St. Vincent’s Votes to Shut Hospital in Manhattan/Nearby Hospitals to Fill Gap When St. Vincent’s Closes

St. Vincent’s Votes to Shut Hospital in Manhattan
By SHARON OTTERMAN
Copyright by The Associated Press
Published: April 6, 2010
http://www.nytimes.com/2010/04/07/nyregion/07vincents.html?th&emc=th


The board of St. Vincent Catholic Medical Centers voted on Tuesday night to close its flagship hospital in Greenwich Village, ending its long struggle to stay afloat despite millions of dollars of debt.

The Decline of St. Vincent’s Hospital (February 3, 2010)
The exact timing for the closing of St. Vincent’s Hospital Manhattan, which has about 400 inpatient beds, was not immediately clear, but the process of shutting down has already begun, and the State Department of Health will become involved to ensure an orderly closing. Elective surgeries are to end by April 14.

“The decision to close St. Vincent’s Hospital Manhattan inpatient services was made only after the board, management and our advisers exhausted every possible alternative,” Alfred E. Smith IV, chairman of St. Vincent Catholic Medical Centers, said in a statement. They were unable to come up with a plan, he said, “to save the inpatient services at the hospital that has proudly served Manhattan’s West Side and downtown for 160 years.”

Gov. David A. Paterson said Tuesday that he would work with the board and the Department of Health to preserve some of the hospital’s most important community functions, perhaps by scaling it down to an urgent care center that could take patients with conditions ranging from ankle sprains to heart attacks. That plan would also try to maintain some outpatient services, like those that provide H.I.V. treatment and primary care, but it remains at a conceptual stage and would require finding a partner, people close to the process said.

In the meantime, outpatient services will continue without interruption, the board said.

The hospital and a task force convened by the governor had tried without success to find another hospital to absorb or unite with St. Vincent’s.

“While we are disappointed that we were unable to find a partner for the acute care inpatient services,” the governor said in a statement, “we should use this as an opportunity to ensure that the health care needs of this community are met by creating an urgent care center combined with other vital health care services the community needs. To that end, I have directed the Department of Health to solicit proposals for this new model of care.”

With its vote, the board effectively closed the last Roman Catholic general hospital in New York, a beacon in Greenwich Village that has treated victims of calamities from the sinking of the Titanic to Sept. 11. In recent years, its management troubles were worsened by the difficult economics of the health care industry, changes in the fabric of a historic neighborhood and the low profit in religious work.

The search for a partner hospital, which would be needed to maintain an urgent care center, is already under way. Mount Sinai Medical Center, which recently withdrew a bid to partner with St. Vincent’s to keep its acute care hospital open, has indicated some interest, according to an official involved in the restructuring efforts who insisted on anonymity because he was not authorized to comment. Mount Sinai officials could not be reached for comment late Tuesday.

Christine Quinn, the speaker of the City Council, who represents the neighborhood, called on the governor not to approve any closing until an urgent care plan was in place.

To satisfy its creditors, the hospital may sell or lease much of its valuable Greenwich Village real estate, as it drastically reduces its staff of doctors, nurses and others, to repay its estimated $700 million of debt, people involved in the hospital’s restructuring efforts said.

St. Vincent’s now gets most of its admissions through its emergency department, which could be a natural match for an urgent care facility. But with vastly reduced services, it would no longer be a Level 1 trauma center, so patients with high-level emergencies would be routed to full-service hospitals.

An urgent care center could remain open all night, but patients could not stay more than 24 hours, and would be discharged or transferred to another hospital if they required inpatient care.

Anemona Hartocollis contributed reporting.



Nearby Hospitals to Fill Gap When St. Vincent’s Closes
By ANEMONA HARTOCOLLIS
Copyright by The New York Times
Published: April 7, 2010
http://www.nytimes.com/2010/04/08/nyregion/08vincents.html?hpw


A day after St. Vincent’s Hospital in Greenwich Village announced it was closing its inpatient facilities, other Manhattan hospitals said Wednesday that they were making plans to accommodate its patients, doctors and employees at their own institutions.

Local politicians also said that they would press for St. Vincent’s to remain open at least as an urgent care facility, which would assume some of the hospital’s emergency room functions. But some doctors at the hospital expressed doubt that such a facility would be a legitimate replacement for a hospital emergency room.

Two private hospitals, Roosevelt, at 59th Street and 10th Avenue, and Beth Israel Medical Center at First Avenue and 16th Street, will increase the staff in their emergency rooms to accommodate patients who would have gone to St. Vincent’s, said Jim Mandler, a spokesman for Continuum Health Partners, which runs the hospitals.

Mr. Mandler said there had been a sharp rise in emergency room admissions over the past few weeks at the two hospitals, along with another Continuum hospital, St. Luke’s, at 113th Street and Amsterdam Avenue, as St. Vincent’s struggled to stay open despite deepening financial problems.

Alan Aviles, president of the city’s public hospital system, said Wednesday that there had been a 13 percent rise in emergency room patients at Bellevue Hospital Center, at First Avenue and 27th Street, over the last 30 days.

Mr. Mandler said Continuum was immediately offering temporary admitting privileges to physicians from St. Vincent’s, and would try to give laid-off St. Vincent’s healthcare workers priority in hiring. Mount Sinai Hospital, on the Upper East Side, also said it was extending privileges to St. Vincent’s doctors.

The board of St. Vincent Catholic Medical Centers voted on Tuesday to close the hospital, which is the last full-service Catholic hospital in New York City. The vote came after futile efforts to find a partner that would help run the hospital, which is burdened with $700 million in debt and is losing millions more every month.

It was not clear exactly when St. Vincent’s would stop admitting patients. Some doctors said Wednesday that they had been told the hospital would be closed unit by unit, with State Health Department oversight, over the next two weeks to two months.

Local politicians and health care workers rallied outside the hospital on Wednesday to denounce the closing, and several elected officials said they would continue to push for the creation of an urgent care center in the Village that would provide some of the services of an emergency room. But anyone needing to be admitted would have to be transferred elsewhere.

Both Mount Sinai and Continuum have expressed interest in running an urgent care facility at St. Vincent’s, hospital industry officials said. The hospital that operates the urgent care center could benefit from access to its patients, who could be funneled to the hospital’s other facilities. Mount Sinai also has discussed taking over H.I.V./AIDS care services at St. Vincent’s.

It was unclear on Wednesday whether an urgent care center would be obligated to care for uninsured patients, who are a large part of St. Vincent’s patient load and a major reason for its financial troubles. And some doctors were skeptical that an urgent care center could fill the void left by the closing of St. Vincent’s emergency room.

“Obviously, they’re trying to make lemonade from lemons,” said Dr. Charles Carpati, the chief of the medical intensive care unit and a member of the hospital executive committee. “Someone will be able to profit by getting the patients that can’t be stabilized by urgent care, and the politicos want to take some credit for doing something.”

Dr. Carpati said St. Vincent’s was the only full-service hospital below 58th Street on the West Side providing trauma, radiology and neurosurgery, among other services. But, he said: “Once we go, this part of town will be isolated and dependent on traffic to gain these services in emergencies. Even in common emergency diseases such as heart attack and stroke, time is of the essence.”

Another doctor, Jeffrey Lazar, said he was disappointed that the city and state had been unable to save St. Vincent’s, which takes a large proportion of poor patients.

“I also don’t see how the city is going to smoothly absorb” the hospital’s estimated 60,000 emergency department patients a year, Dr. Lazar, an attending physician at St. Vincent’s, said. On warm-weather Friday and Saturday nights, he said, the emergency room “is crazy with Chelsea-West Village assault victims, drunks, overdoses, psychiatric patients.”

The status of St. Vincent’s valuable real estate also remains uncertain. The hospital had proposed to sell some of it. Its creditors may seek a sale to pay off some debt.

Colin Moynihan contributed reporting.