NuHealth System said it will seek $30 million and antitrust clearance from the state of New York to downsize its hospital and affiliate more closely with North Shore-Long Island Jewish Health System.

The proposal, to be submitted to the state, won unanimous approval from the NuHealth governing board. Arthur Gianelli, president and CEO of NuHealth, said in a written statement that the hospital could bolster its affiliation with North Shore-LIJ, restructure operations, stabilize finances and improve quality under the proposal.

NuHealth, which includes 481-bed Nassau University Medical Center in East Meadow, N.Y., has struggled with pension costs, Medicaid cuts, less support from local government and rates from managed care, according to a statement from the hospital. “NuHealth continues to confront very significant financial and clinical challenges,” the statement said. Revenue and income for NuHealth were not available at deadline.

NuHealth would cut 50 beds from its medical and surgical unit, and detoxification and residential rehabilitation units. Under the plan, Nassau University Medical Center would expand primary care, outpatient behavioral health and substance abuse, build an observation and detoxification unit near its emergency room and invest in electronic medical records and communications with $30 million from the state.

North Shore-LIJ, an 11-hospital system based in Great Neck, N.Y., and NuHealth would integrate clinical and quality programs and selectively develop or consolidate services. Plans include seeking antitrust protection to allow North Shore-LIJ to help NuHealth in negotiations with insurers, a statement from NuHealth said.

Terrance Lynam, a spokesman for North Shore-LIJ, said the proposed affiliation would not change the governance or management of either organization. North Shore-LIJ did not pledge any cash to its partner or agree to assume any NuHealth liabilities.

NuHealth will also seek a temporary increase for Medicaid hospital payments to offset losses from fewer inpatients and other operating expenses.