Concern Grows Over Mount Sinai Closure Plans for Both Beth Israel and Eye & Ear Institute

In late October, 2023 the Mount Sinai Health system, owner and operator of the Beth Israel Medical Center (BI) - and New York Eye and Ear Infirmary (NYE&EI) announced its plan to close Beth Israel by this coming July. This plan represents an abrupt change from an earlier plan - described in a recent (November 13, 2023) column in this paper - to merge the two hospitals. The closure of BI alone would remove 696 licensed hospital beds from the community, thus making hospital-based care less accessible to lower Manhattan residents.

The closure of the entire BI-NYE&EI complex appears to be Mount Sinai’s goal. This would leave only one general hospital, New York Presbyterian of Lower Manhattan with 180 beds, south of 23rd Street where nearly 400,000 New Yorkers live. On average there are 2 - 3 hospital beds in the US for every 1000 people. It seems reasonable to assume that that hospital beds would be distributed geographically in proportion to neighborhood population density.

This is clearly not the case in our city. Recent data show that Manhattan has 6.1 hospital beds per 1000 residents while Brooklyn has 2.19 and Queens 0.94. While it is difficult to quantify need for hospital beds, surrogates for health care need suggest that these needs are greatest in the outer boroughs. It is well recognized for examples that longevity is lesser and health care needs greater among minority and other lower income people. In this regard, the mean income in Manhattan is $139K. In Brooklyn, $51K. In Queens, $78K. Minority populations are concentrated in the outer boroughs. This disparity between population and bed availability is most pronounced on our Manhattan island where in lower Manhattan there would be 0.45 beds per 1000 residents were both BI and NYE&EI to close.

Oversight for determination of either the location of new hospital facilities or the relocation of existent ones is inadequate. The mission statement of our State Public Health and Health Planning Council (PHHPC) requires a Certificate of Need (CON) for all hospital projects that either involve substantial capital expenditure or generate high operating cost. The CON process must include input from the local community. However, there are no rigorous criteria for this assessment process. It appears that the PHHPC merely applies a rubber stamp to most CON applications for approval.

Of note, a recent NY Daily News report (November 23, 2019) describes the potential for conflict of interest among CON committee members. This report referred to a proposal by Northwell Health and Lenox Hill Hospital who together planned to build two large hospital / condominium towers adjacent to the current Lenox Hill site on the upper East side. Two administrators of Northwell which would profit from the project sit on the CON committee. Those members have recused themselves from the debate. Recusal alone however does not eliminate the appearance of a conflict of interest among PHHPC members.

The Mount Sinai consortium claims that closing Beth Israel is necessary because bed occupancy is unacceptably low and the hospital is losing $100 million yearly. These claims are disingenuous in that Mount Sinai has closed some core services at both hospitals and moved others to uptown sites. The “Save Beth Israel / NY Eye and Ear Campaign” launched late in 2023 must push for a critical objective CON process to precede either the relocation or closing of any E.16th Street hospital facility. To this end, the Department of Health (DOH) has recently issued a cease and desist letter to Beth Israel, requiring it to halt any further downsizing without DOH approval of its overall closure plan.

To assist the community with planning and organizing to oppose this hospital closure, Physicians for a National Health Program is holding an on line forum on the evening of February 20, 2024. All are welcome and may join via a link posted on its website: www.pnhpnymetro.org.

Dr. Marc Lavietes is a Manhattan resident and has been a board member of Physicians for a National Health Program, NY Metro Chapter for approximately 25 years. He was chapter secretary from 2004 - 2023 and continues to sever on the board.