Thursday, July 31, 2008

Going, going .... gone ?

LICH is "downsizing." The maternity ward is closing, and buildings are being sold, possibly to create condominiums on Amity Street. There is considerable internal dissent among the staff. The details are given in an article in today's New York Times by the reporter Anemona Hartocollis. Another take on the story is in today's Brooklyn Paper, in an article by Mike McLaughlin.

In the meantime, this Blog has obtained the memo that was sent yesterday to the LICH staff by Stanley Brezenoff, president of Continuum Health Partners. Here is the text:

Date: Wed, 30 Jul 2008 09:20:36 -0400
DATE: July 30, 2008

FROM: Stanley Brezenoff

TO: The Long Island College Hospital Physicians and Employees

RE: Restructuring Efforts at Long Island College Hospital

Over the past year, the Board of Regents and our senior leadership have
carefully examined the challenges that have long faced Long Island
College Hospital and have developed a strategy that will allow us to put
the hospital in a more sound financial position so that the hospital can
continue to meet its mission.

This memo outlines the strategy that we expect to implement as quickly
as possible. At its core are steps that will bring LICH into a more
viable financial position. Specifically, we need to eliminate services
that have long been huge financial burdens and reduce the size of the

Reconfigure the medical and surgical services to a smaller and more
efficient size. Although LICH has an official operating license for
approximately 500 beds, we presently have approximately 350 beds
actively in operation. This may still be too many given present demand
and need. Together with our clinical colleagues, we are going to
carefully examine what LICH's optimal operational size should be in
order to secure an optimistic future for the institution.

Discontinue Obstetrical services.
These services are associated with many of the operating costs that
have caused financial distress at LICH, including escalating malpractice
insurance premiums. Last year, the OB/GYN service accounted for 33%, or
$11 million, of the hospital's total losses. In addition, OB
malpractice accounted for $8.8 million of the total $22 million in
malpractice insurance costs for LICH; this represents 40% of the
hospital's total malpractice costs. Yet OB accounted for only 2,845
discharges, or 12%, of the hospital's total discharges of 22,830.
Obstetrical services are no longer viable for us. In addition, the loss
of OB services will have implications on Pediatrics. We will carefully
examine what those implications will be to determine the future
configuration of Pediatrics at LICH.

Reduce the size of the hospital's campus.
The elimination of clinical services allows us to include in our
strategy the sale of real estate, specifically the Polhemus building and
97 Amity Street. This will provide us with much needed cash to help
reduce the hospital's debt.

One of the most important issues will be the impact of these changes on
all of you. To this end, we have already begun to meet with the unions
representing LICH staff employed under collective bargaining agreements.
Our goal will be to maintain as many of our present staff as we can and
eliminate positions through attrition and other means. One of the
benefits of being part of a larger hospital network is that we also can
look to where we might be able to move displaced staff to one of the
other Continuum hospitals.

In addition, we will communicate all clinical changes with our patients
and work hard over the coming months to ensure a smooth transition for
them to other care providers. And we will assist LICH-affiliated
physicians impacted by these changes with any transitional issues
related to their practices.

This strategy also will affect our residency teaching programs. To
this end, we have discussed our restructuring strategy with our
colleagues at SUNY Health Sciences Center at Brooklyn, and will work
closely with them on the transition of affected residents to other
teaching programs.

We have shared this strategy with the New York State Department of
Health whose approval is necessary to move forward with our plans. We
also have had discussions with the Dormitory Authority of New York State
and the U.S. Department of Housing and Urban Development, which insures
much of our present debt.

We recognize that these changes are not going to be easy for many.
Unfortunately, in the difficult environment in which we operate, the
choices are hard and the options few. Yet I am confident that this
strategy is the best course of action for our future. I look forward to
working with Dominick Stanzione, John Byrne, and, most importantly, all
of you, on its implementation.

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