Mothers, clinics scramble as temporary closure of NUMC's maternity wing continues, providers say

The suspension of maternity services at Nassau University Medical Center — now entering its third week — has created a cascading effect on some of the poorest women in the county, according to providers who also say they hope the safety-net public hospital will once again begin delivering babies. 

Doctors and nurses who serve the indigent have scrambled to redo birth plans in the final days and weeks of pregnancy to ensure these women are comfortably cared for during what could be a monthlong diversion to other area hospitals. Most are being sent to the Katz Women's Hospital at Northwell's Long Island Jewish Medical Center in New Hyde Park, Queens, which is more than 30 minutes by car without traffic from NUMC in East Meadow.

At a time when the hospital is under intense pressure to stabilize its finances, infrastructure and personnel after decades of decline and political fighting between county and state leaders, experts say even a temporary pause of these services could create a dangerous gap in care, longer travel times, financial and immigration fears. Such a move forces these women to miss or delay appointments and possibly increase the medical risk, particularly for a population that already experiences disproportionate rates of maternal and fetal morbidity.

For many of them, NUMC was a familiar place, despite the recent low quality and safety scores of industry groups that measure hospitals nationally. Many of the women declined to be interviewed by Newsday for this story, mostly for fear of drawing attention to their immigration status  at a time of strict enforcement. 

Caught 'off guard'

David Nemiroff, president and CEO of Harmony Healthcare, said the abrupt closure on April 30 caught his team and the uninsured and Medicaid-insured women treated at the federally qualified health centers "off guard."

"It's been a little cumbersome to interact with all of our patients who are due within the next 20 to 30 days just to make sure they are aware," Nemiroff said. "Our providers are meeting individually with all of those patients to make sure that their birthing plan is updated and they can access care when they need it and as close to where they need it." 

Harmony provides prenatal care for 300 to 500 patients annually in its clinics servicing the communities of Elmont, Westbury, Freeport, Hempstead and Roosevelt, and sends the most deliveries of any health system to NUMC. About 90% of those patients are living below the federal poverty line and more than 65% prefer to be spoken to in a language other than English, according to a recent patient survey.

 

Dr. Muskan Ghotra, medical director at Harmony Healthcare, told Newsday she is concerned about patients finding themselves in a new and unfamiliar environment and the logistics of transportation and the transfer of medical records. 
 

One patient, who declined to be interviewed by Newsday, was turned away from one of the other hospitals because the new care team hadn't received her medical records, Ghotra said. And, even as all hospitals in the nation are required by law to see patients regardless of their immigration status, Ghotra said a majority are living in fear of Immigration & Customs Enforcement agents who have become more visible in communities in Nassau County over the last year. 

"Being pregnant is like the greatest joy of people's lives. And you want to enjoy that time. However when you are faced with all of these economic issues and these immigration issues going ... it's a burden for these moms," Gothra said. 

Neither NUMC or state Health Department officials provided immediate answers to Newsday's questions about when the maternity care would be restored. When Newsday first reported the temporary closure of the maternity unit, a spokesman for the hospital said it would last two to three weeks.

Under state guidelines, a temporary closure can last up to 60 days. Health Department officials must then approve the temporary closure, and it is the hospital's responsibility to ensure affected patients have access to nearby services. NUMC's state-appointed leadership requested the temporary closure after an independent consultant was brought in to review patient safety, quality metrics and conduct training, officials said, and when complete, will work with the state Health Department to reopen the unit.

"The reaction from community providers and patients alike makes clear the vital role NUMC plays as a safety-net hospital and why maintaining strong local healthcare access is so important," said Thomas Stokes, president and CEO of Nassau Health Care Corporation, the public benefit corporation that runs the 530-bed NUMC. "At the same time, we are building stronger relationships with FQHC leadership and other healthcare partners after years of neglect, with ongoing conversations focused on coordination, continuity of care, and ensuring patients continue to receive the services they need during this temporary closure."

Nassau County Executive Bruce Blakeman, a Republican, who is challenging Gov. Kathy Hochul, a Democrat, in this year's gubernatorial race has refused to appoint representatives to the NUMC Board of Directors after a nearly two-year political fight  and deepening operational deficits led to a shift in the control from county to state lawmakers. Blakeman appointees had run the hospital from 2022 to last May, when Hochul installed new leadership.   

A Blakeman spokesman did not immediately respond to questions about whether the county executive would step in, appoint Republicans to the hospital board or provide any services to help blunt the impact of the closure on affected families. 

In a statement, Blakeman called the hospital board Hochul's "personal fiefdom" and predicted "the community was going to suffer without any plan for expectant mothers ...without a clear date of reopening. Disgraceful." 

Nassau County Legis. Rose Walker (R-Hicksville), chairwoman of the Health and Social Services Committee, also blamed Hochul and state leaders for what she called "a women's healthcare crisis" and vowed to fight "to restore these vital services and ensure NUMC is fully funded, fully staffed, and fully capable of providing essential care to every family."

Widespread impact

When a public hospital closes or suspends its operations "the community impact is really widespread" said Diana Romero, director of the Center for Immigrant, Refugee and Global Health at the CUNY Graduate School of Health and Health Policy.

"The very nature of safety-net hospitals is that their overwhelming proportion of patients are typically those who either receive public insurance like Medicaid or don't have any insurance at all and its very difficult to be seen in many other institutions that are not safety-net institutions," Romero said. "Whether they'll be able to make appointments with doctors who deliver at those other hospitals or can get seen is often the question." 

Nine deliveries that would have occurred at NUMC over the last two weeks happened at Northwell's Katz Women's Center in New Hyde Park, according to Dr. Kevin Holcomb, chairman of obstetrics and gynecology at North Shore University Hospital and Long Island Jewish Medical Center. Holcomb said he did not have the total number of NUMC patients who have sought care by Northwell doctors but their hospital will be able to absorb the NUMC patients.

He said the first few patients were showing up at NUMC in labor and were initially diverted to Northwell hospitals but are now going directly to Katz at LIJ. Some have been seen by Northwell doctors ahead of delivery, and they encourage the high-risk patients to do so. 

"We recognize what a critically important role NUMC plays, particularly as a safety-net hospital on Long Island, and we feel we want to do everything we can to help them to get through this moment and support their patients in the interim," Holcomb said. 

For Gothra, worries over where to go have engulfed her patients.

"They aren't happy, they are just worried having to think 'where am I going to be delivering my baby or where can I go or how much am I going to have to pay or will I even be able to provide for this baby,'" Ghotra said.