One afternoon late last week, a nurse manager at St. Vincent’s Midtown Hospital walked into the sixth-floor medical and surgical ward looking for a fax machine. She found a nearly deserted hallway.

“Oh, it’s gone,” Marva Smith, 55, said. She glanced around a unit that had been emptied of its patients and equipment in preparation for the hospital’s closing this week. “The fax machine is gone already,” she said to no one in particular.

St. Vincent’s this week will become the first hospital in the city to close under directives handed down by Governor Pataki’s Commission on Health Care Facilities in the 21st Century. Overall, nine hospitals statewide and five in New York City are slated for closure by 2008 — though few are going quietly.

In accepting its fate, St. Vincent’s will incur $100 million in closing expenses despite an objective of the Berger Commission to streamline health care spending by reducing the number of hospital beds in the state.

“There’s a lot of expense that we are incurring that we normally wouldn’t incur,” the hospital’s chief financial officer, John Mertens, said.

Like other hospitals, St. Vincent’s, the former St. Clare’s, initially fought to stay open. Following a rocky decade that included bankruptcy, the 250-bed hospital in 2003 became part of the Saint Vincent’s Catholic Medical Centers network that includes St. Vincent’s Manhattan Hospital in Greenwich Village. Last month, the network announced it was set to emerge from its own bankruptcy nearly two years after filing for Chapter 11 protection.

An early proposal by the Midtown hospital, situated on West 51st Street, called for strengthening ties with the network and its downtown hospital.

“We fought it,” the vice chairwoman of the hospital’s board of directors, Sister Jane Iannucelli, said. “We went to Albany. We went to members of the Berger Commission. We went to every place that was important and significant and said how foolish it was to do this,” she said. “There was no answer except, ‘You’ll close.'”

In March, hospital administrators began to evaluate how long they could afford to stay open. As patient volume decreased, the hospital settled on a close date of August 31.

St. Vincent’s will close officially Friday at the stroke of midnight, when it stops accepting new patients and ambulances are routed to other facilities. Ultimately, the hospital’s inpatients will be transferred to St. Vincent’s in Greenwich Village, which also will absorb the Midtown hospital’s AIDS center and methadone clinic.

However, it will take at least another year until the corporation is completely shut down.

Mr. Mertens said the hospital owes $35 million to bond holders, and it will pay another $25 million to third-party payers such as insurance companies. The hospital is expected to post a $10 million operating loss this year, and after spending at least another $10 million on vendor bills, the hospital must pay severance to roughly 700 employees.

In interviews, hospital executives said most of the costs associated with closing will be covered by the sale of the hospital’s property for $90 million, a deal that is under contract and could close in mid-September. They also said they hope to receive another $10 million in grants from a state and federal pool set aside to help hospitals pay closing or restructuring costs.

Indeed, in its executive summary, the Berger Commission authors cited the expense associated with closing, but wrote: “Without intervention, our providers will spiral further into debt and be forced to make difficult decisions to cut services and lay off workers.”

Outside observers said it remains to be seen if the expense of closing hospitals will ultimately yield savings. “If we fast-forward three years or five years from now, will we have saved any money, or will we have changed the hospitals people go to and not really have saved any money at all?” a health policy analyst at the Manhattan Institute’s Empire Center for New York State Policy, Tarren Bragdon, said.

Despite the best-laid plans, hospital executives acknowledged that some staff members believe the hospital gave in too easily, and that closure may pose a public health risk. In fact, two of the five city hospitals slated for closure are staging legal battles in an effort to stay open, including Parkway Hospital in Queens and New York Westchester Square Medical Center in the Bronx.

“All one has to do is spend one minute in my emergency department to know this is a mistake,” the head of St. Vincent’s emergency department, Dr. Robert Labinson, said.

But executives at St. Vincent’s said that upon losing their battle, they elected to work with — rather than to antagonize — the state’s Department of Health in order to receive much-needed grant money to help pay for closure.

“It’s law, we have to close,” the hospital’s senior vice president and chief operating officer, Regina Zuvich, said. “And so we had to make a decision: How would we close? We decided to do it in an orderly and responsible manner.”

Ms. Zuvich also said that by closing first, there would be better job opportunities for hospital employees, a quarter of whom already have jobs, she estimated. In interviews, several hospital leaders said they are not yet seeking jobs themselves. “We can’t jump ship,” the vice president of operations, Michael Antoniades, said. “We have so much on our plate,” he said.

Among the tasks, there is the equipment to consider. Next month, everything from office furniture to hospital beds will be sold at auction. The hospital must also arrange and prepay for storing personnel files and patient records, as the law requires patient records be kept for 10 years. The hospital’s staff is also helping patients find new treatment options. “We can’t leave them without resources, and we can’t close unless we have done all these things,” Sister Iannucelli said.