Not enough cash to keep dialysis unit running

BY Aline Reynolds

Downtown Hospital patients suffering from kidney failure will soon have to go elsewhere to get their weekly dialysis treatments.

The hospital’s hemodialysis unit will be closing in the middle or end of March, according to Kit Yuen, the unit’s administrative director of nursing. Its board of trustees decided in November that the center, which serves an average of 50 patients per year, is too costly and high-maintenance to keep open.  

“Principally, due to the small size – seven stations – of the hospital’s outpatient dialysis unit, the service is unable to operate in a solvent manner,” according to Jeffrey Menkes, the hospital’s president and chief operating officer. The unit would require significant capital costs, he explained, to upgrade existing infrastructure in order to meet new federal and state health codes.

The new regulations, Yuen said, requires isolation rooms in every dialysis unit, which the hospital couldn’t afford to construct.  

“Unfortunately, hospitals are businesses,” said Warren Licht, chief medical officer at the hospital. “Every year, you have to evaluate every service to make sure you’re not losing money.”

Yuen had trouble conveying the news last week to her patients. She herself feels sad to be leaving the unit — it’s far easier, she explained, to join a new department than to leave one that is shutting down.

Yuen’s patients rely on artificial dialysis to stay alive, making visits to the hospital three times a week to rid their blood of toxins that their failing kidneys aren’t able to filter out.

Many of them began to cry when informed of the news.

“Some of them feel like this is a [death] sentence to them. They get used to coming, and suddenly, we’re going to close,” said Yuen.

That’s because it could be life threatening for a patient not to have uninterrupted care, Yuen explained, since the chances of successfully finding a kidney for a transplant are very slim. In Yuen’s two years supervising the unit, only one of the unit’s patients has been lucky enough to get a new kidney.

“They’re not going to stop doing service for any one of [the patients] until they’re safely transferred to another facility,” assured Chui-Man Lai, assistant vice president of patient services at Downtown Hospital.

The patients are equally aggrieved because they have formed close bonds with their nurses. One of Yuen’s patients told her that she sees Yuen more than she does her own daughter.

Yuen and her colleagues are now focusing on transferring their patients to other dialysis units in Lower Manhattan and elsewhere in the city. Options below 23rd Street include the Chinatown Dialysis Center, the Lower Manhattan Dialysis Center, the South Manhattan Dialysis Center and Beth Israel Medical Center.

The process of moving patients, Yuen said, will take approximately three months. “I foresee there’ll be a smooth transition,” she said.

The board now awaits approval from the New York City Department of Health to officially close the unit. Yuen and other staff will be reassigned to other departments in the hospital; none of them, Yuen said, would be laid off.