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Health

As Mount Sinai Beth Israel Hospital faces closure, patient care suffers

Once a full-service hospital that performed heart surgeries and treated a range of stroke patients, Beth Israel on Manhattan’s East Side today offers more limited services. The number of employees increased from 1,800 to around 1,300 in less than a year. Some floors are almost empty of patients.

That’s because for years Beth Israel’s parent hospital system, Mount Sinai, has been trying to shut it down, saying it’s losing too much money. The plan faced resistance from community members, a judge and the state Department of Health, and led to a long-running fight to prevent the hospital from closing.

The delay created its own problems.

With services reduced and employees leaving for more secure jobs at other hospitals, the hospital’s ability to care for patients has suffered, according to interviews with medical staff and reports from hospital inspectors. The result has been dangerous, sometimes even deadly, according to patient advocates.

Last January, George Faust, a 76-year-old retired printer from Greenwich Village, woke up from a nap in his Eames chair, tried to get up and fell. He broke a few ribs and was taken by ambulance to Beth Israel, one of the few remaining hospitals serving downtown Manhattan.

In the emergency room on Jan. 16, he was discovered to have a collapsed lung as well as broken ribs, his wife, Kathleen Faust, said in a telephone interview. Staff members at Beth Israel said the facility was understaffed to care for a “traumatized patient,” according to an affidavit filed by Ms. Faust.

He ended up in two other hospitals and eventually died after blood accumulated in his lungs and abdomen, according to Ms. Faust.

“His death would not have occurred if Beth Israel Hospital had been fully operational,” according to his affidavit filed in March as part of a lawsuit challenging the proposed closure. A Mount Sinai spokesman said the nature of Mr Faust’s injuries meant he would naturally have been transferred to another hospital.

Mr. Faust is just one of the patients arriving at Beth Israel in recent months who faced a delay in receiving care or were told the hospital could not treat them, according to two reports investigators from the public hospital.

Investigators found the hospital stopped doing MRI scans between midnight and 8 a.m., meaning patients with a range of worrying symptoms — vision loss, spinal cord compression, neurological changes — would have to wait or be transferred. At the end of 2023, the hospital also informed the city’s ambulance service that it would no longer be able to treat the most serious strokes.

In January, a man with slurred speech and weakness – signs of a stroke – arrived at the emergency room. The extent of brain damage after a stroke often depends on how long it takes to receive treatment, but “there was a delay in the response of the stroke team,” says a report from stroke investigators. ‘Statement dated January 31. Beth Israel disputes this claim, saying it only took 9 minutes for it to be examined.

The stroke patient, identified in the state report only as “patient 44,” was ultimately transferred to another hospital.

In January, another patient was brought to the emergency room in septic shock from pneumonia, but was transferred to another hospital due to “lack of space and understaffing” at Beth Israel, investigators say of State.

Hospital closures in New York typically spark outcry and organized community opposition. And usually, the end result is the same: the hospital closes anyway. More than a dozen have closed in the past 20 years.

But community activists hope the battle ends differently for Beth Israel. Since 2013, Beth Israel has been part of the Mount Sinai Health System, which operates several major hospitals in Manhattan.

A few years after taking over, the hospital system sought to close Beth Israel, claiming it was a financial drain. But the hospital was saved by the coronavirus pandemic: Instead of closing, it took care of the influx of seriously ill patients who filled, and nearly overwhelmed, the city’s health systems in early 2020.

Late last year, Mount Sinai began implementing a new plan to close the hospital in July, or sooner. But community groups have pushed to keep it open, arguing that more hospitals, not fewer, are needed after the pandemic pushed capacity to the breaking point.

“Everyone’s attitude has been affected by the pandemic,” said Arthur Schwartz, a former Beth Israel patient and attorney who filed a lawsuit earlier this year challenging the closure plan.

The fate of Beth Israel, which began as a small clinic serving Jewish immigrants in the late 19th century and grew into one of the largest downtown hospitals, has broader implications. Over the past 20 years, two nearby hospitals have closed, even as the area’s population skyrocketed. Closing Beth Israel would result in longer ambulance rides for downtown residents, many of whom would end up in hospitals in Midtown or farther north.

Spokespeople for two of the hospitals closest to Beth Israel — Bellevue, the flagship of the city’s public hospital system, and NYU Langone, both just off First Avenue from Beth Israel — expressed concern about a dramatic increase in the number of patients if Beth Israel closes.

NYU Langone has already seen a 32 percent increase in emergency room visits from patients in Beth Israel’s coverage area, which includes the Lower East Side and the East Village, according to a spokesperson, Steve Ritea.

Loren Riegelhaupt, a spokesperson for Mount Sinai, said the hospital system tried to save Beth Israel with hundreds of millions of dollars in investments. But the hospital wasn’t attracting enough patients, and a relatively high percentage of them were on Medicaid, which reimburses at lower levels than private health insurance. Beth Israel lost more than $1 billion, according to Mr. Riegelhaupt.

“No system can continue to suffer losses of this magnitude,” he said, adding that these losses endanger the entire health system in Sinai.

Beth Israel would be the first New York City hospital to close as a result of the pandemic. Hospital leaders and community groups are watching to see if the state finds a way to keep it open, perhaps by finding another hospital system willing to take it on.

So far, the state Health Department’s position has been difficult to parse. The department sent Beth Israel a cease and desist letter, ordering it to stop closing beds and services at this time. And after five months of inaction, he rejected the plan to close Mount Sinai as incomplete, calling on Beth Israel to resubmit it with more data on its finances, among other topics.

Slow decision times are costly. Mount Sinai says it is losing $15 million a month by keeping Beth Israel open. This figure could increase as the hospital attempts to reopen some services in an attempt to maintain the status quo in the meantime.

“Refusing to allow the closure of a bankrupt, independent, nonprofit hospital is unconstitutional,” the hospital said in a statement.

News Source : www.nytimes.com
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