Yves here. This post about New York City hospitals and clinics may seem a bit parochial, but I anticipate that for American readers, it may evoke discussion of hospital closures and service cutbacks in their area. Plus nurses have been particularly effective at organizing, so it seems useful to support their efforts, even if in a small way.
I found this story shocking and sad. New York City has long been the place to go, not just in the US but internationally, for medical care. The large number of teaching hospitals (plus Medicaid plus other New York City specific programs such as for HIV positive cases) has, at least as far as I can tell, produced a much better level of typical care for low-income patients than in most of the US.
But that standard has eroded substantially over recent decades. St. Vincents Hospital, a Greenwich Village fixture that famously had treated 9/11 victims, closed in 2010 due to financial pressures and the failure to find a hospital system that would accept it as a merger partner. From a bloodless New York Times story at the time:
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….
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.
Beth Israel, which merged into Mount Sinai, had had its major hospital on East 16th, just north of the Lower East Side. Despite the considerable gentrification of the area, it looked shabby the few times I visited a sick friend there, so there were visible signs of stress. We will skip over the details of the recent state of play. Late last year, Mount Sinai announced its intent to close the hospital, but the State Department of Health rejected the closure plan in April, with a gaggle of Federal, state and city elected officials supporting that decision. The story from THE CITY says Mount Sinai submitted a revised plan last week but is still cheekily sticking with closure date of July 12 without having the authority to do so. So what happens next is still in play.
The article below focuses on an ear and eye clinic, formally the New York Ear and Eye Infirmary, on 14th Street that Mount Sinai also plans to shutter, by turning it into an urgent care center. That is despite the fact, as the piece points out, that an urgent care center there looks redundant. One might infer that this is a phased closure plan, with the old ear and eye location being set up to fail.
I used that facility and was happy with the care I got. It had a very good reputation. It was spartan and you could expect a wait, but if you had an eye or ear problem, you’d get treated in at most a few hours by a very competent doctor, and at lower cost than most GPs and definitely most specialists would charge.
By contrast, when I had an eye disaster on the West Coast (scratched cornea one night in Los Angeles, which led to an ER visit, then due to temporary loss of vision in that eye the next night in San Francisco due to inflammation, an outcome I had not been warned might occur) I spent better than 12 hours in the emergency room, panicked that I was going blind. The only other place I have encountered a specialist eye clinic was an actual eye hospital in the University of Alabama. As you can imagine, the triaging on eye-only cases is different than in a general emergency room.
The bigger issue is that this is yet another high quality yet affordable facility that appears to be destined for closure, and the explanations don’t seem sufficient. The adminisphere bloat and related cost burden in medicine, particularly in big medical systems, has been ginormous. Why isn’t the axe falling there?
By Claudia Irizarry Aponte. Originally published at THE CITY on June 4, 2024
With weeks to go until Mount Sinai Health System’s planned July 12 shutdown of Beth Israel Hospital, nurses at a sibling facility on Manhattan’s East Side are in the midst of bargaining a new contract for higher salaries.
They’re also negotiating a layoff plan for if and when the health system closes their place of work, the New York Eye & Ear Infirmary of Mount Sinai.
Mount Sinai is proposing to turn its Eye & Ear Infirmary, an ambulatory center on 14th Street off Second Avenue, into an urgent care center after Beth Israel closes, Mount Sinai CEO Brendan Carr wrote in a May 17 letter to lawmakers.
Nurses rallied outside the East Village facility on Tuesday, seeking to push management back to the table after their most recent contract expired on April 30. The roughly 60 nurses employed at Mount Sinai Eye & Ear are represented by the New York State Nurses Association.
John Paul Montemayor, an operating room nurse and the bargaining unit’s president, told THE CITY that Mount Sinai “hasn’t promised anything in terms of reassigning or relocating” nurses if Eye & Ear closes. As far as the current contract negotiations, the union and management have also not reached an agreement on the nurses’ demands for raises, enforceable staffing ratios or a layoff plan since their most recent bargaining session on May 6, he added.
“We could reinvent this place to be an infirmary for everybody, but Sinai’s saying that they just don’t have the money – that it’s going to take millions of dollars to revamp this place,” Montemayor said.
Mount Sinai spokesperson Lucia Lee said in a statement that the health care system “is negotiating in good faith with the goal of reaching an agreement that honors our skilled nurses and ensures that patients receive excellent care.”
“Thanks to our nurses and the NYEE community for their patience as we work toward a resolution,” she added.
Concerns among staff and community members about Mount Sinai Eye & Ear’s closure have been swirling for years.
In 2022, Mount Sinai began distributing the ambulatory center’s services to other locations in order to merge its operations with Beth Israel. At the time, Mount Sinai denied it was shutting down the facility, and asserted that it was instead taking on a “on a multimillion dollar plan to strengthen and modernize all NYEE programs and services by moving them into new and newly renovated ambulatory settings.”
Last September, Mount Sinai asked state officials to approve of its plan to close Beth Israel on July 12, 2024, citing financial and staffing troubles – a plan that was shut down by the state Health Department as “incomplete” and blocked by a judge.
The hospital system resubmitted their closure plans to the state last week — one that will reportedly include turning the Eye & Ear campus into an urgent care center. That plan is still pending a review from the state Health Department.
The union claims nurses at Mount Sinai Eye & Ear are the lowest-paid nurses in the Mount Sinai system, a disparity that grew even wider after nurses at several other Mount Sinai facilities successfully struck and won higher wages in January 2023.
Though staffing had not previously been an issue, nurses say, many have quit and vacancies have gone unfilled with Mount Sinai Eye & Ear’s future in limbo.
“This used to be a workplace where management was supportive, collaborative, and would celebrate everyone through milestones, anniversaries and retirements. Now it is a workplace of insecurity and rumors of closure,” nurse Teresa Moriarty, who has worked at Eye & Ear for 17 years, said during the rally. “It’s very hard to maintain nurses and safely staff our hospital.”
There is no upcoming bargaining date on the calendar, said Montemayor, the unit’s president.
The proposed urgent care facility would be open seven days a week and offer more services than an ordinary urgent care center, such as ultrasounds and CT scans, wrote Carr in his May 17 letter to lawmakers. Mount Sinai also pledged to give an unspecified amount of funds to nearby New York City Health + Hospitals/Bellevue after Beth Israel’s closure so the public hospital can renovate its emergency department in order to accommodate a higher volume of patients, Politico reported.
Health + Hospitals CEO Mitch Katz said during a March 5 City Council budget hearing that Bellevue will need to open more beds if and when Beth Israel closes.
Councilmember Carlina Rivera (D-Manhattan), among the elected officials pushing back against the hospital’s closure, was skeptical of Mount Sinai’s plan for an urgent care center in the current Eye & Ear facility — noting that the hospital system already owns and operates an urgent care center three blocks to its west in Union Square.
“An expanded urgent care center is not a replacement for a full-service hospital that is open 24/7 and can accept ambulances,” she told THE CITY. “We can’t rely on Bellevue for everything. It’s not feasible.”
