Local nurses and hospital officials vow to fight state commission's recommendations
Doreen DeVito, RN, a staff nurse at Victory Memorial Hospital, Brooklyn, NY, is worried about finding a nurse manager position with only a nursing diploma in hand, even though she has almost 40 years of experience in nursing.
Mel Hess, RN, a nurse at Cabrini Medical Center in the Gramercy Park section of Manhattan, is anxious about the prospect of losing her family of co-workers and patients.
DeVito and Hess are two of the thousands of healthcare workers at five New York City hospitals whose fates lie in the hands of the state Legislature.
A state commission recommends closing nine hospitals across the state, including the five in New York City to modernize New York's healthcare system and help contain skyrocketing Medicaid costs.
The New York State Commission on Health Care Facilities in the 21st Century recommends closing:
Brunswick Hospital Center, a nursing home on the Nassau/Suffolk county border.
Consolidation
In addition, the 231-page report (also known as the Berger Commission after its chairman) recommends 48 hospitals and 14 nursing homes be consolidated, converted to other uses or reduced to such an extent that it could, in some cases, constitute a closure. In New York City, 10 additional hospitals were tapped as potential merger or downsizing candidates. In Long Island, nine hospitals were targeted for mergers or downsizing.
The commission recommends, for example, eliminating the few remaining inpatient beds at Manhattan Eye, Ear & Throat Hospital in Manhattan, which is primarily an ambulatory care center.
Naomi Zauderer, executive director of the New York Professional Nurses Union, which represents RNs at Manhattan Eye, Ear & Throat and Lenox Hill Hospital, is not concerned.
"We may lose 10 or 11 RN positions," she told ADVANCE for Nurses, "but they will be placed elsewhere at Lenox Hill."
7,000 Jobs
The outright closures would eliminate 4,000 of New York states' roughly 60,000 hospital beds and 7,000 jobs, including 4,200 in New York City. Stephen Berger, the commission's chairman, said closing hospitals is just one step and reimbursement policies must also be fixed.
Zauderer agreed. "The Berger Commission is attributing the problem to excess bed capacity, but the real problem is with the whole way the system is financed.
"Unfortunately, the insurance companies are making money by denying care," she said.
Outgoing Gov. George E. Pataki had until Dec. 5 to act on the report, but he and Gov.-elect Eliot Spitzer already have endorsed the report. It is now at the state legislature, which will either accept or reject the all-or-none proposal in its entirety by Dec. 31.
If approved by the governor and the New York State Legislature, the report's recommendations will have the power of law and the state commissioner of health could revoke the licenses of hospitals that do not close.
Mixed Reactions
The Nassau-Suffolk Hospital Council (NSHC), in a press statement by Kevin Dahill, president/CEO, said the authors of the report "faced a tough job" poring through "mountains of data" and listened to hundreds of hours of testimony. The Long Island hospital council "applauded" the Commission's efforts believing the report would spark "meaningful reform and changes in our areas of the healthcare delivery system."
Shaun Flynn, associate director for governmental affairs at the New York State Nurses Association (NYSNA), on the other hand, was very critical and urged rejection of the report.
Flynn told ADVANCE for Nurses that not only was it a "flawed report, but a flawed process" in that it "was not as open as it could have been."
"The regional meetings were open to the public, but when it came time for decisions, it all happened behind closed doors and was very secretive," Flynn said. "We don't believe a process that is going to affect so many communities across the state should be done by a group that is not elected and is not accountable to the public."
Gov. Pataki and the legislature established the commission, a nonpartisan panel, in 2004.
Flynn said NYSNA disagreed with the list of closures, expressing particular concern about the lack of healthcare access for poor, underserved communities. He said if the recommendations get the green light as is, they will worsen the current nursing shortage.
Nurses Will Find Homes
Roseann Raso, MS, RN, CNAA, senior vice president of nursing services at Lutheran Medical Center in Brooklyn, agreed that in the long run the closings will not help the shortage. But she frankly admits if nurses at nearby Victory Memorial in Bay Ridge are displaced, Lutheran will gladly hire them.
"There are wonderful nurses who work there who I would love to welcome into our family," Raso said.
Hess, a staff nurse who works in the outpatient infusion department at Cabrini Medical Center in Manhattan, is concerned about the loss of her "family" at the hospital.
"We are all very anxious," said the staff nurse with 20 years of experience at the 328-bed hospital. "Cabrini is a close, family-oriented hospital. Everyone knows everyone, we're all on a first-name basis.
"Naturally, we don't want to see it closed, especially with all the elderly patients who think of Cabrini as their second home."
As the news of a possible closing hit Cabrini, the facility was preparing to expand its infusion unit from eight to 25 beds on Dec. 18, and open a geriatric psych unit with 28 beds.
"It is very hurtful when we read in the media that Cabrini gives poor quality care," Hess said. "Everyone is still working hard here and focused on giving the best quality patient care."
RNs at Cabrini planned to hold a noon rally and a candlelight vigil Dec. 5 in front of the governor's Manhattan office to reject the commission's recommendations.
'Devastated'
DeVito, a nurse at Victory Memorial Hospital, was devastated by the news of the possible closing of this Bay Ridge hospital known in its community as the "baby hospital." She likened the small, private hospital fighting the government to the battle between David and Goliath.
After earning her nursing diploma 32 years ago, DeVito joined the hospital and worked her way up to a nurse manager. She doubted she even could get an interview today for a management position, where more and more facilities are requiring BSN degrees or higher.
"I'm a working manager but still very involved with patients, however," she told ADVANCE for Nurses, "so I could go back to bedside nursing. I may not get the shift or unit I want but I know I'd find a job because nurses are in demand.
"It's not what I love to do, however, and the worst is leaving my family at Victory Memorial," she said.
'Astounded'
Marlene Bloom, director of communications at St. Vincent's Midtown Hospital, said the hospital took action when the commission issued its report. They protested the commission's recommendation because "they ignored their own regional advisory committee's advice.
"We met them and gave them a very comprehensive and thoughtful recommendation for restructuring, which included reducing our inpatient facilities, increasing our connection with St. Vincent Manhattan and expanding our ED and ambulatory services," she said.
The committee told them their recommendations were "right on target" and the state department of health, to which St. Vincent's Hospital also made its proposal, awarded the hospital $16.7 million to put the recommendations into effect.
"Then, 3 days later, the Berger Commission recommends closing us. We were astounded," Bloom added.
St. Vincent's Midtown planned to hold a rally Dec. 7, send hospital President Len Walsh to testify in Albany and rally the community in support of keeping the doors open.
The only question now is whether their slingshot is powerful enough.
Kathleen Waton is regional editor at ADVANCE.