TOWN OF WALLKILL – Garnet Health and Montefiore Health System, Inc. continue to move forward with an affiliation announced last October, but they still have not submitted an application for approval to the State Department of Health (DOH).
Meanwhile, the 1199SEIU union, which represents healthcare workers in the region, has expressed concerns about whether the affiliation could result in layoffs and impact access to care. Healthcare and legal experts told Mid-Hudson News that any hospital deal of this magnitude could face intense scrutiny due to the recent consolidation of healthcare in the Hudson Valley and potential antitrust issues.
According to a spokesperson for Garnet Health, Garnet and Montefiore Health System “have signed a definitive agreement to affiliate.”
“The affiliation remains subject to customary regulatory approvals, which are in process and are expected to take several months to more than a year to complete,” the spokesperson said. “At this time, there are no additional details to share.”
The process could take up to two years.
A spokesperson for the state DOH confirmed that it “has not received an application regarding this matter.” Asked about potential antitrust issues with a Garnet-Montefiore affiliation, the state DOH spokesperson said:
“The Department is focused on maintaining access to care and promoting efforts that improve quality of care for all New Yorkers.”
Garnet emphasized that the impending deal with Montefiore, which operates 10 hospitals and more than 200 outpatient sites, is not an acquisition. Consolidation of healthcare may have negative economic and population health impacts in a region, primarily by increasing prices and reducing access to care.
Optum Health, a subsidiary of UnitedHealth Group, which bought Crystal Run Healthcare in 2023, has received harsh criticism from Congressman Pat Ryan (D-NY-18), who has referred to it as “a monopoly that directly hurts everyone in our community.” He has brought his concerns about Optum to Attorney General Pam Bondi.
UnitedHealth is also facing multiple investigations by the Department of Justice, including an antitrust review of Optum’s acquisition of doctors’ offices. Optum has purchased medical practices across the Hudson Valley with market control of more than 2,500 providers at CareMount Medical and Crystal Run Healthcare, and 10 percent of doctors nationwide.
Following the finalization of the ownership transfer of St. Anthony Community Hospital from Bon Secours Mercy Health to Westchester Medical Center Health Network in September 2025, WMCHealth initiated a realignment of operations that included the elimination of approximately 50 union and non-union positions across its newly acquired hospitals, including St. Anthony’s in Warwick, Good Samaritan Hospital in Suffern, and Bon Secours Community Hospital in Port Jervis.
Earlier this month, Crystal Run Healthcare/Optum announced it is closing its OB/GYN practice in Rock Hill on July 1. Assemblywoman Paula Kay (D, Rock Hill) called the move “a devastating loss for women’s health in Sullivan County.”
Angela Lane, Vice President for the Hudson Valley, 1199SEIU United Healthcare Workers East, said that the union and elected officials have concerns about a potential Garnet-Montefiore affiliation.
“How would the affiliation impact competition, access to care, costs, and the healthcare workforce in Orange and Sullivan counties?” Lane said. “We believe these concerns deserve transparency and careful public review. 1199 members are on the front lines and see firsthand how these decisions affect patients, workers, and healthcare delivery in our communities.”
Citing upcoming Medicaid cuts, left-leaning advocacy group Public Citizen said 45 hospitals, including three in the Mid-Hudson, are at risk of closing or having to cut services due to Medicaid cuts approved by Republicans in Congress and the Trump administration.
Bon Secours Community Hospital in Port Jervis, Garnet Health Medical Center, Catskills in Sullivan County, and Montefiore St. Luke’s Cornwall Hospital are among 45 hospitals in the state at risk of closing or scaling back services, according to the report.
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