Public NYC hospital system merger with Maimonides takes power away from Orthodox Jews, rabbis warn

After New York state regulators approved a proposed merger between Maimonides Medical Center and New York City’s public hospital system on Thursday, Orthodox Jewish leaders warned that the deal could cost the community control over a hospital that has accommodated Jewish religious needs for generations.

A committee of the New York State Public Health and Health Planning Council voted on Thursday to advance the proposed merger of the Borough Park hospital with NYC Health & Hospitals. The full council is scheduled to meet on Sept. 17.

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Rabbi Yeruchim Silber, director of New York government relations at Agudath Israel of America, told JNS that the community’s concerns go beyond assurances from current Health & Hospitals officials that Maimonides will retain its religious accommodations.

“They’re promising now that nothing’s going to change,” Silber said. “They’re going to keep the same kosher kitchen” and keep accommodations for Jewish observance and end-of-life care, he said.

“Administrations come and go,” he told JNS. “What’s to say a future administration or future Health & Hospitals won’t say, ‘We’ll do it differently?’”

Maimonides operates a fully glatt kosher kitchen under rabbinic supervision, Silber told JNS. That standard means that kosher supervisors check the lungs of slaughtered animals to make sure that there aren’t holes or other forms of damage.

Food prepared throughout the hospital is kosher irrespective of the faith of the patient, and Maimonides has worked closely with Orthodox families on sensitive end-of-life questions “where other hospitals are not willing to work,” he said.

Silber recalled one case, in which a patient who had been declared brain dead at a Manhattan hospital remained on life support amid a dispute over the patient’s status. Maimonides agreed to take the patient in, he told JNS.

Mitchell Katz, president and CEO of Health & Hospitals, said at the hearing on Thursday that the public hospital system would maintain Maimonides’ kosher kitchen and accommodations for Jewish end-of-life practices.

“We’re not here to change Maimonides,” Katz said. “We’re here to support Maimonides.”

Maimonides, which is named for the 12th century rabbi and court physician, has deep roots in Borough Park, home to one of the largest Orthodox Jewish populations in the country. Silber said that many residents view it as more than just a medical facility.

“It was part of the community, for the community,” he told JNS.

Residents fear that “a community hospital that works so well with the community would be just taken away from them and become another city hospital,” he said.

Silber told JNS that negotiations over the merger prior to the proposal becoming public “was done quietly.”

“No rabbis were involved in discussions,” he said. “The way it was done was very not above board.”

“It was done behind closed doors,” he told JNS. “Apparently, they weren’t giving all the information.” (JNS sought comment from Maimonides.)

The proposed merger comes as the 711-bed hospital faces significant financial challenges. Originally proposed by then mayor Eric Adams and later supported by Zohran Mamdani, mayor of New York City, New York Gov. Kathy Hochul committed $2.2 billion over five years to subsidize Maimonides’ deficits, the New York Post reported.

Maimonides has explored affiliations with larger health systems for years, including previous discussions with Northwell Health, as standalone hospitals have become increasingly difficult to operate, according to Silber.

Talks with Health & Hospitals began about two years ago, as the state continued providing financial support to the hospital, he said.

Health & Hospitals runs 11 hospitals, 29 medical clinics and five long-term care facilities across New York City.

Some members of the community believe the financial problems at Maimonides stem at least in part from mismanagement and question if transferring control to the city is the only solution, Silber told JNS.

“City hospitals are known not to be well run,” he said. “The care is not the best. There was a fear that a lot of doctors would leave, and it was just very, very concerning.”

Silber said that Health & Hospitals plans to enlist Epic, a medical records and billing system that officials say could save the hospital significant money.

“If it costs about $150 million to put in and it could generate $180 million, you make your money back in one year,” Silber said. “Why didn’t the hospital put it in years ago?”

He also said that the large number of Medicaid patients at Maimonides has hurt its finances. Many patients with private insurance seek care at Manhattan hospitals.

One reason that Silber said that he is skeptical that future leaders will feel bound by promises made during the transition is the former Long Island College Hospital in Brooklyn, which closed. Much of its former property was redeveloped, he said.

“They promised when they would take it over, nothing would change,” he told JNS. “Right now, it’s luxury housing. They turned it into luxury housing, because they gave up on it.”

“How do I know that in five years they won’t say, ‘Ah, the hospital is not profitable. We’re going to turn it into a homeless shelter?’” Silber said. “We have no way of knowing. The community totally loses control of the power. We don’t know what’s going to happen in the future.”

The opposition has coalesced around an ad hoc group organized by Chaskie Rosenberg, a community activist, according to Silber. Rosenberg testified alongside Silber at the hearing in Albany on Thursday.

The Coalition to Preserve Maimonides stated that it “argues that the central question is not whether NYC Health & Hospitals could operate Maimonides, but whether anyone has conducted a truly independent analysis demonstrating that transferring Maimonides to government ownership is the best available option.”

More than 34,000 Brooklyn residents have indicated their opposition to the proposed Maimonides merger, and doctors and patients may abandon the hospital if the deal goes through, the group said.

The coalition released a letter signed by several Brooklyn lawmakers, including Assembly members Simcha Eichenstein and Kalman Yeger and City Council member Simcha Felder, calling for a “full, independent, open-books analysis” of Maimonides’ finances and alternatives to the merger.

“There should be no predetermined outcome and no fear of the facts,” Rosenberg stated. “Before Brooklyn permanently transfers a century-old community institution, the state must ensure that the decision is based on a full, independent analysis—not on secrecy, assumptions or the failures of the management that brought Maimonides to its current financial condition.”

Legal challenges to the proposed merger also remain pending. Two lawsuits seek to block the deal, and opponents say that Maimonides still needs additional court approval before the merger can move forward.

Silber told JNS that the vote on Thursday did not make the merger a “done deal.”

“It’s not over yet,” he said. “The final vote is next month. But even after the final vote, it will be in court. It’s not over yet.”

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