More Options for Beth Israel
By Alec Pruchnicki, MD
Before we look at what options Beth Israel has, let’s look at its history. Hospitals don’t merge and give up independence easily but are usually forced to by financial pressure or projected financial problems. I don’t know everything about the merger of Beth Israel, Roosevelt and St. Luke’s hospitals in 1997 to form Continuum Health Partners but I would imagine money problems were a major factor. I was on the staff of St. Luke’s when Continuum merged with Mt. Sinai in 2013 and I remember many staff members predicting problems because of finances.
Following the merger, Mt. Sinai started decertifying presumably empty beds and started moving services from Beth Israel (BI) to other hospitals. Large hospital systems do this all the time. If a service is bringing in $20 million at one site but can bring in $30 million at another site, moving it to improve finances is a frequent result. Everyone acknowledges that BI serves a very poor population, which means that its patients have very poor insurance, if any. I don’t think many people with extensive profitable insurance utilize BI as their major hospital but there might be many who use the emergency room when necessary. Many of the complaints about its closing focus on the lack of emergency room services in the large area between Downtown Hospital and Bellevue, not necessarily about the lack of in-patient beds.
There is a possible solution that can save part of BI even as Mt. Sinai rushes to close it. Lenox Hill Greenwich Village is a free-standing emergency facility in one of the buildings previously used by St. Vincent’s Hospital. The facility appears to be thriving, and there are many other services within the building and in newly established offices around it that appear to be doing well. This brings in money to Lenox Hill and serves to funnel patients to Lenox Hill Hospital for in-patient admission when appropriate. Could Mt. Sinai set up a similar free-standing ER on the East Side that serves the community, provides a hub for Mt. Sinai offices and services, and sends patients to main Mt. Sinai or Mt. Sinai West (previously known as Roosevelt Hospital)?
Speaking of Lenox Hill, could it be convinced to take over Beth Israel and do on the East Side what it did on the West Side? For some reason, the Northwell Health system came into Manhattan when it didn’t have to. It had a flourishing highly respected system throughout Long Island. Just as St. Vincent’s was closing, the gossip in the medical community was that Lenox Hill Hospital would be next to go under. But it gave up its independence and made a deal to become part of the Northwell system. For Northwell, it was probably a risky financial move. They doubled their risk by opening Lenox Hill Greenwich Village. Yet, they took the risk, and all of these places seem to be doing well. Could the BI buildings be transferred to Lenox Hill? And, it doesn’t have to be done immediately. It took several years after the closing of St. Vincent’s for Lenox Hill to take over and set up its Greenwich Village site.
If a deal like this requires money to compensate Mt. Sinai for the property for example, where will it come from? The Department of Health, various courts, and countless politicians have been involved in this issue. Do any of them have any money to help, if it comes to that, or will their involvement be limited to studies, court decisions, press releases and photo ops?
