by Bill Batson
On June 26, 2014, Nyack Hospital and Montefiore Health System issued a joint press release announcing a merger. When the process is complete, Nyack will have a medical institution informed by over two centuries of history in health care. Will the philanthropic and progressive impulses that characterized the creation of nonprofit hospitals in nineteenth-century America endure? Will the services that we receive be enhanced or diminished?
“We see great opportunity in working with Nyack Hospital and enhancing its rich history of providing excellent care in the community,” said Steven M. Safyer, M.D., president and CEO of Montefiore. In the same statement, his counterpart, David H. Freed, DHA, President & CEO, of Nyack Hospital said, “Montefiore has a long history of both clinical excellence and innovative care delivery. It will be an exemplary partner in developing the advanced models of care management and regional collaboration required to serve the Rockland community well under healthcare reform.”
Since the word “history” appears in the remarks of each of the CEOs that are party to the agreement, a moment of reflection seems to be in order. Here’s a snapshot of the origins and early days of each health care institution that may provide some prologue and set expectations for what will follow.
Nyack Hospital was incorporated in 1895. Initial funds were raised by an initiative called “Kirmess,” that drew inspiration from medieval festivals that used merrymaking to accomplish good.
The original edifice, depicted in this week’s sketch, was designed by Marshall B. Emery and erected in 1900. The structure still stands as one of the complex of buildings that occupy the land between Midland, Highland, Fifth and Sickles Avenues. The original building now houses physicians’ offices.
The first Nyack Hospital ambulance was a horse-drawn conyevance that was purchased in 1903 for $550. The carriage was described in press accounts as a “shiny new vehicle,” when the first patient was transported from West Haverstraw with acute appendicitis. Before this new “ambulance,” patients were “jolted to the institution on the floors of delivery wagons.”
In the 1920s, a county-wide effort raised $400,000 to build a new addition and a nurses residence. A photo from the 1930s shows elephants from Pierre Bernard’s Clarkstown Country Club entertaining patients in the hospital’s Children’s Ward.
Nyack Branch NAACP President Frances Pratt began working at Nyack Hospital in 1959 after obtaining a degree in Nursing from Rockland Community College. During her 53 year career she held titles including Head Nurse of the Emergency Room and in the Office of Employee Health. This picture of her induction as a nurse includes George Celentano, center, the first male nurse at that institution.
The five story main hospital building was constructed in 1955. A sixth floor was added in 1983. The Union Bank Cancer Center was designed by local architect Jan Degeshien and built in 2000.
In April 2014, Nyack Hospital announced the creation of a Behavioral Health Center. The unit has 26 beds that are bolted to the floor, recessed shelves and covered lighting to ensure the safety of patients on the locked-down ward.
What is now Montefiore Health System was founded in 1884 by Jewish philanthropists as a home for chronically ill members of their community that were excluded from other facilities. By 1890, Montefiore was among the first to test tuberculin for the diagnosis of tuberculosis and by 1901, Montefiore was the site of one of the earliest clinical uses of adrenalin, – asthma patients were treated with adrenalin chloride.
Other milestones include:
- 1912 – Montefiore expanded its services and built a new hospital in the Bronx.
- 1916 – first woman joined Montefiore’s house staff.
- 1930s – African American medical residents were accepted at Montefiore at a time when such integration was rare.
- 1959 – Montefiore became the first hospital to recognize a hospital workers union, 1199 SEIU. 1199 SEIU represents workers at both Nyack Hospital and Montefiore.
The tale of the tape
Monterfoire was founded in 1884.
Nyack Hospital was founded in 1895.
Montefiore Medical Center has 1,491 acute-care beds and treats the Bronx community, which has more than 1.4 million people.
Nyack Hospital is a 375-bed community acute care medical and surgical hospital located in Rockland County, which has 300,000 people.
Montefiore Medical Center has 17,600 employees.
Nyack Hospital has 1,600 employees.
Montefiore Medical Center had a profit of nearly $111 million with revenues of $2.3 billion in 2012, according to its most recent tax filings.
Nyack Hospital had a profit of nearly $4.5 million with revenues of $208 million during the same period.
The details of the agreement between Montefiore and Nyack, and the next chapter of health care in this village, are being written at the negotiating table. Although the final agreement between Montefiore and Nyack has to be approved by the State Department of Health, the industry trend is moving toward these mega health care systems.
In the last year, Montefiore has purchased New York Westchester Square Medical Center, Mount Vernon Hospital and New Rochelle Hospital. Montefiore also operates 9 clinics in Westchester.
New York-Presbyterian Health, the system that Nyack Hospital had been affiliated with since 2004, has taken over Lawrence Hospital in Bronxville. The North Shore-LIJ Health System is partnering with both Phelps Memorial Hospital in Sleepy Hollow and Northern Westchester Hospital in Mount Kisco.
In January 2013, I spent a week in Nyack Hospital at my father’s bedside. His nearly $40,000 hospitalization was almost entirely covered by Medicare and his secondary insurer and he received excellent care. I counted our blessings that he had both good coverage and care and pondered whether future generations would be so fortunate.
How will this next round of consolidations affect the cost and quality of health care in Nyack? Will regional networks like New York-Presbyterian, Northshore-LIJ and Montefiore be responsive to local concerns? And in the most basic measure of the health of a hospital, will Montefiore keep all inpatient, outpatient, and emergency services at their current levels?
Sides seem to be forming in a giant game of chess in the health care industry. Let’s hope that our hospital is a castle on the side that prevails and that patients are not used as pawns by the winners or the losers.
Special thanks to Carol Weiss.