Gov. Kathy Hochul and legislative leaders plan to use the budget to purge the board of cash-strapped Nassau University Medical Center, the county’s only public hospital, and take greater control over appointments to its governing body.
The proposal, released late on Tuesday, will fire the board’s current members by June 1 and reconfigure the appointing powers to give the state greater authority over their replacements while reducing the influence of the county executive’s office, currently held by Republican Bruce Blakeman, a frequent foe of the governor’s.
The move marks the latest development in the effort to bring the hospital to more stable footing, a saga marked by growing friction between the Hochul administration and hospital leadership over who is responsible for the facility’s approximately $500 million in debt. It also marks an escalation of tensions between Hochul and Blakeman, whose lawyers threatened to sue if state lawmakers move ahead with the proposal.
The budget bills, which will soon be voted on by rank-and-file lawmakers, will reduce the number of board members from 15 to 11 and give the state full control over the appointment of a majority of the seats. It will also give the governor authority to select the board chair, a power currently held by the county executive, while eliminating the requirement that the board’s choice in CEO be approved by that office.
The hospital has long been a site for Republican powerbrokers in the county to exercise their authority. The board is responsible for steering the 530-bed hospital, the largest safety-net facility on Long Island, appointing its CEO and approving executive pay and large contracts. The board has worked with the state to pull the hospital out of financial straits in recent years, but the relationship took a nosedive last fall when the board sued the state over what it claims are decades of withheld funds.
Currently, the governor holds eight of the 15 appointments, with the county executive holding three and the Nassau County Legislature holding four. Of the governor’s eight appointments, two must come from a slate recommended by the county executive and four from a list provided by the county legislature. Under the new system, the governor’s appointments will not be limited to any list recommended by county officials, with two subject to the recommendations of state legislative leaders.
Blakeman had previously selected NUMC’s former board chair, Matthew Bruderman, who he abruptly terminated after a dramatic 24-hour episode in which Bruderman reportedly said that documents related to a supposed FBI probe into the hospital’s financial relationship with the state had been burgled from his Oyster Bay home.
Bruderman, an investor and Republican donor who gave $21,000 to Blakesman’s campaign in 2024, state filings show, had taken the helm of the 530-bed facility in East Meadow and a nursing home in Uniondale managed by the same health system, known as Nassau Health Care Corporation, in 2022 to help turn its finances around. After first negotiating with the state over a rescue plan, Bruderman changed course, launching a bombshell lawsuit against the state for allegedly siphoning $1 billion in Medicaid funding from the hospital over two decades. The lawsuit, which is pending, further frayed the relationship between the hospital and the Hochul administration.
In a letter to Hochul, Senate Majority Leader Andrea Stewart-Cousins and Assembly Speaker Carl Heastie, both Democrats, a lawyer for Nassau County threatened to sue the state if it moved forward with a proposal to change the lines of power in the board’s structure. The letter states that changes could illegally alter the parameters on which the county guaranteed bonds to the hospital and appears to be a retaliation for the $1-billion lawsuit.
“This timing is more than suspect,” wrote Matthew Shwartz of international law firm Sullivan & Cromwell, in the letter, which was dated May 1, before the budget language had been printed. “Put simply, this takeover is an attempt to put the fox in the chicken coop.”
The hospital’s current leadership vehemently opposed any changes to its board structure in a letter from an advisory board of doctors and at a rally at the State Capitol this week with state Senator Steven Rhoads, a Republican representing the district.
On Wednesday afternoon, NUMC’s current board chair, former Orange County Health Commissioner Irina Gelman, who Blakeman appointed in April after Bruderman’s ouster, blasted the budget deal as a “hostile takeover.”
“The notion that a state appointed board would have a higher rate of success in managing this critical care facility from Albany is a logical fallacy, given the abysmal record New York State has with their own SUNY hospital facilities,” she said in a statement.
On the other side of the battle is the Civil Service Employees Association, a union representing thousands of Nassau County employees, including those at the hospital, which issued a letter to members last week calling for a new board of directors.
“The current board of directors has refused to cooperate with New York State to secure much needed funding,” union leaders wrote. “Simple requirements, like a comprehensive five-year plan, was never submitted to the New York State Department of Health.”
The budget also codifies oversight powers of the Nassau County Interim Finance Authority, an entity created after a financial crisis in the 1990s, including requiring its approval of executive compensation and contracts over $1 million. It will also require the hospital to study and propose a plan to fix its finances by December 2026.
