Editorial: Long Beach should downsize its hospital

Billy Crystal is telling the world that Long Beach is open for business, but the hometown comedian surely is joking when it comes to the doors of the local hospital.

Superstorm Sandy is forcing the city to rebuild destroyed facilities smarter and better, from its water treatment plant to its beloved boardwalk. Smarter and better also means letting go of the legacy institutions that no longer make sense, such as Long Beach Medical Center, closed since Sandy hit Oct. 29. The New York State Health Department is correctly requiring the facility to downsize its operations to a free-standing emergency room, along with some ambulatory surgery and outpatient services. The ferocity of the storm's damage to the hospital, combined with shifting winds in favor of large hospital networks, makes the state's diagnosis hard to ignore.

Unfortunately, Long Beach Medical Center executives and trustees don't agree with this vision, and until they comply with the state's directive, the barrier island community won't get the medical services it needs.

Burdened by heavy debt, the medical center has lost money every year from 2007 to 2011. It's ninth on the state's list of 42 most financially distressed hospitals. For decades, the hospital relied on a business plan of long-term stays and frequent readmissions at rates way above average, mostly through a revolving door with its adjoining 200-bed nursing home, according to state records. Medicare and Medicaid plans won't pay for those unsustainable economics anymore.

And, as the state subtly put it, 60 percent of people in the service area are "self-directing" to other hospitals. If you have a choice of where to go for treatment, odds are you won't choose Long Beach Medical Center. Only 47 percent of patients would recommend it to others, the state says.

When stripped of the emotion and hometown instincts, the state's insistence that the hospital affiliate itself with another local institution, possibly South Nassau Communities Hospital in Oceanside, for acute care beds and other services, is the only sound plan.

Of course, there is understandable worry about the lack of an emergency room right in the city during the busy summer. The barrier island only has three bridges that provide access to its roads, and traffic jams could slow response times for ambulances returning from South Nassau or Nassau University Medical Center, making them unavailable for the next 911 call. But additional ambulances have been added for the summer, and problems haven't surfaced, at least not yet. That's fortunate. Getting even an emergency room opened before the fall is unlikely -- even if the hospital board reached an agreement with the state health department tomorrow. Such a facility still will need X-ray, laboratory and pharmacy departments, and getting those running will take many weeks.

Local officials, merchants and residents, however, are campaigning in vain alongside the trustees for the return of a full-service hospital because it, along with the nursing home, had been the city's biggest employer, with a payroll of 1,200. Already, 460 employees are back at work, and more will be needed even with a smaller operation. Others have found new jobs and likely won't return. Other jobs are gone.

Indeed, storm-ravaged Long Beach is open for business, including a small portion of the boardwalk. But the city still needs an emergency center, and enhanced outpatient primary care and mental health treatment. Needlessly blocking that outcome isn't a joke.