Recent murmurs of Beth Israel Hospital's imminent closure

weren't far off the mark: Mount Sinai announced today that the 127-year-old, 856-bed facility will be replaced by a 70-bed facility within the next four years. Once the new Mount Sinai Downtown Beth Israel Hospital opens in 2020, the current facility will eventually be sold, and will join the ever-growing list of city hospitals that have shuttered in recent years.

Despite rumors circulating earlier this month, Mount Sinai was saying as recently as last week that Beth Israel would not close, but that it was "working on a plan which will enhance existing services and develop new facilities in the Beth Israel community."

That plan, as it turns out, involves shutting down most of the existing Beth Israel facility at 16th Street, after all. New investments will preserve and enhance Mount Sinai Beth Israel's Bernstein Pavilion, the New York Eye and Ear Infirmary of Mount Sinai, the Phillips Ambulatory Care Center, and Mount Sinai Beth Israel's Comprehensive Cancer Center West. The new Mount Sinai Downtown Beth Israel Hospital, located at 14th Street just off Second Avenue, will have an emergency department that can handle all emergencies on site, but that will transport patients with complex conditions to other hospitals in the Mount Sinai health system upon stabilizing them. Mount Sinai is adamant that there won't be any losses of services during the restructuring, as the current facility will remain open until the new one is built.

Overall, Mount Sinai will invest $500 million in its new Mount Sinai Downtown network, and it'll likely make that money back in its eventual sale of the 16th Street facility, which is expected to sell for $600 million.

Mount Sinai, the largest private employer in the city, says that it will retrain and place as many employees as possible elsewhere within the Mount Sinai system when MSBI closes; it will also place any potentially displaced physicians-in-training in other programs within the system. All union employees—1199SEIU United Healthcare Workers East represents over 4,000 nurses and caregivers at the hospital—will be given other union jobs with equal pay. Between 600 and 700 nonunion employees will reportedly lose their jobs.

"For several years, we have been transforming the Mount Sinai Health System toward a new model of care, where we focus on keeping entire communities healthy and out of the hospital," said Mount Sinai Health System President and CEO Kenneth L. Davis on Wednesday. "Mount Sinai Downtown is a dramatic next step that will enable us to improve access and increase quality by providing care for residents of downtown Manhattan where they live and work."

After St. Vincent's shuttered in 2010, following a series of layoffs, Beth Israel was the last remaining large hospital serving Lower Manhattan. But the hospital, which joined Mount Sinai's network in 2013, has been struggling: it lost $115 million in 2015 and had already lost $23 million in the first quarter of this year, the Wall Street Journal reports. It currently has an outstanding debt of $200 million.

Mayor de Blasio has been a vocal critic of the number of hospital closures under his predecessor's tenure, and he was arrested in 2013, while campaigning for mayor, for protesting the closing of Long Island College Hospital in Brooklyn. De Blasio said today that "major decisions about the future of hospitals have been happening in this city for the past decade, too often based on no plan whatsoever and without a larger strategy in place, and that has to end...While it is good to see that layoffs of unionized staff will be avoided and some important investments made, [Mount] Sinai must work with the community to ensure that the in-patient and emergency care needs of local residents are met."

In a letter sent to Davis last week, a number of elected officials expressed concerns about any downsizing or closure at Beth Israel, which they said "threatens to further strain an already overburdened network of healthcare providers in Manhattan, reduce healthcare options and curtail services in the immediate neighborhood, and eliminate jobs."

But Mount Sinai says that the whole point is to shift away from inpatient care: in announcing this downsizing, officials pointed to data showing that the number of empty hospital beds has been increasing over the past several years, and said that since St. Vincent's closed, the total average daily inpatient census at other hospitals has declined. At Beth Israel, more than 40 percent of beds are typically empty, and the hospital's patient volume has apparently plummeted in recent years.

"When St. Vincent's closed we were told over and over again, 'everyone can go to Beth Israel, don't worry,'" recalled Manhattan Borough President Gale Brewer when reached by phone today. "Now, Beth Israel say that they're not closing, that they're getting smaller—but they're getting an awful lot smaller, so I am concerned."

In addition to the shrinking number of inpatient beds, Brewer said she's concerned about making sure Beth Israel can provide all the medical procedures that might be needed by patients who come to the hospital. She would also like to ensure that the current building, which is zoned as a community facility, remains that way, rather than going the way of St. Vincent's and becoming luxury condos.

Brewer isn't the only politician upset by news of Beth Israel's restructuring: City Council Member Dan Garodnick said that while Mount Sinai's plan for a new emergency room is promising, "the planned reduction of licensed in-patient beds from 856 to 70 raises real questions about whether that is adequate capacity for the downtown community; what percentage of patients would need to be moved for appropriate treatment; and how Mount Sinai would expand the number of beds if that proved necessary." Congressman Jerrold Nadler was similarly critical, and said that he is "concerned that the drastic reduction in hospital beds in New York City—and now twice in Lower Manhattan—in recent years will result in insufficient care downtown."

Construction on the new, smaller facility at 14th Street and Second Avenue is expected to begin in 2017. There will be a community meeting on the upcoming changes at Beth Israel at the Bernstein Pavilion tomorrow, at 11 a.m.