Change is needed from the top down at NUMC

Nassau University Medical Center is accusing New York State of game-playing, suggesting the state owes the hospital money and isn’t treating it fairly. But it’s the hospital that’s playing games — with its patients, staff and finances. It has gone on for too long.

NUMC and its public benefit corporation, Nassau Health Care Corp., suffer from a toxic mix of mismanagement, poor governance and troubled finances, all the result of prioritizing patronage over patient care. For more than a year, state officials have tried to work with hospital and county officials, by providing clear directives and meeting with Nassau County Executive Bruce Blakeman. But NUMC’s leaders, including the board, chairman Matthew Bruderman and chief executive Megan Ryan, refuse to take the steps needed to improve hospital finances and management.

NUMC, in lawsuits filed against New York State and the Nassau Interim Finance Authority, the county’s fiscal watchdog, claims the state committed fraud and owes NUMC $1 billion in payments for distressed hospitals.

Let’s set the record straight.

The “disproportionate share hospital” payments, as they’re known, are part of a byzantine and long-established funding system involving the hospital, county, state and federal governments. But the county and the hospital have yet to present any evidence that the state defrauded NUMC of anything. Yet, Bruderman and Ryan are bizarrely counting the $1 billion they hope to win in court as ready cash in their budget projections and debt analyses. That strategy allows them to say that they reduced NUMC’s operating deficit by $100 million and no longer owe more than $400 million to the New York State Health Insurance Program, or NYSHIP, which handles medical insurance for employees and retirees.

Both claims are false.

Meanwhile, NUMC officials are seeking more money from Gov. Kathy Hochul and state lawmakers in current budget negotiations. The final budget is likely to include funds for distressed hospitals; the State Senate’s counterproposal provides $1.5 billion. However, any share for NUMC should come with strings attached. Sweeping changes are needed. That starts at the top. The proposal to amend state law to allow for the possibility of installing a “temporary operator” at a failing facility like NUMC would be a first step. The hospital also requires an overhaul to its board, long stacked with political appointments.

Currently, the county executive and county legislature appoint or recommend the majority of board members. The county executive picks the board chairman and approves the CEO. Giving the state — which is responsible for much of NUMC’s funding and oversight — a greater say would help. NUMC needs capable, thoughtful professionals throughout.

The slogan promoted by Ryan is correct: “Nassau Needs NUMC.” But no one needs the dysfunctional mess Ryan oversees. County residents need a thriving, well-managed safety net hospital. With the state’s intervention, they might get it.