When are we going to serve the population first, and the economics of a health care delivery system second?”

Dina Greenbaum

Lost services

SULLIVAN COUNTY, NY — Neither the hospital in Harris nor the emergency department in Callicoon offer pediatric care.

In 2021, Garnet Health Medical Center - Catskills closed its 64-bed skilled nursing unit.

The single hospital in the county is actively recruiting for vacancies in cardiology, full-time psychiatry, general surgery and orthopedics.

The county’s only Planned Parenthood clinic closed in 2020 and the next closest location recently announced it planned to close.

Garnet Health no longer offers GYN services and does not have an obstetrician on staff in the county.

SULLIVAN COUNTY, NY — Sullivan residents say the county has a health care “emergency” and point to the difference in insurance reimbursement rates between Sullivan and neighboring counties as the reason why.

Over 80 people gathered on September 5, for a “town hall”-style meeting to speak with leadership from Garnet Health, the operator of the only hospital in the county. 

Sullivan County Garnet Health facilities are being stripped, providers are scarce, and  as a result people are “farmed out” to Garnet Health’s facility in Middletown, residents claimed. 

Why? 

Dina Greenbaum, whose late husband worked as a physician in the county for 45 years, said at the town hall, “A lot of decision-making is because we’re in the third level of reimbursement for Medicare and private insurances. This is the fact: a lot of what has gone from this hospital from 2007 onward has been ported away because of its higher pay.”

Sarah van Ouwerkerk said when her husband was injured there was no surgeon at Garnet Health’s Harris campus, and she and six to eight other people had to wait to be taken to Middletown for care. Another resident said she had to bring a friend to Middletown for a 15-minute electrocardiogram (EKG) test because the Sullivan location no longer had a cardiologist. 

“When are we going to serve the population first, and the economics of a health care delivery system second?” Greenbaum asked.

Resident Katie Childs said, ”When I was ready to deliver my daughter, I wanted to deliver at Harris, but I was routed to Middletown because I was an older mother.” It’s automatic because Harris doesn’t “have the services to support complicated births,” she said.

The long driving time to urgent and critical care was among the metrics that landed several Sullivan County towns on New York State’s Disadvantaged Communities (DAC) list.

Jerry Dunlavey, CEO of Garnet Health Medical Center - Catskills and vice president of operations for the system said, “Reimbursement has an impact depending upon where a hospital is located.” He said there is a formula used to determine the insurance reimbursement rate to the hospital. Garnet Health’s Harris campus is reimbursed differently than the Callicoon campus, he said.

Garnet Health clinical staff are obligated to provide treatment regardless of insurance. Depending on rates of reimbursement, from both private insurance, Medicaid and Medicare, costs then fall on facilities to be absorbed.  

About 5.6 percent of Sullivan County residents have no health insurance and 30 percent of Sullivan County residents are on Medicaid.