BY PHYLLIS ECKHAUS
Updated July 11, 2024 4:15 p.m.
Mount Sinai executives have backed off from saying Beth Israel's closing is imminent. (Photo by The Village Sun)
What does it mean when a hospital is “open” but turns away ambulances and patients?
In a victory of sorts for community advocates and local politicians, Mount Sinai Beth Israel will almost surely remain open beyond this Fri., July 12, the date by which Mount Sinai — which owns the E. 16th Street facility — has twice told the New York State Department of Health that Beth Israel must close.
“There’s no way” M.S.B.I. will close July 12, state Assemblymember Harvey Epstein told The Village Sun this week.
Epstein — one of more than a dozen politicos fiercely critical of plans to shut down the hospital — cited two looming obstacles to the closure: the lack of D.O.H. approval and a temporary restraining order (T.R.O.) that an array of community advocates secured in state court.
D.O.H. not only rejected Mount Sinai’s first closure plan as incomplete, it ordered Mount Sinai to cease and desist the elimination of Beth Israel services and departments and to restore eliminated services or potentially face fines.
Yet, D.O.H. did not follow up with enforcement against Mount Sinai. Nor has it yet responded to the amended closure plan that Mount Sinai submitted in May.
Similarly, the state court injunction also requires Mount Sinai to stop closing down Beth Israel and instead to restore eliminated services.
Plaintiffs in the lawsuit, which was filed in 2017 in response to a Mount Sinai plan to relocate and shrink Beth Israel, include many community advocates active in the wider Save Beth Israel and New York Eye & Ear Campaign, a broad-based coalition that coalesced last fall, and which includes local politicians.
Mark Hannay spoke at an April march and rally to save Beth Israel Hospital. (Photo by Ian B. Kwok)
Mark Hannay, the director of Metro New York Health Care for All, and coordinator of the campaign, credited the campaign with halting Mount Sinai’s aggressive efforts to shutter and sell the E. 16th Street campus.
“Despite the worst efforts of Mount Sinai Health System to intentionally destroy Beth Israel Hospital since taking it over more than a decade ago, the hospital and its emergency room remain open and operating to serve Lower Manhattan, with a daily bed census of 70 to 90 patients,” he said. “This situation has only come about because the community activists and our local elected officials have worked together to preserve it as an essential community resource.”
Noting silence and inaction from New York State authorities, Hannay declared, “Our campaign continues to pressure Governor Kathy Hochul and the New York State Department of Health to guarantee hospital care in Lower Manhattan, and for them to enforce the state’s order that Mount Sinai Health System restore services at Beth Israel Hospital that it has illegally closed down since last fall, in defiance of both a Department of Health directive and state court order.”
At the April march and rally, attorney Arthur Schwartz accused Mount Sinai Health System of using creative accounting to justify Beth Israel Hospital’s closure. (Photo by Ian B. Kwok)
Though Beth Israel remains officially open, Arthur Schwartz, the lead attorney in the lawsuit, nevertheless described the hospital today as a kind of ghost town. He told The Village Sun that Beth Israel “is telling everyone they’re closing. And the result is, everyone’s leaving. They can’t hire anyone because nobody wants to come to a hospital that’s closing July 12th, right?”
Schwartz also contended that the hospital is actively turning away ambulances and patients. He used his 102-year-old mother as Exhibit A.
In the past several months, his mother has repeatedly needed emergency care. During that time, Schwartz has had to overcome the resistance of ambulance crews in order to bring his mother to Beth Israel. In one instance, the head of the responding emergency medical team refused to transport his mother there, telling him that an e-mail from the Fire Department of New York said Beth Israel was not accepting ambulances.
Yet, twice, Schwartz has prevailed: “She was there again last week,” he said. “She was running a fever and I called 911. I said, ‘We go to Beth Israel.’ They said, ‘Are you sure? I don’t think that’s open.’ And then they took her there and she was the only patient in the whole ER. It was great. She got a lot of attention: ‘Wow, like, look — a person!’”
In a July 1 affidavit to the court, Schwartz linked his mother’s recent experience to what he has described as Mount Sinai’s intentional sabotage of Beth Israel. Although the hospital ER had more than 55,000 visits in 2022, by this May it was down to just 33 for the month.
“The story I witnessed with my mother was not anecdotal, it represented an utter disappearance of ER visits — this translates to no ambulances, no [inpatients] and no income,” Schwartz said in the affidavit. “It also puts to a lie the description by [Beth Israel President] Elizabeth Sellman about how she spends 40 percent of her time trying to restore services. Without the restoration of ambulance services that were cut in February, and without making it known to the public and E.M.S. that Beth Israel remains in business, of course Mount Sinai is losing money, and doctors and other health professionals are loathe to stay.”
Mount Sinai has said that Beth Israel is financially unsustainable. As The Village Sun recently reported, the campaign has challenged that claim with a financial analysis that appears to show that Mount Sinai intentionally created losses by stripping Beth Israel of lucrative services and departments, and shifting them to Mount Sinai.
Plaintiff and campaign member Jeannine Kiely, whose 10-year experience in nonprofit healthcare finance included a stint as a director in the Healthcare Group at Citibank, detailed the campaign’s analysis in another July 1 affidavit filed with the court. Her statement concluded: “Given that Beth Israel’s services, and revenue streams, are under the control of the Mount Sinai Health System, it is not hard to extrapolate that the decline [in operating net income] is intentional.”
In addition, Kiely’s affidavit noted most of the annual losses reported by Beth Israel are attributable not to reduced operating net income but to depreciation.
Plaintiffs also filed with the court a 2023 comparison of Beth Israel with Lenox Hill Hospital, done by the Lowne Institute Hospital Index. At that time, Beth Israel had an overall “A” rating and Lenox Hill had an overall “B” rating. In an affidavit, Schwartz remarked that the comparison “shows how amazingly fast Mount Sinai Hospital System acted to destroy what was still a viable hospital.”
Both Mount Sinai and New York State seek to have the court case dismissed. The next date in the litigation is a court conference on Aug. 8.
Asked to comment on the status of Mount Sinai’s Beth Israel closure plan, Mount Sinai spokesperson Loren Riegelhaupt told The Village Sun: “We are continuing to work closely with D.O.H. on safely closing the hospital while also complying with the law.”
(Photo by Ian B. Kwok)
On Wednesday — two hours before The Village Sun went to press with this article that reporter Phyllis Eckhaus had been working on for the last week — Crain’s New York Business reported that Mount Sinai had “indefinitely postponed” Beth Israel’s closing. The Crain’s report was based on an internal memo sent to staff.
In addition, attorney Schwartz said he sent a letter to Mount Sinai’s lawyers Tuesday night, charging that Beth Israel C.E.O. Sellman was “telling all who ask, ‘We are closing Friday,'” and that other news outlets that asked about the hospital’s status were also being told this. In his letter to Mount Sinai’s counsel, he stressed, “[B]esides being unlawful and contemptuous, a closure on July 12 would cause an immediate health crisis.”
Schwartz further warned that, if pushed to it, he would seek to have top hospital executives arrested — and thrown into jail. He dared Mount Sinai to call his bluff.
“Should there be any actual move to close Beth Israel, which could include moving equipment out, or transferring staff, with the T.R.O. in place and without D.O.H. approval,” Schwartz fumed, “we will seek to have Ms. Sellman and Mr. Carr [Mount Sinai Health System C.E.O. Brendan Carr] serve some time locked up. Please don’t dare us to seek that sort of relief.”
In turn, the response from Mount Sinai’s attorneys, Schwartz said, was to threaten him with “sanctions.” However, Schwartz retorted in an e-mail that Mount Sinai’s Web site was still saying that Beth Israel would close on July 12.
“Do we need an Emergency Motion?” he warned them.
Schwartz’s aggressive threat worked. Wednesday morning, Mount Sinai back down and scrubbed its Web site of the notice stating Beth Israel would close July 12.
The notice had said, in part: “Due to the changing healthcare landscape and financial reality at MSBI, Mount Sinai Health System has made the difficult decision to close the 16th Street campus. The proposed closure date is July 12, 2024. After closure, patients will still be able to access care from across the Mount Sinai Health System, including through our extensive ambulatory platform downtown. …”
For his part, Hannay framed the fight over Beth Israel’s survival as part of a bigger battle to stop hospital closures statewide, a struggle in which community advocates have recently gained ground. He pointed to the passage this past session of long-stalled legislation to improve New York’s oversight of hospital closures and to make local community input a required part of the process. The advocate described the new law as a “welcome turnabout in Albany’s typical power politics,” in which the hospital industry, with its “inordinate influence,” has previously been “unchallenged.”
Councilmember Carlina Rivera, left, other politicians and advocates rallied outside Beth Israel this past December. (Photo by John Keller)
In a statement, Councilmember Carlina Rivera cheered the latest news on Beth Israel — but stressed that a “long-term commitment” to maintaining adequate healthcare in Downtown and Lower Manhattan is critical.
“It is a relief that Mount Sinai’s indefinite postponement of the closure of Beth Israel will keep the hospital open for now,” Rivera said, “but their failure to make a long-term commitment puts the healthcare of over 400,000 Manhattan residents in jeopardy. Together our community has been fighting back against Beth Israel’s shutdown, and today’s announcement allows more time to urge the State government to intervene and protect our neighbors. I remain firm in my position that the closure of Beth Israel would have devastating consequences and that mitigations proposed by Mount Sinai remain wholly insufficient to support residents in maintaining their health and well-being. It will take years for existing alternative healthcare providers to scale up their infrastructure to meet the demand that will be placed on them, and the State must intervene to halt Mount Sinai’s hasty efforts to close the hospital down. The State must ensure that mechanisms are in place to provide accountability for essential healthcare services before any reduction in services is permitted.”
After this article’s publication, Mount Sinai spokesperson Loren Riegelhaupt offered an additional statement, saying, “We firmly believe it is even more vital that we close M.S.B.I. as quickly as possible. We submitted our plans over 10 months ago and we will soon be past the date when we thought we could safely remain open. The actual closure date now depends on state and legal decisions but the urgency and need to close has never been greater.”
Also, the day after this article’s publication, the Save Beth Israel and New York Eye & Ear Campaign issued a lengthy statement that said, in part, “In yesterday’s e-mail to staff, Mount Sinai Health System (MHSH) has finally acknowledged the reality that Beth Israel Medical Center (BIMC) will not close tomorrow (July 12), despite their continued claims to the contrary since last fall. Mount Sinai is not able to close BIMC until a closure plan is approved by the New York State Dept. of Health (DOH), and until a Temporary Restraining Order issued last winter by a New York State court is lifted or resolved. Both actions are not expected anytime soon. We welcome MSHS’s recognition that they cannot simply bully their way to what they want.”
In addition, the campaign’s statement said, “We challenge MSHS’s assertion in yesterday’s staff e-mail that ‘roughly 450 staff have left the hospital of their own accord to seek employment elsewhere.’ We know from many BIMC employees who have spoken to us in confidence, fearful of losing their continued employment within the MSHS system, that workers were pressured by MSHS and BIMC management to participate in job fairs designed to quickly relocate them to new sites within MSHS. These workers say they were told by management that if they did not do so, they would not be guaranteed a job within MSHS going forward. Again, MSHS intentionally created a staffing crisis to then subsequently bemoan and blame.”
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