Volume 79, Number 38 | February 24 - March 2, 2010
West and East Village, Chelsea, Soho, Noho, Little Italy, Chinatown and Lower East Side, Since 1933
Villager photo by Lincoln Anderson
From left, Eric Legome, chairperson of St. Vincent’s E.R.; William Mandell, head of infectious diseases at St. Vincent’s; state Senator Tom Duane; and Charles Carpati, head of intensive care at St. Vincent’s, at Sunday’s “visibility rally” for the hospital.
Times adds to St. Vincent’s trauma, hospital’s docs say
By Lincoln Anderson
As St. Vincent’s Hospital struggles to stay afloat, top physicians at a “visibility rally” Sunday said a main obstacle the hospital is facing is negative media coverage.
There was the New York Post editorial earlier this month that urged to “pull the plug” on the Greenwich Village hospital.
But even worse, to hear the doctors tell it, have been misleading articles about what is going on at St. Vincent’s as it battles to stave off bankruptcy and keep from closing after more than 160 years of service.
Physicians at the rally — held in the lobby of the McBurney YMCA, on 14th St. near Sixth Ave. — singled out for special criticism a Feb. 12 New York Times article as having been particularly hurtful, creating the misperception that the hospital was shutting down key departments.
The Times article stated: “Arthur Y. Webb, the hospital’s chief of operations, confirmed...that six programs — sleep medicine, endocrinology, pathology, ophthalmology, renal medicine and neurology — would be closed by the end of the month. But he said the hospital’s well-known H.I.V., psychiatric and community clinics were fully operating, reversing a decision to stop taking new patients.”
Dr. William Mandell, St. Vincent’s chief of infectious diseases, said the Times article should have clarified that what the hospital will be eliminating as of March 1 are its residency programs in those six areas. Residencies are known as “teaching programs” — a stage of post-graduate medical training. Although resident doctors typically examine a patient first, they report back to the attending physician, who has the final say on treatment.
“The Times made it look like we’re not going to have radiology, pathology...anymore — not true,” Mandell said. “The hospital is setting up a way to take care of the patients — attendings. The people leaving are the people still in training,” he said of the residents in the teaching programs slated for closing.
Mandell — who has worked at the hospital 22 years — said St. Vincent’s C.O.O. Webb also bears responsibility for conveying an accurate message to the media.
“He was, I can’t say misquoted — but it came across wrong,” Mandell said.
“We feel like we’re fighting the press and the image more than anything else,” Mandell said. “Certainly, Crain’s New York Business has not been very friendly; they’ve written some pretty harsh things.”
Despite the doomsday news reports, St. Vincent’s is carrying on basically as it was before, according to Mandell and other department heads.
“We’re still doing open-heart surgery,” he said. “We’re still doing neurosurgery. From a patient point of view, little has changed. I myself had shoulder surgery there two weeks ago. If you didn’t know, and you didn’t read the press, and you come to our emergency room, you wouldn’t know the difference.”
Asked how the hospital’s prognosis is looking, Mandell said that because a merger is still a possibility, St. Vincent’s may have earned a bit more time.
“We’ve been told there are interested partners,” he said. “Because of that, the hospital has given us longer than a month. It looks like we have a lifeline longer than March 1.”
Mandell and another doctor, Charles Carpati, head of intensive care at St. Vincent’s, said if the hospital finds a partner, they hope it has a residency program.
“The word ‘doctor’ means ‘teacher’ — that’s what we like to do,” Carpati said.
“It’s something we like to do — hand down knowledge to the next generation,” Mandell echoed. They noted that St. Vincent’s has always been known as a “teaching hospital.”
The visibility rally was organized by state Senator Tom Duane. More than 800 “Save St. Vincent’s” signs were handed out; the idea is for merchants and neighborhood residents to stick them in as many windows as possible — especially ground-floor and second-story windows — sending a massive visual message that the community is behind the hospital and pulling for its survival. People also signed a petition, which already had more than 7,000 names, to keep the hospital open.
E.R. still busy
Eric Legome, chairman of St. Vincent’s emergency room, also attended the rally.
“We’re still having days with 40 to 50 admissions,” he said, referring to patients seen in the E.R. who are then admitted to the hospital for further treatment. “And we’re seeing 150 and 170 patients a day,” he said of the E.R.
St. Vincent’s emergency department has 63,000 to 65,000 patient visits annually, according to Legome.
Asked what impact closing the hospital’s E.R. would have, he said, “I think it would be a disaster to be honest. You’ll have N.Y.U. [Medical Center] seeing three times its capacity. Bellevue is packed. Beth Israel is pretty full.”
However, a nurse who came to the rally, who works at both St. Vincent’s and Lenox Hill Hospital on the Upper East Side, reportedly told people that in the last two weeks, E.R. visits at Lenox Hill have tripled amid the anticipation of St. Vincent’s E.R. closing; that’s because some ambulance drivers have already decided not to go to St. Vincent’s anymore, she said.
Theresa Tretter, a doctor of ophthalmology, who has her office in St. Vincent’s O’Toole building, said the hospital’s end would affect numerous West Siders — many of them elderly — who depend on it for eye care.
“I have so many patients that don’t want to go east — and there are tons of them,” she said.
Judith Callet, resident chairperson of the Bleecker Area Merchants’ and Residents’ Association (BAMRA), came by to join the rally and pick up some “Save St. Vincent’s” signs.
“I think it would be a great tragedy to lose it,” she said of the hospital. “My husband had a couple of close calls, and if it had been farther away, he would have lost his life.”
Meeting with governor
Afterward, Duane said he had joined by telephone the St. Vincent’s meeting that was held last Wednesday at the governor’s office in East Midtown.
“We continued to press and stress how important St. Vincent’s was,” Duane said. “I felt that the governor was supportive, and we need every possible assistance from the state to keep St. Vincent’s functioning — and then we can strengthen it once its survival is assured. The city should have a very strong interest in keeping St. Vincent’s providing care,” he added, saying that losing it will overburden other hospitals that see managed-care and uninsured patients, like Gouverneur and Bellevue.
Duane noted that people came from as far away as Mott St. and Battery Park City for the rally, since St. Vincent’s has 40 clinics and a wide reach.
Asked if he thought the hospital would pull through, Duane said, “We’re all trying to do everything we can do to save it — and we’re pretty effective in these neighborhoods. Not saving it is not an option.”
Bringing in the feds
At the meeting with the governor, the idea of getting the federal government involved was discussed — specifically having the Department of Housing and Urban Development refinance the hospital’s mortgage. A HUD representative attended the meeting, and reportedly has been assigned as the agency’s point person on St. Vincent’s.
A person familiar with the discussions, who requested anonymity, said that the HUD program is called “242” and allows financing for hospitals. But it’s unclear if it would be applicable to St. Vincent’s, first of all, because the hospital is on the verge of bankruptcy. Also, according to the source, some think the HUD financing can only be used for new capital construction, as opposed to for an existing hospital. However, the hope is that perhaps the funding could be allowable since there is often construction going on within St. Vincent’s.
Congressmember Jerrold Nadler reportedly spoke to HUD Secretary Shaun Donovan last week.
On Feb. 1, Nadler and U.S. Senators Chuck Schumer and Kirsten Gillibrand wrote a joint letter to Donovan requesting that HUD refinance the hospital’s mortgage, specifically asking him to look into Federal Housing Administration mortgage insurance programs, which offer insurance to healthcare facilities.
The refinancing wouldn’t be the total solution for all the hospital’s ills, rather just a part of the overall package; but it would put St. Vincent’s on firmer financial footing. With the federal government securing the hospital’s $700 million debt in case of default, lenders would be more likely to give St. Vincent’s money, the source explained.
In addition, St. Vincent’s Catholic Medical Centers is planning to sell off some of its assets in order to ensure that its core services — the Greenwich Village acute-care hospital — will be preserved. Three Catholic nursing homes — one each in Brooklyn, Westchester and Staten Island — will be sold, as will a Westchester hospital offering psychiatric and chemical-dependency treatment.
As for a merger, while the hospital is keeping quiet on the talks, it’s not a mystery who some of the potential players likely are, the source said. There are four or five, including N.Y.U., Mt. Sinai, North Shore-Long Island Jewish and New York-Presbyterian. Continuum Health Partners — which made an offer to reduce St. Vincent’s to essentially a clinic, but then withdrew it in the face of criticism — also could still be in the mix. Some may be waiting for St. Vincent’s to go into bankruptcy, the source added, since then it would be cheaper to acquire.
‘Praying’ for funds
In addition, Nadler and City Council Speaker Christine Quinn two weeks ago went to speak to the bishop of Brooklyn to see if the diocese could help out the hospital financially. The bishop said they had nothing to offer.
(St. Vincent’s is in the Catholic Diocese of Brooklyn, as opposed to the Catholic Archdiocese of New York — which includes Manhattan — because of its merger with several other Catholic hospitals in 2000; St. Vincent’s divested itself of those hospitals in 2005 when it filed for bankruptcy, but it remained under the Brooklyn diocese.)
Some people are said to be going even higher, religiously speaking, approaching the Vatican — which has a bank — to see if it can aid the troubled Greenwich Village hospital.
Debt and pay cuts
Michael Fagan, a St. Vincent’s spokesperson, gave a rough breakdown of the hospital’s $700 million debt: The mortgage on the hospital’s Greenwich Village campus is $300 million; the three nursing homes and the Westchester hospital have $165 million in debt; medical malpractice liabilities — from the other Catholic hospitals from the failed merger — total $123 million; and pension payment liabilities, also from the hospitals in the failed merger, amount to $65 million.
St. Vincent’s employees have taken a temporary, 120-day pay cut: Staff at the vice president level and above have taken a 25 percent pay cut; staff at the manager level, including doctors and physicians, have taken a 20 percent deduction in salary; unionized nurses and other staff have all taken a cut in pay of 10 percent.
Asked about the physicians’ complaints of negative and inaccurate media coverage, which they say has been hurting St. Vincent’s cause, Fagan agreed with them.
“Unfortunately, in this back and forth, there’s been some inaccurate reporting — there has been some by the Times,” the spokesperson said.
As for the impressive turnout of physicians and department heads at last Sunday’s rally, Fagan said, “The physicians have really led the effort” to save the hospital.