Excerpts from Save Beth Israel and New York Eye & Ear Campaign

Critique of Mount Sinai’s New Closure Plan for Beth Israel Hospital

By Community Coalition to Save Beth Israel Hospital & the New York Eye and Ear Infirmary

The latest version of Mount Sinai Health System’s closure plan for Beth Israel Medical Center acknowledges that Mount Sinai cannot simply close Beth Israel and leave Lower Manhattan residents to fend for themselves. This new version includes promises to a) open an urgent care center at the New York Eye and Ear Infirmary (NEEI) and b) help Bellevue expand its emergency department (ED) to absorb and care for some patients who would be displaced by Beth Israel’s closure. While there are very modest improvements from previous closure plans, they are still woefully inadequate, for the following reasons:

• The community has no reason to trust that Mount Sinai will actually fulfill these promises, given their record of promising and reneging on projects. Just four years ago, Mount Sinai received state approval to build a new, smaller version of Beth Israel, but then abandoned that project. Two years ago, Mount Sinai announced it would, instead, renovate the existing Beth Israel facility. That never happened. Last year, Mount Sinai insisted that it must merge NEEI into Beth Israel to prevent the closure due to reported low daily in-patent census numbers. After the State Health Commissioner granted approval of that merger, contingent on Mount Sinai officials meeting with community members and local elected officials to discuss the future of NYEEI, Mount Sinai did not move forward on that plan either. 

• The fine print of the new closure plan makes clear that Mount Sinai would only provide assistance to Bellevue in expanding its ED “post closure” this summer.  There is no commitment to timing or amount of assistance. In other words, Mount Sinai would first close Beth Israel and then help fund the Bellevue ED expansion. The closure plan does not address how the immediate gap in emergency services would be filled during the time it would take for Bellevue to get construction approved and completed. The closure plan also threatens that if Mount Sinai is forced to keep Beth Israel open beyond July then it might be unable to provide either the Bellevue funding or the promised urgent care center.

• Both the promised urgent care center and the help in expanding Bellevue’s emergency ED fall far short of what Mount Sinai previously said was needed. In their 2019 Certificate of Need (CON) application approved by the NYSDOH for a new, replacement Beth Israel. Mount Sinai called for a smaller hospital adjacent to the NYEEI campus with a) a full and enhanced emergency department, b) 70 inpatient beds and c) a “platform to include cardiac catheterization, electrophysiology. and interventional radiology procedures.” Mount Sinai also said that there was a need to accommodate 70,000 ED patients a year. In that CON application, Mount Sinai stated it had carefully studied the population, demographics and health care needs of the downtown community and had concluded that: 

“The community requires access to critical emergency care, including cardiac and stroke emergency care, operating room facilities to respond to these emergencies and other surgical procedures, emergency mental health facilities and observation and inpatient beds…The new MSBI facility will be a full-service hospital consisting of inpatient beds, an adult and pediatric ED, radiology functions, operating rooms (OR) and IR suites, including neuro-IR and cardiac catheterization. The new hospital building will serve as a neighborhood hub of critical care, treating patients in need for lifesaving treatment when suffering strokes, heart attacks, aneurysms and trauma.”

Mount Sinai’s patient numbers show that in 2023, the Beth Israel ED had more than 65,000 visits. Even as recently as February 2024, hobbled by Mount Sinai’s dismantling, the Beth Israel ED had 139 daily visits. On an annual basis, that is more than 50,000 EDs visits. In addition, Beth Israel’s current daily bed census is 90 patients who mostly come through its ED.

How does Mount Sinai argue that these ED visits could be “absorbed” elsewhere? First, Mount Sinai says that 52 of the 139 daily ED visits seen in February 2024 could be served at urgent care centers. We find that calculation optimistic at best, given that most patients are unsure whether they have an urgent medical need or an emergency one, and will tend to opt for the higher level of treatment. Moreover, urgent care center patients are often sent to hospital EDs for more advanced care.

After skimming 52 visits off the top, Mount Sinai says that would leave 86 daily ED visits to be treated at area hospitals. We note that only three of these visits are likely to go to NYU Langone, while 27 are predicted to go to Bellevue, 26 to NY Presbyterian Lower Manhattan and 23 to the Lenox Hill Greenwich Village. Our own community survey found that few of the nearly 1,000 respondents said they would turn to NY Presbyterian Lower Manhattan (4.4%) or to the Lenox Hill Greenwich Village ED (4%) if Beth Israel were to close. We seriously doubt the validity of Mount Sinai’s calculations. 

Over the last five years, Lower Manhattan residents have suffered through chaotic mismanagement of Beth Israel characterized by one “transformation” plan after another that failed to materialize. Mount Sinai has brazenly moved ahead to close services and frighten staff into relocating elsewhere, all without receiving the required written approval from the NYSDOH.

In fact, the NYSDOH had to issue a “cease and desist” order in December 2023, and several community groups and patients had to file a lawsuit to stop the ongoing destruction of the hospital in February 2024.  Mount Sinai has since defied a temporary restraining order from a New York State court, and an order by the Judge to restore services illegally closed.

Our Demands
Mount Sinai should not be allowed to shutter Beth Israel, sell off its campus to real estate developers, and then walk away from a) its charitable mission and b) its latest round of promises and feeble plans to assure hospital-based care in Lower Manhattan.

We call on the NYSDOH to hold Mount Sinai accountable for its intentional destruction of a widely respected and beloved hospital with a history of 134 years of service to Lower Manhattan residents, particularly low-income and uninsured people and immigrants. 

We also call on the State Attorney General to hold Mount Sinai accountable for its deliberate failure to fulfill its legally required charitable mission to operate Beth Israel.

Finally, we call on the NYSDOH to convene all stakeholders to craft a way to restore and provide necessary hospital services in Lower Manhattan, and we stand ready to participate in such a process.

Mount Sinai Has Deliberately Dismantled Beth Israel

Since acquiring Beth Israel in 2013, Mount Sinai has removed:

  • 31 chemical dependence beds (2015)
  • 29 physical medicine and rehabilitation beds (2016)
  • 20-bed pediatric unit and a five-bed pediatric intensive care unit (both 2016)
  • Cardiac surgery (2017)
  • 42 maternity beds (2017)
  • 14 neonatal continuing care beds and 17 neonatal intermediate care beds (2017)
  • 5 medical/surgical beds (2017)
  • Linear accelerator service (2017)It is no wonder that the hospital’s in-patient bed census began to drop and its finances falter. At the time Mount Sinai acquired Beth Israel, the hospital was solvent and highly regarded for its psychiatric care, addiction services, cardiac care, and maternity and pediatric services. Many patients chose to seek care there, helping to keep the hospital financially stable.