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Eastern Niagara Hospital is making significant changes to try to ensure its future survival, including shutting down its maternity unit and three service centers at its Newfane facility. The hospital's first-ever family medicine residency program is ending, too.

Anne McCaffrey, hospital president and CEO, said the ENH board of directors recently approved, by a unanimous vote, the "2020 Transformational Program," which calls for closing the maternity department and, in Newfane, the dialysis center, Newfane Express Care and its radiology facility, while investing in UBMD Emergency Medicine and Great Lakes Medical Imagining, achieving accreditation for the hospital, continuing the hospital's family medicine clinic at 475 Transit St., and pursuing state grants for debt relief and IT implementation.

Forty-four jobs, the majority full-time equivalent, are associated with the programs and departments being cut. McCaffrey said affected employees have been encouraged to apply for open positions elsewhere in the hospital.

Rocco Surace, chairman of the board of directors, said in a statement Wednesday that the board's decisions to eliminate certain services "were not made easily or without extensive analysis and reflection."

"As a smaller community hospital, ENH must take these necessary steps and be proactive to secure our future. We are committed to serve the community for the long term. This new service model and transition of care is what is needed to position our hospital for the future.”

The hospital board looked at upcoming budgets, analyzed services that aren't bringing in enough revenue and concluded that the maternity unit and three programs in Newfane were hurting the hospital's bottom line, according to McCaffrey.

ENH has seen "a significant decline" in births over the past 20 years, McCaffrey said. In 1998, 500 babies were delivered at ENH and in 2018, the hospital hosted about 325 deliveries. In the past two decades, the local population of women of childbearing age decreased by 24 percent and, at the same time, a growing number of women in the hospital's service area have chosen hospitals other than ENH for childbirth. Currently, 65 percent of women in ENH's primary service area give birth at other hospitals.

"We're not getting those births here that we used to get," McCaffrey said. 

The hospital's maternity unit will be closed in June or July, pending approval of the state health department, she said. Patients will be referred to either Millard Fillmore Suburban Hospital in Amherst or Oishei Children's Hospital in Buffalo.

The Newfane dialysis center, despite having a high volume of patients, has been experiencing "financial losses of a significant proportion" because insurance payments fall "extremely short in covering the service," McCaffrey said.

The dialysis center will remain open until all current patients find another outpatient center.

"If that takes a while we will stay open as long as we need to, to ensure those patients are taken care of," McCaffrey said. 

Newfane Express Care, which was established in the aftermath of inpatient care and surgical services being taken out of ENH-Newfane (formerly Intercommunity Memorial Hospital) in 2014, isn't drawing enough business to sustain itself, according to McCaffrey. The urgent care center, which was set up in the old emergency department, has an average daily patient load of fewer than 10 people.

The Newfane radiology facility also can't support itself, McCaffrey said. The equipment is expensive to maintain and it's not drawing enough business to cover costs.

Both the Express Care and radiology facilities will be shut down in two to three months.

Other units and services at the old hospital, including Reflections Recovery Center, the physical therapy department and laboratory station, will remain.

ENH's family medicine residency program, established in 2016, is being discontinued with closing of the maternity unit. The residency program offers hospital-based training to medical school graduates, so they can get experience in the area(s) they need to be practicing physicians, and McCaffrey said that since ENH will no longer have a maternity unit it cannot host residents who need experience in obstetrics.

ENH administration is doing what it must to adapt to shifts in the healthcare industry and help the hospital survive, according to McCaffrey.

"This was a difficult decision, and as difficult as it is, I think it puts us in a position to ultimately make us stronger," she said. "Healthcare is an environment that changes rapidly, and for us to be current and strong we need to continue (to) monitor the market."

On the plus side of the hospital's 2020 Transformational Plan, McCaffrey pointed out, the physicans' group UBMD will be staffing the emergency department and that means ENH will have the same kind of quality care offered at other hospitals such as Millard Fillmore Suburban.

“As our new emergency department project progresses, it will heighten our ability to provide a much higher level of emergency services and acute care for the entire eastern Niagara County region," McCaffrey said. "As we focus more on providing the fundamentals of health care, we will also be elevating the quality of care we provide and increase patient satisfaction. ... All of this will make us stronger for the future.”

The ER department renovation project is not affected by the announced program cuts, McCaffrey said.