Friday, December 1, 2006

My testimony before the State Senate Health Committee

Testimony of Thomas P. Quinn
President and Chief Executive Officer
Community General Hospital, Syracuse, New York

New York State Senate Health Committee
Albany, New York December 1, 2006

Senator Hannon and the Members of the Senate Health Committee:

Thank you for the opportunity to testify before you today. I am Thomas Quinn, President and CEO of Community General Hospital in Syracuse, New York. Community General is a 306 bed community hospital. We also operate an additional 50-bed skilled nursing facility (SNF), attached to the hospital.

Community General and the Van Duyn Nursing Home, a 526 bed SNF owned and operated by Onondaga County, sit on contiguous parcels of land. In the last few years Community General and Van Duyn have begun to take steps to treat those parcels as a common health care campus.

Before I comment on the particulars of the Commission’s report as they relate to Community General, I first want to state my respect for the work of the Commission. The Commission members and staff accepted an enormous task. They completed their work in a thoughtful and timely fashion. The report is a positive step towards reform of the State’s health care system.

The Commission’s report calls for the establishment of a unified governing structure between Community General Hospital’s SNF and Van Duyn Nursing Home, under the control of Community General Hospital, and for the reduction, between the two facilities, of about 75 SNF beds.

Because of our proximity, and ongoing joint efforts, Van Duyn and Community General have had exploratory discussions about the possibility of uniting in some form. We also have discussed other, less encompassing joint activities that would benefit both Community General and Van Duyn. In my own meetings with Commission staff, I discussed the possibility of affiliating with Van Duyn. We at Community General engaged a consultant to undertake an initial review of what affiliated operations would look like, either by close coordination of planning and investment of the two institutions or by combining institutions in some form. Community General also surveyed the legal issues that uniting could present. We did not conclude that a united operation was the best alternative at this time.

Our discussions with Onondaga County, both prior to and since the Commission’s meetings, have been open and productive. Onondaga County is among the best-managed county governments in the state, and its decision-making process is thoughtful and businesslike. Onondaga County has been committed to operating Van Duyn as a public, safety net institution, and Community General has supported that position. We have believed that close collaboration could accomplish the “integrated continuum of care” envisioned by the Commission.

I must tell you that the issues presented by joint control are daunting. They begin with the transfer of a publicly operated facility to private control. Bond covenants need to be respected. Labor contracts need to be examined. Governance and operational issues need to be addressed. But above and beyond all that, there is the issue of finance. Van Duyn has been operating at a substantial deficit over the last few years. My understanding is that Van Duyn expects to operate at a $5 million deficit in its upcoming fiscal year. Community General does not have the wherewithal to fund any deficit, much less a deficit of that magnitude, nor do we have ready access to funds for the technical, business planning, and legal services that would be necessary to address the changes recommended by the Commission.

Obviously, if Van Duyn were placed under the control of Community General, we would expect to introduce operational and programmatic changes to address the deficit. But to even begin that process requires funding. The Commission’s report was released on Tuesday. We have not had a sufficient opportunity to determine how much would be needed in planning and transitional funding. If the Legislature accepts the Commission’s report, Community General would need assurances of adequate state support for this process. Community General cannot allow itself to be weakened by a proposal that is intended to strengthen the delivery of health care.

I would also like to call the Committee’s attention to the special role that the Van Duyn Home has played in Onondaga County. Van Duyn has been the nursing home with a significant safety-net mission. That means that Van Duyn continues to admit a large number of residents on Medicaid-pending status. At best, that presents a significant cash flow problem for Van Duyn’s operation. The Commission’s report calls upon Community General to continue to fulfill that role. That is not an obligation a not-for-profit community hospital should be expected to bear by itself.

Community General Hospital shares a vision with Onondaga County to develop a health care campus from our contiguous sites. We see the advantage of the integrated campus concept endorsed by the Commission. We could foresee joint operations. But achieving this will require time, resources, and a public commitment to support the special role that Van Duyn plays in Onondaga County.

Thank you for hearing my testimony today.

No comments: