The Commission on Health Care Facilities in the 21 st Century

1. The Commission on Health Care Facilities in the 21st Century • Established by the Governor and the State Legislature in 2005 • ‘The Berger Commission’ or ‘The Commission.’

2. What, Why and the Goals of The Commission • To conduct an independent review of health care capacity and resources in New York State. • To align hospital and nursing home bed supply with regional needs. • To reduce excess bed capacity in favor of ambulatory and community-based care. • To “rightsize” the health care system.

3. Commission Structure • 18 Statewide Members • 36 Regional Members (6 per Region) • 6 Regional Advisory Councils (RACs) of up to 12 members each • 19 public hearings

4. The Commission’s Recommendations • 57 mandatory recommendations, effective January 1, 2007. • Affected 81 acute care and long-term care facilities. • 57 hospitals (one-quarter of total in state) • 24 nursing homes (4% of total in state)

5. The Commission’s Recommendations • Close, • Downsize, • Consolidate, • Convert, or • Restructure facilities within each region.

6. Bed Reduction Acute Care • Eliminated 2,810 hospital inpatient beds through • 10 facility closures • 47 downsizings reconfigurations, affiliations, conversions, mergers • 768 bed reductions pending

7. Bed ReductionLong-Term Care • Eliminated 2,548 nursing home beds • Closure of 6 nursing homes • 18 downsizings, reconfigurations, conversions, affiliations • 417 beds in litigation (two closures)

8. Funding for Implementation • $550 million from HEAL NY

9. Regional Highlights

10. NYC Region: Five Hospitals Closed

11. Long Island Region Joined Southampton Joined Joined Eastern LI Peconic Bay East End Health Alliance Affiliation Affiliation Affiliation University Hospital @ Stony Brook Brookhaven continues joint planning with the three hospitals.

12. Hudson Valley Region Joined Kingston Benedictine Health Alliance

13. Northern Region Ellis Hospital Ellis Hospital-Bellevue Woman’s Care Center Division Ellis Hospital- St. Clares Division

14. Central Region SUNY Syracuse Crouse Created Affiliation Council The two facilities did not merge but created an Affiliation Council.

15. Central Region Albert Lindley Lee Memorial Hospital Closed. Converted to urgent care center, to be operated by Oswego Hospital.

16. Central Region Community General Hospital-SNF Van Duyn Home and Hospital • SNF Closed Single Unified Governance Structure ‘County Health Information and Planning Services (CHIPS)’ Under the Control of CGH

17. Western Region Lockport Hospital (LH) Inter-Community Memorial Hospital @ Newfane (ICH-N) Full Asset Merger

18. Western Region Great Lakes Health System Kaleida Facilities Erie County Medical Center Facilities Joined Under A Single Unified Governance Structure The Great Lakes Health Alliance

19. Modifications to Implementation Health and Access Concerns Governing Boards’ Concerns Logistics, Construction, Financing

20. Health and Safety Maintain Access to Care Sky View Nursing Home Split Rock Nursing Home Auburn Memorial Hospital OASAS/OMH Requirements St. Charles and John T. Mather Hospitals Sheehan Memorial Hospital

21. Governing Boards • New York Methodist Hospital • New York Community Hospital of Brooklyn • St. Joseph’s Hospital (Elmira) • Arnot Ogden Medical Center • Crouse Medical Center • SUNY Upstate Medical Center

22. Logistics, Construction, Financing • Kaleida and ECMC • Mercy of Northern NY • Mount View Health Facility • Long Beach Medical Center

23. Litigation Legal Challenges to Closure Andrus-on-Hudson RHCF Williamsville Suburban RHCF

24. Achievement • Consensus on Need for Change • Public Input on Regional and Local Needs • Constructive, Resourceful Response to Mandates

25. Commission’s Legacy • Rightsizing as a Framework for Decision Making for • Policy • Regulation • Planning • CON • Funding