The state's money for health care is spread so thin among its "too many hospitals" that its medical facilities are financially among the weakest in the nation, the health commissioner said.
Dr. Richard Daines spoke to The Associated Press on Friday as health officials were fielding proposals for St. Vincent's Hospital, a 160-year-old Greenwich Village facility with a debt of about $2 million per bed.
That's four times the state's average debt of $500,000 per hospital bed, Daines said.
Saint Vincent Catholic Medical Centers, which operates the hospital, filed for bankruptcy protection owing at least $1 billion, making it economically unfeasible to operate the full-service hospital in a cash-strapped state, the commissioner said.
"New York has too many hospitals, and we're just about the weakest financial picture of hospitals in the country," Daines told the AP in his Manhattan office. "But if you want the absolutely best care, come to one of our New York hospitals."
Four health care organizations submitted proposals by Friday's deadline for bids, Daines said. Their names were not released because a law requires that proposals not be made public so as not to jeopardize the presentation of contract awards.
Many of St. Vincent's 3,500 dismissed employees insist more effort could have been made to save the city's last Roman Catholic general hospital, which treated Civil War veterans as well as people fleeing the World Trade Center attacks, while pioneering HIV/AIDS treatment.
The aging buildings coupled with the debt left the hospital in a "dreadful position," Daines said, and the idea of keeping open the 727-bed facility was daunting.
He agreed with St. Vincent staff that the hospital might have been mismanaged for years. President and CEO Henry Amoroso quit Tuesday, a day before operators filed for Chapter 11 bankruptcy protection.
"My heart goes out to all the good nurses and doctors who have nothing to do with that — or even these issues of debt," said Daines, who previously worked as a critical care doctor at a financially failing Bronx hospital. "You do really good work in a hospital, and you say, 'How can this be? I take wonderful care of every patient I see.' And then the hospital enters bankruptcy."
Last week, the Department of Health issued a request for grant applications to run a self-sustaining St. Vincent's urgent care clinic that would serve as a walk-in facility for blood tests, X-rays and other non-life-threatening conditions.
Now, St. Vincent's patients are being sent to nearby Manhattan hospitals that critics say stand to profit from its demise, including St. Luke's-Roosevelt Hospital Center, where Daines was president and CEO until 2007. It's owned by Continuum Health Partners, which considered taking over St. Vincent's in January, then withdrew.
Daines would not say whether Continuum has offered another proposal.
He emphasized that he had severed ties with St. Luke's-Roosevelt and Continuum after becoming commissioner.
The decision of who will run the downsized St. Vincent's is "a process," Daines said, possibly with more than one entity taking over services.
"We might have one party saying, I'd like to do A, B and C, and another party saying, I'd like to do C, D and E, and then we might have to do some negotiation on the overlap," said Daines, adding that the state will help out with transitional costs.
Asked whether he's concerned that lower Manhattan had lost a top-level trauma hospital, he said, "We have whole counties in the state that don't have a hospital." The nearest, most high-level trauma center, Bellevue Hospital Center, is two miles away.
With the worst trauma cases dwindling to an average of one a day at St. Vincent's, the costly care "is certainly not economically viable. That's reality," Daines said.
The latest St. Vincent's takeover attempt comes two weeks after Mount Sinai Medical Center, a major teaching hospital on Manhattan's East Side, made what Daines called a "last-ditch" effort to save the acute-care hospital. The state had contributed $6 million to cover short-term payroll and supplies, but Mount Sinai pulled back, citing too many financial obstacles.