Like cars backed up on the Long Island Expressway, gurneys of patients waiting for beds encircled the emergency department nurses station at Brookhaven Memorial Hospital Medical Center and spilled out into the halls.
Some of this crowding on a recent Monday -- not unusual for the 321-bed community hospital -- could be alleviated with a ready-to-go $82-million expansion. But in the current financial crisis, banks have been unwilling to give the hospital a $50-million loan, and the project is stalled.
Meanwhile, Gov. David A. Paterson, facing a state budget shortfall, has proposed slashing Medicaid and other reimbursements that would mean $2.4 million less for the hospital's $242-million operating budget. What's more, said Tom Ockers, chief executive of the East Patchogue hospital, the hospital is anticipating its loyal donors will give less this year.
Brookhaven is hardly alone. Hospitals across Long Island are facing deep state budget cuts, frozen credit markets, investment losses, a downturn in donations and worries about funding pensions. Construction projects are being postponed, programs curtailed, and layoffs are on the table. So far it's unclear how or whether the state's share of the federal stimulus package passed last week will relieve these needs, though local hospital officials are hopeful it may offset some of the proposed state budget cuts.
But getting less money doesn't mean hospitals are treating fewer patients. As the population of Brookhaven Town grows and as its residents age, hospital admissions rose 5 percent last year. "We can't turn the faucet off," Ockers said.
And many of these patients don't have health insurance or can't pay their medical bills. The hospital, which serves about 350,000 people, many of them in financially strapped communities such as Mastic Beach, North Bellport and Gordon Heights, is spending about $1 million a month on charity care. That's a one-third increase from 2007, Margulis said.
Asked if he thought that any Island hospitals would fold, Kevin Dahill, chief executive of the Nassau Suffolk Hospital Council, was cautious: "Not as of this moment," he said.
But he said it wouldn't take much to push some over the edge because New York hospitals, unlike many in other states, already operate on slim margins. In fact, because of tight regulations and antiquated facilities, New York's hospitals rank 48th nationwide in profitability, he said.
Brookhaven is typical: Last year, Ockers said, the hospital, which opened in 1956, did "a little better than break even."