Dozens of employees at Nassau University Medical Center earned over $400G in 2022

The operator of Nassau University Medical Center, the county's only public hospital, is running out of cash and has recorded deficits totaling more than $100 million for each of the past three years. Auditors doubt its survival.

But the struggling health system carries some of the highest salaries in state and local government, peaking at $1.1 million for its top earner, according to a Newsday analysis of NuHealth and state payroll records obtained through a Freedom of Information Law request.

Newsday reviewed the salaries of more than 500,000 employees participating in the New York State and Local Retirement System, the largest in the state, and found that of the 100 highest-paid employees in that system, 36 worked for NuHealth and earn more than $400,000. The data includes public authorities such as NuHealth and hospital systems in Westchester and Erie County. It does not include some SUNY hospital employees, who are in a separate retirement system. 

Salaries at NuHealth are lower than at New York's other two public benefit corporations that run health systems, and comparable to salaries in the private sector, experts say. But they draw additional scrutiny at NuHealth, a system some say is no longer financially viable. 

Most of the top earners were physicians who chair specialty departments, including neuroscience, trauma, general surgery and anesthesiology. The highest paid NuHealth employee was Dr. David Weintraub, chairman of the department of neurosciences, who received more than $1.1 million in annual compensation in 2022. 

Dr. Anthony Boutin, president and chief executive, was paid $824,632 in total compensation, according to NuHealth payroll records. Dr. Lambros Angus, chair of the department of surgery and director of trauma, received $768,584.

Other top earners included administrators, such as the hospital’s chief operating officer, John Donnelly, who made $473,180 in 2022, and Megan Ryan, general counsel, who made $448,276.

The employees did not immediately respond to requests for comment.

For the fifth straight year, an outside auditor warned that NuHealth could cease operating without a major infusion of funds. In June, Boutin said layoffs "would be irresponsible, but maybe unavoidable" without more state and federal aid, which has been reduced in recent years.

NuHealth is expected to run out of cash by year's end, according to a warning issued in January by the Nassau Interim Finance Authority, a state control board that oversees county and hospital finances. 

“Given all of the conditions around the hospital, being in a stressed financial condition ... it’s alarming that they would be carrying that number of high-salaried people," NIFA chairman Adam Barsky said. "It appears to be excessive and unacceptable.” 

NuHealth officials declined an interview request. In an emailed statement, they said it's challenging to recruit top-tiered professionals who can earn more at larger, private hospital systems that allow them to also manage private practices. Union contract requirements also affect compensation totals, officials said.

“Just because we serve one of the [most] economically challenged and racially diverse patient populations on Long Island doesn’t mean our patients deserve any less than the best quality physicians, nurses and staff," according to the NuHealth statement. 

"Being competitive in recruiting qualified doctors and nurses absolutely requires [NuHealth] to compensate those professionals commensurate with other New York area hospitals," according to the statement.

Comparing salaries

The data shows NUMC administrators and physicians pulling salaries in the high six figures, much larger than their counterparts in municipal government.

A total of 1,050 NuHealth employees earned more than $100,000 in pay last year, NuHealth records show. Eighty-five of the system's 4,000 full-time and part-time employees made more than $300,000.

County government pay usually caps off at around $200,000 for the highest-earning police officers, though their overtime pay and exit packages can be in the hundreds of thousands of dollars when they cash out unused sick and vacation time. 

NuHealth paid $315 million in salaries in 2022, records show, and has budgeted $322 million for salaries in 2023 as part of its overall $703.9 million spending plan.

The system expects to lose $179.3 million this year.

NuHealth physicians also can earn money from a Faculty Practice Plan, where they get a share of about $30 million in revenue for treating patients.

“For a public benefit corporation that is definitely underwater, the salaries should be looked at more closely for the top administrators," said Ron Gurrieri, president of the Nassau Civil Service Employee Association, Local 830, which represents county and hospital employees. "But you still have to have the talent at the top to run the institution, and for talent you have to pay for.”

The contract for his union employees expires at the end of 2023, and they plan to push for a new agreement that boosts wages into the future.

NuHealth officials said they have reduced hiring to about 1% annually since 2017, and often those new hires fill roles left vacant by retiring staff.

"Reducing salaries, even if that were possible, would make it more challenging to secure and retain health care providers," according to NuHealth's statement. "We believe the patients served by [NuHealth] deserve the same quality of care as patients who visit private hospitals on Long Island."  

NuHealth's top salaries were lower than those at other public benefit systems in New York, which are in better financial health, the data shows.

At Westchester Health Care Corp., four employees made more than $1 million, according to records from the most state's most recent fiscal year. Dr. Michael Israel, president and chief executive of the Westchester Medical Center Health Network, made $3.31 million, records show.

Gary Brudnicki, senior executive vice president, network chief operating officer and chief financial officer, made $2.28 million. 

The corporation had surpluses of $34.2 million in 2022 and $28.6 million in 2021, records show. 

At Erie County Medical Center, Thomas Quatroche Jr., president and chief executive, made $1.7 million. Dr. Thom Loree, chief of the Department of Head and Neck and Plastic and Reconstructive Surgery, made $921,663.

Erie Medical Center had a $71 million deficit in 2022.   

NuHealth pay is comparable to salaries in the private sector, experts said.

In July, a working paper from the National Bureau of Economic Research in Cambridge, Massachusetts, found that average physician pay was about $350,000. It did not address administrator salaries. 

Dean Baker, senior economist at the Center for Economic and Policy Research in Washington, D.C., said physician compensation is often "very high.”

If salaries were any lower at NUMC, “They’d have a really hard time getting people to fill those positions," he said.

But Ken Girardin, a fellow at the Empire Center for Public Policy, a conservative think tank based in Albany, said compensation at NUMC is "more than just pay."

"It involves taxpayer-guaranteed pensions, civil service protections and other things that are unavailable or rare in the private sector," he said. 

Hospital too big?

In 2021, as NuHeath recorded an operating loss of $135.6 million, Manhattan consulting firm Alvarez & Marshal said it needed to downsize drastically, whether by reducing staff from 3,400 to about 300, selling the nursing home it operates or closing the hospital's emergency room. The firm's report did not address salaries. 

In 2022, NuHealth's operating loss rose to $164 million, representing its widest budget gap ever and heightening concerns about NUMC's survival. Much of the increase came from a nearly $20 million spike in the deficit at the A. Holly Patterson Extended Care Facility in Uniondale.

Accounting firms that review NuHealth’s financials have issued a “going concern” warning for the past five years. Auditors use the term when there is substantial doubt an entity can continue to operate.

The system is suffering in large part because of the end of state and federal programs that provided tens of millions of dollars in annual funding to the hospital and nursing home.

Nassau County owes New York State more than $250 million in premiums for employees' health insurance, and more than $1 billion for retiree health care benefits. 

NuHealth hasn't had a chief financial officer since May 2020. It launched a nationwide search for one last year.

Strategies for survival

NuHealth has tried to expand to compete with larger systems and generate revenue by performing more complicated surgeries, creating a dialysis center and building out its cardiac catheterization lab.

But Barsky said: "To me, it's about, what's the strategy?"

"For those positions that they are recruiting and paying, are those areas the hospital can be successful in?" Barsky said. "And if they're not, the question is, why are they carrying all those people at those salaries? What should they be doing and what should they be not doing?"

"We are advancing a program of financial reforms to improve efficiencies and increase revenue," according to NuHealth's statement.

Girardin questioned Nassau County's operational role in the management of NUMC, saying it has been unusual for decades. 

NUMC is one of three county-controlled hospital systems in New York State that receives most of their funding from state and federal government.

Nassau County no longer provides a direct subsidy to the health center, but it backs $115 million in hospital system debt and would be on the hook for the unpaid debt if NuHealth were to shut down.

In recent decades, other municipalities have ended their oversight of hospitals and nursing homes.

In 2013, Suffolk County closed the John J. Foley nursing home in Brookhaven after a proposed sale to a private operator fell through. In 2015, Long Island Community Hospital purchased the property for $15 million.

There has been no public discussion of a sale in Nassau County. 

Nassau Legis. Siela Bynoe (D-Westbury) has called for legislative hearings into the financial conditions at NuHealth.

“We need funding; we need all levels of government to get involved in creating a plan that would serve to provide funding that would offset the deficit they're facing," she said.

By Scott Eidler

scott.eidler@newsday.com@ScottEidler

Scott Eidler covers Nassau County government and politics for Newsday. Scott has worked at Newsday since 2012 and previously covered municipal government and education.