With the new year underway, I wanted to provide a general update to our community concerning the work we have been doing to bolster Adirondack Health’s sustainability and expand access to care.

As previously communicated, Adirondack Health posted an operating loss in fiscal year 2022 of approximately $14 million. Recognizing the threat that presented to our independent healthcare system, we made several substantial changes to the organization. We sought and received authorization from the New York State Public Health and Health Planning Council to sell Mercy Living Center, and the same from the state health department to close the part-time Lake Placid emergency department and the dental clinic. These decisions were not made lightly, and while it is never painless to modify or eliminate service lines, we did so with an eye to the overall viability of the organization.

Selling Mercy Living Center to a private, third-party nursing home operator has saved Adirondack Health approximately $5 million per year. We were able to keep long-term care available in the community of Tupper Lake and dozens of local jobs were also preserved.

Closing the part-time Lake Placid emergency department has saved Adirondack Health approximately $2.2 million per year. In mid-June, Hudson Headwaters Health Network (HHHN) completed renovations in the former Lake Placid emergency department space and began seeing primary care patients there.

Closing the Lake Placid Dental Clinic has saved Adirondack Health more than $300,000 per year. While the loss of a Medicaid dental provider in the Adirondacks was challenging, we were unable to recruit a dental hygienist prior to closure, severely impacting the clinic’s operational and financial stability.

Taken together, these savings total approximately $7.5 million per year. In the first fiscal year following the implementation of these changes, Adirondack Health reported an end-of-year income of approximately $800,000. To go from losing $14 million in 2022 to generating $800,000 in 2023 represents a one-year financial turnaround to the tune of almost $15 million and reflects our commitment to this organization’s long-term sustainability.

Final audited financial results won’t be available for a few more months, but Adirondack Health’s 2024 financials will be positive. As of Sept. 30, estimated net operating income stands at about $2 million. Improved financial performance enables us to invest in critical infrastructure, our cybersecurity posture and new technology — like the two additional surgical robots that were delivered over the holidays. It also enables us to maintain the significant investments we’ve made in our employees and medical staff over the past several years. While we are in an objectively better position than we were a year or two ago, we continue to monitor our financial performance very closely, given the inconsistent nature of hospital finances and the persistent financial headwinds facing our industry.

With many systems across the state and country on the financial rocks, building and maintaining strong collaborative relationships becomes even more important. Adirondack Health works closely with HHHN, a federally qualified health center (FQHC) with 24 primary care offices operating across the North Country.

Together, we have expanded access to primary and acute care throughout the Tri-lakes region. HHHN currently leases space from Adirondack Health in the Redfield medical office building, Lake Placid Health and Medical Fitness Center and Tupper Lake Health Center. In addition to the recent renovations to the former Lake Placid emergency department space, HHHN made a considerable investment in the expansion of their Saranac Lake office location, further increasing regional access to primary care. Adirondack Health also benefits from HHHN primary care referrals to our specialists and ancillary services (mainly laboratory, medical imaging and surgical services). We look forward to continuing to collaborate with HHHN wherever and whenever it makes sense, as we do with Citizen Advocates, Behavioral Health Services North and other community-based organizations (CBOs).

Adirondack Health has also been hard at work expanding access to care and several key service lines, adding advanced practice providers in our cardiology and vascular departments and achieving full staffing of our hospitalist service. By increasing capacity in these areas, we not only expand access to care, but also increase the revenues we are able to generate through higher patient volumes.

The sustainability of a health system like ours requires an active and engaged medical staff. Adirondack Health’s most recent strategic plan called for the creation of a succession plan for current physicians and providers. By anticipating future gaps in provider recruitment and retention, we can further reduce locums costs and think long term about where we intend to go as an organization and how we intend to get there.

Whether we’re talking about service line optimization, workforce stabilization, or increased regional collaboration, it starts with the formulation of solid, measurable plans of action. In less than two years, we have made considerable progress through adherence to our most recent strategic plan and are preparing to update that framework, beginning in the first quarter of 2025.

One of the most pressing challenges we face as a small, rural, independent health system is that we do not consistently generate enough cash from operations to adequately fund capital investments. That’s why, whatever happens with future grant applications in Albany and Washington D.C., Adirondack Health is incredibly fortunate to enjoy the strong support of the communities and residents we serve. And therein lies the crux of the matter: individuals and organizations that are intimately familiar with Adirondack Health understand the central role we play in healthcare delivery in the North Country and choose to support us accordingly. With every application we submit to state, federal, or private grant-making entities, we strive to appropriately share those narratives and experiences. Our recent and ongoing capital investments, along with the Adirondack Health Foundation’s Cornerstone Campaign to renovate our 1960s-era inpatient rooms and relocate our dialysis unit, demonstrate our enduring commitment to this region.

I remain optimistic about Adirondack Health’s future because I know firsthand both the hard work in which our teams are engaging on behalf of our organization, and how much our patients and communities depend on us. It is reflected time and again in our five-star patient experience ratings, HCAHPS scores and contributions to the Adirondack Health Foundation. We do what we do exceptionally well, and the best way to position ourselves for future success is to keep doing it.

Thank you for your ongoing support. It matters to our patients, it matters to our employees and it matters to the place we call home.

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Aaron Kramer is the president and CEO of Adirondack Health.