Nassau University Medical Center is in critical condition

Hospitals impending financial crisis threatens Nassau’s most vulnerable populations


Since 1935, Nassau University Medical Center has been the cornerstone of medical care in the county and one of the largest hospitals on Long Island. But by this time next month, there is a very real possibility that the Island’s only Level I trauma and burn center may be forced to close.

The hospital — located on the border of East Meadow, Uniondale and Westbury, serves as a crucial medical lifeline to some of the county’s most vulnerable residents, serving over 300 patients a day, 70 percent of which are minorities, including patients from the Nassau County Correctional Center, according to officials.

Despite its importance, NUMC is the county’s most vulnerable public hospital, struggling with perennial financial problems and operating at nearly a $180 million loss for 2023, according to the Nassau Health Care Corporation, or NuHealth, the public benefit corporation that runs the hospital.

In an open letter to Matthew Bruderman, NuHealth’s chairman, written in late December, County Legislator Siela Bynoe, demanded that NuHealth provide details on the hospital’s fiscal condition and any solutions they have been trying to implement to keep them afloat.

“We are now in the window of time in which experts have warned that the Corporation may become insolvent and cease to operate,” Bynoe wrote. “Yet, the Legislature and the public remain in the dark as to whether NUMC’s doors will remain open into this New Year. Outside auditors have warned for five consecutive years that the collapse of the Nassau Health Care Corporation — and thereby the closure of Nassau University Medical Center and the A. Holly Patterson Extended Care Facility — is a real possibility,” Bynoe continued. “Analysts have furthermore stated that the system would fully exhaust its liquidity and cease to operate by February 2024.”

That, Bynoe said, is not just “unacceptable,” but also “an avoidable public health disaster.”

“It would be a catastrophic failure to the communities who deeply rely on this public benefit health system,” the legislator added.

Jeannine Maynard, a resident and co-facilitator of the Greater Uniondale Area Action Coalition, agreed that the potential closure of NUMC would not only be catastrophic, but would disproportionately affect low-income residents — especially those in Uniondale, many of whom have limited access to adequate health care. For Maynard and other residents, ensuring NUMC stays afloat is not just important, it is personal.

“This is a community that does not even have an urgent-care center,” Maynard said. “We need this trauma one center.”

She recounted how her father, who went into cardiac arrest a few years back, was saved by fast-acting doctors at NUMC. “If any more time had passed and he had to be taken somewhere else,” Maynard said, “he wouldn’t have made it.”

Bynoe, a member of the NUMC Forward Task Force — a group of community leaders who consult on the hospital’s financial operations that was created in 2020 by then County Executive Laura Curran — said that the task force has met with hospital leadership more than once in the past year to discuss possible solutions to its deficit. Despite these meetings, Bynoe said, potential solutions have been tossed aside or ignored.

“I left that last meeting with a sense that those proposals had been well received, and I agreed with plans that had been expressed to aggressively pursue grant opportunities wherever they may exist at the federal and state levels,” Bynoe recalled. “However, I am now deeply concerned by the fact that, despite the threat of near-term insolvency looming on the horizon, there has been no follow-up by the Nassau Health Care Corporation or an update providing any level of clarity on progress that has been achieved in the pursuit of the priorities that were articulated.”

But NUMC says they do actually have a plan, and not only has Bynoe seen it, but so has the Nassau Interim Finance Authority and state officials. “(Legislator Bynoe) presents the impression that nothing is being done to improve the fiscal health of the hospital. That is simply false,” said Tom Basile, a representative for NUMC. “The State government cut our gap funding by more than $100 million in 2020 and has refused to restore that aid. With State aid, the hospital would function sustainably today, and in fact, in better financial shape than before due to (the hospital's) reform plan.”

NUMC's money troubles in recent years are mainly attributed to the strains of the coronavirus pandemic and the end of the Federal Delivery System Reform Incentive Payment program — the additional state funding that Basile is referencing — which provided tens of millions of dollars in incentive payments to NUMC from 2011 to 2020, culminating with a final $50 million payment.

Since 2017, state funding for NUMC has plummeted by more than $160, million from $189 million to just $30 million this year, according to County Executive Bruce Blakeman’s office. That is just about all the money NUMC has left to operate — which Hospital Chairman, Matthew Bruderman told the herald he believes is enough to last through July, but not without possibly having to cut nearly 300 jobs in the near future.

Last year, the hospital received the largest share of a nearly $40 million state grant to Long Island, including almost $20 million for Nassau County, with $16 million going directly to NUMC. Additionally, there were other grants worth millions of dollars set aside by the state aimed to help “financially distressed hospitals,” but it is still not clear to the legislture at this time whether NUMC applied to any of them by the March 2023 deadline, although the hospital tells the Herald they have. 

“It’s unacceptable that we’re facing this public health disaster at this moment, with little or no information as to what the future of the hospital looks like even within one month of today,” Bynoe told the Herald.

She blames the "lack of transparency" on the hospital’s “questionable management,” describing the facility as a “hotbed” of nepotism, cronyism, corruption and bloated salaries — referring to hires like Michael Sposato, former commissioner of the county jail who just accepted a job as NUMC’s executive director of public safety and investigations for an annual salary of $275,000, according to NuHealth.

It was also revelaed in a report, released this week by SeeThroughNY — a website designed  to "give New Yorker's a clearer view of how their tax dollars are spent," created by The Empire Center for Public Policy, an independent, non-partisan, non-profit think tank based in Albany  — that 10 surgeons who retired from NUMC bring home annual pensions of over $200,000 per year. 

“Ms. Bynoe is correct that the hospital’s closure would create a significant health crisis in the county,” said Basile, “but the fact must be acknowledged that the state cut aid to a safety net hospital that serves patients that are 70-80 percent Medicare and Medicaid or provide no reimbursement for services.”

If NUMC were to shut down, taxpayers would end up having to foot the bill. Nassau County serves as the hospital’s financial guarantor, meaning that its closure would cost the county more than $131 million, according to the Grant Thornton accounting firm, an outside auditor that conducted a review of the hospital’s finances.

“We are hopeful that the state will provide further funding to keep NUMC viable, and the county is looking to further its contractual relationship with them for a variety of services that create a revenue stream for the hospital,” Chris Boyle, a spokesman for County Executive Bruce Blakeman, said in a statement in June.

“We are not designed to make money,” Basile told the Herald, “we are designed to serve everyone, regardless of their ability to pay.”

Gov. Kathy Hochul’s office had not responded to the Herald’s request for comment by press time.

Updated 1/27 at 2:47 p.m. to include statements from NUMC