The public benefit corporation that runs Nassau University Medical Center cannot survive without dramatic action including closure of the public hospital's emergency room, reduction of hospital staff from 3,400 to about 300 and sale of the A. Holly Patterson nursing home, consultants hired by the health system's financial control board said.
In a 43-page report, the consultants blame the problems on years of political turmoil inside the corporation, NuHealth, and failure to keep up with changing trends in health care.
The report says NuHealth cannot stay afloat beyond 2022, when it is expected to run out of operating cash, unless it overhauls NUMC — a 19-floor Level-1 trauma center on 51 acres in East Meadow — by eliminating almost all outpatient and inpatient care.
The bulk of NUMC's caseload would be transferred to the Long Island Federally Qualified Health Centers, a nonprofit with six main locations in Nassau County communities, and other centers at Nassau schools, according to the report obtained by Newsday.
As Nassau County's only public hospital, NUMC provides care to predominantly low-income patients who rely primarily on Medicaid, or lack health insurance.
"The alternative to doing something is doing nothing. Doing nothing will ultimately guarantee that the hospital must close its doors," Barsky said.
"We don’t run the board — it’s up to the county and the board to make the changes, not us," Barsky said. "The county and the hospital need to decide how they're going to change the operating model so it can be sustainable on a long-term basis."
Barsky continued: "We’ve identified the issues, we’ve identified the financial challenges that they're facing, and we’ve given them various options to consider. The baton is now passed to them to go and fix it."
Robert Detor, NuHealth board chairman, said of the consultants' report: "There’s no surprises in it."
Consultants Alvarez & Marsal of Manhattan also recommend that NuHealth sell the A. Holly Patterson Extended Care Facility, which is located in Uniondale and licensed for 589 beds.
The nursing home is expected to run losses of between $27 million and $35 million a year, according to the report.
The facility, "is an enormous drain on [NuHealth] resources for an entity that should be self-supporting," the consultants wrote.
Overall, NuHealth's "history is rife with missed opportunities to evolve and a failure to adopt new models of care for this community," the report said.
"This has yielded a financially nonviable system that cares for a large number of patients whose inpatient health needs would normally be served by a community hospital, not an academic medical center," consultants wrote.
"Without a major shift in the care delivery model, continued federal and state financial support and a modernization of governance, the survival of [NuHealth] remains doubtful," the report says.
Ultimately, "only closure fully addresses the ongoing operating losses, but even that path fails to resolve the residual balance sheet liabilities … which are likely to exceed $1 billion," the report says.
"The ongoing financial losses and significant leadership turnover has resulted in the organization failing in its mission to serve Nassau County," the report says.
The consultants' recommendations, if accepted by the NuHealth board of trustees and approved by the Nassau Interim Finance Authority, would result in the most far-reaching overhaul of NUMC since its establishment in 1935 as Meadowbrook Hospital, a 200-bed general hospital.
But it is unclear if such dramatic steps will win the support of NuHealth trustees, local elected officials or leaders of the Civil Service Employees Association, which represents nearly all NuHealth's more than 3,400 union employees.
NIFA chairman Adam Barsky said he hoped county officials and NuHealth board members would take action.
Detor, an appointee of Nassau County Executive Laura Curran, said "it's clear from the report, operating off the current platform, that without additional funding or without changes to how we function, the institution is not financially viable."
Asked how the health system would proceed, Detor said he would review the plan with board members. "I don't have the answer right now," he said. "There's some seeds of options in there that we might be able to develop."
John Durso, president of the Long Island Federation of Labor, AFL-CIO, and Roger Clayman, executive director, said in a joint statement: "We firmly reject any proposal to curtail the operations of these institutions and look forward to working with CSEA and our community partners to map a successful future for these health care providers."