Nassau University Medical Center in East Meadow, Sunday, Nov. 26,...

Nassau University Medical Center in East Meadow, Sunday, Nov. 26, 2023 Credit: Newsday/J. Conrad Williams Jr.

Now that the state budget is finalized, it’s time to consider other items on the state’s to-do list that were pushed to the side. Some can wait. Others — including the future of Nassau University Medical Center — require urgent action.

Last month, the state Health Department issued a detailed letter to NUMC interim chief executive Megan Ryan and board chairman Matthew Bruderman, making specific demands before the state would further fund the struggling public mission hospital. It was a good start. And the state has taken other long overdue steps, such as encouraging important changes to the hospital’s board.

NUMC and its public benefit corporation, the Nassau Health Care Corp., responded twice to the state’s demands. Neither response reflected the severity of NUMC’s needs, took full responsibility for current failures, or promised significant specific reform.

Some of what they said was untrue, like the contention that “ . . . the NEW NHCC leadership has been taking swift and immediate action to turn around the decades of financial mismanagement.” Bruderman has been in office for two years, Ryan more than nine, and neither has turned anything around.

Responding last week, State Health Commissioner James McDonald spelled out how NUMC’s response fell short, listing eight requests that remain “outstanding.” The hospital’s five-year transformation plan, McDonald said, was “insufficient.” Its organizational chart was “not legible.” Its gross compensation list didn’t include everyone. Its information on how much was spent on lobbying was incomplete. And its accounting of how state funding supposedly had fallen “continues to represent State aid inaccurately.”

The most worrisome missing piece is the lack of a “professional and public search” for NUMC’s next chief executive. To date, the hospital hasn’t even promised such a search, focusing on an internal review instead of finding new leadership. That raises the concern that NUMC is just doing a perfunctory search to guarantee that the choice is Ryan, its current interim CEO.

That would be unacceptable.

Additionally, the Nassau Interim Finance Authority, the state’s fiscal watchdog, needs to continue approving NUMC’s actions. NUMC has questioned NIFA’s legal authority; McDonald affirmed it. That should be the end of the matter.

Meanwhile, Nassau County Executive Bruce Blakeman has played politics, blaming Gov. Kathy Hochul rather than taking real action, such as replacing Bruderman and other board members. McDonald gave NUMC 30 days — until mid-May — to respond. By then, it’s unclear whether the hospital will have funds to function and pay staff.

If NUMC doesn’t comply with the state’s demands, heads should roll. The state has the power to take over the hospital and install a temporary operator. NUMC can’t survive, much less thrive, with its current leadership.

The hospital remains in critical condition. Emergency care is now needed from the county and the state.

MEMBERS OF THE EDITORIAL BOARD are experienced journalists who offer reasoned opinions, based on facts, to encourage informed debate about the issues facing our community.

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