Berger Commission Measures Implemented, State Health Commissioner Reports

Ongoing Health Care Restructuring, Reform Will Continue

ALBANY, N.Y. (July 2, 2008) – Measures to reform and restructure New York's health care system as recommended by the Commission on Health Care Facilities in the 21st Century (Berger Commission) have been implemented, State Health Commissioner Richard F. Daines, M.D., reported today.

"The nonpartisan commission that handed up the Berger recommendations had a simple goal: to reform New York's health care system to improve quality and affordability and to make it more responsive to current health care needs," Commissioner Daines said. "While the reform process must be ongoing, New York has a stronger, better health care system today because of the Berger measures we have implemented."

The Berger Commission recommendations became legal mandates in New York on January 1, 2007, and were given a June 30, 2008, deadline for implementation. The Commission cited the need to eliminate excess hospital and nursing home bed capacity, eliminate hospital duplication of services, modernize outdated health care facilities, and provide New Yorkers with greater access to primary and preventive care.

The Commission's recommendations included the merging or restructuring of more than 50 hospitals and nursing homes, including closing nine hospitals. By law, the Commissioner of Health was charged with implementing the recommendations in a reasonable, cost-efficient manner, with the authority to modify them if needed to protect patient safety.

The federal government pledged $1.5 billion in aid to the state contingent on the implementation of the recommendations, on the basis that the measures would reduce costs while improving quality and access to needed services. The state has made $550 million available to help health care facilities implement Berger recommendations.

"For more than 18 months, a team of Health Department employees has been working with affected facilities to implement the Berger requirements in a manner sensitive to New Yorkers' health care needs," Dr. Daines said. "Each of the recommendations has now been acted upon."

Dr. Daines announced that:

  • By the end of 2008, nine hospitals will have been closed, removing almost 1,700 beds from the system. In addition, through mergers, affiliations and downsizing, another 1,700 beds will be eliminated by the end of 2010.
  • Seven nursing homes will have been closed by the end of 2008, removing almost 1,100 beds. Another 1,600 nursing home beds will be taken out of the system by 2011.

In most cases, Berger Commission measures were implemented with the cooperation and collaboration of affected providers. However, it became necessary for the Department of Health to unilaterally amend the operating certificates of 18 providers that, as of June 27, 2008, were not yet in compliance with Berger requirements or had not moved significantly toward compliance.

The attached chart identifies the recommendations and status for each of the 81 facilities affected by Berger requirements.

Next Steps

"The Berger Commission recognized that allowing excess institutional capacity to linger in our health care system for years discouraged the expansion of primary care and community-based long-term care services," Dr. Daines said. "Primary and community-based care encourages better health for New Yorkers and reduces overall costs. As we move forward, the state and local communities need to take a more proactive role in restructuring the state health care system along the lines recommended by the Commission."

To accomplish this goal, the Health Department has begun initiatives to improve health care planning and create financial incentives for restructuring:

  • In July, DOH will release a Request for Proposals to distribute $6 million for local health planning efforts.
  • Also in July, DOH will release a new Web-based data tool that will identify the rate of preventable hospitalizations for certain primary care sensitive conditions, helping to focus both the state and health care providers on geographic areas where more can be done to develop primary care.
  • By September 1, $150 million in grants will be awarded to promote mergers, affiliations and joint service planning for hospitals and long-term care providers.
  • By September 15, $100 million in awards will be made to promote the development of primary care services
  • DOH has begun work with the Public Health Council and State Hospital Review and Planning Council to review both the local planning process and the Certificate of Need (CON) process, with the expectation of proposing reforms in the next legislative session.

"Our efforts to restructure the State's health care system through improved planning and primary care development further supports the work we have already begun in Medicaid reform to ensure the State pays for the right kind of care, in the right settings, at the highest standards and at the right price," said Commissioner Daines.

Status Report

Facility Original Recommendation Region* Status
A. Holly Patterson Extended Care Facility Downsize by approximately 589 beds to approximately 300 beds; rebuild a smaller facility on the existing campus and add a 150 bed ALP and possibly other non-institutional services. LI Facility decertified 300 beds; CON for new 320 bed facility approved; an additional 269 beds to be decertified when ALP is operational; HEAL award $14 million.
A.L. Lee Hospital Close all of its 67 beds; convert to outpatient/urgent care center. C Amended the operating certificate to end hospital services 6/30/09 to allow for an orderly transition to clinic services only.
Achieve Rehabilitation Downsize by approximately 40 beds to approximately 100 beds. MH Facility proposal to retain the 40 beds approved by the Department to protect patient health and safety conditional on maintaining improvements in quality and need in county; approval reflects a 5 yr limited life w/ enhanced quality monitoring.
Albany County Nursing Home Merge with Ann Lee Nursing Home, downsize by at least 345 beds for a combined total of 250 beds, rebuild a unified facility, and add financial support for non-institutional services. CD Downsizing complete; facility submitted preliminary plan for new building, site not yet identified; HEAL award of $3 million for non-institutional services.
Andrus-on-Hudson Downsize all 247 beds and add 140 ALP beds and possibly other non-institutional services. MH Facility filed lawsuit, Department prohibited from taking any actions to implement
Ann Lee Infirmary Merge with Albany County Home, downsize by at least 345 beds for a combined total of 250 beds, rebuild a unified facility, and add financial support for non-institutional services. CD Last patient transferred 1/24/08; operating certificate surrendered 1/25/08.
Arnot Ogden Medical Center Explore an affiliation w/ St. Joseph's Hospital. C Department supervised discussions and accepted facility proposal to collaborate on initiatives, but not affiliate.
Auburn Hospital Downsize by approximately 91 beds to approximately 100 certified beds; discontinue obstetrical services. C Facility downsized beds and Department approved plan to keep 10 OB beds to address low income women access issue; facility developed affiliation w/ Crouse to ensure OB quality control; HEAL award of $274,000.
Bellevue Woman's Hospital Close in an orderly fashion, add services to another hospital in Schenectady County CD Closed 10/31/07; HEAL award of $22 million for closing costs; CON approved to transfer services and operate as division of Ellis
Benedictine Hospital Join with Kingston Hospital under a single unified governance structure provided that Kingston Hospital continue to provide access to the reproductive services currently offered. MH CONs for unified governance and reproductive services approved Jan '08; joint HEAL award of $47.6 million w/ Kingston for debt relief and construction.
Bertrand Chaffe Hospital Downsize by at least 25 inpatient beds to less than 25 beds; seek designation as a Critical Access Hospital or sole community provider; affiliate with TLC Tri-County and TLC Lake Shore. W Application to decertify 25 beds approved; facility has sought waiver of Federal eligibility requirements for critical access hospital designation; entered affiliation with TLC Tri-County and TLC Lake Shore; HEAL award of $4.5 million for debt relief, construction.
Beth Israel Medical Center - Petrie Campus Convert approximately 80 detox beds to 80 psych beds, contingent on OMH approval. NYC OMH approved 28 psych beds and CPEP, CON approved; HEAL award $5 million.
Brookhaven Memorial Hospital Decertify 10 OB and 5 pediatric beds, add 20 psych beds; continue joint planning with Eastern Long Island Hospital, Peconic Bay Medical Center and Southampton Hospital and explore becoming part of the new entity. LI Bed reconfiguration approved; joint planning continued; HEAL award of $9 million (Suffolk Health Network total $24 million).
Brooks Memorial Hospital Seek designation as a sole community provider. W Application for sole community provider status pending; PHC approved CON for active parent w/ TLCs; HEAL award of $3.763 million for debt relief.
Brunswick Hospital Center, Inc. Downsize all 94 beds and close. LI Closed Spring '07; HEAL award $1.9 million.
Cabrini Medical Center Close in an orderly fashion. NYC Facility closed; hospice services to be operated by St. Vincent's; HEAL award of $14 million for closing costs.
Cold Springs Center for Nursing and Rehabilitation Downsize by approximately 90 beds to add a 24 bed ventilator unit, an evening ADHCP, and a 12 station dialysis unit. LI CON for downsizing, vent unit and ADHCP approved; developing proposal for dialysis unit; HEAL award $992,500 for closing costs.
Community General Hospital Skilled Nursing Facility Recommended to join under single unified governance structure with Van Duyn Home under the control of Community General Hospital and downsize their combined number of beds by approximately 75. MH Department approved facilities' proposal for governance structure; downsizing completed; joint HEAL award of $12.8 million w/ Van Duyn for debt relief, construction.
Community Hospital at Dobbs Ferry Closure of facility. MH Facility scheduled to close 12/31/08; St. John's Riverside submitted CON to open a hybrid model w/ ER and small # of beds at Dobbs Ferry site; HEAL award $7 million for closing costs.
Crouse Hospital Crouse hospital should be joined under single unified governance structure with SUNY Upstate under the control of an entity other than SUNY and be licensed for 500-600 inpatient beds. C Affiliation and Collaboration Agreement approved; downsized 70 beds; joint HEAL award of $5.1 million w/ Upstate for IT.
DeGraff Memorial Hospital and Downsize all 70 med/surg beds; convert to nursing home including existing 80 beds and the 75 beds to be transferred from Millard Fillmore Hospital - Gates Circle. W Amended operating certificate to close June 2011.
Eastern Long Island Hospital Join in a single unified governance structure with Peconic Bay Medical Center and Southampton Hospital; develop an affiliation with University Hospital at Stony Brook; and add 5 psych beds. LI CON for active parent approved by PHC; agreed on affiliation w/ Stony Brook; psych beds approved; HEAL award of $600,000 (Suffolk Health Network total $24 million).
Ellis Hospital Join with St. Clare's Hospital under a single unified governance structure, with the resulting entity downsizing from 568 beds to between 300 and 400 beds. CD St. Clare's closed, Ellis operating a division at former St. Clare's site; joint HEAL award of $50 million.
Erie County Medical Center Join with Kaleida Health under a single unified structure. W ECMC-Kaleida entered a binding agreement and are co-operating under unified governance of WNYHS board.
Glendale Home Downsize by approximately 192 beds to approximately 168 beds to be operated in the newest building CD Facility downsizing to 220 beds effective 12/31/08, downsizing to be completed 12/31/10; HEAL award of $3 million.
Inter-Community Memorial Hospital at Newfane Engage in a full asset merger and reconfiguration of services with Lockport Memorial Hospital. W Full asset merger approved by PHC; HEAL award $9.1 million for debt relief.
J.T. Mather Memorial Hospital Convert all 37 of its psych and detox beds to med/surg beds, contingent on OMH and OASAS approval. LI OASAS and OMH disapproved recommendations.
Kaleida Health/Buffalo General Hospital Join with Erie County Medical Center under a single unified structure. W ECMC-Kaleida entered a binding agreement and are co-operating under unified governance of WNYHS board.
Kingston Hospital Join with Benedictine Hospital under a single unified governance structure. MH CONs for unified governance and reproductive services approved Jan '08; HEAL award of $47.6 million w/ Benedictine for debt relief and construction.
Lakeside Nursing Home It is recommended that Lakeside Nursing Home close, and that an 80 bed ALP, and a 25 slot ADHCP and possibly other non-institutional services be added somewhere in Tompkins County by another sponsor, pending completion of an RFP process. C Facility to close; new operator of smaller facility approved by PHC with limited 5 yr license based on need for nursing home beds in Tompkins County.
Lockport Memorial Hospital Engage in a full asset merger and reconfiguration of services with Inter-Community Memorial Hospital at Newfane. W Full asset merger approved by PHC; HEAL award $9.1 million for debt relief.
Long Beach Medical Center Downsize bed capacity to approximately 145 beds. LI Facility downsizing approved; HEAL award $11.2 million.
Manhattan Eye Ear and Throat Hospital Downsize all 150 beds. NYC Facility downsized beds and merged w/ Lenox Hill Hospital; HEAL award of $25.1 million.
Mercy Hospital SNF 10 beds be added to 74 current beds, and all 84 beds be transferred to the former Our Lady of Victory Hospital. W CON and relocation plan approved.
Mercy of Northern New York Downsize by 76 beds to 224 beds; add a 60 bed ALP, a 16 slot ADHCP and other possible non-institutional services in the vacated building. C Department amended the operating certificate to ensure downsizing.
Millard Fillmore Hospital - Gates Circle Hospital Close in an orderly fashion and transfer 75 beds to DeGraff Memorial Hospital. W Facility scheduled to close 12/31/09; HEAL award $65 million to support Gates closure.
Mount Sinai Medical Center Enter into a passive parent corporate relationship with North General Hospital. NYC Mt Sinai and North General are participating in joint planning and clinical affiliations.
Mount St. Mary's Hospital and Health Center Recommended that Mount St. Mary's Hospital and Niagara Falls Memorial Medical Center participate in discussions supervised by the Commissioner to explore the creation of a single unified governance structure. W Department supervised discussions and accepted facility proposal to collaborate on initiatives, but not affiliate.
Mount View Health Facility Downsize all 172 beds, and add a 100 bed ALP, a 50 slot ADHCP, and possibly other non-institutional services. W Facility closed; HEAL award of $8.8 million for closure costs.
Nassau University Medical Center Downsize from 631 to 530 certified beds. LI Facility downsizing approved; HEAL award of $23 million for debt retirement and construction.
Nazareth Nursing Home Downsize all 125 beds. W Facility closed Jan '08; HEAL award $7.3 million.
New York Community Hospital of Brooklyn Merge with New York Methodist Hospital into a single entity w/ two separate campuses; downsize to 90 beds and add ambulatory services. NYC Amended operating certificate to end in June 2011 assuming a merger takes place.
New York Downtown Hospital Decertify approximately 70 med/surg and 4 pediatric beds reducing its licensed capacity to 180; discontinue inpatient pediatric services. NYC Facility completed compliance requirements; HEAL award of $6.2 million for downsizing and reorganizing clinics.
New York Methodist Hospital Merge with New York Community Hospital of Brooklyn into a single entity w/ two separate campuses; downsize to 510 beds (reduced by 60). NYC Amended operating certificate to end in June 2011 assuming a merger takes place.
New York Westchester Square Medical Center Close in an orderly fashion. NYC Facility scheduled to close 12/31/08, closure plan under review, proposes establishment of 128 bed division of Presbyterian; HEAL award $5.8 million.
Niagara Falls Memorial Medical Center Recommended that Mount St. Mary's Hospital and Niagara Falls Memorial Medical Center participate in discussions supervised by the Commissioner to explore the creation of a single unified governance structure. W Department supervised discussions and accepted facility proposal to collaborate on initiatives, but not affiliate.
North General Hospital Enter into a passive parent corporate relationship with Mount Sinai Medical Center. NYC Mt Sinai and North General are participating in joint planning and clinical affiliations.
Orange Regional Medical Center Contingent on financing- Close existing campuses and consolidate operations at a new smaller replacement facility that is downsized by 100 beds to 350 beds. MH Proceeding with construction; HEAL 4 award $24 million for debt relief (in addition to HEAL 2 award of $24.6 million for construction).
Parkway Hospital Close in an orderly fashion. NYC Amended operating certificate to close hospital September 30, 2008.
Peconic Bay Medical Center Join in a single unified governance structure with Eastern Long Island Hospital and Southampton Hospital; develop an affiliation with University Hospital at Stony Brook; downsize certified bed capacity from 154 to140; transfer 18 physical rehab beds from University Hospital at Stony Brook. LI CON for active parent approved by PHC; agreed on affiliation w/ Stony Brook; downsizing complete, 18 physical rehab beds approved; HEAL award of $5 million (Suffolk Health Network total $24 million).
Peninsula Hospital Center Downsize by approximately 99 beds to approximately 173 beds; study merger with St. John's Episcopal and building a single facility with approximately 400 inpatient beds. NYC Financial feasibility study completed and downsizing approved; joint HEAL award $750,000.
Queens Hospital Center Add approximately 40 med/surg beds. NYC CON for additional beds approved; HEAL award of $12 million for construction.
Sheehan Memorial Hospital Maintained as an A28 provider, downsize 69 med/surg beds; accept 22 inpatient detox beds transferred from Erie County Medical Center; enhance ambulatory care services; be licensed to provide methadone maintenance, and be licensed as an Article 31 provider of outpatient psych services contingent on OMH and OASAS approval. W OMH and OASAS did not approve recommendations; facility downsized 59 med/surg beds, exploring additional alternatives; HEAL award of $4 million.
Sky View Rehabilitation and Health Care Center Close, downsize or convert, contingent on the determination of the Commissioner. NYC DOH conducted comprehensive study; Commissioner determined close/downsize/conversion no longer being considered.
Sound Shore Medical Center - Mt. Vernon Hospital Downsize and reconfigure beds. MH CON for downsizing and reconfiguration approved; joint HEAL award of $12.4 million for debt relief.
Southampton Hospital Join in a single unified governance structure with Eastern Long Island Hospital and Peconic Medical Center; develop an affiliation with University Hospital at Stony Brook; downsize certified bed capacity from 168 to 125 (103 med/surg, 3 pediatric, and 19 obstetrics) for a reduction of 37 med/surg and 6 pediatric beds. LI CON for active parent approved by PHC; agreed on affiliation w/ Stony Brook; downsizing complete; HEAL award of $8 million (Suffolk Health Network total $24 million).
Split Rock Rehabilitation and Health Care Center Close, downsize or convert contingent on the determination of the Commissioner. NYC DOH conducted comprehensive study; Commissioner determined close/downsize/conversion no longer being considered.
St. Charles Hospital Downsize 77 med/surg beds, convert the remaining 37 med/surg beds to psych and detox beds, contingent on OMH and OASAS approval and discontinue its emergency department LI OASAS and OMH disapproved recommendations; facility downsizing request approved; HEAL award $3 million.
St. Clare's Hospital Join with Ellis Hospital under a single unified governance structure, with the resulting entity downsizing from 568 beds to between 300 and 400 beds. CD St. Clare's closed, Ellis operating a division at former St. Clare's site; joint HEAL award of $50 million.
St. John's Episcopal Hospital - South Shore Downsize by approximately 81 beds to approximately 251 beds; study merger with Peninsula Hospital Center and building a single facility with approximately 400 inpatient beds. NYC Financial feasibility study completed and downsizing approved; joint HEAL award $750,000.
St. Joseph's Hospital Explore an affiliation w/ Arnot Ogden. C Department supervised discussions and accepted facility proposal to collaborate on initiatives, but not affiliate.
St. Joseph's Hospital of Cheektowaga Close in an orderly fashion. W Facility scheduled to close 3/31/09, services to be provided at the site by Sisters Hospital through 6/30/2011; HEAL award $8 million.
St. Vincent's Catholic Medical Center - Manhattan Operate 12 psych beds currently operated by St. Vincent's Hospital - Midtown at St. Vincent's Manhattan. NYC CON to relocate psych beds approved.
St. Vincent's Hospital - Midtown Close in an orderly fashion. NYC Facility closed 9/15/07; HEAL award of $17.1 million for closing costs.
SUNY Upstate Health Science Center Be joined under single unified governance structure with Crouse Hospital under the control of an entity other than SUNY and be licensed for 500-600 inpatient beds. C Affiliation and Collaboration Agreement approved; joint HEAL award of $5.1 million w/ Crouse for IT.
Taylor Care Center Downsize by approximately 140 beds to approximately 181 beds. MH Department approved request to decertify 140 beds; joint HEAL award of $6.9 million w/ Westchester Medical Center.
The Avenue and The Dutch Manor Merge and downsize both facilities by approximately 48 beds to approximately 200 beds in a rebuilt Avenue facility. CD Facilities submitted certificate of merger, are developing merger CON and request for new building.
TLC Health Network - Lake Shore Hospital Downsize all 42 med/surg beds and convert its acute care services to an outpatient/urgent care center; either continue to provide mental health services or downsize all 20 psych beds, contingent on OMH approval; Bertrand Chafee to affiliate with TLC Tri-County and TLC Lake Shore. W OMH did not approve recommendation; PHC approved active parent CON w/ Brooks; new entity co-licensed to operate ER and smaller number of inpatients beds; joint HEAL award $12.6 million for debt relief, construction.
TLC Health Network - Tri-County Memorial Hospital Downsize 28 med/surg beds, convert the remaining 10 to detox beds, and continue to provide chemical dependency, emergency and outpatient primary care services, contingent on OASAS approval; Bertrand Chafee to affiliate with TLC Tri-County and TLC Lake Shore. W OASAS did not approve recommendation; PHC approved active parent CON w/ Brooks; downsizing complete; joint HEAL award $12.6 million for debt relief, construction.
United Helpers Canton Nursing Home Downsize by approximately 64 beds to approximately 96 beds, rebuild its facility, add a 48 bed ALP and possibly other non-institutional services. C CON for downsizing and new building approved; ALP application under review; HEAL award of $8.1 million for construction.
University Hospital at Stony Brook Recommended that Eastern Long Island, Peconic Medical Center and Southampton Hospital develop an affiliation w/ Stony Brook; Downsize 18 certified, but not available physical rehab beds, these to be added to Peconic Medical Center. C Facility agreed to affiliation with Eastern LI facilities; HEAL award of $2.85 million.
Valley View Center for Nursing Care and Rehabilitation Downsize by approximately 160 beds to approximately 360 beds and add an 80 bed ALP, a 30 slot ADHCP and possibly other non-institutional services in the vacated building. MH CON for downsizing and ADHCP approved; HEAL award $7.8 million.
Van Duyn Home and Hospital Recommended to join under single unified governance structure with Van Duyn Home and Community General Hospital Skilled Nursing Facility under the control of Community General Hospital and downsize their combined number of beds by approximately 75. C Approved proposal for governance structure; received joint HEAL award of $12.8 million for debt relief, construction.
Victory Memorial Hospital Close in an orderly fashion. Following planned closure, convert under new sponsorship to a D&TC and/or a LTC continuum facility compatible with the remaining Victory Nursing Home. NYC Inpatient beds closed, final plan for services at Victory site working through bankruptcy court; HEAL award of up to $25 million for debt relief.
Westchester Medical Center Conduct strategic planning process to evaluate its clinical services mix and identify opportunities for reconfiguration that is non-duplicative of services in community hospitals. MH Facility completed evaluation of Children's hospital, developing recommendation; joint HEAL award w/ Taylor Care of $6.9 million.
Westfield Memorial Hospital Downsize all 32 inpatient beds and convert to an outpatient/urgent care center with A28 D&TC licensure. W Facility downsized while completing plans for outpatient/urgicare center; HEAL award of $5.047 million.
Williamsville Suburban Nursing Home Downsize all 220 beds. W Facility scheduled to close 12/31/08. See court ordered statement regarding Williamsville Suburban below.
Willow Point Nursing Home Downsize by between 83-103 beds to approximately 280-300 beds; rebuild its facility, and add a 30 slot ADHCP. C Plan for downsizing and replacement facility approved.

Regions

  • W - Western
  • C - Central
  • CD - Capital District
  • MH - Mid Hudson
  • LI - Long Island
  • NYC - New York City

Acronyms

  • ALP - Assisted Living Program
  • ADHCP - Adult Day Health Care Program
  • CON - Certificate of Need
  • PHC - Public Health Council
  • LTC - Long Term Care
  • D&TC - Diagnostic and Treatment Centers

Statement Regarding Williamsville Suburban, as Ordered by U.S. Bankruptcy Court Judge Michael J. Kaplan

The U.S. Bankruptcy Court has found that reports that Williamsville Suburban "is scheduled to close on December 31, 2008," are erroneous in light of the court's preliminary injunction and the pending litigation. U.S. Bankruptcy Court, on June 27, 2008, issued an order amending a preliminary injunction allowing the Department to issue Williamsville Suburban a new operating certificate with a termination date of December 31, 2008. The court's order also provided that the court reserved the right to extend the termination date of the operating certificate in order to allow the facility to continue to operate pending a final determination of the facility's adversary action. It appears highly unlikely that the litigation will be resolved prior to December 31, 2008, and, at a hearing on November 12, 2008, the court directed that the operating certificate be extended until June 30, 2009 and stated that the court would be considering a further extension of the operating certificate until December 31, 2009.