HARRIS – The COVID-19 pandemic proved to be a cruel two years for many businesses throughout Sullivan County – and the country.

However healthcare was different.

“The years 2020 and 2021 was a time of incredible volume of incredibly sick people due to the pandemic,” Garnet Health Medical Center - Catskills CEO Jonathan Schiller said. “And we received significant federal funds.”

Schiller said as the Cares Act relief funds ran out the hospital experienced a loss in revenue.

As 2022 began to unfold the healthcare industry as a whole saw a dramatic decline in patient volumes and significant increase in expense, officials said.

“Our volume was down 15 percent behind our plan,” Schiller said regarding the first four months of 2022. “Across our system we are nearly $33 million behind budget for the first four months of the year.”

According to Schiller and hospital spokesmen, 30-35 percent of hospitals across the county are in the same boat, trying to determine if decreased demand is the new normal or if demand will pick up following four slower months to start the year.

“Labor, supplies, pharmaceuticals, temporary labor, premium payments are off the charts and no more Cares Act funding,” Schiller said. “It’s been the perfect storm.

“There are not as many sick patients, lower than historical demand and higher than ever costs,” he said. “And we can’t raise our rates.”

Schiller explained that although Garnet Health has been “good stewards of our resources,” the dramatic decrease in demand and increased costs “is not sustainable.”

The Garnet Health systems is roughly a $100 million company that is currently $33 million behind budget – $5 million at the Catskills division alone.

“We are trying to be careful now to avoid a crisis,” Schiller said.

To address this issue the administration and board decided to consolidate the medical-surgical units.

“It’s the third time we have done it,” Schiller said.

The medical-surgical unit is where patients go for post-operation recovery. Right now, Garnet Hospital – Catskills has two such units, one on the second floor and one on the fifth.

The consolidation of the two medical surgical units has occurred to the fifth floor unit.

Garnet Health's Middletown Campus is experiencing the same challenges. Garnet Health System is experiencing significant dips in patient volume with the exception of Garnet Health Urgent Care, officials said.

Hospital officials also decided to apply to the State Health Dept. for a Temporary Closure of the Intensive Care Unit (ICU).

“Through the end of April, ICU was 50 percent below capacity,” Schiller said. “That is our most expensive unit where we provide intensive care on a 24-hour-a-day, seven-day-a-week basis.

“We either have a one-to-one patient-nurse ratio or 2 patient to 1 nurse ratio,” he said.

Alarms immediately sounded in the community as administration notified employees of their decision and the word reached outside the hospital. There were rallies in Monticello as well as long discussions at the Sullivan County Government Center before the Legislature.

On Thursday, the State Health Dept. denied the application for temporary closure of the unit. (See related story).

Work must go on

Summer is notoriously a busy time for Sullivan County – and the hospital.

“We hire additional staff in the emergency room and our OB Dept. sees a lot more births on a per month basis,” Schiller said.

But even with higher patient usage, Schiller said “we are not optimistic about a big spike in ICU [patients].”

Traditionally, patients come to the ER and then are transported to their “home” hospital for more acute care, Schiller said. This could include hospitals in Westchester and Rockland counties.

“We are going through a period of low utilization and extremely high costs,” he said. “It’s not sustainable long-term for the whole industry.

“Our commitment to Sullivan County is unwavering,” Schiller said. “We continue to recruit providers for new services. We have been recruiting and adding services to Sullivan County at a pretty good pace over the last 5 years which has resulted in bringing on a new surgeon, gastroenterology, endocrinology and more.”

Administrators are hoping this means providing more needed services to patients at the hospitals.

These new doctors will see new patients as well as consult on inpatient services, Schiller said.

“No one is losing their jobs,” he said. “There are no layoffs… in fact we have a high staff vacancy rate across our system.”

The following story was written following a Thursday morning interview with Garnet Health Medical Center - Catskills President and CEO Jonathan Schiller, and board president Rick Lander. Schiller left the hospital in a planned transition to a healthcare facility in Oneida County on Friday, June 10.