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Your Middle TN Source for Professional Healthcare News



On the Front Lines of Oral Cavity Cancer Prevention, Detection Incredibly painful to treat, potentially disfiguring, and quite likely to severely impact quality of life in the near- or long-term, a patient’s best line of defense against oral cavity cancer is a good offense in the form of primary prevention and early detection ... 4

March 2017 >> $5

Employing Value-Added Design to Improve Performance GS&P Leader Discusses the Benefit of a Holistic Approach By CINDY SANDERS

While it isn’t a new concept that those working in healthcare design strive for aesthetically pleasing form to accompany a facility’s critical functions, the rapidly changing care delivery landscape has caused many to rethink their value proposition, bringing an even larger, more robust skill set to the table. James Bearden, AIA, executive vice president for Healthcare at Gresham Smith and Partners (GS&P), said it has been interesting to witness the changes in healthcare over the last few decades and to discern the trigger points that prompted those changes. “I anticipate there will be two or three more new things that come at us in the next few years,” he said with a wry chuckle as everyone waits to see what direction healthcare reform takes next. Bearden, who led Nashville-based GS&P for 13 years as chief executive officer, now serves as (CONTINUED ON PAGE 10)

James Bearden, AIA, Executive Vice President for Healthcare at Gresham Smith and Partners

The Next Generation of Dentistry

The Three R’s of Healthcare Reform: Repeal, Replace, Repair On Feb. 23, the Nashville Health Care Council hosted the leaders of two of the industry’s most influential advocacy organizations in Washington, D.C. for a discussion about health policy in the midst of unprecedented uncertainty ... 7

Meharry Medical College Relies on Tradition, Innovation to Train Tomorrow’s Dentist By MELANIE KILGORE-HILL

Meharry Medical College’s School of Dentistry is training the next generation of tech-savvy healthcare providers while staying true to their mission of outreach. The four-year program boasts nearly 250 students and has graduated 40 percent of all African American dentists in practice nationwide, said Cherae M. Farmer-Dixon, DDS, MSPH, FACD, dean of the School of Dentistry. Farmer-Dixon joined the Meharry faculty in 1992 shortly after graduating from the program. (CONTINUED ON PAGE 5)

Dr. Farmer-Dixon treats a patient while on a mission trip in Jamaica.


For more topic-driven information by subject matter experts, check out our new blog.

nashvillemedicalnews.bog For March topics see page 6.





Something to Smile About Delta Dental’s Dr. Phil Wenk Keeps Focus on Healthy Communities By CINDY SANDERS

A smile is a magical gift. It can offer a warm welcome, ease tensions and banish shyness. Poor oral health, however, can do much more than just extinguish that magic … it can also signal much deeper health issues. “If you have lagging oral health, it will affect the entire health of your body,” stated Phil Wenk, DDS, president and CEO of Delta Dental of Tennessee. Wenk added dentists can detect 120 signs and symptoms of diseases exhibited in or around the mouth. These conditions range from diabetes and heart disease to oral cancers and leukemia. Wenk, who hails from the East Tennessee town of Clinton, spent 20 years in clinical practice before joining Delta Dental in 1997 as chief operating officer. Three years later, he was named to his current role overseeing the large Nashville-based nonprofit dental benefits organization. The Tennessee affiliate is one of 39 independent member companies associated with the national nonprofit network Delta Dental Plans Association. Growing up, Wenk had a front row seat to dentistry as he observed both his father and uncle in practice. Still, he was torn between medicine and dentistry as he began his undergraduate studies in Knoxville at the University of Tennessee. Majoring in zoology with minors in chemistry and psychology, Wenk earned his degree in 1973 and headed straight to Memphis to pursue his graduate education. While still in undergrad, Wenk met and married his wife Brenda, a speech pathologist. “We actually met at UT in a love and marriage class,” he said with a laugh, adding it earned him more than just a social science credit. Once settled in Memphis, Brenda went to work with the city’s school system while Wenk took a year off to earn money by working at Methodist Hospital. Ultimately, he decided to follow in his father’s footsteps and started dental school in June 1974. “At that time, dental school was three years. It was a very similar curriculum to today, but it was crammed into three years instead of four, which made for a very busy time,” he recalled. Finishing dental school in 1977, the young couple returned to East Tennessee where Wenk joined his father’s practice. Not only did he enjoy the clinical aspects of his work, Wenk found that he loved being part of the Clinton community after having been gone for seven years. “I think I did a good job as a restorative dentist, but I think the most rewarding part was connecting with people,” he said. “I enjoyed being immersed in the community,” he added of taking on numerous roles including serving on the city council, as chairman of the local school board, 2


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2015 TPAC Gala (L-R) local attorney Dale Allen, Dr. Phil Wenk, award-winning actress Cherry Jones, Vanderbilt Chancellor Nicholas Zeppos, and former Tennessee Titan and Broadway actor Eddie George

and as announcer for Clinton High School football and basketball games. Two decades into his practice, Wenk developed a significant neck and back issue. A benign tumor spanning the C2 through C6 vertebrae required a nearly 12-hour surgery. “It’s tough to be a dentist without bending your neck a lot,” noted Wenk. “It became increasingly more painful to practice.” When the opportunity came up to join Delta Dental of Tennessee, it gave Wenk a way to continue to impact oral health but on a much broader stage. “Delta Dental as an association is the oldest dental insurance company there is,” he said. Wenk added the American Dental Association launched the organization six decades ago on the East Coast and West Coast to serve union workers but soon expanded to other states. Delta Dental of Tennessee debuted 52 years ago. Although the ADA is no longer involved, the plans have continued to flourish and now have a 33.1 percent market share nationwide, according to data published in January from IBIS Associates. “We’re the largest player in the game,” Wenk noted. In Tennessee, the organization counted more than 1.8 million people as members at the end of 2016.

In addition to providing access to oral healthcare providers, Delta Dental of Tennessee has earned a well-deserved reputation for generosity in communities across the state. In 2014, they formalized their philanthropic strategy and giving priorities

to create the Smile180 Foundation. Last year, the organization gave away 75 percent of net revenues to support communities across the state. “Our foundation is basically portioned into three different buckets,” Wenk explained. “The first one is we’ve always been a big supporter of the two dental schools in Tennessee. That is your first line of treatment and your first line of education for oral health,” he said. “The second one is charitable clinics, and the third is children’s hospitals.” Delta Dental of Tennessee has been instrumental at Meharry School of Dentistry in building the simulation lab and in providing funding for the diagnostic center and multiple student scholarships. “We just agreed to be a primary sponsor of their restorative lab,” Wenk added. In Memphis, he continued, “We are the largest single monetary supporter of the UT College of Dentistry.” Following a recent $6.6 million donation, ground will soon be broken on a new building that will bear the Delta Dental of Tennessee name. In addition to aiding the dental schools, Smile180 also backs the broader concept of education, including support of organizations like Books from Birth. “If you’ve got an educated population, you’ve got a healthy population,” Wenk pointed out. The foundation’s second focus is on assisting dental clinics that serve the uninsured and underinsured, including the Interfaith Dental Clinic in Nashville. There are now more than 25 such clinics across the state, but Wenk said there are still many gaps to be filled. Smile180 provides operational support and capital needs for independent clinics. For federally qualified clinics, such as those at Neighborhood Health, the foundation assists with equipment. Wenk said providing oral care to those

with limited means could have an impact on every aspect of life. “No one with their front teeth missing is going to interview well,” he pointed out of donating digital x-ray equipment to open the door to options besides just extraction. The third bucket is focused on funding clinics at pediatric hospitals. “We’ve built an ambulatory dental clinic at every children’s hospital in Tennessee if there is room,” he said. These clinics allow pediatric dentists to serve patients and to bring in children with mental or physical challenges. “Our future is always our children so we’re going to contribute to our future,” he stated. Wenk has been widely recognized and honored for his volunteer efforts both personally and professionally. “I get too much credit for what our staff and board do … I’m just riding the pony,” he said modestly. In truth, Wenk is very hands-on when it comes to giving back. The community connections he enjoyed as a practicing dentist in Clinton are still a big part of his life as a CEO in Middle Tennessee. Wenk serves on numerous boards including Monroe Carell Jr. Children’s Hospital at Vanderbilt, St. Jude Children’s Research Hospital, Tennessee Performing Arts Center, and the University of Tennessee President’s Council. “I’m a staunch supporter of the Vols in every way,” he noted with a laugh. A big football fan, Wenk is also a past co-chair of the Franklin American Music City Bowl, where the Vols were the 2016 victors. When he isn’t busy at work or in the community, he and Brenda can be found enjoying their two grown children and three grandchildren who all live in the Nashville area. “They’re close, which is great! But they aren’t right next door … which is great, too,” Wenk concluded with a big smile.

ACHE Middle TN 2017 Board The American College of Healthcare Executives of Middle Tennessee recently named the 2017 board of directors. Charlotte Burns, FACHE, vice president of Network Affiliates for the TriStar Division of HCA, has taken on the role as president for the organization. Trent Beach, PharmD, FACHE, director of Clinical Pharmacy for Community Health Systems, has been named presidentelect, and Robert Fink, PharmD, FACHE, vice president of Ancillary Services and chief pharmacy executive at Quorum Health will serve as immediate past president. The full list of board members is online at



Waller Expands Dental, DSO Legal Practice Leader Recognized Among Industry’s Most Influential Don Moody – a partner with Waller Lansden Dortch & Davis, LLP – was recently named one of the “32 Most Influential People in Dentistry” for 2017 by Incisal Edge, a lifestyle magazine for dental professionals. The publication highlighted Moody’s longstanding role in the denDon Moody tal support organization (DSO) industry and his representation of some of the industry’s leading companies and private equity investors. He is the only attorney featured in the list. Moody leads Waller’s national dental and DSO legal practice. For almost 25 years, he has played a leading role in forming, acquiring and selling DSOs, dental groups and other healthcare companies across the country and in helping them comply with federal and state laws. Along with partner Neil Krugman, the Waller dental team has assisted large and small clients in hundreds of acquisitions, compliance and regulatory matters, DSO structures, government and internal investigations and a wide range of other legal matters. Waller has also expanded its dental team with the addition of three new attorneys with specialized expertise in the field. Eric Scalzo joined Waller after serving as deputy general counsel and direc-

tor of Compliance and Administration at DentMall MSO, a leading DSO that provides support and administrative services to nearly 50 affiliated practices across eight states. David Marks joined Waller from a global law firm to assist dental and other healthcare clients in acquisitions and private equity transactions. J.D. Thomas joined the firm after serving as an assistant U.S. attorney. Thomas represents dental clients and other health-

care providers in a broad array of criminal, civil and regulatory matters with a focus on government investigations and actions and False Claims Act and qui tam defense. “My recognition as a person of influence and the growth of our dental law practice is really a reflection of our outstanding dental and DSO clients and the success they have had,” said Moody. “As DSOs and the dental industry have evolved over the past 25 years, so too has our practice. Our dental clients know we understand

their business and have the experience and insight to help them achieve their goals and assist with the challenges they face.” The members of Waller’s dental law practice contribute to professional and business organizations serving the dental sector, including the Association for Dental Support Organizations (ADSO) and the American Academy of Dental Group Practice (AADGP). Additionally, the group has contributed to a number of white papers on critical issues in the dental industry.

SmileDirectClub Plans Major Team Expansion Direct-to-consumer orthodontics startup SmileDirectClub recently announced plans to add more than 400 jobs locally over the next five years to both its Bank of America Plaza headquarters and its manufacturing and distribution center in Antioch. Setting out to “democratize orthodontics,” the teledentistry company uses a network of affiliated licensed providers around the country to evaluate candidates for SmileDirectClub Invisible Aligners. Impressions for the customized aligners are made via an in-home impression kit or by visiting a SmileShop for a mouth scan. Dental pro-

fessionals review the 3D images to create an individual treatment plan, which generally takes about five to six months. Customers receive the treatment plan and several sets of aligners to shift teeth at a cost of less than $2,000. Gov. Bill Haslam, officials with the Department of Economic and Community Development and SmileDirectClub CEO Doug Hudson made the announcement Feb. 7 that the company would invest $4.5 million to grow their local presence. “The surest way for our cities and communities to continue to prosper is by fostering a business climate that encourages

our existing businesses to hire and grow,” Haslam said. “Nashville is growing exponentially, and we’re happy to be growing right alongside it,” Hudson said. “We put our new office in the heart of downtown because we want to be in the middle of all the energy, growth and fun this city has to offer. These are the exact qualities we wish to exhibit as a Doug Hudson company. We’re all about making people smile, and Nashville is the city that puts a smile on our face.”

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MARCH 2017



On the Front Lines of Oral Cavity Cancer Prevention, Detection By CINDY SANDERS

Incredibly painful to treat, potentially disfiguring, and quite likely to severely impact quality of life in the near- or long-term, a patient’s best line of defense against oral cavity cancer is a good offense in the form of primary prevention and early detection. “There has been an increase in the number of oral cancers diagnosed in the United States on an annual basis,” said Barbara A. Murphy, MD, director of Head and Neck Oncology and of the Pain and Symptom Management Program at Vanderbilt-Ingram Cancer Center in Nashville. The American CanDr. Barbara A. cer Society estimates Murphy more than 32,000 cancers of tongue, mouth or other oral cavity location will be diagnosed this year. Between 6,000 and 7,000 deaths will occur in 2017 due to oral cavity cancers, which have seen a decline in the death rate stagnate over the last decade.


To reverse the increased incidence trend, Murphy said it is incumbent upon pediatricians, family practitioners, dentists, and other primary care providers to make sure people fully understand the risk factors, particularly when it comes to tobacco usage. The medical oncologist noted many patients “don’t realize smokeless tobacco increases risk for oral cancers.” When a provider taking a patient history asks, ‘Do you smoke?’ and a patient who chews or dips tobacco truthfully replies, ‘No,’ Murphy said it is a missed opportunity for an important conversation. “We need to extend the question to smokeless tobacco … it’s about asking about the use of tobacco in all its forms,” stressed Murphy, who is also a professor of Medicine at Vanderbilt University Medical Center. Benjamin J. Greene, MD, an assistant professor at the University of Alabama School of Medicine at Birmingham, added patients should also understand the heightened risk for oral cancer that comes with the combination of drinking and smoking. “The two work together. It’s a synergistic effect,” said the head and neck oncologist. Greene added the whole is greater than the sum its parts … so the total risk for an individual who both uses tobacco and consumes alcohol is even greater than simply adding together the risk factor for each vice. He also Dr. Benjamin J. Greene noted there isn’t evidence of e-cigarettes being any safer at this point.

Early Detection

“It’s really critical to recognize the role of dentists and dental hygienists in the early identification of oral lesions,” said Murphy. 4


MARCH 2017

Greene concurred, calling dental professionals a “first line of defense.” He added that many people also go to primary care physicians with a lingering sore on the tongue or jaw and urged all healthcare professionals to refer such patients to head and neck specialists or an oral maxillofacial surgeon for a consult and possible biopsy. “If somebody has an ulcer or lesion in their mouth that hasn’t healed in two weeks, it should be biopsied … especially if they have a history of smoking or drinking,” Greene said. “My thought is it’s better to do the biopsy and then tell the patient it’s nothing. It hurts to have a tongue biopsy but not as much as having half your tongue taken out because we didn’t catch it sooner.” Murphy noted some of the early manifestations of oral cavity cancers include painful lesions, non-healing ulcers, abscessed teeth that don’t respond to treatment, and swollen lymph nodes. Adenopathy, she said, deserves extra attention. Greene agreed. “A swollen, enlarged lymph node in the neck of someone over 40 is cancer until proven otherwise,” he said. “You should be thinking cancer first. It’s not something you should take lightly.” If oral cavity cancer is caught in its early stages, Murphy said, “It’s not only curable … but curable without the aggressive treatments that are associated with significant morbidity.” As pleased as oncologists are to catch the cancer early, Murphy added, “If it can be found in a pre-malignant stage, that makes us even happier.” Red flags for premalignancy, she noted, include white or red plaque in those who might be asymptomatic or leukoplakia – the thickened, white patches that form on the gums, inside of the cheeks or floor of the mouth.


“Most oral cavity cancers are treated with surgery as a first line treatment,” said Greene. “Then we use radiation and chemotherapy postoperatively as indicated by the pathology.” Murphy noted the use of adjuvant therapy is often necessary but increases risks for patients. “Once you add on radiation or radiation with chemotherapy, the toxicities skyrocket,” she said. Mucositis, an inflammation of the mucus membranes within the oral cavity, is a primary … and extremely painful … toxicity associated with radiation. “Even opioids don’t work well on this pain,” said Murphy. Edema is another issue arising from adjuvant treatments where the swollen tissues can create problems with swallowing and speaking. Murphy said thick salivary gland secretions are another complaint for patients that are almost as problematic as mucositis. Large lesions typical in later stage cancers pose a host of long-term issues for patients. “Can you resect large lesions? Yes you can, but the effect on the patient is going to be profound,” said Murphy. “This is high dollar real estate in the mouth. When you go in and resect many of these tissues, there

is going to be function loss.” Speech, taste and swallowing are all potential casualties. Greene concurred, saying, “The surgeries for oral cavity can be pretty debilitating and disfiguring.” In cases where the jawline is impacted, Greene said some surgeries take eight to 10 hours. “Usually we do two teams. One surgeon takes out the cancer, and another rebuilds it … if the jawbone has to be rebuilt, that’s stage 4.” As with most cancers, treatment is most effective if the cancer is caught early. “Surgery is definitely curative,” Murphy said of completely resecting smaller tumors. As the staging moves up the spectrum, the treatment plan becomes more complex and outcomes less assured. Greene said the fiveyear survivability rate for oral cavity cancer is over 90 percent for stage 1 cancers but as low as 25 percent for some stage 4 cancers.

Oropharyngeal Cancer

Although close in proximity and often linked together for the purpose of discussion, oral cavity cancer and oropharyngeal cancer are two different beasts, Murphy and Greene noted. “There’s a big difference in treatment modalities and in etiology,” Murphy said. “Draw a line right along the edge of your mandible – everything in front is oral cavity and everything behind is oropharynx.” These cancers are often discovered later and therefore have a slightly lower fiveyear survival rate than oral cavity cancers. The American Cancer Society’s 2017 statistics estimate 17,000 new cases of pharynx cancer will be diagnosed, and 9,700 people will die from all oral cancers with about one-third of those total deaths being from

pharynx cancer. Greene said some of the signs and symptoms of oropharyngeal cancer include sore throat, persistent cough, ear pain, and a feeling like something is stuck in the throat. As with oral cavity cancers, Greene said smoking and drinking are risk factors for this type of cancer, as well. However, he continued, “We’re seeing a lot of oropharynx cancers in people who have never smoked and who aren’t heavy drinkers. These are mostly HPV-associated … up to 70 percent of oropharynx cancers are associated with HPV.” Murphy agreed, adding, “The number of HPV-associated oropharynx tumors is epidemic.” On a positive note, HPV-associated oropharyngeal cancers respond better to treatment. “In typical head and neck cancer, when someone has stage 3, you’re thinking a 50 percent five-year survival rate. For HPV-associated cancers stage 3, we’re seeing 85 percent five-year survival,” said Greene. He added the American Head & Neck Society strongly recommends the quadrivalent HPV vaccine for both boys and girls. The recommendation was given despite the difficulty in proving prevention of HPV-related oropharyngeal squamous cell carcinoma (OPSCC) due to the inability to reliably screen for pre-malignancy and the extended latent period between HPV infection and clinical cancer development. However, the authors of the AHNS position statement said the vaccines have been shown to be safe and offer a reasonable precaution based on the observed link between HPV and OPSCC.

Neighborhood Health at Lebanon Adds Dental Services Neighborhood Health at Lebanon has recently added dental services to the full-service health clinic. A dentist and hygienist are available three days a week, and the clinic accepts both appointments and walk-in clients. The expansion of dental services was funded by a $350,000 grant from the Department of Health and Human Services. Services include cleanings, x-rays, fillings, extractions and dentures. Care is provided to children from the age of four years old and for adults of all ages. The clinic welcomes those with dental insurance, TennCare and those who have no insurance. Dental and medical services are provided to those without insurance at a discount rate based on income. “Neighborhood Health always tries to provide comprehensive services and holistic care to those we serve,” said Mary Bufwack, CEO. “Over the last few years, we have been able to provide integrated medical and behavioral services at all 12 clinics, including our clinics in Lebanon and Hartsville. To now be able to provide residents of Lebanon, Wilson County, Trousdale County and the surrounding communities access to affordable dental care is very exciting.” She noted that poor oral health often has a serious impact on other health conditions like diabetes and hypertension, and that good oral health is essential for pregnant women. “Tennessee ranks 47th in the nation for the level of overall oral health and is one of only a half-dozen states where Medicaid does not provide dental insurance to covered adults.” Neighborhood Health currently provides dental care to about 2,500 patients through dental clinics at three of its Nashville facilities: Napier, East Side and Mission clinics. A similar project is in process at Neighborhood Health at Cleveland Park in Nashville and will begin serving dental patients in June.



The Next Generation, continued from page 1 “While the foundation of what we do is still the same, changes in technique and application have been transformational,” she said. Part of that transformation includes Meharry’s innovative dental simulation center. Provided by Delta Dental of Tennessee, the labs provide students the opportunity to critique their own work and receive immediate computerized feedback. The multimedia teaching system incorporates manikins with computer simulators to provide a reality-based experience. “The simulation labs give them the opportunity to work on patients before actually working on patients,” Farmer-Dixon said. Students also receive training on digital health systems, including e-health records and digital x-rays, and create onsite computer generated CEREC crowns. “We know that one day the traditional labs dentists have known will be a thing of the past so we want them to have the experience of doing digital crowns in school,” FarmerDixon explained. “We want students to learn the same applications they’ll need to know to be ready to go into private practice or residency.”

Changing Demographics

Another significant milestone for Meharry’s School of Dentistry is a noticeable change in demographics. Women now represent approximately half of both faculty and student bodies. And while the school is


Same School, New Technology

Meharry School of Dentistry’s technologically advanced simulation lab provides critical hands-on clinical experience and actionable feedback to better prepare students for real-world application.

one of the nation’s oldest and largest historically black academic health science centers, the program also boasts a racially diverse student population.

The Ties that Bind

The only black female dean among America’s 64 dental schools, Farmer-Dixon said Meharry’s close-knit community also sets the program apart. “We say we’re a family here because we have a strong academic support sys-

tem which begins when students come to orientation,” she said. “We use that as an opportunity to determine strengths and weaknesses and offer early intervention to students who may be at risk or having challenges. We don’t just admit you to dental school but work with you to help you graduate and reach goals.”

The Future of Dentistry

Meharry’s School of Dentistry joins the University of Tennessee-Memphis as

the only two dental schools in the state. More than half of the program’s grads continue post-graduate training elsewhere in the nation. While one-fourth will go into dental specialties, others go straight into residency. Farmer-Dixon said another trend is the number of grads going to work for corporate or group dental offices vs. traditional solo practices. “It’s a changing of times and dynamics of managed care, and corporate dentistry has given individuals the opportunity to practice without large loans or overhead,” she said. Today’s students also possess a better understanding of the correlation between oral and overall health. “The way that healthcare in general is going, people will ask about something like bleeding gums and what that means,” Farmer-Dixon said. “It’s important for patients to know that more and more studies show correlation between oral and overall health and how it can impact your heart health and systematic disease, and why it’s important to receive routine exams and cleaning every year.” She said the change in attitude reflects an industry-wide transition into health equity as opposed to strictly healthcare. “It’s not just important to know how to treat the disease but how you change the dynamic so you create healthier communities by teaching prevention,” she said. “We want to get communities to move from addressing disease to a discussion about good health habits.”


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NMGMATen Minute Takeaway The second Tuesday of each month, practice managers and healthcare industry service providers gather at KraftCPA headquarters for the monthly Nashville Medical Group Management Association (NMGMA) meeting. During the February luncheon, Rob Bramblett, CEO and co-founder of Visualize Health, spoke about the importance of capturing data and turning it into actionable steps to maximize success in a value-based medical environment. Visualize Health Rob Bramblett began in 2015 after Bramblett helped a friend sort out data for a practice, and the idea snowballed from there. Bramblett recognized an industry need for trained profes-

Blog Log The new Nashville Medical News Blog features additional insights and information from a cross section of industry leaders. The blog can be accessed directly through NashvilleMedicalNews. Blog or from the homepage of the main website. NEW IN MARCH: Susan Heard, SPHR, vice president of Paradigm Group, consults with clients on HR questions, compliance and effective communication. With an aging U.S. workforce, Heard answers common questions in the post, What You Need to Know: Responding to Employee Questions about Medicare. Nicole Kleinpeter, vice president of Lovell Communications – a strategic public relations, marketing and crisis communications firm specializing in healthcare – discusses smart ways to market new facilities and services in her article, If You Build It, Will They Come? Casey Midgett, a financial services officer for Life Credit Union – a financial cooperative solely dedicated to serving those who work in and for the healthcare community – looks at a home construction loan as a way to turn a ‘dream house’ into reality. Is it a viable option … and what are the next steps to take? Go online to learn more.



MARCH 2017

sionals who knew how to talk to doctors and understood the workflow of clinics, could provide EHR training, and would demonstrate to doctors how they could capitalize on their technology assets and get the biggest return on their investment. Visualize Health’s primary service is to leverage data for key performance indicators (KPIs) and turn them into actionable steps and goals. Bramblett said those steps could be change management, clinical support, market action, or all of the above. In January, the company launched an ACO in Florida after noticing a lack of care continuity within the market. Bramblett said primary care practitioners were seeing so many patients a day that they couldn’t keep up and follow up with their patients, meaning that there was very little care coordination. “When we’re talking about how to impact the patient – it’s really hard to go to doctors and nurses and talk about data

by Cara Sanders

entry, but that’s really where it starts,” explained Bramblett, adding such data makes it possible to track and follow a patient’s needs and progress. Bramblett said he knew the idea of value-based treatment had been tried and failed nearly 25 years ago. However, he added, “I think the huge difference in 25 years ago and today is data.” Noting the two big motivators for most people are love and money, he said he thinks fully utilizing actionable data will ultimately help providers make more money and get back to what they love … caring for patients. “Doctors are seeing more and more patients, but they aren’t getting paid more and more,” he pointed out. I really think in this model to make more money, they’re going to need to see less patients.” While he thinks data is central to making value-based care work and helping providers succeed, he said federal regulations set up across the board,

rather than by specialty, probably did everyone a disservice. “Meaningful use gave us a false sense of security when it comes to data,” he noted, adding that hitting MU goals doesn’t make data useable. In fact, he said that most practices still have ‘paper charts’ for all intents and purposes. While they have an EHR, the reality is that if the data can’t be sorted, teased out, studied and acted upon, it’s no more useful than a note in an old filing cabinet. “It’s going in there,” he said of logging important patient data into the EHR, “but it’s not going there in a codifiable language.” To thrive in a value-based environment, Bramblett said practices must know what reporting requirements are expected in contracts and what their practice systems are capable of doing. Then, they should form a plan to bridge that gap. For information on upcoming NMGMA events or to learn more about the association, go online to

CAC Raises Heart Disease Risk for Younger Adults A major report led by Vanderbilt investigators found the mere presence of even a small amount of calcified coronary plaque, more commonly referred to as coronary artery calcium (CAC), in people under age 50 was strongly associated with increased risk of developing clinical coronary heart disease over the ensuing decade. The study, which appeared Feb. 8 in JAMA Cardiology, also revealed that those with the highest coronary artery calcium scores, as measured by computed tomography scan, had a greater than 20 percent chance of dying of a heart event over that same time period. CAC has long been associated with coronary heart disease and cardiovascular disease. However, prognostic data on CAC in younger adults — people in their 30s and 40s — has been very limited, especially in African Americans and women. “We always thought you had to have a certain amount of this plaque before you were at risk of having events. What we showed was that, for younger people, any amount of coronary artery calcium dramatically and statistically significantly increased risk of clinical heart disease,” said Jeffrey Carr, MD, MSc, Cornelius Vanderbilt Chair in Radiology and Radiological Sciences at Vanderbilt and lead author of the Dr. Jeffrey Carr study. “Any measurable CAC in early middle age — scores of less than 100, and even less than 20 — has a 10 percent risk of heart attack or acute myocardial in-

farction, both fatal and non-fatal, over the next decade beyond standard risk factors,” Carr continued. The study points to CAC as a very specific imaging biomarker for identifying those people who are at risk earlier in life for heart disease and who might benefit from proven interventions such as cholesterol and blood pressure management, working toward a healthy BMI, smoking cessation and more. “The person may not be at risk for a heart attack tomorrow or next month, but they are at very high risk over the next 10 years of their life. For individuals at this elevated risk, we have proven interventions that could reduce their risk,” Carr pointed out. Data for this study comes from the National Heart, Lung and Blood Institute (NHLBI) Coronary Artery Risk Development in Young Adults (CARDIA) Study, a longitudinal, community-based study that recruited 5,115 black and white adults age 18 to 30 in four cities — Oakland, Minneapolis, Chicago and Birmingham — beginning in 1985 and followed them for 30 years. Institutions participating included Vanderbilt, the University of Minnesota, Northwestern University Feinberg School of Medicine, the University of Alabama at Birmingham, the Colorado School of Public Health, the American Heart Association, the NHLBI and Kaiser Permanente. CT scans were performed on 3,330 subjects for the CAC study, and the mean follow-up period was 12.5 years. CAC of any amount was seen in 30 percent of that group. Investigators sought to answer two primary questions: 1) Can the simple presence of CAC on a chest CT inform clinical

practice? 2) Is a CAC score greater than 100 associated with premature death? The answer to both was yes. “The presence of any coronary artery calcification, even the lowest score, was associated with between a 2.6 and tenfold increase in clinical events over the next 12.5 years,” Carr said. “And when it comes to those with high CAC scores (100 or above), the incidence of death was 22 percent, or approximately 1 in 5. Very few times do you get a biomarker, be it genetic or imaging, that predicts death at a level of 22 percent over 12.5 years.” Carr said whether the amount of CAC is high or low, it’s presence is a signal that advanced coronary artery disease is present and enhanced prevention could be warranted. A change in clinical practice that could impact care today is that CAC can easily be identified on routine CT scans of the chest obtained for other indications, Carr said. “Our study provides strong evidence that an individual under age 50 with any amount of CAC is at markedly elevated risk for heart disease; and for healthcare providers and patients, it should be viewed as a call to action to enhance cardiovascular disease prevention,” Carr said. Whether any kind of general screening for CAC is warranted needs additional research, although the study’s authors suggest that a “CT scan everyone” strategy in all individuals age 32 to 46 is not indicated. Instead, they suggested a more targeted approach based on measuring risk factors in early adult life to predict individuals at high risk for developing CAC in whom the CT scan would have the greatest value and should be considered. nashvillemedicalnews


The Three R’s of Healthcare Reform: Repeal, Replace, Repair Tavenner, Pollack Talk Policy at Health Care Council Event On Feb. 23, the Nashville Health Care Council hosted the leaders of two of the industry’s most influential advocacy organizations in Washington, D.C. for a discussion about health policy in the midst of unprecedented uncertainty. Marilyn Tavenner, president and CEO of America’s Health Insurance Plans (AHIP), and Rick Pollack, president and CEO of the American Hospital Association (AHA), joined moderator Susan Dentzer, president and CEO of The Network for Excellence in Health Innovation, to share perspective on the Affordable Care Act and other health reform issues. Dentzer led off the discussion by addressing the current state of “ACA whiplash” as different factions discuss repeal, replace and possibly repair. When asked where they thought the country would be in the healthcare reform discussion six months from now, both Pollack and Tavenner wryly said they expected to be pretty much in the same place as today … still talking about it. The day before the Council event, President Donald Trump said he anticipated having a healthcare reform plan ready for release as soon as this month. However, his statement didn’t clarify whether the plan would be from the White House or some sort of joint Republican effort. Tavenner and Pollack said that putting partisan politics aside, there currently wasn’t even consensus on healthcare reform between the White House and Congress or between House and Senate Republicans. While conversations will continue about the best way to move forward, the two said the complex issue has a lot of moving parts that will take time to fully address. Both Tavenner and Pollack agreed the most fundamental challenge facing Republicans is how to implement repeal without constituents facing a decrease in coverage. “In the hospital field, nothing is really more important than trying to retain coverage,” said Pollack. Tavenner added, “About 85 percent of those on the exchange received an advance payment of the premium tax credit. Right now, we’re waiting for Congress to decide how they want to manage subsidies and income credits. It really is crunch time.” When it comes to Medicaid, Dentzer called it a ‘double barreled’ issue, noting conversations cover both rolling back Obamacare Medicaid expansion and considering a conversion to block grants for states. Currently, about 75 million individuals are covered by Medicaid. While supportive of the concept of flexibility for states, Pollack said, “If we’re going to use block grants and per capita caps as a vehicle to cut programs that are nashvillemedicalnews




AHIP CEO Marilyn Tavenner and AHA CEO Rick Pollack recently shared their perspectives on looming health policy changes with Nashville industry leaders.

already severely underfunded, it’s not really a productive conversation.” Tavenner, who previously served as administrator for the Centers for Medicare & Medicaid Service (CMS), agreed improvements could be made to the Medicaid program and said she thought many would support reforms that would cut bureaucracy and give states more flexibility. However, she said it was important to address the issues without kicking people off rolls or cutting reimbursements to provid-

ers and questioned the usefulness of block grants to meet those objectives. Pharmaceutical pricing was another hot topic of the day. Pollack and Tavenner both said they are not in favor of price controls. Tavenner noted, “I think most of the action around pharma pricing will be at the state level.” As an organization, she added AHIP is supportive of transparency, value-based pricing for pharmaceuticals and getting generics and biosimilars on the market. She added that as we move into a year where everything is up for de-

bate, “It’s a good time for all of us to get engaged about what we want to see.” Amidst the uncertainty and change, Pollack and Tavenner said the move toward value-based care enjoys bipartisan support. “The movement from volume to value will only continue,” said Tavenner. “I don’t see anyone on either side wanting to undo this trend. If you look at Nashville, this is a community that’s embraced population health and delivering healthcare in a meaningful way. Lowering costs while doing what’s best for patients is a win-win for everyone.” One outcome of the move from volume to value, said Pollack, has been consolidation in the industry. “We’ve been asked to take on more risk, which means you have to have bigger scale,” he explained. Pollack also noted that as the industry evolves, healthcare organizations must also adapt to meet their members’ needs. “We are redefining the ‘H’ in AHA because the ‘H’ is more than the building,” he said. “Care outside the hospital – whether that is managing chronic conditions, telemedicine, hospitals at home or other care settings – is central to the continuum. Consumerism, convenience and accessibility are all top-of-mind for our members, and we continue to adapt to changes in the provider space.”

Hughston Clinic Orthopaedics Welcomes

Morgan P. Lorio, MD

Dr. Morgan P. Lorio – who is triple board certified in spine, orthopaedic and hand surgery – recently joined Hughston Clinic Orthopaedics in the Centennial and Summit offices. Having recovered from a significant spinal injury himself, Lorio brings a unique perspective to patient care. He is widely recognized for his pioneering work in spine technology, patient advocacy and expertise in spine policy. Medical Degree & Training • Louisiana State University School of Medicine • Orthopedic Surgery, Spine, Hand and Microsurgery, SUNY University at Buffalo School of Medicine and Biomedical Sciences To refer a patient or schedule an appointment, call 888-366-8894. MARCH 2017



Building Boom If Nashville had a city bird, it would be a crane … no, not the long-necked, long-legged avian but the soaring steel tower cranes that seem to dot the sky in every direction. While lot of new hotels, condos and apartments are popping up throughout the city, the healthcare industry is responsible for a good number of those steel birds. This list is by no means comprehensive but is, instead, a small sampling of the recent building boom.

Monroe Carell Jr. Children’s Hospital at Vanderbilt

Construction is underway at Monroe Carell Jr. Children’s Hospital at Vanderbilt on a four-floor expansion that will advance the size and scope of the hospital’s comprehensive array of specialty and subspecialty pediatric healthcare programs. Once fully completed, the four new floors will add 160,000 square feet of additional space, bringing the hospital’s total footprint to ore than 1 million square feet. The first two floors to be completed will provide approximately 80,000 square feet of new patient care space and will include 76 critical and acute care beds for newborns and pediatric patients. The new space will also include family areas, a playroom, a large waiting room, educational space and patient consultation rooms. Construction, which got underway last fall, is expected to take 30 months to

complete. The hospital surpassed its fundraising goal of $40 million to support the expansion through the Growing to New Heights Campaign.

TriStar/MRH Joint Venture

Maury Regional Health and TriStar Health received CON approval at the Feb. 22 meeting of the Tennessee Health Services and Development Agency meeting to develop a joint venture behavioral health hospital in Columbia. The inpatient facility will add 60 behavioral health beds for adult and adolescent patients and will be located on North James Campbell Boulevard. It is estimated that the $24.4 million investment for Maury County will employ approximately 100 caregivers and support staff. Pending design and construction, officials hope the facility will open in 2018. The unique collaboration across two healthcare systems is anticipated to help address a gap in services for the county. “Every day, patients who would benefit from behavioral health services visit emergency departments and physician offices throughout the region. Because of the current shortage of available services, these patients may experience delays in treatment or travel long distances for their care. With the approval of this new behavioral health facility in Columbia, patients will soon have greater access to the care they need on their journey to recovery,” said MRH CEO Alan Watson.

LBMC Celebrates New Office

In January, regional accounting firm LBMC celebrated the move to their new office space at the corner of Franklin Road and Maryland Way in Brentwood. The company is leasing 80,000 square feet in the new Hill Center Brentwood. Incorporating sleek, modern design, the new office includes amenities Andrew McDonald, FACHE, leader of the LBMC Healthcare like standing desks for em- Consulting Practice (Left) welcomes guests to the LBMC open house event. ployees, private Mother’s Rooms for new mom returning to work, and Temple Road by Mt. Juliet-based de‘phone booth’ rooms where employees veloper Commercial Realty Services. Ancan hold private phone conversations, ticipated to be finished by late 2017, Saint and 38 ‘collaboration rooms’ (rather than Thomas Medical Partners will lease the conference rooms) that feature original art more than 22,000-square-foot building and high-tech equipment to connect with and will feature specialty care, imaging, clients across the country. radiology, physical therapy and occupa“Our building was designed with our tional therapy, among other services. entire family of companies and all of our In addition, Saint Thomas Health is team members in mind,” said COO John building a comprehensive oncology cenLitchfield. “From the offices all being the ter currently under construction at 2004 same size to everyone having the same Hayes St. chair to the majority of the offices being Editor’s Note: Go online to NashvilleMedioff the glass to allow for everyone to enjoy to read an op-ed on patient-centered a view of outside, we hope we have credesign by John Goodman, vice president of onated an environment that allows folks to cology service line for Saint Thomas Health, ad do their best every day in a relaxed effecDon King, president and CEO of Saint Thomas tive work space.” Midtown & West.

Saint Thomas Additions

Onward and upward … construction is underway to add four floors to Monroe Carell Jr. Children’s Hospital.

HCA’s 1100 Charlotte Building

At the end of 2016, HCA cut the ribbon on their new 1100 Charlotte building at Capitol View. Located in the North Gulch, the new 17-story facility provides office space for employees of HCA subsidiaries HealthTrust, Parallon and Sarah Cannon. The $200 million structure has a total of 560,000 square feet with more than 400,000 square feet designated for office space and another 30,000 square 8


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feet allocated for retail space. Additionally, the building features a full-service café, fitness center, and modern conference rooms. HCA made a commitment to diversity in the construction process. The company exceeded their goal of 20 percent contracting, with nearly one-third of the project components going to minority- and women-owned businesses. The Capitol View building is the first phase of a mixed-used project.

Saint Thomas Medical Partners recently opened a full-service care center in Murfreesboro. Saint Thomas Health – New Salem offers primary care, outpatient rehabilitation, on-site lab testing, Premier Radiology imaging services, and ExpressCare all under one roof. “Our new care centers tailor to the needs of each community,” said Fahad Tahir, president and CEO of Saint Thomas Medical Partners. “We researched and identified the services that are in high demand, but difficult to access in these communities, and put all Fahid Tahir of these services in one place to simplify our patients’ overall care experience.” A similar center is currently under construction in Bellevue at Old Harding

SRMC Celebrates ER Grand Opening Sumner Regional Medical Center has officially cut the ribbon on their new stateof-the-art, freestanding Emergency Room at Sumner Station in Gallatin. The new facility will begin treating patients on Monday, March 20 and will be open 24 hours a day, 365 days a year. The same board certified, fellowship trained emergency medicine team that see patients at SRMC will provide care for both adult and pediatric patients at Sumner Station.




Building Healthcare

Construction Leader DeAngelis Diamond Brings Healthcare Division to Nashville By MELANIE KILGORE-HILL

A nationally known construction firm has joined Nashville’s rapidly growing healthcare and commercial construction market, bringing decades of industry expertise to Middle Tennessee. Headquartered in Naples, Fla., DeAngelis Diamond recently chose Franklin as a home for its fourth regional office. “Considering the market for resources and talent, Middle Tennessee won out over Denver and Austin, which were also in the running,” said Jason Sain, vice president and principal of DeAngelis Diamond. “Many of our clients are based out of Nashville, and we felt we could better serve them by having more of a local presence.” DeAngelis Diamond has completed well over $2 billion worth of construction projects ranging in size and value throughout the commercial and healthcare market

Vice President/Principal Jason Sain and Senior Project Manager, Eric Brackin, in front of Naples Community Hospital, Free Standing Emergency Department.

sectors. Sain said the Nashville office is anticipated to produce a significant and growing amount of the company’s revenue this year.

Humble Beginnings

DeAngelis Diamond was founded in 1996 by David Diamond and John

DeAngelis, who began their construction industry careers as project managers in Southwest Florida. “They soon realized there had to be a better way to build, and a better way to enrich the client, community and subcontractors’ experience,” Sain explained. Several prayerful months later, the friends launched DeAngelis Diamond from a small executive suite. Today, the company is top-ranked in the United States, licensed to build in over 45 states, and also holds a presence in the Caribbean Islands. DeAngelis Diamond has five fully staffed offices in Naples, Fort Myers, Sarasota, Birmingham and Nashville. Today, the company has built up a diverse project portfolio – with experience

ranging from multi-phased renovations to projects in excess of $100 million – serving clients from some of the largest and most well known companies in the country, including Nashville-based HCA. Healthcare construction, with all of its specific requirements and regulations, is one of the company’s specialties.

Core Beliefs

DeAngelis Diamond is driven by their seven core values of faith in God, lasting relationships, leadership, integrity, healthy environment, excellence and quality, and their company motto, “the Honor to Build.” “Our founders recognized quickly that it really was about relationships and the experience of building projects,” Sain said. “Honor and integrity set the company apart. When we make a commitment we keep it, and that’s a pretty powerful and difficult thing to do in this industry.” Joshua Rhodes, division manager for the Nashville DeAngelis Diamond office, said those expectations are consistent company-wide. “By the time we’re done with a project, it’s our goal that we’re (CONTINUED ON PAGE 11)

You have a lifetime of experience. So do we. Y

ou deserve a health care partner as experienced as you are. Over the last 45 years, NHC has grown from a small office in Murfreesboro into a nationally recognized leader in long-term care. With more than 130 NHC-affiliated health care centers in 10 states, we’ve succeeded by focusing on what we do best: providing experienced staff and innovative services in locations close to home.

Visit to explore our full range of services and to find the NHC nearest you. To learn more about our homecare services visit ©2016 NHC 23025




MARCH 2017




chairman emeritus for the company, which has more than 26 offices in three countries. The recent move – back to his healthcare roots – is part of the firm’s long-term leadership succession plan. While Bearden’s focus has shifted, his daily workload hasn’t lightened. “About onethird of our company is healthcare work and services,” he said. The concept of Floor-to-ceiling windows, pendant and task lighting, white counters, and light stone tiles all value-added design help weave lightness and brightness into a task station at Phoebe Sumter Medical Center in began several years ago Georgia. Backlit ceiling panel art brings an unexpected sense of the outdoors into an interior space. as GS&P crafted a 2020 strategic plan, Bearden PHOTOS ARE COURTESY OF GRESHAM, SMITH AND PARTNERS explained. He said the firm began asking these tenets into the fabric about layout,” Bearden clients very specific questions about the of the project on the front stated. He added that an challenges they faced. “It started allowing end. “It’s taking the proeye-opening exercise is to ask us to see what we might do with our work cesses and working with the staff, “If the physical environto help them be more successful,” Bearden staff within the physical enment wasn’t there, how might noted. vironment and looking at it you be more effective in deWhen looking for common elements holistically,” he explained. livering patient care?” Really that would be applicable to improve perFor example, Bearden listening to the answers, he formance across the healthcare spectrum, continued, to address the continued, informs innovaBearden said they came up with six key safety concerns surroundtive design. indicators – patient safety, operational efing patient falls, GS&P’s “All these things now ficiency, integration of technology, adaptmultidisciplinary design have to mesh together in ability and resiliency, sustainability, and team moves through the order to work,” Bearden said enhancing the human experience through steps a patient would take of creating an efficient, effecevidence-based design. – whether that’s from the tive built environment. “One An interplay of textures and colors from nature create a restful sitting area. The key, Bearden said, is to weave bed to the bathroom or of the things I love about working at Gresham Smith is down the hall to diagnostics. “It is literhaving multidisciplinary teams that allow ally putting yourself in the position of the us to address complex problems holistiKeeping pace with the business needs patient,” Bearden noted. In doing so, cally.” He added the different points of he continued, designers begin to think expertise and connectivity of the team of healthcare providers. about physical proximity between points brings about better solutions, which is esof service, walking surfaces, patient bed sential in today’s climate of change as care design, alarm systems, and assistive techdelivery continues to evolve. nologies. “Healthcare institutions are looking Integrating technology has become a at their return on investment for their prominent consideration in facility design. capital expenses in a much shorter and Bearden said they have seen a significant shorter time frame,” Bearden added. “It increase in technology budgets over the used to be about 20 years … now it’s five last several years for many of their clients. to seven years.” “How do you turn that needed IT infraBecause of that, he said architects structure truly into the building infrastrucand designers have moved away from creture and think about it the same way as ating rooms or departments for a single, Serving Nashville’s healthcare industry for more than 50 years. you would for mechanical, electrical and specific use and instead are devising multi» ICD-10 education and consulting » physician practice consulting plumbing?” he questioned. Considered functional areas that anticipate future uses essential elements, mechanical, electrical through open-ended design. “Change is » Medicare/Medicaid cost reports » outsourced accounting and plumbing features are designed into going to be inevitable,” Bearden pointed and related services » tax planning and preparation the building from the beginning. While IT out, “so the goal is to reduce future reno» executive compensation consulting » coding and documentation audits needs used to be added in at some point vation costs by extending a department’s down the design road, technology recently lifecycle through adaptable healthcare » CDM reviews and analysis » mergers and acquisitions has made the transition to essential eledesign.” » HIPAA, HITECH and meaningful use » valuations ment. “It’s really exciting to not only get Ultimately, he said the goal is to » RAC appeals and risk assessments » assurance services it budgeted but to get it designed well,” incorporate all or part of the six defined Bearden said. value-added areas into a project as » litigation support » wealth management services Designing with operational efficiendetermined by each client. Equally Contact cies in mind has also become mission important is thinking about how each of critical. “There’s not any institution the areas impact staff, patient experience, that I’m working with that isn’t employand aesthetics. That thought process ing lean and Six Sigma into their basic is woven throughout the project from operations,” Bearden observed. Today, the research phase to the design stage due diligence includes having departand three-dimensional modeling to ments sit down and think through their implementation and construction. workflow. “That, I think, is the secret sauce “You actually have to take the pro… integrating it into the entire process,” Lucy Carter Scott Mertie cesses into account first and then think Bearden concluded. 615-346-2497 615-782-4292 10


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Employing Value-Added Design to Improve Performance, continued from page 1

Change and Opportunity Rethinking Healthcare Design & Construction

… that’s now going directly to your bottom line.”


Skanska has been building hospitals and healthcare projects for more than 100 years. It’s safe to say the construction firm has witnessed more than a few trends come and go over the last century. Andrew Quirk serves as senior vice president and national director of the Nashville-based Healthcare Center of Excellence for Skanska USA. “Healthcare and the health sciences sector is the largest for Skanska,” he noted. Adopting the Center of Excellence business model 15 years ago, Quirk said the goal was to be a better partner within the industry by highlighting challenges and successes borne of experience. “We wanted to be able to share information about products, about designs and general knowledge about the healthcare industry across all of our offices,” he explained. Then, he continued, the company began looking outward, Andrew Quirk meeting with the leadership of hospitals and health centers, along with providers, to add their perspectives on solutions and barriers. In Europe, Skanska actually owns hospitals through P3 (public-private partnership) arrangements where the company designs, builds, finances and operates the medical facility … everything but clinical care. “The reason it works so well is it aligns core competencies where they are better managed,” said Quirk, a registered architect who also has experience in health system management. While the P3 model isn’t in place in America, the perspective gained in Europe adds to the skill set the company brings to the table here. “We can talk to clients as owners and talk to them about what we see,” he said. What Quirk and others in the healthcare design and construction industry are observing is a period of great change … but also one of great opportunity. With a shift to value-based care across the continuum, he said now is a great time to take a step back, refine processes, evaluate the impact on outcomes, make corrections, and find ways to work more efficiently within the industry.


Quirk said with all the upheaval healthcare has faced over the last few years … and because providers have so much on their plates at this point … the industry is really reaching out for partners and looking for guidance and ideas about how to make the physical environment better. “Integrated Project Delivery is a contract between the developer, architect, and the client. It makes all three of those equally responsible and at risk for the delivery of a project and the outcome of a project. IPD is nashvillemedicalnews


Change & Opportunity

used across industries, but it’s perfect for the healthcare industry because of the inherent complexity of the projects,” Quirk noted. “There’s an interest in partners coming on board who are willing to take risk,” he continued. “There’s really good partnership building that I haven’t seen as much in the past.” Because of that risk component each participant in the contract bears, Quirk said IPD projects tend to be built faster, less expensively, and with better outcomes. “Everyone has some skin in the game,” he pointed out.


“The industries that serve healthcare are mirroring what’s happening in healthcare,” Quirk said. “Efficiency … that to me is one of the overarching trends in the industry right now.” Whereas Quirk called the 1980s the ‘land of unchecked building,’ today the trend is rightsizing – building in the right place at the right time with the right square footage to get the job done. “ROI is talked about at every level,” he said, from the earliest discussions of a project all the way through to completion. He said a lot more questions are asked on the front end. “Let’s review every square foot that’s built and designed … what’s the ROI of that square footage … and if the ROI isn’t high enough, do we need to build it?” In the pre-recession 2000s, Quirk said the industry saw the rise of the luxury hospitality look with palatial atriums, massive lobbies and larger and larger patient rooms. “Those spaces continued to grow without anyone saying, ‘Have we gone too far?” Now we’re seeing a bit of retreat from that … not from warm, inviting spaces but from just massiveness.” He was quick to add rightsizing doesn’t forsake evidence-based design at all but simply looks to incorporate those elements into smaller, more efficient spaces. Health systems, he added, are only building what is needed or what the community needs. It’s one of the reasons he believes micro-hospitals are on the rise (see related article on page xx).

Integrated Technology & Future-Enabled Design

In the past, Quirk said there was a distinct separation between the built environ-

“Moving from volume-based to outcomes-based has turned the industry upside down,” said Quirk. “There’s really no playbook or path to solving what’s happening right now.” However, he continued, with the paradigm shift comes a unique chance to rethink the status quo and make real changes to the built environment that supports outPHOTO © 2015 KIERAN REYNOLDS comes. By bringing more partners ment and the equipment itself. However, and perspectives to the table, he said, there he continued, the use of smart technology, is a greater chance to create truly innovatelemedicine and data capture are all retive solutions. shaping care. “If the delivery of healthcare “If we get to the end of this upheaval, is changing, it has to change the environand we haven’t made the delivery of healthment where healthcare is delivered,” he care better, then shame on all of us for not pointed out. stepping up and taking the opportunity to Quirk said he believes integrating techdo more,” Quirk concluded. nology into the building itself is an important next step. As critical as that is, however, Quirk was quick to note, “There’s absolutely continued from page 9 no way you can design a building that’s ready for the technology that is coming.” actually missed. If our project managers Therefore, the best option is to plan and staff put on those goggles, they can view for change by creating footprints with people and relationships greater flexibility. One example of this and construction in a type of future-enabling design is to move different way than our mechanical systems from the middle of facompetition. This ties cilities to the outside edges of a building. into Biblical principles That way, Quirk said, there is less expense and helps us view issues and less disruption of service when the time through the lens of comes to renovate or expand. who’s really in control,” Rhodes said of company Joshua Rhodes Sustainability philosopy. Although technologically advanced in many ways, Quirk said the healthcare At Home in Nashville industry has been slow to accept change Rhodes said the company has received on other fronts. “On the sustainability a warm welcome from Nashville’s vast side, healthcare was the last to adopt those healthcare market, from local architects to practices,” he said. “I think it’s a huge opcontractors. “It’s a close-knit community portunity for the industry. Healthcare is and staying in contact with these groups the biggest sector for the consumption of has been beneficial for us,” he said. energy. Let’s do something about it.” The Nashville office has become inIncreasingly, health systems are warmvolved with a local non-profit, Our Kids, ing to the concept of ‘net zero’ as an impethrough sponsorship of charity events. tus to create their own energy. Geothermal They also host monthly leadership lunsystems, wind, solar panels, and methane cheons through the Williamson County from landfills are all option to hit net zero Chamber of Commerce. energy consumption. Gundersen Health System – which inFinding a Niche cludes hospitals, clinics and skilled nursing Acute and behavioral health facilifacilities in Wisconsin – made news in early ties are frequent projects for the company, 2015 when officials announced they were along with rehab and addiction centers. producing more energy than they conRhodes said another trend driving healthsumed, making it the nation’s first net-zero care construction is skilled nursing and health system. “If it can be done in a cold assisted living, as memory care units are climate, it can be done anywhere,” Quirk becoming increasingly standard practices pointed out. in senior living facilities. Quirk said it’s surprising how many Freestanding emergency departments hospitals and health systems either don’t are another increasingly common project know exactly how much they are spendfor DeAngelis Diamond. “There’s nothing ing on energy or don’t know how to get a too small or too complicated that we won’t handle on the expenditure. look at,” Rhodes said, “We consider it an “For the facilities that get ahold of this, honor to build for our existing and new cliit’s really found revenue,” he said. “The ents, and we don’t take that responsibility money you would have spent on energy lightly.”


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Big Trend? Think Small

ESa Architect Discusses the Rise of Micro-Hospitals Kevin Harney, AIA, NCARB, has worked in healthcare design for two decades. While much of the architect’s attention has been spent on large-scale projects, a newer trend has him thinking small. Harney, a principal with Nashvillebased ESa who provides project planning and design management for healthcare projects nationwide, said the concept of the micro-hospital is gaining traction. “In theory, it’s been around the last five to 10 years, but we’re seeing it come up more and more.” Part of the larger trend of right-sizing faKevin Harney cilities, a micro-hospital typically falls between an outpatient clinic and acute care hospital in terms of space and capabilities. Harney said micro-hospitals generally encompass



Natural light floods into CHI St. Luke’s Springwoods Village, which is located in the Houston suburb of Spring, Texas.

15,000 to 20,000 square feet. Those that offer more services, however, might be as large as 40,000 to 50,000 square feet. Rather than adding more beds to a large, tertiary facility, Harney said the trend is to put the beds out in the community closer to patients. “They are accessible. They are convenient,” he said of the appeal, adding most patients would only

expect to be at the micro-hospital for 24 to 48 hours. Similar in geographic concept to building freestanding EDs in high growth markets, Harney said micro-hospitals are typically woven into the urban fabric. “It’s also a branding opportunity. If it’s tied to a larger organization or larger system, they are carrying that brand into the commu-

Seeing an Opportunity

Dr. Ming Wang Looks to Expand Aier Eye Hospitals to U.S.

Aier Eye Hospital executives form the company logo at a recent national conference.

For the past 15 years, Ming Wang, MD, PhD, has worked with Aier Eye Hospital to grow and expand the private company’s presence in China. Now, the noted Nashville eye surgeon is hoping to duplicate that same success in his adopted country as CEO of Aier-USA. When Aier Eye Hospital Group Chairman and Founder Chen Bang approached Wang about working with the company, he was seeking a top ophthalmologist with ties to the United States who could bring the latest technologies to China and help train Aier physicians in these new techniques. In addition to the required skill set, Wang was a perfect match for the businessman’s other two key criteria: the U.S. eye surgeon must speak fluent Chinese and be from mainland China. Wang, who immigrated to the United States at the age of 21, laughingly noted that narrowed the candidate pool down considerably. The collaboration has worked well. Today, Aier Eye Hospital has grown from a small company with several facilities in rural areas of China to a publicly traded company with 154 hospitals, more than 25,000 employees, and an annual surgical volume of 500,000 eye procedures. In terms of facility size, Wang said the eye hospitals 12


MARCH 2017

fall between the American concept of a small community hospital and a large clinic. The company announced its IPO in 2009 while Wang was with then-Governor Phil Bredesen on a Tennessee trade mission to China. Today, Aier has about 10 percent of the Chinese eye care market, making it the largest non-government eye hospital group in China. Of the 154 facilities, all but two are on the mainland. Wang said there is one in Hong Kong … and the other is the Wang Vision Institute in Nashville. “Overall, the U.S. market has not been a focus for the Aier Group,” said Wang. “Its focus is in China because it wants to build 1,000 eye hospitals in the next three to five years – very ambitious.” Almost from the beginning of his association with Aier, however, Wang has worked to convince the company to expand in America. “As someone from the U.S., I wanted them to invest in the U.S.,” said Wang, who also is president of the Tennessee Chinese Chamber of Commerce. Wearing his chamber hat, Wang noted, “Our mission is to help America with its trade with China. We have a $380 billion annual trade deficit with China.” He added there are two ways to offset that deficit – sell more to China or get Chinese companies to

invest more in America. It’s the latter tactic he has proposed to Aier for years. Recently, the company announced they would, indeed, open Aier-USA, naming Wang to lead the American division. “We take Chinese money, invest in this country and create jobs here … I think it’s wonderful,” said Wang. While the financial investment in America is important to Wang, he said there is a clinical need, as well. “We actually do have a need to provide better care to American citizens,” he stated, citing a lack of access to specialty care and the latest technology in communities outside urban areas. “Our initial intent is to follow the winning strategy of Aier Hospital in its early days, which is starting with medium to small cities,” he said of the plan for North America. He added the company would look both at building new clinics and partnering with existing facilities. Wang said 2017 has been earmarked for due diligence with new Aier facilities probably not coming online before 2018. After starting with a focus on Tennessee, Wang said the second stage would be to look at potential sites in the rest of the country. He will continue his private practice and will look to train new physicians as Aier-USA grows. Encouraging Chinese investment in the U.S. and creating new jobs for the American workforce are two ways Wang said he could have some small impact on the nation that has given him so much. “I’m very grateful to America,” he said. “America has a system that’s fair, open and gives opportunities. I feel there is an obligation for every single immigrant to give back.”

nity,” Harney noted. A couple of years ago, Harney worked on a micro-hospital project in Spring, Texas where a larger health system wanted to grow their presence in a suburban area. What started as an outpatient center wound up with several inpatient beds. “We actually designed it so that the little microhospital could be expanded into a larger 200- to 300-bed hospital in the future,” Harney explained. He added, however, that plan was a bit of an anomaly. While micro-hospitals are usually intended to stay small, he pointed out flexible design does offer the opportunity to expand the facility to match population growth. Generally, Harney said a micro-hospital would include full-blown emergency services, four to 10 inpatient beds, some diagnostic services, pharmacy, and other limited support services. “The ones in the 40,000- to 50,000-square-foot range may have a little more robust diagnostic/imaging component to them,” he noted. “They may even offer some outpatient surgery services.” Harney said the trend is much stronger in states without a certificate of need program like Texas but added the facilities are still designed to meet the licensed hospital requirements in that state. In addition to meeting patients where they live, there are other considerations that make these small hospitals appealing. Harney said micro-hospitals could be built faster and at lower cost than going onto an existing campus and having to expand vertically or buy adjacent property. “The real estate around an existing campus may be cost prohibitive,” he noted. Instead, microhospitals are usually built on ‘greenfield’ sites … meaning the health system buys an empty parcel of land for the project. “I would say from an aesthetic standpoint, they are more upscale,” Harney continued of micro-hospitals. “They tend to have a retail feel to them. They want you to feel like you aren’t walking into a sterile environment.” He added the small size lends itself to design elements that usually aren’t found at their higher acuity counterparts. “These little micro-hospitals allow you to introduce more natural lighting into spaces where you typically wouldn’t see natural light in a larger hospital. Because they are smaller, you can introduce natural light into an ED exam room. By doing these little things, you enhance the experience.” He said another goal is to introduce finishes that might be different from a larger facility. “We like to use materials that are durable and easy to maintain … and obviously meet codes … but are also inviting and have some warmth to them,” Harney explained. Ideally, micro-hospitals fill a service gap and offer another option to deliver care at the appropriate time and in the proper setting. While Harney is seeing a growing interest among clients, he said the staying power of the trend would largely depend on the direction of healthcare moving forward. nashvillemedicalnews



Joanna Conley has been appointed chief executive officer of the 126-bed TriStar Southern Hills Medical Center effective April 1. Currently, she serves as CEO of Poinciana Medical Center, an HCA affiliate in Kissimmee, Fla. Prior to her current role, Conley served as Joanna Conley COO of Poinciana and associate COO at HCA’s Osceola Regional Medical Center, also in Kissimmee. Conley earned her undergraduate degree in Public Health, Health Policy and Administration from the University of North Carolina at Chapel Hill and her MBA from Vanderbilt University Owen Graduate School of Management.  She is a Fellow of the American College of Healthcare Executives.  Conley replaces Tom Ozburn, who was appointed CEO of Parkridge Health System, sister HCA affiliate in Chattanooga earlier this year. 

Toth Tapped to Lead Saint Thomas Women & Children

Kristen Toth, formerly executive director of Saint Thomas Health Alliance, has been named vice president of Program Development-Women and Children, at Saint Thomas Health, which is part of Ascension. In this new position, Toth is responsible Kristen Toth for overall management of the STH Women and Children Program, including planning, services, clinical processes and business practices. She joined STH in January 2014 after working for 12 years in the pharmaceutical industry, specializing in women’s and pediatric health. Toth holds a bachelor’s degree in mathematics from Maryville College and a master’s in statistics from the University of Tennessee. She currently serves on the board of directors for Mercy Community Healthcare.

Sibley Named LifePoint Central Group COO

Brentwood-based LifePoint Health recently announced Cherie Sibley, FACHE has been named chief operating officer of the company’s Central Group of hospitals, effective March 13. Sibley, who has been part of LifePoint since Cherie Sibley 2001, most recently served as Central Kentucky East market president and CEO of Clark Regional Medical Center in Winchester, Ky. In her new role, she will provide leadership and operational support for LifePoint operations in Indiana, Kentucky, Georgia, Mississippi and Tennessee. She earned her nursing degree from the University of North Alabama and an MBA with an emphasis in Healthcare Administration from South University in Montgomery, Ala. Sibley is a Fellow of the American College of Healthcare Executives and was a member of the innashvillemedicalnews


augural class of the Advisory Board Fellowship Program in 2009. She replaces Robert Klein, who was named president of LifePoint’s Western Group in January 2017.

NHC Names New CIO

National HealthCare Corporation announced in mid-February that longtime healthcare technology leader B. Anderson “Andy” Flatt has joined the

company as senior vice president and chief information officer. Flatt brings more than 32 years of experience in healthcare technology to NHC. He comes to the Andy Flatt company from correctional healthcare company Corizon Health, where he also served as SVP and CIO. Previously, he held the same role for Cig-

na-HealthSpring from 2006-2014, and AIM Healthcare Services (now Optum) from 2000-2006. Earlier in his career, Flatt served in technology management positions at HCA and Baptist Hospital (now Saint Thomas Midtown). He co-founded MIQS, Inc., an award-winning EMR company, after beginning his career as a software developer for Dialysis Clinic, Inc. Flatt, a graduate of Lipscomb University, serves on several boards.

New Addiction Treatment Center Adds Emphasis on Reducing Relapse

Research has shown patients who seek residential addiction treatment relapse at a rate of 60 percent. JourneyPure At The River, located in Murfreesboro, sought an innovative way to address the issue. The result: JourneyPure Coaching™ app aimed at gamifying aftercare for lifelong sobriety. In partnership with Vanderbilt University, this new 70bed facility combines luxurious amenities with evidencebased residential addiction treatment and dual diagnosis mental health services. JourneyPure At The River delivers an integrated, trauma-informed treatment model to meet the specific needs of men and women in the Middle Tennessee area. Recognizing that like other chronic illnesses, treating JourneyPure at the River addiction demands more than a 30-day plan. JourneyPure committed to access to ongoing care and created the One Year Promise to provide all patients with its JourneyPure Coaching™ app for a minimum of 12 months post-treatment at no additional cost. The clinical team assigns each patient a personal recovery coach to help create an individualized aftercare plan that integrates recovery skills learned in treatment into everyday life by utilizing the app to designate goals and monitor participation in real time. The hope is that by creating a recovery support system, JourneyPure patients can achieve lifelong sobriety.

Initiative Launches to Stop Heart Disease, Stroke in Women

In late February, the Women’s Heart Alliance (WHA), Nashville Mayor Megan Barry and country music superstar Martina McBride joined other community partners to announce the Cities and Communities with Heart Initiative (CCHI) Nashville – a collaborative, multi-year effort to address cardiovascular disease (CVD) in women. Led by WHA—a national non-profit organization co-founded by Barbra Streisand and Ronald O. Perelman and dedicated exclusively to women’s heart health—the purpose of CCHI is to improve the cardiovascular health of women where the CVD burden is high and where stakeholders are ready to take action. WHA selected Nashville as the first city because of its committed and collaborative leadership in local government, healthcare, academia, community and faith-based organizations and the private sector. “The statistics about women’s heart health in Nashville and Davidson County are startling,” said Mayor Barry. “But we’ve got a great team and a great plan to fight this problem. I’m proud that Nashville is taking a big step to improve women’s heart health, and I’m grateful to the Women’s Heart Alliance and our other partners for the passion and expertise Mayor Barry kicks off CCHI Nashville with a #getHeartChecked screening program for the leadership workforce group and participates in a press conference with partners. each of them brings to this fight.” “Women’s cardiovascular disease is a national epidemic, claiming more women’s lives than all cancers combined,” said WHA CEO British Robinson. “By demonstrating the power of partnership, Nashville will be a model for other cities.” Martina McBride added, “For me, this issue is about equity, and about ensuring that women have the same chances in life that men do. We don’t know enough about women’s heart disease, but we do know that it is under-funded, under-researched and under-diagnosed. We must end this epidemic—for our moms, our daughters and all the women we love.” CCHI Nashville’s five program components will roll out throughout 2017 and include: • Caring for the Caregiver, which focuses on nurses in Nashville’s hospitals and health systems; • A clinical study on pregnancy complications and their link to CVD risk factors and CVD; • A workforce health initiative through the Office of the Mayor to improve the heart health of female municipal workers; • A screening and prevention effort in collaboration with Tennessee State University to reduce CVD and its risk factors in younger women; and • A community initiative centered around one or more health centers and reaching African American, and/or immigrant refugee women. CCHI Nashville is led by a six-member community steering committee that includes WHA, the Office of Mayor Megan Barry, Metro Public Health Department Nashville, Meharry-Vanderbilt Alliance, NashvilleHealth and Saint Thomas Ascension Health. For more information, go to MARCH 2017




Conley Named CEO of TriStar Southern Hills

GRAND ROUNDS TMA Hires One, Promotes Two

The Tennessee Medical Association has added to its government affairs division and elevated two other staff members. Ben Simpson, JD, has joined TMA as associate director of Government Affairs. Simpson will work strategically with TMA’s lead lobbyist to Ben Simpson promote better healthcare policies in the Tennessee General Assembly. He previously spent three years as legislative liaison and attorney for the Tennessee Department of Health

and also worked as a claims examiner for the Tennessee Department of Treasury. Simpson earned a degree in political science from the University of Tennessee and his law degree from the Nashville School of Law. He is a 2015 graduate of LEAD Tennessee. Yarnell Beatty, JD, has been promoted to senior vice president. He was previously vice president of Advocacy and has served as general counsel since joining TMA in 2001. Beatty, who graduated from Vanderbilt and Emory University School of Law, will continue to oversee TMA’s government affairs, legal, insurance and regulatory efforts.

Dave Chaney has been promoted to vice president. Chaney, who joined TMA in 2014, was previously director of Communications. He manages all facets of the organization’s strategic communications, membership recruitment and retention efforts, and events. Chaney earned a bachelor’s degree from Western Kentucky University and is a graduate of the American Association of Medical Society Executives Leadership Academy.

Compassus Names New CMO

Brentwood-based Compassus, a nationwide network of hospice, palliative and home health programs, recently an-

Let’s Give Them Something to Talk About! Awards, Honors, Achievements


Linda D. Norman, DSN, R.N., FAAN, dean of the Vanderbilt University School of Nursing and Valere Potter Menefee Professor of Nursing, has been named ambassador for the Friends of the National Institute of Nursing Research (FNINR), an independent nonprofit organization that advocates for nursing science and its role in promoting the health and wellbeing of Americans. The dean was one of 15 nurse leaders selected nationally for their abilities to advance public, health profession and policy-maker awareness of the National Institute for Nursing Research’s agenda. The ambassadors focus on working with congressional leaders and educating them on the high-impact, cost-effective treatments and quality-of-life developments generated by nursing science. The group’s ultimate goal is Dr. Linda Norman to expand funding to ensure training of nurse scientists. Altha Stewart, MD, associate professor of psychiatry and director of the Center for Health in Justice Involved Youth at the University of Tennessee Health Science Center (UTHSC), is the new president-elect of the American Psychiatric Association (APA). She is the first African American to lead the more than 37,000-member organization, which sets policy, establishes practice guidelines, and represents the field of psychiatry nationally and internationally. Stewart, who is also chief of Social and Community Psychiatry at UTHSC, will serve as president-elect beginning in May, and will assume the role of president in May 2018. Nashville Vascular and Vein Institute, PLLC (NVAVI) was recently awarded three out of three stars from the Dr. Altha Society for Vascular Surgery Patient Safety Organization. NVAVI is the only vascular surgery practice in Middle TenStewart nessee full participating in the Vascular Quality Initiative. In 2016, there were 324 centers in the United States eligible for VQI Participation Awards. Of the 194 surgical practices recognized, only 40 received three stars, 71 received two stars, and 83 received one star. The Heimerdinger Foundation, a nonprofit organization providing nutrient-rich meals and education at no charge to families facing cancer, was recently named the Middle Tennessee Nonprofit Honoree of the 9th Annual Governor’s Volunteer Stars Awards. Held February 12 at the Franklin Marriott Cool Springs, the event recognized three nonprofit organizations from across the state, three business honorees, and 84 individual honorees from 52 counties. CRN has named TekLinks to its 2017 Managed Service Provider (MSP) 500 list in the MSP Elite 150 category. The annual list recognizes North American solution providers with cutting-edge approaches to delivering managed services. TekLinks CEO Jim Akerhielm said the honor recognizes the company’s extensive technology offerings to help businesses navigate the complex and changing landscape of IT, improve operational efficiencies, and maximize their return on IT investments.  The Tennessee Medical Association is training 16 physicians representing (L-R): Katharine Ray, Executive Director; Natisha Moultry, Volunteer a variety of specialties from across the state through its 2017 Physician Lead- Coordinator; and Kathie Heimerdinger, Founder. ership Lab. Four Nashville-area physicians were selected for the 2017 class: Johnetta Blakely, MD (Hermitage), Jack Erter, MD (Nashville), and Dianna Shipley, MD (Gallatin) are all affiliated with Tennessee Oncology, and Jessica Ruff, MD (Nashville) is a preventive medicine specialist with Meharry. The Oncology Nursing Society has awarded Tennessee Oncology the 2017 Large Employer Recognition Award. This annual award honors an employer for outstanding support for registered nurses working in oncology. In excess of 2,000 entries were received for this recognition at more than 225 ONS Chapters. Tennessee Oncology will be recognized at the ONS Annual Congress in Denver this May. Adam Graham, LPC/MHSP, program manager of Diversion Services at Mental Health Cooperative, recently had two proposals accepted for presentation to the American Association of Suicidology conference in Phoenix in April.  He will be presenting “How to Eat an Elephant: Tennessee’s Implementation of the Zero Suicide Initiative” and “The Opposite of Suicide” theory paper. Brentwood-based WPC Healthcare, a leading provider of data science solutions, has received the Global Annual Achievement award for Best Use of Artificial Intelligence in Food, Health and Medicine from Awards.AI. WPC was recognized for its work in developing the Sepsis Index through the company’s Condition Awareness Platform, which Adam Graham leverages artificial intelligence to effectively treat sepsis by identifying it early. LifePoint Health Chairman and CEO William F. Carpenter III has been named to the Board of Trustees of the American Hospital Association, which is the policymaking body of the AHA and has ultimate authority for the governance and management of its direction and finances. Jordan A. Stivers, an attorney in the Nashville office of Bradley Arant Boult Cummings LLP, has recently earned the Certified Information Privacy Professional (CIPP/US) credential in the United States through the International Association of Privacy Professionals (IAPP). The American College of Surgeons Committee on Trauma has verified Monroe Carell Jr. Children’s Hospital Bill Carpenter III at Vanderbilt as a Level I pediatric trauma center. As a regional comprehensive pediatric facility, Children’s Hospital is the only Level I pediatric trauma center within 150 miles, providing specialty services for children from Alabama to Kentucky and all over Tennessee. There are fewer than 50 ACS verified Level I pediatric trauma centers in the country.



MARCH 2017

nounced the addition of Kurt Merkelz, MD, to the executive team as senior vice president and chief medical officer. Merkelz has been a part of Compassus since 2010, previously serving as medical director of the program in Houston. In his new role, he will lead the company’s quality and clinical initiatives across more than 150 communities. A past winner of the R. Sean Morrison, MD, Award for Outstanding Achievement in Hospice Physician Leadership Merkelz has focused on caring for older adults throughout his career. He received his medical degree from the University of Texas Health Science Center and completed residencies in family medicine and geriatric medicine at the University of Cincinnati. Merkelz is triple-board certified in hospice and palliative care medicine, family practice and geriatrics.


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GRAND ROUNDS CET Appoints Executive in Residence

Last month, Cumberland Emerging Technologies, Inc. announced the appointment of Gary Rawlings, PhD, as CET’s Executive in Residence. In this role, he will work with Joe Rolwing, director of the CET Life Sciences Center, providing assistance on a Dr. Gary number of initiatives. Rawlings Previously, Rawlings spent seven years as vice president of Commercialization for TECHColumbus, a $44 million non-profit organization focused on commercializing advanced technologies in Central Ohio. He helped create 50 startups and raise over $20 million in early stage capital. Rawlings also spent a distinguished 25-year career at the Monsanto Company based in St. Louis and seven years in technology development at three high-tech firms. Rawlings earned his bachelor’s degree in physics and his master’s degree in nuclear physics from Southwest Texas State University. Afterward, he received his doctorate in environmental science & engineering at Texas A&M University.

Cumberland Heights News

Last month, Cumberland Heights announced the creation of the  Timothy Cotton Fund for Patient Assistance, which was made possible by sale of Tim Cotton’s home in East Nashville. Cotton was a former Cumberland Heights patient and  long-time driver for many musical acts, including Tim McGraw, Alan Jackson. Cotton passed away in January 2016 and willed his home to Cumberland Heights. Proceeds from the home’s sale in January 2017 generated $285,000 and will provide financial assistance to patients who cannot afford treatment or do not have insurance that covers costs. In January, Cumberland Heights announced the opening of a new soberliving home for adult men. The Keep It Simple! House, located in Murfreesboro, can serve up to eight male clients at a time. Clients will stay a minimum of three months and must have completed a primary treatment program. The new home joins Searchlight Sober Living for women, which opened in Gallatin in late October 2016. Sober living allows residents to maintain contact with outpatient services and aftercare while integrating school, work and community responsibilities. Cumberland Heights’ sober homes operate on a “social model” where residents share responsibility and accountability to foster greater independence. “By adding sober living to residential, outpatient, and 12-step immersion programs, we now offer the complete support package so our patients can transition properly from treatment back to their lives,” said CEO Jay Crosson.

Wishes Granted

Nashville-based iQuity has received a $150,000 NIH grant to help fund ongoing research into long non-coding RNAs and their usefulness in distinguishing fibromyalgia from rheumatic diseases. nashvillemedicalnews


CHS Retirements

Franklin-based Community Health Systems recently announced the departure of two long-time executives. Rachel Seifert, EVP, secretary and general counsel will retire at the end of this month. Seifert is a 19-year veteran of CHS and has more than 35 years of legal experience. She joined the company as the first and only member of the Legal Department and steadily assembled a strong team of attorneys. Previously, Seifert worked for Columbia/HCA where she served as vice president and associate general counsel after spend-

ing seven years in private law practice. She received her law degree and bachelor’s degree from the University of Maryland. It was also announced that W. Larry Cash, president of Financial Services and chief financial officer, will retire from his executive management position and the company’s board on May 16, the date of the company’s 2017 annual meeting of stockholders. Cash has served as CFO since joining the organization in September 1997 and was elected to the board in 2001. He will continue as a consultant to the management team on issues related

to healthcare finance, management and operations. Widely recognized as a top healthcare financial executive, Cash came to CHS after a short stint with Columbia/ HCA. Prior to that, he had spent 23 years at Humana. Cash, a certified public accountant, received his bachelor’s degree from the University of Kentucky. Thomas J. Aaron, who currently serves as SVP-Finance, will be appointed CFO immediately following Cash’s retirement. Ben Fordham, who currently serves as SVP and chief litigation counsel, will be appointed interim general counsel upon Seifert’s retirement.

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