# STAC and Nassau RTAC Decision Intelligence

Last refreshed: 2026-07-15

This profile package maps the people and decision lenses most relevant to a Mercy Hospital Rockville Centre Level III trauma discussion. It is intentionally committee-facing: the goal is not only to know who is in the room, but to understand what evidence they are built to value.

## Bottom Line

Mercy's strongest posture is a targeted Level III access argument for older-adult and institutional-origin injury patients in Rockville Centre, Hempstead, Uniondale, Valley Stream, and nearby South Shore catchments. The weakest posture is a broad claim that Mercy should become a general alternative to existing Level I/II centers.

Mount Sinai South Nassau is the key opposition stakeholder because it is the nearby existing Level II trauma center, has a larger public-data injury and trauma-proxy footprint, and can argue that regionalization already works. Mercy should answer that directly with limited triage criteria, transfer protocols, trauma PIPS governance, and measured EMS-origin evidence.

## How NYS/STAC Thinks

NYS does not treat Level III designation as a branding or market-growth decision. The regulatory definition is system-access driven: a Level III trauma center is a verified facility designated to serve communities that do not have immediate access to a Level I or II center and that can provide prompt assessment, resuscitation, emergency operations, and stabilization, with transfer agreements for patients whose needs exceed the facility's capabilities. [nys_10nycrr_40545]

In practice, STAC/RTAC members are likely to think in this order:

1. Is there a real access gap for a defined population, or is the proposal just duplicating existing Level I/II coverage?
2. Will EMS destination decisions become clearer or more ambiguous?
3. Can the hospital prove readiness through ACS/Department verification, trauma medical leadership, trauma program management, registry participation, PIPS, and transfer agreements?
4. Does the proposal strengthen regional performance improvement, EMS feedback, injury prevention, and disaster readiness?
5. What happens to incumbent centers, especially Mount Sinai South Nassau, Nassau University Medical Center, North Shore, NYU Langone Hospital-Long Island, and Stony Brook?

For Mercy, this means the strongest argument is not "more trauma volume." It is a bounded Level III access function for high-friction older-adult institutional patients, paired with explicit high-acuity bypass rules, transfer triggers, and South Nassau/Level I safeguards.

## Committee Structure

### New York State STAC

New York Public Health Law 3064 says the State Trauma Advisory Committee consists of trauma surgeons, trauma nurses, emergency physicians, emergency nurses, and other emergency medical and trauma professionals appointed by the commissioner. It advises the Department of Health and the commissioner on trauma and disaster care, including statewide appropriateness review standards and quality improvement guidelines for trauma systems, trauma centers, and trauma stations. [nys_phl_3064]

The NYS DOH STAC page describes the committee's mission as developing, coordinating, and maintaining emergency medical, trauma, and disaster-care systems, including effective and expeditious transfer of patients to facilities that are appropriately staffed and equipped, with the goal of reducing trauma morbidity and mortality. [nys_stac_members]

Current STAC roster highlights for a Mercy/Nassau discussion:

| Member | Institution | Why it matters |
|---|---|---|
| L.D. George Angus, M.D. | Nassau University Medical Center | Direct Nassau County Level I trauma-center leader. [nys_stac_members] |
| Matthew A. Bank, M.D. | North Shore University Hospital / Northwell Trauma Institute | Northwell/North Shore trauma-system leader; also a major ACS and STAC performance-improvement figure. [nys_stac_members] [hofstra_bank_profile] |
| Ariel Goldman, M.D. | North Shore University Hospital | Orthopedic trauma leader in the Nassau/Northwell orbit. [nys_stac_members] |
| Jamie Ullman, M.D. | North Shore University Hospital | Neurotrauma leader; relevant to Level III neurotrauma transfer/diversion questions. [nys_stac_members] |
| Abenamar Arrillaga, Jr., M.D. | Good Samaritan Hospital Medical Center | Suffolk trauma medical director; relevant as a South Shore regional comparator. [nys_stac_members] |
| James A. Vosswinkel, M.D. | Stony Brook University Hospital | Suffolk Level I trauma leadership. [nys_stac_members] |
| Donald Doynow, M.D. | SEMAC / Stony Brook | EMS advisory bridge and emergency medicine perspective. [nys_stac_members] |
| Michael Dailey, M.D. | Albany Medical College | Prehospital and operational medicine perspective. [nys_stac_members] |
| Multiple trauma program managers | Westchester, Erie County, Albany, Canton Potsdam, Jamaica | They will care about registry, staffing, trauma program management, PIPS, and implementation realism. |

The full roster is in `data/committee_research/stac_members.csv`.

### Nassau Regional Structure

New York Public Health Law 3065 says regional trauma advisory committees are composed of trauma surgeons, trauma nurses, emergency physicians, emergency nurses, and other trauma/EMS professionals from trauma centers, EDs, and EMS services in each region. They advise STAC, the department, and the commissioner on regional trauma and disaster care, and assist with regional coordination and implementation of statewide quality-improvement guidelines. [nys_phl_3065]

Nassau REMSCO is adjacent and operationally important. Its own site says the council was established in 1993, has 30 members who live in Nassau County, and divides representation roughly into active EMS providers, hospital-based professionals, and other EMS functions such as communications and disaster management. The council says it is responsible for coordinating EMS within Nassau County. [nassau_remsco_about]

Current Nassau REMSCO roles that matter for Mercy:

| Seat | Current member | Why it matters |
|---|---|---|
| RTAC | Deanna Ripley | Direct regional trauma advisory seat. [nassau_remsco_council] |
| Nassau Medical Control | Dr. Jessica Berrios | Medical-control and protocol interpretation. [nassau_remsco_council] |
| ACEP | Dr. Allen Cherson; alternate Kugler | Emergency physician constituency; the Kugler alternate is especially relevant because Joshua Kugler is Mount Sinai South Nassau leadership. [nassau_remsco_council] [mssn_leadership] |
| Nassau/Suffolk Hospital Council | Jennifer Mandel | Hospital-system coordination and institutional politics. |
| Nassau County DOH | Nia Williams | Public-health lens. |
| Nassau OEM | Robert Fineo | Disaster and MCI planning. |
| Emergency Nurses Association | Michaels Schwartz | Emergency nursing operations. |
| ER Nurse Manager At-Large | Mary Beth Grieser | ED operational feasibility. |
| Police/Fire communications | Karen Brohm, Neil Velasco | Dispatch/routing practicality. |
| Hospital ambulance provider | Keith Wilken | Hospital-based EMS operations. |
| Northwell EMS education | Steven Orlando | Northwell training influence. |
| Equity of Care Community Member | Olena Nicks | Community-access and equity lens. |

The full roster is in `data/committee_research/nassau_remsco_members.csv`.

## What They Look At

### 1. Does the proposal improve the trauma system, or just add another label?

STAC and RTAC are not designed to reward an individual hospital's ambition. Their statutory role is system coordination, appropriateness standards, and quality improvement. Mercy's application logic therefore needs to show a system improvement: faster appropriate stabilization for a defined patient subset, clearer transfer pathways, better geriatric injury management, or better EMS feedback.

Mercy implication: lead with a small, measurable role. Avoid claiming that current centers are inadequate unless the EMS-origin and outcome data prove it.

### 2. Will EMS routing remain clear?

The STAC mission emphasizes effective and expeditious transfer to facilities appropriately staffed and equipped. ACS Level III standards likewise expect prompt evaluation, initial management, and transfer for patients whose needs exceed the center's resources.

Mercy implication: the proposal needs a routing matrix:

- direct-to-Level I/II criteria that remain untouched;
- Mercy-appropriate Level III criteria;
- transfer-out triggers;
- neurosurgery, vascular, orthopedics, ICU, blood, OR, and imaging escalation criteria;
- feedback loop to EMS agencies and referring providers.

### 3. Can Mercy prove trauma-program governance?

The ACS standards used by trauma systems focus heavily on administrative commitment, trauma medical director authority, trauma program manager resources, trauma registry data submission, risk-adjusted benchmarking, and PIPS loop closure. The NYS 2025 STAC PI presentation search index also emphasizes peer-review minutes, loop closure documentation, event-rate monitoring, OPPE, benchmarking, and PI data.

Mercy implication: public SPARCS and CMS data are useful for phase-one positioning, but the decision-ready packet needs the internal operating model: TMD, TPM, registry, PIPS committee calendar, audit filters, attendance expectations, transfer review, mortality review, and EMS feedback process.

### 4. What happens to Mount Sinai South Nassau?

South Nassau is the main opposition fact pattern:

- It is the nearby existing Level II trauma center.
- The public data model shows South Nassau has 1,204 conservative inpatient injury discharges versus Mercy's 710.
- South Nassau has 772 age-70-plus injury discharges versus Mercy's 320.
- South Nassau has 504 SNF-discharge injury cases versus Mercy's 165.
- South Nassau has 575 Medicare IPPS trauma-proxy discharges versus Mercy's 76.
- Mercy is faster than South Nassau for 13,532 analyzed nursing-home beds, but South Nassau is faster for 9,546 beds.

That means South Nassau can credibly argue volume dilution, regionalization risk, and patient-safety risk if EMS routing becomes ambiguous. Mercy can credibly argue a narrower access improvement for specific institutional catchments where Mercy is closer, especially if transfer criteria are explicit.

### 5. Is the niche population real enough?

The best niche is not "Nassau trauma" broadly. It is older adult injury, nursing-home/post-acute, assisted-living/adult-care, Medicare-heavy injury, and SNF-discharge burden near Mercy.

Committee members will likely test whether this population is:

- high enough volume to justify readiness;
- appropriate for Level III care rather than direct Level I/II routing;
- materially helped by Mercy's location;
- supported by EMS incident origin and actual transport data;
- supported by geriatric trauma protocols and safe transitions.

### 6. Does the regional EMS machinery support it?

The June 11, 2025 Nassau REMSCO minutes show the council discussing hospital-dashboard use, REMAC vacancies, regional authority legal review, airway training, LVAD, RSI medic approvals, disaster/MCI training, and RTAC support for tranexamic acid for all-cause bleeding. That is the practical operating world Mercy has to plug into.

Mercy implication: prepare to discuss dashboard status, EMS education burden, TXA/hemorrhage protocol compatibility, airway protocol compatibility, MCI participation, and whether Mercy will add friction or clarity.

## Member/Stakeholder Profiles

### Matthew A. Bank, M.D. - Northwell / North Shore / STAC

Likely lens: system performance, Level I/II readiness, trauma PIPS, ACS standards, regional leadership, and Northwell system implications. Public profiles identify him as North Shore acute-care surgery chief, Northwell Trauma Institute executive director, STAC member, and chair of the STAC trauma-center performance-improvement subcommittee. [nys_stac_members] [hofstra_bank_profile]

Mercy read: expect rigorous questions about PIPS, registry quality, transfer safety, benchmarking, and whether a Level III Mercy role improves or fragments the regional system.

### L.D. George Angus, M.D. - Nassau University Medical Center / STAC

Likely lens: Nassau County Level I trauma coverage, safety-net volume, system adequacy, high-acuity routing, and the effect of any new Level III designation on NUMC's role.

Mercy read: do not frame Mercy as replacement capacity for high-acuity trauma. Frame it as a defined stabilization/access layer with clean transfer criteria to Level I/II centers.

### Ariel Goldman, M.D. and Jamie Ullman, M.D. - North Shore / STAC

Likely lens: orthopedic trauma and neurotrauma readiness. Level III proposals often trigger questions about fractures, anticoagulated falls, TBI, head CT, neurosurgical contingency, transfer timing, and orthopedic call coverage.

Mercy read: Mercy should build geriatric fall and anticoagulated-head-injury protocols, neurotrauma escalation criteria, and orthopedic transfer/consult pathways before external discussion.

### Donald Doynow, M.D. and Michael Dailey, M.D. - EMS/prehospital bridge

Likely lens: EMS protocols, field triage, operational clarity, transfer timing, destination rules, and whether a new trauma designation makes prehospital decisions easier or harder.

Mercy read: bring CAD/ePCR origin data, proposed field-triage language, and a simulation of which calls would actually route to Mercy.

### Nassau REMSCO/RTAC seat - Deanna Ripley

Likely lens: regional trauma coordination. The public council page names this as the RTAC seat; the person behind this seat is a priority stakeholder for any Mercy build-out. [nassau_remsco_council]

Mercy read: meet early with a concrete draft of what Mercy is and is not asking EMS to change.

### Nassau Medical Control / ACEP / Emergency Nursing

Likely lens: whether clinicians in the region can safely operationalize the change. The ACEP alternate on the Nassau page is Kugler, which matters because Mount Sinai South Nassau leadership includes Joshua Kugler, MD, an emergency physician and interim president of Mount Sinai South Nassau. [nassau_remsco_council] [mssn_leadership]

Mercy read: expect South Nassau's emergency-medicine leadership to be well positioned in the same regional EMS governance ecosystem.

### Mount Sinai South Nassau Trauma Program

Likely lens: incumbent Level II role, trauma volume, readiness costs, injury-prevention/community education, CME/ATLS/Stop the Bleed, and whether Mercy's plan would pull patients that South Nassau believes should remain in its system. [south_nassau_trauma]

Mercy read: treat South Nassau as a sophisticated incumbent, not a peripheral competitor.

## Evidence Mercy Should Add Next

1. EMS ePCR/CAD origin analysis for injury, fall, head injury, anticoagulant use, nursing-home origin, assisted-living origin, and Mercy/South Nassau/NUMC/North Shore/NYU LI destinations.
2. Transfer-out history from Mercy for injury cases: reason, destination, elapsed time, consultant involved, and patient outcome proxy.
3. Trauma activation simulation for a Level III Mercy scope: which 2024-2026 cases would have qualified, which would still bypass, and which would transfer.
4. Geriatric trauma protocol packet: delirium, goals of care, anticoagulant reversal, mobility, medication reconciliation, SNF handoff, and safe transitions.
5. Trauma PIPS blueprint: audit filters, mortality review, transfer review, EMS feedback, committee attendance, loop closure, and benchmarking.
6. South Nassau impact model: cases likely retained by South Nassau, cases likely routed to Mercy, cases still routed to Level I centers, and safeguards for high-acuity routing.

## Source Notes

Source IDs:

- [nys_phl_3064] NYS Public Health Law 3064 - State Trauma Advisory Committee.
- [nys_phl_3065] NYS Public Health Law 3065 - Regional Trauma Advisory Committees.
- [nys_10nycrr_40545] NYCRR Title 10 section 405.45 - Trauma centers.
- [nys_stac_members] NYS DOH STAC meetings and members page.
- [nassau_remsco_about] Nassau REMSCO About Us page.
- [nassau_remsco_council] Nassau REMSCO officers and members page.
- [nassau_remsco_2025_06_11] Nassau REMSCO June 11, 2025 minutes.
- [south_nassau_trauma] Mount Sinai South Nassau Trauma Division page.
- [mssn_leadership] Mount Sinai South Nassau leadership page.
- [hofstra_bank_profile] Matthew Bank Hofstra faculty profile.

- `data/committee_research/stac_members.csv` - structured roster from NYS DOH STAC page.
- `data/committee_research/nassau_remsco_members.csv` - structured Nassau REMSCO roster from Nassau REMSCO council page.
- `data/committee_research/decision_themes.csv` - decision-lens matrix tying statutory and minutes evidence to Mercy implications.
- `outputs/committee_research/minutes_index.csv` - indexed meeting minutes and STAC documents reviewed or identified.
- `data/committee_research/raw/` and `data/committee_research/text/` - local source captures and extracted text where access allowed.