A billion in the red, taxpayer-backed NUMC spent millions to create a neurosciences unit. It failed.

Nassau University Medical Center was hundreds of millions of dollars in debt when its leadership embarked upon a new initiative: launching a premier neurosciences department.

Administrators hoped the new unit, led by a neurosurgeon hired from Northwell, would attract much-needed new patients, with insurance that paid well for cutting-edge procedures.

The problem? There was no apparent long-range strategy, market analysis or even public discussion about the plan. Nearly everyone involved in the decision was gone within three years, before the renovated unit even opened for business.

Millions later, instead of becoming an advanced neurological hub, the taxpayer-backed safety-net hospital fell ever deeper into the red.

The failed attempt to create the department highlights problems that have long plagued the public hospital: limited oversight, questionable management, frequent leadership turnover and a chronic inability to stem the financial bleeding.

A cash-strapped public hospital "gets a few markers it can put on the table. Like [in] Atlantic City, right?" Kim MacPherson, the executive director of health management at the University of California, Berkeley’s Haas School of Business, said in an interview.

"You need to bet well. And you need to not just bet on a gut."

Since last year, Newsday has been publishing a series of stories examining the hospital’s financial struggles — issues that the facility’s new leaders must face as they seek to balance the hospital’s books and avoid another taxpayer-funded cash infusion.

The initiative raises questions about what sort of institution the financially strapped hospital should be. Can it provide both premier specialized services, as well as safety-net care, under the same roof? Or does it have to choose?

‘Additional salaries are included’

Hospital leaders saw potential in building an in-house department, according to hospital documents, public records and conversations with people familiar with the effort. To report this story, Newsday contacted multiple former hospital board members, administrators and employees, nearly all of whom declined to comment.  

Neurosurgery, which covers surgeries of the nervous system, including the brain, is a highly specialized field of medicine. Neurosurgeons are very well-compensated, and neurosurgery departments can bring in significant money to hospitals.

As a level one trauma center, NUMC was already required to have neurosurgeons available. Before 2022, however, the practice was nested in the hospital’s department of surgery, and neurosurgery was provided by practitioners from a private group who were on call, according to David Weintraub, who was hired from Northwell in 2022 to lead the new department.

Weintraub declined a request for an interview but provided answers to questions via email. The creation of the new department was intended to reverse a "larger shift away from advanced services at the hospital," he said.

"This will be a major growth area for NUMC, expanding our capabilities to include first-class treatments for spine, brain and nerve conditions," Matthew Bruderman, then the chair of the board, wrote in a July 2022 op-ed for the Long Island Herald. Bruderman could not be reached for comment. 

But the decision to create the new department did not appear to involve the hospital's board of trustees. In minutes and agendas for board meetings from 2021 and 2022, there is no record of any plan, data analysis or vote on creating a new, multimillion-dollar department. Nor is there any record that the board discussed the department's creation beforehand. According to hospital documents, Bruderman publicly informed his fellow board members of Weintraub's hiring in September — even though he'd started in April, according to payroll records.  

As part of those efforts, the hospital began renovating patient rooms on the eighth floor — cleaning, painting and re-flooring rooms that were not being used for patient care, according to Weintraub. "No structural changes were made," he said.

Newsday asked both the hospital and the Nassau County Interim Finance Authority, which oversees the hospital's finances, for an estimate of the cost of those renovations. Neither was able to provide one.  

But payroll records from the department show a unit that was growing rapidly, in both headcount and expense.

In 2022, the department listed 27 employees in total, eight of whom — including Weintraub — had been hired that same year. That year, the hospital paid staff in the department $3.8 million. Roughly one-third of those funds went to Weintraub, who started work in late May. 

While preparing the operating budget for the following year — 2023 — hospital leaders noted they were ramping up spending in the department "to increase patient volumes in this area," according to budget documents.

The total payroll for 2023 came to about $6.9 million for a total of 39 employees, some of whom only worked part of the year. By 2024, the hospital paid out $7.1 million in salaries for the department to a total of 36 employees. The records do not appear to include nursing staff.

Soon after his hiring, Weintraub became NUMC’s highest-paid employee, according to payroll records. In 2023, Weintraub made a salary of $2.1 million, over $1 million more than the next-highest-paid employee.

In 2024, he made nearly $1.2 million. The decline, he said, was due to the fact that he was on call significantly more in 2023 than in 2024.

‘Not increasing revenue or patients’

Newsday obtained hospital procedure data collected by the state Department of Health to assess the trends in the number of procedures performed at NUMC.

The analysis calculated the number of treatments classified as either neurosurgical, neurological or spinal from 2021 — the year before the new department was announced — to projections for 2025.

The analysis shows that the number of such treatments done by the hospital barely budged in those years.

In 2024, in fact — the same year the hospital spent $7.1 million on salaries for the department — NUMC performed fewer procedures in all those categories than it had in 2021, the year before the new department was announced.

Put simply: The new department, and the millions of dollars spent on it, did not attract more patients and money to the hospital.

Weintraub wrote that he had not seen that data, but "the suggestion that there was little change is not consistent with my experience."

From the beginning of 2022 to 2023, he said, the number of neurosurgical procedures increased under his tenure. He pointed to a list of accomplishments during his time there, including reducing wait times for neurology appointments, largely ending transfers to other hospitals and performing an array of new complex surgical procedures.

Megan Ryan, who took over as the hospital’s CEO in early 2024 and departed in spring 2025, determined that the "department was not increasing revenue or patients," a spokesperson for Ryan said in an email, "so she began to pare down the associated expenses."

Tommy Meara, a spokesperson for the hospital, said in a statement that the unit "ultimately failed to demonstrate the patient demand or financial performance needed to justify the investment."

‘Inches on a football field’

Investing in an expensive new department like neurosurgery at a safety-net hospital is a highly uncertain proposition, MacPherson, the University of California professor, said in an interview.

MacPherson, who was previously the chair of the board of a nonprofit community hospital in San Francisco, said that competing for patients with other, better-resourced hospitals is extremely difficult. Just two years before the announcement of NUMC's neurosciences department, in fact, NYU Langone had opened a new ambulatory care center offering neurology and neurosurgery in East Meadow — less than 2 miles away.

"It's like getting inches on a football field," MacPherson said.

That’s especially difficult if a hospital has very few resources to spend — like NUMC, which is projected to have an operating loss of over $80 million this year.

"It all comes down to trade-offs," Thomas Tsai, a professor of health policy and management at the Harvard T.H. Chan School of Public Health, said in an interview.

"You may not need to have the premier neurosurgical, you know, brain tumor center," he said. Referring to the vaunted New York City cancer center, Tsai said: "Not every hospital is going to be a Memorial Sloan Kettering, right?"

NUMC has lost tens of millions of dollars on a near-annual basis and is carrying total debts of over $1 billion. Any losses from the neurosurgery unit are likely only a drop in the bucket of red ink.

Still, the failed department highlights how hospital initiatives have fallen apart in the churn of chronic turnover. In the past decade, the hospital has been led by a total of eight CEOs, some of whom served in interim roles for just a few months.

New York’s other public benefit corporation hospitals have had far fewer CEOs during the same time frame. Erie County Medical Center has been led by only one CEO, with a new one scheduled to take over this summer, while Westchester Medical Center has had two.

‘Never fully utilized’

By 2025, expenditures for the neurosurgery department appeared to be slowing. Payroll data from the first three quarters of 2025 lists fewer staff, and less pay, than an equivalent percentage of 2024 expenditures.

Weintraub, too, left NUMC in early 2025. The departure of Anthony Boutin, who was the hospital’s CEO prior to Megan Ryan, ultimately convinced him to leave, he said. Boutin declined to comment.

"After Dr. Boutin’s resignation in early 2024, hospital leadership expressed a desire to shift away from the growth of the department in a broader effort to contain hospital costs," Weintraub wrote. "As those changes materialized, I chose to pursue other areas of professional growth."

Weintraub did not stay long enough to see the renovated eighth-floor rooms open for neurological patients. As late as September, then-interim CEO Richard Becker said that a "floor that was converted for a neuro center" was "never fully utilized."

The rooms are currently being used, according to Meara, the hospital spokesperson — but for patients in the general population.

Recent hospital leaders have expressed skepticism that the hospital can provide such advanced neurosurgical services. Stuart Rabinowitz, who chaired the board of trustees from spring 2025 until last month, said as much at a board meeting last year.

"To think that we can steal neurosurgery doctors, surgeons, you know, from NYU Langone or Northwell, or that we have the infrastructure for brain surgery here — I think maybe someday, but not yet," he said.