NUMC is poised for recovery

With the hiring of a permanent chief executive, the long-troubled Nassau University Medical Center is poised to begin what will certainly be a lengthy and arduous, but extraordinarily important, turnaround effort.

In choosing Thomas W. Stokes, the new directors of Nassau Health Care Corp., NUMC's public health corporation, have put the hospital on a promising path. Long Island knows Stokes well — and Stokes knows the territory. As the chief financial officer of Weill Cornell Medicine in Manhattan and former Nassau County deputy county executive, the Brookhaven resident brings with him an important combination of vast health care experience and a deep understanding of Nassau's politics and communities. He previously served on the Nassau Interim Finance Authority's board, and was a top candidate for NUMC's CEO job six years ago before he withdrew for personal reasons.

Stokes' hiring is the latest chapter in what hopefully will be a new trajectory for Nassau's beleaguered safety net hospital, one that began earlier this year with legislation that gave Gov. Kathy Hochul and state lawmakers more control over the hospital system, including the ability to appoint new board members and its chair. The chief executive search, conducted by the board and new chair, Stuart Rabinowitz, included 400 applicants, and fulfilled the demand from the state Health Department that new leadership be put in place — a demand that dates back three years, when former NuHealth Chairman Matthew Bruderman refused to conduct a new search or replace former chief executive Megan Ryan.

Stokes must navigate NUMC's many short-term and long-term challenges, including patient care, capital needs and financial concerns. He'll have to work with the state, county, town and NIFA, the fiscal watchdog, while avoiding political pitfalls and patronage. And he must think through innovative solutions to key questions regarding the future of the hospital system and the vast amounts of land around both the hospital building in East Meadow and its nursing home, A. Holly Patterson in Uniondale.

Stokes can start with hiring experienced and creative professionals to fill out the hospital's executive team, building upon what interim chief executive Richard Becker began. Just as importantly, Stokes must develop connections and relationships with stakeholders inside and outside the hospital, including union leaders, employees, community members, advocates, elected officials and other Long Island hospital executives. Change is hard, and continued communication, conversation and openness are key.

Stokes won't have much time to get up to speed before Albany's annual budget frenzy is underway. And NUMC must be part of those conversations. Stokes will lead a hospital system which expects to lose $167 million next year without state assistance, and which carries debts surpassing $1 billion, including about $450 million owed to the New York State Health Insurance Program for employee and retiree premiums.

Increased funding from Albany is paramount. 

Three years ago, state officials told Ryan and Bruderman that such funding was contingent on the hospital's ability to "implement significant changes supporting financial stability." That included the CEO search and NIFA approval for contracts, appointments and payments. NUMC's new leaders have accomplished those goals and more. The state must now fulfill its end of the bargain. Beyond necessary direct funding, Stokes and state officials will have to agree on a plan for NYSHIP-related payments and debt so it doesn't continue to hover as a death threat.

Addressing union contracts, staffing and collective bargaining must be on the to-do list. Just as Stokes should connect with employees, union officials should be open to new ideas and recognize that change is necessary. Forming potential partnerships, affiliations and cooperative arrangements with other hospital systems could help NUMC save money on shared services and improve reimbursement rates. Also crucial: modernizing and innovating the hospital's systems and operations, with new technology and best practices.

Perhaps most significantly, Stokes must map out his vision for NUMC's future. An in-depth study regarding the "modernization and revitalization" of the hospital system is due to the state by Dec. 1 of next year. That analysis should spotlight the hospital's most important and well-utilized departments, assess where changes in NUMC's size and scope make sense, and include a look at what's next for A. Holly Patterson. Any strategic plan also must address the real estate surrounding the hospital and nursing home. Stokes would be wise to bring in those with real estate expertise to work with him and the board to determine what's possible, and how to maintain the best of the safety net hospital, while also making the best use of NHCC's property. That could be game-changing for the hospital and the county.

Stokes can't do any of this alone. Beyond partnering with the state, NIFA and fellow hospitals, he'll have to work with Nassau County Executive Bruce Blakeman and the county legislature, as Nassau plays a key role in the hospital's bonding, and in the future of the land. If Blakeman and the legislative majority truly care about their constituents, who use and need NUMC, they must show it, by making their appointments to the NUMC board, and working with Stokes in good faith.

None of this will be easy. But this is a key moment, perhaps the hospital's best chance. With the right expertise, partnerships and vision, Stokes can put NUMC on a path of recovery and good health.