NEW YORK — Kingsbrook Jewish Medical Center is in the process of closing its emergency department and halting acute rehabilitation and outpatient dialysis services by this fall.
The East Flatbush safety-net hospital, which predominantly serves low-income patients in a majority Black and brown neighborhood, has been gradually gutted as part of a state-funded $664 million merger that created the One Brooklyn Health system. In July 2021, Kingsbrook stopped admitting patients.
But the forthcoming closures run against previously approved plans for Kingsbrook under the broader consolidation effort, which said the hospital would continue operating a freestanding emergency room as it transforms into a hub for rehabilitation services and outpatient care.
One Brooklyn Health executives briefed health care workers on the plans in July and have already begun preparing patients and staff to transition to other providers and move into other jobs within the system. Over 300 employees, many of them unionized, will be affected by the closures.
However, the system has yet to apply for state approval of the closures or submit an independent health equity impact assessment, both of which would be required for what One Brooklyn plans to do, state Department of Health spokesperson Cadence Acquaviva said.
One Brooklyn Health CEO LaRay Brown said the system will save tens of millions of dollars by halting Kingsbrook’s little-used emergency, acute rehab and dialysis services. The emergency department, which received 34,000 to 36,000 visits annually before the pandemic, is now seeing 42 patients a day on average — less than half its pre-Covid volume. The rehabilitation unit is less than half full. And most of the dialysis patients are residents of the nursing home on Kingsbrook’s campus, which already offers the treatment on-site.
“We have to be responsible in identifying where there are opportunities for us to reduce our expenses and to reduce our dependency on the state,” Brown said in an interview.
One Brooklyn Health’s actions are not unprecedented. In 2021, the New York State Nurses Association lambasted the system’s decision to unexpectedly close a psychiatric wing at Kingsbrook that specialized in caring for elderly patients.
That, too, had been on the list of units One Brooklyn intended to keep open, according to its 2020 merger application.
NYSNA expressed disappointment with the news of the forthcoming changes.
“These closures violate the spirit of the original plan that unions and elected officials agreed to years ago, and we implore OBH and the State of New York to explore other funding options before taking this drastic step,” executive director Pat Kane said in a statement to POLITICO.
A state-funded ‘restructuring’
The One Brooklyn Health consolidation, which united Kingsbrook with nearby hospitals Interfaith and Brookdale Medical Centers, was initiated by former Gov. Andrew Cuomo’s administration as a condition of what was effectively a bailout for the financially struggling facilities.
Cuomo also tapped Northwell Health, run by his political ally Michael Dowling, to prepare a report on how to more broadly transform the area’s health care landscape.
In the eyes of Northwell’s report, released in 2016, the so-called restructuring of the three hospitals was far from optional. That fiscal year the three hospitals would need over $300 million in state support to keep their doors open, the report concluded.
Dowling declined to be interviewed for this article.
The $664 million state grant for capital projects is not the only way the state is subsidizing One Brooklyn Health’s consolidation.
Under its Vital Access Provider program, the state provides financially distressed hospitals in the midst of a merger, consolidation or restructuring with a temporary Medicaid rate adjustment to protect or enhance access to quality care.
One Brooklyn Health is slated to receive a $315 million boost between now and the end of the 2024-2025 fiscal year as part of the program, records show. A request for the federal government to contribute a portion of the cost is pending.
Even that is insufficient to plug the system’s operating deficit of over $500 million, Brown said.
However, the system is forging ahead with its transformation. One Brooklyn plans to spend between $40 million and $47 million to build a two-story center for outpatient services on Kingsbrook’s campus. Other major projects are in the works on Brookdale and Interfaith’s campuses.
“We’re not going to leave anyone unserved,” Brown said.
