Charting a way ahead at NUMC

Nassau University Medical Center had its annual financial checkup recently, and the prognosis is daunting. The organization is unwell, has been ailing for years, and faces a very uncertain path to recovery.

But under new board chairman Edward Farbenblum, a tenuous way forward toward stability and a future for the facility is emerging.

Among numerous problems, the most pressing is the hospital's finances. Auditors say NUMC lost $102 million in 2020, and annual deficits have increased each year since 2017. The urgency is masked by an influx of federal money related to COVID-19, but officials say NUMC has about 24 months before the hospital goes broke. And that’s with the state currently letting $160 million in NUMC's own state health care premiums from the past few years go unpaid.

But while financial shortfalls get headlines, they are the symptom, not the disease.

NUMC is broke because it is run inefficiently and because many in the community do not trust it to give good health care. It also suffers financially because most of its customers are on Medicaid or Medicare, or are uninsured, which means low reimbursement rates, and because it offers services few patients need or want from it that torpedo its operating margins.

Add in a unionized work force married to the untenable status quo, a board dedicated to pleasing that union, and a county executive, Laura Curran, hesitant to make waves months before an election, and the most likely prognosis is death a few years hence.

But Farbenblum seems to have a found a way forward, on two tracks, and there are indications the state might help NUMC if the facility can make a start toward stability on its own.

In the short term, Farbenblum needs to show he can slow the fiscal bleeding. Given his own expertise in health care as a nursing home operator, his willingness to bring in more help where his expertise is lacking, and a consultant’s plan that offers about $50 million a year in possible savings, he’s making progress.

If those savings and efficiencies can be achieved, it would be an auspicious start. Then, if Farbenblum can show how he’d recruit top doctors, begin rebuilding NUMC’s reputation, and limit services it provides to those the hospital won’t lose a fortune providing or that customers can't get elsewhere, he’d have a very strong argument to garner needed political support from the CSEA and Curran, and crucial financial support from the state.

NUMC, with over 3,000 employees and a meaningful mission, is a political problem as much as a financial one. If NUMC does not change, it will close. That would be a disaster.

And that means the CSEA, Nassau County elected officials, Albany and the NUMC board all need to start rowing in the same direction as Farbenblum who does, at least, have a map.