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River Hospital Celebrates Twenty Years of Healing

According to developmental psychology, the science that studies how and why we change throughout our lives, adulthood begins at the age of twenty. On April 15, 2023, River Hospital will mark its twentieth birthday with great celebration. Having survived a tenuous beginning, the hospital has matured into an essential and vibrant part of the river communities. Saving River Hospital was only possible with the help, commitment and support of its staff and its communities. As the story continues to unfold, this bond grows ever stronger.

On April 15, 2003 Alexandria Bay’s E.J. Noble Hospital was reborn as River Hospital. Since the hospital’s opening in 1941, dramatic changes in the medical services business had transpired, and demands upon this simple rural hospital threatened to surpass its capabilities. The hospital was in imminent danger of closure, although the need for a local hospital, particularly one accessible by boat or car, was undeniable. But time was of the essence, and close cooperation between the hospital, its staff and its constituents was the key to success. The situation was critical, and creative solutions had to be improvised. Quickly.

To be a sustainable enterprise, a hospital must generate income, largely through payments from health insurers. But the nascent River Hospital did not have a functional system to translate diagnoses and procedures, lab and radiologic results and even Doctors’ notes into alphanumeric “codes” used to populate insurance claims. As early as the summer of 2003 it appeared that existing funds would be gone by October 1st.  Without a coding system, no income had been generated since April 15th. Although some 3,000 Emergency Room records existed, there was no means by which to bill insurance companies. There were no coders.

Not until the end of the first year were formal Human Resource policies and procedures established. But the hospital’s dedicated employees, some of whom had been working on an “honor system”, stepped in to help with the financial nightmare. Registered Nurses and administrative employees worked side-by-side to create a new financial system, transforming medical records into codes and creating bills for submission to insurance companies. And they kept at it through October of 2004. The new financial system generated income urgently needed to keep River Hospital solvent in its earliest days.

At the same time, strong community support for River Hospital gathered quickly. Financial contributions, from year-round and summer residents alike, began to arrive. Offers of furniture, computer equipment, supplies and donations of other necessities arrived exactly when they were most needed. The local Masonic Lodge and area Fire Departments arranged to help perform basic maintenance at the hospital, and worked to rejuvenate the grounds on one Saturday each May, for four years. The communities demonstrated strong support early on, and have continued to do so for two decades.

Emily Mastaler, MA, MBA, became River Hospital’s Chief Executive Officer in September, 2019. “This hospital can celebrate its twentieth birthday thanks to the sustained efforts of our staff, our communities, our patients and our generous donors,” says Ms. Mastaler. “Our staff will observe this milestone over the course of a week with various activities and sweet treats. And we will celebrate with our communities and donors at every hospital event over the coming year. We are extremely grateful for everyone’s commitment.”

“River Hospital is a shining example of health care sustainability that rural hospitals often struggle with,” she continues. “This hospital has grown every year, expanding capabilities and services offered even though it operates in what can be a volatile business environment. The recent pandemic presented additional challenges. It’s rare to see communities work in such close alignment to preserve fundamental health care services, near home. Our communities “show up” for River Hospital, and we work hard to make sure that they receive the high-quality health care that they deserve. That tradition will continue.”

During the twenty years between “birth” and “adulthood”, River Hospital has developed in many notable ways. From 2003 through 2010, its allies rallied to confirm the hospital’s very survival, ensuring the preservation of local health care in Alexandria Bay. By 2020, through intensive support from the New York State Department of Health, unwavering staff dedication and generous community support, it stabilized operations while pursing excellence in community healthcare.  It was during this period that River Hospital embarked on its largest-ever modernization project: the popular and successful Hope + Healing Campaign. In 2021, it was the only hospital on the east coast named among the “Top 20 Critical Access Hospitals” by the National Rural Health Association. Through tenacity, resilience, compassion and partnership, River Hospital has truly set the standard for excellence in rural healthcare.

Since its birth in 2003, community support has been essential to River Hospital’s growth and development. To learn more, please contact Stephanie Weiss, Executive Director of Development, at This email address is being protected from spambots. You need JavaScript enabled to view it. or 315-486-2920.

By Wayne Strauss, Contributing Writer