Arthur Handley, director of perioperative services at Adirondack Medical Center, gives a tour of the Saranac Lake hospital’s new operating rooms in January 2019. (Enterprise photo — Jesse Adcock)

SARANAC LAKE — The state is now letting hospitals in some counties, including Essex and Franklin, do elective outpatient procedures, and local hospitals are piecing together plans to restart them.

Elective procedures keep many rural hospitals afloat, and the state-ordered cancellation of those services, to curb the spread of the novel coronavirus and make room for an anticipated influx of COVID-19 patients, has been a financial blow to most health networks in the North Country. Hospitals around the region have reported multi-million-dollar losses since the order was put in place on March 22.

Gov. Andrew Cuomo has acknowledged the financial pressure hospitals are facing, and he announced a plan on April 21 to let hospitals outside of COVID-19 hot spots restart some outpatient procedures — as long as patients test negative for COVID-19 before being treated, and hospitals are able to keep 30% of their bed capacity open in case of a surge of COVID-19 patients.

Details on reopening elective procedures are still forthcoming from Adirondack Medical Center in Saranac Lake, run by Adirondack Health.

“We’re looking forward to the safe resumption of outpatient elective surgeries and procedures,” Adirondack Health spokesman Matt Scollin said. “Right now, we’re reviewing the state health department guidance that accompanied the governor’s executive order and providing some additional information and documentation requested by the state.”

Elizabethtown Community Hospital doesn’t have a surgical department but offers outpatient procedures in Elizabethtown and Ticonderoga. Its first doctor to resume services will be Dr. Lynne Macco, who specializes in obstetrics, gynecology and medical acupuncture. Her clinic hours will restart on May 11 in Elizabethtown.

“Dr. (Eugene) Cassone, a gastroenterologist, is expected to start May 13 at Elizabethtown and May 18 in Ticonderoga,” ECH spokeswoman Elizabeth Rogers said. “The remainder of our clinic schedule is being confirmed and will be shared on our website, ECH.org.”

Asked on Thursday if Malone’s Alice Hyde Medical Center plans to restart services, which procedures would be available and when they would be available, spokesman Phillip Rau said it’ll take some time for hospital administrators to answer those questions.

“That’s not an easy question to answer, and our first priority remains the safety of our patients and employees, as well as ensuring we deliver high-quality care to our community,” he said. “We plan to prioritize restarting services based on the needs of our community. Restarting any medical service line takes an incredible amount of planning and coordination, especially as we take into account the risks associated with COVID-19.

“The governor’s executive order gave us the authorization we need to move forward with our planning process, but it was only the first step,” he added. “We have a lot of work to do before we are ready to welcome elective patients back to our campus, and we look forward to sharing more information with our community as we put our reemergence plans in place.”

The Albany Times Union reported Wednesday that even before the coronavirus pandemic reached New York, hospitals in this state had the lowest operating margins nationally, with revenue exceeding expenses by 1.7%, according to Cristina Batt, vice president of federal relations for the Healthcare Association of New York State.

Elective surgeries, as well as the medical imaging and testing that goes along with them, serve as a significant money-maker for rural health care providers that serve relatively high numbers of elderly and low-income patients. With elective surgeries canceled, many North Country hospitals have seen their revenue plummet in a time when they are being asked to increase their capacity. The revenue loss has prompted many health networks to either furlough or layoff staff.

Seeing the toll of these revenue losses on hospitals across the country, Congress passed the $2.2 trillion Coronavirus Aid, Relief and Economic Security Act last month, which set aside $100 billion for hospitals and community health centers. Last week Congress voted to add another $75 billion to the CARE Act’s Provider Relief Fund for hospitals. Around half of the first round of federal aid for hospitals had been disbursed as of Thursday.