County Executive Edward Mangano acknowledged Wednesday that Arthur Gianelli, chief executive of NuHealth, which runs Nassau University Medical Center and other facilities, was asked to resign so the county could search for new leadership.
"I have to protect this county and we want to fulfill the hospital's mission, but we want to look to see if there are other ideas out there for making the hospital solvent," Mangano said in an interview.
He said the board would launch a nationwide search to replace Gianelli, who has agreed to stay for three to six months. Gianelli is free to apply for the job he held for eight years, Mangano said.
Mangano said the corporation's board moved quickly -- one day after Mangano won re-election -- in deciding not to renew Gianelli's contract before it would have been renewed automatically. "We didn't want to be locked in," Mangano said. "We wanted to explore the brain trust to see what other ideas there are for making this hospital solvent."
Gianelli, reached Wednesday night, declined to comment on his resignation. But he said, "I would proudly match our accomplishments over the past eight years with any comparable hospital in the country," noting that the facility had broken even in three of the past four years.
On Friday, Gianelli announced his resignation to staff in a three-page letter that took workers, union leaders and health care professionals around the nation by surprise.
When it comes to fixing finances, Nassau will find it difficult to fill Gianelli's shoes.
As North Hempstead's director of operations in the late 1990s, Gianelli masterminded a plan to rebuild town finances in the wake of budget deficits and a court decision that left the town responsible for a $33.25 million judgment resulting from a failed waste management contract.
Gianelli also created a plan to turn Nassau finances around during former County Executive Thomas Suozzi's first term. During Gianelli's tenure as deputy county executive for finance, Nassau's bond ratings rose 12 times.
Gianelli left Suozzi's administration in 2005 to try his hand at righting the county hospital, the A. Holly Patterson nursing home and community health centers, which had been transferred to a public-benefit corporation now known as NuHealth.
During his tenure, the hospital saw significant improvements in patient care and infrastructure, and expanded breast cancer, burn treatment and other services. Patterson went from being at the center of patient-abuse investigations to becoming a top-ranked and profitable nursing home. Community health care centers were reorganized to provide better care and pull in more revenue, too.
The feather in Gianelli's cap was an agreement -- signed into law by Gov. Andrew M. Cuomo just two weeks ago -- for closer collaboration between NuHealth and North Shore-Long Island Jewish Health System.
The pact allows NuHealth to negotiate alongside North Shore-LIJ with commercial insurance companies and to expand an existing program to share doctors and services.
The measure is attracting national attention because it allows NuHealth to remain public while benefiting from private-company negotiations with insurance companies.
In short, Gianelli had a plan -- and, in the midst of a complex, ever-changing health care market, it was working.
If Mangano wants change, so be it. But abruptly switching horses is risky -- especially since county taxpayers are responsible for NUMC's more than $200 million in debt, should the facility go bankrupt.
There was a time when the county's health care facilities were more a source of patronage than patient care. The county, literally, cannot afford to go back there.