LICH WATCH

Yes, LICH surgeons do scrub before entering O.R (I hope)

2011-09-02T14:35:00.000-04:00

LICH was taken over by SUNY Downstate some weeks ago. But by outward appearance at least, its cleanliness standards have sunk.

Here are some pictures of the outside of the LICH buildings between Amity and Congress streets. Garbage, more garbage, weeds, graffiti, more weeds, more garbage.

Inside the hospital: surely the surgeons still scrub there, although I haven't actually checked.

The Salary Scandal at NYC Hospitals

2011-03-26T14:10:00.005-04:00

The scandal of outlandishly high salaries at "non-profit" hospitals extends way beyond LICH. Here are some excerpts from a recent column by Jim Dwyer in the New York Times:

At Bronx-Lebanon, a hospital that exists only by the grace and taxed fortunes of the people of New York State, the chief executive was paid $4.8 million in 2007 and $3.6 million in 2008, records show. At NewYork-Presbyterian, a hospital system that receives nearly half a billion dollars annually in public money, the chief executive was paid $9.8 million in 2007 and $2.8 million in 2008.
In an urgent search to cut the state’s health care costs and lift revenue, a task force came up with a plan to increase the cost of a hospital stay by $5 and to limit housekeeping services for the disabled in their homes.
One area of plump costs, however, remained undisturbed: executive suites where salaries and compensation run into the millions of dollars, even at the most financially struggling hospitals.

But let's get back to LICH, or rather to Continuum Health Partners, which runs LICH. Here we have data that though a bit outdated is still more current than Jim Dwyer's. Non-profit entities are required to file annual reports to the IRS, including (Schedule J) an accounting of top salaries. I produce this schedule from Continuum's 2009 report, the latest available, below:

Sorry -- I worked on this technical problem for a while but I just couldn't make these figures large enough to read easily. So here are some highlights, figures for Continuum employees who, hm, earned more than a million dollars for the year:

Chandra Sen, MD, $2,109,204
Stanley Brezenoff, $2,014,413
Kathryn C. Meyer, Esq. $1,049,807
John Collura, $1,307,556
Gail Donovan, $1,365,354

Of course this leaves out a host of others who, hm, earned in the upper six digits. For instance ? Dr. Harris Nagler, $973,242

For the curious (that should be YOU), here is a link to Continuum's 2009 Form 990. (You may be asked by GuideStar to register, but this is free of charge.)

Our saviors: our politicians

2011-02-13T13:00:00.002-05:00

so ..... the politicians have decided to keep LICH open.

see the NY1 video

Is LICH Closing ?

2011-02-10T17:21:00.003-05:00

There is some speculation in the media to the effect that LICH may be forced to close, as a result of State budget problems.
Here is the video on NY1

Day Five is Day Zero for LICH

2010-12-31T15:13:00.005-05:00

On Day Five of the snow storm, all New York homeowners have long ago managed to clear their sidewalks. We are a considerate bunch. We wouldn't want grandma to fall and break her neck because of any fault of ours. None of us would. None ? Well, there is always LICH, at its building of 387 Hicks, which is, as LICH bigwigs like to boast, exceptional.

Where the roses bloom

2010-09-16T15:38:00.003-04:00

Who can be angry at a hospital where the roses bloom like this ?

Anyway, the street in front is much cleaner too:

I hope the LICH Operating Room is cleaner than this !

2010-09-03T13:26:00.004-04:00

Here is the law:

"Property owners must keep their sidewalks clean and are also responsible for snow removal."

And here are the facts (pictures taken outside LICH buildings on Hicks Street near Amity, 9/3/10):

The Wallflower of Long Island College

2010-06-24T12:34:00.003-04:00

As I have had numerous occasions to remark, LICH does a nice job of landscaping. In particular I like the two separated individual rose bushes on Hicks Street. The picture here is of the one to the south, close to the corner of Amity Street. It is a beautiful bush, here shown as of today, out of its prime blooming season, but there is still one bloom on top (and, I believe, another one toward the bottom).

Rita and I enjoy these roses each time we pass by. But here is a question: why are these roses so lonely ? By adding another few bushes, it would seem, the result could be truly fantastic. Does it really take that much more effort to care for, say, five bushes than for one ?

Once Again: Springtime at LICH

2010-04-12T19:04:00.007-04:00

And here is more about springtime in Brooklyn, 2010

To Merge or not to Merge

2009-09-02T22:40:00.004-04:00

The Organized Medical Staff of LICH (which is independent of management) maintains its own website. This group is opposed to a merger of LICH with the SUNY Downstate Medical Center. Readers of this blog know that there may indeed be good reasons for such a merger. In particular, Mr. Murray Adams has favored it (read and the postings following). I must confess that I am not adequately conversant with all the factors surrounding this issue. So, while strictly neutral on the matter of a merger, I do present the latest propositions from the group of doctors:

September 1, 2009
Dear Fellow Members of the Medical Staff of Long Island College Hospital:
Now that the summer is coming to an end and we are all focusing on the coming year, we are taking this opportunity to provide you with an update on the progress that we have made on our objective to separate LICH from Continuum and re-establish LICH’s independence.
Rumors that a Downstate Merger is Imminent are FALSE. We are well aware of the rumors that have been circulating that the LICH/Downstate merger is basically a “done deal”. This is ABSOLUTELY NOT TRUE.
The so-called Memorandum of Understanding that has been signed between the two hospitals has not been made available to us or the public, but we know that it is little more than a statement that the parties would like to come to terms on a deal.
Key Business Issues Have Not Been Resolved. We also know for a fact that there are many critical deal points that must be resolved before a merger can be completed including allocations of very significant expenses and professional liability exposure. There are issues relating to the Othmer Endowment. There will be issues since Downstate and LICH are served by different Unions. Sharing of systems and resources must be worked out. And the list goes on. It is quite possible that the parties will not be able to come to terms on these issues.
Numerous Approvals Required Any purported deal between Downstate and LICH require the approval of, among others:
• New York State Department of Health (DOH) • Public Health Council • Dormitory Authority of the State of New York (DASNY) • U.S. Department of Housing and Urban Development (HUD) • State University of New York (SUNY) • New York State Attorney General and Supreme Court • Medicare Program • Medicaid Program • Board of Regents of LICH
NONE OF THESE APPROVALS HAVE BEEN OBTAINED AND, IN FACT, SINCE NO FINAL DEAL HAS BEEN AGREED TO BETWEEN LICH AND DOWNSTATE, NO REQUEST FOR APPROVAL HAS EVEN BEEN SUBMITTED TO ANY OF THESE ENTITIES. Even if LICH and
NY: 476542v1
Downstate are able to come to terms on a deal, it is quite likely that some or all of these approvals will be denied. If approval is sought, we, the Medical Staff will have an opportunity to express our concerns and object to the plan. There are significant reasons why approvals may not be granted.
Very Positive Meeting with the DOH. IMPORTANTLY, we met with very senior level DOH officials on August 6, 2009 to discuss the Medical Staff’s position on the future of LICH and the Downstate proposal in particular. These officials have made it absolutely clear that the DOH understands that the continued existence of LICH under any plan will not be financially feasible without the full support of the Medical Staff and accordingly, THE APPROVAL OF THE MEDICAL STAFF IS CRITICAL to obtaining the approval of the DOH. In fact, the DOH has committed to use its influence to orchestrate a meeting between the Medical Staff Executive Committee and its advisors with Downstate to discuss what terms, if any, would be acceptable to the Medical Staff for an affiliation. As per the petition that we signed, we have and will continue to make it clear that we will not agree to any plan that does not result in re-establishing LICH as an independent institution.
Memorandum Summarizing the Improper Constitution of the Current LICH Board. The DOH has asked our attorneys to prepare a written summary of the reasons why the current LICH Board is improperly constituted and the Continuum takeover of LICH was improper. Our attorneys are in the process of preparing such Memorandum and have advised us that there are many grounds for making such determination that the Board is improper.
Appointment of a New Board for LICH In furtherance of our plan, we have selected and obtained the commitment of 10 highly qualified nominees to reconstitute the Board of LICH. We have submitted their names and CVs and other credentials to the DOH for their review. A copy of such submission is attached to this letter for your information.
Status of Our Plan. At this point, if the Downstate proposal is not approved, the only other plan that has been submitted to the DOH and others is the carefully prepared and analyzed plan presented by the team of professionals retained by the Medical Staff. While the DOH has not yet ruled on the plan since it has not been submitted by the LICH Board, we are confident that if the Downstate deal is not approved, the DOH will find our plan to be the only other feasible and acceptable plan for approval.
Application for HEAL Grant. We have prepared and submitted an application on behalf of LICH for a $15 million HEAL grant to be used in furtherance of the Hospital’s needs in accordance with our plan.
We look forward to meeting with you in early September, at which time we will be able to give you further updates and answer any questions that might occur. In the meantime, we implore you not to fall victim to believing rumors that are being circulated to induce you to passively fall in line and accept the Downstate proposal. A Downstate takeover would doom LICH. The only workable solution remains establishing an independent LICH with a possible affiliation with Downstate on terms acceptable to the independent LICH. STAY THE COURSE - WE WILL GET THERE IF WE REMAIN UNITED AND COMMITTED TO RETURNING LICH TO ITS FORMER INDEPENDENT STATUS.
Sincerely, The Medical Staff Legal Committee
NY: 476542v1

Secrecy at LICH

2009-06-24T01:11:00.004-04:00

Reported negotiations to merge LICH with SUNY seem to proceed in utmost secrecy. There are reports that the medical staff, in particular, is upset because important medical decisions seem to be in negotiation without input from the professional staff.

Denis Hamill of the Daily News has a fulsome report. To read it, click here.

Springtime at LICH

2009-04-21T17:06:00.005-04:00

Whatever the virtues and/or vices of LICH's past and LICH's future, for the moment there is springtime at LICH, at least in its landscaping.

LICH real estate up for sale

2009-01-24T16:25:00.004-05:00

LICH property at 385 Hicks
photo by Werner Cohn

According to Barbara Benson (Crain's Health Pulse, Jan. 23), Continuum has put some of LICH's real estate up for sale.

Writes Benson:

Offered by Grubb & Ellis on an all-cash basis, the properties include 74, 76-78, 82 and 86 Amity St., and 113 Congress St. Of those, 74 Amity is a 12-unit walk-up apartment house; the others are townhouses. Also for sale is 43 Columbia Place, a four-story, 11-unit walkup. The last is 385-389 Hicks St., a one-building site that can be developed to about 23,000 square feet. Most of the buildings are vacant or will be by July.

Update from LICH Medical Staff

2009-01-19T23:23:00.002-05:00

I have received the following communication from members of the LICH medical staff, and hasten to present it as received. WC

Update from the LICH Medical Staff
January 2009

Since there has been very little “official” activity on the LICH front in the past month, we have decided to provide an update of recent activity and events regarding LICH.

As you are all probably aware, in December 2008 the NY State Dept. of Health refused to allow the proposal by Continuum Health Partners (CHP) to close the Obstetrics and Pediatrics programs at LICH, and these departments, as well as all other services at LICH, are still fully functioning.

The LICH Medical Staff, at its quarterly meeting in December, unanimously passed a resolution demanding that CHP send out a letter to the Brooklyn community in this regard, in an effort to counteract the extreme negative publicity generated by the letter that CHP sent out in August 2008 announcing the proposed closures.

CHP has repeatedly refused to send out such a letter, and CHP CEO Stanley Brezinoff stated as recently as Jan. 5, 2008 at the LICH Medical Executive Meeting, that such a letter “Will not be sent”. Although the LICH Medical Staff offered to send such a letter out to the Brooklyn community at its own expense, if provided the database for the mailing, this request was denied as well.

In December 2008, the Chairmen of the Departments at LICH proposed to the CHP Board that all property sales and proposed program closures by CHP be halted until the NY State Dept. of Health makes its final determination regarding LICH. This proposal was voted against by every Manhattan-based CHP Board member, as well as by Board members Joseph Broadwin and Patrick Burns, who are a few of the remaining so-called LICH Board members. Mr. Broadwin is in fact part of a group calling themselves the “Ad-Hoc Committee for LICH”, but this group is clearly driven by its CHP ties and is not acting in the best interest of LICH.

John Wren, the titular “Chairman of the LICH/CHP Board”, has not been heard from in at least six months and clearly has abdicated any responsibility regarding LICH.

There is currently very little if any LICH voice on the CHP Board.
CHP CEO Stanley Brezinoff, who stated in August 2008 that if his plan to “close OB, Peds, and sell real estate” was not accepted, he would close LICH by year’s end, now says that “LICH will not be part of CHP, but if LICH is not merged with Downstate Medical Center, which I’m working on, it will close”.

CHP continues to attempt to sell off LICH properties – several LICH brownstones have recently been summarily emptied.

The LICH Medical Staff and its team is in active, ongoing discussions with the NY State Department of Health, DASNY (Dormitory Authority of the State of New York) and HUD (the holders of the LICH property mortgages), as well as the NY State Attorney General, and we have presented our plan for the preservation (and liberation) of LICH. These discussions have been constructive and well received by the authorities, and we are hoping to report a positive outcome in the very near future.

We still need support from all of you – the community, the elected officials, physicians and staff at LICH, and everybody else – we need letters, emails, meetings, articles, press contacts, etc……… the more you do, the better for LICH!

Thanking you all for your support of LICH, and hoping for a Happy New Year in the very near future for LICH.

The Medical Staff of LICH

Anyone in Charge ?

2008-12-06T21:40:00.006-05:00

Mr. John D. Wren
Business Week

Mr. Stanley Brezenoff

The Brooklyn Paper/Tom Callan

The law requires a board of a not-for-profit corporation to be in overall charge. No matter how many executives and other employees there may be, it is the Board, and nobody else, that is charged with the fiduciary duty to preserve and nurture the organization. In the case of LICH, that would be the Board of Regents, whose chairman is Mr. John D. Wren.

Mr. Brezenoff, who has made all the policy statements more or less on his own, has certainly given the impression that it is he, and nobody else, who is in charge. But, at least in form, he is but a paid servant of LICH, with but one seat on the Board. Where in all this is the legally-responsible Board ? Where is Mr. Wren ? What does Mr. Wren have to say about the important policy decisions that lie ahead for LICH ?

Yes, Mr. B., there is so a Plan B

2008-11-19T00:09:00.003-05:00

Not long ago, on September 22 of this year, Continuum boss Mr. Stanley Brezenoff pounded a table for emphasis and, he thought, laid down the law: I will cut out obstetrics at LICH, and, for good measure, I will cut pediatrics as well. That is my plan. There is no plan B.

Well, local officials, local activists, the medical staff of LICH, and many others organized to tell the State government that LICH should remain whole. And what do you know, the State listened, and decreed that yes, Mr. B., there is so a Plan B: the hospital will retain the services that Mr. B. had decided he would not.

For the text of the NYC Department of Health decision, click here.

Dr. Licht replies to Murray Adams

2008-11-12T14:42:00.003-05:00

Mr. Cohn

Murray Adams has a personal view based on his feelings for what is best for LICH. However, he gives the wrong impression by characterizing the medical staff as being fractionated. All of the steps both leading to what is referred to as "the Doctor's Plan" as well as our public postures represent the nearly unanimous position of the Organized Medical Staff of LICH as voted on at our monthly Medical Executive Committee Meetings.

Murray makes it seem as if the LICH Medical Staff has no interest in a relationship with Downstate. That is not true. However we believe that any relationship with another institution including Downstate must include the Medical Staff as a full assenting partner. Murray's plan has LICH being handed over to Downstate as so much chattel without negotiation and without the involvement of the Organized Medical Staff. More bizarrely Murray's plan would have the current Continuum Board select the members of a new LICH Board. We have had 10 years of governance by a Continuum Board and cannot imagine having them appoint our new governing body.

There are indeed some physicians who, for whatever reason, are not in agreement with the majority opinion but they speak as individuals and not as representatives of the Organized Medical Staff and it's elected officers.

You may post this on your blog if you wish.

Arnold L. Licht, MD
President of the Organized Medical Staff
Long Island College Hospital

Some Doctors Have a Different View: Additional Comments from Murray Adams

2008-11-12T10:52:00.005-05:00

Murray has sent me some additional comments regarding yesterday's posting (see below):

All of us owe a vote of thanks to Borough President Marty Markowitz for convening the hearing held at Borough Hall on Monday night. Inexplicably no one from the NYS Department of Health showed up. Fortunately, all of our local elected officials or their representatives were there to hear so many of our neighbors, our doctors, LICH’s employees and others who testified movingly and forcefully about the necessity for preserving Long Island College Hospital as an Brooklyn-managed major community hospital having all its present services, especially including Obstetrics and Pediatrics to serve our growing neighborhoods and the many young families with young children who crowd our sidewalks.
Unfortunately the top elected officials of the medical staff, Dr. Licht and Dr. Sorra, and other physicians such as Dr. Ricciardi, all of whose medical practices are office-based and who rarely if ever admit patients to LICH, do not agree with the plan I outlined to immediately affiliate LICH with SUNY Downstate. The Medical Staff Plan submitted to the Department of Health proposed that LICH re- establish itself as an independent hospital. Drs. Licht and Sorra however acknowledge the long-existing academic affiliation between the two institutions and agree that ultimately to enter into a management affiliation with Downstate or another large system might make sense.
On the other hand, I, several of the Brooklyn-based LICH trustees, including Rev. Dr. Paul Smith, Dr. Mike Avram, Joseph Broadwin and Lou Valentino, and most of the doctors whose practices, like Ciril Godec’s in urology, depends heavily on LICH’s surgical suites or, like Deborah Reade’s in radiology, depends heavily on LICH’s specialty equipment, do not believe that LICH can survive and rebuild as an independent hospital without affiliation with a major medical center such as SUNY Downstate.
I emphasize, however, that all of us are in full agreement that Continuum’s management of LICH must be terminated. Our major problem now is getting the Department of Health to turn down Continuum’s plan to close OB, inpatient Pediatrics, and Dentistry, bringing LICH’s management back to Brooklyn under a Brooklyn-based Board of Regents, and getting the DOH and our local elected officials to help us get Downstate to take over the management of LICH and its OB beds and getting help from them and HUD to make the takeover financially possible for Downstate. And it better come soon, or with Continuum continuing to shut down programs such as the school based clinics and the rape crisis intervention program and to fire large numbers of LICH employees, there will be nothing left of LICH to salvage.
C. Murray Adams

Cobble Hill Association: Have SUNY run LICH ! Submission by Murray Adams.

2008-11-11T15:39:00.006-05:00

Murray Adams
photo by Werner Cohn

Murray Adams, a prominent personality in Cobble Hill and former president of the Cobble Hill Association, has presented a plan to save LICH at a public hearing last night. Here is his submission:

TESTIMONY OF C. MURRAY ADAMS, ON BEHALF OF
THE COBBLE HILL ASSOCIATION
November 10, 2008

My name is Murray Adams, and I speak on behalf of the Cobble Hill Association, a civic association which represents the interests of the residents of Cobble Hill, Brooklyn, where The Long Island College Hospital has been providing medical care for 150 years. The people of our community believe that the real reason behind Continuum Health Partners’ announced plans to close LICH’s Obstetrics and in-patient Pediatrics services, its Dentistry program and its school based clinics program is to close LICH entirely so they can sell off LICH’s valuable real estate to benefit Continuum’s Manhattan hospitals. This must not be allowed to happen!
Late in August, 2008, the Medical Staff of LICH filed a plan with the New York State Department of Health to revitalize LICH without closing any of these services and by returning LICH’s management to an independent group of Brooklyn-based trustees. That plan is a good plan, but it must be supplemented because it does not provide working capital which LICH must have in order to finance the transition and the rebuilding of the Hospital. Although the Medical Staff leadership has retained an investment banking firm to help obtain financing, given the present collapse of the credit markets, we do not think it likely that they will obtain loans for the necessary working capital in the very short time remaining to save LICH. To make the Medical Staff plan feasible, in our opinion, it needs to be supplemented in three respects:
First, the Medical School at SUNY Downstate and the Department of Health must agree that the management of LICH must be moved to Downstate and LICH’s Obstetric beds must be moved under Downstate’s operating certificate. This would mean New York State would bear the losses and the malpractice premiums which now burden LICH. Continuum wants to close Obstetrics, because, according to Continuum’s figures, this would save LICH more than $13 million per year. It would cost the State about half that much because the State does not have to pay malpractice premiums. Obviously, if Downstate continues to operate the Obstetrics beds at LICH where they are, there will be no need to close inpatient Pediatrics or the school based clinics program or the Dentistry program.
Second, the Medical School at Downstate and the Department of Health must agree to Downstate’s entering into leases of several LICH buildings so that Downstate can move much of its medical school as well as its clinical practices over to LICH. These buildings are LICH’s Polhemus building, where until 1953 Downstate had its medical school; LICH’s Clinic Building; and much of LICH’s 97 Amity Street building. This would answer Downstate’s need to expand its medical school facilities. An annual lease rental of $15 million will offset $15 million of LICH’s annual debt service, and so take care of the second part of what Continuum’s “plan” says needs to be done to put LICH on a stable financial basis.
Third, we need our elected officials’ help in getting the federal Department of Housing and Urban Development to defer for a reasonable period LICH’s debt service payments of about $2.5 million per month in order to provide LICH with working capital essential to LICH’s effort to restore itself. Also, LICH needs time to reconstitute and expand its primary care clinics, as the Medical Staff plan contemplates, and thereby rebuild LICH’s volume and its cash flow, which will probably take up to two years.
For the better health of all Brooklyn residents, Long Island College Hospital must be saved and restored as a premier Brooklyn health care institution. Brooklyn’s public health care standing is below New York City standards in almost every category, such as infant mortality per 1000 births, prevalence of asthma in children, incidence of heart disease, strokes, etc. The State would save money by setting up a Borough wide system of primary care clinics which would treat asthma, high blood pressure, breast cancer, high cholesterol conditions, nutrition problems, substance abuse and other common medical conditions that early intervention can treat much less expensively than if the patient arrives months or years later in a hospital emergency room and requires inpatient treatment because the untreated condition has become a major threat. We believe that what Brooklyn needs, as the Medical Staff Plan contemplates, is the establishment of a chain of Primary Care Clinics in the medically underserved areas of Brooklyn, such as Bedford-Stuyvesant, Brownsville, Mill Basin and East New York, and the linking up of existing clinics in those and other underserved areas, such as the BHS Clinic in East New York and the Red Hook Health Center in Red Hook, with the combined tertiary care capabilities of Downstate/University Hospital and LICH. We believe federal funds can be obtained to help establish this network of clinics.
We understand that Continuum and Downstate are in negotiations which we hope will result in LICH’s management being returned to Brooklyn under Downstate’s management and supervised by a new Brooklyn-based Board of Regents. We urge the Borough President and all our local elected officials to take every step in their power to make this come about and save our hospital for the entire Brooklyn community.
Thank you.

Communication from LICH doctors

2008-10-25T23:08:00.002-04:00

I have received this communication from the group of LICH doctors who oppose the current LICH management:

The LICH Medical Staff website now has links to sign a petition in support of LICH,
as well as to send a letter to Governor Paterson - please sign the petition!
In addition, there is a link to download flyers for distribution to friends, neighbors and patients - print these and distribute!

LICH MEDICAL STAFF

A friend of LICH has also established a "Save LICH" group on Facebook,
the link is below.

To see more details and confirm this group invitation, follow this link.

Thank you all for your support of LICH!

LICH Medical Staff

Pictures from a Demonstration

2008-10-14T17:58:00.007-04:00

Rally for LICH

2008-10-12T13:43:00.004-04:00

LICH in 1899

Members of the LICH medical staff and a number of local politicians are staging a rally at 1 p.m. on Tuesday, October 14, in front of the hospital.

Mr. Brezenoff Explains

2008-09-26T12:46:00.005-04:00

As I write, Congress and the Administration are trying to find a way out of the current financial crisis. To many an innocent bystander, it was amazing to discover that the CEO's of the most mismanaged corporations took multi-million dollar salaries. How is this relevant to LICH ? Read on.

This last Monday (Sept. 22) was a remarkable day for LICH. The public was invited to a meeting at LICH, sponsored by Community Board Six, that featured a spirited, forceful address by Stanley Brezenoff. Mr. Brezenoff is the President and CEO of Continuum Health Partners, the non-profit management organization that is responsible for the executive functions of the hospital.

Mr. Brezenoff was blunt in what he had to say: 1) LICH is in a severe financial crisis (because there aren't enough patients); it is financially moribund. 2) It is my plan to cut out obstetrics and pediatrics, because these services lose money. Those steps will revive this near-death patient. 3) This is my plan. There is no plan B. Take it or leave it.

Mr. Brezenoff's remarks and those of his questioners are well reported on the website of the (dissident) medical staff. This site, highly critical of Mr. B. and his management, needs to be consulted by anyone interested in the hospital.

I sat in the audience, taking it all in, but my thoughts were on matters that nobody mentioned, although they had, indeed, been mentioned by the dissident medical staff before: if LICH is in such dire straights, why are the executive salaries so high ? According to the Daily News, LICH's doctors want cuts in executive pay.

Like everything else, executive salaries are relative. This blog has previously reported on the salary of the recently-resigned LICH president Ms. Rita Battles (whose name, curiously, was never mentioned at this meeting), and also, for comparative purposes, the salary of Alan D. Aviles, the man who runs the city hospital system. (see my postings of November 14, 2007 and others.) In brief, while Ms. Battles was paid approximately $700,000, Mr. Aviles, responsible for a far more extensive operation, earned but $291,000.

Continuum Health Partners manages several other hospitals in addition to LICH, so Mr. Brezenoff's salary, presumably, is not paid by LICH alone. Still, it is an interesting figure. Now like all other not-for-profits, Continuum is required to report its top salaries to the IRS on form IRS990. These reports are publicly available online, for instance on the site of GuideStar.

People should more often examine these reports about the non profits that they support. In the case of Continuum, the latest report covers the year 2006. In that year, Mr. Brezenoff was paid a total of $1,442,412, or, roughly, just about five times the sum paid to Mr. Aviles, whose job, remember, is far more extensive than Mr. B's.

Day of the Pols

2008-08-06T16:03:00.004-04:00

Today outside of LICH. Local pols give speeches and all say: don't close LICH ! Ordinary folks lend an ear.

Going, going .... gone ?

2008-07-31T11:12:00.004-04:00

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
Subject: MEMO FROM STANLEY BREZENOFF RE: RESTRUCTURING EFFORTS AT LICH
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
campus.

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.

Internal Turmoil at LICH, ct'd

2008-07-24T22:32:00.004-04:00

President Rita Battles of LICH, without warning, is gone; President no longer. The LICH statement says that she prefers to pursue "other endeavors."

Rita Battles

Moreover, there will not be another president at all, at least not for the moment. Instead there will be a Chief Restructuring Officer ("a title with great portent," according to the Brooklyn Paper), Mr. Dominick Stanzione.

Dominick Stanzione

And what does the staff of LICH think ? The medical staff, at least, seems to dissent, once again, from management, according to the Brooklyn Paper:

“[It] is another indication that Continuum Health Partners, a management company that now thinks it owns LICH, is moving to downsize and possibly ultimately close Downtown Brooklyn’s most prominent medical center,” Dr. Arnold Licht, president of the hospital’s medical staff, said in a statement.

Internal Turmoil at LICH

2008-06-11T13:48:00.004-04:00

Ruby Washington, New York Times

Dr. Arnold Licht addressing a protest rally

Some weeks ago I was invited to a breakfast/pep rally at LICH. President Battles was there, pouring out the charm, and so were other dignitaries. One Hasidic rabbi, unable to contain his enthusiasm for LICH, reported that his male congregants complain to him that they cannot take advantage of the great infant delivery services of LICH.

Any problems at LICH ? None that were mentioned at this event. Continuum Health Partners, the owners of LICH who operate out of Manhattan ? Never heard those nasty three words mentioned at this affair.

So here is the New York Times of yesterday, with a long story about the troubles of LICH. It seems that Continuum may well sell this Cobble Hill prime real estate (the LICH buildings) to raise money. And, as reported on this blog previously, LICH's medical staff seems to be in revolt against Continuum.

Planters beautified on Hicks Street

2008-04-29T19:45:00.002-04:00

LICH has effected some very nice improvements on Hicks Street between Congress and Amity. As I reported recently, the two planters on that block had morphed into garbage receptacles. LICH has now beautified one of these (see picture), and (wisely) removed the other one. Good work, LICH !

The Two Faces of LICH Management: Tulips and Trash

2008-04-19T10:00:00.003-04:00

Two Cheers for LICH Landscaping

2008-04-14T23:01:00.003-04:00

Look at the top picture. Beautiful magnolias, in full bloom, on LICH property on Henry Street. It's a sign of spring, of the Good Lord showing us his benevolence, but also of the creative lanscaping done by LICH. Thank you, thank you.

And now there is the second picture; a tulip that has also been planted by the good people of LICH, on Hicks Street, just below the LICH garage. But what is that garbage next to it ? Can't somebody keep the place a little neater ?

And here is one of the three new planters that LICH put on Hicks Street just a few months ago. It has been allowed to morph into a garbage pail. The same holds for the other LICH planters on the same block.

Moral: 1) Landscaping, no matter how good, needs to go hand in hand with some attention to garbage removal. 2) You can spend a lot of money on plantings, but if you don't show attention to cleanliness, the place will turn into a slum anyway.

Internal Dissent at LICH

2008-02-09T02:30:00.000-05:00

A recent article in the Brooklyn Eagle tells a story of dissatisfaction with LICH's association with Continuum Health Partners. It provides more information on the story I published here previously. There is a related discussion on the blog McBrooklyn.

Graffiti Reappearing

2008-01-22T18:01:00.000-05:00

All these pictures were taken on Tuesday, January 22, at about 5 p.m. They show new graffiti on the 300 block of Hicks on two buildings that belong to LICH. These buildings are just north of 385 Hicks, which had heretofore been the worst spot on the block. The new graffiti is not as conspicuous as the old, and the situation in not as bad as it had been. But all experts on graffiti warn that it must be removed immediately when spotted in order to discourage further vandalism.

As I have had occasion to say before on this blog, LICH needs to inspect its exterior surfaces daily. All self-respecting private homeowners, obviously, keep an eye on the appearance of their properties. Should requirements be lower for a not-for-profit hospital ?

The general neglect that LICH management has shown with regard to these buildings is also shown by the fact that neither of these two properties is properly marked with a street number. One door says "3", with the last two digits missing. The other building has no address signage at all. In an emergency -- say Fire or Police -- how could 911 be told where help is needed ?

Loose Lips from Licht, Tight Lips at LICH.

2008-01-14T23:57:00.000-05:00

Readers will recall my report about LICH's strange inability -- or unwillingness -- to accept a modest financial contribution from me. Something funny about its IRS status.

Now more information about LICH's secretive financing has emerged in the media. Mike McLaughlin, a reporter for the Brooklyn Paper (largely quoting the Daily News), tells a story that LICH would prefer to keep quiet. It seems that Continuum Health Partners, which operates or owns LICH (I don't know which) favors Beth Israel Hospital, another of its holdings, over its little stepchild on Hicks Street. And apparently Dr. Arnold Licht, president of the LICH medical board, is unhappy; he wants more money for LICH programs. In fact, according to the Daily News story, LICH doctors have complained to Attorney General Cuomo. But LICH management will not talk to the media about this, according to McLaughlin.

Loose lips from Licht, tight lips at LICH.

Graffiti removed

2008-01-08T16:36:00.000-05:00

The graffiti at 385 Hicks Street have now been removed.

The deplorable conditions in front of this building and on its walls have been a feature of LICH management for years. I began to report on this problem in August of last year. The tree pits were cleaned up fairly soon, and good new plantings were supplied. The ugly graffiti had to wait until now.

So far so good. But obviously, the underlying problem has been one of long-term neglect. The clean-up is welcome, but without constant attention and vigilance on the part of LICH, conditions can well slide back. As any conscientious property owner knows, to be a good neighbor requires daily inspection of your frontage.

2008 Starts Right for LICH !

2008-01-02T11:14:00.001-05:00

Wednesday, Jan. 2, 2008, 11 a.m. Great ! The graffiti, or at least some oft them, seem to be in the process of removal. Was it pressure from the City ? Was it that good old LICH conscience kicking in ? No matter, it seems to be getting done. I do hope that they won't forget those ugly black doors ! Anyway, Happy New Year, LICH, Happy New Year, neighbor.

311 to the Rescue ?

2007-12-27T16:46:00.000-05:00

An anonymous reader of this blog recently suggested that I DO something about the graffiti, instead of just talk talk talk. Well, thanks to this poster, I called 311, the City's all-purpose information and complaint address. And, what do you know, this poster was right: there is something I could do that I had not thought of before. And I did it.

I called 311 to report these graffiti, and was told that the City will notify the owner of the property, LICH, within 21 days. The City will ask LICH to remove the graffiti, and will, in fact, offer City money to do this in the form of a City work crew (I did know about the financial aspect, and so notified LICH several months ago). The City will tell LICH that unless something is done, it will be fined. My complaint number is SR #: C1-1-368592991.

Will all this come to something ? Will this story have a happy ending in, say, 2008 ? Will it be a matter of 311 TO THE RESCUE ? Stay tuned, stay tuned.

Is LICH a good neighbor ?

2007-12-19T14:01:00.000-05:00

Picture taken 12/19/07

Not only is graffiti unattractive, it lowers property values and encourages other types of crime in neighborhoods.
Fort Worth Police Department

LICH DEFIES MAYOR BLOOMBERG

2007-12-04T15:20:00.000-05:00

Mayor Bloomberg:

"Graffiti is something for which our administration has zero tolerance," the mayor said, calling it "an invitation to criminal behavior."

And here is the reply by LICH, in a photo taken Tuesday, December 4, 2007:

Is it too much for LICH ?

2007-11-28T12:55:00.001-05:00

Picture taken Wednesday, November 28

How much does it take, in money and effort, to repaint a black door ? How much does it take in care and consideration ? Is it too much for LICH ?

Here are some thoughts from the National Crime Prevention Council:

Graffiti Prevention Improves the Quality of Life for Communities and Residents

Graffiti is a sign of decay and makes people feel that their neighborhood is being lost to gangs and crime. If allowed to remain, it sends the message that the community is unconcerned about its appearance.

Why can the City hire its hospital boss for so much less ?

2007-11-14T18:28:00.000-05:00

In my posting of September 25, I reported on the salary of LICH president Rita Battles, approximately $700,000. I did have figures at the time for the presidents of other private (non-profit) hospitals in the area, and found that of Ms. Battles to be on the low side.

But I did not have the figure for the chief executive of New York City's Health and Hospitals Corporation, Mr. Alan D. Aviles, who oversees a far larger complex of hospital facilities than does Ms. Battles. Here is NYCHHC's own job description for Mr. Aviles:

Alan D. Aviles is the President and Chief Executive Officer of the New York City Health and Hospitals Corporation (HHC), the largest municipal healthcare system in the nation. Mr. Aviles was appointed by New York City Mayor Michael R. Bloomberg in February 2005 to lead the 38,000 employees of this $5.4 billion corporation, which includes 11 acute care facilities, four nursing homes, six large diagnostic and treatment centers, more than 80 community-based clinics, a large home care agency, and a Medicaid managed care plan with more than 250,000 enrollees. Last year, HHC facilities served 1.3 million New Yorkers that reflect the diversity of this global city – including nearly 400,000 uninsured.

Unlike the non-profit private groups, HHC does not file IRS disclosure forms that show top salaries. And unlike "direct" government departments, HHC, a public corporation, does not show its salaries in public directories like New York City's famous Green Book. I found that I could get HHC salary figures only by filing a Freedom of Information Law (FOIL) request. This I did, about two months ago, and today I received the information I requested.

The salary of Mr. Aviles is currently $291,192. And remember, Mr. Aviles's responsibilities are far more extensive than those of Ms. Battles.

In my view, the relatively modest salaries paid to public servants like Mr. Aviles calls into question the necessity -- the appropriateness, if you will -- of the much higher sums paid at non-profit facilities like LICH. The current crisis in health care costs is one of the most pressing public issues in the country. Perhaps our public officials could look at the contrast between Ms. Battles and Mr. Aviles as pointing to one way of alleviating the crisis.

A biography of Mr. Aviles, with an outline of his background, is given in the NYCHHC site. That of Ms. Battles may be consulted on the LICH site.

Does LICH want Bush impeached ?

2007-11-09T14:14:00.000-05:00

Among the many unsightly graffiti that adorn the exterior of LICH's building on 385 Hicks Street, there is one that says "Impeach Bush." I first showed it here clearly on August 16 of this year.

Federal statutes prohibit non-profit groups from engaging in partisan political campaigns. Is this a case of political partisanship, or is it something worse: a willful negligence that drags down an otherwise attractive residential neighborhood ?

(Picture taken Friday, November 8, 2007)

Madison Ave. vs. Hicks St. -- ct'd

2007-10-26T12:09:00.001-04:00

The planter in front of LICH's Graffiti House (385 Hicks) has once again become the target of theft. Another beautiful plant has been stolen within the last twelve hours or so.

Is other crime encouraged by the vandalism known as graffiti ? Mayor Guiliani thought so. These graffiti are ugly and should be removed for that reason alone. But they also contribute to the blight and crime of a neighborhood. There is no excuse for LICH to just ignore the situation.

Would Mr. Wren tolerate this at his other location ? I don't think so.

Hicks Street is not Madison Avenue

2007-10-25T22:27:00.001-04:00

The graffiti at 325 Hicks Street, a LICH building, are still where they were months ago. Is that a pretty sight ?

As it happens, LICH shares leadership with the Omnicom Group, "A Global Leader in Advertising ...," as it describes itself. Mr. John D. Wren is the CEO of Omnicom and the chairman of the board of LICH. Omnicom is headquartered at 437 Madison Avenue in Manhattan. So I went over there this morning to see how that building is kept, in comparison with 325 Hicks. I took seven pictures on Madison Avenue, another seven new ones here on Hicks, all today, October 25, 2007.

Can you tell which picture was taken where ?

LICH: What do you mean, you want to give us money !!

2007-10-22T18:11:00.000-04:00

danmeth

As the faithful readers of this blog know, I have tried to effect a modest financial contribution to LICH, in recognition of its good work for the sick, and also in appreciation for its beautification of our block. This latter project is not complete, but it's on its way.

My wife and I manage our charitable contributions through the Fidelity Charitable Gift Fund (CGF). Here is how this works. We give the money to CGF, and CGF gives it to any charity that we recommend, as long as it is properly recognized by Internal Revenue. There are tax advantages to modest givers like us, and also, it turns out, another advantage: CGF vets contributions to make sure that the proposed charity complies with federal rules. In the several years of our relationship with CGF, the procedure has worked without a hitch.

Well, with LICH there is a hitch. Not being privy to the ins and outs of the LICH bureaucracy, I don't know just why LICH does not currently qualify for charitable contributions from charitable gift funds. It apparently has something to do with the way LICH has structured its IRS status. I've been on the phone with CGF several times, and I was told that LICH needs to fill in some papers to qualify. CGF has repeatedly phoned LICH but LICH has not responded. And neither has LICH responded to the several e-mails that I have sent to their man in charge of fund raising. Of course it's only a matter of $300 in contributions from me, and so, it seems, from LICH's point of view, why bother.

And so, reluctantly, I withdrew our grant recommendation for LICH today.

The Thief of Hicks Street

2007-10-09T21:39:00.000-04:00

One of those nice planters on Hicks Street that LICH placed there so recently has just been robbed of most of its flowers (Diana Garden Mums). The first picture shows the holes that the thief left. The second picture shows another planter on the same block, which the thief has not (yet ?) emptied of its flowers.

The plantings are very new and easy to scoop up. It's easy to steal the easy prey. But why would a person do a thing like this ? Is the thief the kind of person you would like as friend or neighbor, or, God forbid, as family member ?

I chatted with a LICH employee as we both inspected the damage. "Whoever did this," she said, "will not enjoy the flowers. They will not grow for him. Why ? Because cheaters never prosper." Amen.

Health Care Report Card

2007-10-02T01:25:00.000-04:00

I have previously reported on available data about the overall quality of LICH. Most of these data, and more, are conveniently brought together in an excellent site called Health Care Report Card.

So, how good is LICH in comparison with other area hospitals ? It emerges from these HCRC reports that LICH is more or less average. It receives some bad marks in some areas, but so do most of the other hospitals. This site needs to be studied, however, and in detail. One surprising detail is that Columbia Presbyterian, which I have mentioned before (for example in connection with its extraordinarily high compensation for its top executives), doesn't seem to be doing much better than LICH in patient care, at least according to these HCRC data. Lenox Hill Hospital was another surprise to me -- coming in so very low in patient care scores.

I cannot believe that these HCRC scores tell the whole story of these hospitals. Columbia Presbyterian is connected with one of the top research institutions in the world. I would certainly hope that the indisputably high quality of its science accrues to the benefit to its patients, although perhaps not in ways that HCRC can measure.

Welcome, Baby Oak !

2007-09-28T18:38:00.000-04:00

LICH has put a beautiful little oak tree into what only recently was an ugly pit of weeds. As Joyce Kilmer already put it, back in 1914 (well, he almost said it):

Blogs are made by fools like me

But only LICH can plant a tree

On the other hand ... a phrase I hate to need so often ... there remains the problem of debris that is not cleared up. A nice environment needs daily attention ! Here is the tree pit just next to that beautiful baby oak:

It takes 190 LICH nurses ....

2007-09-27T13:39:00.001-04:00

At LICH, it takes 190 nurses to earn as much as the Chairman of the LICH Board of Regents. Even LICH executive salaries -- and those of hospitals generally (see previous posting, below) -- pale when compared to top executive salaries in private industry.

LICH's President was no doubt appointed by the LICH Board of Regents, a board that contains many accomplished men and women from many walks of life. The Chairman of this Board of Regents is Mr. John D. Wren, who is also the CEO of the Omnicom Group. Omnicom is required to file detailed reports with the SEC, including detailed information about its top salaries. For 2006, Mr. Wren's compensation package at this corporation totaled $13,241,034, roughly nineteen times the salary of LICH's President/CEO, almost forty times the salary of a LICH surgeon, and one hundred ninety times the pay of a LICH Registered Nurse.

Salaries at the Hospital -- the President and the Others

2007-09-26T00:39:00.001-04:00

Rita Battles became President and CEO of LICH on Monday, September 20, 2004 -- three years ago almost to the day.

For the calendar year of 2004, which is the last year for which salary figures are readily available, Ms. Battles was paid $163,036, plus $8012 in benefits, or a total of $171,048. This covered the 102 days that she served in 2004. If we prorate this figure to arrive at an annual salary rate, we get $613,735 for that year. It is fair to assume that now, three years later, her compensation is higher than that, perhaps, roughly, $700,000 per year.

There is another job title at LICH for which compensation figures are readily obtained, that of Registered Nurse. According to the contract currently in force, RN's at LICH at the lowest level of experience are paid $61,188, and are granted regular increases until they reach the maximum, after 28 years of service, of $89,118. The President of LICH, then, earns between eight and twelve times the salary of the average registered nurse at her hospital.

Compensation figures for physicians are more difficult to ascertain. But the New York area median salary for (employed) family practice physicians is $184,555. For surgeons this figure is $335,751. These are current figures. Based on them, we can estimate that the President of LICH earns about four times the salary of the average family physician, and more than twice as much as the average surgeon at her hospital.

For a complete outsider like myself, it is difficult to compare the background and experience of the President with, say, that of a surgeon. Ms. Battles has had years of distinguished work experience in hospital administration, but her formal education does not seem to have gone beyond that of a master's degree in business administration from Suffolk University in Boston. The formal educational and professional requirements of a surgeon, on the other hand, are much more clearly defined. In addition to graduation from medical school, a surgeon must have served an internship, passed the State Board examination in medicine, and then have spent many years of specialized training leading to certification by his specialty Board.

With all that, LICH, which has 506 beds [not 258, as I had said originally], seems to lag behind certain other area hospitals in executive compensation. Or you might say, since its salaries are more modest, it is ahead of these institutions.

New York and Presbyterian Hospital is perhaps the most noteworthy. In 2004 it had two part-time chief executives, each working about 22 hours per week. The combined salaries of these two (one a physician, the other not), was $6,412,332. This hospital has 2233 beds.

Here are some other examples of presidents' 2004 salaries at New York area hospitals:

New York Hospital Medical Center of Queens (439 beds): $817,867

Bronx Lebanon Hospital Center (565 beds): $ 1,888,553

St. Vincent Catholic Medical Center (845 beds, as of 2003): $1,412,452

SOME WHO WORK FOR LESS

President of the United States -- $400,000, plus $50,000 benefits

Governor of the State of New York -- $179,000

Mayor of the City of New York -- 0

Associate Justice, U. S. Supreme Court -- $164,100

Commissioner of Health and Mental Hygiene, City of New York (currently Thomas R. Frieden, M.D.,M.P.H) -- $171,038

Chancellor, New York City Schools -- $250,000

President, Fordham University -- 0 (Jesuit priest)
highest paid vice president at Fordham -- $233,250, plus $40,472 in benefits

DATA SOURCES

Non-profit groups are required to file annual reports of their financial dealings, including salaries paid to their top employees (religious groups, unfortunately, are exempt from this requirement). These reports to the IRS on IRS form 990, and, in principle, become public documents. Each group is required to make its report available to any member of the public. In practice it is often difficult to inspect these reports in a timely manner, mainly because the groups have little incentive to make such inspection convenient.

Fortunately now, for the last few years, a great many of these reports are available on line at Guidestar.com. For most of the groups that I looked up for this posting, the last available 990's were for the calendar year of 2004. Readers who wish more up-to-date information should approach the organizations themselves.

The information on the salaries of public officials came from the 2005-06 edition (the latest) of The Green Book, an official publication of the City of New York, and a mine of information on matters of government on all levels -- city, state, and federal.

Average salaries come from another fabulous source of information, the Salary Wizard of salary.com. This site takes a bit of practice to get the hang of it.

The information on the salaries of nurses at LICH was furnished to me by the New York State Nurses Association.

A particularly interesting source of data on New York City public salaries is the City's Civil List. It is thousands of pages long and contains salary information on all city employees. All the other sources I have mentioned so far only have information on top salaries, but the Civil List is exhaustive. Your cop on the beat, if you happen to know his name, can be found there. (Are there still cops who walk beats ? Never mind.)

Finally, I must report an unfortunate gap in what is easily available in this area. The New York City Health and Hospital Corporation (HHC) seems to fall between the cracks. It was created by state legislation, and, while run by a board that is appointed by the Mayor, it is an independent body, at least in some ways. Anyway, I was unable to find the salaries of its top officers anywhere on line. I was told that I am entitled to the information, and that I will, in fact, receive it in good time ... but the good time has not yet arrived. My interest in the HHC stems from the fact that it operates the twenty-odd public city hospitals, and of course it would be interesting to know how its top officers are compensated.

Beautification is progressing !

2007-09-18T14:16:00.000-04:00

LICH has put a couple of planters on our block last week, so the beautification project seems to be under way. To express my appreciation, I've sent the first half of my promised $300 contribution to the LICH Corporation.

So there's light at the end of this tunnel but we're not altogether out of it yet:

a) The graffiti on the wall are still there, in all their gory.

b) As the picture shows, the planter is a big improvement over what that tree pit used to look like. But as the picture also shows very clearly, the pit around the planter obviously needs attention. The ground there looks ugly and detracts from the flowers in the planter. Perhaps some sort of ground covering would do the trick.

c) A different topic but not entirely unrelated: No matter how beautiful the flowers on the perimeter, data for what goes on inside the hospital are still inadequate. Here LICH should emulate the City's hospitals (see my posting of 9/8/07).

How Good a Hospital is LICH ? --Part II

2007-09-08T22:00:00.000-04:00

The New York Times of Friday, Sept. 7, published an important article by Sarah Kershaw about a new policy of openness on the part of New York City's own hospitals, the New York City Health and Hospitals Corporation (NYCHHC). This policy affects city-owned hospitals, not private hospitals and nonprofits like LICH. The data to be made available concern infection and death rates, preventable blood stream infections and pneumonia cases, and other items. One of the new HHC web pages for this purpose gives data for heart attack care; data for other crucial categories are linked to this page.

Kershaw's article makes it clear that this is a new step by the city administration to provide data that are crucial to patients. The article also makes it clear that the rest of the industry, and this presumably includes LICH, has a long way to go to match this level of transparency.

Ladies and gentlemen of the LICH administration: follow the mayor on this !

Below please find data taken directly from the website of the HHC. It shows that in the crucial area of preventing surgical infections, the city hospitals do better than other hositals in the NYC area. Where does LICH stand here ? It would sure be good to know !

Note: the remainder of this posting is taken directly from the HHC site.

==================================================

The chance of surgical infection can be minimized if doctors adequately seal wounds, ensure completely sterile conditions and administer appropriate antibiotics in a timely fashion. The appropriate antibiotic should be given no more than one hour before surgery and should be stopped within 24 hours after surgery.

As reflected in data reported by the Centers for Medicare and Medicaid Services (CMS) and the New York State Department of Health, many HHC hospitals have achieved some of the best results in the nation in this category of care.

Preventing Surgical Infections

Hospital-Specific Data

HHC Average= 85.1%
NYC Vicinity Average = 76%
National Average=74.5%

How Good a Hospital is LICH ?

2007-09-04T21:06:00.000-04:00

How good is the Long Island College Hospital from the point of view of the patients that it serves ?

Here is my short answer: I think it's good, but I am not sure.

The Department of Health in Albany publishes grades for hospitals in the state, broken down by several dimensions. Readers should study these materials themselves on the site of the Health Department. But the matter is highly technical and without interpretation by experts, these data may be misleading.

I gave the matter only a preliminary study. Moreover, I have no expertise in interpreting public health statistics, so my impressions may be wrong.

The site, as far as I can see, has four areas that give meaningful information about LICH performance when compared to averages for the state.

1) Overall performance related to heart failure conditions.
LICH gets a grade of 94.58, as compared to 91.35 for the state average. This would seem to be an excellent performance by LICH. Columbia-Presbyterian gets 94.45, about the same as LICH.

2) Overall performance related to pneumonia care.
LICH gets 74.64, with a state average of 87.77. LICH does not seem to be doing very well here. On the other hand, Columbia-Presbyterian is worse than LICH, with a grade of 70.47. So -- I am guessing -- for a city hospital, LICH seems to be doing well, even though it falls short of the state average.

3) Heart attack care.
Hospitals in the state seem to do very well in this category. LICH gets 97.06, Columbia-Presbyterian 97.30, with a state average of 95.28.

4) Overall grade related to Surgical Infection Prevention.
This area, at least on the surface, may well be reason for concern for LICH patients. LICH is given a score of 77.13, the statewide average is 80.11, and Columbia-Presbyterian gets 80.77.
Do we need to worry ? I really don't know. But LICH may very well wish to explain its score here, and, indeed, explain its other scores as well.

LICH's playgrounds on Henry Street

2007-08-25T21:27:00.000-04:00

The frontage of the LICH building at 385 Hicks Street, despite the great recent improvement, is still a bit of a mess. The graffiti are still there, and no maintenance person seems to have been assigned to keep a daily lookout for dirt and debris.

But a block east, on Henry Street, LICH continues to show what it can do for the beauty and pleasure of the neighborhood: two really nice playprounds.

These LICH-built and LICH-operated playgrounds have an interesting history. They were built some ten years ago in an agreement with the City in return for City park land (North Van Voorhees Park) which the hospital used to build a parking garage.

There was great controversy at the time over this deal. Opponents felt that city park land is sacred and should never be diverted for private use. I was one of these opponents. The opponents were also skeptical about LICH's ability and good faith to produce worthwhile playgrounds. The controversy is well described in a New York Times article of August 8, 1993. Well, it's now about a decade later, and I, for one, am happy, very happy with what LICH has done here. Over the years I have used these spaces to play with some of my grandchildren, to meet neighbors, and, weather willing, to enjoy the glorious outdoors.

Here are some pictures that I took of the northern playground today (if you look real hard -- well, not all that hard -- you'll spot a grandson of mine) :

Dawn of a New Day ?

2007-08-17T10:42:00.000-04:00

Here is the news I've had this morning from LICH :

1) The landscaper is coming in over the weekend to have a look.
2) Additionally, we are looking to hire a company to power-wash the graffiti off the brick face. Our corporate compliance policies dictate we solicit bids for the project rather than just award it to a vendor. Meaning that this, too, will churn through the system, but eventually get done.

Obviously we'll have to wait and see. But, in anticipation, let's just say good work, LICH.

Debris is gone, but grafitti stays

2007-08-16T19:15:00.000-04:00

Here are some pictures, taken on Thursday, August 16, 2007, about 6:45 p.m. This is the exterior of LICH's building at 385 Hicks Street. It is a block that also has residential homeowners who try to keep their neighborhood neat and clean. As Mr. Reagan might have put it (if he had been as polite as I): Ms. Battles, madam, please, clear up that ugly facade !

IT'S ALL CLEANED UP

2007-08-14T22:49:00.000-04:00

LICH has today cleaned up the frontage to its 385 Hicks property !! Not only was the trash and debris removed, but all those unsightly weeds have been cut down. Great job, LICH.

The next step, to which they have also agreed, is beautification, meaning well-cared-for plantings and ongoing monitoring of the site. As I have shown in a previous posting, there are some beautifully executed tree pits on Hicks just north of State. These should serve as a model of what can be done.

I had previously agreed to contribute $300 toward the cost of beautification, and I am eager to send my check. I have asked for details of the planning, perhaps sketches, and also, most important, a time table. I have asked for a completion date no later than a month from now. I hope to be able to send my check real soon.

In my preoccupation with the debris problem, I have been remiss in not mentioning the many good experiences I have had with LICH over the years. One of my grandchildren was born there; my wife had a successful operation at LICH; a number of times the LICH emergency room saved us from much grief. Thank you for all that good medical service, LICH.

Please stay tuned for the progress of the beautification program.

CARROTS FOR LICH

2007-08-13T12:45:00.000-04:00

August 13, 2007

Ms. Rita Battles,
President, LICH

Dear Ms. Battles,

As you know, I am one of your neighbors on the 300 block of Hicks Street. I want to help you beautify the perimeter of your buildings on this block. We're in this together.

I will make a modest donation ($300, say) to help you buy plants for those unsightly tree pits if your people will provide the labor and you promise to do the maintenance on an ongoing basis.

Sorry to be so public about this little letter, but the LICH site does not furnish a contact address. Besides, this public communication may encourage others to also make donations ! I have already written to a neighbor along these lines.

Your neighbor

Werner Cohn, 391 Hicks St.

Whose Pits are These ?

2007-08-12T21:02:00.001-04:00

Yes, these tree pits are on Hicks Street. Yes, each is but a stone's throw from LICH's main hospital building. Do they front buildings owned by LICH ?

Not !

The private owners of the buildings that these pits do front are tax payers. They do not benefit from the municipal tax exemptions of the non-profits. But their simple beauty and cleanliness, and civic spirit, could well serve as an example to certain non-profit groups.

The Garage Door

2007-08-12T20:47:00.000-04:00

LICH's building at 385 Hicks has two entrances. One, only partially shown here, is on the right, and is regularly used by LICH personnel. The other, on the left, seems to be an unused garage. As this picture show, it is surrounded by debris, weeds flourish, and some trenchant grafiti seems to enjoy tolerance from the LICH administration. The door does not seem to have been cleaned, let alone painted, since the days of Mayor Jimmy Walker.

Remember that this building stands in a residential block of Cobble Hill where private owners take pride in both cleanliness and property values.

Pit #2

2007-08-12T20:35:00.000-04:00

I have so far only talked about the left, southern tree pit that is found in front of LICH's building at 385 Hicks Street. But there is also a Pit #2, as I call it, which is located a few feet north of Pit #1. The top picture here shows this tree pit, bereft of trees, but well supplied with weeds. What kind of weeds ? Several different kinds, not including, I sincerely hope, rag weed.

Now the lower picture here is what you see if you look through the weeds from above, directly to the ground. At this level there is a nice assortment of debris, bottles, papers, you name it.

Both pictures were taken today, 8/12/07.

The Pit, 8/12/07

2007-08-12T12:10:00.000-04:00

The top picture shows the situation a day later. Not much has changed. The bottom picture gives a closeup of one part of the this pit, as of today.

The Tree Pit - 8/11/07

2007-08-11T18:42:00.000-04:00

LICH owns a building at 385 Hicks Street. In front of this building there are two tree pits. The left one has a tree, some weeds, and a lot of debris. The right one has just weeds and debris. I am watching the left one. This picture above was taken on 8/11/07, at 6 p.m.