New York Attorney General Letitia James on April 13 announced a settlement agreement with New York-Presbyterian Hospital following an investigation into the way the health care provider has treated some patients with mental health issues. NY-Presbyterian is paying $500,000 for its misconduct and faces a $10,000 penalty per violation for any future violations of the settlement terms.
The investigation by James’ office found a pattern of failures that put vulnerable patients at risk. Failures included not properly evaluating and stabilizing patients in emergency departments, leaving critical psychiatric beds offline during a worsening mental health crisis, and frequently diverting ambulances from bringing mental health patients to the emergency department. The settlement requires NY-Presbyterian to implement extensive reforms to better serve emergency department patients experiencing mental health and substance use challenges and improve its screening, stabilization, and documentation procedures.
The settlement said that NY-Presbyterian operates 10 hospital campuses in New York City and Westchester and named Hudson Valley Hospital in Cortlandt Manor and NY-Presbyterian Westchester in Bronxville.
“Mental health care is necessary medical care, and hospitals have a legal and moral obligation to treat these crises with urgency and compassion,” James said. “These sweeping reforms will protect patients, strengthen oversight, and help ensure that no one is left without care in their most vulnerable moments.”
The attorney general’s investigation found that patients were routinely discharged without the care, stability, or follow-up support they needed, and NY-Presbyterian’s records did not always include complete or accurate documentation.
In multiple cases, patients experiencing serious psychiatric symptoms left the hospital before being properly discharged or transferred due to inadequate supervision and safety protocols, putting both patients and the public at potential risk, the investigation found.
The investigation found that NY-Presbyterian failed to bring all of its licensed inpatient psychiatric beds back online after the Covid-19 pandemic, despite clear legal requirements and growing demand for care. The settlement said that 23 beds at NY-Presbyterian Westchester Behavioral Health had been taken out of service as a result of Covid and not timely restored. The settlement requires Westchester Behavioral Health to add two inpatient psychiatric beds, for a total of 235 licensed and operational inpatient psychiatric beds, by December 2026.
The settlement specifies that NY-Presbyterian must strengthen its screening policies to identify risks such as suicide, violence, and substance use, with required follow-up assessments and ongoing reassessment for higher-risk patients. It must also strengthen patient safety and monitoring, including establishing mandatory observation protocols, maintaining monitoring logs, and documenting clinical decisions. If a high-need patient goes missing, staff must immediately escalate the situation, notify leadership, and fully document and review each incident.
Other requirements include NY-Presbyterian improving its electronic health record system to ensure providers have real-time access to complete patient information and can follow care protocols. NY-Presbyterian also is required to ensure that patients with complex needs leave the hospital with appropriate follow-up care, including scheduled appointments and connections to ongoing services.
