Hospitals rushing to meet governor's bed expansion mandate

Long Island hospitals are adding thousands of beds — in conference rooms, gymnasiums and lobbies — as they push to hit Gov. Andrew M. Cuomo's mandate to expand capacity by 50% to accommodate COVID-19 patients.

Hospitals in Nassau and Suffolk counties also have opened emergency triage centers and canceled elective surgeries to make space for coronavirus patients.

While the transformation has been hampered by logistical and technical challenges, employees are thinking creatively and moving quickly to meet strict medical standards, heath care officials said.

Cuomo wants hospitals statewide to boost their capacity 50% to 100%, which would potentially create an additional 32,000 beds. In total, the state needs space for 140,000 beds and about 40,000 ventilators, the governor repeatedly has said.

Nassau, which had 7,340 coronavirus cases as of Monday evening, has about 4,000 hospital beds, according to the county's health department, and that would need to grow to 6,000 to meet Cuomo's request.

Suffolk, with 5,791 cases as of Monday evening, originally had beds for 2,300 hospital patients, but since has grown its capacity to 2,710, according to county spokesman Derek Poppe. That figure would need to grow to 3,450 to meet the 50% target.

NYU Winthrop Hospital in Mineola, which was operating at 511-bed capacity, expects to hit the expansion target by adding beds in areas including those used for elective surgeries, conference rooms, a library and tents.

"Our Post Anesthesia Care Unit, employed in elective surgeries, is being converted into an intensive care unit for those with COVID," said Anne Kazel-Wilcox, a spokeswoman at NYU Winthrop. "We will also be erecting a tent near our ER entrance to help manage those with respiratory symptoms."

The engineers working at NYU Winthrop are "unsung heroes," said Barry Rosenthal, chairman of the emergency department at the hospital. 

"In the 23 days since the first Long Island case was confirmed at NYU Winthrop, those engineers have transformed the hospital so rapidly and efficiently, it's a feat no one would have thought possible a mere month ago," he said. "That includes transforming not just rooms, but entire annexes of our emergency department into negative pressure areas to treat COVID patients."

Negative pressure means that fresh air can flow into the annexes, but negative pressure within the unit prevents contaminated air from leaving the areas, Rosenthal said.

Mount Sinai South Nassau hospital in Oceanside has built two triage tents on its grounds to help with the influx of patients coming in with symptoms of the virus. Officials said the hospital is treating more than 200 patients who have tested positive for the virus, and nearly 50 of them are on ventilators.

The tents have been outfitted with specialized air filtration systems and opened Monday morning, hospital spokesman Joe Calderone said.

“The idea is to screen people with serious COVID-19-like or flu-like symptoms in these tents to try and keep the emergency department clean of contamination,” Calderone said. “This is for people who have trouble breathing, have a high fever or are dizzy. But if you just have a cold, cough and wondering if you have COVID-19, it’s not appropriate to come to the emergency department for that.”

Mount Sinai South Nassau has filed a plan to increase its bed capacity from 343 to 515.

The hospital also is "doing everything we can to increase the number of ventilators,” Calderone said. “In the operating rooms where we have curtailed elective surgeries, we have freed up 20 ventilators. We are also attempting to purchase additional ventilators on our own and from the Mount Sinai Health System.”

Northwell Health is also tucking beds wherever it can to hit the 50% mandate, spokesman Terry Lynam said. 

The New Hyde Park-based health system has 5,550 beds across its health system, which includes 19 hospitals on Long Island, New York City and Westchester, Lynam added.

Northwell's hospitals include North Shore University Hospital, which has 722 beds available to COVID-19 patients there, and can expand that to 922 by using conference rooms, an employee cafeteria and other open spaces. The hospital's Schwartz Ambulatory Center, which is on North Shore's property, also could be used, if needed, Lynam said.

Northwell's Long Island Jewish Medical Center has 514 beds that COVID-19 patients can use, and that could be increased to 996, in part, by repurposing the hospital's lobby, cafeteria, conference space and teaching areas, Lynam said. Northwell also is working on an agreement with Parker Jewish Institute for Health Care and Rehabilitation to use space there, if necessary. Parker is located on the grounds of LIJ, but is not affiliated with Northwell.

Northwell's Peconic Bay Medical Center could go from 116 beds to 183, Lynam added. Peconic's expansion includes putting beds in the Corey Critical Care Pavilion for COVID-19 patients, including an area of ICU beds. Peconic also negotiated a short-term lease to use the gymnasium of the former Bishop McGann-Mercy Diocesan High School, which the Diocese of Rockville Centre had closed in 2018.   

The Northwell bed counts don't include maternity, neonatal and psychiatry areas, which cannot be used for COVID-19 patients, he said.

Catholic Health Services, which has six hospitals on Long Island, including St. Francis Hospital and Good Samaritan Hospital Medical Center, said it is finding ways to boost its bed count beyond the capacity of 1,928 beds.

The hospitals are redeploying clinical teams from ambulatory environments into hospital environments and have canceled elective hospital-based surgeries to free up staff, said Patrick O'Shaughnessy, executive vice president and chief clinical officer at Catholic Health Services.

“We are also repurposing some of these care areas like our post-anesthesia care unit as additional potential sites for COVID-19 surge treatment areas,” he said in a statement.

As of Monday, the system was treating 300 patients who had tested positive for COVID-19, O’Shaughnessy said.

At Nassau University Medical Center in East Meadow, enough space already has been set aside to increase the public hospital’s bed count from 350 to 525, said Dr. Anthony Boutin, the hospital’s chief medical officer, emergency department chairman and interim president and CEO.

“We’re just waiting for the physical beds to come in,” he said.

The hospital’s reconfiguration in anticipation of more COVID-19 patients — there are already 183 people with the virus or who are being investigated for possible exposure to the virus — includes reclaiming what years ago had been patient rooms, he said.

“In the past, it used to be bed space,” he said. “It was turned into offices and now we’re converting them back to bed space.”

The suspension of elective surgeries at NUMC and other hospitals under a statewide directive to handle the influx of coronavirus patients also is freeing up more space, such as in the post-anesthesia care unit, where patients go after surgery and anesthesia, he said.

With David Olson