The dissonance appears to stem from how the public data is consolidated and the time of day hospitals choose to capture their numbers, which is not standardized. The result, workers say, is that the state gets a rosier picture than reality.
Benny Mathew, an emergency room nurse at Montefiore Medical Center's Moses campus in North Central Bronx and a board member of the New York State Nurses Association, said some patients wait as long as two days to be admitted.
"It is so crowded, to get from one bed to the next we have to move the stretchers," Mathew said.
The ER had 32 patients waiting for beds Wednesday evening, Mathew said, and two patients waiting for an ICU bed. The conditions were corroborated by two other ER nurses who spoke to Crain's on the condition of anonymity and by two written complaints sent to Montefiore management the last week of December and obtained by Crain's.
Yet Montefiore's self-reported data suggests no such issue. It publicly reported that the Moses campus was at 75% capacity Wednesday, with more than 200 open beds.
In response to a detailed list of questions and findings, a Montefiore spokeswoman said in a statement: "Like other healthcare systems across the state battling this pandemic, we submit accurate information to the Hospital Emergency Response System daily. Relying on anecdotal information and hearsay in reporting on the state of our hospitals during this critical moment is both misleading and irresponsible."
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The spokeswoman did not answer any follow-up questions.
The stakes are high for hospitals to keep numbers down. If their average occupancy rate reaches 90%, the state may order them to pause nonessential, elective procedures—a primary source of revenue. The state Department of Health relies on hospitals' self-reported data to make those determinations. A representative said Friday that the department has not ordered any city hospitals to pause elective procedures.
Hospitals have until 1 p.m. each day to submit their data, but they can tally their numbers at any time of day—a flexibility that healthcare workers said can be exploited. The public dataset also appears to combine adult and children's hospitals and does not specify availability by bed type, even though workers said beds are not always interchangeable.
Workers who spoke to Crain's compared the public data to the numbers on their hospitals' internal dashboards and pointed out inconsistencies.
New York-Presbyterian Columbia Hospital in Washington Heights reported it had an 86% occupancy rate Wednesday, but its occupancy rate excluding the children's hospital was roughly 92% midday Wednesday, according to data from the hospital's internal dashboard. The public data listed 20 available ICU beds, while the internal dashboard reported six adult ICU beds.
One worker there, who asked to remain unnamed, said a supervisor said a patient could not be moved to the ICU because open beds were being conserved. The worker's employment was independently verified by Crain's.
In response to a detailed list of questions and findings, a spokeswoman for the system said only, "We have sufficient ICU bed capacity at this time."
NYC Health + Hospitals/Bellevue in Kips Bay publicly reported that it had 12 open ICU beds on Wednesday, but a healthcare worker, who asked to remain anonymous, said there were just two that morning. The worker said the ER is struggling to find beds for patients who need to be admitted, even though Bellevue publicly reported having 93 open beds on Wednesday.
Health + Hospitals said it complies with the state's reporting requirements and is redeploying workers to understaffed facilities and units as needed.
"To manage the increased demand for our hospital services, we continue to rely on time-tested strategies, including level-loading across our system, surging beds, and onboarding additional nursing and clinical staff to ensure all New Yorkers have access to comprehensive healthcare," a Health + Hospitals spokeswoman said.
Workers said the capacity issues are intertwined with dire staffing shortages, all while the omicron surge sickens New Yorkers and the healthcare workers caring for them—a vicious cycle.
Mathew said ICU nurses typically have no more than one or two patients at once, because of the intensive nature of the work. On Wednesday, he had five.
As the city's COVID cases skyrocket, experts say the situation has yet to peak, because hospitalizations lag cases by about two weeks.
While all the workers interviewed by Crain's agreed that today's COVID patients are less sick than in previous waves, they said the rising hospitalizations and workforce shortages are creating a perfect storm.
This story first appeared in our sister publication, Crain's New York Business.