Superstorm Sandy caused catastrophic damage, severe financial losses and emotional trauma on a level not previously seen on our barrier island. Our only hospital, the Long Beach Medical Center, established in 1922, was forced to close after it sustained major damage. All of the major work to allow two of five wings to reopen, including the emergency department, was completed in June, at a cost of approximately $26 million.
However, the New York State Department of Health, without any attempt at a public hearing or public input, announced that LBMC would not be permitted to reopen, leaving us isolated and at great risk. LBMC served a barrier island with more than 30,000 permanent residents and an additional 55,000 summer visitors. The barrier island is accessible by three bridges, which open frequently to permit the passage of marine traffic, especially in summer, and mechanical failure cause delays at times. Travel is also often delayed by heavy summertime traffic, and storm-induced flooding can block transit for an indefinite time.
Because of this isolation, the state’s 2006 Berger Report — a sweeping set of recommendations to restructure hospitals and nursing homes throughout the state — has stated that LBMC must remain open. The report’s findings have formed the basis of hospital policy ever since.
The Health Department, without any attempt to justify its efforts to the community, has forced LBMC to declare bankruptcy and has forced it to agree to transfer its assets to South Nassau Communities Hospital. Furthermore, $100 million in FEMA funds earmarked for the rebuilding of the hospital cannot be utilized, taking yet another community asset from us.
Why has the state taken this position, placing the entire population of the barrier island at risk?
The Health Department is blocking LBMC from reopening, citing financial losses and a failure to produce a sustainable business plan that would meet the needs of the community. The state said that LBMC should merge with SNCH and function as a freestanding emergency department with urgent-care and primary-care services. Is this a fair deal for our communities?
Urgent care center no substitute for a hospital
It can only provide routine care and is typically open only 12-hours per day. The American Academy of Pediatrics condemns the use of such centers for the routine care of children. A freestanding 24-hour, 911-receiving emergency room is impracticable. A freestanding emergency room would require the availability of sophisticated imaging equipment such as CAT scans and MRI. The major capital expense associated with this equipment is reasonable only if it’s shared with a full service hospital. A similar argument also applies to the complex laboratory back up needed. Major life and limb-threatening events can require the availability of a fully staffed intensive care unit to achieve stabilization, and a full operating suite with facilities for subsequent hospitalization may well be needed. These capabilities are only possible in a full service hospital.
Emergency departments generally lose money, and are supported as a public service and as a feeder for a hospital’s inpatient services. A freestanding emergency room will unquestionably lose money. This is the reason given by the Health Department for closing LBMC in the first place. Therefore, any freestanding emergency room will be closed or go bankrupt, a further waste of money.
The Berger Report states: “There are approximately 40,000 residents in Long Beach and its adjacent island communities. There is a relatively large concentration of nursing homes, adult homes and assisted living facilities in Long Beach, and 16 percent of the population is over 65-years-old. Because of the concentration of healthcare and housing facilities for the elderly, summer-time surges in population, recreational and boating facilities, geographic isolation, and dependence on drawbridges to access the mainland, LBMC, despite its size and unstable financial situation, must remain open so that the community has appropriate access to emergency services and acute care.”