Providing sustainable hospital care in remote, rural areas is becoming increasingly challenging, intensifying the search for effective models of regional health systems. Gouverneur, a rural community in the southern corner of St. Lawrence County, was living under the threat of being without hospital services following the closure of EJ Noble Hospital in 2012. The closed hospital entered into a management agreement with Canton-Potsdam Hospital (CPH), who collaborated with other community organizations—United Helpers, Community Health Center of the North Country, Kinney Drugs, and Clarkson University—to reopen the facility's laboratory under stringent quality standards.
A primary care center was opened in the closed facility, new practitioners were recruited, the confidence of existing practitioners was restored, and the OR was re-opened for minor surgeries. The two hospitals then came together and formed a permanent health system affiliation. The new hospital is now open, employing a majority of the former staff. The community of 18,000 residents now has a stable, financially sustainable health system on which to rely for its health needs, and the county has a working model of regional collaboration.