It's time for the state to take over Nassau University Medical Center

The numbers don’t lie.

A recent audit of the Nassau University Medical Center by the Grant Thornton accounting firm showed that NUMC’s public benefit corporation, Nassau Health Care Corp., ran a deficit of $141.9 million in 2023 — the second-largest deficit in the hospital’s history.

“These matters raise doubt about NHCC’s ability to continue as a going concern,” Grant Thornton auditors wrote. The “going concern” warning is standard language used when a company may not survive beyond a year.

Yet in a news release responding to the audit, NUMC board chairman Matthew Bruderman is quoted as saying the hospital has had “tremendous success” thanks to the “tireless work” of interim chief executive Megan Ryan. The release argues that “the prescription is working.”

“The numbers don’t lie,” Ryan says in the release.

But they don’t tell the story NUMC officials seem to think they tell. And the prescription isn’t working.

The audit results, Grant Thornton’s legitimate concerns, and the last several years of inadequate leadership, financial losses, mounting debts, and poor decision-making paint a reality far darker than the utopia NUMC officials are describing. Instead, it’s a picture of an important Long Island institution — a 530-bed public mission hospital that handles more than 178,000 patient visits a year and employs nearly 4,000 people — that’s in critical condition and needs a complete makeover and competent new leadership.

MISLEADING SUCCESS

So, what is this tremendous success that Bruderman and Ryan are applauding? It appears to be a decrease in the deficit from a high of $164 million in 2022, and according to the news release, an increase in the hospital’s cash position, which hospital officials said improved to $57 million.

But that cash position is tenuous at best, as its cash levels have been dangerously low for months. Those familiar with NUMC’s finances note that much of the recent NUMC cash boost is due to one-time payments the hospital was owed — one-shots that won’t come again and won’t sustain the hospital in the long term. And despite officials’ focus on a one-year dip, the hospital’s budget gap has more than tripled in size over the last six years.

NUMC’s financial difficulties go beyond the audit findings and the lack of cash. Most significantly, Nassau Health Care Corp. owes about $340 million to the New York State Health Insurance Program, which handles health insurance for NUMC employees and retirees. The hospital has been paying $2 million a month to cut into past arrears but isn’t paying its current premiums, increasing its debt. Last year, the health insurance program noted that an agency in default “risks termination of NYSHIP coverage . . . ”

That means NUMC has put its own employees and retirees at risk. While the health insurance program hasn’t taken further action, and NUMC officials have said they’re paying what they agreed to pay, that risk remains. The hospital is in a precarious position for its patients, employees, and retirees.

ERRONEOUS BLAME

NUMC officials, wrongly, have long blamed “cuts” in state funding for their troubles. The reality is that it’s the state that’s keeping NUMC afloat, even providing a $60 million payment to the health insurance program that NUMC itself couldn’t cover.

Bruderman and Ryan have had enough chances to acknowledge the depth of NUMC’s difficulties and to develop a serious plan to remake the hospital. They cannot be left at the helm any longer.

It’s time for Gov. Kathy Hochul to take over NUMC and NHCC and install a knowledgeable, experienced operator to run the hospital and develop a smart, workable plan for its future. She must use every tool available, including a state law that allows her to appoint a temporary operator when a facility is “experiencing serious financial instability that is jeopardizing existing or continued access to essential services within the community.”

NUMC fully meets that criteria.

The law is clear that such an operator would have “sole control and sole responsibility for the operations of that facility.” That means the person Hochul installs would report directly to the governor. The selected operator must be authorized to make very tough choices, unhampered by the political patronage that has long strangled the hospital and its leadership. The governor must also replace the board of directors which has not fulfilled its duties.

This is a key moment. Hochul has the chance to move beyond the politics that infect the hospital and show she has the resolve required to take ownership of a long-troubled, but deeply important institution. By choosing the right person and giving that individual the power to do what’s necessary, Hochul could be key in making NUMC the health care facility Long Island residents deserve.