By Maria Rocha-Buschel
The New York State Department of Health has presented data that supports Mount Sinai Beth Israel’s reasoning for downsizing due to beds going underused.
The DOH discussed its own findings at a public meeting with the Public Health and Health Planning Council (PHHPC) last Thursday.
PHHPC is charged with making decisions concerning the establishment and transfer of ownership of healthcare facilities and makes recommendations to the Commissioner of Health concerning major projects and service changes, and heard presentations from the State DOH as well as from Mount Sinai Beth Israel.
Dan Sheppard, the Deputy Commissioner in the Office of Public Health for the DOH, said that utilization rates appear to be down throughout the city, but also specifically at Beth Israel, since 2006. Data from the Statewide Planning and Research Cooperative System (SPARCS) showed that occupancy of certified beds at MSBI was 61.5 percent in 2006 and decreased to 55.9 percent by 2015.
“Making providers think about how to keep people out of hospitals is driving down utilization rates,” Sheppard said. “Medical technology is also turning inpatient care into outpatient care, and even with inpatient care, the length of stay is shorter. We expect this downward trend to continue.”
Representatives from Mount Sinai Beth Israel also gave an abbreviated version of their presentation offered at previous town hall and community meetings, explaining the rationale behind a reduction of more than 550 beds once the new facility is completed, noting that the decrease is possible due to changes in healthcare delivery, such as a focus on ambulatory care, shorter lengths of stay and alternative care models, such as the “Hospital at Home” program.
Sheppard said that the DOH’s absorption analysis, which is used to assess the impact of changes the number of beds has and determines whether or not decertification of beds would result in shortages, used actual hospitalization patterns at the zip code level. According to the results of the analysis, Sheppard said that there is sufficient inpatient bed capacity in New York to accommodate patient needs with the construction of the new 70-bed facility for medical and surgical services.
Mount Sinai executive vice president Jeremy Boal explained that the hospital uses less than 400 of the 799 beds currently licensed for the facility, with 150 in use for behavioral health and 250 available for other patients. Mount Sinai’s proposal maintains the same number of behavioral health beds but reduces the number of other beds to 70. Mount Sinai estimates that 180 patients, which is the difference between the current number of beds in use and the number of beds for the new facility, will be treated through alternative methods outside the hospital.
Public Advocate Letitia James was at the meeting and said that she was worried about the DOH’s interpretation of the data because of conditions in Brooklyn hospitals that could have an impact on care for patients in Manhattan. She noted that there could be challenges of whether or not hospitals in Brooklyn will be able to absorb patients who might normally go to the Manhattan facility because the closure of Long Island College Hospital has had an impact on healthcare in that community.
“The analysis is deeply flawed,” she said. “The decision should be based on data and community input. The decision might be correct but we don’t want to make the same mistakes as with St. Vincent’s when that facility closed.”