Pulled Back from the Precipice
By Arthur Z. Schwartz villageview.nyc 28 March 2024 Two weeks ago, I delivered a “we lost” message to the broad coalition of community activists and leaders, who had endeavored since 2018 to keep Beth Israel Hospital open. But, in fact, this fight has now backed off the precipice. City lawmakers and health care advocates protest Mount Sinai’s decision to close Beth Israel hospital on March 24th. Photo by Gerardo Romo/NYC Council Media Unit. As we have often reported, Mount Sinai Hospital has been plotting for years to close Beth Israel. (In 2021 they announced they would keep Beth Israel open and invest $1 billion in improving the facility and services. The closure would leave no full-service hospital in Manhattan south of 30th Street (Bellevue). On the West Side, the nearest full-service hospital is St Luke’s/Mt. Sinai Morningside on 114th Street and Amsterdam. Downtown would have the small Presbyterian Downtown Hospital, which is not a full-service hospital. The problems go beyond the distance needed to travel to get emergency care; it’s that the two hospitals on First Avenue between 30th and 34 Street (Bellevue and NYU) are already overcrowded. Beth Israel, pared down since 2017, still sees 70,000 E.R. patients a year. They absolutely could not squeeze into Bellevue and NYU without a calamity. And should another COVID-like pandemic hit, Lower Manhattan would be overwhelmed. But the greedy executives at Mt. Sinai, with their multi-million-dollar salaries, really could not care less. Nor it seems, does Governor Hochul who has been pushing to close state-owned Downstate Hospital in Central Brooklyn. In turn, this has met huge push-back in the Assembly and Senate. Last October Mt. Sinai released a plan to the State Health Department (DOH) to close Beth Israel by July 2024. A few weeks later they released an Amended Plan to close by the end of March-early April. Although DOH regulations require no diminishment in services until a closure plan is approved, Beth Israel started closing immediately. We now know that on 11/2023 the ICU beds were decreased from 24 to16. On 11/11/2023, a 32-bed medical telemetry unit was closed. On 12/3/2023, a 30-bed medical surgical unit was closed. As of 12/15/2023 only emergent cardiac catheterization procedures were performed. No “elective” (scheduled) procedures were allowed. (Like getting a stent in your heart is “elective.”) As of 1/25/2024 cardiac catheterizations were running at 1-4 cases per day; prior to that there were 15-20 per day. After 12/31/2023 the Emergency Department no longer accepted categories 4 and 5 stroke patients. After 12/31/23 the MRI on-call service (12:00AM – 8:00AM, seven days a week) was cancelled. CAT scans were no longer performed in the ED. Outpatient CAT scans were no longer performed. As of 1/26/2024, outpatient elective surgeries were stopped. Only emergent surgeries were performed. And on and on. Even after the DOH issued a Cease-and-Desist Order on December 17, 2023, the arrogant folks leading Mount Sinai barreled full speed ahead. A lawsuit was filed in February by the Community Coalition to Save Beth Israel and NY Eye and Ear Hospital, and the Center for the Independence of the Disabled NY, alleging violations of the Public Health Law, the NY Constitution, disability rights laws and environmental laws. One week in, we got a Temporary Restraining Order to stop closure of any other services. But on March 5, the press caught wind of a Fire Department directive to stop bringing heart attack victims to Beth Israel. Beth Israel told the press that they had lost staff and could not do the procedures safely. Within minutes my phone rang; two nurses from the Cardiac Unit called and said, “It’s a lie. We haven’t lost any staff.” They gave me all the details. On March 10, the FDNY stopped bringing heart attack patients. On March 12 we were in Court seeking a new Temporary Restraining Order. The next day we met with Judge Nicholas Moyne and he was incensed. That morning a Federal Report came out accusing Mt. Sinai of illegally diverting ambulance patients away from the Beth Israel Emergency Room. On March 13, with an incensed judge, who thought his prior TRO was being violated, we thought the fight was over. Mt. Sinai’s five lawyers told the judge. “There is nothing we can do. Doctors and staff are leaving en masse. We have a huge group of physician resignations effective March 31. It’s going to be difficult to operate after that.” And guess what? March 31 had always been the target date to close most of Beth Israel. Mt. Sinai hadn’t missed a beat, despite a Cease-and-Desist Order from DOH and a court Restraining Order. Our hearts sank; we began to explore a sit-in at the Governor’s office. The judge called us in for a hearing on March 25 to see what he could do. All of a sudden on the morning of Friday March 22 we got an email from Mt. Sinai’s lawyers. They would agree to a new restraining order. They suggested one which was still not going very far. Then it was revealed that they had been served with a DOH “Finding and Order,” which listed dozens of Public Health Law violations -closures of services without permission – since November and demanded a response within 10 days about how those services were going to be reinstated! In my 45 years of practice, I have never seen lawyers from a white shoe firm more shaken. And as we go to press, the judge has issued an order requiring reinstatement of the full catheterization lab and “best efforts” to restore all services back to December 17, 2023. Mount Sinai is promising to hire doctors back and restaff, while also calling the DOH findings unfounded, blaming everything on the loss of staff that they just could not control. Fact is, they pushed the staff out. Mount Sinai’s press release on March 26th:“The basic truth remains: the dilapidated 16th Street hospital is simply not sustainable and continues to hemorrhage staff and resources. We must close MSBI and nothing about today’s allegations changes these facts.” Arthur Schwartz is the lead counsel in Community Coalition v Mt Sinai Hospital System. https://villageview.nyc/2024/03/28/pulled-back-from-the-precipice/