Vol. 12, No. 22 Nov. 18 - Dec. 1, 1999


NCB Gets Rave Reviews, But Community Remains Skeptical


North Central Bronx Hospital (NCB) has passed a rigorous accreditation review with flying colors. But hospital staffers worry that the city has only temporarily masked recent cutbacks and layoffs during the inspection to ward off accusations that it intends to close the facility.

Although the official results of the survey, conducted by the Joint Commission on Accreditation of Health Care Organizations (JCAHCO), will not be in for at least another two months, preliminary reports are glowing. "They indicated that we should be very proud of the results and that our medical staff was excellent," said NCB spokeswoman Nancy McPartlin. "They said they were impressed by the services that we offered."

JCAHCO is a private organization that surveys hospitals every three years. Those that pass are eligible to receive federal Medicare dollars. All aspects of NCB's services were considered, including the quality of medical records, staff knowledge and housekeeping services.

The good marks pleased both NCB staff and officials of the Health and Hospitals Corporation (HHC), the city agency that oversees all public hospitals. Lately, staff and administration have been at odds over allegations that the city intends to close NCB. Although officials of HHC have repeatedly stated there are no plans to close the facility, employees argue that recent cutbacks and layoffs indicate the opposite. Workers have staged numerous rallies in front of the facility during the last several months.

But JCAHCO's three-day visit has not erased the concerns of staff and other hospital supporters who allege that the workforce was inflated for the review with new hires, staff from Jacobi Hospital and overtime staffing.

McPartlin acknowledged that there was some recent hiring, but, she said, "It has nothing to do with the Joint Commission. What may look to someone like additional staff, was just the filling of vacancies."

Staffers also report that the administration went to great lengths to make the facility "spic and span." "They ran around like headless chickens trying to get the place ready," said Jean Jones, NCB's chief shop steward. Walls were painted, new lights were installed, vents were cleaned and televisions were even added to lounges, employees said.

But hospital staff said they are worried that the new faces and special attention will disappear now that JCAHCO is gone. Such concerns stem from NCB's recent history; in the past three years, staff has dropped from 2,700 to 1,200 and major services, such as the pediatric in-patient ward and the asthma unit, were transferred to Jacobi Hospital. (Jacobi and NCB are coupled under the one administration called the North Bronx Healthcare Network.) Also, obstetric and gynecological services have been cut.

Just one year ago, Alfred Grant's job as a respiratory technician was eliminated. But as a 20-year employee, he was offered a position in the housekeeping department. "It's a waste of my state license," he said. And, he added, "I had to bump somebody in housekeeping to keep my job." Grant also was given the option of early retirement, which he said is being widely offered.

Though proud of the survey's results, employees are critical at the same time. "It's a farce for anybody to believe that this mark is indicative of 365 days a year," Grant said. He described the actual hospital staff as a "skeleton crew."

Jones, who sometimes works in transport, said she usually sees three or four patients transferred to Jacobi every day. But during the hospital survey, the administration made sure many of those patients stayed put, she said.

One of the most consistent criticisms is that NCB lacks meaningful on-site management. Judy Wessler, coordinator of the Commission on the Public's Health System, and four community members, representing the Coalition to Save North Central Bronx Hospital, testified before surveyors from JCAHCO on Oct. 19. "Decisions are made for the network by people located over at Jacobi Hospital to the detriment of the NCB community," testified Monsignor Robert Trainor of St. Ann's Church in Norwood. "Our goal is to get accreditation and see positive change."

McPartlin contested the charges. "There is management in place there," she said. "There is an on-site administrator." But the coalition testified that the only on-site administrator, Barbara Rosado, is responsible for the physical plant, and not for healthcare decision-making.

"They need somebody who's a director and knows what the community needs," said an NCB doctor who requested anonymity. "Not just someone who makes sure the elevator is working." Joseph Orlando, director of the North Bronx Healthcare Network, makes major decisions about health services, but "75 to 80 percent of the time, he's at Jacobi," the doctor said. He added that even many lower-level decision-makers, like the head of purchasing and linen service, are based at Jacobi.

Despite the lack of on-site management and the transfer of services to Jacobi Hospital, unofficial results indicate that NCB actually scored higher than Jacobi on JCAHCO's survey by as much as 10 points, said the NCB doctor. He and Jones said NCB's preliminary scores excelled at 96 or 97 out of 100. "I think it's what the employees knew all along," the doctor said. "It's a high-quality place ... It showed that NCB is the flagship or jewel in terms of a modern building and support services."

So why would hospital officials bend over backwards to prep NCB for its review if it intended to close the facility? Critics like Wessler argue that the city is using the clean bill of health as an insurance policy. If NCB ever did close, the city could point to the review and claim that there was nothing wrong with services. Instead, blame would be placed on underutilization, Wessler said. A 457-bed facility, NCB now averages 200 patients daily. If its patient census falls between 50 and 80 patients per day, the hospital may be able to legitimately close its doors.

Employees and coalition members are generally pessimistic that the high score will reverse downsizing at NCB. "We would hope they come to their senses," Wessler said. "But I wouldn't count on it."

Wessler and members of the Coalition to Save NCB pledged to watch the hospital more closely now that the accreditation survey is over to make sure services and staff do not go below their current levels. But the majority of the "extra" help, employees report, has already returned to Jacobi.

"It used to be a joy to come to work," Jones said. "Now that we're affiliated with Jacobi, it's not the same. Things are changing so rapidly."

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