Anyone Remember The United States Public Health Service Hospitals?

canned_bread · Jul 14, 2012

So are you saying these hospitals allowed people with no health insurance to get medical care? If so, that's fantastic. It's exactly what America requires.

I do wonder (I am from Australia), what happens to someone who is in labour and requires a hospital, but has no medical insurance? Is their provisions for them?

Okami_CCRN, BSN, RN · Jul 14, 2012

EMTALA (Emergency Medical Treatment and Labor Act) requires all people who seek emergency medical treat which includes labor to be seen at any facility participating in medicare regardless of ability to pay.

The issue with EMTALA is that EVERYONE has to be seen from the young man who shattered his leg while skateboarding to the lady who has a paper cut and rates her pain 10/10. You are treated and discharged and later billed by the hospital in the hopes that you can pay back; most do not. In my area of the country many use the emergency room as if it was a primary care clinic.

rngeneral · Nov 3, 2012

Hey! I actually GREW UP living in one of the Quarters 7 on the hospital grounds of the USPHS Hospital on Staten Island, NY. My father was a physisican there. Lived there from 1964-1978. I remember it well. Went through there about 4 yrs. ago and was SO sad to see the state of disrepair of my childhood home....abandoned, open windows (probably full of pigeons), etc. Such a shame that a solid brink facility both the hospital itself and the quarters surrounding it have fallen into disrepair.

Until Ronald Regan ordered it closed back in the 1980's we had one on Staten Island, NY, and IIRC there were at least seven others.
Maybe am not looking in the proper section but don't see much talk here about them. Seems the concept (federal government owned hospitals) would be a great idea for the underserved areas of the country

rngeneral · Nov 3, 2012

ALSO, this hospital was initially the Marine Hospital and was the Health Corps for the US Marines. The USPHS is a branch of the military...the UNIFORMED services not the ARMED services, but those enlisted and officers in the USPHS receive military benefits.

DoGoodThenGo · Nov 3, 2012

Hey! I actually GREW UP living in one of the Quarters 7 on the hospital grounds of the USPHS Hospital on Staten Island, NY. My father was a physisican there. Lived there from 1964-1978. I remember it well. Went through there about 4 yrs. ago and was SO sad to see the state of disrepair of my childhood home....abandoned, open windows (probably full of pigeons), etc. Such a shame that a solid brink facility both the hospital itself and the quarters surrounding it have fallen into disrepair.

After being order closed by Regan, the USPH Hospital on Staten Island was purchased by the Sisters of Charity (they also owned Saint Vincent's Hospital in West New Brighton), and renamed Baley Seton Hospital. The Sisters later sold the hospital to the ill fated Saint Vincent's Healthcare system which went bankrupt. Prior to this the order ran mainly substance abuse and mental care out of the facility in addition to being a "small" hospital. Saint Vinny's nursing school was moved from West Brighton to the place as well.

Yes, as you say sadly most of the grounds sit rotting away. The Salvation Army purchased a large portion of the lands and buildings intending to build some type of community center. Last one heard no ground was ever broken and the deal has fallen through because SA cannot line up funding.

Bayley Seton Hospital Â« AbandonedNYC

There is also a huge fight amount those wishing to preserve the buildings (IIRC many are landmarked or some such) versus those seeking development. Some North Shore residents would like to see another full service hospital open on the site, but given the current state and nature of hospital systems in NYC much less most of NYS don't see that happening anytime soon.

Rock4321 · Oct 13, 2018

There doesn't seem to be any major activity there, even the nursing school moved out.

DoGoodThenGo · Oct 25, 2018

There doesn't seem to be any major activity there, even the nursing school moved out.

Actually there has:

Mayor de Blasio Cuts Ribbon on Staten Island's New NYC Health + Hospitals Community Health Center | City of New York

City Breaks Ground on $25M Medical Facility in Clifton - Clifton - New York - DNAinfo

City's new Island health facility opening this fall; cost doubles | SILive.com

Although to be clear 165 Vanderbilt Avenue is next to the old Bayley Seton (formerly USPHS hospital), and thus not part of main campus. Never the less it was owned and part of the former Saint Vincent's Medical Center/Sisters of Charity health network on SI.

Problem with the main USPHS/Bayley Seton campus is what ails and has lead to closing of other huge old barns of hospital campuses. It simply is too large and thus ill suited to modern healthcare where the focus is on less inpatient and more outpatient. That is despite what many on Staten Island claim (and other parts of NYC as well), there are too many inpatient beds chasing fewer and fewer patients as stays are shortened for acute care.

Even back when Saint Vincent's owned the place they were losing money: Bankrupt St. Vinny's puts S.I. assets on block

There are no end of plans or schemes for the campus, but nothing really ever seems to happen.

Future of Bayley Seton site: Revamped community center and plans for a green campus | SILive.com

Rock4321 · Oct 26, 2018

There doesn't seem to be much activity there, except for mental health units.

DoGoodThenGo · Oct 26, 2018

There doesn't seem to be much activity there, except for mental health units.

If by returning to a full service acute hospital as "activity", forget it, just won't happen.

The Sisters tried to get any of the large NYC private hospitals (IIRC) to take over BS, and none were interested. That building and campus are just too large to be remotely profitable for a healthcare system.

BAYLEY-SETON HOSPITAL - NYS GOVERNOR'S OFFICE FOR MOTION PICTURE & TELEVISION DEVELOPMENT

Rock4321 · Oct 26, 2018

I worked at USPHSH from 1955-1981, and Bayley Seton for several more years as a nurse. It was a wonderful place to work as a nurse, and it's a shame that Ronald Reagan shut it down, when previous presidents were unable to do so. People in the Commissioned Corps only had to do twenty (20) years of service to qualify for a pension, but Civil Service had to do thirty (30) years, and meet an age requirement.

DoGoodThenGo · Oct 27, 2018

I worked at USPHSH from 1955-1981, and Bayley Seton for several more years as a nurse. It was a wonderful place to work as a nurse, and it's a shame that Ronald Reagan shut it down, when previous presidents were unable to do so. People in the Commissioned Corps only had to do twenty (20) years of service to qualify for a pension, but Civil Service had to do thirty (30) years, and meet an age requirement.

Was born and raised on SI, and knew the old USPHS hospital well. Also agree with much of what you are saying, but fast forward to the 2000's or even 2010 and beyond highly doubt even Bayley would have survived, well again not as a full service acute care in that huge building.

Reagan in a way was correct and foresaw by a few decades where healthcare was going. Federal government already provided for the care of poor/indigent via Medicaid, and veterans/military via the VA and or government health insurance schemes.

Medicaid in particular began the long, slow and painful reckoning that hit and continues to affect "charity care/hospitals of last resort". Saint Vincent's isn't the only nor last religious affiliated healthcare network to go bust recently. In theory Medicaid patients can go anywhere, and many do choose other places than charity hospitals.

Saint Vincent's had many faults with their business model (along with it seems some *VERY* bad management and advisors), but their main downfall was that wealthy/well insured patients viewed the place as just that a charity hospital and simply refused to go, preferring the wealthy east side/uptown Manhattan places like NYP, Mount Sinai, and NYU.

Indeed if you believe Mount Sinai/Beth Israel the closing of Saint Vincent's had no real affect on their utilization rates and or ER visits. This is why they are largely getting away with shutting down and tearing down Beth Israel with little protest from NYS.

Back to Staten Island, the North Shore has seen dramatic changes in demographics/population since the 1980's. The flight out of Saint George/Tompkinsville, etc... that began when Staten Island Hospital packed up and moved to Ocean Breeze picked up steam as one by one other large institutions (HIP, College of Staten Island, etc...) left as well.

Simply put there just doesn't seem to be a large nor stable enough pool of wealthy/well insured patients to support two hospitals on North Shore. Remember no one wanted to buy Saint Vincent's on Bard Avenue either. Had (then) nearly bankrupt Bayonne hospital hadn't stepped in ST.V's would have closed because again no one wanted the place.

This coupled with fact many on North Shore wouldn't go to Bayley Seton nor Saint Vincent's then nor now if their lives depended. Rather they go off to Ocean Breeze/South Shore to Staten Island University Hospital.

None of this even begins to touch the strong refocus of healthcare delivery in USA favoring shorter inpatient stays coupled with more community/ambulatory/clinic based services.

If any of the major healthcare players in NYC thought they could make it work, they would have taken USPHS campus. North Shore-LIJ (now Northwell) who already own two of the three major hospitals on SI, and are swimming in money (they just purchased an entire city block on UES of Manhattan), in particular comes to mind. But again no one would touch the place which is why the city (HHC) stepped in and opened that new clinic.

In summation problem with healthcare on Staten Island is the place just that; an island. While plenty of resident can and do choose to go into Manhattan or elsewhere for care, you aren't going to be bringing large numbers of people from say lower Manhattan or South Brooklyn onto SI. Thus you are left with native population. As things stand now Richmond University Hospital (formerly Saint Vincent's) seems to serve the North Shore population well enough. They are now affiliated with Mount Sinai which should bring in more money and other benefits.