Lake Placid transforms former emergency room into primary care facility

Community celebrates new health services, while still recovering from loss of ER

By Lauren Yates

The former emergency room at Adirondack Health’s Lake Placid Health and Medical Fitness Center is now a four-doctor primary care facility, a shift in community health services that local officials and emergency service workers say has its benefits and drawbacks.

The Lake Placid ER was among three Adirondack Health facilities shuttered or sold in 2023 as the hospital dealt with staffing issues, early pandemic losses and more than $14 million in reported losses in 2022. 

Adirondack Health closed its Lake Placid dental practice in June 2023 and sold its Tupper Lake nursing home, Mercy Living Center, in Aug. 2023. Later that month, it discontinued the Lake Placid ER.

Hudson Headwaters Health Network, or HHHN — a Queensbury-based nonprofit that now has 24 health centers across the Adirondack and Glens Falls regions — announced this past April that it was partnering with Adirondack Health to convert the former ER into a new primary care office called Family Health at Lake Placid.

Since the Lake Placid office opened on June 24, doctors have seen more than 270 patients— 52 of which are new patients, according to Hudson Headwaters Director of External Affairs Pamela Fisher. 

The office has five exam rooms for family medicine, care management, family planning, behavioral health and preventative women’s health. The facility also serves patients with “acute needs,” providing same-day services to people already enrolled as patients with Hudson Headwaters. 

The Lake Placid office has six staff and four providers —Danielle King, Emily Monaco, Sarah Thompson,  and Arianne Wilson. They’ve already been working in the community as doctors at Hudson Headwaters’ primary care offices in Tupper Lake and Adirondack Health’s Saranac Lake hospital, and Fisher said they’ll continue to work at multiple locations. 

Jessica Rubin, a HHHN vice president, said the group often looks to hire staff from its existing ranks,  a benefit to the health network and a side effect of hiring in a housing-crunched community. 

Adirondack Health told the Adirondack Daily Enterprise in 2023 that it had struggled for nearly three years to hire a dental hygienist at its Lake Placid dental facility.

Recovering from the loss of emergency services

North Elba Supervisor Derek Doty told the Explorer on Tuesday that he was “happier than hell” to have more primary care in the area. He and Lake Placid village Mayor Art Devlin praised what they see as a blossoming relationship between Adirondack Health and Hudson Headwaters, which now operate facilities with more than 8,000 patients in Saranac Lake, Tupper Lake and Lake Placid, according to HHHN CEO Tucker Slingerland.

But the town and village are still reckoning with the loss of the ER.

“We have to take a step back and realize that, no matter what we did, we weren’t able to save the emergency room,” Devlin said. 

The Lake Placid ER’s closure drew criticism from some community members and officials, who argued that taking the ER off the map could stretch already-strapped emergency services departments and endanger critically ill patients by forcing rescue squads to travel further to the Adirondack Health’s hospital in Saranac Lake.

Rick Preston, deputy town supervisor and executive vice president of the Lake Placid Volunteer Ambulance Service, said losing the ER has doubled the ambulance squad’s call times from 30 minutes to an hour. 

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Lake Placid’s rescue crews typically work in 12-hour shifts, with one ambulance driver and an EMT per shift. A backup crew is on call for each shift, but Preston said many rescue members don’t live in the area because they can’t find housing in the village — they can’t get there fast enough when multiple calls come in over a short period, and the department has had to call for mutual aid from nearby squads in Saranac Lake, Wilmington and Keene. 

Preston said back-to-back call volume is only increasing. There were a total of 25 back-to-back calls last year; the department has already fielded 26 this year.

Over the last week, Preston said the squad started bringing an extra person on duty per shift. He called it a safe but costly move; the historically self-sustaining ambulance department has had to seek funding from the town to cover extra employee hours. 

This year, North Elba budgeted $67,000 for ambulance services. Now, the ambulance service is looking to bring on at least one extra employee to adjust to the new travel times.

“It does affect the taxpayer,” Preston said.

Devlin said the closure has had similar effects on Lake Placid’s short-staffed police department. Still, he sees the loss of the ER as a necessary step to keeping Adirondack Health’s Saranac Lake hospital open.

Hudson Headwaters’ expanding services

As urgent and emergency services across the North Country shrink, Hudson Headwaters is expanding its primary care services around the region. A recent partnership with the University of Vermont Medical Center Dental Residency program brought five dental residents to the network’s Warrensburg health center. They started on July 1.

Hudson Headwaters is slated to open its 25th health center in Plattsburgh in August at Plattsburgh Pediatric and Adolescent Health. Fisher said the network is seeking state funding to expand dental services in the region. 

Collaboration, like the one between HHHN and Adirondack Health, is necessary to sustain rural healthcare, Rubin said.

“The only future is a future that’s everyone working together,” she said.

Rubin said HHHN is also looking to expand its scope to make “direct community investments” and partner with local nonprofits like the Adirondack Foundation and the Homestead Development Corp., a developer which has so far built two affordable housing complexes in Lake Placid, to address local needs like housing, childcare and transportation.

“If we don’t address these things, it’s going to show up downstream as negative health consequences,” she said.