Plan Could Close 20+ NY State Hospitals

[Guest]

Full text of Report link:

http://www.nyhealthcarecommission.org/final_report.htm

More info:

Court fight considered to keep Dobbs Ferry hospital open

By Melissa Klein

The Journal News

(Original Publication: November 29, 2006)

The report

Recommendations made by the Commission on Health Care Facilities in the 21st Century:

- Close Community Hospital at Dobbs Ferry

- Eliminate 32 beds at Mount Vernon Hospital. Convert another 20 beds into a transitional-care unit and 24 more beds into a unit for mentally impaired chemical abusers.

- Eliminate nine pediatric and 60 medical/surgical beds at Sound Shore Medical Center in New Rochelle. Convert another five beds into beds for the neonatal intensive care unit. An additional five beds would be converted into detox beds.

- Evaluate the possibility of making the Maria Fareri Children's Hospital at Westchester Medical Center in Valhalla a separate entity. The medical center also should evaluate its clinical services and identify opportunities for reconfiguration.

- Cut 140 beds at the Taylor Care Center, a nursing home at Westchester Medical Center.

- Eliminate all 247 beds at the Andrus-on-Hudson nursing home in Hastings-on-Hudson and add 140 assisted-living beds.

- Look at closing or downsizing the Sky View Rehabilitation and Health Care Center in Croton-on-Hudson. The facility did not respond to the commission's request for information.

NEW YORK - As legal action was contemplated to keep open Community Hospital at Dobbs Ferry, other hospital administrators were sorting through massive changes to New York's health care system announced yesterday by a state commission.

"We believe we have a pretty decent lawsuit to file," said Jim Foy, president of the Riverside Health Care system, to which Community Hospital belongs. Foy said the hospital makes money as an integral part of the system.

The hospital was one of nine across New York on the closure list put out by the Commission on Health Care Facilities in the 21st Century.

The panel recommended reconfiguration for another 48 hospitals, including Sound Shore Medical Center in New Rochelle and Mount Vernon Hospital, which together would lose 101 beds but add services.

"We're OK with everything they've recommended," said John Spicer, president of Sound Shore, which has an affiliation agreement with Mount Vernon Hospital.

Other recommendations include cutting 140 beds at Westchester Medical Center's nursing home; eliminating all the beds at the Andrus-on-Hudson nursing home in Hastings-on-Hudson and turning it into an assisted-living facility; and examining the Sky View nursing home in Croton-on-Hudson for closure or downsizing.

The commission's long-awaited report recommends cutting some 4,200 hospital beds and 3,000 nursing-home beds across the state in an effort to reduce excess capacity and trim costs.

The recommendations, if adopted, are expected to save $806 million a year for insurers, including the state's costly Medicaid program.

Five New York City hospitals were on the closure list, including St. Vincent's Midtown Hospital and Cabrini Medical Center in Manhattan and Westchester Square Medical Center in the Bronx.

Community Hospital was the only one in the Hudson Valley slated to close.

"It is an unnecessary institution," Stephen Berger, the chairman of the commission said yesterday after a press briefing to announce the recommendations. "There are a series of institutions which have excess beds, which are not necessary."

Berger said he considered the commission's recommendations a first step.

"To try to do more up front would have been massively destabilizing," he said.

The state's hospitals collectively have lost money for the past eight years, don't have enough money to invest in new technology or upgrade their buildings and operate with a large number of empty beds, the commission found in its report.

The length of time patients stay in a New York hospital is longer on average than in the rest of the country.

"Absent intervention, the future of our system looks bleak," said David Sandman, the executive director of the commission, which has been meeting over the past 18 months. "Unless we act, further facility closures and bankruptcies are almost certain."

Two Westchester County hospitals, St. Agnes in White Plains and New York United in Port Chester, have closed in the past three years.

Kenneth Raske, the president of the Greater New York Hospital Association, an industry group, said the commission's recommendations were much broader than he had anticipated.

"The report is the most massive restructuring of the hospital system ever undertaken in the United States," Raske said.

The hospital closures are expected to eliminate about 7,000 jobs, including 4,200 in New York City, although it is thought that some of those workers would be able to pick up other jobs in the health-care system.

"Our initial reaction is that this is a sad day for New York's health-care community," said Mike Rifkin, the executive director of 1199 SEIU, the state's largest health-care workers union. "The recommendations that were released today, they far exceed what had been anticipated."

The recommendations will now go to Gov. George Pataki for approval. He must act by Dec. 5.

If he approves the report, he will send it to the state Legislature, which then can accept or reject it as a whole. If the recommendations become law, it would be up to the state health commissioner to implement the cuts and closures by June 2008.

At stake if the recommendations are not implemented is $1.5 billion that the federal government has promised New York for restructuring costs.

State Sen. Nicholas Spano, R-Yonkers, said the Senate's Health Committee will hold a hearing Friday on the report.

Spano said he had grave reservations about closing Community Hospital, which could jeopardize the affiliated St. John's Riverside Hospital in Yonkers. The hospitals now share overhead, and profits made at the Dobbs Ferry hospital go into the Riverside system.

Foy said the commission seemed to be protecting large teaching hospitals at the expense of smaller community hospitals.

But Sandman insisted that there were no sacred cows, that nothing was off-limits.

He said the criteria used to evaluate the hospitals included services to low-income residents, quality of care, utilization and contribution to the local economy. The commission simulated the closure of a particular hospital and examined whether there was enough room at other nearby institutions to absorb more patients.

The commission's recommendations actually gave some hospitals what they wanted.

Spicer said that Mount Vernon Hospital had been seeking to turn some of its beds into a transitional-care unit for patients who were not severely ill. That was included in the report, as was a recommendation to add a unit at Mount Vernon for mentally ill patients with substance-abuse problems.

He said the recommended loss of 69 beds at Sound Shore was acceptable because the hospital did not need all the beds it was licensed to operate. He said no staff cuts would come from the downsizing.

Westchester Medical Center is already examining the need for all of its nursing-home beds, according to a statement from Michael Israel, the hospital president.

The hospital also was asked by the commission to consider a spin-off of its children's hospital to an independent entity and to examine the services it provides.

"As part of our strategic planning process we are evaluating the role and structure of the Children's Hospital along with all of our other clinical service lines, consistent with the commission's recommendations," Israel said in the statement.

Edited November 29, 2006 by hoss

[Guest paramedico987]

Dobbs Ferry is such a great facility! They may not be able to handle a significant volume, but their care is above reproach!

All these busy city hospitals essentially lose track of their patients... There's only one nurse on the floor that's even heard of you as a pt and she likely doesn't know what's wrong with you.

Whereas at CHDF EVERY nurse in the HOSPITAL knows you AND your condition. Furthermore CHDF's capabilties for any given pt aren't any lower than any other area hospital... they still cary Levaquin!

[Guest paramedico987]

OMG! Just read their "reccomendation" for TMVH.... I only have one thing to say, NO F*CKING WAY! They can barely handle their load with the beds they've got.

Here's a better solution for the "fiscal crisis" make people pay the F*CKING BILL!

Dear Medicaid,

Stop paying for Bull Sh*t. Kick it back and make the patient pay for their ED eval of a runny nose. Oh, and if they don't pay, then they don't get Medicaid anymore! We're tired of them spending all of OUR tax money.

Sincerely,

An angry mob

[Guest]

This man is certainly not my choice in '08.....

Pataki endorses hospital closings

By Jay Gallagher

Albany Bureau

(Original Publication: November 29, 2006)

ALBANY - Gov. George Pataki said today he supports closing nine hospitals statewide and shrinking or consolidating nearly 50 more.

Speaking to reporters in Albany via satellite from Kuwait after a three-day tour of Iraq, Pataki, who will leave office at the end of the year, endorsed the recommendations of the so-called Berger Commission, which yesterday recommended the closings and cuts to hospitals and nursing homes, including the closing of Community Hospital at Dobbs Ferry.

The cuts would eliminate about 4,200 hospital beds and 3,000 nursing-home beds and save about $1.5 billion a year.

"I want to see its provisions implemented,'' Pataki said. "I would urge the Legislature to take a good hard look at it.''

Pataki's endorsement removes one of the impediments to the cuts taking place.

The Legislature has until the end of the year to act on it. If lawmakers fail to act, it goes into effect automatically.

Both the Assembly and Senate have been non-committal and have scheduled hearings on the matter in the next two weeks.

The plan has already sparked strong opposition in communities where the closings are to take place.

Five of the nine hospitals that would close are in New York City. Two are in Buffalo, the one in Dobbs Ferry and another in Schenectady.

The proposed mergers and consolidations are spread around the state.

[Guest]

both Mrs. Clinton and Mrs. Lowey are getting a phone call from me tomorrow about this

[IFCLIDF 1]

http://www.thejournalnews.com/apps/pbcs.dl.../1076/OPINION03

Closing hospital in Dobbs Ferry will create hardship

By PETER J. ROY

(Original publication: December 4, 2006)

I was greatly disturbed to hear the Commission on Health Care Facilities in the 21st Century's recommendation to close our Community Hospital at Dobbs Ferry. I am a life-long resident of the rivertowns, growing up in Irvington and now residing in Dobbs Ferry. Community Hospital is a vital part of the community; pure numbers, and dollar and cents, cannot be the measures alone in the hospital's importance to the region.

I am a emergency medical technician who "rides" for both the Irvington and Dobbs Ferry Volunteer Ambulance Corps. I am a former captain and line officer in Irvington and currently serving as lieutenant of the Dobbs Ferry Corps. In addition, I am a member of the Irvington Fire Department, where I have also served as an assistant chief and line officer. I have more than 14 years of experience with emergency medical service in the area and cannot overstate the importance of Community Hospital.

The ability to bring non-traumatic medical emergencies to Community Hospital vs. transports to Westchester Medical, or St. John's Riverside or Phelps Memorial is reason alone to keep this facility open. The other facilities, while larger and having additional services, are many times overwhelmed with patients, and depending on the time of day, could be difficult to transport due to traffic conditions. Closure of Community Hospital will tax the surrounding area emergency departments as they will need to absorb the patients that Community Hospital currently handles as well as delay care to patients that are currently served.

What bothers me most is the fact that the commission seems to dismiss the improvements in the financial well being of Community Hospital since its inclusion in the Riverside Health Care System. The partnership with St. John's Riverside Hospital has been an economic success as well as relieved potential overcrowding of St. John's Riverside Hospital that may have occurred if Community Hospital was closed a few years ago. The commission's report itself stated, according to a Thursday article in The Journal News, "There are no efficiencies to be gained and possibly profit to be lost . . ." with the closing of the Community Hospital. The article also noted that "only eight percent of their (Community Hospital) patients are Medicaid patients. It does not cause any real burden to the taxpayers (financially.)"

Health-care costs do need to be examined; there are excesses in the system, and improvements should be made. Yet it is my opinion that the closing of the Community Hospital at Dobbs Ferry is far from an improvement in the well-being of the overall system. Closing it will, in fact, cause greater hardship. We are talking about life-saving, time-sensitive care that this facility offers to the community. It is not in excess, it is necessity.

The writer is NYS EMT-B #192686 and ex-captain of the Irvington Volunteer Ambulance Corps as well as ex-chief of the Irvington Fire Department and lieutenant of the Dobbs Ferry Volunteer Ambulance Corps.

[Remember585 815]

They're considering closing Sky View in Croton?

One word:

FINALLY!!

[Guest]

both Mrs. Clinton and Mrs. Lowey are getting a phone call from me tomorrow about this

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You're not wrong, but save your breath.......

[Guest alsfirefighter]

lol. 585. How will I ever get to Croton now?

Hang on tight gang. Its only going to get worse. Before you know it we will be down to a handful of hosptials in Westchester. And 2 hour waits for stretchers, lol.

[Guest]

You're not wrong, but save your breath.......

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maybe so - but there really isn't any other recourse for me as a citizen.

[OoO 24]

Does anyone know exactly what authority the state has to close a private hospital?

[dadbo46 50]

The NY State Department of Health licenses hospitals much like they license nursing homes.

[Guest alsfirefighter]

The only thing I wanted to add since this is slowing down is this. When we try to make a point about how a particular event could effect our operations and trying to be an additional patient advocate, can we please come up with some better facts/points then talking about cardiac arrest and how we would have to "drive" an x amount of minutes to the next hospital. Cardiac arrest is the last point I would ever use, if at all in regard to closing of a hospital. There is nothing occurring during a cardiac arrest that those few minutes matter what so ever or treatment that isn't going on that would occur in the hospital. You drive those x amount of minutes for trauma patients some of them clinging barely on to life itself but thats no good for a patient that has already expired and we are doing resuscitative efforts that have the lowest percentage chance.

I would make the argument about all those "in between" cases. The CHF'er who isn't responding to initial treatments and is about to bite a tube or the same case that even with narcotics intubation facilitation is difficult.

The person with severe crushing chest pain that isn't responding to treatments. But again this is a double edged sword if the said hospital often transfers these patients out quickly for other advanced diagnostic procedures they cannot perform.

The severe asthmatic that treatments above the ALS level could stop them from being intubated.

The fact that other hospitals are talking and beginning expansions to their ED's and patient floors due to the influx's created by population shifts and other closures and how that "little community hospital" helps out with those bumps, bruises, scrapes, flu's and other things. Key word to use is "community" and hospital. Much like the big corporate sales world..where WalMart is crushing small businesses...the same is happening with hospitals sucking up more treatments and patient services.

Use facts of the hospital closures that have occurred and work as a consortium with other area hospitals that would be affected by the new patient influx (if they are looking at it that way, some management is more patients = more $$$) and work together.

This isn't a poke at anyone, just adding my own opinion on the topic. Using cardiac arrest makes the profession seem like we are still in Cadillac's and throwing patients and speeding away. This is a time for professional and educated decisions, quotes and conversations and sometimes and again this could just be the press taking stuff out of context, but we sometimes come off looking like we just show up.

[27east 19]

OMG! Just read their "reccomendation" for TMVH....  I only have one thing to say, NO F*CKING WAY!  They can barely handle their load with the beds they've got.

Here's a better solution for the "fiscal crisis" make people pay the F*CKING BILL!

Dear Medicaid,

    Stop paying for Bull Sh*t.  Kick it back and make the patient pay for their ED eval of a runny nose.    Oh, and if they don't pay, then they don't get Medicaid anymore!  We're tired of them spending all of OUR tax money.

    Sincerely,

    An angry mob

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and the illegals