But city residents remain wary of change

The restructuring of the Mount Sinai Health System, including the closure of the historic 825-bed Beth Israel hospital, indicates private hospitals will be increasingly reliant on outpatient services and look to reduce the number of beds in the pursuit of savings.

The fact is not as many patients are being admitted to many city hospitals. Hospital stays at all New York City facilities decreased just over 5%, or about 65,000 stays, between 2012 and 2014, according to state planning data. Shifts in health care delivery and surgery times have also significantly reduced hospital occupancy rates: In Manhattan, there are 6 beds for every 1,000 residents, over twice the national average.

“The delivery of care has changed,” said John Rowe, Professor of Health Policy at Columbia University’s Mailman School of Public Health and former CEO of Mount Sinai Health System. “In the old days, if you needed an operation, you would be out a week later. Now [hospitals] send you home as soon as you wake up and they say a nurse will call you this afternoon.”

The drastic growth of empty beds in the Mount Sinai Health System—inpatient services have declined roughly 10% annually since 2012—created losses of $250 million over the past three years. The closure of Beth Israel in favor of a 70-bed inpatient hospital two blocks away will substantially reduce the number of empty beds in Mount Sinai’s network and free up $500 million to invest in more specialized services, Mount Sinai said.

But Mount Sinai’s guarantees that the closure of the historic Beth Israel hospital facility will have little impact on the quality or access to healthcare services has raised eyebrows from residents and elected officials.

“There’s a lot of fear and anxiety that there will not be enough of services to take care of the East Village,” said Carlina Rivera, policy director for District 2 Council Member Rosie Mendez. “A cut in beds and services, regardless of where health care is pivoting, puts people in a bad place and they’re nervous.”

Rowe, however, dismissed community concerns.

“Taking 400 active beds out of the Mount Sinai healthcare system will not stress the city network,” he said. “We’re so under booked that we’re an extreme outlier.”

The restructuring of Mount Sinai, however, may not be a viable option for smaller, private hospitals that cannot fall back on the strength of a health care network to disperse services. The Mount Sinai Health System comprises seven hospital campuses, more than 300 ambulatory care practices and 38,000 employees that provide the flexibility to shift its care and absorb closures.

“If you are going to be downsizing a neighborhood hospital, it is critically important to make sure that it is well networked with other facilities,” said Assemblyman Richard Gottfried, the Chair of the Assembly Health Committee.

Gottfried indicated that smaller hospitals might be better served becoming incorporated with a regional health system.

The closure of Beth Israel will allow a massive reinvestment in the Mount Sinai Downtown health network, including the construction of a $250 million emergency room, $85 million behavioral health service and $200 million in upgrades to its ambulatory care facilities.

The updates to the Mount Sinai Health system, including the closure of “the old and outdated” Beth Israel hospital, will ultimately improve the quality of the City’s healthcare, Rowe said

“If you renovate your apartment, the kitchen is going to be different—with a better stove and better refrigerator,” he said. “That’s how it will be with hospitals. It will be higher quality, better outcomes and safer.”