By Arthur Schwartz
2 March, 2024
Mount Sinai Hospital still shows no concern about the anger and fear that its decision to close Beth Israel Hospital and the NY Eye and Ear Infirmary (NYEE) has engendered on the entire community below 23rd Street in Manhattan. On February 9, NY State Supreme Court Justice Nicholas Moyne issued a Temporary Restraining Order (TRO) directing Mt. Sinai to stop all movements towards a closure. The TRO is in effect through a hearing at a not-yet-set date in late April or May. The TRO has slowed Mt. Sinai somewhat. On February 10 and 11 Beth Israel “blocked” several beds in the Intensive Care Unit. However, a threat by the plaintiffs in the pending lawsuit got the beds reopened. But Mt. Sinai continues to move surreptitiously to effectuate a late March shutdown.
For those who haven’t followed this unfolding tragedy, Mount Sinai Hospital, which grosses $23 billion (not a typo) a year in revenue from its five hospitals in Manhattan, and which on paper “loses” money (about 1.5% of gross) in every one of those hospitals, has been on a seven-year campaign to close its two hospitals south of West 59th Street: Beth Israel and NYEE. Closing Beth Israel would leave Lower Manhattan without a full-service hospital south of 29th Street (Bellevue). On the West-side the nearest full-service hospital, other than Bellevue, would be St Lukes/Mt. Sinai West on 114th Street and Amsterdam.
In March 2021, after Beth Israel was forced to stay open during COVID, Mt. Sinai issued this statement: “The COVID-19 pandemic brought unprecedented challenges to our city, regional healthcare providers and the Mount Sinai Health System. These changes forced us to assess and rethink many aspects of how we can provide and improve care, including re-envisioning the future of Mount Sinai Beth Israel. Under our new plan, we will be staying on our current block and overhauling, modernizing, and investing in the current 16th St. campus. These changes will provide upgraded and enhanced facilities, as well as better enable us to surge capacity to meet the needs of our community, no matter what the future brings. One key aspect of the new plan is a greater flexibility of space and increased ability to expand the number of surge beds, should we need them. While we are still in the early phases of the process, under our new plan, we will be able to surge to the same bed capacity as we did during the height of COVID, which is also more than twice the surge-bed capacity as the old 14th St. plan. We will be able to provide more details and specifics soon but all planning on the new Mount Sinai Beth Israel campus will be subject to state review and approval.”
Now, Mt. Sinai is singing a different tune — not only have they decided not to invest, but they say the paper “loss” of $170 million a year on $3.7 billion in revenue, is just too much to bear. And they add that NYEE, one of the top specialty care hospitals in the United States, has to go too, even though the NY State Department of Health (DOH) said no. Its attitude is contemptuous.
A Community Coalition has been organizing to stop the closing, with the support of every elected official in Lower Manhattan. In late December, the DOH, embarrassed by a NY Post report that NYC Fire Department ambulances were refusing to bring stroke patients to Beth Israel, issued a Cease-and-Desist Order. Mt. Sinai, which sees itself as above the DOH, largely ignored the Order. It closed ICU and general surgical beds, shifted staff to other hospitals, and then thumbed its nose at the DOH and terminated its contract with the Mt. Sinai Ambulance Service, so that its Emergency Room volume plummeted. That when the Community Coalition went to court.
The Federal Centers for Medicare and Medicaid Services (“CMS”), which records provider-level data reflecting quality of hospital care, reports that Beth Israel, Bellevue and NYU Tisch-Langone receive “very high” emergency department patient volume (meaning they receive more than 60,000 patients a year). This designation represents the highest emergency department volume that the agency records. CMS further reports that patients wait well over three hours in each hospital’s emergency department before leaving the facility. While CMS does not collect data on New York Presbyterian/Lower Manhattan (a less than full-service hospital in the Financial District), it is inconceivable that a 170-bed facility could shoulder the burden of servicing patients displaced by Beth Israel’s closure.
Further, Lower Manhattan currently has five hospital beds for every 1,000 residents including Beth Israel. This is already the lowest bed-to-resident ratio in Manhattan. The Upper East Side has double the capacity, boasting 10 beds for every 1,000 residents and Upper Manhattan maintains six beds for every 1,000 residents. MSHS’s Beth Israel Closure “plan,” still wholly fails to account for how the remaining downtown hospitals, with already strained bed capacity “can accept [any] new patients,” much less carry the burden of the entire population Beth Israel serves.
This author (who is lead counsel on the lawsuit), gets calls every day from nurses, technicians and doctor, some sobbing, about the quiet moves that Mt. Sinai is undertaking to push the closure forward, even with the Orders in place. And I hear stories from neighbors who (like me) are alive today because they got to Beth Israel quickly and had a life-threatening illness addressed. I can report that I went to the hospital and sat in the lunchroom on Valentine’s Day and had a line of employees who wanted to talk. Beth Israel’s new president, Elizabeth Sellman, intervened and walked me out the door.
But this fight will continue – it is a life-or-death situation – FOR REAL.
Arthur Schwartz is the pro bono lead counsel in the lawsuit Community Coalition to Save Beth Israel vs. Mount Sinai Medical Center.
Photo: Community Rally December 3. Courtesy of NY Metro Health Care for All.
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