“What I’m not seeing is a focus on women’s health. I’m not seeing a focus on pediatric health, and we have to take care of people my age—otherwise, we’re gonna leave. If my child is sick, I have to drive them an hour for urgent care. And I’m emotional about that, because it’s scary, and I worry that this is not the right community for us.””

Katie Childs

Brief history of Garnet Health Medical Center - Catskills

In 1965, there were two hospitals, one in Liberty, NY, and one in Monticello, NY. Jerry Dunlavey, CEO of Garnet Health Medical Center - Catskills, says, “They got together and they said, ‘You know, it doesn’t really make sense for us to have two hospitals so close together.’”

In 1967, the two facilities merged their boards, planning to build one new hospital.

In 1971, the Grover M. Hermann Division in Callicoon, NY was added to provide care in western Sullivan County as well as surrounding communities in Delaware County, NY and Wayne County, PA.

In 1977, Community General Hospital of Sullivan New York opened its doors.

After 24 years of service, in 2001, Community General Hospital announced that it would be changing its name to Catskill Regional Medical Center (CRMC). In a press release from the facility published in the Sullivan County Democrat, Arthur L. Brien, president and CEO at the time, said the name change did not reflect any shift in ownership but “a continued development of regional centers of excellence far and beyond those in the typical community hospital.”

In 2002, Horton Medical Center and Arden Hill, hospitals located seven miles apart in Orange County merged to form Orange Regional Medical Center, which eventually became a Garnet Health facility.

At a celebration honoring the 25th anniversary of CRMC in 2002, the Sullivan County Democrat reported Brien as saying, “There has been a lot of work done. We have revitalized our image.” He added, “Our future is wrapped with the future of the county. We will provide the best health care so people will not have to leave the county.”

In January 2003, Dr. Hal Teitelbaum, founder of Crystal Run Healthcare in Orange County, announced plans to open a Rock Hill facility and inquired about Catskill Regional Hospital privileges for its doctors. Shortly after, in the summer of 2003, the Crystal Run Rock Hill location broke ground.

In the summer of 2006, citing concerns about quality, Teitelbaum, then the president of Crystal Run, said that Crystal Run doctors would no longer treat patients at Catskill Regional. His doctors accounted for nearly a quarter of all doctors at the hospital.

In 2007, an affiliation between ORMC and CRMC was established under the umbrella of the Greater Hudson Valley Health System.

Also in 2007, according to Dunlavey, ORMC was contacted by the CRMC board of directors. “They were struggling, in the middle of a very large project with regard to the building, and were running into some challenge,” Dunlavey says, “They were behind schedule; they were over budget; and they reached out to our new CEO for help.”

Dunlavey says this is when the affiliation between the two hospitals “commenced” but it was never “a full asset merger; even till today, there are two separate boards,” at the Harris Hospital campus in Sullivan County and Middletown Hospital Campus in Orange County.

In 2007, a new board of directors was appointed to CRMC.

In 2011, Fred Kuriger joined as the new CEO of Catskill Regional.

In the fall of 2012, Catskill Regional laid off 25 management and nonmedical employees, saying that patient volume was down 10 percent for the year.

In 2013, an article in the Times Herald-Record asked, “​​Is it any wonder one doctor calls it ‘the incredible shrinking hospital?’ When Catskill Regional Medical Center laid off about 60 employees in May—or eight percent of its staff—the cuts marked the fifth time in the last decade Sullivan County’s only hospital slashed its workforce. As recently as 2006, Catskill Regional had 1,000 employees. It’s now down to 656.”

In 2019, Halso Advisors, a management consulting service company, spent a year at the Harris campus coming up with an initial feasibility study draft according to Dunlavey, but put it on pause in 2020 in the pandemic.

In 2020, both hospitals and medical services were rebranded under Garnet Health.

In 2021, Garnet Health Medical Center - Catskills closed its 64-bed skilled nursing unit, citing below-optimal occupancy level.

In 2023, Dunlavey says the feasibility study by Halso Advisors was revived and as of September 2024 is underway.

In 2024, Garnet Health - Catskills has vacancies in cardiology, full-time psychiatry, general surgery and orthopedics.

In September 2024 at a public town hall, the current president and CEO of Garnet Health Catskill said they will not be closing Garnet Health Medical Center-Catskills and are in the early stages of a feasibility study which is considering a building or moving the physical location of the hospital to a new location.

Sources:

Garnet Health Town Hall, September 6, 2024

http://www.sc-democrat.com/archives/2002/news/08August/02/crmc.html

http://www.sc-democrat.com/archives/2002/news/08August/02/crmc.html

https://www.recordonline.com/story/news/casino/2013/07/07/despite-bare-bones-conditions-catskill/42460634007

—Ruby Rayner-Haselkorn

MONTICELLO, NY — Services at Sullivan County Garnet Health facilities are being stripped and providers are scarce, claim residents. 

Garnet Health says there are no plans to close Sullivan County’s hospital and the hospital is actively recruiting for physicians. However, residents described being “farmed out” to receive health care at Garnet Health’s Middletown campus in Orange County. 

One resident characterized the situation as a “self-fulfilling prophecy.”

Over 80 Sullivan County residents, far more than attended a single legislative meeting this year, gathered in the hearing room at the government center on September 5 to talk about the state of their county’s health care. 

Holding back tears, Katie Childs, a mother of two, addressed Jerry Dunlavey, CEO of Garnet Health Medical Center - Catskills and vice president of operations for the system.

“What I’m not seeing is a focus on women’s health. I’m not seeing a focus on pediatric health, and we have to take care of people my age—otherwise, we’re gonna leave. If my child is sick, I have to drive them an hour for urgent care. And I’m emotional about that, because it’s scary, and I worry that this is not the right community for us.”

The organizers of the “town hall”-style meeting—Aileen Gunther, Assemblymember for NY-100, and Ken Walter, a member of the Senior Legislative Action Committee (SLAC), a group of residents who have for years attended most legislature meetings—sat at the front of the room next to Dunlavey. Given the lack of seating, attendees stood, lining the perimeter and back wall. 

No plans to close the hospital

Garnet Health owns and operates Sullivan County’s hospital, Garnet Health Medical Center - Catskills, Harris Campus; and the Grover M. Hermann Division in Callicoon. As one of few providers, it holds a large stake in the health care of county residents. 

Dunlavey addressed the claim that he had heard “in the community from time to time, that the hospital is closed and that we want to close the hospital.” He said, “I’m a growth-oriented health care executive. I enjoy building programs and increasing clinical services, and that’s not what we plan to do in terms of any concept of closing a hospital.”

“Another part of that,” Dunlavey said, “[is that] if we’re going to close the hospital, we’re just going to send everybody to Middletown.” 

Garnet Health Medical Center in Middletown has 384 beds and often has a census of 400 and an emergency department with 40 patients being seen, 20 patients in the waiting room and 40 patients waiting for admission, according to Dunlavey. 

Dunlavey said, “There is no capacity in Middletown to close one hospital and force everybody to go to Middletown. So I just want to emphasize that closure of our Catskill hospital is not an option at this time, and in fact, New York State would never approve of it.”

Garnet Health is currently in the early stages of a feasibility study that will consider building or moving the physical location of the hospital to a new location, Dunlavey said at town hall. 

Shrinking services

Childs told the River Reporter she attended the meeting because “we as a family have seen the services in the area decline,” and wanted to show up and “hear what the plans were for the future of Garnet Health.

“When I didn’t hear anything about expanding services to serve the population, I was hit on an emotional level,” Childs said. “In that moment I felt truly helpless.”

Neither the hospital in Harris nor the emergency department in Callicoon offer pediatric care. 

There is urgent pediatric care in Monticello but it is not 24/7. Childs said they could not find primary pediatric care in Sullivan County. 

There are no gynecological services available through Garnet Health in Sullivan County. 

A town hall attendee asked Dunlavey if the obstetrics unit was closed. 

“No, the OB unit is not closed. It’s one of the busiest departments in our hospital,” said Dunlavey.

“Delivery in Harris and OB is open?” asked the same attendee

 “That’s correct,” said Dunlavey

“What about GYN?” another attendee called out.

“OB/GYN services are available through Sun River Health and Crystal Run Healthcare,” said Dunlavey.

A Garnet Health employee from the Birthing Center in Harris said “Garnet Health does not have an OB practice.” The employee said there is one obstetrician from Sun River Health and three from Crystal Run who use the Harris facility for delivery, but there are no OBs available through Garnet Health. According to the same Garnet Health employee, it’s been about six months since Garnet Health has had an OB in Sullivan County.

Childs said she wanted to deliver her second child at Harris but was routed to Middletown because she was an older mother and Harris does not have the services to support a complicated birth. 

“Can you imagine being in labor and being like, maybe we should go now because it’s an hour away from the hospital?” Childs said.

Staffing 

Dunlavey says they are actively recruiting for vacancies in cardiology, full-time psychiatry, general surgery and orthopedics but, “its challenging.”

He says it’s especially challenging to recruit physicians, partially those needed for a hospital, into Sullivan County. “Recruitment of one doctor takes time. Recruitment into a rural community takes time. We continue to make an effort every day to fill all of those positions,” Dunlavey told the River Reporter.

Childs says that the lack of pediatric and OB/GYN services is part of the problem. “Let’s say you’re trying to attract a young doctor and she has children of her own or wants to build a family. You know those are going to be some of her very first questions and concerns. If we don’t have basic services in this community to attract young professionals, they are not going to be able to maintain a pool of qualified people, and we’re just going to have an aging population.” 

Erica Callender, a union representative for 1199 SEIU at Garnet Health’s Harris campus told the River Reporter, “We have had a few people who were hired, who applied for jobs at Catskill, but for some reason, they were rerouted to the Middletown side. Why? We don’t know.” 

“People are also applying and not being called,” Callender added. 

Callender said if someone leaves a position at Garnet Health Catskill they are not hiring people back into those positions, and the employees who are there are “upset” and “burnt out.” 

“There was a question, when a doctor leaves or is let go, does the hospital work to replace them? And the answer is yes, provided there is patient demand,” Dunlavey said.

Hiring people for per-diem positions rather than full-time is another practice Callender says is happening at Garnet Health Catskill. “You can’t live and feed your family in Sullivan County on a per diem job,” Callender said at town hall.

‘A self-fulfilling prophecy’

Residents say with fewer services and staff it’s inevitable that people are forced to seek care at the Middletown campus. 

Further distance for care also puts more pressure on local emergency services. 

​​Michael Bruce, captain of the Town of Cochecton Volunteer Ambulance Corps, said, “A lot of the things we used to be able to go to locally we have to travel for.” He said the acquisition of health care systems in the area has made things worse.

“When they formed Garnet Health, and Garnet and Catskill Regional absorbed Callicoon Hospital, they all became a health system,” he said. “Then it seemed, and I don’t know why, a lot of the services that were offered at Catskill Regional and Callicoon were stopped. They tried to close the ICU a skilled nursing home. They cut back on mental health. They’re taking away Sullivan County’s health care centers and funneling everything to Orange County. What they are mandating of us is taxing our system.”

One individual who spoke at town hall said there were more services before the merger between the hospital in Sullivan County and Orange County in 2007 (see sidebar). “Our understanding was, you were going to increase services, not take services there. There are no services in our emergency room,” the individual commented. 

Dunlavey said, “The average daily census of the Harris hospital is about 50 percent. There are days that we go up to the upper 60s, or low 70s, and there are days where we drop down to the 40s or the 30s.

One speaker at the town hall said, “You’re running at 90 to 100 percent capacity in Middletown because you’re taking from this county.”

Another attendee, Marion, asked, “Why, if there is an overflow of patients down in Middletown and only one-third of the patients in Harris?”

Dunlavey said that sometimes that does happen, but patients can refuse to be transferred. He added, “You have to go to a place where you can receive the care that’s needed.”

“So bring doctors from Middletown to Harris,” Marion said.

“Why can’t you bring services here?” someone in the audience yelled out. 

Dunlavey said, “We can’t force doctors to where they work.” 

Dunlavey said of Garnet Health’s total financial investments, approximately 70 percent has been on the Middletown campus and 30 percent in Catskill.

Next steps

After the town hall, Dunlavey told the River Reporter he wanted to have another smaller meeting with community stakeholders. “I think the next step is to get into some small conversations about health care.” 

“I recognize it’s part of my job, and I have a responsibility to the community, and I think that if folks are, you know, feeling a certain way, and they need to vent in a situation like this, that’s OK,” Dunlavey said. “I do know this, and I can speak about my organization, and everybody that works in my organization: we come to work every day committed to delivering great health care. We recognize that there are areas that we need to improve—what organization doesn’t need to improve? So how I feel is I appreciate it. I am going to respond to what I can, but I’m also going to keep my nose to the grindstone and continue to do the good work that I think we do actually. “

Deborah Worden, executive director of Action Toward Independence, an agency that helps any individual with a disability, asked, “What is our collective next action? What are we going to do? When are we all meeting again?” 

“Obviously there seems to be a little disconnect,” she said.

Childs said, “I think that while this meeting was a good first step to try to bridge the gap in communication, it almost feels like they would be better served walking a mile in our shoes.”

Katie Childs, a mother of two, addresses the town hall and asks Jerry Dunlavey, CEO of Garnet Health Medical Center - Catskills, a question.