NY Eye and Ear Infirmary closure fear continues

BY PHYLLIS ECKHAUS | Updated Aug. 29, 1:30 p.m.: Is Downtown Manhattan on the verge of losing another historic hospital?

Community advocates say yes. Thirteen years after the closure of Saint Vincent’s and five years after Cabrini Hospital bit the dust, they warn that the New York Eye and Ear Infirmary, between 14th and 13th Streets on Second Avenue, is also likely to be sold off for condominium development.

According to Andrew Berman, executive director of Village Preservation, which has spearheaded a thus-far unsuccessful campaign to landmark NYEE, “The building at 218 Second Ave. is more valuable to Mount Sinai as marketable real estate than as a place to provide irreplaceable services.”

Local fears are fueled by months of relentless stonewalling by Mount Sinai Health System. The $11 billion hospital conglomerate bought the 203-year-old NYEE in 2013 and has repeatedly refused to answer questions about its plans for the property, its reallocation of local NYEE services, and its stalling on the state Department of Health mandate that it actively engage the local community.

“We are waiting,” said Dr. Paul Lee, the NYEE ophthalmologist who heads the teaching hospital’s alumni association. “The ball is in their court.”

For its part, however, NYEE denies that it is stalling.

Mount Sinai did not answer a March 3 letter from 16 local politicians. Nor did it respond to the large and spirited July 31 “Save NYEE” rally, at which more than 100 community leaders and activists called on Mount Sinai to heed the state mandate, and involve the community in its NYEE planning process.

All agree NYEE is in trouble. Exactly what kind of trouble — and whether Mount Sinai is actively fomenting that trouble — is in dispute.

At a contentious January hearing before New York State’s Public Health and Health Planning Council (PHHPC), Mount Sinai urged the Council to approve a merger between NYEE and Mount Sinai Beth Israel, asserting that the merger would rescue NYEE from an immediate and dire risk that it could lose its federal license as an acute-care hospital.

Throughout the country, as hospitals shift from inpatient to ambulatory surgery, maintaining that license is increasingly difficult, especially for specialty hospitals. The license requires an “inpatient census” averaging two overnight patients per night. Merger with MSBI would mean MSBI’s inpatient census would cover that requirement.

But merger with MSBI would also join NYEE with a corporate parent bleeding money. MSBI has an accumulated debt of $700 million, with an anticipated debt of $150 million this year alone. Sale of the NYEE property could improve MSBI’s balance sheet by an estimated $70 million.

Acknowledging the inpatient census issue as “tricky,” Lee said that the feds have yet to raise the alarm. And he pointed to other ways the heavily resourced Mount Sinai could solve the problem.

Indeed, he noted, since 2016 Mount Sinai has upped NYEE’s inpatient census by performing gender-affirmation surgeries (GAS) at the facility. Though GAS patients have been happy with their experience at NYEE, Lee said Mount Sinai plans to move the GAS unit out.

For community advocates, the real NYEE emergency is one of Mount Sinai’s making — the disinvestment in NYEE’s venerable East Village campus, where operating rooms have been closed, and the decentralization and widespread dispersal of services.

Mount Sinai has proudly proclaimed its agenda to move NYEE’s brand and services beyond Downtown. In a release celebrating plans for a “state-of-the-art” NYEE-branded, private-equity-funded ambulatory surgery center in Midtown, Dr. Paul Sidoti, the chairperson of NYEE’s ophthalmology department, declared decentralization as key to modernization: “Changes will certainly need to occur in how we’ve done things in the past, when our culture was centered on a single building,” he asserted.

In the same press release, Dr. James Tsai, NYEE president, touted the “migrating [of] many of our surgical procedures from the hospital to the community [as] significantly enhancing the patient experience.”

Disability advocates beg to differ. They describe the shift of services away from the hospital, so conveniently located near a transit hub, as a life-and-death concern.

Dr. Sharon McLennon Weir, the fully blind executive director of the Center for Independence of the Disabled, NY, uses her personal experience to underscore the point. McLennon Weir, who describes herself as a “survivor,” is very careful. Still, she’s been hit three times while crossing traffic, each time when she’s had a green light right of way.

Advocates say NYEE’s longstanding location is uniquely accessible to people who need it most.

Mike Schweinsburg, a Lower East Sider who is president of the 504 Democratic Club, which advocates for the civil rights of persons with disabilities, cites an analysis of census data by Community Board 3. Not only does Mount Sinai’s threat to NYEE “dramatically impact the disability community,” the analysis states, but it especially impacts the vicinity of the East Village and Lower East Side, noting: “Along the corridors of Avenues A and D there is a 38 percent higher population of seniors with disabilities than anywhere else in New York City and when you add the adjoining blocks it is 44 percent higher than anywhere else in New York City.”

Dr. Andrea Lyman is a longtime physician, many of whose patients hail from the Lower East Side and Chinatown, neighborhoods with limited public transit and more than a dozen public housing developments. She emphasized that there are direct bus lines that readily connect people from the LES and Chinatown to NYEE, critical for seniors and people with disabilities who struggle to use the subway.

Lyman recalled a disabled elderly woman from the LES, whose care was moved Uptown by Mount Sinai, all the way from Beth Israel on E. 16th Street to East Harlem. When she protested that the near-impossible trip for an 8 a.m. appointment would require at least two very long bus rides, “she was told to take a cab,” Lyman said.

Because LES and Chinatown residents are disproportionately poor, elderly and persons of color, they have multiple chronic diseases, such as diabetes, hypertension and vascular disease. This means, Lyman noted, that a single individual might need a cataract surgeon, a glaucoma subspecialist, a retinal subspecialist, a low-vision optometrist and optician and a low-vision occupational therapist. Having them all in one familiar place is much to the patient’s advantage, she said.

Lyman decried Mount Sinai’s eagerness to recruit experienced eye surgeons to its for-profit ambulatory surgery centers, observing these facilities take relatively few private-pay and Medicaid patients.

Far from being on the 21st-century cutting-edge, ambulatory surgery centers serve to segregate patients and the care they receive by their ability to pay.

“It’s a spaceship to the past!” she declared.

For healthcare advocates, the current contretemps with Mount Sinai vividly recalls the health system’s high-handed, pre-pandemic plot to downsize MSBI from 700 to 70 beds by building a new mini-hospital at E. 13th Street and Second Avenue. Despite vehement community opposition, that plan was approved by the state. Only the pandemic, brutally demonstrating the need for beds, prompted Mount Sinai to reverse course.

This time, says healthcare advocate Lois Uttley, things are different.

“State oversight has been improved somewhat,” she observed, thanks in part to two vocal consumer advocates recently added via state legislation to the PHHPC. Their voices amplified the concerns of local politicians and community stakeholders. Ultimately, the PHHPC sent Mount Sinai’s merger proposal to the Department of Health without a recommendation, “a very rare occurrence,” Uttley noted.

In another heartening advance, the new state Health commissioner, Dr. James McDonald, told Mount Sinai officials that any approval of the proposed merger of Eye and Ear into Beth Israel is contingent on hospital officials first engaging the community.

Uttley described Mount Sinai’s continued lack of community engagement as “certainly puzzling.”

In a statement to The Village Sun, a Mount Sinai spokesperson said, “For over 200 years, NYEE’s mission has been to provide the highest quality, most innovative specialty patient care to all New Yorkers and administer specialty training to generations of excellent and dedicated physicians. The reality is — due to technical advancements in eye and ear procedures, federal rules and insurance policies — NYEE was at severe risk of losing its status as a stand-alone inpatient hospital without this merger. This technical merger of inpatient hospital licenses preserves our ability to continue this important work.

“Now, with the Department of Health’s contingent approval, we can continue the NYEE tradition and provide this specialty care to our patients as well as train the next generation of outstanding eye and ear doctors and medical professionals. While this merger of licenses is strictly technical, it was critically necessary to ensure we can continue NYEE’S work as part of an inpatient hospital, preserving NYEE’s services, funding and ophthalmology residency program.”

Mount Sinai’s statement to The Village Sun was puzzling, appearing to characterize the state’s approval of the merger as a done deal that allows Mount Sinai now to proceed with all its bright, ambitious plans for NYEE.

Pressed by The Village Sun if this means Mount Sinai does not plan to fulfill the requirement for community engagement, the Mount Sinai spokesperson responded, “Obviously, we intend to fulfill the contingencies and that is what we are saying.”

Any plan that would eliminate services or beds — or cut them by more than 10 percent — would trigger the need for an impact assessment, with specific requirements for meaningful engagement with key stakeholders, including local residents, public officials, public health experts and the patients who depend on the facility.

A finding of significant “negative impact” would be likely, Uttley said, given that that the law is written to protect the “medically underserved,” including the visually impaired. Mount Sinai would have to offer a mitigation plan.

In what’s been described as a possible loophole, though, the Health Equity Impact Assessment Law does not apply to hospital closures.