Northfield Center -- Representatives from the Cleveland Clinic told the Northfield Center Sagamore Hills Fire District Board of Trustees the hospital will not keep the emergency room at the Sagamore Hills Medical Center on Route 82 open past Dec. 1.

About 30 area residents showed up at the Fire Board's Nov. 19 meeting and many expressed concerns about the closure, ranging from emotional ties to the emergency room, to wanting to know more about the express care unit the Cleveland Clinic is preparing to open in its place.

Dr. Brad Borden, chairman of the emergency services institute for the Cleveland Clinic, told the Board that the facility was only seeing 17 patients per day and receiving 2.3 EMS squad runs per day. He said that most of the patients were suffering from "lower acuity" ailments that would be best served by an express care facility.

Dr. Tarek Elsawy, also with the Cleveland Clinic, said the express care will be a walk-in facility staffed by nurse practioners and physician's assistants who can treat anything that is not life-threatening.

"Those providers are backed up by all the resources of everybody at the Cleveland Clinic," Elsawy said. "The express care model that we have is actually something we are using throughout the community and we're using in multiple different communities."

Northfield Center Trustee Paul Buescher said the change is sudden, and leaves the fire department with an urgent need to expand staffing due to longer transport times.

"It's leaving us high and dry, and it all comes down to money," Buescher said. "It's going to cost us $109,000 off the bat just for personnel."

Sagamore Hills Trustee John Zaccardelli asked Borden if there was any way to extend the Dec. 1 cutoff date to Jan. 1 to allow time for the district to staff properly.

Borden said no.

"Some of the staff have already transitioned out," he said. "That's set in stone."

Northfield Center-Sagamore Hills Fire Chief Frank Risko said significant travel time will be added when transporting patients.

"If we travel to Marymount, it's a 17-minute, 11 mile trip; if we go to Ahuja it's 19 minutes, 12 miles," Risko said. "If we go to Twinsburg we have University Hospital and Cleveland Clinic … they are roughly 14 minutes driving time.

"This is not as the crow flies, this is normal driving time. This adds a minimum of a half an hour driving time to each call, at least," he added.

Risko said inclement weather and road construction will be factors as well.

"We are going to do the best we can as a fire department to make sure our residents are covered and taken to the proper places at the proper time," Risko said.

Adding that time to travel means that squad is out of service, Buescher pointed out.

Mutual aid is available to cover when firefighters are away on longer trips, but Risko said the district doesn't want to burden neighboring municipalities, adding mutual aid is strictly for emergencies.

He said the district responds to more people than the city of Macedonia -- with a total of 18,000 people including seven schools, two nursing homes and a mental hospital.

Borden said the clinic is providing a lower cost-type of service to residents, and a lot of factors went into the decision to shift services.

Another concern from residents was the express care's 14-year-old minimum age for treatment.

Elsawy said the staff will be undergoing special certification training that will qualify them to treat younger children. He added the training should be complete by the end of the first quarter.

One resident asked if anyone from the Cleveland Clinic actually visited the Sagamore Hills facility prior to deciding to close the emergency room.

Borden said no "dedicated road trip" was made, adding the decision was based primarily on numbers.

He added there are two other emergency facilities being built near I-77 and Route 82 -- one by University Hospitals and another by Cleveland Clinic -- which Borden said would have caused a further decline in how many patients the Sagamore emergency room would see.

Risko said he would be meeting with Northfield Village Fire Chief Jason Buss, Macedonia Fire Chief Tim Black and possibly Valley Fire District personnel to discuss how everyone is going to handle the closing and transporting patients.

Briana Barker: 330-541-9432