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Questions about Montefiore Westchester Square emergency department

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An emergency room without a full service hospital offering critical surgery is raising questions about plans for the takeover of Westchester Square Medical Center.

Under its plan to purchase WSMC assets, the state Department of Health granted Montefiore Medical Center a five-year operating license for the state’s first “freestanding emergency depart-at the new Montefiore Westchester Square.

The new Montefiore facility replaces the full-service hospital, and should also offer ambulatory surgery on day one, said Dr. Peter Semczuk, Montefiore vice-president and executive director of clinical services.

He said the same physician group and many of the same nurses that currently staff WSMC’s emergency room will also likely be in place at the new facility.

But questions remain as to potential medical scenarios with an emergency room without a backup surgery unit.

Montefiore initially said that ER patients in need of further medical assistance would be transported to a nearby medical facility with fuller services.

But Deborah Hunt, a college professor of nursing and chair of Community Board 10’s health and human services committee, has raised a number of questioned about the plan, including:

• What would happen if a patient comes in with a ruptured appendix and time is of the essence for surgery?

• What about a patient with a Myocardial Infarction (heart attack)?

• What about a patient with respiratory failure who requires intubation and mechanical ventilation?

• These patients would require a Critical Care Unit. What if no beds are available?

• What if all the EDs in the catchment area are at full capacity and there are no inpatient beds available for patients who are at the freestanding ED and require admission?

While not responding specifically to those questions, a Montefiore spokeswoman called a possible scenario where a patient would be too unstable to be transferred to another facility, but in need of immediate specialty surgery at Montefiore Westchester Square “an elaborate hypothetic­al.”

With the first “freestanding” emergency department in New York state, Semczuk said he expects the state “will very carefully look at...how we manage it moving forward” and would not be surprised “if this model was not further deployed in the state of New York.”

He added: “Should hospital care be required [at the ED], Montefiore Westchester Square emergency physicians and nurses are, as part of their training, well prepared to care for and stabilize the sickest patients until they can be safely transferred to a nearby hospital.”

As of Wednesday, March 6, WSMC no longer accepted inpatients, closed inpatient services completely on March 13, and will cease operations on March 21, reopening the next day under Montefiore’s wing.

“This is a sad but inevitable day for Westchester Square Medical Center,” said Alan Kopman, WSMC’s president and CEO. “We are focused on ensuring appropriate ongoing care for our patients through an orderly closure.”

WSMC’s end came after several years of struggling to emerge from bankruptcy.

Patrick Rocchio can be reach via e-mail at procchio@cnglocal.com or by phone at (718) 742-3393

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