New Jersey Department of Health Commissioner Shereef Elnahal is a finalist in the CEO search at University Hospital in Newark and could be leaving his post in Gov. Phil Murphy’s administration, ROI-NJ has learned.
Elnahal applied for the CEO role earlier this spring, according to three sources. A decision on the CEO is expected during a University Hospital board vote on May 1.
The sources confirmed the information to ROI-NJ on the condition of anonymity because they were not authorized to speak publicly.
But his application for the post is why Elnahal avoided addressing any questions about University Hospital during state Senate and Assembly budget hearings in the past weeks.
In those hearings, questions and comments were directed to Marcela Ospina-Maziarz, deputy commissioner of health systems, who answered the legislators.
It also is why Elnahal has recused himself from the determination of whether Trinitas Regional Medical Center should be approved as a Level II trauma center, a designation that University Hospital officials have opposed.
The application is being reviewed by a different DOH official.
If Elnahal were to leave the DOH, he would be stepping into a tough situation at University Hospital.
The hospital has received stark criticism over its handling of a virus outbreak and bacterial infections late last year, and the Department of Health spent time looking into the issues, reporting findings of infection control deficiencies in October.
Some of the problems can be traced to the hospital’s past and its struggle to attract commercially insured patients — which would provide greater financial support.
Despite this, two sources familiar with Elnahal’s thinking said he was intrigued by the opportunity since he already is spending a lot of his time at the department focused on University Hospital.
The struggles at the hospital are something past commissioners understand well.
Former Commissioner and current Princeton University professor Heather Howard said University Hospital always has been a focus, and there always have been ideas about how to fix it.
Her comments were echoed by former Commissioner Fred Jacobs, who said there were always “plans to fix it, but they didn’t get anywhere.”
For example, when Jacobs was in office, there was a discussion about making St. Michael’s Medical Center an ambulatory center, moving University Hospital’s cardiac center to Newark Beth Israel, but still have a team assigned to University, and then taking all inpatient services from St. Michael’s and moving them to University.
But that idea ran into issues with the Archdiocese of Newark and the Catholic health system, he said.
The core issues, Jacobs said, always were governance issues. The quality of work, he said, wasn’t as big a problem as some may think.
“The truth was, there’s an awful lot of good work being done there,” Jacobs said.
“People there are doing major work, which was, I think in New Jersey, the best-kept secret. There wasn’t ever the recognition, medically, that there should have been.”
That being said, University Hospital has faced its share of problems.
One came when former Gov. Chris Christie was the U.S. Attorney for New Jersey. His office found that there was Medicaid fraud and assigned a federal monitor.
“The issues of that episode were resolved, but the basic fundamental structural issue of not enough patients to support its operations persists,” Jacobs said.
The hospital largely relies on Medicare, Medicaid and charity care — as many urban hospitals do — and doesn’t have enough of a volume of commercially insured patients to support its operations.
But, Jacobs said, with the amount of “political juice” behind University Hospital, it should have access to better resources.
Jacobs feels the hospital could build the right operational structure and partner with an educational entity — as other hospitals have done in the state — to become like other urban centers. He noted two that have set the standard, including Johns Hopkins in Baltimore and Columbia-Presbyterian in New York City.
“I’m optimistic, but the problem is that management, as good as it is, doesn’t admit a single patient to the hospital,” Jacobs said.
“You’ve got to have … patients admitted willingly. Patients in the neighborhood should feel like … this should be their preferred alternative. That requires the kind of outreach — meaningful outreach, not just marketing — that makes the hospital’s reputation improve and makes the desirability of being cared for there very great.”
Howard also highlighted the fact that, because New Jersey doesn’t have a public hospital, the way other states do, University Hospital captures the most vulnerable patients.
If Elnahal is selected, the state would conduct a search for a new commissioner, according to one source.
It is unclear if current Deputy Commissioner Jackie Cornell would take on the role in the interim.
University Hospital declined to comment.