The statewide Commission on Health Care Facilities in the 21st Century recently announced a sweeping set of reform recommendations to restructure hospital and nursing home systems in New York, and some of those reforms would have a significant impact on Capital District facilities.
On Tuesday, Nov. 28, the commission issued a report that proposed changes to one quarter of all the hospitals in the state. Locally, that includes a suggested merger of two Albany County nursing homes, changes to Ellis and St. Clare hospitals in Schenectady and a recommendation to close Bellevue Woman’s Hospital. On Tuesday, Dec. 5, Ellis and St. Clare’s agreed to merge.
In its report, the commission said Bellevue’s weak financial situation and the benefits that consolidation with other area hospitals would have on the quality of care, are reasons for the proposed closure, as well as improving the viability to other Schenectady hospitals as a result of capturing Bellevue’s patient base a high percentage of whom are privately insured.
Under the law that founded the commission as part of the 2005-2006 state budget, the report’s findings are recommendations only and would need to be accepted by both the governor and the Legis-lature as a whole to become law.
The plan has been publicly endorsed by Gov. George Pataki and Governor-elect Eliot Spitzer.
Anne Saile, president and CEO of Bellevue, said she is challenging the commission’s findings.
I’m here to say that Bellevue is here to stay,` said Saile.
Saile said the findings surprised her, and the report did not include anything about the impact that closing the only women’s hospital in the state could have on the region.
`It was disappointing that there wasn’t any talk about that,` she said.
`We have such a special, unique, award-winning hospital,` said Saile. `For that not to be recognized is very disappointing not just for me but the thousands of women who come to Bellevue.`
In response to the report’s recommendation that the hospital’s maternity, neonatal, eating disorders, and mobile outpatient education and screening services be added to another hospital, Saile said she doesn’t feel that other area hospitals would be able to absorb all of the patients and provide to them the same level of expertise.
Bellevue is one of two remaining nonprofit women’s specialty hospitals in the nation. It has 55 beds and its average daily census was 22 patients in 2004.
According to the commission, its chief service is low-risk obstetrics. Because it does not offer high-risk maternity care, medical surgical care or emergency services, the report said, closing the hospital won’t affect the availability of high-tech services that are already directed to large facilities.
The report also called the hospital’s financial situation dire and stated `its future viability is in serious jeopardy,` citing substantial debt-load and negative net worth and losses in 2004 and 2005.
According to Saile, this depiction of the hospital’s financial situation is incorrect.
`The report is not accurate; it’s not based on actual facts,` she said. `It mischaracterizes the debt that Bellevue is in.`
Saile said, since the hospital became a nonprofit its debt has been reduced from $17 million to $12 million ` in just five years.
`We’re anything but in dire straits,` she said.
The report listed the hospital’s 2005 net deficit as $1.3 million, and its total deficit at the end of 2005 was $17.6 million.
A number of area politicians have stepped up in support of Bellevue.
`I am not pleased with this report,` said Assembly leader James Tedisco, R-Schenectady. `To suggest Bellevue Woman’s Hospital should close and St. Clare’s and Ellis Hospital should merge based solely on the population of Schenectady County ignores the fact that these outstanding facilities serve a broader population, including the fast-growing southern Saratoga County population.`
Schenectady Legislature’s chairwoman Susan Savage also spoke out against the commission’s findings.
`These recommendations would result in dire consequences for infants, women and the elderly throughout the Capital District,` said Savage.
Additionally Savage cited the economic impact the mergers and closing would have in the county.
`The closure of Bellevue would result in the loss of 225 full-time jobs and 140 part-time positions and the reduction at Glendale Nursing Home would result in the loss of approximately 100 jobs,` said Savage.
`The report’s recommendations threaten Schenectady’s hospital ‘safety-net’ for low-income patients, could force frail senior citizens into distant nursing homes, and would eliminate specialized health care for women,` said state Sen. Hugh T. Farley, R-Niskayuna.
Furthermore, Farley said, he would `insist that the Legislature reject this all-or-nothing approach.`
In Schenectady County ` in addition to closing Bellevue Woman’s Hospital ` the commission recommended the merger of both St. Clare’s and Ellis Hospitals and The Avenue and The Dutch Manor nursing care facilities, as well as downsizing Glendale Home.
Rather than closing the Bellevue hospital, Saile said the answer to the improving the county’s health care lies in strengthening the system as a whole.
`We have long wanted to collaborate with other hospitals in the area,` she said. `We are poised to step forward and establish a lead in developing health-care policy in Schenectady.`
In Albany County, the commission recommended that the Ann Lee Infirmary and the Albany County Home merge, downsize and rebuild a unified facility.
Albany County spokesperson Kerri Battle said the recommendation is in line with what County Executive Michael Breslin had in his proposed 2007 budget.
`Albany County’s commitment to long-term care remains strong and clear, but I have been saying for some time that the manner in which we do this needs to change,` said Breslin. `So I am pleased the commission supports my plans for a much smaller facility and the expansion of non-institutional home and community-based services.`
The Commission on Health Care Facilities in the 21st Century is chaired by Stephen Berger, former state Social Services commissioner, and is a broad-based, nonpartisan panel created by Pataki and the state Legislature to review health-care capacity and resources in the state.
In developing its recommendations, the commission-reviewed 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’s recommen-dations are fair, responsible and distributed equitably across the state. Affected facilities may complain, but pointing a finger and saying excess capacity is someone else’s problem is inadequate,` said Berger. `The opportunity for change is real, and the money needed to achieve it is available. We cannot afford to squander either.`
The Health Care Efficiency and Affordability Law for New Yorkers allocated $1 billion to fund restructuring and closing costs in addition to $1.5 billion for similar purposes promised from the federal government.“
