The corporate attack on Certificate of Need

The single strongest regulation protecting New York patients — the Certificate of Need process — is under attack! And powerful corporate interests and private hospital chains are hoping no one notices.

In December, the Public Health and Health Planning Committee voted on new regulations that significantly water down our state’s Certificate of Need process. If they get their way:

  • Private hospitals will be able to close units and cut services for “unprofitable” patients – and shift the burden on to our public and community hospitals.
  • For-profit hospital chains will find the door wide open to come in to our state.
  • Communities and patients will be silenced when hospitals want to close services. Nurses will be laid off. Staffing will get worse.
  • Our state’s healthcare divide will get worse. Even more New Yorkers – especially working people, people of color, and people in rural areas – won’t be able to get access to the care they need.

Nurses were at that hearing in December. They tried to speak. The so-called Public Health and Health Planning Committee refused to let us talk – while Healthcare Association of New York State (the employers’ union) praised the deregulation.

But the fight is not over. Far from it.

Any change to Certificate of Need has to be approved by our lawmakers in Albany.

And you can bet they will hearing from nurses like you and me.


I probably don’t need to tell you why Certificate of Need is so important.

It gives patients, nurses, and communities a voice in decisions that could help or hurt patient care.

It’s one of the few tools we have to hold big private hospitals accountable. And it’s a critical protection for our public sector hospitals.

No wonder healthcare administrators are so eager to get rid of it or water it down.

They don’t think patients or communities should have a voice. They want to make decisions about which units should close or stay open on their own – based only on the bottom line.


Nurses and patients at St. Luke’s Roosevelt got a taste of what’s to come if Certificate of Need deregulation goes through.

Very quietly, after Hurricane Sandy, administrators at Manhattan’s St. Luke’s Roosevelt Hospital pulled a sneak attack on patient care. They eliminated an unprofitable pediatric unit and merged a detox unit into a separate substance abuse unit.

Those closures should have been subject to Certificate of Need review, but the hospital used the pretext of an emergency to cut services without input from the Harlem community or the state.

Under a weakened Certificate of Need process, that kind of unilateral, unaccountable action will become the norm.


Top tier hospitals want to to be able to pick and choose what services they provide – based solely on profit.

They want to poach insured patients from public and community hospitals, and shift unprofitable patients onto our safety net facilities.

We know that’s already been going on for years. If lawmakers take the teeth out of Certificate of Need, the disparities in our healthcare system will get worse – much worse.

Units will close. Nurses will be laid off. Staffing will get worse.

Public hospitals, community hospitals, their patients, and taxpayers will pay the price.


It gets worse. If lawmakers deregulate Certificate of Need, they will open the door to for-profit hospital chains. 
These hospital chains have destroyed patient care in other states.

I know first-hand. I spent the last twenty years in California, taking on the for-profit chains like HCA and Tenet. They have shown again and again by their action that they will sacrifice patient care for profit – every time.

But don’t just take my word on it. A recent story in The New York Times said that for-profit giant HCA’s practices include denying emergency room care; questionable and potentially fraudulent billing practices; providing sub-standard specialty care such as dialysis; the overuse of lucrative cardiac procedures and poor nursing staff levels, resulting in pressure ulcers; infections and avoidable deaths.

We can’t let them do that to New York patients.


Here’s the good news. Nurses at St. Luke’s Roosevelt are fighting back against the patient care cuts.

They’ve been reaching out to lawmakers, the press, and the public to save their units and save patient care. Thanks to their action, they’ve forced St. Luke’s to reverse course and submit the closure to the Certificate of Need process.

I am confident that New York nurses across our state will follow their lead and fight to save Certificate of Need.

The corporate healthcare giants tried the sneak attack. They tried to silence us. But nurses will be heard.

We are going to take our concerns to Albany. We are going to let our governor and our legislators know how important Certificate of Need is. We are going to fight. I hope you will join me.

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