By Penny Mintz
On July 22, 2019, Mt. Sinai submitted an application to the State Department of Health for a certificate of need (CON) to build a 70-bed hospital on Second Avenue between 13th and 14th Street. If the plan is approved, the Beth Israel Hospital building on First Avenue and 16th Street will be closed. Beth Israel is certified to operate 774 beds, of which between 250 and 300 are occupied every day by medical and surgical patients. Those 250-300 actively used beds will be replaced with 70.
The public first learned of this plan in May of 2016, when three nurses first leaked it to The Villager. Since then, despite concerns that have been voiced by individuals, community groups, and every locally elected official, nothing in Mt. Sinai’s plan has changed other than the timing of the closure. They have been deaf to all community concerns.
Mt. Sinai has consistently asserted that one of the primary reasons for the closure is “a rapidly declining inpatient census” at Beth Israel. But census numbers can be easily manipulated. According to the three Beth Israel nurses quoted in The Villager, after Mt. Sinai took over Beth Israel, busy units stopped hiring sufficient staff, particularly doctors, to serve the existing demand. Doctors’ salaries were cut, which caused doctors to leave, particularly in general medicine and the surgical O.R. When doctors leave, patients are diverted to the doctors’ new hospitals. So it may be that, to a significant extent, the census decline is the result Mt. Sinai’s decisions and actions, not a diminution in the need for hospital services.
In a letter to Mt. Sinai in July, 2016, all 17 of the city, state, and federal elected officials representing lower Manhattan asked Mt. Sinai for data to support the claimed census decline. They wanted to know how the decline compared to other hospitals in Manhattan. They asked how many patients could be shifted to ambulatory care and to other Mt. Sinai facilities if the current 295 medical/surgical beds in use are transitioned to a 70-bed facility. No studies were conducted to answer these questions.
Mt. Sinai also asserted in 2016 – and reasserted in its recent CON – that Beth Israel is losing over $100 million a year. As we know from President Trump’s financial statements, these numbers can easily be manipulated. Mt. Sinai’s figures need to be substantiated with an independent audit.
Elected officials and community members have repeatedly asked these questions, as well as life-and-death questions about the sufficiency of health care accessible to downtown residents.
At a public forum in April, 2017, Mt. Sinai’s Jeremy Boal faced angry and concerned residents and elected officials when he presented the plan to replace Beth Israel with a 70-bed facility. The community and its elected officials wanted an independent assessment of community needs, and they wanted Mt. Sinai to be responsive to those needs. Boal said that there was no time to conduct an assessment. So, they were determined to go forward no matter how much pain the plan might cause lower Manhattan and the vulnerable members of its population.
Now, more than two years later, no independent assessment has been made and Boal has again presented the exact same plan to the NYS Department of Health and to the community. This time, instead of appearing at a forum to explain the transition, Dr. Boal wrote an article for The Villager extolling the plan that raised so many concerns in 2017. Mt. Sinai has not only been unwilling to respond to the concerns of the public and its elected officials, it is no longer even willing to send someone to face the community.
One of those elected officials, State Assembly Member Harvey Epstein, is deeply concerned about Mt. Sinai’s CON. “Mt. Sinai’s unwillingness to engage in an open dialogue with the community and change their plans based on community feedback raises serious questions,” says Epstein. “I expect complete transparency throughout this project. Lives can depend on this.”
Transparency has not been the hallmark of this process. At this point, the public will have one opportunity to testify prior to the approval of the CON by the Department of Health. The application will be reviewed by Public Health and Health Planning Council (PHHPC), which advises the Department of Health. PHHPC’s Establishment Committee will conduct one public hearing. Unfortunately, they do not make it easy to find out when and where the hearing will occur. That information is not released until a week before the hearing.
If you want to attend the hearing, write to Deputy Commissioner Daniel P. Sheppard, NYS Department of Health, Empire State Plaza, Rm 1415, Albany, NY 12237. Ask to be informed about the meeting as soon as it is scheduled, and ask that the meeting be held in the evening, so that working people might be able to go.