IN RE: the Application of Lenny Nartowicz (2026)

The following papers numbered EF 1-13 read on this Order to Show Cause by the petitioner for a Judgment requiring respondent M.A. to discharge himself forthwith from Long Island Jewish Medical Center and other relief.

PAPERS NUMBERED

Order to Show Cause - Petition - Exhibits EF 1-13

Upon the foregoing papers and following a virtual hearing held in this Part on July 27, 2026 in which petitioner, respondent and respondent's guardian ad litem appeared, it is ordered and adjudged that this Order to Show Cause by the petitioner for a Judgment requiring respondent M.A. to discharge himself forthwith from Long Island Jewish Medical Center ("the hospital") and other relief is decided as follows:

Respondent M.A., a 40-year old male, has resided at Midway Nursing Home ("Midway") in Maspeth, New York since February 2022. He is a paraplegic and requires assistance with his activities of daily living. He also has a suprapubic catheter for urine drainage and a colostomy bag in place. He was sent to the emergency room of the hospital on April 20, 2026 after he was found to have blood in his urine. At the emergency room, he was also found to have low blood pressure and an elevated heart rate. Respondent's bladder was irrigated, and he received one unit of blood and fluids in the emergency department and was admitted to the Hospital for

monitoring. Respondent was deemed medically stable for discharge on April 23, 2026, and was given a discharge notice dated May 13, 2026. However, respondent has refused to return to Midway and has refused discharge from the hospital.

Petitioner commenced a special proceeding and filed an Order to Show Cause pursuant to Public Health Law § 2801-c to require the respondent to discharge himself from the hospital. This court signed the Order to Show Cause and appointed Mark J. Keller, Esq. as guardian ad litem for the respondent. The court thereafter held a virtual hearing on the Order to Show Cause on July 27, 2026.

At the hearing, Diego Martinez, the Social Worker Senior Manager testified on behalf of the petitioner. He stated that the respondent is stable for discharge from the hospital, and the appropriate discharge plan is for him to return to Midway. Mr. Martinez stated that when the respondent expressed concerns about returning to Midway, the hospital explored approximately 200 other nursing facilities across the state, but there was no appropriate alternative available. He testified that no other facilities have accepted him for long term care. Mr. Martinez testified that the respondent expressed that Midway was not allowing him to leave its facility for medical and personal appointments, and he believed that Midway was neglectful with his care. He further testified that the respondent stated that his ability to leave Midway for social reasons was limited. Mr. Martinez noted that the respondent is not permitted to leave the hospital to visit with friends, and he opined that the hospital is a more restrictive environment than a residential healthcare facility.

According to Mr. Martinez, after he gave the respondent the discharge plan, the respondent appealed it. IPRO, a quality improvement organization that manages appeals in accordance with a contract with the New York State Department of Health, rendered a decision on the appeal on May 14, 2026. IPRO agreed that hospital services for the respondent were no longer medically necessary and an appropriate discharge plan has been established for him.

Mr. Martinez, upon questioning, testified that he learned from Midway that the respondent violated its policies that allowed the residents to go out into the community. He stated that he was informed that the respondent misled Midway on various occasions and did not return to the facility within the time parameters of Midway's policies. Mr. Martinez testified that it was his understanding that any resident in a skilled nursing facility needs permission to leave the facility, and it must be approved by the administrator.

Dr. Doreen Chung, the Chief of Urology at North Shore University Hospital, then testified on behalf of the petitioner. Dr. Chung stated that respondent has been her patient for approximately one year and was coming to her office approximately every three weeks to change his catheter. She stated that he has been stable for discharge since April 23, 2026, and she further testified that Midway is an appropriate facility to care for his needs. In addition, Dr. Chung opined that it is in the respondent's best interests to leave the hospital and return to a long term care facility, and he subjects himself to additional risks by being in an acute care setting.

Respondent then testified that in the last year Midway began to require him to have an escort if he was leaving the facility for a medical appointment. He further testified that Midway required him to have medical visits via telehealth unless they involved critical care. He further explained that Midway placed restrictions on his ability to socialize in the community. Respondent acknowledged, however, that his ability to move around at the hospital is more restrictive than at Midway.

The Public Health Law requires a hospital to "admit any person who is in need of immediate hospitalization with all convenient speed ..." (Public Health Law § 2805-b[2].) In addition, Public Health Law § 2801-c permits the Supreme Court to "enjoin violations or threatened violations of any provisions of this article; and it may enjoin violations of the regulations of the department adopted thereunder." Further, 10 NYCRR § 405.9(f)(7) provides that every removal, transfer or discharge of a patient from a hospital "shall be carried out after a written order made by a physician that, in his/her judgment, such removal, transfer or discharge will not create a medical hazard to the person or that such removal, transfer or discharge is considered to be in the person's best interest..." Additionally, 10 NYCRR § 405.9(h)(7)(ii) states that "[p]atients discharged from the hospital by their attending practitioner shall not be permitted to remain in the hospital without the consent of the chief executive officer of the hospital..."

The court finds that the petitioner has demonstrated its need for a mandatory injunction to discharge the respondent from the hospital. (Matter of United Health Servs. Hosps. Inc. (J.W.), 47 Misc 3d 1202[A][Sup Ct, Broome County 2013].) Although mandatory injunctions are not common, where a party acts deliberately and intentional, a mandatory injunction requiring the party to cease is proper. (Matter of Wyckoff Hgts. Med. Ctr. v Rodriguez, 191 Misc 2d 207, 209 [Sup Ct, Kings County 2002].) All the relevant hospital discharge guidelines in New York, as set forth in 10 NYCRR § 405.1, et seq. were followed in this matter. Respondent received a written notice of discharge following a medical assessment by the hospital. Respondent appealed the discharge, which was denied.

The hospital has established that it made diligent efforts to find an alternative facility for the respondent. Mr. Martinez testified that they looked into 200 other facilities, but Midway was the only appropriate one that would accept the respondent. Further, as explained by Dr. Chung, respondent is medically cleared for discharge and is at risk for further infection by remaining in the hospital, particularly given his medical history.

Moreover, by remaining in the hospital, the respondent is utilizing the very scarce resources that the hospital has to treat ill patients. As noted above, under the Public Health Law a hospital is required to "admit any person who is in need of immediate hospitalization with all convenient speed ..." (Public Health Law § 2805-b[2].) A hospital will be unable to fulfill this statutory obligation if patients, such as respondent, continue to occupy beds and utilize resources that are needed to treat seriously ill patients. "Hospitals have a duty not to permit their facilities to be diverted to uses for which hospitals are not intended." (Lucy Webb Hayes Natl. Training School for Deaconesses & Missionaries v Goeghegan, 281 F Supp 116 [D DC 1967].) Furthermore, the Superior Court of New Jersey granted an injunction permitting a hospital to remove a patient, noting that "overcrowding [of a hospital] ... poses a real danger in that those patients actually in need of emergency medical care might receive less than optimal care if the overcrowding persists." (Jersey City Med. Ctr. v Halstead, 169 NJ Super 22, 404 A2d 44 [1979].) The Superior Court of New Jersey further stated that a hospital owes a duty to the public "to take all steps necessary to insure that adequate care is available to those in need of it, and this includes the removal of patients no longer in need of medical care." (Jersey City Med. Ctr. v Halstead, id.) Thus, the respondent's continued hospitalization not only unnecessarily consumes scarce resources but also impedes the hospital's ability to meet its obligation to provide prompt care to needy patients who require immediate hospitalization.

Accordingly, this Order to Show Cause by the petitioner is granted, and it is

ORDERED AND ADJUDGED, that respondent shall discharge himself from Long Island Jewish Medical Center forthwith, but no later than the time that arrangements have been made to transfer him to Midway Nursing Home or any other appropriate long term care facility, and it is further

ORDERED AND ADJUDGED that respondent is directed to charge the battery on his electric wheelchair or permit Long Island Jewish Medical Center to do so, and it is further

ORDERED AND ADJUDGED, that in the event the respondent refuses to discharge himself from the hospital as set forth herein, the petitioner may submit an ex parte Order, which directs the Sheriff to remove the respondent from his room at Long Island Jewish Medical Center, and it is further

ORDERED, that the records of this proceeding shall be kept under seal and not open to the public, and the documents in this file may only be accessed and viewed by the parties, parties' attorneys, and court personnel, and it is further

ORDERED, that the guardian ad litem appointed herein, Mark J. Keller, Esq., shall submit an affirmation of legal services rendered for his fee and disbursements.

Dated: August 19, 2026

CARMEN R. VELASQUEZ, J.S.C.

Carmen R. Velasquez, J.