As seen at last week’s meeting when officials from North Shore-Long Island Jewish Medical System tried to describe their plan for a Greenwich Village urgent-care center, the anger over St. Vincent’s Hospital’s closing remains palpable.
There’s also a deep-seated suspicion among many people that there was something deeply wrong, even corrupt, behind what appeared to be St. Vincent’s startlingly quick collapse. However, in truth, it’s now clear that the hospital’s failure was set in motion at least 15 years ago, and that there were actually a number of intersecting causes for its closing — a “perfect healthcare storm,” so to speak.
Nevertheless, there are continued calls for an investigation into St. Vincent’s implosion. A key part of any such probe would be a “postmortem,” to use a medical term, and, in our front-page story this week, we attempt to do so.
Helping us immensely in our efforts was Arthur Webb — the former C.E.O. of VillageCare and the C.O.O. of St. Vincent’s during its agonizing last 15 months — who agreed to sit down with us and go over, point by point, what he saw as the main factors behind this sad story. We thank Webb for being the stand-up guy that he is and always has been.
The single largest reason for St. Vincent’s failure was its decision to merge in the 1990s with several other struggling New York City Catholic hospitals, as well as nursing homes. With these other hospitals promptly failing, coupled with tough managed-care rates and federal cuts in Medicaid, the network couldn’t hold and St. Vincent’s Catholic Medical Centers declared bankruptcy in 2005.
But the writing on the wall became clear when St. Vincent’s emerged from its massively mishandled bankruptcy in 2007 — with its debt nearly tripled to $700 million, partly as a result of liabilities from the other closed hospitals.
St. Vincent’s leadership then decided that constructing a new, high-tech hospital, with a land deal with a private developer to partly finance the project, would be their savior. However, by the next year, it was apparent St. Vincent’s wouldn’t survive without a merger with a strong, larger healthcare system. Also, as Webb said, the hospital project should have been scaled down significantly. And merger efforts should have been the priority.
St. Vincent’s was “top heavy,” something long alleged by both former hospital employees and advocates. That consultants and restructuring advisers raked in $3 million a month is outrageous — and they weren’t even effective.
Also, St. Vincent’s itself simply should have been scaled back. It was operating with two times as many staff as it needed, boosting its operating overhead. The fact that St. Vincent’s was in Manhattan, an ultra-competitive healthcare environment, also hurt it.
In fact, the fate of St. Vincent’s can be seen as part of a trend in Catholic healthcare. A March 16, 2009, article in America, a Catholic weekly, summed up the situation well. The article’s headline, “Then There Was One: The Unraveling of Catholic Health Care,” really tells it all, as do its first two sentences: “In 2007 there were eight Catholic acute care hospitals in New York City. By the end of 2008 there was only one.” That one was St. Vincent’s…and then there were none.
Yes, the Lower West Side definitely needs a hospital — even if the state says the borough has enough hospital beds. The state has its own debt of more than $9 billion and doesn’t want to take on the expense.
We support hospital advocates in their fight for a new hospital. But this fight needs to be grounded in reality — and not in conspiracy theories, wishful thinking, fear and temper tantrums. It seems that for the Lower West Side to get a new hospital any time soon would be a miracle.
