Interfaith hospital profits; poor may be paying price; Axing maternity care boosts Brooklyn facility.(News) - Crain's New York Business

Byline: Gale Scott

Because Interfaith Medical Center cares for people who live in medically underserved neighborhoods of central Brooklyn, the state and federal governments have long poured money into efforts to keep it from closing.

Starting in the 1990s, the state provided Interfaith with funds to hire a turnaround consulting firm, Kurron Shares of America Inc., as its manager. Kurron gradually slashed the number of beds to the current 287, from 620. But the hospital--formed by the merger of Brooklyn Jewish Hospital and St. John's Episcopal Hospital in 1982--kept losing money.

So Kurron looked for other ways to shrink Interfaith, which primarily serves Bedford-Stuyvesant and Crown Heights. In 2004, it shut two primary care clinics that it said were underused; it also stopped offering obstetrical services because of the high cost of malpractice coverage.

The moves saved $14 million that year. By 2006, the hospital had a surplus of $8.6 million on a budget of $221.5 million.

But critics question whether Interfaith's new profitability has come at the expense of the poor, who need the services that Interfaith has cut.

'We have a major crisis in maternity care in central Brooklyn,'' says Ngozi Moses, executive director of the Brooklyn Perinatal Network, a nonprofit group that helped procure a three-year, $600,000 grant to start a midwifery service at Interfaith that is now defunct. 'It is disgusting to me to hear that a hospital that walked out on mothers and babies is now being profitable.''

Ms. Moses notes that there are no other hospitals nearby.

A necessary move

kurron's edward glicksman, chief executive of Interfaith, says that pregnant patients appear to have found care elsewhere and that cutting costs was necessary to ensure the hospital's survival.

'We want to be the best community hospital we can be,'' Mr. Glicksman says, 'and we're well on the way.''

Nevertheless, reduced access to obstetrical care has undeniably had an effect on the area. Interfaith once delivered more than 1,500 babies a year. The loss of its maternity unit--combined with the closing of nearby St. Mary's Hospital last year--has left central Brooklyn with an acute shortage of obstetrical beds.

Mr. Glicksman counters that by eliminating maternity care, Interfaith was able to invest in improvements, including a new lobby with amenities such as armchairs and sofas upholstered in orange velvet, and a huge flat-screen television. The hospital also has a new endoscopy unit, and a multistory building for medical offices will open soon.

Some patient advocates, however, say the price of success is too high.

Backups in the ER

the hospital's own numbers show that since the clinics closed, emergency room visits have risen dramatically; they hit 46,106 in 2006, up from 39,111 in 2005. Patients routinely wait long hours before receiving care. If they're admitted, they may spend the night in the emergency department because no beds are available.

Mr. Glicksman says that the hospital is adding a dozen medical-surgical beds to ease overnight stays in the ER, and it's using staff efficiently to make the most of the primary care it still provides. For instance, it offers disease-management programs under which nurses call patients with chronic illnesses, such as diabetes, to make sure that they're following prescribed regimens.

Furthermore, Mr. Glicksman expects that physicians will be eager to practice in the hospital's new ambulatory care wing, which could help ease the strain on the emergency department.

State officials are watching to see if he is right.

In its final report on how to rightsize the state's hospitals, the Berger commission describes Interfaith as an essential hospital, adding, 'They seem to be on their way to a stable operation.'' But, as the report notes, 'access to primary care services for this community is a significant challenge.''

In other words, one former state Department of Health official says: 'The Berger commission spared Interfaith because of the community it serves, but it also warned Interfaith that it had to step up to the plate on primary care. We haven't seen that happen.''

Dr. Linda Brady, chief executive of Kingsbrook Jewish Medical Center in East Flatbush, agrees. But she points out that Interfaith is not the only Brooklyn hospital struggling to provide care.

'In this economic climate, anyone who can create a surplus has to be commended,'' Dr. Brady says. 'We need real reform in our system of paying for outpatient care. Interfaith closed its clinics and obstetrics beds because it couldn't afford to keep them open.''

COMMENTS? GScott@crain.com

CAPTION(S):

Cost crunch: Reducing expenses was necessary for survival, says CEO Edward Glicksman, with Ebone McIntosh, vice president of administration.