Nassau University Medical Center reports improvements in fiscal health

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Nassau University Medical Center reported significant improvements in its financial health at the end of last year, due in part to significant financial reforms introduced in late-2023, despite an ongoing funding battle with state officials that hospital administrators say threatens its long-term stability.

NUMC, Long Island’s largest public safety-net hospital, serves all patients, including the uninsured and undocumented, regardless of their ability to pay for medical care.

In November 2023, Matthew Bruderman, board chairman of the Nassau Health Care Corporation, which oversees NUMC’s operations, unveiled an aggressive financial sustainability plan.

The plan called for the hiring of a chief financial officer, the implementation of timely monthly financial statements, the renegotiation of many of the hospital’s contracts, the creation of a financial dashboard with daily cash balances available, and an updated charge master and billing software. Those reforms and additional upgrades to services have resulted in a substantial turnaround for the hospital — without any financial assistance from the state, hospital officials said.

NUMC ended 2024 with nearly $80 million in its cash reserves, up from $28 million in December 2023 — a whopping $49 million increase. Recent financial reports also show that NUMC’s revenue was up $6.2 million in November 2024, and its operating expenses were down $1.7 million, when compared to 2023 numbers.

The reforms produced the hospital’s first on-time budget ever, and the fiscal improvements slashed the projected budget deficit for the hospital by more than 56 percent over 12 months, according to a Dec. 31 hospital news release.

NUMC’s financial turnaround has transpired despite currently pursuing legal action against New York state for allegedly orchestrating a ruse to withhold Medicaid reimbursement payments the hospital was entitled to, since at least 2001. In November, a notice-of-claims was sent to the state, outlining NUMC’s plan to file a lawsuit for $1.06 billion.

The following month, the hospital also filed a suit against the Nassau County Interim Finance Authority, claiming gross negligence and abuse of power. The finance authority assumed financial oversight over NUMC in 2020, citing poor financial conditions but failing to acknowledge the state’s actions, which included a reduction in aid, the hospital said.

The state, in response to the claims, told the Herald: “We are continuing to work with Nassau County on an appropriate solution for the future of NUMC. Our concerns are the fiscal health of the hospital and patient care.”

Bruderman said, “the course of treatment we laid out last year for the long-term fiscal health of the hospital is working,” adding that the finance authority and the state continue to mislead the public about NUMC’s finances.

“We’ve proven conclusively that if Albany would only comply with federal Medicaid law and restore even a portion of our aid, NUMC will be profitable,” Bruderman said. “While NUMC was barely making payroll when I arrived, the hospital (ended) 2024 with $80 million in the bank. Unfortunately, despite our progress, we’ve seen little interest on the part of state to choose patients over politics.”

During the last year, NUMC has also expanded its clinical services, revamping a multitude of patient areas, and received the Gold Seal of Approval from the Joint Commission, a nonprofit organization that evaluates and accredits health care organizations and programs nationwide. NUMC also received an elevated safety grade from the Leapfrog Group, another nonprofit that collects and publishes data on health care safety and quality.

“This is the most significant financial improvement NUMC has shown in years,” Megan Ryan, president, chief executive and chief legal officer of the health care corporation, said. “NHCC has made tremendous progress to enhance NUMC’s financial health and ensure the hospital moves toward long-term fiscal sustainability. Our staff have played an invaluable role in making this reform program a tremendous success.”

Ryan also expressed frustration with the ongoing funding dispute with the state.

“It is beyond comprehension that while we continue to improve, the State continues to ignore their legal obligation to provide critical funding for our at-risk patient population,” she said. “The reform program is proving that with the support to which we are legally entitled, NUMC will not only survive but be profitable and a model for other safety-net institutions.”