State funds will help compliance with Berger Commission

This morning’s Post Standard reports the allocation of $12.8 million of New York State HEAL NY funds for Community General Hospital and Van Duyn Home and Hospital. These funds will be used to comply with the requirements of the Berger Commission. I’ve written before about the Berger Commission.

The funds are necessary because the Berger Commission requires the affiliation of CGH and Van Duyn. These changes are part of a larger state plan affecting 74 institutions – the closure of nine hospitals and seven nursing homes, plus changes in the affiliations or bed configurations of another 48 hospitals and 14 nursing homes.

The state’s decision to fund changes at CGH and Van Duyn comes after many months of dialogue between CGH and Onondaga County, the operator of Van Duyn. County Executive Nick Pirro and his staff fought diligently for the affiliation scenario called “A,” under which the County would continue to own and operate Van Duyn. Scenario “B” would have involved the more complex and more costly process of transferring the ownership of Van Duyn to CGH. Both Onondaga County and the Civil Service Employees Association (CSEA) sued New York State to prevent such a change in ownership.

Our discussions with the County have been straightforward and cordial throughout this process. We have also had a number of discussions with the state, and these too have been helpful. The state remained noncommittal about scenarios “A” and “B” until about 5:00 p.m. last Friday, September 28, when it faxed the announcement of its grant allocation to the County and to CGH.

Although the state has not formally accepted scenario “A,” the funds it has allocated are based on the costs identified for “A” – so “A” appears to be the de facto decision of the state. Here is a summary of what the scenario “A” affiliation involves:

1. CGH and Onondaga County will create a new not-for-profit corporation, called the Onondaga Hill Corporation (OHC) to conduct strategic planning for CGH and Van Duyn. The OHC’s plans are intended to create operating efficiencies, to improve organizational effectiveness, and to develop a more integrated continuum of care on the CGH-Van Duyn medical campus.
2. Van Duyn will remain a county-owned facility, subject to OHC planning activity. CGH will remain a private, not-for-profit organization with its planning also subject to the OHC. Both CGH and Onondaga County will appoint OHC directors, with CGH designating the majority of them.
3. CGH and the County will decertify a total 63 long term care beds. Van Duyn will decertify 13 beds, and Community General will ultimately close its 50-bed skilled nursing facility, converting that space into fully renovated acute hospital capacity. After these changes, there will remain 513 long term care beds on the campus, all of them at Van Duyn. (The Berger Commission did not require any change in CGH’s licensed 306 acute care beds.)

The state funds will reimburse Onondaga County and CGH for the legal and planning costs incurred in complying with the Berger Commission. The funds will also cover the transition costs involved in closing CGH’s 50-bed long term care unit, they will fund the planning work of the OHC, and they will fund facility renovations at both CGH and Van Duyn that are consistent with the Berger Report.

Changes for nursing home residents can be disruptive and stressful. That means we need careful plans for the closure of CGH’s sixth floor skilled nursing unit. These plans have yet to be developed, and they too will be subject to approval by the State Health Department. We are committed to assuring that transitions for residents and their families are fair and respectful.

Of CGH’s 1,200 employees, about 50 will be affected by the closing of the sixth floor long term care beds. These employees may be eligible for positions elsewhere in the hospital, and we expect some may transition to Van Duyn or other community long-term care facilities. We will do our best to communicate fully with employees and to work with SEIU1199 in assuring fair and respectful transition opportunities.

You’ll notice I’ve used the word “allocation,” not “award,” in describing the HEAL NY funds. That’s because there are a number of steps to be completed before the state money is actually awarded and paid. These steps include state approval of a work plan and the sign-off by the Office of Comptroller, among other things.

The state’s decision to fund compliance comes 10 months after the Commission issued its report. It is a necessary step. It is a positive step. But it isn’t the end of the process – only the beginning.