The Nassau Interim Finance Authority decided to exempt the Nassau University Medical Center and NuHealth, the public-benefit corporation that runs the East Meadow hospital, from oversight in 2011, at a time when the facility was seemingly thriving.
Since then, too many factors have impeded the hospital’s mission to serve Nassau County’s most vulnerable residents. Financial woes, politicization of leadership positions and poor quality of patient care have plagued the hospital over the past decade. Roughly 80 percent of NUMC patients are on Medicaid, Medicare or private insurance companies that do not properly reimburse NUMC. Since 2015, the hospital has lost $193.9 million, and it owes the county $188 million.
The East Meadow site is too big for the number of patients that it sees, spanning 75 acres, with a 19-story main building and 535 beds that are never close to being at maximum capacity.
At its Feb. 4 meeting, the NIFA board of directors unanimously voted to take financial control of the hospital. The authority does not control daily operations, but rather requires the hospital to submit financial contracts for review and approval, as the County Legislature has done since 2000, when NIFA was first appointed by the state.
The board’s appointment of a “turnaround consultant” is also a necessary step toward righting the ship at NUMC. The consultant will advise NIFA, the county and the state on when and how to step in to make changes at the hospital.
NIFA Chairman Adam Barsky and his fellow board members were on the mark when they addressed the hospital’s issues at the Feb. 4 meeting and decided to intervene. Criticism came from board member Howard Weitzman, a former county comptroller. The hospital’s losses, he said, were the fault of the CEOs who focused too heavily on competing with the county’s more renowned hospitals for private patients. Although Weitzman’s analysis seemed harsh, it is a brutal reality.
The hospital’s chief executive officer position has been a revolving door over the past 20 years, with roughly 10 CEOs serving in that time. And being the best hospital in Nassau was never a goal that NUMC leadership should have prioritized, because it was impossible to achieve, given its budget woes. NUMC has its own mission to fulfill to be a safety-net hospital for county patients who rely on its services.
With the hospital’s finances crumbling, so has the quality of patient care. Since the fall of 2018, NUMC has received D grades in a biannual study of patient safety at 2,600 hospitals nationwide. The Leapfrog Group, a Washington, D.C.-based nonprofit that focuses on health care, conducts the study, with the Johns Hopkins Armstrong Institute for Patient Safety and Quality. They conclude that patients at hospitals graded D or F face a 92 percent greater risk of avoidable death. The hospital earned a C each time the study was conducted from the spring of 2016 to the spring of 2017, the oldest grades Leapfrog has on record.
Nassau County needs NUMC to change its course and head in the right direction because of the integral services it provides patients who would otherwise have no other option for medical care.
The Nassau County Firefighters Burn Center is a vital resource for treating firefighters and victims of disasters and other emergencies. The hospital first established a burn center in the 1950s, and it was last renovated in 1974, before the new one was built in 2008.
The Chemical Dependency Rehabilitation Unit has 30 beds and a 28-day program to help those recovering from the disease of addiction. And since last April, a partnership with Freeport’s Maryhaven New Hope Crisis Center has connected overdose patients with addiction counselors who help them enroll in long-term recovery programs.
Now the fate of the hospital is in the hands of Robert Detor, who began his tenure as NuHealth chairman on Jan. 16, and, for the next 18 months, Anthony Boutin, the hospital’s chief medical officer, who took over as CEO on Jan. 28 while NuHealth looks for his permanent replacement.