Originally Posted - November 28, 2006

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ALBANY---The Commission on Health Care Facilities in the 21st Century has recommended the closure of nine hospitals statewide including the Bellevue Woman's Hospital in Niskayuna.

The report, which must be approved by the state Legislature in order to become final, also recommends the reconfiguration of 48 other hospitals including St. Clare's Hospital and Ellis Hospital in Schenectady.

About a quarter of the state's hospitals would be affected by the report which would eliminate 4,200 hospital beds statewide.

Other hospitals targeted for closure are the Millard Fillmore Gates Circle Hospital in Buffalo, St. Joseph Hospital in Cheektowaga, Community Hospital in Dobbs Ferry, St. Vincent's Midtown Hospital in Manhattan, Cabrini Medical Center in Manhattan, Victory Memorial Hospital in Brooklyn, New York Westchester Squares Medical Center in The Bronx and Parkway Hospital in Queens.

Anne Saile, president and CEO of Bellevue and Neil Golub, CEO of Price Chopper supermarkets who is chairman of the Bellevue board and member of the Ellis Hospital Foundation, held a press conference Tuesday and said that an unnamed state official had told them that Bellevue would not be closed. Saile said "Bellevue is here to stay".

The report had said that "Bellevue Woman's Hospital should close in an orderly fashion and its maternity, neonatal, eating disorders, and mobile outpatient services should be added to another hospital in Schenectady County".

Bellevue is the only woman's hospital in the state.

The commission also recommended that St. Clare's and Ellis be joined under a "single unified governance structure and the resulting entity should be licensed for 300 to 400 beds".

Stephen Berger, former state Social Services commissioner, chaired the commission.

The commission targeted smaller facilities that they said were financially troubled. They claim that by closing the smaller institutions that the quality of care at the larger medical centers would improve.

Nursing homes are also targeted including a recommendation to merge the Ann Lee Nursing Home in Colonie which has 175 beds with the Albany County Nursing Home which currently has 420 beds. The commission would cut 250 beds and create a new facility with about 345 beds.

In Schenectady, the commission would merge the Dutch Manor Nursing Home and The Avenue Nursing Home, cutting 48 beds. It is also recommended to cut 30 beds at the Glendale Nursing Home in Glenville.

Several groups have already announced that they are considering legal challenges to block the closures and mergers. Opponents believe that the recommendations would hurt poor and low-income residents and make a bad situation worse.

Gov. George Pataki created the commission for the purpose of reducing Medicare payments and creating a stronger health care system.

The recommendations address one-quarter of all hospitals in the state and would reduce approximately 4,200 hospital beds statewide, representing around 7% of current supply. Nearly 50 hospitals will be restructured and nine will be closed. In addition, the nursing home recommendations will make highly-targeted reductions of approximately 3,000 beds, almost 3% of the state's supply, while creating home and community-based alternatives to nursing home placements.

In many cases, facilities closed or downsized would be replaced with facilities or services better suited to the needs of the local community. Approximately one-third of the recommendations reflect voluntary initiatives developed by providers with the Commission's active encouragement and assistance.

Financing is available to implement these recommendations. The Health Care Efficiency and Affordability Law for New Yorkers (HEAL-NY) allocates $1 billion to fund system restructuring and facility closing costs. The federal government has also promised New York State an additional $1.5 billion for similar purposes through the Federal-State Health Reform Partnership (F-SHRP). To receive the F-SHRP funds, the Commission's recommendations must be accepted by the legislature and implemented.

In developing its recommendations, the Commission says it reviewed extensive data concerning each hospital and nursing home within the State, conducted nearly 20 public hearings statewide, and held meetings with stakeholders representing all sectors of the health care industry. The Commission also benefited from the reports of six Regional Advisory Committees that provided a perspective on regional and local needs.

The Commission's recommendations is claimed to produce an estimated total benefit to payors and providers of over $1.5 billion annually, or $15 billion over 10 years. Included in this figure is an estimated $806 million annually in savings to Medicaid and other payors. The benefits to providers in the form of reinvestment opportunities are estimated to be $721 million annually.

Since 1983, 70 hospitals and over 63 nursing homes have closed. For the past eight years, the state's hospitals as a group have lost money. Some hospitals are in bankruptcy, while the majority of the states' nursing homes operate at a loss. The Commission's recommendations are the most comprehensive response to date to the precarious position and expense of the current institutional care system.

"Our health care system is broken and needs repair. It is not too late to restructure the care delivery system. Unless we act decisively, further facility closures and bankruptcies are almost certain to occur. Moreover, the hospitals that close due to market forces alone may be the ones most critical to preserving access," said Dr. David Sandman, executive director of the Commission. "These recommendations will help to avoid future calamities that would further destabilize the system and compromise patient care."

The Commission's report also includes recommendations for broad policy reform in the areas of reimbursement, the uninsured, primary care infrastructure, workforce development, the SUNY hospitals, county-owned nursing homes, and information technology. Such recommendations provide a blueprint for further efforts to fully reconfigure the health care system.
http://www.nyhealthcarecommission.org/final_report.htm 11-28-06

© 2006 North Country Gazette