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Told to Reinvent Themselves, Brooklyn Hospitals Continue to Struggle

Monday, July 29, 2013

Dr. Angela Ng examines a newborn baby at Lutheran Family Health Center in Sunset Park. Experts say Brooklyn's struggling hospitals could better serve their communities in clinics like this one. (Fred Mogul/WNYC)

Brooklyn is close to losing two large and historic hospitals -- despite the efforts of community activists, elected officials, and blue-ribbon panels to keep them open. A mix of economics, politics and long-term healthcare trends has been shuttering hospitals around the region for decades and could claim more Brooklyn institutions in the years ahead.

“If a hospital is serving a low-income community, it probably has a fair number of patients who are not paying – who are uninsured – so, left on its own, a hospital serving a low-income community is going to be financially in distress,” said Jim Tallon, president of the United Hospital Fund of New York.

Interfaith Medical Center, which has been in bankruptcy since December, followed a state order on Thursday to submit a closure plan to the New York state Department of Health. The timetable for shutting down has not yet been disclosed, as regulators review the plan.

SUNY Downstate has been trying to close Long Island College Hospital, in Cobble Hill, since March – over the objections of hospital workers and community supporters. SUNY Downstate, whose flagship hospital and medical school is located in East Flatbush, four miles away, has been losing millions of dollars a year, and has said selling off LICH is a crucial part of restructuring what’s left of the system.

In addition to LICH and Interfaith, there is a long list of financially troubled hospitals in Brooklyn, including Brookdale, Wyckoff Heights, Brooklyn Hospital Center and Kingsbrook Jewish.

A special panel appointed by Gov. Andrew Cuomo in 2011 outlined the economic and demographic challenges facing all these institutions and anticipated more closures. The panel’s final report said Brooklyn’s hospitals weren’t serving the healthcare needs of the borough’s residents.

“You want a network of outpatient clinics and ‘surgi centers’ and primary care linked to different kinds of inpatient facilities, and much smaller inpatient facilities with much smaller lengths of stay,” panel chair Stephen Berger told WNYC late last year. “Now, you don’t do this overnight, it takes several years to build things and change things out and change concepts.”

The report said despite a glut of hospitals, these institutions could still survive and play a valuable role – if they joined forces and consolidated their services. A series of proposed mergers generated negotiations that all came to naught.

“The concept of merging was to buy us some time and transition to a new system,” Berger said. “But no one’s been willing to merge, and everybody’s been resistant. People would rather hang on by their fingernails.”

At the same time, a few Brooklyn hospitals are doing relatively well – or at least breaking even, including New York Presbyterian-Methodist, Maimonides and Lutheran.

Berger’s panel singled out Lutheran, in particular, for creating a network of family health centers.

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Comments [12]

bill from manhattan

This is such bull

if you look at the bankruptcy filings for hospitals(st vincents in nyc)
the administrators always make a million a year

st vincents was paying doctors $50,000 per week!! how obscene

st vincents paid the bankruptcy lawyer $1000 per page to file for them

the average is about $100 per page.

Usually its greed that closes hospitals and a union the could care less
about its workers.

usually the real estate is worth millions to the owners, so

st vincents as a hospital was worth nothing, but as real estate
it was worth houndreds of millions!!

Why does not 1199 buy these hospitals in bankruptcy to preserve
workers jobs?

answer: because the union could careless about their members losing
their jobs

UAW got obama to buy gm to preserve jobs, 1199 is no uaw!!!

Dec. 26 2013 06:00 PM
hh from Brooklyn

“You want a network of outpatient clinics and ‘surgi centers’ and primary care linked to different kinds of inpatient facilities, and much smaller inpatient facilities with much smaller lengths of stay,” panel chair Stephen Berger told WNYC late last year.

#1. Those clinics & "surgi-centers" are for people who are basically well. Where do the SICK people & major, complicated, risky or emergency surgery cases go? Clinics & centers cannot replace a HOSPITAL.

#2. Berger keeps saying we need smaller hospitals. Last week Mayor Bloomberg said we cant have a hospital on every corner so we need BIGGER hospitals. These are the people in charge.

G-D help us all.

Aug. 04 2013 01:35 PM
realBrooklynite from South Brooklyn

Between Court and Smith from Carroll Gardens is worth repeating

'Changing demographics' and 'failure to reinvent ourselves' has less to do with the LICH closing than SUNY would have everyone think. This will come to be seen as the criminal land grab it is, an engineered failure at the hands government gangsters who ran their own facility into the ground before consuming ours. As a LICH employee directly involved with reimbursement,I have seen first hand the obstructive billing policies, the flat refusal to allow us legitimate access to managed care contracts, their delayed or absent response to our requests for directives, and their total lack of support in efforts to secure rightful insurance payments. This is just a small list of the tactics SUNY employed to insure our failure and thus guarantee their access to our real estate. Happy now, Mr. Cuomo??

Aug. 04 2013 01:28 PM
Between Court and Smith from Carroll Gardens

'Changing demographics' and 'failure to reinvent ourselves' has less to do with the LICH closing than SUNY would have everyone think. This will come to be seen as the criminal land grab it is, an engineered failure at the hands government gangsters who ran their own facility into the ground before consuming ours. As a LICH employee directly involved with reimbursement,I have seen first hand the obstructive billing policies, the flat refusal to allow us legitimate access to managed care contracts, their delayed or absent response to our requests for directives, and their total lack of support in efforts to secure rightful insurance payments. This is just a small list of the tactics SUNY employed to insure our failure and thus guarantee their access to our real estate. Happy now, Mr. Cuomo??

Jul. 30 2013 11:49 PM
CECIL SMITH from Ireland

Oh I do not know its like private and public education in the U.S.A. and a model of health financing cannot exist for a hospital serving poor income neighbourhoods. I suggest an army of cuban doctors work alongside their u.s. counterparts and some incentivisation is given to the cuban doctors who would not be paid the same rates.An unlikely and crazy solution to a crazy situation but it requires some crazy change in order to stay open.

Jul. 30 2013 09:25 PM
Brooks White from Brooklyn

Is the intent to make LICH part of the Governor's START-UP program if it can be closed. Will med-tech or other related incubators be housed in a revised LICH for which angel investors could get tax credits if NYC Admin Code is revised?

Jul. 30 2013 07:38 PM

Where is the proof that merging hospitals has had a successful outcome. Further, different communities have different cultural needs, mushing all together for some unrelated for profit new business does not solve the needs of patients.

Jul. 30 2013 05:16 PM
NotFooled from cobble hill

Clinics like this certainly have a place in the community but they cannot replace a hospital. Heart attacks, strokes, pancreatitis, bleeding ulcers, septicemis & shock cannot be taken care of in clinics and urgent care centers. You still need a real emergency room with the back up of a full hospital services. LICH is just been ranked the #2 hospital in Brooklyn for the 3rd yr in a row & was filled everyday to 90% capacity of its staffed beds -- until SUNY Downstate saw enough $$$ signs in its real estate to bail out their entire enterprise & fund their grand plans for itself & took actions to close it. LICH was not losing money - the money was being siphoned off. Even the judge who originally approved giving LICH to SUNY has ordered them into court to open their books & show where all LICH's assets went. Interestingly, the amount of money SUNY claimed LICH was losing every month was almost exactly equal to the amount money it was forced to pay the previous owners every month for outsourced back-office services in a sweetheart deal that SUNY made part of the merger. LICH wasn't dying. It is being killed by its operators as a means to their end... a windfall real estate sale. It is disgusting what Governor Cuomo is doing here.

Jul. 29 2013 07:06 PM
sue from brooklyn

All that comes to mind about this is that LICH is/was a poorly run bad hospital, from the unnecessary c-section I got there in 1999, during which I recall a nurse saying, "why is the broken contraction machine in here?" , to the operation I was going to have there this year but changed my mind when no one could figure out where their job started and another's began. AND I was told to go through a door to get a doctor's signature, behind the doors, the doctor was performing a procedure, he came out with bloody gloves and signed my referral. No Way was I going back.

Reminded me of St Mary's in Weeksville, I worked on the pilot of Nurse Jackie and they were filming some at St Mary's. I was talking to a toothless local who someone gave a couple of bucks to watch the place??, and he said, St Mary's was the kind of place where, "someone would come in with a broken arm and left in a body bag".

While we were there, pre-housing bubble, slimy developers including people familiar with the neighborhood were around - all these shenanigans are inside jobs usually, right? - and I imagined their laughter was about how much more advantage they could take of a horribly devastated area. I'm not making any claims but after hearing about Bill Thompson's circuitous involvement with Interfaith, it would not surprise me if he were one of those involved with that hospital's closing and the super-expensive, poorly constructed AND ugly condos wedged in between the bad hospital and the gigantic housing projects.

Jul. 29 2013 01:11 PM
Mike Mercilliott from Crown Heights

Mr Bergers (solutions)is for Brooklyn hospitals are to merge. It is overly simplistic solution to a very complex problem. SUNY Downstate merged with LICH and the financial problems were increased for both. Now LICH is being closed and Downstate's hospital is in critical financial condition as a result. The reason the Brooklyn hospitals have not merged is it is not a realistic solution. Besides Mr. Bergers connections to our present govenor he has no real knowledge of the problems the Brooklyn hospitals face and has any real solutions. The problems include less NYS funding cut by our present govenor, less Medicaid reimburement, increasing health care costs, while providing health care to a population increasingly without any health care. Merging hospitals does not address any of these problems. That is why LICH is being closed after Mr Bergers solution of a merger was done.

Jul. 29 2013 10:50 AM
lisad from brooklyn, NY

I would like to point out that Mr Berger has no direct knowledge of hospital financing and health care. I am not sure how he came to be considered the local expert on fixing the care of the poor and working class patients in brooklyn, outside of his political connections.

Jul. 29 2013 10:29 AM
Louis Flores from Queens

Stephen Berger alludes in this WNYC report that Brooklyn hospital mergers are a "transition" to another solution. “The concept of merging was to buy us some time and transition to a new system,” he said. Based on his track record, the word "transition" is code for hospital downsizing or possible outright closure.

Because he rarely gives interviews, WNYC should have asked him whether it has been the intention of Gov. Andrew Cuomo's Medicaid Redesign Team, which Mr. Berger chaired, to deliberately weaken the community hospitals in Brooklyn to clear a path for for-profit hospitals to swoop in and set up new hospital "businesses" in Brooklyn. Presently, hospitals in New York state are forbidden to be run as for-profit corporations, but that may change if Gov. Cuomo and Stephen Berger have their way.

This reports also appears biased, because there is no solution offered. For example, a single payer healthcare system would end the funding disparities between "well insured" patients and Medicare/Medicaid patients. And single payer would also cover uninsured patients by providing funding for them, too, so that the healthcare system wouldn't be being crushed by how the free market system that we now have for healthcare leaves so many people out. A single payer system would finally fully fund hospitals to meet their patient needs. How could an ideal solution like this be left out of an article that offers the public no hope for a way out ?

You report portrays the inevitability of healthcare cuts as a fait accompli. To see WNYC cross over to this defeatist mentality is a bad sign about how the media will not challenge politicians or look at how for-profit corporations want to get into the hospital "business" in New York. What is motivating Stephen Berger to wreck community hospitals in Brooklyn ? Mr. Berger is a Wall Street pro, and he is in the business of creating opportunities that will allow for-profit corporations to get into the hospital business. And like a true Wall Street opportunist, he's doing his best to create the conditions to allow for-profit hospital corporations to buy entry at the lowest price possible by driving community hospitals into utter collapse.

It's pretty sad to see how WNYC could be played so easily to help advance this agenda.

Jul. 29 2013 07:45 AM

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