This article points out how Downtown Hospital had to double the beds in the neonatal intensive care unit in 2010, which was when St. Vincent's Hospital was closed. Downtown Hospital could not afford the expansion of maternity care, but the State Department of Health gave Downtown Hospital no extra support in the face of the closing of St. Vincent's. In contrast, Medicaid reimbursement rates were cut by Gov. Cuomo. It is almost three years since St. Vincent's closed, and we are still dealing with the severe effects to public health. And the State Department of Health still has no plan to equally fund all of our hospitals and medical centers, so that each hospital can fully meet the needs of all patients.
NY-Presbyterian to bail out Downtown Hospital
Lower Manhattan's last medical center on brink of collapse.
By Barbara Benson @Barbara_Benson
January 27, 2013 5:59 a.m.
The last remaining hospital in lower Manhattan, financially unstable after years of operating losses, is being bailed out by a wealthy uptown white knight, Crain's New York Business has learned.
New York-Presbyterian Hospital has asked state health officials for permission to acquire New York Downtown Hospital, the only institution below 14th Street since St. Vincent's Hospital closed in 2010. Downtown "has experienced persistent, significant financial difficulties that threaten its future viability," New York-Presbyterian officials wrote in December in a request to the New York State Department of Health. '[Downtown Hospital] is projected to have a significant operating loss in 2013, unless the current situation is changed."
Downtown will become the sixth campus of New York-Presbyterian. Currently a 180-bed community hospital, Downtown may look very different as a campus of an uptown owner, although it was not clear late last week what plans the huge health system has for Downtown. "[The facility will] transition into a sustainable and financially feasible model of care," according to New York-Presbyterian's application to the state.
The proposed deal seems similar to the transaction struck last week between Montefiore Medical Center and New York Westchester Square, a bankrupt Bronx community hospital. Both Montefiore and New York-Presbyterian are buying financially troubled community hospitals. Under Montefiore's ownership, Westchester Square will cease being a hospital and will have only emergency, surgical and primary care services.
Unlike its Bronx counterpart, Downtown will stay a hospital, simply because lower Manhattan can't do without one. Manhattan overall has 6.3 hospital beds per 1,000 residents. Lower Manhattan has a paltry 0.57. New York-Presbyterian executives believe they can save Downtown by improving the "quality, delivery and efficiency of the existing services."
"Our plan is for Downtown to remain a community hospital," said a New York-Presbyterian spokeswoman, declining to elaborate further. Jeffrey Menkes, Downtown's president and chief executive, declined to comment.
Downtown has been in the New York-Presbyterian health system's sprawling network since 2006 but is a separate corporate entity. Downtown has struggled for years, even selling off a parking lot to developer Bruce Ratner in 2004 to raise cash.
New York-Presbyterian, meanwhile, is a behemoth with nearly $4 billion in revenue. It employs some 20,000 workers, including 6,000 doctors, and has nearly 2,300 beds.
Heavily reliant on Medicaid
The uptown health system expects to be able to absorb Downtown's losses and assume all its outstanding debt. Under new ownership, Downtown would become a "financially viable division of NYP Hospital," according to the state filing.
New York-Presbyterian blames Downtown's financial collapse on federal and state reimbursement cuts and the hospital's inability to either boost revenue or reduce costs. Downtown is heavily reliant on revenue from Medicaid, the government program for low-income and disabled people, which covers 45% of the patients it discharges. Among patients treated in the emergency department, 20% are uninsured.
Downtown also has been forced into the red by maternity care. Between 2002 and 2011, the number of obstetric patient days grew about 3.3% a year, prompting the hospital to convert eight regular beds to maternity beds, for a total of 24. That move followed a doubling of beds in 2010 in the neonatal intensive care unit. Now the neonatal IC and maternity units lose more than $1 million a year, thanks to high staffing and operating costs, pricey medical malpractice insurance and low reimbursement rates.
Despite that shaky financial foundation, Downtown is the only hospital serving the 314,273 New Yorkers who live below Houston Street—not to mention the daily surge of 750,000 people who work in the area. And once the September 11 Memorial and 1 World Trade Center come online, those numbers will spike even more.
Downtown evacuated before Superstorm Sandy hit, based on the assumption that lower Manhattan would lose electrical power. It suffered no damage beyond the loss of revenue for about a week. And a good thing, too: In early January, more than 20 passengers from a ferry crash in lower Manhattan were treated at Downtown.
A version of this article appears in the January 28, 2013, print issue of Crain's New York Business as "NY-Presby to bail out Downtown Hospital".
Here is information to read before you contact State Sen. Hoylman : please make a plug for the single payer bill that is being discussed and reviewed by the state legislature.
