Officials Order Yale To 'Cease Use, Occupancy' Of Hospital ER Annex

NEW HAVEN, CT —There are 35 fewer beds at the emergency room today.

When it was built in December 2021, the Yale New Haven Hospital York Street campus emergency department annex was meant to be a temporary structure to handle a high volume of patients in part as a result of the coronavirus outbreak.

Now, according to state public health department documents obtained by Patch, the annex has been ordered closed effective this past Wednesday for code violations.

In a Patch request for confirmation on the shut-down, state Department of Public Health spokesperson Christopher Boyle noted that it was not the health department that ordered it to close. He said that on April 10, the health department received a copy of the city's Building Department's order to Yale New Haven Hospital to "immediately cease use and occupancy of the ED Annex" as its temporary certificate of occupancy lapsed on Feb 23, 2023."

The state health department's letter to Yale forwarded to Patch notes that the waiver it had granted in March "is revoked, effective immediately."

Boyle said that, "As we indicate in the letter, DPH will pause any further review of this space until YNHH completes the building approval processes with the City and State that ensures that patients receive care in a structurally safe place."

When asked what is preventing Yale New Haven Hospital from complying with building regulations, hospital executive vice president and chief operating officer Michael Holmes told Patch the hospital has been, “Working with city and state building officials collaboratively since December 2022 to find a pathway forward."

“Those conversations will continue,” he said, adding, “A resolution is needed so we can continue to meet community need.”

In December 2021, the annex was 'temporary' but necessary

Yale New Haven Hospital announced it would build a "temporary patient care structure on what is now the West Pavilion entrance driveway," in December 2021.

It noted at the time that the structure would "accommodate 35 emergency patients with less-serious illnesses or injuries who will likely be discharged from the ED after treatment." Adding that the existing York Street Campus emergency department "would be used for patients with more serious conditions."

At the time, hospital officials said that both the York Street and Saint Raphael campuses were "experiencing patient volume surges before COVID-19."

"While there was a lull during the pandemic’s height, the surges have resumed, it noted, adding that it expected "COVID-19 and flu cases will likely add to the volume this winter."

Holmes said at the time the annex structure was "temporary" but necessary.

“But with record volume, rising COVID-19 cases and the coming flu season, we must take steps to ensure we can continue providing the safest, highest-quality care in the most appropriate settings," he said in 2021.

Created for 35 beds, YNHH told the state health department that it needed the additional space, albeit temporarily, to "accommodate patient surges related to the COVID-19 pandemic." But over the course of more than a year, repeated waiver deadlines permitting the site to remain open came and went.

The city told Yale on Feb. 16 that it had until Feb. 23 to correct code violations or vacate the emergency room annex and lose its Certificate of Occupancy.

On March 1, DPH met with YNHH leadership to "discuss the ongoing use of the ED Annex to treat patients." Yale told health officials, according to DPH, that it was "working with building inspectors from both the City and the State to resolve code issues and represented that it had been having difficulty getting answers from each."

But, health officials said, "at no time during the March 1st meeting did YNHH leadership reveal to DPH that the City’s Certificate of Occupancy already had expired a week earlier on February 23, 2023, and that the City had told YNHH that it was to vacate the ED Annex by that date."

When Patch reached out to Yale New Haven Hospital president Dr. Keith Churchwell for comment, spokesperson Dana Marnane forwarded the following statement via email:

"Yale New Haven Hospital ceased use of its ED Annex after receipt of a letter from the City of New Haven. For more than a month prior, the hospital leadership had been working with city and state officials to obtain an extension of the Certificate of Occupancy due to the continuing high volume of patients. YNHH leaders are meeting with state and city officials and are optimistic we will come to a resolution."

In a late Saturday phone interview, Holmes explained how vital the annex is to the community.

Over the last year, the 8,000 square foot, 35-bed annex has served 30,000 patients, 24 hours a day, seven days a week, 365 days a year, Holmes said. All the patients in the annex are ambulatory and only primary care is provided, much-needed primary care, he noted.

“The annex allows us to treat all with dignity. We deliver the best care, and we treat everyone, regardless of ability to pay. It’s really a 24-7 portal for people” who cannot get care from primary care physicians, urgent care clinics and other healthcare facilities on off hours.

“Taking patients regardless of their ability to pay is the best investment in social justice and patient health,” Holmes said. “As the largest safety net hospital with a Level 1 trauma in the ED, we take patients from across Connecticut. Without the ED annex, we are challenged to treat all those patients.”

Holmes opined that it’s unfortunate “building regulations that can be mitigated get in the way of a 24-7 portal for patient care.”

Read the full DPH letter to Yale New Haven Hospital here:

DPH Rescission Letter to YN... by Ellyn Santiago

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