Monday, April 21, 2025
This Opinon Editorial will appear in print on Thursday.
“Victory has a hundred fathers,” President John F. Kennedy famously responded when the public wanted to know whom to blame for the Bay of Pigs debacle, while “defeat is an orphan.”
But not always.
Take the financial debacle that is the Nassau University Medical Center. Its parentage as a health care institution on the brink of collapse could not be clearer: an inept board of directors appointed by an unserious county executive in partnership with a subservient county legislative majority, completely not up to the task of managing a hospital whose complicated and challenging core mission is to provide health care to Nassau County’s most vulnerable residents.
The only long-term solution to NUMC’s leadership crisis is for our governor and locally elected state officials — who are already connected to the state’s health care budgeting and regulatory ecosystem — to appoint a majority of NUMC’s governing board of the Nassau Health Care Corporation, which includes NUMC, the A. Holly Patterson Extended Care Facility and other divisions.
The numbers tell the story, and they don’t lie.
NHCC began 2024 anticipating ending the year $97 million in the hole — a staggering sum for an institution expecting less than $600 million in revenue. Numbers released at its board meeting in early December showed it closing out 2024 over $158 million in the red — 63 percent worse than planned. In 2024 it spent 18 percent more than it received in revenue.
Additionally, NUMC owes over $400 million in unpaid health insurance premiums for its employees, a debt that increases by about $7 million each month.
Indeed, the board and management couldn’t even make a serious application to the state for emergency financial relief. The state offered NUMC nearly $84 million if it would, among other things, produce a detailed five-year transformation plan; commit to conducting a bona fide, professional search for a new chief executive (the current interim CEO is the hospital’s former in-house lawyer); and provide accurate and up-to-date information on its highest-paid employees and its outside lobbying and financial consultants. But NUMC’s board couldn’t do even that.
At a town hall-style event last March with NUMC employees, a hospital worker afraid of losing her job asked the chair if NUMC would comply with the state’s conditions for receiving the aforementioned $84 million in emergency aid. His response? “I’m going to give you a real simple answer — no.”
Instead, in December, NUMC’s chairman hastily added a resolution to the board’s agenda to install the current interim CEO as the permanent CEO for a five-year term, with a 66 percent raise, to $750,000 a year, retroactive to her time as interim CEO. (She ultimately settled for $550,000.)
The chair called those challenging his obstinacy “idiotic” — people “who want a gimp with a ball in their mouth to do what they say.” He derided other candidates whom he purportedly interviewed for the CEO role as “fat old men.” (Age discrimination in employment is illegal.) These antics only scratch the surface of the chair’s inappropriate conduct, including profanity-laced tirades at public meetings.
Here is where we have to ask ourselves, to borrow from Shakespeare: Whence cam’st thou, unworthy board? Or, in President Kennedy’s phrasing, who fathered this failure of a board?
This answer, too, lies in numbers.
By statute, the county executive and the County Legislature’s majority caucus effectively appoint 12 of NUMC’s 15 board members — they either appoint them directly or the governor does so solely upon their recommendation. The county executive also chooses the chair. And, of critical importance at this moment of institutional crisis, the board’s appointment of a CEO is subject to the approval of the county executive.
Make no mistake: while Long Island has had its share of natural disasters, NUMC’s is entirely man-made. Its board can’t govern; its management can’t manage. And if NUMC goes under, that would be a real disaster for the nearly 300,000 patients a year who rely on its services, NUMC’s 3,500 dedicated employees, and Nassau County taxpayers, who guarantee about $85 million in outstanding NUMC debt and count on NUMC to provide health care services for our correction system and numerous other programs.
It’s time to give NUMC the serious and sober governance it needs to survive. Let’s hope the upcoming legislative session brings NUMC’s patients and employees — and taxpayers — this much-needed reform.
Rory Lancman is vice chair of the Nassau County Interim Finance Authority. The views he expresses are his own.
