The Nassau Interim Finance Authority’s plan to put the county's hospital under its oversight, a move expected to get the approval of the NIFA board Tuesday, is a crucial step toward the Nassau University Medical Center continuing to meet its responsibilities and perform its public mission.
For that to happen, NUMC, increasingly troubled and facing mounting challenges, must undergo a transformation.
The advice of a turnaround specialist NIFA is seeking is another key. Northwell Health’s continued assistance is an absolute necessity. The cooperation of the union representing 3,000 of the hospital’s employees, the CSEA, is vital, too. And once the right plan is in place, money from Albany will be crucial to execute it.
With 1.7 million square feet of space on its 75-acre East Meadow campus anchored by the 19-story main hospital, NUMC is far too large for its needs. The hospital has 535 beds but never comes close to filling them all. Employees and equipment spending are misallocated. NUMC’s highest-quality and most popular disciplines, like behavioral health and addiction treatment, have few dedicated resources to grow while specialties with little demand suck up energy.
The end result is often poor care. NUMC received a D-rating for Fall 2018 from the Leapfrog Group, a Washington, D.C.-based nonprofit that focuses on hospital quality and safety. That rating, down from an A a few years ago, tells the tale of a decline under former County Executive Edward Mangano, and how dangerous it is to see this hospital as a political honey pot instead of the county's provider of critical health care services. Patients in hospitals with D or F ratings are 92 percent more likely to die from avoidable medical errors than patients in A-rated hospitals.
NUMC’s problems demand a sweeping plan for redesigning the business and the physical plant, and fairly quickly, or the hospital could shutter. Money is as big a problem for the facility as its faltering reputation. That's where NIFA's oversight and a consultant's help are crucial.
Money is so short because the patient mix is so unprofitable. It's composed largely of the uninsured, Medicaid and Medicare recipients, and patients covered by private insurers who refuse to reimburse NUMC fairly.
From 2014 through 2018, NUMC lost $153 million. It owes $188 million, money the county taxpayer would have to cough up in a default. It faces the possibility that desperately needed streams of operating funding from both the state and the federal government could be cut or disappear entirely in the coming years. And redesigning NUMC would cost hundreds of millions of dollars.
That is why increased oversight by NIFA is one big part of the answer. Another is a sustained push to replace the political hacks on the NUMC board with dedicated and credible representatives.
And the CSEA membership and leadership have to accept that if they are not partners in redesigning NUMC in a way that allows it to stay open and serve county residents effectively, they will be a prime reason it is forced to close.
— The editorial board