As Mount Sinai Beth Israel Hospital Faces Closure, Patient Care Suffers

Once a full-service hospital that performed heart surgery and treated a range of stroke patients, Beth Israel on Manhattan’s East Side offers more limited services these days. The number of employees has dwindled from 1,800 to about 1,300 in less than a year. Some floors are nearly empty of patients.

That is because for years Beth Israel’s parent hospital system, Mount Sinai, has been trying to close it, saying it loses too much money. The plan has met resistance from community members, a judge and the state Health Department, and has led to a drawn-out fight to keep the hospital from closing.

The delay has created its own problems.

With services reduced, and employees leaving for more secure jobs at other hospitals, the hospital’s ability to care for patients has suffered, according to interviews with medical staff and reports by hospital inspectors. The result has been dangerous, at times even deadly, according to patient advocates.

This January, George Faust, a 76-year-old retired printer in Greenwich Village, awoke from a nap in his Eames chair, tried to stand up and fell. He broke a few ribs and was transported by ambulance to Beth Israel, one of the few remaining hospitals serving downtown Manhattan.

At the emergency room on Jan. 16, he was found to have a collapsed lung as well as broken ribs, his wife, Kathleen Faust, said in a phone interview. Beth Israel staff members said the facility was too understaffed to care for a “trauma patient,” according to an affidavit Ms. Faust filed.

He ended up at two other hospitals, and eventually died after blood pooled in his lungs and abdomen, according to Ms. Faust.

“His death would not have happened had Beth Israel Hospital been in full service,” according to her affidavit, filed in March as part of a lawsuit challenging the closure plan. A spokesman for Mount Sinai said that the nature of Mr. Faust’s injuries meant he would have been transferred to another hospital as a matter of course.

Mr. Faust is just one of the patients to arrive at Beth Israel in recent months who faced a delay in receiving care or were told the hospital could not treat them, according to a pair of reports by state hospital investigators.

Investigators found the hospital had stopped doing M.R.I.s between midnight and 8 a.m., meaning patients with a range of worrisome symptoms — vision loss, spinal cord compression, neurological changes — would have to wait or be transferred. At the end of 2023, the hospital also informed the city’s ambulance service that it would no longer be able to treat most severe strokes.

In January, a man with slurred speech and weakness — signs of a stroke — arrived to the emergency room. The extent of brain damage after a stroke often depends on how long it takes to receive treatment, but “there was a delay in the stroke team responding,” a report by state investigators dated Jan. 31 states. Beth Israel disputes this, saying it took only 9 minutes for him to be examined.

The stroke patient, identified in the state report only as “patient 44,” was eventually transferred to another hospital.

Another patient in January was brought to the emergency room in septic shock from pneumonia, but was transferred to a different hospital because of “space limitation and staff limitation” at Beth Israel, according to state investigators.

Hospital closures in New York City typically spark outcry and organized community opposition. And usually the end result is the same: The hospital closes anyway. More than a dozen have closed in the past 20 years.

But community activists hope the battle might end differently for Beth Israel. Since 2013, Beth Israel has been part of the Mount Sinai Health System, which operates a number of major hospitals in Manhattan.

Within a few years of taking over, the hospital system sought to close Beth Israel, saying it was a financial drain. But the hospital was saved by the coronavirus pandemic: Instead of closing, it cared for the surge of critically ill patients who filled, and nearly overwhelmed, the city’s health care systems in early 2020.

Late last year, Mount Sinai began pushing ahead with a new plan to close the hospital in July, or sooner. But community groups have pressed to keep it open, arguing that more hospitals, not fewer, are needed after the pandemic stretched capacity to the breaking point.

“Everyone’s attitude has been affected by the pandemic,” said Arthur Schwartz, a former Beth Israel patient and lawyer who filed a lawsuit earlier this year challenging the closure plan.

The fate of Beth Israel, which began as a small clinic serving Jewish immigrants in the late 19th century and grew to one of downtown’s largest hospitals, has broader implications. In the past 20 years, two nearby hospitals have closed, even as the area’s population has soared. Beth Israel’s closure would mean longer ambulance rides for residents downtown, many of whom will end up in hospitals in Midtown or further north.

Spokesmen for two of the hospitals closest to Beth Israel — Bellevue, the flagship of the city’s public hospital system, and NYU Langone, both just up First Avenue from Beth Israel — expressed concern about a dramatic increase in patients should Beth Israel close.

Already NYU Langone has seen a 32 percent increase in emergency room visits from patients in Beth Israel’s coverage area, which includes the Lower East Side and the East Village, according to a spokesman, Steve Ritea.

Loren Riegelhaupt, a spokesman for Mount Sinai, said that the hospital system had tried to save Beth Israel with hundreds of millions of dollars in investments. But the hospital did not attract enough patients, and a relatively high percentage of them had Medicaid, which reimburses at lower levels than private health insurance. Beth Israel has lost more than $1 billion, according to Mr. Riegelhaupt.

“No system could continue to sustain losses of this magnitude,” he said, adding that the losses put the entire Sinai Health System at risk.

Beth Israel would be the first New York City hospital to close in the wake of the pandemic. Hospital executives and community groups have been watching to see whether the state finds a way to keep it open, perhaps by finding another hospital system willing to take it.

So far the state Health Department’s position has been tough to parse. The department sent Beth Israel a cease-and-desist letter, ordering it to stop closing beds and services for now. And after five months without action, it has rejected Mount Sinai’s closure plan as incomplete, inviting Beth Israel to resubmit it with more data about its finances, among other topics.

The slow time frame for a decision is proving costly. Mount Sinai says that it is losing $15 million a month keeping Beth Israel open. That figure might rise as the hospital tries to reopen some services in order to try to maintain the status quo while it waits.

“Refusing to allow a failing independent, nonprofit hospital to close is unconstitutional,” the hospital said in a statement.