What about Grover Hermann Hospital?

CALLICOON, NY — Decades ago, the tiny hospital was slated to close. But times have changed.

In 2020, it received $1.8 million in federal funding. The emergency department has been upgraded.

Currently, a nurse practitioner there sees patients.

With the retirement of long-time doctor Paul Salzberg, Schiller isn’t sure how the future will play out in terms of a new doctor in Callicoon. But “we are looking to enhance and grow [the] Callicoon primary care practice,” he said.

A recent press release from the Grover Hermann Auxiliary noted that the hospital was named one of the top 20 critical access hospitals in the country for quality in 2019 and for patient satisfaction in 2020. (A “critical access” designation is meant to keep rural hospitals less vulnerable financially and to improve access to healthcare by keeping essential services going.)

Grover Hermann reached the 95th percentile in the emergency department consumer assessment of providers and systems during both years’ reporting periods. “This means performance in the top five percent nationally,” an auxiliary spokeswoman said, “and it’s the third time our hospital has earned this honor.”

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REGION — That rural health care is in trouble is so accepted, it’s not even news.

Rural Americans are more likely to die from heart disease, cancer, unintentional injury, chronic lower respiratory disease and stroke than their urban counterparts, according to the CDC.

Sullivan County’s premature death rate stands at 545 per 100,000, according to the St. Louis Fed. In less-rural Orange County, it’s 327.2.

Meanwhile, hospitals are closing or cutting back on services. Nationwide, 138 rural hospitals have closed or been converted to outpatient use since 2010, according to the Cecil G. Sheps Center for Health Services Research.

In our region, said Garnet Health-Catskills CEO Jonathan Schiller, the hospital and the county are working hard on the problem.

The county, sick

Especially at this time of pandemic, the challenge is connected to an individual’s health and the economics of the county.

“There are two sides to the equation: the needs of the community and socioeconomic factors… Communities need employment, insurance, transportation,” Schiller said, outlining the problems the county needs to solve.

On the individual side is the aftereffects of COVID-19. “We did have a significant number of people who have foregone primary care or screening,” he said. This means that diseases could have advanced without early detection or treatment.

The mental health impact is just as significant. “There’s a strain on mental health… It’s been a lot for people in our community to handle.” Not only are individuals impacted in their personal lives, healthcare workers are under strain at their jobs, he said. “There’s a little trauma… they set their own self-care aside” while they took care of others. Some may cope by deciding to retire early.

The final problem is access to care, which has to do with infrastructure of the community. Without widely available public transportation, given distances to travel, getting to care can be hard. “It does hurt most in the primary care area,” Schiller said. When illnesses aren’t caught early by a primary care practitioner, “then it’s much more costly for the person.”

He’s not talking about money.

Healing it

How do you fix it?

Focus on what needs doing, Schiller said.

Manage chronic disease in outpatient facilities to keep folks out of the hospital.

Recruit more staff. “There’s no substitute for highly trained doctors, nurses, and others,” he said. “We need more primary care providers.” Despite being stretched thin, Schiller said, “We’re doing our best.”

While matters may look bleak, Sullivan County has elements going for it. Schiller credited Crystal Run Healthcare for attracting doctors and specialists to the area. He praised the medical services provided by physician assistants and nurse practitioners, specificially crediting the essential health services provided by Nan Eschenberg, the nurse practitioner at Grover Hermann Hospital. Partnerships with BOCES and SUNY Sullivan, which he said are going well, serve as a vehicle to train a future medical service workforce. For those seeking careers in healthcare, the programs offer hands-on training in the hospital.

It’s easy to focus on what the hospital and the professional community should do, but there’s still a role for the community. “When people need care, use the services we offer,” Schiller said. Not using what’s available here means that it could go away. Expanding home health care would help. Home visits and tech-like portable EKGs would go a long way toward improving outcomes, to making sure nobody is missed and lost, he said.

In terms of the future, Schiller cited technology as an asset. “This is an interesting time as we’re having a dialogue about barriers to care. There’s a potential for technology—Sullivan County broadband—and the hospital is involved because we will provide a backbone for telehealth.” Then providers, even specialists, can be reached from anywhere. Tech would help with remote learning too.

“Our goal is to ensure that residents we serve receive excellent care,” Schiller said. “Nobody should have to go without healthcare in the county.”