Now cracked and crumbling, the limestone slab above the old entrance to the Westchester Square Medical Center still reads “Westchester Square.” But now, a new Montefiore sign juts out onto the sidewalk.

Aside from two delivery trucks, there are few other signs of life. Inside the air conditioned lobby, a snack station advertizes Starbucks coffee. A man with a bandaged head leans on the counter in the waiting room as a TV glares in the background.

In March 2013, Montefiore Medical Center acquired the assets to the former Westchester Square Medical Center (WSMC) which has been bankrupt since 2006, in a $15.3 million bid.

A $20 million grant provided by New York State’s Health Efficiency and Affordability Law financed the purchase. Also known as the HEAL NY Program, the law was passed in 2004 and has provided nearly $3 billion in funding over the past seven years to health care facilities throughout the city.

“There are a lot of services that the Square could not offer before, that Montefiore now can,” said Teresa Mandarino, senior director of ambulatory services and a WSMC employee of 34 years.

The new Westchester Square specializes in out-patient emergency care, offering longer hours and more services than does an urgent care center. The facility houses an emergency room, ambulatory surgery division, radiology lab, and gastrointestinal unit. Renovations include an updated lobby, operating rooms, labs, digital radiology rooms, and outdoor lighting. The upcoming installation of a Pyxis system will facilitate medication management and distribution. Landscaping was set to line the front of the building, but the sidewalk remains shade less.

Leaner, For Now

But as of today, only three of the building’s seven floors including the ground floor are in use. The seventh floor is for ambulatory surgery and the fourth for gastrointestinal procedures, Emergency Department Director Rafael Torres said.

“There are plans to populate the other floors with different programs,” Mandarino said. “It will be at least another year or so,” she added, indicating that the ambulatory surgery department will soon be moved to occupy the same level as the general operating room.

In its first three months, the new Center, which was recently ranked #7 among the top 10 best ranking hospitals in New York and the New York metropolitan area by the U.S. News & World Report, has treated roughly 4,500 Emergency Department patients and is open 24/7 (as was the former facility). Meanwhile, the Ambulatory Surgery Center has performed 1,400 outpatient procedures, according to a recent press release.

But since the facility only functions as an Emergency Department, 250 patients who require overnight stays have already been transferred to nearby Montefiore branches since March, although Torres said the practice is common.

Here’s how the process works: once it is determined a patient needs to be treated elsewhere, the on-site logistics team decides which branch is most appropriate. An ambulance is called as staff members make contact with physicians at the new facility.

Some Still Skeptical

Yet critics, including former members of WSMC’s board, most of whom were physicians, and the New York State Nurses Association, expressed concern about the loss of in-patient care, the strain it might place on nearby Einstein and Jacobi hospitals, and the loss of jobs.

“The people who live in Westchester Square deserve care in their community,” said Judy Sheridan-Gonzalez, RN and vice president of the New York State Nurses Association. “We are closely monitoring how the reduction of services at Westchester Square is affecting nurses and patients at other Bronx hospitals, and we are working with hospital administrators to make sure there are enough nurses to meet the increased patient need,” she said.

“We can handle anything that crosses through the door,” Torres said when asked about the loss of beds.

As for the loss of jobs? Montefiore says it has nearly everyone covered, although the details remain murky.

Of the roughly 600 to 800 employees under the old guard, nearly 300 were given part- or full-time jobs at Westchester Square. More than 200 doctors were granted privileges to practice at the new center, and over 100 staffers were reassigned to other branches, Montefiore said.

According to the hospital, a “huge majority” of former WSMC employees maintained their positions. A representative from 1199 SEIU United Healthcare Workers East reported that as of April 2013, at least 196 of the 320 union members working at WSMC were given jobs at the new facility or at other Montefiore branches.

“We’re pleased that Montefiore has decided to acquire Westchester Square Medical Center’s campus, and that as a result, quality healthcare and good jobs in the community will be saved,” said Joyce Neil, executive vice president of 1199SEIU.

Montefiore said Westchester Square has been busy since opening its doors to the public, and treats an average of 49 patients per day. This is typical for Emergency Departments nationwide, according to the Centers for Disease Control and Prevention (CDC) which reported that in 2012 there was an average of 43 visits per day.

Change is Good

Current employees say they are pleased with the changes.

“It’s more organized, and the flow is much better,” said Andrea Mackiewicz, an administrative nursing manager and former WSMC employee of 20 years.

“We are so pleased the community has embraced Montefiore Westchester Square,” said Steven M. Safyer, president and CEO of Montefiore, in a recent press release. “Our goal from the very start was to preserve access to the best of health care services by providing exceptional care to meet the community’s needs as well as to preserve jobs and support the local economy,” he said.

“There has been nothing but positive changes here, from the updating of the exterior, to the inside of the building where all the renovations have taken place.” Mandarino said. “Basically Montefiore has breathed new life into this facility.”

According to Mandarino, services at the old center were dwindling long before it officially went bankrupt. “It was very rough during the last six to eight months of operation [before Montefiore],” she said, adding that at one point there were only 80 beds in use. “Some of the patients were told that the hospital was closing and not to come here, so that was just another uphill battle that we were facing,” Mandarino said.

But WSMC has a long history of fighting for its life.

In 2007, the Center was added to Governor Pataki’s Berger Commission list of five city hospitals set for closure. But in December 2008, just two days before it was scheduled to shut down, the facility was given a one-year extension during which to find a buyer. State Senator Jeffrey Klein, Assemblyman Michael Benedetto, and Congressman Joseph Crowley were among those who lobbied heavily in the Center’s defense.

“While I would have liked for Westchester Square Medical Center to remain an open and viable, full-service hospital in the Bronx,” Klein said, “I am pleased that Montefiore is able to continue offering emergency care to members of the community and hope that it will continue to provide critical services to the Bronx for years to come.

According to the Bronx Times, the new Westchester Square will not have a community advisory board but will continue to host “community forums” where residents can share input, the first of which is scheduled to take place this fall.

Editor’s note: This article was originally published in the Oct. 3-16 print edition of the Norwood News. The Norwood News is published by Mosholu Preservation Corporation, which is a nonprofit affiliate of Montefiore Medical Center.