NYC’s St. Vincent’s Hospital fights for life _ like other ‘charity’ hospitals across America

By Verena Dobnik, AP
Thursday, March 25, 2010

NYC’s St. Vincent’s Hospital fights for life

NEW YORK — St. Vincent’s Hospital in Greenwich Village has fought to save lives for more than 160 years, treating everyone from survivors of the Titanic in 1912 to New Yorkers fleeing the terror attack on the World Trade Center.

The hospital founded by four Roman Catholic nuns in a Greenwich Village brownstone was also ground zero in the battle against AIDS.

Now, like dozens of others conceived as charity hospitals to treat the poorest patients, St. Vincent’s is fighting for its own survival — faced with a $700 million debt that has led to salary cuts of up to 25 percent and hundreds of layoffs.

“They’re out of time, and they’re out of money,” said David Sandman of the New York State Health Foundation, a nonprofit that seeks to increase public access to health care.

Experts like Sandman say the nation’s health plan will help hospitals in the long term because millions more people will have the insurance to pay for services. But unless a partner is found, it may be too late for St. Vincent’s, which defaulted on payments last year from a bankruptcy reorganization in 2005.

St. Vincent’s uniqueness starts on the ground floor: solid oak doors like an Old World hotel, worn multicolored tiles that lead to corridors free of antiseptic hospital smells. There’s a Jewish hospitality space, a Muslim prayer room and a chapel graced by Tiffany-style windows.

And in a little room on the ground floor, a sleeping white poodle named Chablis. The dog has been a therapy pooch since 1997, after he was brought to a comatose man with a gunshot wound in the head. The dog licked his face, and the man started to awaken.

“There’s a sense of deep loss that New York City, this self-proclaimed capital of the world, has no room for a private, not-for-profit hospital dedicated to caring for all people regardless of ability to pay,” said Dr. Daniel Sulmasy, a longtime St. Vincent’s staff physician and Franciscan friar who teaches medicine and ethics at the University of Chicago. “That’s tragic.”

Four Sisters of Charity nuns opened St. Vincent’s in 1849 with 30 beds in an East 13th Street brownstone that first took in victims of a cholera epidemic, then served generations of poor immigrants. In 1911, it treated the survivors of the city’s worst fire, the blaze at the Triangle Shirtwaist Factory where 146 young women died.

On 9/11, the hospital closest to the World Trade Center treated more than 800 people injured as the towers collapsed.

Located in Greenwich Village, famed for its avant-garde art and music, the teaching facility is the last Catholic-affiliated hospital in New York City; seven others have closed in recent years.

Patients often bypass closer hospitals in the city to go to St. Vincent’s. Some come from other cities or as far away as Israel, to see specialists. There are 1,000 physicians and 770 nurses affiliated with St. Vincent’s but dozens of resident physicians from New York Medical College have been laid off. Beds have been cut from 800 a decade ago to about 400.

What remains of St. Vincent’s could also soon be gone.

With losses of millions of dollars each month covered by short-term loans, St. Vincent’s has only months left for a verdict: to close as a full-service hospital or be financially restructured.

When it comes to financially challenged charity hospitals, St. Vincent’s is not an isolated case.

– Atlanta’s Grady Memorial was on the brink of closure when it was saved by a major civic fundraising effort three years ago.

– New Orleans’ Charity Hospital has been closed since 2005, when Hurricane Katrina’s severe floods forced the desperate evacuation of patients.

– In Downey, Calif., the Downey Regional Medical Center has recently filed for Chapter 11 bankruptcy protection.

– In Chicago, eight hospitals run by Resurrection Health Care are in a pinch — part of the city’s last remaining Catholic medical system.

The financial struggles of such facilities started years before the current economic crisis because of rising medical costs combined with a growing number of uninsured patients.

“Before the recession, about 20 percent of hospitals were in financial trouble; it’s now about one-third,” said Caroline Steinberg, an analyst for the American Hospital Association, a nonprofit representing nearly 5,000 hospitals.

The new health plan enacted by Congress this week “lays a solid foundation on which to build — with a reduction in the number of patients arriving with no ability to pay,” she said.

Sandman suggested the solution could be a new model “that is less than the full-service hospital but more than a clinic, and a financing system that would support that,” said Sandman. “There are many communities in New York where that’s what they need — emergency care, outpatient care and an imaging service, with just a small number of beds.”

St. Vincent’s is the flagship hospital of Saint Vincent Catholic Medical Centers, sponsored by the Roman Catholic Bishop of Brooklyn and the president of the Sisters of Charity of New York. After the 2005 Chapter 11 filing, it received financing from GE Healthcare Financial Services.

Earlier this month, St. Vincent’s got an emergency cash infusion of $8 million in private loans to cover short-term payroll and supplies, and a $6 million loan from the state.

“A long-term solution needs to be reached,” said Gov. David Paterson last month, naming a task force on the hospital. But the state, with its own budget deficit, can’t prop up St. Vincent’s.

The hospital is seeking a possible affiliation or merger with a larger medical facility with deep pockets. Hospital officials declined numerous requests from The Associated Press for an interview.

So far, the only firm proposal for a takeover came from a rival group, the Continuum Health Partners, which wanted to convert St. Vincent’s into a smaller community health center without an emergency trauma unit. Continuum rescinded its offer last month, citing opposition from the state, the community and St. Vincent’s staff.

After news broke that the hospital might be sold and stripped of its emergency room, protesters crowded in front of the facility.

“We’re not going to go quietly, we will not lose St. Vincent’s,” said New York City Council Speaker Christine Quinn.

The nearest full-service hospitals are about three miles away. Traffic jams are endemic and that can be critical for acute cases like heart attacks when every minute counts.

And if these hospitals took over St. Vincent’s patients, “there’s a very real possibility that their already-strained emergency rooms and resources would become overcrowded,” said Brian Conway, a vice president of the Greater New York Hospital Association.

Among patients with a special attachment is Rosemary O’Shansky, who lives across town. The hospital has saved her life several times, she said, and she won’t go anywhere else.

After suffering a pulmonary embolism in August 2001, she fell into a coma that lasted until she awoke three months later. A tracheotomy was performed and she now speaks through a throat tube.

“I don’t want to sound like a sentimental old lady, but when I heard what was happening, I cried,” O’Shansky, 65, said of St. Vincent’s possible closure.

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(This version CORRECTS Corrects that Downey, Calif., center filed for Chapter 11, sted Los Altos facility; that St. Vincent’s has 400 beds, not 300; and that Chicago hospitals are last Catholic system, sted hospital. Minor edits. Moving on general news and financial services.)

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