St. Vincent’s Hospital closes, but who’s to blame?

by Marie Cooper

St. Vincent’s Medical Center in Greenwich Village was founded in 1849, making it the third oldest hospital in New York City. It has been an occasional scene of notoriety but mostly it has witnessed countless episodes of anonymous compassion and care. My two sons were born there. As a major teaching hospital, it has over 1000 affiliated physicians. It is where generations of New Yorkers have gone for legendary medical treatment.

St. Vincent’s will be closing its doors to inpatient services forever.

The facility has been in financial trouble for a long time. However, its board chose poorly in a quest for solutions. It was glacially slow in responding to a decline in third party reimbursements and an increase in Medicaid and Medicare patients. The crisis management organization they hired squandered millions and did little to turn around the problems. Their fiscal irresponsibility will now cost thousands of people their jobs and remove a primary source of healthcare for many more in the area.

Some will say St. Vincent’s was a victim of the times, of low reimbursement and poor patients with expensive, complicated conditions. But to me this demise of a world famous facility is an example of what I maintain is the biggest health care crisis we have in our country: tolerance of mediocrity.

Who was watching the board while the hospital was bleeding cash? Who was calling them to task when their hired hands were not showing any results but instead were costing more and more money? Why were other models of excellence in hospital management not consulted? Why was there not a hue and cry by physicians and the neighborhood when quality began to decline? Why was a renowned gem of a facility allowed to wane and, ultimately, expire?

St. Vincent’s should be a textbook example of what not to do when your hospital is failing. Don’t stick your head in the sand. Don’t leave it to the other guy, start yelling when you see the sky is falling. Don’t ignore successful facilities and how they got that way. Don’t hire consultants who subsequently rob you blind.

There are ways to turn things around. It takes a joint effort and an expectation of excellence, accepting nothing less. That is what saves hospitals.

With much luck, this obit will be premature and some multi-million dollar rabbit will be pulled out of a hat. Although it seems unlikely at this point.

Farewell St. Vincent’s. Thanks for everything.

Marie Cooper is a freelance writer and business consultant who blogs at Nourish.

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  • http://www.drjshousecalls.blogspot.com Dr. Mary Johnson

    First a pop culture reference: I seem to recall that a certain “Beast” in the (late 80′s) TV show “Beauty and the Beast” was abandoned at the doorstep of St. Vincent’s.

    (Pause for heavy, lustful/soulful sigh. Ron Perlman was THE SEXY BOMB as Vincent.)

    Second, this is a perfect example of the fundamental failure of “non-profit” hospital boards to provide responsible fiscal and ethical leadership of the institutions that they lead.

    Indeed, if you spoke to some of these Board members, they would tell you (with a straight face) that their position is merely “honorary” and that they have no responsibility for what goes on during their watch.

    Executives and administrators, often fancying themselves as captains of industry, have carte blanche.

    The ONLY way these Boards/their members can be held accountable is by the public. But in this society, the public cannot even manage to do that because the public is kept IN THE DARK.

    And (apart from oversight by individual states & the IRS being virtually non-existent), that’s because our newspapers (big and small) look the other way . . . because (1) Boards are populated with a lot of “important” people; and (2) most of these non-profit institutions are (A) big employers and (B) fortify the newspaper’s advertising budgets & revenue stream.

    In short, you do not bite the hand that feeds.

    Which is exactly what happened in my situation in a small North Carolina mill town over a decade ago – but these days I’m told it’s neither here nor there.

  • SmartDoc

    St. Vincent’s offers a clear lession: See Medicaid and Medicare patients and your practice is doomed in your typical high tax, over-regulated, out of control liability Blue State.

  • Doc99

    This post understates the scope of the problem. NY City is losing a Level One Trauma Center. How many folks will now die, both waiting for 911 or being transported to the closest Level One on the other side of town? This outrage is a failure at all levels of leadership.

  • ARMANDO V. RODRIGUEZ MD.,FAHA.,FACP

    NON-PROFIT: Really. none for profit. I have never believed that type of business. Business is business. Greed and personal gain is always behind it. But, lets not just hold the board of director and out government responsable for the pocketing of money by the board members and running such a great institution to the ground. The public is also at faught. We are not raising hell!!!!. We do not do public protest. We do not call the the media and show up to the door steps of the board members homes. Knock on their dorrs. Demand and explanation while millions of people are watching. Destroying their name. Doing the same thing to our local, state and federal elected officials. Demanding and investigation. Seeking corruption and holding accountability. Sending out a message to other communities to do the same. No we turn to the right and whoever is there we share this horribl news. And go on with our lifes. As long as we or one of our love ones is not affected. We have become desensitized to corruption and greed. We are too comfortable and egocentric. As long it doesn’t affect me, I do not care. It’s good gossip. This is just and example of all the corruption that would not exist if the middle class would go out and raise hell. Unite. Call the media. Report corruption. Similar situation is occuring now in Dade County, Fla. with Jackson Memorial Hospital. The media is involved. But, people need to go out and raise hell. Follow up with lawful public protests and demonstrations. All the corruption that is, has and will happen in the past is because the general public allows it. By not being unitified citizens. Our protest must go beyond our homes, cars and office. They must go public. Nothing works better then public unity and the power of the media.
    There’s a war on our morals and values. We need to return to old time values. Become more involved with local community corruption issues.
    UNITE AND RAISE HELL AGAINST GREED AND CORRUPTION!!!!
    FIGHT FOR THE CONSERVATION OF THE MIDDLE CLASS.!!!!

    Dr. Rodriguez

  • http://www.transwomantimes.blogspot.com Justine Valinotti

    I was at the rally on Saturday. I had the feeling that a lot of people still don’t believe that St. Vincent’s is really going to close: It’s been there forever and, whenever it gets into trouble, somebody or something saves it. At least, that’s how things used to go.

    It doesn’t look like things will work that way this time. The Diocesese may not be in a position to save them, what with all of the lawsuits they’re facing. Plus, they’re closing parishes and schools, which they see as more central to their mission. And, when the City is talking about laying off teachers and the State is an even worse financial mess, they’re not going to save the hospital, either.

    All of the problems mentioned in the article and comments certainly contributed to the condition of the hospital. It begs the question of just how much good the so-called health care reform will actually do; Even if everyone has insurance, how much can it help them if hospitals like St. Vincent’s are crushed by their debt loads?

    I shudder to think of what 9.11 would have been like if St.Vincent’s had not been there.