Major NYC hospital warns of safety risks from delayed closure

NEW YORK — A continued exodus of health care workers from a historic Manhattan hospital on the brink of closure is posing risks to patient safety “in the very near future,” according to hospital officials.

Staffing woes have escalated in recent weeks as Mount Sinai Beth Israel approached and then passed its long-planned closure date of July 12, which was predicated on state approval. The medical director of Beth Israel’s intensive care unit left at the end of June, and the hospital’s chief nursing officer is resigning next month, hospital officials said in court papers filed as part of an ongoing lawsuit over the closure.

“Staffing instability has reached a critical point where we are no longer able to continue reliably providing safe patient care,” Liz Sellman, the hospital’s president and COO, stated in an affirmation filed Monday. “Staffing at the Hospital is sufficiently thin and unstable that even a relatively minor event, such as staff calling out sick, could have a debilitating and potentially life-threatening effect at the Hospital. These are not appropriate conditions under which to operate a Hospital.”

The hospital’s top clinical and administrative leaders are sounding the alarm in hopes of accelerating the state Department of Health’s review process and convincing a Manhattan judge to loosen a restraining order that temporarily blocks the hospital from downsizing and requires it to maintain a certain level of services.

Derek Mazique, the hospital’s chief medical officer, said the facility has struggled to fill its rapidly widening staffing gaps, even though Mount Sinai administrators authorized him to “spend whatever is necessary” to maintain services as required by the court order. Roughly 450 staffers have left Beth Israel since Mount Sinai announced the closure plan last year.

“We know that all of you who remain at the hospital have been doing everything possible to serve our patients and keep them safe,” Beth Israel executives wrote in a memo to staff last week. “We are using our best efforts to recruit and to bring in staff from other campuses, temporary (locum) doctors and other providers, and agency nurses to help you provide high-quality care. Despite that, we have not been able to bring in all the staff that we would like to.”

Beth Israel leaders’ intensifying rhetoric poses a direct challenge to the Department of Health as it faces heightened pressure from state legislators and the public to use its regulatory authority to restrict private hospitals from closing or reducing services.

The department already rebuffed a request in February by Brendan Carr, CEO of the Mount Sinai Health System to shutter Beth Israel’s intensive care unit due to patient safety concerns — a move that has not been previously reported — and asked for additional evidence of the financial losses and declining demand that Beth Israel has cited as justification for the closure.

Asked what the state Department of Health is doing to address hospital leaders’ concerns, spokesperson Erin Clary said “the Department has been in regular communication with Mt. Sinai leadership regarding staffing concerns and to ensure patient safety.”

“The closure plan remains under review and as a result, the Department cannot comment further,” Clary said in a statement to POLITICO.

Current and former health care workers told POLITICO they fear quality of care has already suffered due to Beth Israel gradually downsizing services and relocating staff, disrupting the interdependent web of various units and medical specialties that enables a hospital to care for nearly any patient who comes in the door.

In March, the state Department of Health found Beth Israel had slashed services and beds without its approval — even after prior downsizing moves prompted the department to issue a cease-and-desist order. The report corroborated a POLITICO investigation into Beth Israel’s decision to curb most surgeries in January, which led to critical delays in care for patients who showed up in need of life-saving procedures the hospital was no longer providing.

Loren Riegelhaupt, an outside communications consultant representing Mount Sinai, said the hospital has complied with the temporary restraining order issued in March.

“Any suggestions otherwise are entirely false,” he said in a statement to POLITICO.

The staffers said they share administrators’ concerns about patient safety but consider the situation at least partly self-inflicted, because months ago the hospital started transferring health care workers to different Mount Sinai locations and had many attending physicians and trainee doctors who work at multiple sites stop coming to Beth Israel.

As the hospital earlier this year handed out gold-hued Beth Israel pins that read, “1889-2024,” many felt the closure was inevitable, so they started planning their next move — even as the Department of Health had yet to approve Beth Israel’s closure.

“This situation is entirely of their own making,” said an emergency department worker, who was granted anonymity because they were not authorized to speak with the press.

With the cessation of non-emergency surgeries, Beth Israel transferred surgeons and surgical staff to other Mount Sinai programs, the hospital recently acknowledged in a court filing . Staffing in perioperative care — the essential services performed before and after surgery — dropped from 92 employees in December 2023 to just 33 as of late March.

Riegelhaupt declined to provide data on the number of Beth Israel staffers who have been transferred to other locations in the health system since the closure plan was announced.

Emergency medical visits to Beth Israel have declined over the past decade, reaching just over 65,000 last year, according to Mount Sinai’s self-reported data. Still, about 4,000 patients every month are continuing to show up at its emergency room.