Trump obviously doesn’t understand the dynamics of the inner workings of a large hospital.
And Trump doesn't understand that there is a difference between international negotiations and twisting a city's arm for some additional tax abatements.
Trump managed negotiating with the city govt for permits and inspections, the contractors for materials, and the labor unions who built the hospital and the landlord who sold the property on which it was built
Then donated millions to foundations and charities to fund its research grants