NUMC temporarily pauses most services for pregnant women, redirecting them elsewhere

Nassau University Medical Center will suspend its maternity care and deliver babies only when the mother is in active labor, officials told Newsday on Friday. 

The hospital will continue to care for emergency maternity patients, but those seeking routine obstetrical care, scheduled deliveries or evaluation for early labor will be sent to surrounding institutions for the next three to four weeks. Patients currently receiving maternity care at NUMC are encouraged to speak with their doctors about other options, officials said. 

The decision to pause most maternity services at the public safety-net hospital in East Meadow comes after a review of the department by its state-appointed leadership.

The hospital averages about two births per day — or more than 725 annually — according to officials. A majority of their expectant mothers rely on public assistance and Medicaid, the federal program for the poor and disabled. Hospital officials said the move is a "proactive" attempt to address safety and quality issues.

 The team led by Thomas W. Stokes, president and CEO of Nassau Health Care Corp., the quasi-public system that operates the 530-bed hospital and clinics, brought the state Health Department into the process to ensure oversight and transparency. 

“Patient safety is our top priority,”  Stokes said in a statement to Newsday. “When opportunities for improvement were identified, we acted immediately. This temporary adjustment allows us to strengthen our clinical operations and ensure that every patient receives care in a safe, fully supported environment that meets our highest standards.” 

State Health Department officials on Friday confirmed that the suspension of maternity services was the decision of NUMC leadership. Under state guidelines, a temporary closure must be communicated to the director of the department and can last up to 60 days. Health Department officials must then approve the temporary closure, and it is the hospital's responsibility to ensure affected patients have access to needed health care elsewhere.

In a statement, Health Department spokesperson Danielle DeSouza said the hospital "has met all requirements to notify the public about the temporary pause in service. The Department has provided guidance and is working closely with the hospital to support the safe and timely restoration of services. Efforts are ongoing and the Department remains committed to keeping the community informed as progress continues."

There were no safety or quality reports from the review publicly available on Friday from the hospital or state Health Department officials. A hospital spokesman told Newsday the maternity unit would be back to full capacity. 

Mired in debt, NUMC is in the midst of a major turnaround plan, and changes to NUMC's obstetrics and gynecology services due to its low-performing finances had been discussed.  

A 2020 report by Alvarez & Marsal, a health care industry group, commissioned by the county's state-appointed fiscal watchdog, had pointed to four hospital departments for potential discontinuation: gynecology, pediatrics, obstetrics, newborn and neonatal, ophthalmology. 

While there has been no discussion that the temporary suspension could become permanent, Medicaid reimbursement rates are generally the primary cause for the lost revenue, experts say, starving hospitals that treat the most vulnerable expectant mothers and babies in a community.

NUMC serves a higher percentage of patients on Medicaid than any other Long Island hospital, 57%, 2024 state data analyzed by Newsday shows. Health Department statistics  show infant mortality rates in Nassau County are relatively low and declining. Maternal care is generally good across the county, with 89% of white mothers getting adequate prenatal care compared to about 85% of Asian mothers, 83% of Hispanic mothers and 82% of Black mothers, according to a state Health Department online chart of birth-related health indicators for Nassau from 2021 to 2023. 

There were 960 births at NUMC in 2022, the latest year for which the Health Department has data. That’s a fraction of the number of births at Long Island Jewish Medical Center, North Shore University Hospital and NYU Langone Hospital, which had nearly 19,000 births combined.

Martine Hackett, who researches maternal and child health at Hofstra University and chairs its population health program, said she worried about how the abrupt decision will affect women already receiving services from NUMC.

“It’s a disruption in the emotional connection that you're making with your provider,” she said. “It's a disruption in the clinical care, especially if you're higher risk. It’s stressful, and the stress in and of itself is not helpful during pregnancy.”

Shakira Settles, president of CSEA Local 831, which represents the hospital's nurses, some doctors and other staff that treat expectant mothers, said she was informed a few days ago about the suspension of services. She said she did not believe the unit — which employs 15 members in the maternity ward — was at risk of permanent closure. 

"This temporary diversion of services was an administration decision, CSEA members remain employed with no loss of compensation or employment status," Settles told Newsday. 

But hospitals nationwide have been closing maternity departments because of the difficult economics. In New York, 20 closed between 2010 and 2022, a study released in July found.

Thomas D'Aunno, a professor of management at the Wagner Graduate School of Public Service at New York University and an expert on health care management, said hospitals lose money on maternity care because the departments have high fixed costs. 

“You’ve got to staff this thing 24/7, and it has to be staffed with high-cost people: obstetricians, anesthesiologists, neonatal intensive care nurses,” he said.

With those high fixed costs, “you have to rely on volume to make up for low margins,” but public hospitals typically have a hard time attracting patients with commercial insurance to balance out costs, he said.

Hackett seemed to agree, and added: “It's kind of not their fault. It really is more the fault of the payment system.”