get replaced – it’s basic business.”
In the case of CRMC, CEO Art Brien is already gone, ousted in September. Gone too is his successor, former Chief Operating Officer Larry Cafasso.
But Hudes said the board of trustees, which is supposed to have oversight over its administration, hasn’t changed.
In fact, when a call was made at a recent medical board meeting for the resignation of each board member, President Joyce Salimeno said instead the board would be expanded and term limits would be put in place of 12 years.
Hudes said what the hospital needs is a board with a mind for business.
“It bothers me that the community’s look at this hospital is terrible,” he said. “They don’t have a tremendous feel for the great quality there.”
Part of that is a fact of every day life.
Sullivan County is a small community, he said, where a dropped bedpan in the emergency room will be the topic of conversation at every coffee shop or gas station.
“Some people are too critical,” he said. “People invariably like to go someplace else – that’s the way it just naturally flows.
“People here go to Middletown, people in Orange County go to Good Sam[aritan Hospital in Suffern], people in Suffern go to the city.”
But a greater part of the problem is the way the hospital is run, Hudes continued.
“Why not fine tune it?” he asked. “I’ve lived here 33 years, and it hasn’t changed, and it won’t change – it won’t change until they get a different mindset, and it has to start at the roots.”
As a podiatrist, it’s nice to have the ability to do elective surgeries right in Harris, but Hudes said the hospital might work better as a center for emergency care with a maternity ward and an ICU, with the services that do make money, like the skilled nursing unit or a bio-medical dependence ward, enhanced.
And the board needs to look into the community for answers rather than bringing in costly advisors like turn-around firm Navigant.
“They need more doctors who can tell them what the medical needs are and they need more business people,” he said. “Let’s not just make this a good ol’ boys club… in this particular case, it’s time to forget about their own personal agendas or feelings and look at what’s best for the community.”
Hudes also had sharp words for Brien and former board president turned consultant Richard Baum.
“I never thought Art Brien had a good handle on the situation; I question what his ulterior motives were in not trying to fix the problems with Crystal Run early on. And I don’t understand why they paid Richard Baum all that money; nobody understands that,” Hudes said.
Baum recently completed his $5,500 a week job as liaison between Navigant and the board, returning to a volunteer position on the board.
But Hudes, and other members of the Sullivan County community, aren’t giving up on the hospital.
“I think they could bring this together and come up with something that would work for everyone,” Hudes said.
“They’ve got to get their act together,” said the White Sulphur Springs resident. “Truthfully, it can be a life or death situation… maybe the board needs to be shaken up, but there are a lot of smart business people in this community and this community cannot be without a hospital.”
Perhaps Les Parks of Youngsville can say it best.
He’s been hospitalized five times in the past three years.
“The care was good, and I recovered,” Parks said simply.
“It’s important that we have it,” he said. “Really, we can’t do without it.”

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