about us: River Hospital - Serving the Thousand Islands ... Close to home

about us

River Hospital Board of Trustees

Officers - Joseph Russell, Chair | Robert Toole, Vice Chair | Patricia Chalk, Secretary | Jeanne Snow, Treasurer

Our CEO

Mr. Ben Moore, III joined River Hospital as the Chief Executive Officer beginning August 28, 2006. Mr. Moore holds a Masters of Health Administration from Duke University and a Bachelors of Arts degree in Government from Harvard University. Mr. Moore has served on the Board of Directors of the Upstate Medical University Foundation, Hospice of Central New York, the Syracuse Community Health Center and the Hospital Executive Council. Mr. Moore has had a distinguished career as a senior healthcare executive, having led organizations for over twenty-five years through institutional strategic planning and implementation, marketing and business development. Mr. Moore served as Executive Director of University Hospital of SUNY Upstate Medical University from 1993-2005 and as Chief Operating Officer from 1987-1994. Mr. Moore served most recently as the Hospital Management Coordinator prior to his retirement in February 2006, after almost twenty years of service to the hospital.

River Hospital History

	1941 -The first hospital in Alexandria Bay was founded by Dr. Walter G. Robinson. It was housed in the Cornwall House on Market Street. This hospital served the community throughout the 1940s.
River Hospital is located on the former site of the Thousand Islands House, once a premier resort hotel built in 1872 by Colonel O.G. Staples. The structure was four stories high, and would accommodate 700 guests. Many notable people stayed at the hotel during its heyday, including industrialist Andrew Carnegie, writer Mark Twain, and statesman Henry Cabot Lodge. By the 1930's, during the Great Depression, the hotel was abandoned and the property was sold in 1935 to Mr. Abe Cooper of Syracuse, who razed the structure. The site was sold to the Edward John Noble Foundation Inc. in 1946 for construction of the new hospital.
	1947 - Edward John Noble pledged $125,000, one half the cost of building a hospital, if the people of Alexandria Bay could raise the other half. The Edward John Noble Foundation was founded to promote a cohesive health system for the North Country. (Photo: Edward John Noble)
	1949 - Through the efforts of the local community and the generosity of Edward John Noble and Abe Cooper, who offered a favorable deal on the riverfront property, ground was broken for the first phase of the hospital. (Photo: Abe Cooper) Ground breaking for the new Noble Foundation Hospital, later to become River Hospital, was held in 1949 after a large public fund-raising campaign. The two-story structure had a capacity of more than 25 beds, including a pediatrics room, maternity section and nursery. There were also doctors' offices, an operating room, emergency room, kitchen and dining room, a laboratory, radiology unit, and fluoroscopic rooms.
	1950 - July 14, the Edward John Noble Hospital, a 29 bed facility, was dedicated. Mr. Noble and Mr. Royal Garlock, President of the Hospital Board, sealed historical documents in the cornerstone declaring the hospital officially the property of the people. Dr. Charles W. Mayo, of the Mayo Clinic, was the keynote speaker.
	1970 - The second story was added to the facility and the bed capacity increased to 51 beds, and provided a wider range of services to 20,000 permanent residents and more than 80,000 summer residents and visitors.
1991 - As a result of radical changes in the healthcare industry during the 1980s, EJ Noble Hospital filed for Chapter 11 bankruptcy protection and entered into a relationship with Samaritan Medical Center, Watertown, in an effort to maintain quality healthcare services.
2000 - Threatened with closure of the hospital, a group of concerned citizens formed a task force to appeal to the New York State Department of Health to become an independent institution.
	April 15, 2003 - The hospital is 'reborn' as an independent facility and named "River Hospital".
In the years that followed the opening of River Hospital in April 2003, until the conclusion of the 2006 fiscal year in December 2006, River Hospital was confronted with many challenges as a start up operation. There were many obstacles to overcome in establishing services in the area such as attracting staff, and physicians, and assuring the community that River Hospital was a viable entity. Fortunately, there was tremendous community support for River Hospital including significant philanthropy which was of great assistance to River Hospital in navigating the difficulties in establishing financial viability. Fortunately, at the end of fiscal year 2006 all the initially planned elements for services at River Hospital were about to be initiated. The final program was an Ambulatory Surgery Program.
September 2007 - River Hospital opened its Ambulatory Surgery Unit, The Anthony C. "Tony" Malara Operating Suite. This addition to the services provided by River Hospital now offers the option of having minor surgical procedures and colonoscopies performed on an outpatient basis, close to home.
The Board of Directors, realizing that River Hospital was about to transition from a start up operation to a stable operating environment, determined that a strategic planning process should be initiated. The hospital operated long term care beds until 2010. It currently has 15 acute care beds and 9 swing beds. The hospital also operates a Primary Care Clinic and has an active Emergency Room. Laboratory, Physical Therapy, Respiratory Therapy, and Radiology services are available. After considerable administrative reorganization, the fiscal environment has improved significantly. River Hospital met its forecast with its first break-even year for fiscal year 2007.
July 6, 2008 – River Hospital celebrated its fifth anniversary of operation, the opening of the new modular building housing River Community Clinic and the opening of Jefferson Eye Surgeons Ophthalmology clinic. The movement of River Community Clinic into the new building will allow the Clinic to serve more patients and allow room for new Physicians joining the hospital.
Jefferson Eye Surgeons plan to officially open their clinic on August 1, 2008. There will be Ophthalmology services as well as an Optician Shop within the clinic and will be a brand new service at River Hospital. Dr. Ewing-Chow and Dr. Joy plan to begin operating in our Ambulatory Surgery Unit on August 5, 2008.

"Abide"

"Abide" represents the "life cycle," the continuous movement preserving and protecting lives of patients as well as the facility itself. The three waves rolling together act as a sense of spirituality. The waves which overflow the base stone, acknowledge the community outpouring of concern and caring to keep this hospital alive and functional.

Water to Native Americans, represents sustenance of life.
Waves display movement.
The circle, a continuum as in life cycle.
Birds in flight represent free spirits.
Terns classified as an endangered species.

How we became a Critical Access Hospital

River Hospital, a Critical Access Hospital, is here to meet the needs of a Rural Community. In a recent study it was recognized that a considerable number of people do not realize what it means to be a Critical Access Hospital (CAH).

In the 1980s the methodology used to determine reimbursement for hospitals shifted away from “cost based” to “prospective payment based” utilizing Diagnostic Related Groups. For many hospitals this change promoted the expansion of a variety of more specialized services that were financially lucrative. Small rural hospitals, offering predominantly core primary care services suffered as a consequence.

By the mid 1980’s hospitals were closing at an increasing rate. The most common characteristics of the closing facilities included a rural location, less than 100 beds, or they were a specialty hospital. The hospital closures not only resulted in the loss of acute care services but often primary care services that were connected with them were also eliminated. Rural communities across the US were being left with essentially no access to health care.

Responding to the increasing rural health care dilemma the Balance Budget Act of 1997 provided for the creation of the Critical Access Hospital. To be designated as a CAH the facility must be located in an area that meets distance requirements from another hospital, be limited in size to no more than 25 beds, and provide inpatient acute care services with an average length of stay of no more than 96 hours, so as not to ‘compete’ with general acute care facilities.Like other CAHs, River Hospital has developed transfer agreements with a variety of other acute care hospitals for appropriate emergency and non-emergency communications, referrals and transfers when a higher level of care is required.

Critical Access Hospitals are hospitals that are certified to receive cost-based reimbursement from Medicare. The reimbursement is intended to improve financial performance and therefore reduce hospital closures. CAHs establish agreements with commercial insurance companies as well. Reimbursement for CAHs from Medicaid is at a much lower rate than the cost of providing care. However, care is not restricted based upon ability or inability to pay. Due to the reimbursement structure, CAHs rely more on grant programs and philanthropic efforts than what would be typical of a general acute care hospital.

Critical Access designation has had a tremendous impact on hospitals across the nation. As of September 2010 there were 1,320 certified Critical Access Hospitals in the United States, with 13 currently in New York State.CAH is a change in provider designation, not a downgrade. Conversion to CAH status does not necessarily mean losing services. In some cases, hospitals that have converted to CAH may even choose to expand their range of services to better meet community needs.

Community Service Plan (2010 Submission)

I. The Mission Statement of River Hospital:

It is the mission of River Hospital to provide compassionate, cost effective and accessible, primary health care to the year round and seasonal residents, and visitors of the River Communities. The hospital prides itself on high quality outpatient, inpatient and specialty services to meet individual and community needs through partnerships with our patients and communities we serve.

River Hospital’s Long Term Care Unit closed and the Long Term Care license was surrendered to the New York State Department of Health in May 2010 due to the deteriorating reimbursement rates for this service. The facility’s Mission Statement was revised and approved by River Hospital Board of Directors July 2010.

II. River Hospital Service Area:

As in the past reporting year, River Hospital continues to provide health care services to the surrounding communities including the Towns of Alexandria, Orleans, Theresa, Hammond, Clayton, and Cape Vincent, as well as a portion of the Fort Drum military installation. In addition to the full time residents of these communities, River Hospital serves a large population of seasonal residents and visitors as a tourist area.

River Hospital is located in Alexandria Bay, in the northern tier of Jefferson County and New York State, with the general service area reaching a radius of approximately 25 miles. The service area borders Lake Ontario and the St. Lawrence River and into St. Lawrence County, with the county line five miles northeast. Directly to the north, on the opposite shore of the St. Lawrence River is the Province of Ontario, Canada, confining access to the United States health care system to 180 degree radius. Within the range of River Hospital’s service area is the expanding United States Army’s 10^th Mountain Light Infantry Division at Fort Drum, bringing along the influx of family members and residual population. The largest nearby United States population center is Syracuse, New York, located 100 miles to the south.

III. Participants and River Hospital’s Role:

During July and August 2007 River Hospital secured funding to conduct a survey with the assistance of the Center for Community Studies located at Jefferson Community College, Watertown, New York. The purpose of the survey was to obtain a better understanding of the needs of community members served by this facility. River Hospital continues to draw information from this survey. River Hospital is working with a marketing firm to determine community perception since the need to close the Long Term Care Unit. In addition, the administrative staff is working closely with the Board of Directors to develop a long term strategic plan and looking for improving the physical plant and developing more outpatient services for the communities served by this facility.

Since the submission of the last Community Service Plan, River Hospital is continuing to work with the Jefferson and Lewis County Public Health Departments and other area agencies in the Health Planning Initiative. Through the joint efforts of the agencies involved in the HEAL NY Phase 9 work plan sound public input has been used in identifying and addressing health needs of the encompassing communities. The community survey conducted in Jefferson and Lewis County communities was the method of collection data and it was determined that prevention strategies would focus on Diabetes Prevention and Awareness.

In addition, River Hospital is working with Jefferson County Public Health and local agencies, including Cornell Cooperative Extension, Hearts For Youth (under the umbrella of Town of Alexandria), local neighborhood associations, and Alexandria Central School to develop “Building Healthy Communities Coalition” established through a grant received by Jefferson County Public Health Service to bring together community leaders in order to address the physical activity and nutrition needs in this area. This group meets approximately every two months.

Through both of these efforts River Hospital is working with the local school, Alexandria Central, to broaden the awareness and educate the younger population on their ability to make decisions that lead to a healthier lifestyle and reduce the incidences of diabetes.

River Hospital participates in routine meetings with Cancer Services Program to review available services and updates and with Fort Drum Regional Health Planning Organization for marketing and recruiting strategies for the military population in the area.

River Hospital Administration continues to work with its Board of Trustees through a structured Planning Committee in developing an ongoing strategic plan to bridge the gaps where they may exist, to better serve and meet the needs of this rural region.

River Hospital participates in outreach services to provide screenings and health fair style education with a variety of agencies as well as employers when possible.

IV. Identification of Public Health Priorities

River Hospital Board of Directors has charged the hospital administration with increasing appropriate services to the community. Additionally, the expectation of the Board for River Hospital is to provide appropriate services in the most professional manner possible. The administrative staff has actively engaged in data collection and review with a strategic planning firm, Health Strategies and Solutions to begin to assess additional health service needs for the community.

As described previously, River Hospital is working with Jefferson County Public Health on more than one strategy to address increasing activity and diabetes awareness. As this is still in the role out phase of the process, the measurable progress is not yet available.

Through philanthropic and grant funding efforts, River Hospital provides outreach services to offer preventive screening services such as breast cancer screening and prostate cancer screening for individuals with limited or no health insurance benefits.

River Hospital is continuing the progress of prior program initiatives such as diabetes education, nutrition and increasing physical exercise through gym memberships in River Hospital’s Physical Therapy Department. River Hospital also continues to seek additional outreach programs with an increased emphasis on community partnerships.

River Hospital maintains an active role through joint planning and collaboration efforts between state and local hospital associations, local governmental agencies and community partnerships in a mindful effort to continue to respond to the healthcare needs of the communities served.

River Hospital participates in membership alignments and inter-disciplinary projects with a number of organizations including: American Hospital Association (AHA), Healthcare Association of New York State (HANYS), Iroquois Health Association (IHA), Northern New York Rural Health Care Association (NNYRHCA), New York State Association for Rural Health (NYSARH), Adult Day Care Council, and Fort Drum Regional Health Planning Organization (FDRHPO). In addition River Hospital is affiliated with Canton Potsdam Hospital for information systems, as well as the Chief Informational Officer Council for technical development, which includes all North Country Hospitals. To ensure appropriate disposal of medical waste removal a contract is in place with Safeguard Biomed Services.

River Hospital actively works alongside other health care agencies and organizations toward the common mission to improve the health of North Country residents by collaboratively planning, organizing and implementing health outreach events that offer residents, free health services or health screenings in their own communities and through employers when possible.

For the ongoing coordination and cooperation in the best interest of the patient, River Hospital holds patient transfer agreements with the following health care facilities: Samaritan Medical Center, Edward John Noble Hospital, Carthage Area Hospital, Claxton-Hepburn Medical Center, SUNY Upstate Medical University, and St. Joseph’s Hospital Center.

V. Update of River Hospital’s Plan of Action

The aforementioned cancer screening strategies have been priorities and concerns for some time, which through funding opportunities over the past three years this facility has been able to take a more aggressive role in the education and awareness of necessary screening. This facility disseminates information for those who require follow on care who may not have adequate health insurance coverage through our alignment with Cancer Services Program. These are some of the priorities in an effort to raise awareness in the value of prevention.

River Hospital continues to improve efforts in educating the younger population of the community through hospital tours and visits to the local schools, participation in health events in the surrounding community and one-on-one education in the outpatient clinic setting. This is included in the approach to raise awareness and improve the effectiveness of early introduction and education of health care in this population, which could be measured more successfully over a given number of years.

In this time of economic hardship it is evident that the patient population is challenged with affordable health insurance coverage, evident in the rise is Self-Pay and Medicaid payer mix for this facility. This financial hardship poses difficult challenges for the institution as well with the financial reimbursement structure as a Critical Access Hospital.

River Hospital has recently revised the Quality Assurance and Quality Initiative program, drawing additional involvement from its own Board of Trustees. This will lend improved processes to the already quality services available at this facility.

VI. Dissemination of the Report to the Public

(Due to the size of the documents, a link for each is provided for greater efficiency.)

Dissemination of a facility’s public health programs and availability of financial assistance to the public is a key element, River Hospital plans to post its Community Service Plan on its website at http://www.riverhospital.org/ with the specific posting for the plan located at http://www.riverhospital.org/about.php

In addition, other elements of activities this past year are available as follows:

The Heal NY 9 and the Community Health Assessment are at http://www.ncsteps.org/as well as at http://www.co.jefferson.ny.us/index.aspx?page=96
75,000 A Recipe for a Healthy Community inserts in The Mountaineer, Penny Saver and WDT the first week of August, available online at http://www.watertowndailytimes.com/wdt_repository/advertising_files/HealthyCommunity.pdf

VII. Changes Impacting Community Health/Provision of Charity Care/Access to Services

As a Critical Access, not-for-profit 501(c)(3) hospital, River Hospital operates an acute care facility with a variety of inpatient and outpatient ancillary services and primary care clinic. With this critical access status, this facility is subject to changes in federal and state policies and reimbursement levels. As a Critical Access Hospital, one of the most prominent challenges is posed by the unique reimbursement structure, whereby Medicaid reimbursement schedules are not at the 101% rate, but at a much lower rate. Compared to that of non Critical Access Hospitals, this makes a dramatically different financial picture.

A direct result of the negative reimbursement environment as a Critical Access Hospital, River Hospital and its Board of Directors was faced with the very difficult decision to close it Long Term Care unit. The facility voluntarily surrendered its Long Term Care license after the appropriate placement of its 27 Residents in other facilities, with the last placement occurring in May 2010. In an effort to expand clinical services River Hospital is near completion of a project to re-allocate the former Skilled Nursing Unit to address other potential areas of service, which is still in process.

VIII. Financial Aid Program

River Hospital is proud of the friendly and caring staff that assists uninsured patients in arranging appointments for Facilitated Enrollment Program as an effort to determine alternative options for health care coverage.

River Hospital and The North Country Prenatal/Perinatal Council, lead agency for the Facilitated Enrollment Program, have joined forces to help uninsured patients apply for Medicaid, Family Health Plus, and Child Health Plus, without the need to travel out of the community. A facilitated enroller is available locally to answer eligibility questions, help families gather needed documentation, and complete a Medicaid, Family Health Plus, or Child Health Plus application for anyone. The application is prepared for submission by the Facilitated Enrollment Specialist in an effort to obtain assistance with healthcare costs, eliminating the need for our patients to travel outside our area for impersonal appointments. Preliminary eligibility screening can be completed at the appointment to aid in processing the River Care application for appropriate reduction of any recent and future River Hospital bills. More specific information for this service can be found on the hospital’s website, http://www.riverhospital.org/under the ‘patient resource’ tab. Further details and more comprehensive scope of services for River Hospital can be viewed on the electronic brochure located at http://www.riverhospital.org/. This website is maintained on a regular basis.

Facility

River Hospital is a unique institution. The uniqueness is replicated in this web site. Our staff cares deeply about quality patient care and personal attention. We are focused on expanding our current services to the area communities, and visitors of this area. The staff's attitude is summed up in the description of the hospital logo. Our staff is committed to serving you and your family in the most compassionate, competent, and efficient manner. Some photos of the campus can be viewed by accessing our Video Library and Photo Gallery below.