BY PHYLLIS ECKHAUS
MAY 29, 2024
In April, advocates — including attorney Arthur Schwartz, second from left — marched through the East Village to New York Eye and Ear Infirmary and Beth Israel Hospital to protest Mount Sinai's closure plans.
(Photo by Ian B. Kwok)
On May 23, the E. 16th Street hospital, owned by Mount Sinai Health System and serving more than 300,000 Downtown and Lower Manhattan residents and workers, submitted a new closure plan to the New York State Department of Health, stubbornly insisting on the previous July 12 closure date.
The new plan is intended to cure the various deficits that had led D.O.H. in April to reject the previous plan as “incomplete.”
Sixteen Manhattan politicians — Congressmembers Jerry Nadler and Dan Goldman, Borough President Mark Levine, state Senators Kristen Gonzalez, Brad Hoylman-Sigal, Liz Krueger and Brian Kavanagh, Assembymembers Harvey Epstein, Deborah Glick, Grace Lee and Tony Simone and Councilmembers Carlina Rivera, Keith Powers, Christopher Marte and Erik Bottcher —issued a May 28 joint statement slamming the new plan.
“This elimination of services on a hasty timeline without adequate community engagement remains unacceptable and we urge the Department of Health to return this application,” they wrote. “Mount Sinai must engage in a robust and collaborative process to fulfill its obligations to the community in ensuring access to high-quality healthcare is protected in Lower Manhattan.”
The Campaign to Save Beth Israel and New York Eye and Ear Infirmary also condemned the plan, blasting what it called Mount Sinai’s aggressive efforts to cut services while ignoring D.O.H. and judicial mandates requiring those services to be restored.
“Mount Sinai should not be allowed to shutter Beth Israel, sell off its campus to real estate developers, and then walk away from …its charitable mission and…its latest round of promises and feeble plans….to assure hospital-based care in Lower Manhattan,” the campaign said.
“We call on the State Department of Health to hold Mount Sinai accountable for its intentional destruction of what has been a widely respected and beloved community-serving hospital with a history of 134 years of service to Lower Manhattan residents, particularly low-income and uninsured people and immigrants.
“We also call on the state attorney general to hold Mount Sinai accountable for its deliberate failure to fulfill its legally required charitable mission to operate Beth Israel to serve Lower Manhattan, as it promised when it acquired the hospital over a decade ago,” the campaign continued. “We believe such a mission is eminently doable given the 300,000-plus residents and workers in the area, provided there is institutional commitment.
“Finally,” the campaign said, “we call on the Department of Health to adopt a proactive stance and convene all stakeholders to craft a way to restore and provide necessary hospital services in Lower Manhattan, and we stand ready to participate in such a process.”
The new closure plan is the latest twist in a long-standing battle over Beth Israel’s fate. Last December, D.O.H. ordered Beth Israel to “cease and desist” closing hospital departments and to restore hospital services that Beth Israel had already closed without D.O.H. permission.
According to Arthur Schwartz, the attorney representing the Save Beth Israel coalition, it appears D.O.H. took no follow-up action to enforce its unusual December order.
Mount Sinai, meanwhile, contends Beth Israel is financially unsustainable. The new closure plan states that the Gramercy hospital lost $44 million in just this year’s first three months.
Schwartz, who has characterized Beth Israel’s reported deficit as “accountant magic,” asserted that Mount Sinai is deliberately starving Beth Israel of patients, exacerbating the hospital’s money problems.
(Photo by Ian B. Kwok)
He said that on May 2, when his 102-year-old mother became ill, he was able to get an ambulance to take her to Beth Israel, the nearest hospital, only by explicitly insisting. Schwartz reported that “in the entire two hours” he was in the ER with his mom, not a single ambulance arrived at the ER.
“Officially or unofficially, ambulances have been told not to go to Beth Israel,” he declared, a suspicion partially borne out by a leaked Emergency Medical Services memo. In February, Beth Israel allowed its primary ambulance contract to expire.
The community coalition stated that Beth Israel’s current financial woes are a direct result of Mount Sinai having “deliberately dismantled Beth Israel.
“Since acquiring Beth Israel in 2013, Mount Sinai has removed: 31 chemical dependence beds (2015), 29 physical medicine and rehabilitation beds (2016), [a] 20-bed pediatric unit and a five-bed pediatric intensive care unit (both 2016), cardiac surgery (2017), 42 maternity beds (2017), 14 neonatal continuing care beds and 17 neonatal intermediate care beds (2017), 5 medical/surgical beds (2017), [and] linear accelerator service (2017).”
The community coalition observed: “It is no wonder that the hospital’s inpatient bed census began to drop and its finances falter. At the time Mount Sinai acquired Beth Israel, the hospital was solvent and highly regarded for its psychiatric care, addiction services, cardiac care and maternity and pediatric services. Many patients deliberately chose to seek care there for these very services, thereby helping to keep the hospital financially stable.”
The community coalition continues to challenge closure in state court. This past March, Supreme Court Justice Nicholas Moyne issued a temporary restraining order, or T.R.O., requiring Mount Sinai to restore services at both Beth Israel and New York Eye and Ear Infirmary, as well as to negotiate the restoration of services with D.O.H., local politicians, community leaders and lawsuit plaintiffs.
Schwartz told The Village Sun that Mount Sinai is “desperate” to have the T.R.O. go away.
On May 27, Schwartz wrote to Mount Sinai’s attorneys asserting that the new closure plan violates an August 2023 D.O.H. mandate that permits hospital closures to proceed only if D.O.H. first grants written permission.
The next court conference in the “Save Beth Israel” litigation is scheduled for May 30. Schwartz’s proposed briefing schedule includes a June meeting of Mount Sinai respondents with various stakeholders, “community activists involved in this litigation, plus elected officials and maybe even Local 1199.” Both D.O.H. and Judge Moyne have urged Mount Sinai to further engage the community in the closure plans.
Importantly, D.O.H. has also sought to compel Mount Sinai to plan for the dispersal of emergency room patients to already-crowded Downtown ER’s if and when Beth Israel closes.
When D.O.H. rejected the Beth Israel closure plan as incomplete, it ordered Mount Sinai to provide “detailed information about your discussions with other hospitals in the surrounding area…regarding their capability and capacity to accept additional inpatient, emergency department and outpatient volume of patients for medical-surgical care and behavioral healthcare. … Mount Sinai Beth Israel must work with other providers to identify, confirm and explore possible partnerships or solutions to support the availability of emergency services and the capacity to respond to emergencies,” D.O.H. stated.
In response, the new Beth Israel closure plan offers “to help Bellevue renovate its emergency department, acquire an additional CT scanner and create and maintain additional respite care services [services to caregivers].”
The revised plan also proposes to open an urgent-care facility on the current grounds of NYEE, at E. 14th Street and Second Avenue.
“This urgent care center would have enhanced hours, be open 7-days a week, have imaging capabilities, and take Medicaid, Medicare and commercial payers,” the new plan notes.
In a May 17 letter to City Councilmember Keith Powers, Mount Sinai C.E.O. Brendan Carr acknowledged the proposed urgent-care center would not function as an ER: “[W]e cannot offer comprehensive treatment of life-and-limb threats and, as such, I do not think the facility should receive ambulances,” he noted.
The community coalition, however, critiqued these two proposals as questionable and “woefully inadequate”: Not only are these initiatives tentatively proposed to occur only after Beth Israel is shuttered, but they fall short of the ER need Mount Sinai itself identified to D.O.H. in 2019, when the hospital behemoth documented a requirement to serve 70,000 patients a year at Beth Israel’s ER.
In her May 23 cover letter attached to the new closure plan, Beth Israel President Elizabeth Sellman urged D.O.H. to respond to the proposal “as promptly as possible, and hopefully no later than 30 days.”
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