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Greater Naples Leadership Masters Class XXIV

Healthcare Day January 22, 2020

Session Day Materials - Table of Contents

A. Goals & Objectives

B. Agenda

C. Biographies

D. Volunteer Opportunities

E. Reading Recommendations

F. Locations and Directions

G. Dr. Riner’s Presentation

H. Neighborhood Health Clinic Editorial

I. CEO of NCH talks about his first 90 days

(Please click on a heading to be directed to that section in the document)

Dress Code: Business casual for comfort in air-conditioned rooms

Venue: First Venue: NCH Healthcare System-Downtown Campus.Telford Auditorium, 350 Seventh St. NorthSecond Venue: Neighborhood Health Clinic, 121 Goodlette-Frank Rd, Naples, FL 34102

Session Leaders: David Finch (Team Lead), Karen Woodbridge, Ken Logan, SethLeadbeater, Steve Danis; CLT Lead: Beth Stein

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Theme: Navigating the Healthcare System

Goals:

ï Understand the healthcare environment in Southwest Florida.ï Describe the types and work of the major health providers in Southwest Florida.ï Address the major challenges facing patients and providers.ï Appreciate the current and future impact of healthcare on the community.

Objectives:

ï Provide a greater understanding of the complex healthcare environment and the current outlook.ï Identify how we meet the needs of the underserved in our community.ï Identify the health needs of the aging population.ï Identify the issues behind health care costs.ï Identify volunteer opportunities for class members.

Healthcare Day Agenda

8:00 Arrive at Naples Community Hospital-Downtown CampusTelford Auditorium, Second FloorCoffee, tea and light, healthy breakfast will be provided

8:15 GNL Welcomeï Gunther Winkler, GNL Class XXIV Leader

8:20 Team Introductions; Overview of Goals and Objectivesï David Finch, Healthcare Day XXIV Team Leadï Ice Breaker

8:35 Navigating the Healthcare Systemï Dr. Ronald N. Riner, President, The Riner Group

9:20 Q & A with Dr. Riner

9:35 Comfort Break

9:45 Healthcare Delivery in the Collier County Areaï Paul Hiltz, CEO of NCH Healthcare Systemï Scott Lowe, CEO of Physicians Regional Healthcare Systemï Dr. Larry Antonucci, President and CEO of Lee Health

10:45 Panel Q & A with Paul Hiltz, Scott Lowe and Dr. Larry Antonucciï Moderated by Dr Riner

11:15 Comfort Break

11:30 Bus leaves for Neighborhood Health Clinic

12:00 Tour of Neighborhood Clinic and presentation by Nancy Lascheid, Co-Founder

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12:45 Bus Ride back to NCH

1:05 Lunch in the Garden of Hope and Courage

1:50 Patient Careï Ronald T. Garry, MD, Geriatrician, Subsection Chief of Geriatrics, NCHï Andrew Lipman, MD, Oncologist, Partner, Florida Cancer Specialists &

Research Institute

2:50 Panel Q & A with Dr. Garry and Dr. Lipman.

3:10 Comfort Break

3:20 Meeting the Needs of the Underserved in Collier Countyï Scott Burgess, David Lawrence Centerï Wayne Mullican, VP of Senior Friendship Health Centerï Dr. Leela Lavasani, Physicians Led Access Network of Collier County

4:20 Panel Q & A with Scott Burgess, Wayne Mullican, and Dr Lavasani.

4:40 Perspective on the Day and Recap of Key Take-Awaysï David Finch, Healthcare Day XXIV Team Lead

4:42 Complete Evaluation Forms

4:52 GNL Wrap upï Gunther Winkler, GNL Class XXIV Leaderï Turn in Evaluation Forms

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Speaker Biographies

Ronald Riner, M.D

Dr. Ronald Riner is President of The Riner Group, a consulting firm serving hospitals, educational institutions, and other components of the healthcare industry.

A graduate of Princeton University, Dr. Riner attended medical school at Cornell and did his residency at the New York Hospital/Sloan Kettering Cancer Center in New York. His fellowship in cardiovascular diseases was at the Mayo Clinic in Rochester, Minnesota. He has also received formal business education at Washington University, Kellogg School at Northwestern and at Harvard University.

He is also a Fellow of the Institute for Advanced Study on International Business Development at Washington University. He is a former graduate medical education director and had over 15 years of private medical practice before devoting himself to the business of medicine and healthcare. He is a frequently requested speaker and advisor in the healthcare industry. He lives in Naples, Florida.

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Paul Hiltz

Paul C. Hiltz, FACHE, CEO of Naples Community Hospital, recently served as the President and CEO of Mercy Medical Center. Hiltz joined Mercy in July of 2017. Prior to this position, Hiltz was a Senior Executive with Mercy Health (formerly Catholic Health Partners) in Cincinnati, Ohio, serving in multiple capacities, including President and CEO of Mercy Hospital - Mt. Airy. He also served as President and CEO of the Springfield, Ohio Region, where he was responsible for two Acute Care Hospitals, two Skilled Nursing Facilities, and a Free-Standing Cancer Center. Hiltz was responsible for implementing and heading Mercy Health’s Accountable Care Organization, Mercy Health Select, one of the top ACO’s in the United States.

Hiltz began his career in hospital administration in 1983 as the Director of Marketing for Good Samaritan Medical Center in Zanesville, Ohio. He holds a Bachelor of Science in Marketing and Communication Arts and a Master of Health and Hospital Administration from Xavier University in Cincinnati.

Hiltz was a 2017 recipient of the Distinguished Alumni Service Award from the Xavier Graduate Program in Health Administration for outstanding service and is a fellow of the American College of Healthcare Executives. Hiltz is a member of the E.F. Hutton & Co. Board of Directors.

PROFESSIONAL AND COMMUNITY ASSOCIATIONS:ï Fellow – American College of Healthcare Executivesï Member – Board of Directors, E.F. Hutton & Co. – June 2017ï Member – Ohio Hospital Association, Health Planning Committee and Policy Advisory

Committeeï Member – Board of Directors – Springfield, Ohio Chamber of Commerceï Member (former President) – Greater Cincinnati Alliance for Hospital Planning and Marketingï Member – Healthcare CEO Roundtable – 2017 to presentï Board Chair – Clermont Fundï Preceptor – Xavier University Graduate Program in Health and Hospital Administrationï Mayor – City Councilman – City of Fort Wright, KNï Board Chair, Treasurer – Northern Kentucky Family Health (a federally qualified health care

center)ï Dean’s Advisory Board Member – Northern Kentucky University College of Informatics

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Scott Lowe

Scott Lowe brings more than 20 years of experience in Operations and Finance to Physicians Regional. Scott was named Market CEO of Physicians Regional Healthcare System in April of 2015, prior to that he served as the CEO at Physicians Regional-Collier Boulevard for two years and as the System Chief Financial Officer (CFO) from 2011 following his role as CFO at Physicians Regional-Collier Boulevard, which he began in 2008.

His prior experience and education are notable. Scott joined Cleveland Clinic Florida in 1998 as part of the management team that developed and opened the

Naples campus and remained as the Director of Finance for all Florida operations until 2005. He was the CFO of Surgery Partners, LLC in Tampa from 2005 to 2008 prior to returning to Naples to join Physicians Regional Healthcare System. His earlier career includes appointments in managed care with Neighborhood Health Partners and Blue Cross Blue Shield.

He holds a master’s degree in Business Administration from the University of Miami, a master’s degree in Public Health from the University of Texas, and a bachelor’s degree from the University of Virginia. Scott is very involved in the Collier County community, holding board positions with the Marco Island YMCA and the Marco Island Charter Middle School Board and has participated in various civic activities.

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Lawrence Antonucci, M.D., MBA

Larry Antonucci, M.D., is the President/Chief Executive Officer of Lee Health.

Prior to joining Lee Health in 2007, and for 24 years, Dr. Antonucci was a well- respected, practicing obstetrician and gynecologist (OB/GYN). During an era of corporate acquisitions, Dr. Antonucci was determined to keep his OB/GYN practice independent. He strategically expanded the practice by consolidating with another OB/GYN practice and eventually expanded into primary care services. In 1983, he co-founded Physicians Primary Care (PPC), a large multi-specialty physician practice in Lee County. Today, PPC continues as one of Lee County’s premier, independent, group medical practices.

In 2007, Dr. Antonucci joined Lee Health as Chief Administrative Officer for Cape Coral Hospital. In 2009, he was appointed Chief Operating Officer of Hospital Services for the health system and assumed responsibility for Physician Services in early 2010. In October 2011, Dr. Antonucci was named Chief Operating Officer for the health system. He was named President and Chief Executive Officer of Lee Health in June 2017.

During his tenure as Lee Health’s Chief Operating Officer, Dr. Antonucci took a leadership role in hardwiring a lean culture to engage employees, physicians and others in improving quality, safety, and patient experience. As a result, the health system experienced multiple years of successful operations with three consecutive years of record financials and continues to be positioned well for the future.

Dr. Antonucci has been a driving force in Lee Health’s patient safety program, which has won numerous awards. Under his leadership, the health system has made safety the No. 1 core value.

Dr. Antonucci is a strong believer in engaging and empowering front-line staff to improve an organization’s culture and quality. During stints as Chief Administrative Officer for Cape Coral Hospital and as Chief Operating Officer for Lee Health, he frequently embedded himself with front-line work teams, such as housekeeping and patient transport, as a way to stay connected to the care provided to patients each day and identify ways to improve quality and remove barriers.

Dr. Antonucci is guided by passion to deliver care that improves the quality of people’s lives and his commitment to the community, in which he has lived and served for more than 30 years.

Leadership Responsibilities

Dr. Antonucci is responsible for the growth, vitality, operation and success of Lee Health. His responsibilities include the coordination of internal and external affairs of Lee Health by guiding the development of long and short-term objectives. Upon approval of the Lee Health Board of Directors, he executes strategies and plans designed to achieve these objectives. Dr. Antonucci represents Lee Health to key constituencies and engages in a wide variety of activities designed to improve the health of the population served in an effective and efficient manner.

Education

Dr. Antonucci attended medical school at the University of Miami and completed his residency in obstetrics and gynecology at Eastern Virginia Graduate School of Medicine. He also earned a master's

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degree in business administration from the University of South Florida.

Memberships/Community Involvement

Dr. Antonucci is a Diplomate of the American College of Physician Executives and the American Board of Obstetrics and Gynecology, as well as a Fellow with the American College of Obstetrics and Gynecology. He is a member of the American Fertility Society, Lee County Medical Society and Florida Medical Society. He chaired the Horizon Council of Lee County in 2016.

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Nancy Lascheid, BSN, RN

Nancy holds degrees from Allegheny College, Jackson Memorial Hospital, and University of Pittsburgh. Her professional career focused on emergency nursing education. Moving to Naples Florida from Pennsylvania in 1982 she worked with her husband in his private medical practice. Upon retirement in 1999, Nancy and her husband created and developed an innovation option of comprehensive health care for low income workers in Collier County. The concept being funded by private philanthropy and maintained by volunteers.

The Neighborhood Health Clinic a 501©3 opened in April 12, 1999 in a donated storefront and saw eight patients. The NHC now owns a 28,000 sq.ft.

state-of-the-art medical and dental clinic; has 15,000 patients, 500 volunteers and a $2.6 million budget. The funding is raised annually from grants, foundations and private donations. The Board of Directors is comprised of 19 local community leaders. The concept has received multiple awards at both State and National levels. Among them are: National Jefferson Award for Public Service, Florida State Point of Light, Florida Medical Association Partners in Medicine, Hodges University Humanitarian, Naples Daily News Healthcare Heroes, and Greater Naples Chamber Citizen of the Year.

Nancy has also received PBS MAKERS, “Women Making a Difference in Florida”. She is a founding member of the Florida Association of Free and Charity Clinics, serves on the Executive Board of Directors and on the organizations Legislative Policy Committee. She has served on many committees and boards at the County, State and National levels, focusing primarily on social, safety and health care issues.

Dr. Ron Garry

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Dr. Garry was born and raised in New York. He was a scholar in Medicine at Stony Brook’s school of medicine and graduated with added distinction in research. He then moved to Boston where he did his Internal Medicine training at Beth Israel Deaconess Medical Center (BIDMC) and Harvard Medical School. While at BIDMC he received the Dr. James Tullis award for intellectual growth. Dr. Garry did his Geriatric Fellowship at Harvard Medical School and upon completion joined the faculty at BIDMC and Harvard Medical School.

While in Boston, Dr. Garry was instrumental in setting up the first Acute Care for Elderly Unit (ACE) in Boston. ACE units are specialized geriatric units that improve outcomes for acutely ill seniors. Dr. Garry served as the medical director until relocating to Naples in 2002.

Dr. Garry has lectured nationally on such diverse topics as elderly scuba divers, principles of geriatrics, acute care of the hospitalized elderly, and restraint reduction, among others. He has also published two books with Harvard Health Publications titled: Living Independently in Your Later Years and Living Better, Living Longer: The Secrets to Healthy Aging. He has written articles for CBS HealthWatch and Medscape and has been interviewed by various news outlets on health care policy and general geriatric topics.

Dr. Garry is the subsection chief of geriatrics at Naples Community Hospital. He was appointed by Governor Jeb Bush as an expert to the Agency of Health Care Administration and he is President of the Florida Geriatric Society.

Scott Burgess

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Scott Burgess joined David Lawrence Center as the Chief Executive Officer in January 2014. As CEO, he works closely with the David Lawrence Center Board of Directors and is responsible for the overall management of center operations and development. He provides administrative, clinical, and strategic direction to the Executive Management Team and provides leadership and support for DLC’s 300 professional staff.

Burgess came to DLC after an illustrious 22-year career with Alexian Brothers Center for Mental Health – an arm of Alexian Brothers Health System a large multi-hospital healthcare network – in Arlington Heights, Illinois. He began

working for the mental health center as an entry level Vocational Counselor and progressed across time to Executive Director – a position he held for over five years. During his tenure with the organization he also served as the Manager of Aftercare Services, Director of Program Services and Director of Research. As such, he is a proven clinician with experience working with children, adolescents, and adult populations and is a highly recognized supervisor, manager and leader with deep knowledge of community mental health and integrated healthcare.

Burgess earned his Bachelor of Science degree in Psychology from Illinois State University; his Master of Arts degree in Counseling Psychology from Concordia University; a Certification in Clinical Research Trials from the University of Chicago. And in 2016, Burgess attended Harvard Business School’s Executive Education program. He is a Licensed Clinical Professional Counselor (LCPC).

Passionate about effective policy for those struggling with mental illness, Burgess co-authored legislation that became law in Illinois to develop its first ever five year statewide mental health strategic plan (2013- 2018). Recognized as a leader in mental health treatment, he was appointed as a member of the Governor’s Task Force to develop the state road map for improved care which was completed and ratified. Recently, Gulfshore Life magazine recognized his tireless efforts by selecting him as a “Man of the Year 2018.”

Burgess currently serves on the Circuit 20 Regional Council for the Central Florida Behavioral Health Network, is a member of the Executive Committee of the Board of Directors for the Florida Council for Behavioral Health, is on the Steering Committee for Healthways Blue Zones Project, and is a Board Member for the Greater Naples Chamber of Commerce. Additionally, Burgess is a statutory member of both the Collier County Public Safety Coordination Council and the Mental Health Strategic Planning Commission.

In addition to his professional interests, Burgess enjoys sending time with his wife and three children. He spent over 15 years volunteering as a youth coach and is currently active in volunteering in youth ministry.

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R. Wayne Mullican

Wayne Mullican retired as Sr. Vice President of Graphic Packaging Inc. Having been involved with healthcare for 18 years serving on the Board of two HCA hospitals in Richmond, Virginia, he became involved with the NCH Healthcare System. He later served for seven years on the NCH Board. In 2008, he became involved with the Senior Friendship Health Center. He currently is Vice Chair of their local board. Wayne has been active in the Naples community, serving as past Chairman of the Committee for International Visitors in Naples, served on the Leadership Collier Foundation Board, and the Greater Naples Leadership Board. He is a graduate of Greater Naples Leadership Class IX and received the GNL Distinguished Leadership Award in 2016. He is active with Champions for Learning

and helps with mentoring and preparing students for entering college. Wayne is a past Commissioner of the Florida Commission for Volunteer Service in Tallahassee where he served for four years.

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Dr Leela Lavasani, Florida Gulf Coast ENT

Dr. Leela Lavasani is a board certified otolaryngologist, head and neck surgeon with Florida Gulf Coast Ear Nose and Throat and the newest addition to the Board of the Physician Led Access Network (PLAN). She has been an active volunteer for PLAN since she was recruited in 2012 to help provide quality healthcare for low-income, uninsured Collier County residents. She joined the Board of Directors because she sees a critical gap in services to support the healthcare needs of at-risk members of Collier County. She hopes to recruit more young doctors in Collier County to volunteer in the PLAN provider network.

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Volunteer Opportunities

Alzheimer’s Association, Florida Gulf Coast Chapter http://www.alz.org/flgulfcoast

American Cancer Society of Napleshttps://www.cancer.org/about-us/local/florida.html

American Diabetes Associationhttp://www.diabetes.org/in-my-community/local-offices/tampa-florida/

American Red Cross, South Gulf Region http://www.redcross.org/local/florida/central-florida/volunteer

Avow Hospice, Inc. https://avowcares.org/ https://avowcares.org/volunteer/

Blue Zone Project Napleshttps://southwestflorida.bluezonesproject.com/

David Lawrence Center, Inc. https://davidlawrencecenter.org https://davidlawrencecenter.org/get-involved/volunteer/

Friendship Health Clinic Collier http://www.friendshipcenters.org/Locations/Collier.aspx

Garden of Hope and Couragehttps://gardenofhopeandcourage.org/

Greater Naples YMCA, Wellness and Fitnesshttp://www.greaternaplesymca.org/donateyourtime.html

Healthcare Network of SW Floridahttp://www.healthcareswfl.org/

Healthy Start Southwest Floridahttp://healthystartbaby.org/

Juvenile Diabetes Research Foundation, South Gulf Coast Chapterhttps://www.jdrf.org/southgulfcoast/

Moorings ParkFor volunteer opportunities contact the directors directly:Becky Buerman, Director of Activities Orchid Terrace, bbuerman@mooringspark.org, 239-261-2415 Ext 109; or Lauren Wagner, Director of Activities Chateau, lwagner@mooringspark.org, 239-643-9133 Ext 422

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National Alliance on Mental Illness (NAMI) - Collierhttps://www.namicollier.org/

NCH Healthcare Systemhttps://www.nchmd.org https://www.nchmd.org/about-us/volunteer-services

Neighborhood Health Clinichttp://www.neighborhoodhealthclinic.org/

Parkinson Association of SW Fl., Inc.http://pasfi.org/index.html

Physicians Regional Healthcare System https://www.physiciansregional.com/ https://www.physiciansregional.com/volunteer-opportunities

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Reading Recommendations

“Mediscene Newsletter” (rinergroup.com/resources/newsletters/) by The Riner Group

A newsletter published several times per year on the Riner Group website covering the business, art and science of medicine. Provides summaries of key studies and statistics on a wide variety of healthcare topics. To subscribe, please send your email address and contact information to riner@ rinergroup .com . Additional helpful background reading suggested by Dr. Ronald Riner for GNL Healthcare Day can be accessed at the following link: (http://www.rinergroup.com/newsletter/TRG- GNLBackgroundReading- 013019/index.html?r=0).

“Bellevue: Three Centuries of Medicine and Mayhem at America's Most Storied Hospital” by David Oshinsky

This book chronicles the history of America's oldest hospital from its origins to today and, in so doing, traces the path of American medicine from butchery and quackery to a professional and scientific endeavor, and the growth of a civic institution. Many problems of healthcare delivery, thought of as new, are noted historically as being almost always been present with society and communities who needed to address them as best as they could.

“The Emperor of All Maladies: A Biography of Cancer” by Siddhartha Mukherjee

About 600,000 Americans, and more than 7 million humans around the world, will die of cancer each year. With this sobering statistic, physician and researcher Siddhartha Mukherjee presents a comprehensive and eloquent "biography" of one of the most virulent diseases of our time, and examines cancer with a cellular biologist’s precision, a historian’s perspective, and a biographer’s passion. The result is an astonishingly lucid and eloquent chronicle of cancer, a disease that humans have lived with—and perished from—for more than five thousand years.

The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care by T. R. Reid

This New York Times bestselling book discusses healthcare in industrialized democracies around the world- France, Britain, Germany, Japan, and beyond - to provide a tour of some affordable universal health care systems. This book will help you understand the state of health care in our country, and around the world.

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Locations and Directions

NCH Baker Hospital DowntownTelford Auditorium

350 7th St N, Naples, FL 34102

Parking for Healthcare Day

Please park in the Employee Parking Garage on the corner of 2nd Ave N and 8th St. N.

See on map -

Please enter using the ramp on 2nd Ave North, which is opposite Ace Hardware and Wynn’s. Park on levels 2 or 3 or higher, as necessary.

Cross over 8th St to hospital grounds and follow directional signs through The Garden of Hope and Courage.

Please plan accordingly; this is an 8-10 minute walk.

Click on map to make it live

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Largest Health SystemsRanked by 2018 operating revenue ($ in millions)

RANK SYSTEM HEADQUARTERS TAX STATUS ‘18 OPERATING REVENUE

1 Kaiser Foundation Health Plan & Hospitals Oakland, CA Not for profit‐ ‐ $79,7032 HCA Healthcare Nashville, TN For profit‐ $46,677

3 Providence Renton, WA Not for profit‐ ‐ $24,428

4 Ascension St. Louis, MO Not for profit‐ ‐ $23,159

5 UPMC Pittsburgh, PA Not for profit‐ ‐ $18,777

6 Trinity Health Livonia, MI Not for profit‐ ‐ $18,345

7 Tenet Healthcare Corp. Dallas, TX For profit‐ $18,313

8 Catholic Health Initiatives Englewood, CO Not for profit‐ ‐ $14,982

9 Dignity Health San Francisco, CA Not for profit‐ ‐ $14,222

10 Community Health Systems Franklin, TN For profit‐ $14,155

11 Partners Healthcare Boston, MA Not for profit‐ ‐ $13,307

12 Sutter Health Sacramento, CA Not for profit‐ ‐ $12,697

13 Mayo Clinic Health System Rochester, MN Not for profit‐ ‐ $12,603

14 Univ. of CA Health System Oakland, CA Public $12,222

15 Northwell Health New Hyde Park, NY Not for profit‐ ‐ $11,507

16 AdventHealth Altamonte Springs, FL Not for profit‐ ‐ $10,974

17 Universal Health Services King of Prussia, PA For profit‐ $10,772

18 NYC Health & Hospitals New York, NY Public $10,029

19 Baylor Scott & White Health Dallas, TX Not for profit‐ ‐ $ 9,477

20 Advocate Aurora Health Downers Grove, IL/Milwaukee, WI Not for profit‐ ‐ $ 9,213

Source: Adapted from “By the Numbers”, Modern Healthcare, 12/16/19.2

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National Healthcare Trends

Navigating Our Evolving

January 22, 2020

Ronald N. Riner, MD President and CEO

THE RINER GROUP, INC. ▪ Phone: 800.965.8485 ▪ www.rinergroup.com

ystems

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Physician Recruitment: 12 Most in DemandBased on number of recruitment searches in 2018 2019‐

Specialty Reason for Ranking1 Family Medicine “Primary care physicians such as family physicians top the list of most in –demand doctors in part because of their

key role as ‘quarterbacks‘ of the delivery team.”

2 Psychiatry “Today it is widely acknowledged that the shortage of mental health professionals, including psychiatrists, has developed into a public health crisis.”

3 OB/GYN “Nearly half the counties in the U.S. do not have a single OB/GYN, while 56% do not have a single nurse midwife. . .”

4 Internal Medicine “Despite the fact that demand for internal medicine physicians has diminished, the specialty remains difficult to recruit. Only about 10% to 12% of internal medicine residents go on to practice general internal medicine today.”

5 Radiology “Renewed demand for radiologists was inevitable. . .because imaging remains central to diagnostic and procedural work in today’s healthcare system.”

6 Hospitalist “Nine out of 10 hospitals of more than 200 beds now have hospitalists who provide inpatient care to patients, many of whom have complex problems.”

7 Neurology The average wait times to see a neurologist are increasing.

8 Gastroenterology “A variety of internal medicine subspecialists who treat conditions often associated with aging, such as heart disease, cancer and others are projected to be in short supply by 2025.”

9 Pediatrics “Physician demographics may be an additional factor driving demand for pediatricians. Approx. 73% of pediatric residents are women, and women are coming to dominate the specialty.”

10 Cardiology “A variety of internal medicine subspecialists who treat conditions often associated with aging, such as heart disease, cancer and others are projected to be in short supply by 2025.”

11 Emergency Medicine

“Over half of hospital admissions now come through the ED, illustrating that EDs can be an important loss leader for hospitals – a compelling reason to keep EDs staffed appropriately.”

12 Orthopedic Surgery

“Continued robust demand for orthopedic surgeons further illustrates how patient aging is driving the need for medical specialties.”

Source: Adapted from “Phys. Recruitment: The 12 Most in Demand Specialties”, Medical Economics; 7/17/19. 3

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Value Quality Cost

The Importance of Understanding Perspectives: Value Equation (for Patients, Physicians, Hospitals and Payors)

=Patient Value

•••

Meeting outcomes expectationsPhysician communication Easy access

÷ï Friendly, caring staffï Reasonable cost

•

•••••

Hospital & Health System ValueFavorable managed care & payor relationshipsHighly productive physicians Positive revenue streams Coordinated/ integrated care Safe, quality focused care Market leader status

Patients

Hospitals& Health S

Physicians&

Providers

Payors

Physician & Provider Valueï Purposeful and meaningful workï Degree of autonomyï Supportive, knowledgeable colleaguesï Trustworthy systemsï Quality focusedï Knowledgeable support staffï Satisfactory compensationï Credible leadershipï Learning environmentï Quality of life (balance)

Payor Valueï Market shareï Efficient networks of cost‐

effective providersï Excellent Outcomesï Highly satisfied purchasers,

employees and patients

ientnce 3,685are hospitals

ing to the CMS

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WASTE DUE TO: IN BILLIONS OF $$$Administrative Complexity $ 265.6Pricing Failure $ 230.7 $ 250.5‐Failure of Care Delivery $ 102.4 $ 165.7‐Overtreatment or Low Value Care‐ $ 75.7 $ 101.2‐Fraud and Abuse $ 58.5 $ 83.9‐Failure of Care Coordination $ 27.2 $ 78.2‐TOTAL ANNUAL COST OF WASTE $ 760 $ 935‐

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Annual Cost of Health Care Waste in U.S. by Category

Notes: From an article entitled, “Waste in the U.S. Health Care System: Estimated Costs and Potential forSavings,” by William H. Shrank, MD, MSHS; Teresa L. Rogstad, MPH; Natasha Parekh, MD, MS.

Source: MCOL Healthsprocket – JAMA Network, 10/7/19.5

HOSPITAL MORTALITYAnnual estimated deaths

due to medical errors, the 3rd leading cause of death in the U.S. ‐ BMJ

% of physicians saying they had made a medical error in the previous 3 mos. W/in that group, 1.5% believe the error resulted in a patient's death – Annals of Surgery, 2009

PATIENT SATISFACTION Star Ratings for pat experie among acute c ‐report

33711531188

748259 CMS‐

Challenges/Successes in Patient Safety, Quality and Satisfaction

PRIMARY CARE: physicians say. . . Healthcare Research &Quality hospitals between

2005 and 2011 JAMA, 2013‐

54%

Source: Adapted from Data Points, Modern Healthcare, 3/26/18. 6

. . .their practices are not equipped to manage care for patients w/multiple chronic conditions

. . .they aren’t prepared to manage care for patients w/severe mental health problems

. . .they’re notified when a patient is discharged from the hospital or seen in an ER

Commonwealth Fund‐

Drop in invasive MRSAinfections that began in

Deaths annuallyattributable to the infections

– Centers for Disease Control andPatient deaths

averted as a result– HHS’ Agency for

C. difficile infectionsamong patients annually

Drop inhealthcare acquired ‐conditions from 2010to 2015

Since the landmark report To Err is Human shook up the industry in 1999, healthcare has been on a bumpyroad to improving quality and safety.

INFECTION

• Ld

• Lh r

• Si t b

ost$24

ans now

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Sepsis: body’s overwhelming, life‐ threatening response to infection which can lead to tissue damage, organ failure, and death

eading cause of eaths in hospitaleading cause of ospital eadmissionsngle biggest c

o hospitals at illion/year

39% of AmericansINCORRECTLYbelieve sepsis is contagious

SEPSIS DEATHSannually:

270,000+ in U.S.8 million worldwide

There is no simple

WATCH FOR: 72% 12%

test or cure for sepsis but can be prevented

an

d can be treated with early recognition

0% 6%

6% ‐ 5% 5% 5%‐ ‐ ‐

17%‐ ‐13%

12%‐28%‐

37%‐

% Changes for HACs, 2014‐2017

Average number of days added to a patient’s length of stay due to an HAC

HACs increase the risk of

mortality by more than

IBM Watson Health found there were 48,771 HACs in 2016, resulting in more than $2B in excess hospital costs

Rates of Hospital Acquired Conditions Dropping‐The Agency for Healthcare Research and Quality reported that reductions in HACs prevented20,500 deaths and saved $7.7B from 2014 2017.‐ The CMS wants HACs to drop by 20% from

2014 2019.‐ Hitting that mark would result in 53,000 fewer deaths and save $19.1B in hospital costs.

Average annual decline in HACs 2010 2017‐Est. total rate of decline in HACs 2014 2017 = 910,000‐

Source: Adapted from Data Points “Rates of Hospital Acquired Conditions Dropping”, Modern Healthcare; ‐3/4/19. 7

Did You Know. . .Sepsis

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of Americ say they k the word

emperature nfection

ental decline xtremely ill

of Americans can identify stroke symptoms

of Americans can identify common sepsis symptoms

Source: Adapted from Sepsis Alliance “What You Can Do to Prevent Sepsis” 2019

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Large employers adopting virtual care (digital coaching, disease management, remote monitoring, physical therapy and cognitive behavioral therapy)

Large employers implementing alternative payment models

Large employers direct contracting with centers of excellence

Large employers planning on direct contracting with providers

National Business Group on Health‐

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State of Medicaid ExpansionStatus of Medicaid expansion

No border = expanded Medicaid before 2014

Percentage uninsuredBy state, 2018 one year‐

estimates0 3.9%‐

= expanded Medicaid since 2014 8 11.9%‐12 15.9%‐

•••••

NH, PA and MI expanded it in 2014AK, IN and MN expanded it in 2015 LA expanded it in 2016ME and VA expanded it in 2019ID, NE and UT have approved ballot measure expanding eligibility

16% or moreME

VT NHWA MT ND MN WI MI

OHNY MA RI

ID WY SD IA IL IN PA NJ= Did not expand Medicaid OR

CT

NV CO NE MO KY WV VA MD DEï WI did not expand under the ACA,

but covers adults up to 100% of the federal poverty level

CA UT NM KS AR TN NC SC D.C.

AKAZ OK LA MS AL GA

HI TX FL

Source: Adapted from American Community Survey, U.S. Census Report “Health Insurance Coverage in the U.S.: 2018”, Kaiser Family Foundation 9

In 2018, employers spentof total wages on healthcare, up from

in 1988− PwC

of workers said they would pick a narrow network plan under certain conditions− lower premiums and deductibiles, access to high quality providers‐

of workers in a high deductible plan said they'd pick a different option in 2019‐ even it if meant heighter premiums

44%

64%

Rise in cost for large employers to provide medical and pharmacy benefits

Average total cost of healthcare – including premiums and out ‐of pocket expenses – for employees and ‐dependents– National Business Group on Health and Mercer

Spike in healthcare costs overall

forbusiness

– National Business Group

Who picksup the tab

70%Employers

30%Employees

Direct ContractingOpen enrollment is coming to a close for most employer sponsored health plans. Though the percentage is still‐small, more and more companies are turning to direct contracting in benefit design. Here are some projections for 2019.

Source: Adapted from Data Points, Modern Healthcare, 11/26/18. 10

Cardiovascular

1/7/2020

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11

12

Health Care Costs ‐

The higherhealth care

costs over the following decade in

patients with a high risk for‐

cardiovascular disease.

Administrativecosts of care in the U.S., as a proportion of

GDP, compared with one to

three percent in other high‐

income countries.

The proportion ofhealth care costs

attributed to cardiovascular

disease medications for patients with

dyslipidemia. It’s 87% for diabetes, 83% for

hypertension and 71% for patients ≥65.

Proportion ofU.S. physicians who identified time spent on administrative issues related to insurance or

claims as a major issue.

Percentageof the U.S.

gross domestic product spent on

health care in 2016.

Proportion ofcardiovascular

professionals who state cost issues (co‐ pays, co insurance,‐ deductibles) are a

barrier to trying new therapies; 78% state prior authorization/ administrative and 48% state preferred

drug lists are a barrier.

Source: Adapted from Cardiology, ACC, April 2018. 11

Average drug spending per hospital admission increased

18.5% between fiscal year 2015 And fiscal year 2017

Outpatient drug spending per

admission increased by 28.7%

Inpatient drug spending per admission increased

by 9.6%

90.3% of hospitals had to identify

alternative therapies to manage spending

1 in 4 hospitals had to cut staff to mitigate

budget pressures

Hospital Prescription Drug Spending

Source: Adapted from “Hospital Prescription Drug Spending”, MCOL, 1/23/19. 12

1/7/2020

25

Survey respondents said Surveythey were aware of respondents saidbreaches to drug the drug shortagepurchasing and allocation resulted in atpolicies, including using least onesupplies from emergency medication errorcarts or kits for non‐ over a six month‐emergencies. period.

− Institute for Safe Medication Practices

13

14

Reported drug shortages in 2017, down from 154 in the previous year and a high of 267 in 2011.− American Society of Health system Pharmacists‐

9 in 10 – ER docs don’t’ have access to critical medicines4 in 10 – Docs say patients have been negatively affected9 in 10 – Docs report taking time away from patient care to find alternatives

Providers Scramble as Drug Shortages Persist

Drug shortages continue to keep providers across the nation scrambling to findoptions for patient care.

Patients who wouldswitch providers if the substitute drug being

offered was less effective than thePatients

wanting to know if a

substitute drug was available

originalAmericansaware that there is a

drug shortage‐ problem

– Cancer, Journal of the American Cancer Society

Source: Adapted from Data Points, Modern Healthcare, 5/28/18. 13

Amazon’s Healthcare Push: 2019

1) Launching a voice transcription service for physicians – AmazonTranscribe Medical

1) Rebranded “PillPack” to “Amazon Pharmacy” – expanding its pharmacy ventures

2) Partnering with Giant Eagle for Alexa device medication management3) Providing Haven health plans to employees in Connecticut, North

Carolina, Utah and Wisconsin4) Covering employee travel expenses for cancer treatment to City of Hope

in California5) Launched virtual care primary care program – Amazon Care6) Branded virtual care app “first stop for healthcare”7) Acquired startup Health Navigator to provide digital tech and services8) Teamed with Cerner for enhanced AI/machine learning on EHRs9) Collaborating with Pittsburgh Health Data Alliance for innovation in

cancer diagnostics precision medicine, voice enabled‐ tech and medical imaging. 14

tal medical c

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26

15

Number of new diabeticsdiagnosed annually

Amer. Diabetes Assn.‐

Number of Americans who arepre diabetic‐

CDC‐

To osts and lost work and wages for people with diabetes annually

Amer. Diabetes Assn.‐

Percentage of adults 65 years or older with diabetes

CDC‐of diabetes cases are Type 2CDC‐

of people with pre diabetes‐ will develop Type 2 within five years

Amer. Diabetes Assn.‐

16

Statistics on Multiple Symptoms in Older Adults

of older adults surveyed had at least 1 symptom;reported having 2 or more of the 6 symptoms

studied

Some had pain;had anxiety

Nearly − which represents an estimatedU.S. older adults – had 4 or more

symptoms

Pain and fatigue were the most common co occurring‐symptoms, affecting nearly of the survey participants,

or an estimated U.S. older adults

The most common co occurring‐ trio of symptoms were pain, fatigue, and sleep problems, affecting some of

survey participants or about U.S. older adults

Source: Adapted from “How Do Multiple Symptoms Really Affect Older Adults?” JAMA, April 17, 2019. 15

Millions at Risk of Developing Diabetes

23 MILLION + 7 MILLION = 30 MILLION

16

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27

Demographics of Patient Populations: 2019Percentage in Poverty Under 18 All

MIDWEST 12.5% 17%

NORTHEAST 11.8% 16%

SOUTH

WEST 12.2%14.5% 16%

21%

0.0% 5.0% 10.0% 15.0% 20.0%

Percentage uninsuredMidwest 6.7%

Northeast 5.5%South 12.2%West 7.9%

0.0% 2.0% 4.0% 6.0% 8.0% 10.0% 12.0%

Source: Adapted from “By the Numbers”, Modern Healthcare, 12/16/19.17

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Top 10 AI ApplicationsAPPLICATION VALUE APPLICATION VALUE

Robot assisted Surgery**‐ $40B Virtual Nursing Assistants

$20B

Administrative Workflow Assistance

$18B Fraud Detection $17B

Dosage Error Reduction $16B Connected Machines $14B

Clinical Trial Participant Identifier

$13B Preliminary Diagnosis

$5B

Automated Image Diagnosis

$3B Cybersecurity $2B

TOTAL VALUE* ~$150B

*”Value” is the estimated potential annual benefits for each application by 2026**Orthopedic surgery specific

Source: Adapted from Accenture analysis 201718

18

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minutesis the time primary care physicians spend simply processing notifications each day (JAMA)

of alarmsare clinically significant (Anesthesia & Analgesia)

data pointsare in the typical EHR system, which physicians must sift through (Mayo Clinic survey)

of family medicine errorsare related to information handling (Journal of the American Board of Family Medicine)

of cliniciansignore safety notifications (Harvard Medical School)

pieces of informationare in the EHR that physicians say truly matter (Mayo Clinic survey)

Source: “Physicians’ Overwhelming Cognitive Load: By the Numbers”, PharmaVOICE, Nov/Dec 2019.

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Which clinical areas have telehealth services? Where will they be added in2018? Stroke 79% 13%

Psychology/Mental HealthPrimary Care Urgent Care Dermatology

ER

58%50%

33%21%

33% 29%21%

0%

25%38% 0%

20% 40% 60% 80% 100%

Currently use Plan to add in 2018

Why implementremote monitoring systems?Top reasons cited by respondents:

42%DEMAND FROM PATIENTS

75% IMPROVE QUALITY/SAFETY 46% LOWER COSTS

Virtual Care

Source: Adapted from “Top of Mind: For Top U.S. Health Systems 2018”, The Health Management Academy; Dec. 201719

Physicians’ Overwhelming Cognitive Load: By the Numbers – 2018 2019‐

1/7/2020

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(Back to Table of Contents)

As the Decade Changes,Major Trends to Watch Going Forward

The concept of “value” and financial risk sharing for health care providers (physicians, nurses, hospitals, etc.)

The growing clout of organized and sizable medical groups

The role of AI/machine learning and issues of cybersecurity/confidentiality

The necessity to control costs beware disrupters – Game On

Communication and the doctor – patient relationship evolving

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(Back to Table of Contents)© 2019 Journal Media Group

Naples Daily News (FL)

December 4, 2019

editorial - Neighborhood Clinic earns new accoladeEditorial Board Naples Daily News

As a date on the calendar, Thanksgiving has passed.But it's never out of season to offer thanks to those who make life better in Southwest Florida.

It's appropriate then to take a moment to give thanks to the staff and hundreds of volunteers who make up the Neighborhood Health Clinic, located on Goodlette-Frank Road in Naples.

The clinic, which treats working people who are otherwise without health insurance or government assistance, has offered services to an estimated 15,000 patients since it opened in 1999.

It strives to do more, now in the middle of a four-phase expansion plan that will add services and seek to keep up with the growing population.

In total, the expansion carries a cost of $13 million, with $11 million raised so far.

The next phase, the third of the four, involves an 8,000-square-foot addition to the first floor for more radiology services and adding a second floor to the Armstrong Medical Building.

The extra space will allow for additional radiology for women's services, and the second-floor addition is for specialty services such as gynecological services, wound care, cardiology and ear, nose and throat procedures.

The addition is substantial, but so is the need. An estimated 50,000 Collier County residents would qualify for the clinic's services.

The clinic began as the dream of Dr. William Lascheid, a retired dermatologist who has since passed away, and his wife, Nancy Lascheid, a registered nurse.

All patients must pay a small fee toward their own care.

No government funding is involved. Most of the $2.6 million annual budget comes from philanthropic donations. It has a four-star ranking from Charity Navigator.

It is fair to surmise that without the clinic, many of those it serves would simply go without medical and dental

care. Word of the clinic's services is spread mostly by word of mouth.

Over the years it has drawn the attention and support of notables including HUD Secretary Dr. Ben Carson and 2019 Nobel Prize for medicine recipient, Gregg Semenza.

Today the community offers thanks in a small but significant way through the recognition of Nancy Lascheid as the Collier County Citizens Council's Murray Hendel Civic Achievement Award winner for 2019.

Named for Hendel, a Naples icon and co-founder of the Collier Citizens Council, the award honors individuals who have made extraordinary contributions to the community.

The award is to be presented today at a reception at Moorings Country Club.

Leslie Lascheid, the couple's daughter and now chief executive officer of the clinic, stresses that it is a community-wide effort that makes the operation successful.

"When I say 'we,' I don't mean just our dedicated staff and 700 volunteers. I mean everyone who made a donation or referred a patient to the clinic. Naples is a community where we look out for one another," she wrote it a recent fundraising appeal.

For more information or to make a donation, visit the clinic's web site at

www.neighborhoodhealthclinic.org. Brent Batten wrote this for the Naples Daily News editorial board.

(Back to Table of Contents)© 2019 Journal Media Group

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Naples Daily News, Sunday, January 12, 2020

‘I think this place has a great future’: CEO of NCH talks about first 90 daysPaul Hiltz kept his promise of listening to gripes and suggestions from physicians and patients, donors and community leaders during his first 90 days.

He wasted no time taking the helm of the NCH Healthcare System in Collier County to begin restoring the community’s faith in its dominant hospital system after a tumultuous turn-of-events.

Hiltz started Sept. 3 as chief executive officer and president of the two inpatient campuses with a combined 716 beds, along with two freestanding emergency departments and numerous outpatient and diagnostic locations.

NCH reported total revenue of $637 million in 2018 and net revenue of $39 million, according to financial reports. Operating income was reported at $25 million.

Paul Hiltz has been chosen as NCH Healthcare System's next CEO. (Photo: JOE ALBERT)

For 2019, which ended Sept. 30, NCH had $656 million in total revenue but net revenue dropped to $8 million. NCH's operating income was at a loss of $2.9 million, according to its financial reports.

Hiltz replaced Dr. Allen Weiss, who resigned in January 2019 after a battle with physicians and the community over a plan to redesign patient admissions and care oversight using NCH-employed hospitalists, which are hospital-based physicians. Independent physicians and patients balked at the plan and lobbied for a leadership change.

“I’ve learned a ton from the first 90 days,” Hiltz said. “I’m really excited about the possibilities. I think this place has a great future.”

Hiltz most recently served as CEO of the 476-bed Mercy Medical Center in Canton, Ohio. He has spent 25 years in hospital leadership. His salary at NCH, which is a private, nonprofit system, has yet to be disclosed in IRS filings.

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His top three priorities are emphasizing that NCH is a community hospital where independent physicians and employed physicians can work side by side; improving the patient culture; and focusing on quality.

The hospitalist project started under the prior administration was dropped immediately but Hiltz said the message needs to get out often to convince the medical community, he said.

Top administrators are shadowing physicians to see firsthand what it takes to care for patients in the challenging hospital environment.

“Let’s walk a mile in their shoes to hear what’s on their minds,” he said.

Administrators will soon spend one week at a time working periodically at different locations, including nights and weekends, to be visible to employees. It will send a message to employees that NCH is a seven-day operation, he said.

Hiltz said he does not foresee layoffs. Still, department managers will get trained, using the mindset of a small business owner, how to adjust staffing. In some departments during certain shifts, it could mean adjusting staffing upward.

Hiltz envisions growing the orthopedic surgery, general surgery and the cardiology programs. NCH is looking to recruit more primary care physicians to help prevent people from using the emergency rooms unnecessarily.

Physicians are feeling optimistic

Dr. Paul Jones, president of the NCH medical staff, said Hiltz spent considerable time meeting with as many people as he could and listened to what they had to say.

Physicians who stopped admitting patients in protest of the hospitalist project have started to come back. He couldn’t offer an estimate of how many.

“A significant number of doctors are coming back to NCH who had left,” Jones said. “(Hiltz) is very easy to talk to and if you have an issue or a problem, he listens. He’s been all about that.”

NCH is also helping to fund a 24/7 hotline with the Collier County Medical Society for physicians to get help with burnout or other issues affecting their lives, Jones said.

A physician survey will be done soon to gauge how the work environment is improving, Jones said.

“The culture takes a long time to change but it is going in the right direction,” Jones said. “I am really thankful he has come here and it has given a significant number of us optimism about the future.”

Strategies to improve the culture, where employees and physician see it as a great place to work, is beneficial to patient safety, Hiltz said.

“It’s the culture we create between doctors and employees so patients feel cared for,” he said.

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Eliminating employees’ fears about speaking up about anything that concerns them happens at high- performing healthcare systems, he said. Hiltz said he wants employees to feel free to speak up. NCH has 5,000 employees.

A forum has been established for employees to articulate issues; it’s starting to work but takes time, he said.

“The more people feel comfortable speaking up, the better,” Hiltz said.

A common complaint among physicians is how much time they have to spend with electronic medical records, which takes time away from patients, he said. NCH is working to eliminate unnecessary steps, along with improving scheduling.

“We are trying to streamline scheduling, to make it easier to get people in,” he said.

Reaching out in the communitySoon after arriving, Hiltz met with officials from other healthcare organizations, including the publicly- operated Lee Health in Lee County. Relations between Lee Health and NCH had been strained for years.

In October, NCH agreed to sell its 50%-ownership in Bonita Community Health Center, a joint operation with Lee Health since 2000 when relations were cordial. The Bonita center for outpatient services had incurred considerable debt yet the two hospitals had battled in court over severing ties or resolving management disputes.

Lee Health agreed to pay $14.3 million to NCH for its ownership share. Afterward, Hiltz said the two hospitals are entering a new era of collaboration.

Dr. Larry Antonucci, CEO of Lee Health, concurred.

“We have a strong relationship with NCH, and it has been a pleasure to work with Paul on collaborative opportunities to improve care in our region,” Antonucci said in a statement. “As the two largest health care providers in Southwest Florida, a closer relationship between Lee Health and NCH benefits our community and the patients we serve.”

Hiltz is scheduled later this month to tour the 128-bed Golisano Children’s Hospital, which Lee Health operates south of Fort Myers and serves seriously ill children in a five-county Southwest Florida region that includes Collier.

Relations with Golisano have been on the mend after a new transfer agreement was signed last summer. The agreement paves the way for sick kids at NCH’s North Naples Hospital to be transferred for specialty care available at Golisano.

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Historically, NCH transferred sick kids to Nicklaus Children’s Hospital in Miami. The new transfer agreement with Golisano came about while Phil Dutcher, NCH’s chief operations officer, served as interim CEO.

Hiltz toured Neighborhood Health Clinic, a nonprofit outpatient center that serves Collier’s uninsured working adults. NCH had severed ties under the previous hospital administration and stopped accepting clinic patients. The clinic is able to send patients again to NCH.

The relationship with Hiltz has been positive, said Nancy Lascheid, co-founder of the clinic with her late husband, Dr. William Lascheid.

“His perspective regarding the importance of community collaboration is reassuring,” Lascheid said. “The relationship between NCH and the Neighborhood Health Clinic continues forward in fulfilling the scope of medical care. We welcome Paul Hiltz and his leadership.”

Hiltz understands how Healthcare Network of Southwest Florida, which operates outpatient offices throughout Collier, fulfills an important role, said Emily Ptaszek, chief executive officer of Healthcare Network.

With locations in rural and urban areas, Healthcare Network cares for the bulk of children in Collier and a significant share of adults in outlaying parts of the county.

“I very much trust his transparency, and that there will be a much closer collaboration than we have seen historically,” Ptaszek said in an email. “I believe we are aligned in the viewpoint that success is, in fact, fueled by collaboration.”

Hiltz has met with Scott Lowe, chief executive officer of Physicians Regional Healthcare System in Collier, which experienced an uptick of physicians seeking privileges and patient admissions during the unrest at NCH.

They had a cordial introduction and Lowe looks forward to working alongside NCH and others in the area to enhance healthcare services for residents, said Brittney Thoman, spokeswoman for Physicians Regional.

Naples Mayor Bill Barnett said Hiltz has made himself visible in the community.

“I’m getting really good feedback,” Barnett said. “He’s approachable. That goes a long way.”

Hiltz has his work cut out for him in rebuilding the community’s faith in NCH.

“It is getting there,” Barnett said. “He has listened.”

Restructuring

Hiltz eliminated the chief of staff position previously held by Kevin Cooper, who resigned with Weiss.

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A national search is underway by the executive search firm, Russell Reynolds Associates, for a new chief medical officer after the retirement last year of Dr. Frank Astor.

Russell Reynolds, which did the search for the new CEO, has garnered widespread interest in the chief medical officer position and there are a handful of local candidates, Hiltz said.

An internal committee of physicians led by Jones will be critical for the selection. The plan is to have the position filled by the end of March.

He has created a new position of chief quality officer to analyze outcomes and to create NCH’s own quality scores. The scores will be released at the end of the first quarter.

The position of chief quality officer is filled temporarily by Cindy Ebner, who came from Kaiser Permanente in Northern California and who does not want the job permanently, Hiltz said. He wants the future chief medical officer to be in place to help select the permanent quality officer.

What’s in store for 2020

NCH will evaluate converting the remaining 50 semi-private rooms at each campus to all private rooms.

There’s also talk of adding more operating rooms at NCH North Naples off Immokalee Road, Hiltz said.

An extensive expansion of the NCH Downtown Baker Hospital emergency room, pegged to cost $35 million, is getting underway now.

About $2.1 million of the ER expansion cost was raised in November at the NCH Hospital Ball. To date, about $19 million of the expense has been raised through philanthropy.

Donors who had withdrawn their support during the earlier turmoil are coming back, Hiltz said.

In February 2019 after the resignations and criticism for not addressing outcry earlier, the NCH board of trustees added two individuals to the voluntary board, Jay Baker and Scott Lutgert. Both are longtime business and philanthropic leaders in the community.

In December, three more were added, which brings the total to 17, according to the hospital’s website.

The three newcomers are Alan Einhorn, who served as chief quality officer at Deloitte Tax LLP; William Perez, former president and CEO of S.C. Johnson; and Davey Scoon, who specializes in risk management and compensation in a range of industries.

The recent additions were the result of community input, Hiltz said.

“The last board meeting was highly interactive," he said. "I think I will be kept on my toes."

(Back to Table of Contents)