The death of an American hospital By Jerry Mazza

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By Jerry Mazza
Featured Writer
Dandelion Salad
crossposted at Online Journal
April 30, 2010

As I walk past St. Vincent’s hospital in Greenwich Village on 7th Avenue, it seems to be in its death throes. They are taking down the Emergency Room marquee whose red neon was a beacon to the aged and newborn, AIDS-victims, accident cases, the poor, uninsured, and everyday ill.

The 727-bed hospital was founded to serve this lower West-Side area by the Sisters of Charity in 1849, specifically to care for the poor. It is the last standing Roman Catholic general hospital in New York, apparently abandoned by the Catholic diocese, but still in the sights of more than a few predators.

Today, April 21, is a sunny, blue sky day, though darkened by this cloud of St. Vinny’s bankruptcy. It feels like a death in the family. After all, I was born here in 1938, my father born here in 1912, various members of my family were treated here during their lives. I remember St. Vincent’s conducting triage for victims of the 1993 bombing of the World Trade Center and the September 11, 2001, leveling of the World Trade Center and Tower 7, caring for our extended family of New Yorkers.

Also, Poetess Edna St. Vincent (so named for it) Millay was born here and the great, but alcoholic, poet Dylan Thomas, passed away in St. Vincent’s arms.

When my father came down with Alzheimer’s and locked himself in his own apartment, calling the police, fire department and EMS, saying he was having a heart attack, and thought he was in a hotel room, and the people banging on the door (the police, fire department and EMS) were thieves about to rush in, rob and kill him . . . and when I found out about this episode and spoke to his gerontologist and general practitioner, both St. Vincent doctors, offices across the street, they told me to bring him in the next morning, Saturday, to the emergency room, and they would find him a room, no matter what.

During a battery of tests that morning, my father couldn’t remember where he lived, the day or the year (his Timex had stopped like time for him); and after reviewing two brains scan of his, one made a year later than the other by his GP, they’re appeared to be significant brain shrinkage. The doctors decided he should stay for further examination. But the hospital was full. Nevertheless, they knew there would be an open bed sometime during the day or night. So we sat in the E.R. for eight hours and watched a broken humanity limp in, carried in, wheeled in, crying children, an unconscious biker, emaciated AIDS victim, everything you can imagine. All while my father asked me why he we were there. I told him to have his heart examined.

He remained in St. Vincent’s for four months, during which time he was examined and tested in various departments to confirm the diagnosis, then sent to the psyche ward, a lock-in facility, until we could find him a nursing home. In all that time, he was treated with care, dignity, and even allowed to visit with my family at home at Christmas. He was kept until his Medicare Plus ran out. A delay in payment by the insurer had caused the hospital to send me an $84,000 bill. I called the elder-care lawyer I hired to protect my dad, who called the insurance company, and told them he would report them to the State Insurance Board if the bill wasn’t paid to the hospital immediately. It was. So much for memory; now there’s reality.

As of February 3, St. Vincent’s was said by the New York Times to be $700 million in debt, in search of a partner to help forestall a second bankruptcy in five years or have to close. Continuum Health Partners, now operating St Luke’s and Roosevelt Hospital on the Upper West Side and Beth Israel Hospital on East 16th Street and First Avenue, wanted to incorporate St. Vincent’s into its group of New York Hospitals, which also included Long Island College Hospital, the New York Eye & Ear Infirmary.

But Continuum’s plan came with strings attached, which were to close down St. Vincent’s 727 inpatient beds and legendary emergency room, and basically turn the hospital into an outpatient 23-hour stay operation. Needless to say, this generated intense opposition from the neighborhood, because it would leave the West Side, from 59th Street down to the Manhattan’s end without a quality hospital. Yes, it would take the heat off of St. Vincent’s debt, but it would take the heart and soul out of the hospital, and leave its patients in the lurch.

Curiously, New York State Health Commissioner Dr. Richard F. Daines was pushing the deal. Yet he was appointed to his position by Eliot Spitzer in January 18, 2007, after serving with Continuum Health Partners for six years as president, CEO and medical director for two years prior. Now, as NY state health commissioner, his zeal to see his former employer, Continuum Healthcare, take over St. Vincent’s Hospital, carried a taint of conflict of interest, not to mention the odor of a CHP multi-hospital privatization.

Then, too, on February 3, the New York Times reported that Governor Paterson was offering St. Vincent an $8 million loan, $6 million from the state, $2 million from the city to meet payroll. But he reminded the administrators that the hospital had lost $80 million the last year. He made it perfectly clear “We don’t want to put supplies on a sinking ship.” And whose fault was the sinking?

Interestingly, there was one person at the meeting who wished to remain unnamed: restructuring consultant Mark E. Toney who came in to consult at the rate of $125,000 a month, according to Crain’s Book of Lists — a steep fee for a cash-starved hospital. His recommendation was that the hospital needed $20 million to stabilize its terminal condition. Is that a big idea?

The fact is Toney’s fee was outrageous for a hospital hemorrhaging money, surviving on the NYS/NYC life-support system, with their respective budgets bleeding red ink. Ever curious about institutions close to my heart, I did an Internet search and found a number of articles, one from the NY Post that was particularly unsettling, St Vincent’s Hospital Faces Possible Closure.

Was closure that imminent? Was this what the situation was all about, a multi-hospital group seeking to force closure to enlarge its group at any cost to patients and community members?

The NY Post added, “Continuum Health Partners, the operator of St. Luke’s and Roosevelt hospitals in Manhattan that, together, form a medical complex adjacent to Columbia University, submitted the plan, under which it would take over St. Vincent and convert it into a community health center . . .”

The article also mentioned the obvious downside to the plan: “The nearest facilities are New York Downtown Hospital, Beth Israel on the far East Side, NYU, Bellevue, and Roosevelt Hospital.” Importantly, “[T]he plan has the backing of GE Capital and TD Bank, holding a combined $300 million in debt for St. Vincent’s, and it also has the approval of the state.” Of course, they’d take the money and run. No love lost here.

The kicker was that, “The Rudin Group had offered to build a new, state-of-the-art medical facility, along with a market-rate condo complex on the site, and St. Vincent’s and received approval from the Landmarks Preservation Commission to move forward with its $1.6 billion facelift. The hospital is currently $700 million in debt, and in 2007, closed its Midtown hospital and sold off two others in Queens.” So, St. Vincent’s was making some effort at a comeback.

The hitch was that the Rudin plan included tearing down the O’Toole hospital building, the one I was standing near on 7th Avenue. It also wanted to tear down the National Maritime Union building across the street, which had been converted to doctors’ offices decades earlier. The Villager reported, “But the L.P.C. urged preservation of some of the old buildings and Rudin complied, planning the reuse of Smith, Raskob and the Nurses Residence on 12th St. and the Spellman building on 11th St. The plan calls for demolishing the Coleman, Link, Cronin and Reiss buildings to make way for the Seventh Ave. tower, plus a new mid-rise building on 12th St. and a row of townhouses on 11th St. In addition to reducing the height of the Seventh Ave. tower, the new plans call for the tower to step down in three stages from 12th St. to 11th St.”

The deal fell apart when St. Vincent’s, under pressure from antagonists of development, announced that it was closing the hospital due to its mountain of debt and operating loss. Even if a developer desired to buy the building from the medical center, which was in desperate need of cash for debts, any new plans, such as Rudin’s, would require new Landmarks’ commission approval, including the sale of the eight buildings across the avenue to the Rudin family for $310 million. That project did gain City Planning approval.

Then too, as far back as 2006, there were some 40 companies that had been bidding on the land surrounding Number One 7th Avenue at upwards of $100 million per acre. Yet St. Vincent’s had been criticized for inefficiencies in design from layout and operational perspectives. The hospital was losing $10 million a month. Some 40 percent of people entering the emergency waiting room left untreated. A huge share of revenue came from turning E.R. walk-ins into in-patients. A large share of those would-be patients were walking away, and St. Vincent’s bed count dropped by nearly half in the last couple of decades due to lack of funds to support the beds. The hospital was caught in a money-shredding cycle.

Additionally, as a Catholic hospital, they couldn’t provide family planning treatments, including in vitro fertilization, which was a big revenue stream for other hospitals. The surrounding area offered a perfect demographic for IVF, yet due to St. Vincent’s charter, those wealthy, older families were sent across town, including others seeking abortions, not a big money-maker but verboten anyhow.

Subsequently, the plan to keep some part of the hospital open while tearing down the O’Toole building for a 325 foot state-of-the-art hospital, which would also be the tallest building in the neighborhood, did not fly. Also, since current hospitals are impractical for residential use, they had no chance of getting enough value from the real estate without condo prices. Separate approval was needed to rip down the buildings east of 7th Avenue for those condo towers.

So it came down to real estate, i.e., a deal that “could build a new, state-of-the-art [hi-rise] medical facility for St. Vincent’s with a market-rate condo complex on the site” versus “Continuum Health Partners turning St. Vincent’s into a community health center.” The second deal was not an option for the board of St. Vincent’s hospital, though some form of what Continuum was asking for will be the reality, perhaps under CHP’s wing.

Amazingly, the Landmarks Preservations Commission and St. Vincent’s Hospital Manhattan were sued by a coalition of New York historic-preservation and community groups on March 9, 2009 for its plans to raze both the O’Toole Medical Services Building and the modernist Maritime Union building, “a historic vestige of the city’s nautical past,” instead of building a proposed 299-foot tower. They got their way, saved the buildings but lost the hospital. So it goes, strangely.

Lastly, click COMMENTS from the ‘St. Vincent’s closure article’ and scroll to 48 of them, describing the dirty laundry of the downfall of St. Vincent’s and giving off the odor of another reality.

These comments, with the misspellings of working people, notes written furtively, give us the picture of a bloated, overpaid administration, individuals with multi-million dollar retirement packages, round the clock cars, locked in endless meetings (discussing the mounting debt and how to bury it?), while the hospital boasted an absolutely archaic billing system, leaving great sums of money uncollected on an ongoing basis, a billing department without proper supervision, or without even the prospect of being outsourced, not to mention the use of very high-priced consultants who did very little but fatten their wallets.

One comment mentions that doctors and interns were treated “as mushrooms,” as if they didn’t count, even though they were a furiously hard-working and talented group of medical people. Also, the general staff of union members plus the medical staff had been consistently taking salary and benefit cuts, while the administration kept leading the high life, even hosting takeover visitors on tours of the hospital while handing out more about 1,300 pink slips in one day.

What is depicted is an ongoing looting of St. Vincent’s coffers: one CEO followed by another at six or seven figures, all leaving with lavish parting packages, while the nurses in the end were left with nothing, no retirement plan or health plan (unless they had put in 30 years) and not even the prospect for resident doctors of another residency. There are no negative remarks about nurses, doctors or staff, only glowing ones, although the staff’s union takes a few knocks. There are several remarks questioning if Commissioner Daines was getting “a piece of the action” from CHP to make this happen; several for Toney’s and other’s consultant fees; and a few biting comments regarding various board members and trustees for mismanagement and possibly malfeasance.

You get the idea the administrators were treating the heart and soul of this hospital, doctors, aides, support staff, who did the work of keeping people alive, as the corporate-destruction company Cerberus would treat a newly acquired, indebted company for dismemberment. The name Cerberus, from Greek mythology, is for the three-headed dog with a snake tail and snake heads protruding from his back. He guards the entrance to the gate of underworld, allowing the dead to enter but never to leave. How appropriate.

You can click on and scroll to the COMMENTS, all anonymous, all unedited. Do not miss these, ending with Comment #48 Posted By: Anonymous 04/20/10: “At what point does the local (and national) media start to question the Board, especially Al Smith [IV], along with previous CEO’s dating back to Campbell, Sanzone, and Amoroso directly? And how about some sort of official, if not criminal investigation?”

Indeed, how about an investigation? This bankruptcy was no accident, but a decades-long saga of financial mismanagement and personal greed. Attorney General Cuomo, are you listening? Make this your stepping-stone to the governorship? Resurrect St. Vincent’s Hospital or bury it in peace. Beyond that, dear, battered St. Vinny’s you will be sorely missed for your heart, spirit of care, and open arms to all. Let this serve as your requiem and a condemnation of those who brought you to these straights.

* * *

A late-breaking postscript brings some good news that Governor Paterson has secured funds for St. Vincent’s as an urgent care facility in Greenwich Village. “Governor David Paterson announced plans Monday that will keep an urgent care center operating in place of St. Vincent’s for at least the next five years.”

A total of $14 million in grants will fund an urgent care facility along with other health care services in Greenwich Village. In tandem, Lenox Hill Hospital on Park Avenue and East 76th Street will receive more than $9 million to provide non-emergency services 24 hours a day, seven days a week.

St. Vincent’s will remain in ongoing talks to partner with another healthcare system to maintain and expand the services they already have.

Governor Paterson has stated that “the center will initially run out of St. Vincent’s current site, but Lenox Hill will be looking for a new permanent site to run the center at a different location in the Village.

“North Shore-Long Island Jewish Health Care will be in charge of handling emergency transportation for patients in need of acute care.

“A second award of more than $4 million is being awarded to several health centers close to St. Vincent’s so they can expand their services to accommodate what will be as many as 75,000 additional patient visits a year because of the hospital closure.

“Those clinics include Callen-Lorde Community Health Center, The Ryan Community Health centers, and the Charles B. Wang Community Health Center in Chinatown.”

City Council Speaker Christine Quinn added that, “the HIV/AIDS program will be run by Mt. Sinai Hospital,” whose Guggenheim Pavilion and entrances are at 1190 Fifth Avenue (at E. 101st Street) and 1468 Madison Avenue.

“Other institutions will run the behavioral health and pediatric programs. There is no word of what will happen to Saint Vincent’s Cancer Center.” So it goes.

Jerry Mazza is a freelance writer, life-long resident of New York City. His book “State Of Shock – Poems from 9/11 on” is available at, and

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