While many New York hospitals face increasing financial distress, NewYork-Presbyterian Hospital is planning two major construction projects that together will cost more than $400 million.

The first is to be an eight-story, $242 million cardiovascular center at the Columbia-Presbyterian Center in Washington Heights. The Millstein Heart Hospital will be built on vacant land to the south of the present Millstein Hospital building. The new building will connect to the second floor of the original, which houses the present invasive cardiology suite.

The heart hospital will include 20 new intensive care unit beds, eight new operating rooms, a 200-seat auditorium, and other facilities.

The existing Millstein Hospital building houses 955 beds.

At the New York Weill Cornell Center, New York-Presbyterian plans to construct a six-story building to house four new operating rooms, a relocated blood bank, and two new interventional neuroradiology labs, as part of New York-Presbyterian’s decision to make the hospital one of the primary referral centers for stroke patients in New York City.

The hospital also plans to add a 12th floor to the Greenberg Pavilion at the Weill Cornell Center to house 48 surgical rooms.

In total, that project is expected to cost $169 million. New York-Presbyterian estimates that construction will begin in June and that the facilities should be open by September 2008.

The State Hospital Review and Planning Council, a division of the state Department of Health, will decide whether to approve the two projects during a December 8 hearing. A division of the state agency, the Office of Health Systems Management, has recommended that the projects be approved.

A spokeswoman for New York-Presbyterian, Myrna Manners, said the hospital is confident the projects will be approved. She added that they had already received preliminary approval from the council’s project review committee. A spokesman for the Department of Health, Joseph DiMura, would not confirm her statement.

The two development projects reflect a national trend: hospitals focusing their efforts on specialized, high profile, and highly profitable departments like cardiology and neurology.

The chairman of the Commission on Health Care Facilities in the 21st Century, Stephen Berger, told The New York Sun earlier this month that the current system encourages hospitals to move into more lucrative specialty areas, like cardiology.

US News & World Report ranks New York-Presbyterian’s neurology department as the second best in the nation and its cardiology department no.8,the only such department to make the top 10 in the New York area. The department is headed by Dr. Mahmet Oz, who performed President Clinton’s bypass surgery last year.

Cardiology can be especially lucrative, industry watchers say, because many of those who receive treatment are of the age and economic position to give large donations.

Some have criticized this trend for drawing resources away from smaller community hospitals that treat poor patients who do not have private health insurance. Without the financial support of profitable specialty hospitals, critics say, these institutions are financially unsustainable.

However, because the new facilities will be divisions of the original hospital, all earnings will contribute to NewYork-Presbyterian’s total profits.

“New York-Presbyterian is one hospital with one bottom line,” Ms. Manners said.

The hospital had revenues of $2.43 billion in 2004 and $2.41 billion in expenses.

Other New York hospitals are not faring so well.

Last June, the city’s largest Catholic hospital network, St. Vincent Catholic Medical Centers, filed for bankruptcy after years of financial losses. It has closed or announced plans to close at least three of its hospitals, including St. Mary’s in Brooklyn.

The parent company of Beth Israel Medical Center, the Continuum Health Partners, sold the 14-story Singer Division (formerly Doctors Hospital) on the Upper East Side for $185 million.

Several weeks ago, Fitch Ratings and Moody’s Investors Service downgraded Lenox Hill Hospital’s credit rating to junk status. Last year, New York-Presbyterian lured a star cardiology team lead by Dr. Jeffrey Moses to leave Lenox Hill for Columbia Presbyterian.

The Commission on Health Care Facilities in the 21st Century, which Governor Pataki convened last spring, will present recommendations in December 2006 on which New York Hospitals should be modified or closed. It has said the system must be shrunk by 10%.