New NUMC ad blitz asserts closure. Will that actually happen?

A year after the entity that runs Nassau University Medical Center asked for a state bailout, its leadership has launched a new publicity campaign attacking Gov. Kathy Hochul and suggesting the health care facility could close without more taxpayer money.

The campaign asks residents to "imagine Nassau without NUMC" and "save NUMC" by lobbying the state on behalf of The Nassau Health Care Corp. to help recoup money that would keep the hospital open. The move coincides with the hospital's $1 billion lawsuit alleging state officials since 2001 have been withholding its nonfederal portion of supplemental Medicaid funding for treating a disproportionate share of low-income patients.

The publicity campaign is the latest salvo in NUMC’s feud with the state over the fiscal health of the hospital. The health care company asserts that closure is in NUMC's future, despite the fact that shutting down has never been discussed by regulators. State officials are calling the media blitz a "distraction."

As hospital executives and the state appear to be deadlocked over the best way to secure the institution's financial future, the public airing provides a glimpse into private feuds and the political division facing health care for the underserved on Long Island.

"There is absolutely no intent on the part of the governor and our team to see the hospital close in any way," Richard Kessel, chair of the Nassau Interim Finance Authority, which monitors county and NHCC’s finances, told Newsday in a recent telephone interview. "I think that the advertising campaign that NUMC is running is shameless and completely inaccurate and a fraud."

Kessel, a Hochul appointee, has also been the target of the campaign, with negative ads on social media calling him "unqualified" and "dishonest."   

Neither NUMC CEO Megan Ryan nor a spokesman for Matthew Bruderman, chairman of the NHCC board, responded to multiple inquiries by Newsday over the campaign, including the cost, how long it would run and the veracity of its statements. 

Can NUMC close?

Despite NUMC's assertion of imminent closure with no evidence, shutting down a public hospital requires a series of steps. 

The state created NHCC, the public benefit corporation with its existence enshrined in state public authorities law similar to the Metropolitan Transportation Authority or the Port Authority. The quasi-corporations are structured like for-profit entities, but with a board of directors whose members are political appointees and protected because they were created "in the public interest." The status also applies to Westchester County Health Care, which operates Westchester Medical Center in Valhalla and Erie County Medical Center Corp., which operates an eponymous safety-net hospital in Buffalo.

NHCC treats about 275,000 patients annually and employs about 3,500 workers across its hospital, nursing home and community health clinics. 

NUMC is the 19-story hospital in East Meadow and NHCC's main facility that has been treating patients in the county since 1935. It is a Level-1 trauma center, taking on patients with the most serious injuries, and one of only 10 such hospitals in the state with a dedicated center for burn victims.

More than 70% of NUMC's patient population receive Medicaid or are uninsured. It's among a growing number of safety-net medical centers across New York and the country facing intense financial pressure. A few have closed and more are talking openly about shutting down to prevent deeper financial losses, threatening to upend the local health care landscape. 

NHCC is more than $500 million in debt, but there appears to be no state law or regulation on how much debt it is allowed to incur. The current leadership frames themselves in the media campaign as defenders of the underserved, accusing the state of not caring about the poor. In mailers to homes, commercials on cable television and social media posts, NUMC is demanding residents tell Albany, "Hands off our hospital."

NIFA Vice Chairman Rory Lancman called NUMC's campaign "fearmongering" and said hospital officials have resisted calls to secure the hospital's finances.

"NUMC cannot close because it provides essential services that Nassau County cannot do without," Lancman told Newsday in a recent telephone interview, noting the institution's protection as one of the state's three county hospitals that are public benefit corporations. "But how deep of a hole will NUMC continue to dig for itself before the state potentially has to step in some way and rescue NUMC?"

State officials say they have been working with Bruderman, Ryan and Nassau County Executive Bruce Blakeman to negotiate a long-term plan to ensure the hospital's financial stability.

Neither Kessel nor Gordon Tepper, a spokesman for Hochul, would provide an update on negotiations with hospital or county officials. 

Blakeman, who appointed Bruderman to lead the NHCC board, said he supports the lawsuit against the state and told Newsday "the state may have been skimming hundreds of millions of dollars of federal funds" that were supposed to go to NUMC. 

"We are hoping that the state comes to the table and provides the funding they're supposed to," Blakeman said during a quick exchange after a press conference on another topic. "If the state continues to defund it I guess Gov. Hochul will close it." 

If talks between the state, county and hospital fail, the state could invoke a rare state law empowering Hochul to replace the hospital's current leadership with a temporary operator, taking control of its finances and day-to-day operations.

It's a move Blakeman called "putting the fox in the chicken coop" that he said he did not believe the courts would allow.

Hochul also could ask the legislature to approve a bill that would change the structure of NHCC's board of directors. The current board comprises mostly Blakeman appointees. Closure, however, does not appear to be among the options. 

Nassau taxpayers back about $100 million, or about 20%, of NHCC's debt and institution that treats some of the poorest and sickest patients in the region.

NHCC's most recent financial statements were not available. At the end of November, NHCC was running an operating loss of $108 million. The hospital corporation had a cash balance of about $60 million, according to its internally generated and unaudited financial statements.

Financial authority officials estimate NHCC owes the state more than $400 million in state employee health insurance premium payments in addition to possible debts to vendors.

The state has not publicly demanded NHCC pay the $400 million, which officials say help float the hospital's finances.

Along with its media campaign, NUMC has also sued the state, accusing it of breaking federal Medicaid laws by withholding the hospital's Disproportionate Share Hospital payment, funds supplemental for treating a large share of low-income patients. The state owes $1.06 billion in retroactive payments going back to 2001, the lawsuit alleges.

Hospital leadership is also suing NIFA, urging the oversight board be stripped of its power to approve NUMC's finances.

"It is deeply disturbing that the current leadership at NUMC has chosen to waste valuable resources on political distractions instead of addressing critical state health requirements," Tepper, Hochul’s spokesman, told Newsday via text message. "While we cannot comment on pending litigation, I want to emphasize that the state remains committed to ensuring patient care and safeguarding the hospital's financial stability."

By Candice Ferrette

candice.ferrette@newsday.comcandiceferrette

Candice Ferrette covers Nassau County government and politics on Long Island. She has been a reporter at Newsday since 2011.