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NIFA takes over finances at NUMC, reversing 2011 decision

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The seven members of the Nassau Interim Finance Authority board of directors voted last week to take financial control over NuHealth, the public benefit corporation that runs Nassau University Medical Center in East Meadow, reversing their 2011 decision to exempt the hospital from NIFA’s oversight.

“We realized that [NUMC’s] financial situation was deteriorating,” NIFA board Chairman Adam Barsky said at a board meeting on Feb. 4, when he presented the resolution. Barsky noted NIFA’s findings that the hospital owes the county $188 million, and lost $193.9 million between 2015 and 2018.

NIFA was appointed by the state to oversee the county’s troubled finances in 2000. Barsky explained that the authority was not “taking over the hospital” or controlling daily operations, but rather requiring it to submit financial contracts for review and approval, as the Nassau County Legislature does.

The next step is for the NuHealth board to give NIFA 17 “items of request” for review, which include service, employment and revenue contracts. If those contracts do not exist, Barsky said, the NuHealth board must create them and, according to the resolution, it has 60 days to do so. Failure to adhere to NIFA’s standards could result in misdemeanor charges.

“NUMC is the county’s safety net hospital, and the people served by the hospital deserve the highest standard of patient care,” said Christine Geed, director of communications for County Executive Laura Curran. “By reviewing NUMC’s procurements and contracts, NIFA will get a clearer picture of the hospital’s finances. We want to see the hospital stabilized.”

Curran recently appointed Robert Detor as chairman of NuHealth to replace George Tsunis, who had the job for two years. Detor was most recently the president and chief executive officer of Long Island Home, which runs South Oaks Hospital and Broadlawn Manor Nursing & Rehab Center, both in Amityville.

Detor could not be reached for comment by press time.

NIFA is also seeking a “turnaround consultant” to examine the hospital’s financial woes. It issued a request for proposals on Jan. 8, accepted submissions until Jan. 30 and expects to fill the position by the end of the month. The consultant will advise NIFA, the county and the state on when and how to step in to make changes at the hospital.

NIFA board member Chris Wright criticized NuHealth for having an “erratic governance process” that he said had led the hospital down a rocky path. “We need to put the spending and borrowing under some oversight on our part in order to keep that under control,” Wright said.

Since the fall of 2018, the hospital 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 in conjunction with the Johns Hopkins Armstrong Institute for Patient Safety and Quality. Their findings 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.

Wright and his fellow NIFA board members also accused NuHealth’s leaders of not prioritizing the hospital’s mission, which is to be a safety net for the county’s least insured patients.

Board member Howard Weitzman, a former county comptroller, described the hospital’s chief executive officer position as a “revolving door” of leadership over the past 20 years, with roughly 10 CEOs serving in that time. Now NuHealth is looking for a permanent replacement for Anthony Boutin, the hospital’s chief medical officer, who took over as CEO on Jan. 28 for an 18-month period.

“The first thing almost every one of those CEOs did when they came into the hospital was prepare a plan for how to compete for private patients in the county,” Weitzman said. “For 20 years, that hospital suffered losses because the egos of the CEOs required that they show that they could be the best in Nassau.”

He added that the hospital could never compete with private hospitals in Nassau County, but it has a mission to serve the public. “We also have to make sure that they find the funding source that covers what they should be doing,” Weitzman said, “which is acting as a safety-net hospital for the patients that need them.”