For most athletes, access to diagnostic and surgical facilities is a given. But when the athlete weighs more than half a ton and has four legs, state-of-the-art sports medicine can be harder to come by.

Across the street from Belmont Park racetrack on Long Island in New York, a hospital named for a famed equine athlete, the thoroughbred filly Ruffian, has stood empty since 2011, a sign of fallen fortunes that seemed to mirror those of the ill-fated filly herself.

Ruffian ran her last race at Belmont in 1975. During the race, the top-ranked horse catastrophically fractured her right foreleg, yet refused to stop running despite her jockey’s best efforts. Ruffian further injured herself following surgery and was euthanized. For several years, it looked as though the hospital bearing her name would meet a similar fate.

But unlike its namesake, Ruffian Equine has a new shot at life. After several failed deals, the property, built for $18 million in 2008, has been purchased for $2.8 million. The new owner is an investment firm, Racebrook Capital, which also owns a new animal handling and quarantine facility at JFK International Airport.

Cornell University College of Veterinary Medicine, in turn, has entered into a 20-year lease agreement with Racebrook to operate the facility under the name Cornell Ruffian Equine Specialists. The agreement includes an option for Cornell to purchase the site before the lease is up, according to Dr. Alan Nixon, Chief Medical Officer for Cornell Ruffian Equine. Nixon would not divulge details of the lease. He also did not respond to emailed questions on how the university will fund the lease and operations, or the university’s financial expectations for the facility.

Funding and return on investment may prove to be key points for a business dependent upon an industry still cleaning up from the storms of recession. Statistics from the Jockey Club, the national registration organization for thoroughbred horses, show a roughly 30 percent decline in the annual foal crop from 2006 to 2012, and an approximately 10 percent decline in the number of U.S. races during the same period. With fewer horses and less money in the industry overall, equine veterinarians and hospitals suffered significant losses in numbers of patients and in revenues.

From 2011 to 2012, the decline in foal production leveled off. With those horses now hitting the racetrack, Cornell is poised to enter the field as the industry attempts to recover from the downturn.

Nixon said the revived Ruffian hospital will benefit the university by broadening its outreach and expanding the application of expertise by faculty in surgery, imaging and internal medicine/critical care. And it will benefit the racing industry, he said, through clinical research on poor performance and racehorse breakdown injuries. But teaching and research are not the facility’s chief priorities. “The main focus is service,” Nixon said.

Speaking enthusiastically about the possibilities the facility presents to the local horse industry, Cornell and equine medicine in general, Nixon said, “I think there’s been a sense of loss since Ruffian closed.” He pointed to the facility’s emphasis, before it closed, on advanced diagnostics and procedures such as treadmill-based upper airway assessment, nuclear scintigraphy (bone scans) and trauma surgery.

Nixon said the new Ruffian will bring expertise in orthopedics; upper airway surgery; assessment of poor performance, including the use of a high-speed treadmill and dynamic (while the horse is in motion) endoscopy; and imaging, including the use of standing MRI, mobile CT and scintigraphy. Equine hospitals possessing equipment for evaluations of this level are few and far between.

The Ruffian facility will partner with Cornell’s main equine hospital on the Ithaca campus and will refer some cases there. “We certainly don’t wish to duplicate the main campus hospital service and breadth,” Nixon said.

Ruffian also will not involve mandatory student rotations. Instead, the facility will offer externships to students from other veterinary schools in addition to Cornell. The “real teaching focus will be limited to the Cornell Ithaca veterinary teaching hospitals, with a downstate teaching focus extending only to intern and externship programs,” Nixon said.

Ruffian is not Cornell’s first venture into private-sector veterinary medicine. In 2011, the veterinary school opened a small animal referral and emergency hospital in Stamford, Conn. At the time, the venture came under criticism from some local veterinarians who perceived the university as unfair competition.

Saying that “the area is not too badly serviced at the moment” and referencing several equine hospitals in the region, Nixon says Cornell Ruffian’s specialized amenities will supplement the services provided by local veterinarians. While not discounting the realities of competition for caseload in a struggling industry, Nixon stressed that Cornell’s intent is “not to undercut local practices.”

The only private-practice equine veterinarian receptive to a request from the VIN News Service for comment was Dr. James Hunt, a racetrack practitioner at Belmont who was instrumental in the design and management of the original facility. Hunt said he believes that Cornell’s experience with the Connecticut practice made the Ruffian venture possible.

“They built a beautiful small animal practice, and now they’ll do the same with an equine facility,” he said.

Hunt, who no longer is affiliated with Ruffian, said he looks forward to seeing the hospital reopen and being able to refer patients there.

Ruffian Equine Medical Clinic originally opened in 2009 with the intention of providing world-class medical and surgical care for the region’s high-end racehorses and sport horses. The facility initially was funded by the racing consortium International Equine Acquisitions Holding (IEAH), owners the 2008 Kentucky Derby and Preakness winner Big Brown.

In the horse business, though, sometimes luck is everything, and by 2011, economic woes hit IEAH hard. The clinic ran out of money and time.

"Had the racing part not encountered difficulties, which hampered their (IEAH’s) finances, the hospital probably would’ve been successful,” Hunt said. He attributes the to failure to insufficient funding from IEAH during the hospital’s growth phase. “It was understood that funding would be available for operations as the hospital established itself,” Hunt said. “Unfortunately, that did not happen.”

Hunt said the capital was insufficient to keep the expensive facility operational until it could pay for itself. But the hospital did not lack for business. In fact, Hunt said, “We still had calls coming in ... a year after it closed.”

The new owner, Racebrook Capital, “typically invests in … distressed middle market real estate assets” among other things, according to Bloomberg Businessweek.

Both Nixon and Hunt pointed to a shift in the horse industry that is concentrating the reduced population of horses to fewer areas. Hunt sees an impact of hard times on private and university veterinary clinics alike. “It’s not desperation,” he said, “but there is movement and relocation by private practice clinics, ambulatory practices and universities like Cornell to areas where horse populations are more concentrated. There are a lot of vets and not enough horses.”

In the realm of thoroughbred racing, state regulations on racing and gambling affect the horse economy as much as the profits generated by the horses themselves. For that reason, Hunt sees reason for optimism in New York, which firmly supports the industry.

According to the New York Gaming Commission website, “The New York State Thoroughbred Breeding and Development Fund encourages the breeding and maintenance of Thoroughbred horses in New York by distributing financial incentives to breeders and owners whose horses compete successfully in New York-based races.” The fund receives a share of wagering revenues from at-track and off-track betting and a portion of the gross win on video gaming machines.

Hunt believes that decisions concerning the direction of gambling revenues may drive the future of the horse industry and the success of hospitals such as Cornell Ruffian. “If someone is going to buy a broodmare in foal, they want her to drop the foal in a state where the purse revenues are great and are going to stay great,” he said.

Nixon, too, sees “some aggressive changes in the availability of equine medical care. The anticipation, at least from our standpoint, is that the racing industry is undergoing changes; there is more concentrated racing of higher quality horses in several states,” he said. “Cornell wanted to position an affiliate hospital to accommodate horses at the New York tracks as well as the sport horses on Long Island.”

Nixon said he anticipates having four full-time veterinarians at Ruffian, including an internist with expertise in critical care; the clinical director, yet to be hired, who will be a surgeon; and several interns.

Additionally, Nixon and two other faculty members — Dr. Norm Ducharme and Dr. Lisa Fortier — will make the 4-plus-hour one-way drive from Ithaca to Elmont, Nassau County, each week to staff the hospital and perform more specialized surgeries.

Cornell Ruffian Equine is on schedule for a March 31 opening, although the full range of services the hospital intends to offer will not be immediately available. For example, colic surgery — major abdominal surgery to correct potentially life-threatening disorders of the digestive tract — is always in high demand but is not among the procedures that Cornell Ruffian is prepared to perform at the outset. Nixon estimates that it will be late spring before the facility is able to offer colic surgery.

Until it is fully staffed, Nixon said the facility will begin with elective and emergency orthopedic and airway surgeries, a regenerative medicine service, a sports medicine and poor performance clinic, advanced imaging and routine laboratory services. With the need for 24/7 surgical staffing in mind, Nixon says Cornell has begun a “push to get a surgeon there as clinical director.”

In order to succeed, Hunt said, Ruffian will need to become a full-service specialty hospital in short order. “I’ve recommended to them that the sooner and faster they get up to full scale, the more services they offer, the sooner they’ll get to that point where it can sustain itself,” he said.

He added that Cornell needs “to develop a rapport with the sport horse people on Long Island. The owners, trainers, and vets of this group of horses are desperately concerned about surgical colics.” In order to offer colic surgeries, an equine hospital needs a large staff, including more than one surgeon and several technicians, available around-the-clock. Hunt estimates Cornell may need about two years to reach that point. But, in the meantime, he said, “They’ll do very well on bone scans and diagnostic services.”

“Cornell’s a good group,” he concluded. “They’ve got the right approach…The fact that Cornell’s opened that hospital, that’s great. It helps owners, trainers, vets, everybody. It certainly helps the horse.”