Long Island College Hospital has fired 100 employees, will lay off at least 200 more, wants to close three key wings, has sold several buildings and plans to sell more. Management says the “restructuring” will put the hospital on stable financial ground. But the cutbacks have angered employees, patients and politicians who sense that LICH’s parent company, Continuum Health Partners, won’t stop scaling down until it closes the 150-year-old medical center entirely. Amidst these questions, Dominick Stanzione, LICH’s CEO and Chief Restructuring Officer since July, invited The Brooklyn Paper in for an exclusive interview.
The Brooklyn Paper: In 1998, Long Island College Hospital merged with Continuum, which also runs St. Luke’s-Roosevelt and Beth Israel hospitals. How has Continuum’s relationship with Long Island College Hospital been positive?
Dominick Stanzione: It’s very difficult for a hospital to sustain itself as a standalone facility, so most have looked for opportunities to join in partnership with others. When you purchase as part of a larger group, your price per unit goes down. When you bill together, you usually bring more leverage and expertise so you can have better reimbursement rates and collections. When you negotiate with large for-profit insurance companies, you are in much better position than if you are a much smaller nonprofit company.
BP: What about the actual quality of care?
DS: To the extent that you’re operating costs are less [and] purchasing more efficiently, it’s going to provide more resources for health care.
BP: Have there been any negative outcomes from being affiliated with Continuum?
DS: Whenever you become part of something larger you give away a certain degree of autonomy.
BP: It sounds like the hospital has given up some control over its services by having to close the maternity, pediatrics and dentistry departments.
DS: No, the board of Long Island College Hospital made those decisions. Continuum does not “own” LICH. The decision that the best way for Long Island College Hospital to continue to be a strong health care provider in the community is to close certain services was made by the board of Long Island College Hospital.
BP: With families moving into Brooklyn Heights, Cobble Hill and Brooklyn in general, why is this not a golden opportunity for LICH to grow and expand the maternity and pediatrics departments?
DS: First, the maternity services have been declining here at LICH for well over a year prior to any announcement. In the past, LICH had done up to 3,000 deliveries a year, but at the time of its announcement it was on a runway to about 2,200 this year. Maternity services in general tend to lose money. In other hospitals there are other services that make money that are able to subsidize those losses. In this case, because of the financial situation here, the board decided that the hospital could not subsidize the OB services.
BP: Why was there the drop-off in maternity when there were so many more conceivable customers?
DS: Many people go into Manhattan. Also, a large group of obstetricians were recruited to another facility in Brooklyn and that group left. It was a combination of many things.
BP: Would any department that sees a decline over the course of one year be put on the chopping block at LICH? Don’t things fluctuate?
DS: Things do, but generally you don’t go on a decline like that. When a hospital is losing money to the extent that this hospital has been for a number of years, many many services are going to be losing money, but you don’t close them all. You come up with a plan to fix those services that are losing money. However, OB was losing so much money and the volume had been declining that there wasn’t enough time or resources to fix that service without really jeopardizing the entire institution.
BP: Isn’t the maternity wing a gateway service to acquaint people with the hospital who would come back in the future?
DS: I’m not aware of any study that actually shows that. All services are a gateway for other services. At LICH, 80 percent of the patients come in through the emergency department, so that’s the gateway more than any other service.
BP: One thing we learned when we looked at LICH’s audits was that the audit from 2006 described the hospital in very stable terms, whereas the audit from 2007 painted a drastic picture. How could things fall apart so quickly?
DS: You’d have to ask the accountants why they came to their conclusions. If you look at 2005, there were still substantial losses about in the range of $10 million. In 2006 and 2007, we lost about $30 million. In 2008, it accelerated, principally because the volume has gone done.
BP: You said you needed to act differently than in past attempts to stabilize Long Island College Hospital. What has LICH done wrong before?
DS: When property has been sold in the past, proceeds from those sales have been used to offset the deficits. It made everybody happy at the time, because nothing had to change. But at the end of the day, the problems that were causing those deficits were never addressed.
BP: Is money from Albany or Washington the only thing that would help? How much money are you talking about?
DS: The operating losses for OB are probably around $15 million a year. I don’t know if government has the wherewithal to help even if they want to. We can’t assume that a Brinks truck is going to come down Hicks Street.
BP: So it’s just political showmanship when the elected officials rally outside your building?
DS: I wouldn’t say that. They are truly trying to be advocates for the community. I respect that, but they don’t have a pot of gold to tap into.
BP: Will there be more layoffs?
DS: Yes. The layoffs that just occurred will not be the final layoffs [he estimated 200 to 300 more pink slips]. There is no intention of requesting the termination of any additional services than what has been requested. In the case of dentistry, we’re looking to have those services continued under a different sponsorship.
BP: What will Long Island College Hospital look like after the dust settles?
DS: It’s going to be a community hospital that’s focused on growing the services that the community needs, principally in medicine and surgery, and an active emergency department.