How Megan Ryan rose and fell as NUMC CEO

Before stepping down as chief executive of the health system that cares primarily for Nassau County's sickest and poorest, Megan C. Ryan sent a letter to the staffers and the community in late May describing her decade of employment as "a calling rooted in public service." 

"Like so many of you, I do this work out of love. It is a vocation, not a job," she wrote. 

A month later, Ryan, 45, of Merrick is in a dispute with the new leadership at Nassau Health Care Corp. that has turned her resignation into a firing "for cause." A new board chairman and CEO, installed by Democratic Gov. Kathy Hochul, allege that Ryan authorized $3.5 million in excessive termination payouts to herself and 12 employees. Ryan has defended her actions as being within her authority.

The dispute bookends the rise and fall of Ryan, who climbed the ranks from a hospital compliance officer to general counsel and to executive vice president. She rose to become the health system's CEO — one of the highest-paid  public jobs in Nassau — assuming broad responsibilities. That included overseeing the operations of the 530-bed Nassau University Medical Center in East Meadow, the A. Holly Patterson nursing home, community health centers and the delivery of health care to inmates at the county jail. 

"The future will tell what kind of CEO she really was over there and what actions she took that may not be proper and appropriate," said Richard Kessel, chairman of the Nassau Interim Finance Authority, the county's state-appointed fiscal oversight board. Kessel for months has criticized the leadership of Ryan and NUMC's former board chairman Matthew Bruderman.

'A survivor'

In more than a half dozen interviews, former employees and political insiders from both the county Republican and Democratic committees say the institution suffered from polarizing forces seeking lucrative vendor contracts and opportunities for loyalists. They say Ryan was able to flourish at an institution with loose guardrails and frequent board turnover. 

But Ryan had never led a hospital nor could she stop NUMC from bleeding money, they said.

Ryan watched as a Democratic-controlled hospital board eliminated nine Republican-appointed positions. Last year, she was interim CEO when the Republicans fired the hospital's chief operating officer, a Democrat.

And yet, neither Republican nor Democratic county committee leaders described Ryan as a "party loyalist" to Newsday.

"It's not a patronage place where you're going to find a lot of committeemen," said Nassau Republican Committee chairman Joseph Cairo. "I think the hospital now obviously has become a political football and she's caught in the middle."

State and county Democratic chairman Jay Jacobs instead characterized Ryan as "a survivor."

"Given that her priority was survival, she did what she was told as it related to hiring the people she was told to hire at high salaries and giving the contracts that she was told to give out and that did not benefit the hospital though it certainly benefited the Republican machine," Jacobs said. 

John Ciampoli, a Republican who had been fired from his job in 2018 as counsel to the NUMC board, said the hospital's leadership has always been "a ship that's out of control." He said unstable leadership created an environment that made it easy to manipulate political connections. 

Despite a mission to turn around the beleaguered institution, under Ryan's watch the health system logged an operating loss of $144 million last year, according to a draft financial report from May, bringing its total debt to $1.4 billion. NUMC was, however, able to recoup money for medical bills at a higher rate last year when compared to the year before.

Ryan declined Newsday's interview request for this story.

"Having seen what I have seen at NUMC, I’m not at all surprised at the absolutely catastrophic financial situation that they’re in nor the events of recent days in which people have made payments with the public benefit corporation funds to themselves and their friends," Ciampoli said. "I’ll leave it to history as to who was benefiting or why it was out of control." 

A spokesman for Ryan has called her firing a "political hit job" and says she is being wrongfully accused and new interim CEO Dr. Richard Becker doesn't have the authority to terminate Ryan's employment. He said a confidential, personnel letter was leaked to Newsday and other news outlets before Ryan had the opportunity to respond. 

"It was malicious, vindictive and unconscionable. The fact the letter was leaked to defame Ms. Ryan is more proof that this takeover of NUMC is a brazen political operation," said Ryan spokesman Tom Basile. "Ms. Ryan has enjoyed bipartisan support for her work for many years, until Albany politicians resolved to take over the facility." 

Last few months 

Ryan's 18 months at the helm were fraught as county Republicans and state Democrats fought over how best to represent and address the institution's dire financial outlook. State health officials said they would not provide rescue funding unless NUMC launched a national search for a new CEO, the job Ryan had been doing for a few months as interim.

Bruderman, a Centre Island businessman and major Republican donor, was the chairman of the board. He was appointed by Nassau County Executive Bruce Blakeman, a Republican.

Under Bruderman, NUMC's previous board in December 2024 defied the state health commissioner's orders by approving a resolution naming Ryan CEO with a five-year contract at a $550,000 annual salary. It also included retroactive pay for most of 2024 year when she led the organization as interim CEO, Newsday previously reported. 

Ryan was appointed to the interim role earlier that year, replacing Dr. Anthony Boutin, who served as CEO and medical director for four years at more than $700,000 annual salary. The initial contract would have given Ryan a $750,000 salary but Bruderman said she had "volunteered" to take the lower sum.

Weeks later, Ryan, backed by Bruderman, filed a $1 billion lawsuit on behalf of NUMC against the state, claiming the hospital was owed federal money for treating a large share of low-income and uninsured patients that the state was withholding.

Attorneys for the Bruderman-Ryan administration also sued NIFA, attempting to strip the state panel of its oversight authority. The team then launched a print and social media campaign against NIFA, Kessel, Hochul and state officials, warning staff and surrounding community of an impending closure and widespread layoffs should the state step in and play a larger role in the financial management of hospital operations.

It is still unclear whether the termination payments were valid under hospital policy and Ryan's employment contract.

"Was she a hard worker? Yes. But you don't pick a fight with the state. This is all about math and it will get figured out but, the timing of the payments don't look good. I pray that she and others did not take a penny more than they were owed," said a former Democratic appointee to the hospital board who asked for anonymity so they can speak on NUMC's day-to-day operations.

Ryan's attorney has said she is contractually entitled to more than 1,000 hours of accrued work time plus salary payments and will pursue severance through April 2027. 

Blakeman was highly critical of Hochul's move to revamp the hospital board, appointing new board chairman Stuart Rabinowitz and shifting the majority of appointments from county to state lawmakers. Rabinowitz and the new board at a June 10 meeting voted to place Ryan on leave, appointing Becker, who about a week later sent Ryan a letter communicating she was "terminated for cause" because of the excessive payouts.

Blakeman declined to comment on the payments. His spokesman, Chris Boyle, said Blakeman had "no direct knowledge of the circumstances of any payouts to NUMC employees."

Jacobs, however, said he believes the Nassau district attorney should look into the issue of the payouts.

"This is an independent auditing of what the rules are in terms of severance and what she actually distributed," he said.

By Candice Ferrette

candice.ferrette@newsday.comcandiceferrette

Candice Ferrette covers Nassau County government and politics on Long Island. She has been a reporter at Newsday since 2011.