University of Rochester Medical Center

The chief medical officer at Rochester Regional Health today said that due to nursing home admission limitations as many as 80 patients who are ready to be transferred to long-term care facilities or rehabilitation centers are stuck in the system’s hospitals.

“There are, on any given day, in our … hospitals, a combined 60 to 80 patients in this category,” Dr. Rob Mayo said. “So, it is a considerable number.”

RRH is an integrated health care system with nine member hospitals, including United Memorial Medical Center in Batavia.

Mayo (photo at right) took part in a video press conference with Adam Bello, Monroe County executive; Dr. Michael Mendoza, Monroe County commissioner of public health, and Dr. Michael J. Apostolakos, chief medical officer at University of Rochester Medical Center Strong Memorial and Highland Hospitals.

The session focused on the vaccine mandate imposed upon health care workers by Gov. Kathy Hochul and its effect on staffing at hospitals and nursing homes, as well as the situation in schools and delays in receiving care at hospital emergency rooms.

Mayo said RRH is working with the other health systems and community partners to alleviate the hospital-to-nursing-home logjam.

“What we do is continue to care for them, and we continue to look for options,” he said. “We work with our partner home care agencies … but, by and large, it is a challenge to do this.”

All three doctors emphasized that employee vaccination rates at their hospitals are very high – up to 99 percent at RRH and URMC locations – but acknowledged that lower levels at nursing homes are causing significant problems.

“Among nursing home staff not all staff fit into the same categories,” Mendoza offered. “When you look at the positions, the nurse practitioners who work in the nursing homes, the vaccination rate is like among other positions – upwards of 99 percent.

“What we’re seeing among other staff, particularly the nurse aides and CNAs (Certified Nursing Assistants) and so forth, their vaccination rate more appropriately parallels the demographic from which they are representing. So, if many live in the city (of Rochester), their vaccination rate as a population is roughly the same as the vaccination rate that we’re seeing in the city.”

Mendoza called it “an absolute concern … that represents a disparity in care and health access that we’ve been seeing all across this pandemic. It is a very important problem.”

He said nursing homes are limiting the number of admissions from the hospitals in order to “keep appropriate ratios in place.”

“Right now, unfortunately for the rest of the health care system, they’ve decreased their admissions, which is creating a bottleneck, if you will, across the entire system.”

Apostolakos said the nursing home issue has resulted in the inability to transfer 55 patients in the URMC system – almost 10 percent of its inpatient capacity.

“… those patients are still taking up acute care beds in our acute care hospital,” he said. “It is causing a significant percentage of our beds to be taken up and, therefore, making it more difficult to get patients through the emergency room and into our hospital, and to accept transfers into our facility.”

 HIGH PERCENTAGE ARE VACCINATED

Mayo said that as of Monday, more than 99 percent of RRH employees are vaccinated, with less than 1 percent placed on administrative leave because of their unvaccinated status. He also said that a small percentage requested religious or medical exemptions – and those were granted in compliance with New York State regulations.

Those employees who do not qualify for an exemption and refuse to get vaccinated will be terminated sometime in the morning of Oct. 3 (this Sunday), he reported.

“Despite the successes with this vaccination mandate and regulation, we do have understaffed areas,” he said. “Many people are working overtime. We have patients in our hospitals awaiting discharge and we pleased to participate in a community-wide effort to create solutions for hospitals and for nursing homes … so we can all move patients into their appropriate environments as quickly as possible.”

He also said RRH is participating in efforts to managing strains on pediatric practices and the impact of COVID in schools.

Apostolakos said that more than 96 percent of URMC employees have been vaccinated, another 3 percent received religious exemptions and less than 1 percent elected to resign their positions.

“The not so good news,” he said, is the increasing number of COVID cases.

Sixty-nine patients at Strong have COVID, with 15 of those on a ventilator, he said, and another 84 are at other URMC facilities.

“That number continues to increase,” he said, adding that most of those patients are unvaccinated.

He pleaded with the community “to get vaccinated for yourself, for your family, for your community and for our health care workers that have been under stress and strain for the past 18 months.”

Bello said 93.8 percent of workers at Monroe County Hospital are vaccinated, with 61 employees not vaccinated, seven receiving exemptions and one who has resigned.

He said the unvaccinated workers have been placed on unpaid administrative leave for three months, but would be welcomed back if fully vaccinated.

The county executive said employees are working under stressful conditions and that he was disheartened to see people protesting in front of hospitals.

“The patients inside are sick; they’re seeking care. The health care providers are working long hours, under considerable stress. Neither patients nor health care workers deserve the disdain and anger that’s being targeted towards them and where they work,” he said.

MENDOZA: STUDENT ILLNESS INCREASES

Mendoza spoke about situation in schools, noting that they are seeing an unseasonal increase in Respiratory Syncytial Virus or RSV, which causes mild symptoms in school age kids but can be serious for infants, toddlers and older adults.

Also, a growing number of school age children who have contracted COVID-19, he said.

Per state Department of Health guidelines, the only authorized tests are the NAT and PCR tests, he said, and not the rapid antigen tests due to Monroe County’s “high” transmission status.

He said health officials are working with schools to increase testing capabilities, a procedure that is also taking place in Genesee County.

“Do not send your sick children to school. Make sure they are properly masking and follow all of the other safety protocols in place … and if they are eligible, please get them vaccinated,” he said.

EXPECT DELAYS IN THE EMERGENCY ROOM

Both Apostolakos and Mayo said that for the immediate future, delays in the emergency rooms, waiting rooms and even some urgent care centers are inevitable.

The emergency department has a triage process, with priority is given to patients depending upon severity of illness or injury, Apostolakos said, “so the wait could be several hours.”

“We encourage our patients to call their primary care providers to seek health care at urgent care if their illness is less severe,” he advised.

He also said URMC is pausing temporarily some elective surgeries where hospital stays are necessary to ensure there is enough space for patients admitted with COVID and other non-COVID illnesses.

Mayo said RRH emergency rooms and urgent care facilities have been crowded over the last couple weeks.

“It’s disappointing to acknowledge … but waits in our emergency rooms can be long; they can be several hours,” he said.

Many outpatient services have been unaffected, he said, but RRH hospitals are limiting some elective surgeries, primarily at Rochester General Hospital.

Drs. Andrea Kudel, left, and Kelly Rose Nichols are on staff and accepting new patients at Le Roy Medical Associates. The primary care practice opens today at its new location at 127 W. Main St., Le Roy.

When it was time to recruit doctors for its primary care practice in Le Roy, the University of Rochester Medical Center didn’t have to look far.

Kelly Rose Nichols, D.O., grew up in Le Roy as a member of the Stein farming family. She went to medical school in Philadelphia, but never felt comfortable in a big city.

“I grew up on a farm,” Nichols said. “I couldn’t figure out how to lock and unlock the house!

“It was about six weeks before the novelty of being able to walk everyplace wore off. I said, ‘This isn’t for me, I need to go home.’ ”

Now, she and Andrea Kudel, D.O., have joined longtime practitioner Vladimir Gaspar, M.D., in a relocated and much-expanded Le Roy Medical Associates.

The practice was formerly located on Lake Street Road. It reopens today in its new location in Le Roy Village Plaza at 127 W. Main St.

Hometown medical practice is familiar territory for Nichols, who picked her profession early in life.

“When I was 3, I had the Fisher-Price doctor kit,” she said. “I literally had no other career plan.”

When she was in high school, Nichols thought she should get some hands-on experience. As it happens, she worked for Dr. Lorne Campbell, whose Genesee Family Practice at 8745 Lake Street Road eventually became Le Roy Medical Associates.

“I would come in after school, file charts, and invite myself to exciting stuff that Dr. Campbell was doing,” Nichols said.

Nichols went on to earn a bachelor’s degree in Biology at the University of Rochester, and then her doctor of Osteopathic Medicine degree from the Philadelphia College of Osteopathic Medicine.

Kudel, meanwhile, was following a similar career path.

She grew up in Williamsville, and had decided on a medical career by second grade. (“I commit to things, and that’s it,” she said.) She earned a bachelor’s degree in Biomedical Sciences from the nearby University at Buffalo, then a doctor of Osteopathic Medicine degree from the New York College of Osteopathic Medicine in Nassau County, Long Island.

Their paths crossed during their residencies in family medicine at Sisters of Charity Hospital in Buffalo, where Kudel was chief resident.

They also formed a friendship. So earlier this year when URMC was recruiting a doctor to practice Le Roy — well, Nichols happened to know a great candidate in Buffalo.

Le Roy is a small town, but it’s minutes away from URMC and everything else Rochester offers. Kudel calls family practice here, “the best of both worlds.”

“I like getting to know people better,” said Kudel, 30, who lives with her husband in the Town of Sweden. “You know where they’re coming from; you get to understand them in a more comprehensive way.”

Nichols, 30, lives in the Village of Le Roy with her husband, Ben Nichols, and their two daughters.

“This is truly family practice,” Nichols said. “And you feel like you’re more a part of the community.”

The Le Roy primary care practice was formerly part of Lakeside Health System of Brockport. It was one of the properties sold after Lakeside closed in 2013, and renamed URMC’s Strong West.

Its growth reflects URMC’s commitment to to the region, said Dr. Wally Johnson, who directs UR Medicine Primary Care.

“These are appealing places to work, and it’s where the need is,” he said.

Johnson said Batavia has a “thriving” hospital in United Memorial Medical Center, which just this summer completed an affiliation with Rochester General Health System.

“But we know there are people in the area who want to have University of Rochester doctors as their primary care practitioners,” Johnson said. “So we think it makes very good business sense to expand our presence in the area.”

Down the road, UR may recruit another physician assistant or nurse practitioner as required in Le Roy, Johnson said.

Both Nichols and Kudel are happy with the new location, which is on one floor — and thus more handicap-accessible — and at least three times bigger than the Lake Street Road site. A new medical laboratory is on site, too.

Nichols said Dr. Gaspar has always focused on customer service. But additional exam rooms will accommodate more patients, and cut down on wait times.

“This is going to be a nice change,” Nichols said.

Le Roy Medical Associates is planning an open house for 5 to 7 p.m. Jan. 20. Meanwhile, both Nichols and Kudel are accepting new patients. For information call (585) 768-2620.