Kingsbrook Jewish Medical Center, a 303-bed hospital serving mostly low-income patients in East Flatbush, Brooklyn, has stopped admitting patients as it pushes ahead with a plan to shut down most inpatient care by the end of the month.
Now five years in the making, the move is a condition of a state-backed merger between Kingsbrook, Interfaith and Brookdale University medical centers, which are now collectively known as One Brooklyn Health. The partial closure was supposed to occur last July but was delayed due to the high demand for hospital beds after the city began its battle against COVID-19.
Since then, the plan has faced renewed opposition from community members and hospital staff who hoped to permanently stave off Kingsbrook’s transformation into a “medical village” with an increased focus on outpatient care. The hospital will be cutting about 200 beds overall.
“There’s been a huge evolution [in health care], not only in how people are treated with different conditions but where they’re treated,” LaRay Brown, CEO of One Brooklyn Health, said at an online community forum on the plan last week. As an example, she pointed out that people with HIV once occupied hospital beds but are now largely treated on an outpatient basis.
But staff at Kingsbrook hospital say it was bustling before officials recently started winding down their inpatient operations.
“The area is going to suffer a whole lot,” said Dr. Subhash Malhotra, who has worked at Kingsbrook since the 1980s. “When the patient is acutely ill, and they require inpatient hospitalization and care, you cannot provide them with the outpatient clinic.”
Kingsbrook’s emergency department will remain open, but patients who need to be admitted to the hospital will now be directed elsewhere in One Brooklyn or to other facilities in the area. Of the 66 patients who arrived at Kingsbrook in need of inpatient care between June 9th and 16th, Brown said 54 were transferred to Brookdale or Interfaith, each about a 10-minute drive away.
During the forum, some members of the Kingsbrook Community Action Committee, a coalition of hospital staff and community members who have sought to stop the plan, questioned the wisdom of cutting hospital beds in an area lagging in COVID-19 vaccines while new variants of the coronavirus are still emerging.
But Brown remained steadfast that the changes at Kingsbrook, part of a nearly $700 million plan funded by the state, will enhance care in the neighborhood without putting people at risk. She noted that One Brooklyn is working with local salons and barbershops to get people vaccinated. “If there’s another COVID surge and we don’t have capacity within One Brooklyn, we have agreements with other hospitals in central Brooklyn to provide that patient load balancing support,” Brown added. Brookdale, for example, will be adding 61 inpatient beds next year.
Kingsbrook’s campus will continue to maintain inpatient behavioral health care and rehab, as well as a 466-bed nursing home. A building housing other inpatient units will be renovated to provide a mix of primary and specialty care.
The hospital plans to convert some buildings into affordable housing, creating a 266-unit complex called Kingsbrook Estates. Brown said the project would be completed in partnership with private developers, but One Brooklyn will retain ownership of the real estate and gain “some financial benefit” from the deal.
Governor Andrew Cuomo invested in Kingsbrook’s transformation and other capital projects involved in the One Brooklyn merger following a study his administration commissioned in 2016. Cuomo enlisted Northwell Health, a large, private hospital system, to create a proposal to generate financial stability and independence for safety-net hospitals in central Brooklyn that require significant public subsidies to stay afloat. Northwell ultimately issued its recommendations in 2017, and they are largely being put into action.
The Cuomo administration often pushes mergers on hospitals that are losing money. However, Brown admitted to WNYC/Gothamist in March that the plan would be unlikely to make the hospitals involved “fully financially independent or viable.” Interfaith, Kingsbrook and Brookdale all suffer losses because they primarily serve people who are uninsured or on Medicaid, which pays less for care than private insurance. The state sets Medicaid rates.
Health care unions and politicians representing the Kingsbrook area have largely supported the governor’s plan. Last year, State Assemblywoman Diana Richardson said, “Some people cause havoc and fear-mongering in the community unnecessarily, as a result of bad information.” And State Senator Zellnor Myrie told Bklyner that he felt reassured that the plan did not pose a public health risk. Neither lawmaker responded to requests for comment for this story.
There are several nearby hospitals, including Kings County Hospital Center, less than a mile away. But critics remain unconvinced that there is anything but financial motive at play.
“I see the closures of hospitals in mostly Black neighborhoods while Manhattan has six hospital beds for every 1,000 people,” said Gerry Hopkins, a member of the Community Action Committee who has been a patient at Kingsbrook over the years. Brooklyn’s bed count is 2.2 per 1,000 people, which is more in line with the U.S. average but less than comparably wealthy countries.
Hopkins concedes that Kingsbrook, like Interfaith and Brookdale, could use some quality improvements. All three have one-star ratings from the Centers for Medicare and Medicaid Services.
“That is what we needed,” he said. “Better management and upgrades in terms of the delivery of services. Not closure, not to phase it out.”