A downsized Brooks-TLC Hospital System facility planned for Fredonia is expected to include more medical offices and fewer beds than the current site in Dunkirk. It may also be without an obstetrics unit due to a continued lack of staff and a small volume of births handled in recent years.

Both Mary E. LaRowe, president and chief executive officer of Brooks-TLC, and Mike Hughes, senior vice president and chief administrative officer for Kaleida Health, expressed optimism regarding the new build while noting continued challenges facing smaller institutions. “Rural health care has been in dire straits for years,” LaRowe said in an interview with the OBSERVER. “While a lot of rural hospitals have closed, we’re doing everything in our transition plan to avoid that at all costs.”

Brooks-TLC’s financial woes have been well documented since 2008 when they attemped to go from competing entities in Irving and the city to both being under one umbrella. Over the last 13 years, the deficits have been massive and ultimately forced the closure the Lakeshore Hospital location in February 2020 — right before the start of the COVID-19 pandemic.

In 2020, LaRowe said, the hospital ran a $19.6 million operating deficit, but received $11.7 million in federal COVID funding. The 2021 deficit, which is unaudited, is reported at $11.7 million.

As virus numbers have waned in recent weeks, both LaRowe and Hughes aim to get state officials — and those locally — refocused on the region’s health-care future. “It’s time to get the conversation and the project back on track,” Hughes said regarding the new facility. “COVID was certainly a necessary distraction, but more than anything the community deserves a decision in terms of moving forward. What’s it going to look like, what’s it going to be.”

Six years ago, New York state announced $57 million in funding — with another $13 million delivered a year later — to transform and improve the delivery of health care in northern Chautauqua County with some strings attached. Most importantly, Brooks would have to transition out of an antiquated Central Avenue site that is too large for the community it serves.

Within the last month, as noted by Chautauqua County Executive PJ Wendel last month, letters of support from community and hospital leaders have been sent to major state Health Department officials as well as Western New York native and Gov. Kathy Hochul. “We just thought the time was right to try and jump start a dialogue and make sure that the state understands the importance of this project and hat it means to rural health care and what it means to Chautauqua County in particular,” Hughes said. “We’re trying to make sure the decision makers in Albany understand the importance of the project and that there’s a consensus that people want to see this get done.”

State officials re-emphasized their commitment to the major project last week. “To ensure that access to essential health services for the community is maintained, we continue to work with the leadership of Brooks Memorial and other health-care providers, as our commitment to the community has not changed,” said Jeffrey Hammond, department spokesman.

Throughout the rough financial road, New York state has not failed Brooks or community residents. More than $22 million in state subsidies have been paid, according Internal Revenue Service documents, from 2017 to 2019.

Through the new Fredonia location, at the former Cornell Cooperative Extension site on East Main Street, the hope is that Brooks-TLC will become financially stable. “We are looking at an amplified medical office building concept to house our providers in so that it’s convenient and easy for the patient population,” LaRowe said.

Besides fewer beds — the Dunkirk site has about 35 that are staffed, there may not be a birth unit in Fredonia. In early October, the hospital suspended operations due to what it called staffing challenges.

“We’ve been trying to recruit, which has been extremely difficult,” LaRowe said, noting the volume of births remain low for the facility as emergency deliveries are continuing as needed. “It’s not the ideal situation.”

Moving forward, LaRowe said there is “anxiousness and excitement” regarding the possibilities that exist with a new Brooks-TLC site. “Obviously, 2020 and 2021 with COVID, was extremely challenging and the community supported us,” she said. “We certainly anticipate we’ll do our best to meet the community’s health needs going forward and consider ourselves in a partnership with them to make sure we address what is needed for the future.”