Columbia Memorial Hospital serves two primarily rural counties - photo Rokosz Most
60-something, Bari Senecal waits outside the emergency department at Columbia memorial in the City of Hudson, on one her aluminum-frame rollator. Brought by ambulance from the hinterlands at the border of the county the night before, now a car service will have to drive her back. The sky above is hazy with ash blown in from far-away Canadian forest fires. She smokes a cigarette while she waits.
“I fell three stories,” Senecal explains. “I was on top of the scaffold and this new kid we hired didn’t put the braces on correctly.”
“I do construction,” she adds.
Like 70 million Americans- 7.5 million of them New Yorkers- Senecal qualifies for Medicaid, the federally-funded public health insurance program which provides for the care of low-income patients. She also qualifies for Medicare, a health care program intended for those 65 or older, or living with permanent disability or end stage renal failure. She’s what’s known in the business as a ‘dual-eligible.’
At Columbia Memorial, 63 percent of patient service revenue is reimbursed through a combination of the two programs. But reimbursement by the federal government comes up short.
“We still provide care in our communities but we run a deficit every year,” explains Dorothy Urschel by cellphone, CEO of Columbia Memorial Health. “For many, many years, we’ve been reimbursed at well below cost.”
Providing the only emergency room for more than 110,000 residents scattered anywhere among 1,306 square miles in two counties separated by the Hudson river – Greene County to the west, Columbia county to the east- Columbia Memorial hospital is considered a rural hospital.
“Of course, we’re struggling,” says Urschel, “but rural community hospitals always struggle.”
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