It’s no secret that the Nassau Health Care Corporation, which operates Nassau University Medical Center is in financial trouble. NUMC is a public benefit hospital which serves Nassau County’s at-risk population and communities. NHCC also operates the A. Holly Patterson Extended Care Facility in Uniondale, a 589-bed skilled and rehabilitation facility.
Because of its mission of treating all patents regardless of ability to pay, NHCC serves a substantial proportion of patients who are uninsured, underinsured or covered by Medicaid and Medicare. Of the approximately 275,000 patient population served, more than 70% are reliant on Medicaid, 70% are minority and 60% are women.
Included in the patient population are 67,000 emergency room visits, which are the most expensive primary medical care and often not reimbursed fully by Medicaid. This compounds the financial challenges facing NHCC: Despite the rise in medical costs and the last four years of inflation, Medicaid reimbursement rates have not materially increased in 15 years. Additionally, while NHCC continues to have the increasing financial obligation of its 3,500 employees and their pension and healthcare requirements, NHCC faces other financial obstacles brought on by New York State.
NHCC executives explain that New York State has systematically reduced its aid to NHCC from
$189 million in 2017 to $170 million in 2020, ultimately making the financial situation critical in 2023 by reducing state aid to $30 million. Since the end of 2020, NHCC has seen its state aid reduced by more than $267 million. Not surprisingly, NHCC deficits have increased during that period from $25.7 million in 2017 to $102.3 million in 2020, to $164 million in 2022totaling $538.8 million.
Between 2020 and 2022, the accumulated net deficit was nearly $402 million. Let’s not also forget the accumulated deficits of $19.6 million in 2021 to $38.5 million in 2023 from the A. Holly Patterson nursing home, which treats uninsured and Medicaid enrolled patients. The result is an insurmountable amount of lost financial assistance to make up for a public health safety-net hospital.
When there are deficits and dwindling cash, as is the case with NHCC, the easy answer is staff reductions to balance out the loss of state aid. But how effective would that be without gutting NHCC’s mission? This especially when staffing levels have increased by only 1% per year since 2017, while employee pension costs and benefits have increased by more than $80 million.
While suggestions that employee reductions are necessary to restructure NHCC, the choices are daunting. NUMC has the region’s only burn center and the only multi-chamber hyperbaric units. As Nassau County’s only safety-net hospital, it also has the mission of handling accidents, natural disasters and public health emergencies. NUMC was the overflow center during COVID-19 pandemic as well as Hurricane Sandy. Additionally, the hospital is designated as a direct treatment site for federal officials including the President of the United States. These functions have to be constantly staffed.
Irrefutable is that NHCC and its health delivery safety net is vital to the healthcare of Nassau County residents. New York State, with a $237 billion budget, has the fiscal means and obligation to fund the mission of NHCC, which is critical to the delivery of that care.
The choice to be made is what is more important: mission or money?
Martin Cantor is director of the Long Island Center for Socio-Economic Policy and former Suffolk County economic development commissioner. He can be reached at EcoDev1@aol.com .
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