By SHARON OTTERMAN
Published: April 6, 2010

The board of St. Vincent Catholic Medical Centers voted on Tuesday night to close its flagship hospital in Greenwich Village, ending its long struggle to stay afloat despite millions of dollars of debt.

The exact timing for the closing of St. Vincent’s Hospital Manhattan, which has about 400 inpatient beds, was not immediately clear, but the process of shutting down has already begun, and the State Department of Health will become involved to ensure an orderly closing. Elective surgeries are to end by April 14.

“The decision to close St. Vincent’s Hospital Manhattan inpatient services was made only after the board, management and our advisers exhausted every possible alternative,” Alfred E. Smith IV, chairman of St. Vincent Catholic Medical Centers, said in a statement. They were unable to come up with a plan, he said, “to save the inpatient services at the hospital that has proudly served Manhattan’s West Side and downtown for 160 years.”

Gov. David A. Paterson said Tuesday that he would work with the board and the Department of Health to preserve some of the hospital’s most important community functions, perhaps by scaling it down to an urgent care center that could take patients with conditions ranging from ankle sprains to heart attacks. That plan would also try to maintain some outpatient services, like those that provide H.I.V. treatment and primary care, but it remains at a conceptual stage and would require finding a partner, people close to the process said.

In the meantime, outpatient services will continue without interruption, the board said.

The hospital and a task force convened by the governor had tried without success to find another hospital to absorb or unite with St. Vincent’s.

“While we are disappointed that we were unable to find a partner for the acute care inpatient services,” the governor said in a statement, “we should use this as an opportunity to ensure that the health care needs of this community are met by creating an urgent care center combined with other vital health care services the community needs. To that end, I have directed the Department of Health to solicit proposals for this new model of care.”

With its vote, the board effectively closed the last Roman Catholic general hospital in New York, a beacon in Greenwich Village that has treated victims of calamities from the sinking of the Titanic to Sept. 11. In recent years, its management troubles were worsened by the difficult economics of the health care industry, changes in the fabric of a historic neighborhood and the low profit in religious work.

The search for a partner hospital, which would be needed to maintain an urgent care center, is already under way. Mount Sinai Medical Center, which recently withdrew a bid to partner with St. Vincent’s to keep its acute care hospital open, has indicated some interest, according to an official involved in the restructuring efforts who insisted on anonymity because he was not authorized to comment. Mount Sinai officials could not be reached for comment late Tuesday.

Christine Quinn, the speaker of the City Council, who represents the neighborhood, called on the governor not to approve any closing until an urgent care plan was in place.

To satisfy its creditors, the hospital may sell or lease much of its valuable Greenwich Village real estate, as it drastically reduces its staff of doctors, nurses and others, to repay its estimated $700 million of debt, people involved in the hospital’s restructuring efforts said.

St. Vincent’s now gets most of its admissions through its emergency department, which could be a natural match for an urgent care facility. But with vastly reduced services, it would no longer be a Level 1 trauma center, so patients with high-level emergencies would be routed to full-service hospitals.

An urgent care center could remain open all night, but patients could not stay more than 24 hours, and would be discharged or transferred to another hospital if they required inpatient care.

Anemona Hartocollis contributed reporting.