Day of the Pols

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

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
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

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

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

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

Two Cheers for LICH Landscaping

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

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

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.

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

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 !

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 ?

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 ?

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

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 ?

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 ?

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 ?

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

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

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 !!

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

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

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 !

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: