By Maria Rocha-Buschel
Community members and elected officials have expressed concern about the steep reduction of beds at Mount Sinai Beth Israel, once the hospital is downsized as planned. At a forum held in the Union Square hospital facility last Thursday, State Senator Brad Hoylman and City Councilmember Corey Johnson brought up the number of beds, and Hoylman added that he was concerned about a lack of community input on the plan, as were representatives for Borough President Gale Brewer and City Councilmember Dan Garodnick.
When Hoylman criticized the lack of community involvement in the issue and asked if any of the plans would be modified based on input from residents, Mount Sinai Downtown President Dr. Jeremy Boal admitted that the plan would not.
“We’re skiing in front of an avalanche,” he said, citing financial concerns for Beth Israel. “We’re losing money at such a rapid clip that if we take a giant pause, the community will be left with nothing.”
The hospital system is required by law to conduct a community needs assessment, but this review covers policy changes, environmental changes and system changes rather than individual input from neighborhood residents. Boal confirmed that the system will be doing a community needs assessment, to be completed by the fall, but that an “assessment that informs the work (community workshops) is not happening.”
Regarding the decrease of beds at the new facility planned for East 14th Street and Second Avenue, representatives for Beth Israel first reported the change at a joint community board meeting last June and Boal noted at the forum last week that the total reduction of beds from the current facility to the new campus would be from 799 to 220. The decrease is partially based on reported usage, Boal said, as well as a shift in focus from in-patient care to ambulatory (out-patient) services. Of the almost 800 beds licensed at the current hospital, Boal said that less than 400 are used daily.
There are currently 150 psychiatric beds at the 16th Street campus and Boal explained that this would remain the same, but the 250 other beds usually in use would be reduced to 70 in the new facility. Ninety of the 250 beds would be completely eliminated because of the hospital system’s focus on ambulatory care. Sixty beds would be available in uptown hospitals for complex procedures, with 30 available at hospitals in Brooklyn. He also noted that the new building will be built with the flexibility to add four additional floors if the hospital ultimately needs the beds.
“Healthcare is a dynamic environment,” Boal said. “The HIV/AIDS epidemic and Ebola crisis demonstrated that we have to be prepared to be flexible.”
Dr. Kelly Cassano, a primary care physician who works in community based programs and who is helping to oversee the transition to out-patient care, said that the specialty care services leaving the area will be attended to in “centers of excellence” within the Mount Sinai network, the idea being that care is more effective in facilities where special procedures are performed more often.
Johnson, who represents the Chelsea neighborhood, said that he was concerned about whether or not 70 beds was appropriate for the new facility, and Boal admitted that while it would be “unrealistic to predict” whether or not the removed beds would be necessary, Beth Israel has already removed 150 beds since joining the Mount Sinai health system in 2013 due to reduced readmissions.
“This is continuing trends to what we’ve already seen,” he said.
Johnson argued that members of the community are especially anxious about the reductions since the closure of St. Vincent’s and other hospitals in the area in the last 15 years.
“This is a real fear that keeps getting chipped away,” he said. “It’s not that you’re misleading us but we’re just taking your word for it. The community has to understand how you get to these numbers. If you have the ability to build those four stories, build the four stories.”
Boal said that while the hospital is sensitive to the worry in the community about healthcare, the system also has financial concerns that need to be considered.
“It costs $3 to $4 million per bed in New York and we have a fiduciary responsibility for the tradeoffs we’re making,” he said. “If we build something we don’t need here, that’s something we can’t build elsewhere. Because of limited funds, we have to make decisions about what won’t be provided.”
Boal also cited financial concerns as for why the hospital was starting the project as soon as possible.
“Beth Israel is budgeted to lose $147 million in 2017,” he said. “The rest of the (Mount Sinai) health system will cover that but it’s clear that we need a new path.”