THE ASSEMBLY

STATE OF NEW YORK

CHAIR
Subcommittee on
Catastrophic Natural Disasters

ALBANY
JAMES SKOUFIS
Member of Assembly
99th District

COMMITTEES
Agriculture
Insurance
Labor
Local Governments
Transportation
Veterans Affairs

August 17, 2016

Mr. Daniel Sheppard
Deputy Commissioner
NYS Department of Health
Office of Primary Care & Health Systems Management
Corning Tower, Empire State Plaza
Albany, NY 12237

Dear Deputy Commissioner Sheppard:

Your office recently received a request from St. Lukes Cornwall Hospital (SLCH) to amend
their operating certificate and cease emergency room service at the Cornwall campus. Three
years ago, SLCH applied to operate their Cornwall ER on a part-time basis, a proposal that was
eventually withdrawn after significant public opposition from the very community the hospital
serves.
The same objections that existed three years ago exist today and then some. We
respectfully request that the Department of Health (DOH) reject the hospitals pending
application, an uncommon but warranted action given the following reasons:
1) Subsequent to the hospitals withdrawal of their part-time application in early 2014, SLCH
management promised many in the community that input would be sought prior to any
significant changes to the Cornwall campus. Yet, just like last time, the hospital only
came to residents and elected officials after their decision had already been made.
Furthermore, the so-called town hall meeting the hospital hosted to explain their intention
to close the ER was, we believe, set up in such a way to prevent people from attending:
three days notice was given, so little time that weekly newspapers did not even have
ample notice to get the announcement into their newspapers; the forum was held at
6:00pm in the middle of summer in a heavy commuting area where thousands of
residents do not return home until 7:00pm or later; and no mailers or automated calls
were sent out in fact, many of the attendees only learned of the event through
communications from legislative offices.
Despite promises to the contrary, the same disregard was given to the community
serviced by the Cornwall campus as was given three years ago.

ALBANY OFFICE: Room 821, Legislative Office Building, Albany, New York 12248 518-455-5441 FAX: 518-455-5884
DISTRICT OFFICE: 11 Main Street, Chester, New York 10918 845-469-6929 FAX: 845-469-0914
EMAIL: skoufisj@nyassembly.gov

2) SLCHs intention to close the Cornwall emergency room may well be a violation of
charitable indentures. Documents dated April 14, 1924, and December 16, 1924, both
deeding over property from Ernest Stillman to The Cornwall Hospital, are subject to the
conditions set forth in an earlier indenture dated November 26, 1923 (all enclosed). The
very first condition enumerated in the 1923 indenture states, To receive, hold, manage,
sell, invest, and reinvest the same and every part thereof as well as such additional
moneys, securities, and property...in support and in furtherance of the objects of The
Cornwall Hospital, and the maintenance thereof..."
Since the merger of St. Lukes and The Cornwall Hospital in 2002, the former Cornwall
Hospital has been systematically dismantled. The ER is arguably the last remaining
vestige of the full-service hospital that once existed. While it is certain SLCHs
management continues to violate the spirit of the Stillman Familys wishes, there is also
legitimate question as to whether SLCH has breached the aforementioned obligation in
the indenture to maintain The Cornwall Hospital.
We believe it would be an abdication of the DOHs fiduciary responsibility to approve
SLCHs operating certificate amendment if the DOH considers the hospitals proposed
action to violate a long-standing legal agreement.
3) Since the 2002 merger of St. Lukes Hospital and The Cornwall Hospital, the
overwhelming majority of cuts to core hospital services have occurred in Cornwall:
inpatient beds, the operating room, the mental health unit, and labor and delivery, to
name a few.
When will SLCH and the DOH give the Greater Cornwall community the respect it
deserves?
4) To our knowledge, no actuarial study or formal analysis has been conducted to
determine the impacts of the Cornwall emergency rooms closure on life and health.
Most notably, how many lives will be lost as a result of this decision? When questioned
on this, hospital administrators have responded, We dont have a crystal ball.
5) Has the DOH thoroughly and independently analyzed the fiscal impact of the ERs
closure? How is the hospital improving their bottom line by approximately $3 million if all
Cornwall ER employees will be given jobs in Newburgh, as hospital administrators have
stated?
If the Cornwall ER closes, SLCH estimates they will lose $3 million annually in revenue
(of $8 million total) that the ER currently collects as many patients move to non-SLCH
urgent care centers instead of traveling to the Newburgh ER. It does not appear,
however, SLCH has considered that many if not most residents in the Towns of Blooming
Grove, Highlands, and Woodbury who currently use the Cornwall ER for emergencies will
now travel to a different hospital for emergency care as well. This could have a
substantial impact on SLCHs revenue projections.

ALBANY OFFICE: Room 821, Legislative Office Building, Albany, New York 12248 518-455-5441 FAX: 518-455-5884
DISTRICT OFFICE: 11 Main Street, Chester, New York 10918 845-469-6929 FAX: 845-469-0914
EMAIL: skoufisj@nyassembly.gov

6) SLCHs 2014 990 IRS form, the most recent that is publicly available, shows executive
pay continuing to climb over previous years. In fact, Alan Atzrott, the former CEO who
stepped down from his post on January 1, 2014, was apparently provided a six-figure
retirement bonus. All told, at least nine executives made more than $250,000 in total
compensation in 2014. Have these salaries and bonuses escalated further over the past
two years? If so, we suggest this be the first place management looks to cut not an
emergency room.
7) One argument SLCH is making to justify the closure of the ER is that there are five
urgent care centers less than nine miles away from the Cornwall campus, a
circumstance that did not exist three years ago when the hospital pursued a part-time
department. First and foremost, true emergencies cannot be treated at urgent care
centers. Additionally, three of the five urgent care centers are in Newburgh, just as far if
not farther than SLCHs Newburgh emergency room; and the other two only provide 12
hours of coverage during weekdays and 10 hours during weekends.
The bottom line is that urgent care centers are not a viable replacement for ERs in
general or for the Cornwall ER specifically.
8) New Windsor Volunteer Ambulance Corps Chief Michael Bigg recently shared that he
and his team have been redirected from Newburghs ER to Cornwalls ER per SLCHs
orders 287 out of 1312 times over the past ten months. Additionally, he reported the
turnaround time for ambulances is 39 minutes at the Newburgh ER which stands in stark
contrast to 11 minutes at the Cornwall ER. This large discrepancy takes crew and
ambulances out of communities and amplifies the risks associated with the Cornwall
ERs potential closure.
There is no question SLCH faces difficult financial circumstances but, for all the aforementioned
reasons, the Cornwall emergency room should not be the department to shoulder the burden.
We urge the Department of Health in the strongest possible terms to reject the hospitals
application to close the Cornwall ER.
Sincerely,

James Skoufis
Member of Assembly

Katherine Bonelli
Orange County Legislator

Matthew Turnbull
Orange County Legislator

Kevin Hines
Orange County Legislator

James DiSalvo
Orange County Legislator

Christopher W. Eachus
Orange County Legislator

ALBANY OFFICE: Room 821, Legislative Office Building, Albany, New York 12248 518-455-5441 FAX: 518-455-5884
DISTRICT OFFICE: 11 Main Street, Chester, New York 10918 845-469-6929 FAX: 845-469-0914
EMAIL: skoufisj@nyassembly.gov

Robert A. Formaget
Supervisor, Blooming Grove

Richard Randazzo
Supervisor, Cornwall

Mervin R. Livsey
Supervisor, Highlands

George A. Green
Supervisor, New Windsor

David Sutz
Supervisor, Woodbury

Brendan G. Coyne
Mayor, Cornwall-on-Hudson

Stephen H. Welle
Mayor, Harriman

Patrick Flynn
Mayor, Highland Falls

Robert Jeroloman
Mayor, South Blooming Grove

David Heintz
Mayor, Washingtonville

Michael Queenan
Mayor, Woodbury

ALBANY OFFICE: Room 821, Legislative Office Building, Albany, New York 12248 518-455-5441 FAX: 518-455-5884
DISTRICT OFFICE: 11 Main Street, Chester, New York 10918 845-469-6929 FAX: 845-469-0914
EMAIL: skoufisj@nyassembly.gov