Inside Columbia's 2017 Spring CEO

STORYTELLER

Sarah Hill Draws Inspiration From A Passionate Cause

STARTUP STRATEGY

Bill Turpin Takes Over At The MU Life Science Business Incubator

TOWERING ACHIEVEMENT: The Broadway Hotel Builds On Success

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www.ColumbiaCEO.com

The Holy Grail In Health care Challenges And Opportunities

11 Trends In Real Estate

Columbia’s Residential Market

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“The whole-body approach of caring for a patient is something that I apply to my business. I listen to and validate my employees and my clients.”

Dan Latham prides himself on making good on his company’s motto of being “just a heartbeat away” from solving a client’s staffing problems.

Pulse Medical Staffing provides temporary supplemental staff and medical professionals to more than 300 hospitals and long-term care centers nationwide.

Latham and his employees provide 24/7 service and support to their clients.

The company pays personal liability and offers basic life-support certification and renewal courses for medical professionals.

Whether your facility needs supplemental, temporary or permanent professional staff, or you are a nurse, physician or other professional looking to feel the difference, Pulse Medical Staffing is ready to serve you.

PulseMedicalStaffing.com 620 N. Trade Winds Pkwy. Columbia, MO Telephone: +1-877-883-8677 E-mail: dan.l@pulsemedicalstaffing.com SPRING 2017 I INSIDE COLUMBIA’S CEO

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CONTENTS

Inside Columbia’s CEO • www.ColumbiaCEO.com • Volume 8, Issue 3

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Opening Bell: The Buzz On CoMo Biz

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CEO Roundtable: Columbia’s Leaders Speak Out

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Up & Coming: The Ladder Report

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Regional Roundup

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Business Basics: How To Be A Better Leader

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Data Bank: Health Outlook

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CEO At Play: 3 Questions

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The Conference Room: Broadway Hotel Plans To Expand

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Networking

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Publisher’s Note

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Dawson’s Shoe Repair Cobbles Together Four Generations

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Closing Quotes

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Market Outlook: What’s Happening In Real Estate

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Entrepreneurial Spirit: Quick Lane Opens In Columbia

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The Reading List: 5 Business Books To Read This Spring

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ON THE COVER: The Broadway hotel’s planned

expansion would include a seven-story tower constructed due north of the existing hotel. A walkway would connect to the new tower, providing additional meeting space, 80 new rooms and a ballroom with a panoramic view of Columbia. Read more on page 25.

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STAFF Publisher Fred Parry fred@insidecolumbia.net Associate Publisher Melody Parry melody@insidecolumbia.net Chief Executive Officer Cathy Atkins catkins@insidecolumbia.net Copy Editor Brett Dufur brett@insidecolumbia.net Editorial Assistant Peg Gill peg@insidecolumbia.net Contributing Writers Carla Leible, Rebecca French Smith, Jack Wax, Rob Wolverton, Photo Editor L.G. Patterson lg@insidecolumbia.net Graphic Designers Trever Griswold trever@insidecolumbia.net Shelby Finch shelby@insidecolumbia.net Joe Waner joewaner@insidecolumbia.net Operations Manager Adam Brietzke adam@insidecolumbia.net Marketing Representatives Joshua Huber Josh@insidecolumbia.net Matt Melton matt@insidecolumbia.net Alex Stear alex@insidecolumbia.net Finance Manager Chad Morrow chad@insidecolumbia.net Distribution Associate Steve Leible, Annie Leible

Inside Columbia’s CEO magazine Zimmer Strategic Communicatios 3215 Lemone Industrial Blvd., Suite 200 Columbia, MO 65201 573-442-1430 www.ColumbiaCEO.com

Inside Columbia’s CEO is published quarterly by

Zimmer Strategic Communicatios LLC, 3215 Lemone Industrial Blvd., Suite 200, Columbia,

MO 65201, 573-442-1430. Copyright OutFront Communications, 2016. All rights reserved.

Reproduction or use of any editorial or graphic content without the express written permission of the publisher is prohibited. Postage paid at Columbia, Mo. Annual subscription rate is $19.95 for four issues.

Please Recycle This Magazine.

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OPENING BELL

THE BUZZ ON COMO BIZ

GET IN THE GAME

Columbia College To Host Midwest Campus Clash And Gaming Expo Touted as the one of the largest new eSports and gaming events in the United States, the inaugural Midwest Campus Clash and Gaming Expo is coming to Columbia College on April 8. The event will bring some of the top collegiate eSports teams in the Midwest together in Columbia to compete for a $25,000 prize pool. In addition to the live tournament viewing space, the expo area will include a range of gaming experiences for all ages, plus food trucks and an 12

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exhibitor space to sample the latest gaming gear. The expo area will also play host to the finals of the Collegiate Star League’s (CSL) Madden NFL Championship Series, part of a partnership between the CSL and EA Sports. Students from across North America will have the opportunity to represent their school and have a shot at $10,000 in prize money.

Visit www.midwestcampusclash.com for complete details on the event.

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OPENING BELL

THE BUZZ ON COMO BIZ

THE DOVE RADIO STATION TAKES FLIGHT 98.3 KDVC became Columbia’s newest radio station on Nov. 8, starting out with 24 hours, commercial-free Christmas music. In December, 98.3 The Dove officially took flight, playing lite rock favorites from the 1970s, 1980s and more. Before its launch, Owner Joe Uzoaru and Operations Manager Brady Middlecamp discussed different options for the new frequency, and decided there was a gap in mid-Missouri when it came to lite rock songs.

They believed a family-friendly radio format was needed in mid-Missouri.

Middlecamp recalls countless messages from listeners while he was working in local radio, asking for more older lite rock options like Billy Joel, Jim Croce, Michael Jackson, Phil Collins, Elton John, Whitney Houston, The Beatles and many more artists from the 1960s, ‘70s, ‘80s and ‘90s. 98.3 The Dove is still commercial-free, and plans to begin adding local on air talent to their programming mix soon. The station is owned and operated by IRIS Media.

Uzoaru owns a commercial real estate firm and serves on the Cape Girardeau City Council.

UMB REACHES NEARLY $2 BILLION IN HSA ASSETS AND DEPOSITS UMB Healthcare Services, a division of UMB Bank, n.a., has reached nearly $2 billion in health savings account (HSA) assets and deposits as of Jan. 31, a 30% increase from $1.5 billion at Jan. 31, 2016. In addition, individual health savings accounts surpassed 988,000 as of Jan. 31, compared to 818,000 accounts as of Jan. 31, 2016. UMB Healthcare Services benefit cards for Flexible Spending Accounts, Health Reimbursement Arrangements and HSAs numbered more than 5.6 million as of Jan. 31. According to Tony Mayfield, chairman of UMB Bank in Greater Missouri, his area also reported an 11.8% increase in year-over-year loans for the region.

CHAMBER TO HOST ANNUAL BUSINESS SHOWCASE Join the business community for an extraordinary day on Tuesday, March 7, at the Columbia Chamber of Commerce’s annual Business Showcase. This day-long event is designed to give Chamber members a venue to showcase products and services in both a business-to-business and business-to-consumer tradeshow.

Exhibits and special attractions make up just part of this event’s draw. The Business Showcase will open at the Holiday Inn Executive Center immediately following the Chamber’s Quarterly Membership Breakfast. The Showcase will be closed from 11:30 a.m. - 1 p.m. for the Women’s Network luncheon, but will reopen immediately following the luncheon until 4 p.m. For more information, visit ColumbiaMOChamber.com.

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Who’s Your Favorite?

BEST OF COLUMBIA AWARDED BY

2017 Nomination Period for

Columbia’s Favorite People Begins May 1st!

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THE BUZZ ON COMO BIZ

NH SCHEPPERS WINS DISTRIBUTOR OF THE YEAR New Belgium Brewing has awarded national top honors to N.H. Scheppers of Columbia as one of three companies awarded top national honors by New Belgium Brewing. The 2016 Distributor of the Year Award recognizes distributor partners who have gone above and beyond in the areas of market plan execution, new beer launches and sustainability efforts. A points system broke

out distributors into two tiers based on volume. Three winners from each tier were chosen with top honors going to the highest score. New Belgium area sales managers and sales directors totaled points and compared notes for the final outcome. The two other distributors recognized were Skyland Distributing of Asheville, N.C. and RMC Distributing Co. of Colorado Springs, Colo.

COLUMBIA LANDCARE ACQUIRES CREATIVE SURROUNDINGS Columbia LandCare acquired Creative Surroundings and absorbed its full-time staff on Dec. 30, 2016. The acquisition was made possible when Creative Surroundings owner Gloria Gaus expressed interest in retiring.

Gaus will remain on board for 2017 as the transition takes place, and all other full-time staff have started working at Columbia LandCare’s headquarters at 7105 Henderson Rd. Columbia LandCare has roots in mid-Missouri that trace back more than 20 years, when it was founded as Columbia Turf. Jed Taylor became majority owner in 2012, three years after his company Missouri Mowing merged with Columbia Turf. The acquisition adds to Columbia Landcare’s approximately 110 staff members. The company provides year-round landscape maintenance services, including snow removal, mowing, irrigation, floriculture, landscape design and installation.

TICKETS AVAILABLE TO LEADERCAST COMO

PLANNING CONTINUES FOR THE LOOP CORRIDOR

For the sixth year, Leadercast, a one-day leadership event broadcast live from Atlanta to more than 100,000 leaders worldwide, will be in streamed in Columbia. More than 850 midMissourians are expected to attend the event on Friday, May 5, from 8 a.m. to 4 p.m. at The Crossing. Leadercast CoMo 2017 will explore what can happen when teams and individuals are connected with purpose to create a strong organizational culture with intentional leadership that inspires extraordinary results. Speakers include national leaders such as communication expert Andy Stanley; Sports Agent Molly Fletcher; Entrepreneur Jim McKelvey; Founder Donald Miller; Entrepreneur Jess Ekstrom; Behavioral Science Expert and Author Daniel Pink; Institute Founder Suzy Welch; Clinical Psychologist Dr. Henry Cloud; Actor and Writer Tyler Perry. Tickets can be purchased online at LeadercastCoMo.com.

Corridor planning for the Business Loop is ongoing. After a review of a community priority survey, a walking audit, a biking audit, a SWOT analysis and comments from a town hall meeting, the Loop Corridor Planning Committee outlined its objectives. Some of the goals include developing a strong visual identity, managing traffic more effectively and creating a street that welcomes all modes of transportation. To achieve these objectives, the Loop Community Improvement District is accepting proposals for The Loop Corridor Plan.

They are seeking an inter-disciplinary team (urban design, traffic engineering, landscape architecture, etc.) to provide professional services to prepare a conceptual master plan for the Business Loop 70 corridor. This master plan will guide all design and treatments to be phased in over the next five to 10 years, and approximate costs for implementation and maintenance.

COLUMBIA VIRTUAL REALITY COMPANY CREATES FILM WITH FACEBOOK’S OCULUS StoryUP, a Columbia-based immersive media company specializing in virtual reality, has teamed up with Facebook’s Oculus and the Ad Council’s “Love Has No Labels” campaign to create a virtual reality film experience that helps people “See Beyond Labels.” The film premiered at the Oculus House during the Sundance Film Festival in Park City, Utah. The 7-minute film experience requires each user to wear a Samsung GearVR headset. “See Beyond Labels” places the user in close proximity to people of different abilities, races, religions, genders and ages to celebrate diversity and raise awareness about implicit bias, or discriminating unintentionally through our implicit biases. To create this experience, StoryUP used a reality camera to shoot 360-degree video in locations including Santa Fe, N.M., San Francisco, Calif., Jefferson City and Columbia, Mo. The eight views are then stitched together with special software so the viewer can be “inside” the video, and look in all directions. “See Beyond Labels” will be available for viewing later this year on the Love Has No Labels Facebook page.

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UP & COMING

THE LADDER REPORT Look Who’s Moving Up In Business ARIC JARVIS has been recently promoted to the General Manager of THE BROADWAY DoubleTree hotel. He has been with the hotel since May of 2013, serving as assistant general manager. In the past 12 years, Jarvis has worked in hotels such as Choice Hotels, Marriott and now Hilton. He attended State Fair Community College in Sedalia, Mo. prior to moving to Columbia.

Three employees at FRESH IDEAS FOOD SERVICE MANAGEMENT have been promoted. MARIA SCRUGGS has been named as controller of the organization.

Scruggs recently earned her CPA certification and oversees all accounting functions and department. She creates financial reports and manages cash flows, account receivables, monitors payroll expense, accruals and cash outlays.

DAVID SHANTEAU has advanced to area manager and oversees Fresh Ideas’ accounts in Arkansas.

Shanteau is part of the Fresh Ideas Culinary Council, which provides culinary leadership to Fresh Ideas’ chefs and dining services accounts. TAYLOR STRECKER is now the area manager and oversees Fresh Ideas’ accounts in Missouri, Kansas and Nebraska.

Strecker works closely with dining service directors and clients to ensure innovative programs.

KARLA WASHINGTON, PH.D., M.S.W., assistant professor of family and community medicine at the UNIVERSITY OF MISSOURI SCHOOL OF MEDICINE , has been chosen as the recipient of 18

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the 2016 David B. Oliver Family and Community Medicine Faculty Award.

The award recognizes MU faculty members for outstanding work and significant contributions to geriatric and palliative medicine. Washington earned her master’s and doctoral degrees in social work from MU. She has been a research faculty member in the Department of Family and Community Medicine since 2013. In addition to her career as a social worker, Washington’s research has involved hospice and palliative care.

The CENTRAL BANK OF BOONE COUNTY Board of Directors has named MAGGIE LANEAVE as manager of the Lake of the Woods Bank, located on St. Charles Road. LaNeave graduated from Truman State University with a bachelor of arts in business administration and has been working in financial services with Central Bank since 2014. She began her career at the Smiley Lane Bank as assistant manager. As manager, LaNeave has already set up volunteer opportunities for her branch such as adopting a veteran and mentoring high school students. HOPE SCOTT was promoted to electronic banking specialist at the Customer Service Center, which assists customers with account maintenance by telephone. Electronic banking specialists help customers with daily activities involving all things electronic such as website and mobile phone application assistance.

TYLER STRETZ of the bank’s downtown location was promoted to a mortgage lending processor. A mortgage lending processor reviews the credit reports of the mortgage buyer along with verifying the borrower’s credit history.

JOHN D. LAROCCA, general manager of the University Club of MU and its Catering and Events Services, has been named president of the MISSOURI RESTAURANT ASSOCIATION for 2017. LaRocca began his restaurant hospitality career as a dishwasher at his father’s Italian restaurant in St. Louis.

While attending college, he worked at LaCantina d’Italia and later the Ramada Inn restaurant in Columbia. He returned to St. Louis for a job with Marriott, which took him around the country during the next 17 years, and later opened his own restaurant. In 2006 he became the general manager of the University Club.

JAMIE DAVIS, senior manager of Financial Aid at COLUMBIA COLLEGE, was recently honored with the prestigious Bob Berger Newcomer Award presented by the Missouri Association of Financial Aid Professionals (MASFAP). The award recognizes the outstanding contributions of an individual new to the financial aid profession, with less than five years of experience in the field. Davis, who will serve as the vice president of the MASFAP in 2017, is the first Columbia College employee to receive the award in its 15-year history. She joined the college’s Financial Aid team in 2011.

JORDAN C. DILLENDER has joined the law firm of BROWN WILLBRAND, P.C., as an associate, where he will practice in the areas of business and commercial law. Dillender has worked for Brown Willbrand since 2014 and he has experience representing clients in the employment, construction and real estate industries. Dillender earned his J.D. from the University of Missouri-Columbia School of Law in 2012.

MARJORIE LEWIS, shareholder and member of the BROWN WILLBRAND management committee, was elected as the president of the Boone County Bar Association. She has previously served as vice president, secretary and at-large executive committee member for the association.

The HAWTHORN BANK board of directors has announced the promotion of TODD HOIEN to market president for the Columbia area. Hoien began his banking career in 1997. He joined Hawthorn Bank in June 2010 as a commercial loan officer. Most recently Hoien held the position of senior vice president, senior commercial lender for the Columbia market. He graduated from the University of Kentucky and moved to Columbia in 1997. In addition to serving as chief risk officer, KATHLEEN BRUEGENHEMKE was named chief operating officer. She assumed the additional responsibilities following Senior Vice President Operations Officer Gary Collins’ retirement. Bruegenhemke joined Hawthorn Bank in 1992 as the company’s internal auditor and currently serves as senior vice president Investor Relations and corporate secretary of Hawthorn Bank’s parent company, Hawthorn Bancshares.

MARILYN CUMMINS has been named full-time associate editor for RED BARN MEDIA GROUP in Birmingham, Ala. For the past 23 years, Cummins has been president of her own communications firm, Cummins Consulting, working with a variety of agribusiness clients.

PAT CARNEY has been named chief strategy officer for AGENTS NATIONAL TITLE INSURANCE. Carney will oversee the strategy behind the company’s technology and industry partnerships and will look at the agent experience based on heightened needs and expectations. He most recently was chief innovation officer at ClosingCorp.

Share your business news with Inside Columbia’s CEO. Email the editor at CEOeditor@insidecolumbia.net.

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NEW SLU HOSPITAL TO OPEN IN 2020 Recently SSM Health officials released renderings of its new $550 million St. Louis University Hospital. According to the St. Louis Business Journal, the facility includes more than 800,000 square feet of space and 316 private patient rooms. Construction is tentatively scheduled to begin Aug. 31, with a completion date of September 2020.

The exterior of the modern design is all-glass. The hospital will be located on 15 acres adjacent to the current facility off Grand Boulevard between Rutger and Lasalle streets. The rendering depicts a nine-story patient tower and a threestory ambulatory care center connected by a common space that will include the cafeteria, gift shop and chapel.

Plans for the new space include an expanded trauma center and emergency department, larger intensive care units and expanded parking. As a teaching hospital, one priority for the design was to include space conducive to health care education. The trustees are also planning for future growth, with green space set aside for later expansion and to project a healing environment. SSM Health acquired the hospital in 2015.

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REGIONAL ROUNDUP

KANSAS EYES AIRPORT POSSIBILITY AS TALKS ABOUT KCI STALL Talks about Kansas City International Airport’s future recently stepped up as Kansas Gov. Sam Brownback confirmed pursuing a large-scale passenger airport in Johnson County. According to the Kansas City Star, some, like Kansas City Councilwoman Jolie Justus, think his recommendation is a “far-off dream,” but talks have been revived about redesigning KCI. Following the April 4 bond election, officials say discussions will increase about the airport. Southwest Airlines, along with other KCI airlines, have offered to assist with the financing of a redesigned terminal system at KCI. However, talks have been stalled since last year when the airports’ plan supported turning KCI’s original three-terminal design into a single-terminal airport, costing nearly $1 billion. Southwest Airlines representatives believe the oneterminal airport will be more convenient and cost effective, and they do not support the renovation of the 43-year-old “horseshoe” terminal. However, many Kansas City residents favored the airport’s current layout, and consensus wasn’t

reached on the single-terminal idea.

Kansas City officials say the earliest that voters could weigh in on a new terminal is November.

BRANSON AIRPORT ANNOUNCES SERVICE TO FIVE METROPOLITAN AREAS Privately owned Branson Airport recently announced 2017 service to five cities, which will be operated by Via Airlines. Scheduled flights from the airport are to Austin, Dallas, Houston, Chicago and Denver. There will be two flights each week to Dallas and Denver, according to the Springfield News Leader, and three flights each week to Austin, Houston’s Hobby Airport and Chicago Midway International. Branson Airport Executive Director Jeff Bourk said the cities were selected because they were the best-performing routes among those the airport has had over the years. He was unsure whether the airport planned to announce additional service for 2017. Branson’s two last two mainline carriers — Southwest Airlines and Frontier Airlines — pulled out of the market in 2014. Since that time, the airport has utilized public charter flights,

with the belief that they will show a demand for air service and lure a mainline carrier back to the area.

KANSAS CITY VOTERS TO DECIDE ON $15 PER HOUR MINIMUM WAGE In August, Kansas City voters will decide on the fate of an initiative to raise the minimum wage to $15 per hour.

The proposal is supported by civil rights activists, urban ministers and other social justice advocates in Kansas City. The initiative calls for the minimum wage to boost to $10 per hour by Sept. 1 and then gradually move to $15 per hour by 2022. According to the Kansas City Star, the Kansas City Council agreed to comply with a Missouri Supreme Court order to put the petition initiative on the ballot this summer. Initially advocates tried to get the minimum wage proposal placed on the April 4 ballot, but the council didn’t have the votes to put the initiative on the ballot in time. This issue has been hotly contested in Kansas City since 2015. Opponents of the issue, such as the Greater Kansas City Restaurant Association, indicate that the initiative would lead to inconsistent wage rules throughout the state. Currently the minimum wage is set by the state at $7.70 per hour.

ST. ANTHONY’S MEDICAL CENTER CONSIDERS AN AGREEMENT WITH MERCY A merger is being proposed between two health care systems in the St. Louis area. St. Anthony’s Medical Center has entered into an agreement to affiliate with Mercy, one of the largest Catholic health care systems in the region. Under the agreement, St. Anthony’s will affiliate with Mercy’s four hospitals and 730 physicians in metropolitan St. Louis. According to the St. Louis Business Journal, this proposal will leave St. Luke’s Hospital in Chesterfield as the last remaining independent hospital in the area. St. Anthony’s Medical Center is the thirdlargest medical center in the St. Louis area. It has 3,500 employees and nearly 670 medical staff members, including a 176-member physician organization. St. Anthony’s also operates four urgent care facilities — located in Arnold, Fenton, Lemay and Kirkwood. Leaders, board members and physicians from both organizations are finalizing the details, with the goal of completing the agreement this spring.

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DATA BANK

HEALTH OUTLOOK

A Look At CoMo Health Care By the Numbers

44.5 MINUTES According to a recent survey by the Centers for Disease Control and Prevention’s National Center for Health Statistics, this is the average length of time patients spent in an emergency department in a Columbia hospital before they were seen by a health care professional. The national average is 58.1 minutes.

262 This figure represents the combined number of years Columbia-area hospitals have been serving mid-Missouri. University Hospital is the oldest, opening originally as Parker Hospital in 1901. On Dec. 10, 1921, Boone Hospital Center began operations. Harry S Truman Memorial Veterans’ Hospital opened in 1972 and Landmark Hospital’s Columbia location opened in 2009.

This represents the number of hospital beds in the three hospital systems of Columbia, plus the number of available beds at the long-term acute-care Landmark Hospital. From Boone Hospital Center to the University of Missouri Health Care system, the Harry S Truman Memorial Veterans’ Hospital to Landmark Hospital, Columbia’s hospitals always have a bed open for patients.

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It’s a boy! It’s a girl! In the last year, both University of Missouri Health Care and Boone Hospital delivered a remarkable number of babies. That’s more than the capacity available at Missouri Theatre and The Blue Note combined, and is enough people to fill more than a quarter of Mizzou Arena.

1,256 Columbia is fortunate to have more than 1,000 physicians. From primary care to specialties, the dilemma in this city isn’t finding a physician; it’s choosing one.

140 MPH

1,112

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This is the cruising speed of the University of Missouri’s Staff for Life helicopter.

Since 1982, the helicopter has flown more than 30,000 patient missions. From July 1, 2013, to June 30, 2014, the Staff for Life helicopter transported 782 patients.

1:178 This is the ratio of licensed physicians to Boone County residents, compiled in 2011 by the Columbia/ Boone County Department of Public Health and Human Services.

The national ratio is 1 physician for every 391 Americans, according to a 2011 report by the American Medical Association.

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THE CONFERENCE ROOM

HOTEL TOWER EXPANSION

The Broadway Hotel Owner Plans To Add A Seven-Story Development

by MELODY PARRY

T

he Broadway Hotel opened for business in 2014, giving visitors a boutique hotel in the heart of downtown Columbia. The hotel also offered Columbia residents an eighth floor Rooftop Bar and meeting space with one of the best views downtown offers.

David Parmley, owner of Chesterfield Hotels, Inc., which includes The Broadway hotel, explains the expansion plans for the hotel, adding a tower and enclosed walkways between the two buildings.

Give us a short overview of the proposed expansion project.

We are looking to construct a new seven-story hotel tower at 1034 E. Walnut. This parcel is located due north of our existing hotel and is just west of the Short Street garage. We have the land under contact and hope to close on it by year end. The original hotel we built was about 98,000 square feet and the new tower would be about 25% smaller with approximately 73,000 square feet. The ground floor would include a reception lobby entered off of Walnut Street, two new meeting rooms, a boardroom, and ancillary support areas and offices for our banquet staff.

We would also be adding an additional 80 guest rooms and suites on the second through sixth floors. The hallmark of the project will be the large ballroom and reception area with expansive windows providing panoramic views of downtown Columbia from the top floor of the new tower.

Explain the need for a conference center space and the proposed size.

Currently The Broadway hotel only has around 3,000 square feet of meeting space, which is much less than many comparable

A new tower would enable the hotel to triple the amount of meeting space and add 80 guest rooms.

hotels. Our largest meeting room will accommodate around 150 with banquet style seating. This has limited our ability to host many larger out-of-town meetings and events that would like to stay in downtown Columbia.

Our existing spaces have been very popular venues for corporate and association meetings and an ideal place for hosting social events. Both meeting planners and attendees alike enjoy traveling to interesting destinations like downtown Columbia.

We think there is a real untapped demand from meeting planners who would like to hold their events here but who are unable to find suitable meeting space.

Construction of the new tower would allow us to almost triple the amount of meeting space that we currently have, with the addition of a 6,000 square foot rooftop ballroom & reception area and another 2,000 square feet of meeting space on the ground floor.

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The Broadway Hotel Owner, David Parmley, hopes to add a second tower due north of the existing hotel.

Tell us about the tower connecting the two hotels.

The new tower would be connected to the existing hotel via enclosed walkways at the fourth and seventh floors. These walkways would span about 20 feet across the alleyway that separates the two towers. Having the seventh floor walkway will also allow guests to pass between both our new ballroom directly over to The Roof venue at our existing hotel.

How has The Broadway hotel done since its opening three years ago?

When developing The Broadway hotel, one of our main goals was to create an upscale hotel that would serve as the gateway to downtown Columbia, act as an anchor for the North Village Arts District and would be a catalyst for future development in the area. I think we have accomplished those goals and created a hotel that our city can take pride in. Our property has been well received by travelers who appreciate our hotel’s vibrant boutique design and convenient location, providing them with easy access to explore all of the unique shopping, dining, entertainment and nightlife that The District has to offer. In addition, The Broadway, a Doubletree by Hilton 26

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hotel, was recognized by Hilton Hotels and received their worldwide award for “Best New Doubletree Development in 2014.”

Tell us about the need for a TIF (Tax Increment Financing) for this project.

How will it help your expansion efforts?

In planning and budgeting for the new tower, we are discovering large cost increases for land, general construction and furnishings for our proposed project as compared to just five years ago. Currently all of the construction trades are extremely busy and are bidding any new jobs accordingly. We estimate that the new tower will cost more than $20,000,000 to develop. That price represents a 38% increase per square feet in development costs as compared to the expenses we incurred constructing the existing hotel. These increased costs make the economic feasibility of building the new tower prohibitively high. Without TIF, redeveloping of the old Regency hotel site into what is now, The Broadway hotel, would not have been possible. The costs associated with redeveloping the new site are even more prohibitively high, which makes TIF an absolutely essential component for moving forward. Without TIF, the new tower project is not a possibility. We

appreciate the past community support that helped make The Broadway hotel a reality. With this new project we hope that the city will continue to place their trust and confidence in our vision and plans for a growing downtown Columbia.

How do you see the lodging/hotel business in Columbia?

Overall I think Columbia hotels are doing well. Weekends are especially busy due to the numerous special events that Columbia hosts. Sunday through Thursday nights generally lag the weekend occupancy and those nights continue to be the focus of the Columbia Convention and Visitors Bureau as they continually work to attract more conferences and meetings to Columbia during the weekdays. Leading industry expert Smith Travel Research (STR) compiles a monthly report that compares the overall Columbia hotel market to other cities and benchmarks important indications such as City-wide occupancy, Average Daily Rate (ADR) and Revenue Per Available Room (REVPAR). In comparing the years of 2016 vs. 2015, Columbia showed growth in all three indicators with a 4.4% increase in occupancy, 1.8% growth in ADR and 6.3% increase in Revenues Per Available Room.

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by JACK WAX l Photos by LG PATTERSON

Cobbling

BOB WOOD

Together Four Generations of Business and Family

Bob Wood, owner of Dawson Shoe Repair, takes his position each morning behind the vintage wooden and glass counter at his shop at 212 S. Eighth St. If he looks out the large storefront window directly before him, he can see the University of Missouri’s Lee Hills Hall. Inside the university’s building, students learn the craft of journalism, using the latest computer technology. Inside Bob’s shop, a more ancient craft is practiced, one that isn’t based on computers or cloud networks. The tools Bob uses are from long before the digital age dawned. His favorite machine – a clunky electric shoe shiner with spinning brushes – dates back to the 1950s, long before the students in Lee Hills Hall were born.

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At age 70, Bob has achieved what few people ever do. He has spent his days doing what he likes with the people who mean the most to him. He cheerfully goes to work every day and stays there every hour the store is open. Since the start of this year, Bob’s son, Matt, age 27, can also be found in the shop, helping his father and learning from him. Matt’s daily presence in the shop marks the beginning of a transition.

Bob isn’t ready to step aside, but he welcomes Matt into the business as an apprentice, son, and hopefully, the third generation of Woods to own Dawson Shoe Repair and the fourth generation to work in the craft.

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ob is old-school Columbia. His voice has an old-timer’s Boone County twang to it. It hides nothing, revealing the honest and direct personality behind it. He has the humility of someone who has spent his life serving others; he has the pride of someone who runs a successful small business that he thoroughly enjoys. Matt is the new Columbia. With his beard, calm demeanor and jeans, he looks like he could be on his way to class at the university. In a way, he is a student – a serious one – set on learning a craft that runs four generations deep.

“I’m trying to learn as much as I can from my dad. I don’t want this craft to die,” Matt says.

Business at Dawson Shoe Repair is strong and steady enough that Bob is relieved to have his son carry part of the daily load. Throughout the day an intermittent stream of people come in, bringing their shoes to the counter or picking up a pair that Bob has just finished. In addition to shoe repair, Bob has branched out to do some key duplicating, zipper work and the occasional leather repair.

Columbia has been the home of Dawson Shoe Repair since the 1930s, when Fred Dawson first opened his doors for business at 13 N. Eighth St. Despite the Depression, shoes needed repairing and the business was able to survive. But during the ‘50s, it ran into trouble.

That’s when the Wood family entered the picture. Bob’s father, Estel Wood, saw an ad in a trade publication for a shoe repairman to run a business in Columbia.

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The way Bob tells the story, his father left southwest Colorado, taking his wife, three young sons and three dollars with him to Columbia. “Dad was poor,” Bob says.

By then, Dawson Shoe Repair had changed hands from the original owners a couple times and was owned by L.D. Johnston. Johnston’s main interest was in running the paint company he had founded, and he was looking for someone to take care of the shoe repair shop he had recently bought.

“Dad convinced L.D. that he could turn it around from a losing proposition to a winning one,” Bob says. At the time, that was no easy task. “Columbia had 19 shoe repair shops back then. Now there is one,” Bob explains.

Between 1956 to 1964, Bob’s father ran the business as an employee proprietorship. “The harder Dad would work, the more of it he’d own,” Bob says. Finally in 1964, one day before L.D. Johnston died of a heart attack, he signed the papers giving Estel Wood sole ownership of Dawson Shoe Repair.

Bob’s personality and life were shaped

among the smells of shoe polish and leather. He started working at the business at age 9, when his father would pay him 50 cents a week to sweep the shop. He immediately took a liking to his work. It was a chance to be near his father and his grandfather – another shoe repairman – who occasionally helped out in the business.

“I idolized my dad and my grandpa.

I was like a shadow, everywhere they went I would hang on with them.

That’s how I learned to fix shoes,” Bob says.

By the mid-sixties, Bob knew he wanted to be a shoe repairman. “My grandfather passed away in 1964, and the more I watched my dad, the more I realized he needed help. So I started doing things like putting heels on,” he says.

Listening to Bob explain the history of Dawson Shoe Repair, it is obvious that there is no separation of business, craft and love of his family. Everything flows together – his heart, his hands, his family, his pride in serving the community. In 1990, Bob took ownership of the business from his father, who was ready to slow down.

“He never really retired, and he would come in half days. He’s like me,” Bob says, “If I were to retire, I’d never totally retire.

I’d be in here doing something.”

In 2009, Bob lost his father and seriously considered closing the business.

“When he passed away, I thought the world had come to a stop,” he says. But after three weeks of grieving, he reopened the business.

“Dad didn’t open the shop so I could feel sorry for myself. I opened it back up

Matt Wood (left) is learning the craft of shoe repair from his father Bob Wood. Dawson Shoe Repair has been open since the 1930s, surviving the Depression and changing trends in shoe styles.

to serve you, the public. I said ‘Hey, this is exactly what I want to do,’ and I’ve never looked back.”

In the academic world, just a few blocks away, future entrepreneurs study business theories, marketing plans and case studies to determine the best way to grow a business. Bob has a simple explanation for Dawson Shoe Repair’s more than 50-year run of success. His said his strategy is based on an age-old principle: “Follow the Golden Rule – Do unto others as you would have them do unto you.”

Before Matt started full-time this year, Bob ran the day-to-day operation of the shop by himself. That meant answering the phone, helping customers at the counter, repairing shoes and boots, shining them, keeping the equipment running and making sure he had the supplies and inventory he needed. He had tried overseeing employees in the past, but it wasn’t the same. “They just didn’t have the family-do attitude,” Bob says.

He doesn’t need to explain what his term “family-do attitude” means. He’s spent most of his life learning how to treat customers from his father and grandfather, and can remember his father coming home from work at the end of a day with a barrel full of shoes that he’d work on at night. If something needs to be done, it happens. If he promises a customer a pair of shoes by Thursday, those shoes will be ready then.

In addition to his dedication to customers, Bob is motivated by the sheer pleasure he finds in repairing shoes and running a business. When he picks up a pair of shoes, he sees beyond the leather.

For Bob, who has handled thousands and thousands of shoes, each one is different because each one belongs to a different person. By repairing the shoe, he is helping the person who owns it.

“I love doing what I do, and I don’t get bored working on shoes,” he says. “My favorite part of the business is trying to take a shoe from its worn-out or broken state and bringing it back to a satisfactory state that the customer is happy with.”

Bob’s wife, Mary Ann, plays a supporting role in the business. Although she works at the Harry S Truman Memorial Veterans’ Hospital, she finds time in the evenings to take care of the business’s accounting from home. She remembers the days when Bob helped his father, and now she sees a role reversal with her son now helping Bob. She understands what the business means to her husband.

“If you watch him, you see that he enjoys people – talking and working with them. And he enjoys the actual work of repairing shoes. There’s not a part of the business he doesn’t like,” she says.

Matt has a realistic outlook, recognizing that he is part of an industry with an uncertain future. “I’d love to be able to do this until I’m my dad’s age,” he

says, “But I’m not naïve enough to think that this is something that is guaranteed to continue. It’s something of a dying art.”

Dawson Shoe Repair depends on shoe manufacturers creating quality shoes and boots that are worth repairing and people choosing those more expensive shoes over low-priced toss-aways. One positive trend Matt sees in Columbia is that as students get closer to graduation, they are more likely to spend money on good shoes for job interviews. And those shoes need repairing and an occasional shine. For now, there’s more than enough business to keep Matt and his father busy eight hours a day and more.

As they weather the changing trends in shoe styles, Matt and his father keep their priorities in perspective. “I love the fact that my son is working with me,” Bob says. “Like my dad loved having his son work with him. I love the thought of four generations of our family – Matt, me, Estel Wood and Grandpa, Forrest Henry Wood.”

Can this father and son keep the family tradition alive for another generation? If so, it will be because of their “family-do” attitude toward customers and their family ties to each other. “I respect my father for the man that he is and because he’s my father,” Matt says. “Working for my father and with my father, and keeping a business going that my father and grandfather owned – it’s a huge source of pride.”

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MARKET OUTLOOK

WHAT’S HAPPENING IN REAL ESTATE 11 Trends In The Boone County Residential Real Estate Market

by ROB WOLVERTON

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ast year was an interesting one for the Boone County residential real estate market. The market for 2016 was stagnant when compared to 2015. The sale of detached single family homes through the Columbia MLS system in the Columbia Public Schools territory were 1,880 in 2016 as opposed to 1,897 in 2015, which reflects a 1% decrease in number of homes sold. Note that all of these statistics are based on single-family detached homes in the Columbia Public School territory, which represents the core of our market.

The stagnant market can easily be explained by the tumultuous election year we just experienced. The market always goes dormant in Presidential election years from about Sept. 1 until the election is over. Unfortunately, in 2016 it felt like the market went stagnant about mid-year and is just now regaining its footing. Regardless, this small change should not be a cause for concern. We currently have 435 homes listed in this area, which represents a 2.75 month supply on the market. This is a very low supply, which is good for sellers and owners of rental properties, but not so good for buyers.

SO THE QUESTION IS ALWAYS “WHERE ARE WE HEADED?” I SEE THE FOLLOWING TRENDS COMING: 1 I anticipate the average time of home ownership will increase, which is good for the remodeling business. A large number of sales that happened in 2004-2006 were due to declining interest rates. A person could sell their existing home, buy a more expensive home, initiate a mortgage at a lesser rate, and keep their payment steady or only slightly higher. If rates rise, people with a 3.75% fixed 30-year mortgage will be less inclined to move up in price and then get a new mortgage at 5%. That homeowner will be more inclined to stay where they 32

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The millennial market is untapped. Their expectations in a first-time home are greater than previous genrations.

are and add a room or remodel what they have and keep their 3.75% money. I just said I believe sales will increase if rates rise, so the new buyers will come from the pent-up demand that is currently in the rental market. If rates rise, the cost to rent will also rise and encourage people who are now renting to buy.

2 The size of the Columbia market has reached a point where targeted housing is becoming popular. Housing aimed at seniors, age restricted housing and student housing are becoming more prominent. As our market grows, I anticipate more targeted housing will emerge.

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7 The increase in construction costs also pull up the value of existing homes.

If new construction costs rise 4-5%, existing homes will also increase in value. They may not increase at the exact same rate, but they will definitely increase.

8 Buyers today have far more information available than ever before.

Unfortunately, not all of the information available is accurate. The need for consultants (lenders, inspectors, realtors) is more important than ever so the inaccurate information can be replaced with accurate information. This is a trend that has been going on for years and there is no reason to think it will end.

9 I heard from many people last year that sales were great the first half of the year and slow the second half of the year.

Part of this is due to the Presidential election. I also believe there are a certain number of buyers in the market every year. If we have a hot first half of the New construction costs will continue to rise, which will also increase the value of existing homes. year, then we will likely have a slow second half of the year. I see some pent 3 The luxury student housing market is now full. up demand from 2016 hitting the market in 2017.

The current inventory plus the new units coming Therefore, I see overall sales in 2017 being up slightly on combined with a decrease in enrollment is now from 2016, but not by a dramatic amount. putting pressure on the student rental business.

This segment of the market is still healthy, but there 10 Our new construction market has become a is downward pressure on rents for the older four largely custom build market. We still have some bedroom units. speculative homes being built, but the ratio of custom build homes to speculative homes has 4 As usual, the sale of homes under $200,000 and changed. Part of the stagnant growth numbers we ROB WOLVERTON homes in southwest Columbia continue to dominate are seeing is due to a significant number of homes is president the market. There are other areas doing well, but this being custom built and never being put into the of R. Anthony price point and this area are still very popular.

Columbia MLS system. In addition, the singleDevelopment family building permit numbers (469 in 2016 Group, LLC. He 5 New construction costs continue to rise. versus 1,239 in 2005) reflect a much slower new worked for 14 years Increasing lot development costs, increased construction market than 10 years ago. In today’s as a licensed realtor material costs, increased labor costs and increased market, a successful subdivision will absorb 15 to and 18 years in land government regulation continue to push new 20 building lots per year. In 2004-2006, there were development. construction home costs higher and higher. It is multiple subdivisions absorbing 50 to 100 lots per year. If the custom build market were to be added difficult to produce a new construction home for less to the numbers that go through MLS, the average than $180,000 in today’s market. I anticipate new and median sale prices would be higher and the construction of homes starting at $200,000 within number of sales would be higher. It is difficult to say the next five years. how much higher, but I think the overall number of 6 The millennial market is massive and is virtually homes sold would rise by 10% or more. Again, this is nothing new, it is just more pronounced now that we untapped. As this generation gets married, has kids have a shortage of inventory. and gets college debt under control, they will become homebuyers. However, they are not the “traditional” 11 Our population continues to grow, but our rate first time home buyer. It seems the average age of the of growth in new homes is slow. So where are these first time home buyers is increasing and the housing people going? The answer is the high-end rental expectations are greater than they were in years properties have filled the housing needs for the past. Most of the millennials I work with will rent growth we are experiencing. At some point, a large before they buy a home that would be a decrease in number of those renting today will either move out their lifestyle. The millennial buyers are interested of town or become home buyers. So I do believe there in energy conservation, upscale finishes and low is a pent-up demand for home buyers currently living maintenance. The size of the home is important, in rental units. but typically not near the top of the list of priorities.

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ENTREPRENEURIAL SPIRIT

QUICK LANE OPENS IN COLUMBIA

by MELODY PARRY | PHOTOS BY L.G. PATTERSON

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new service center that can assist with all makes and models of vehicles opened mid-January.

Quick Lane is associated with Ford dealerships but technicians can work on all makes and models.

Quick Lane is one of the fastest growing franchises in the United States. Jim Rollin, who came to Columbia to help with the opening of the store, says, “Quick Lane is the sixth largest tire company in the nation.

Nine years ago the franchise had 350 stores and it has climbed to 820 stores.”

The main difference between a Jiffy Lube and Quick Lane are the factorytrained technicians and full service available, Manager Ryan Riddick says. The store also offers more services, with 14 core services ranging from oil changes, tires, brakes, maintenance and repairs.

Michael York, who has been with the Machens organization one year, said it was in his initial plan to add a speedy service center. “I’m a true believer of the Quick Lane model, it’s a more efficient service overall.”

The store, which previously housed the Toyota dealership, is located at 900 Bernadette Dr. The space took four months to remodel. With 13 bays it’s one of the largest Quick Lanes and its goal is to serve 70 customers a day. After three weeks, the new business is already serving 45 customers a day.

One reason the new location has already exceeded expectations may be because of the base of customers the Machens main service department has been assisting for years. The main service center, located on Worley St., will continue to stay open and focuses on major repairs. The opening of Quick Lane allows customers more timely service since they won’t be bogged down behind major repairs.

“Our main focus is to bring service customers into a nice environment and expedite their service agreement,” Riddick says.

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Quick Lane Service Manager Ryan Riddick

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THE READING LIST

Five Business Books To Read This Spring Fortune magazine recently came out with the five books that could teach entrepreneurs the most. They are listed below.

RIGHT AWAY AND ALL AT ONCE

HOW TO HAVE A GOOD DAY

by Greg Brenneman (Rosetta Books, 2016)

Greg Brenneman believes that true business success and personal fulfillment are two sides of the same coin. The techniques that will grow a business will also help entrepreneurs achieve a rich, purposeful and integrated life. In Right Away and All At Once, Brenneman takes what he’s learned from turning around or tuning up many businesses—including Continental Airlines and Burger King—and distills it into a simple, clear, five-step roadmap that anyone can follow.

His five steps instruct readers how to prepare a succinct Go Forward plan, build a fortress balance sheet, grow sales and profits, choose all-star servant leaders, and empower the team.

Brenneman’s inspiring examples demonstrate the astounding effects these five steps can have when you apply them.

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by Caroline Webb (The Crown Publishing Group, 2016)

PRE-SUASION

by Robert Cialdini (Simon & Schuster, 2016)

What separates effective communicators This much-needed from truly successful book gives readers persuaders? Using the tools to have the same combination a lifetime of good of rigorous scientific days. Economist and research and former McKinsey accessibility that made partner Caroline Webb his Influence an iconic explains how to apply bestseller, Robert recent findings in Cialdini explains how science to daily tasks to capitalize on the and routines. She essential window of translates three big time before delivering scientific ideas into an important message. step-by-step guidance This “privileged that shows how to set moment for change” better priorities, make prepares people to be time go further and receptive to a message ace every interaction, before they experience Through it all, Webb it. Optimal persuasion teaches how to is achieved only navigate the typical through optimal prechallenges of modern suasion. In other words, workplaces — from to change “minds” a conflict with colleagues pre-suader must also to dull meetings and change “states of mind.” overflowing inboxes Cialdini draws on an — with skill and ease. array of studies and Filled with stories narratives to outline of people who have the specific techniques used Webb’s insights one can use on online to boost their job marketing campaigns satisfaction and and even effective performance at work. wartime propaganda.

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CONFESSIONS OF THE THE COACHING HABIT PRICING MAN

by Michael Bungay Stanier (Box of Crayons Please, 2016)

Coaching is an essential skill for leaders.

But for most busy, overworked managers, coaching employees is done badly, or not at all. They’re just too busy, and it’s too hard to change. But what if managers could coach their people in 10 minutes or less? In Michael Bungay Stanier’s book, coaching becomes a regular, informal part of the day so managers and their teams can work less hard and have more impact. A fresh, innovative take on the traditional how-to manual, the book combines insider information with research based in neuroscience and behavioural economics, together with interactive training tools to turn practical advice into practiced habits.

The Coaching Habit takes work — and the workplace — from good to great.

by Hermann Simon (Springer International Publishing, 2015)

The recipe for successful pricing often sounds like an exotic cocktail, with equal parts psychology, economics, strategy, tools and incentives stirred up together, usually with just enough math to sour the taste. That leads managers to water down the drink with hunches and rules of thumb, or leave out the parts they don’t feel comfortable.

While this makes for a sweeter drink, it often lacks the punch to have an impact on the customer or on the business. It doesn’t have to be that way, though, as Simon illustrates through dozens of stories collected over four decades in the trenches.

A world-renowned speaker on pricing and a trusted advisor to executives, Simon has helped countless executives use pricing as a way to grow their businesses.

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CEO ROUNDTABLE

by Rebecca French Smith photos by LG Patterson

The Holy Grail in

HEALTH CARE Challenges And Opportunities For Boone County’s Health Care

igh quality, low cost, instant access, online quick fixes, new technology, the costs associated with all of that and hospital food were topics on the table at a CEO Health Care Roundtable discussion in early February. Key Columbia stakeholders were present — Boone Hospital, MU Health Care and Harry S Truman Veterans’ Hospital, among others — and they brought many of the same challenges and opportunities with them.

Sponsored by Peak Sport and Spine and the Broadway Hotel, the luncheon prepared by Broadway Hotel’s Food and Beverage Director and Executive Chef Jeff Guinn featured dishes inspired by “hospital food.” Typical menu items like apple sauce, pot roast, mashed potatoes and banana pudding were transformed into a salad featuring bacon cinnamon apples, candied walnuts, honey dijon and baby spinach; braised short ribs with yukon gold potato puree, pan sauce and baby carrots and asparagus; and finally, a phyllo-wrapped brownie with brûléed banana and roasted peanut caramel.

Inside Columbia Publisher Fred Parry kicked off the conversation, asking for opinions on the health of the Columbia and Boone County health care industry given the amount of transition and change in recent years.

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CEO ROUNDTABLE GROWTH University of Mo. Health Care has been growing very quickly the past several years. While it’s a good challege to face, growth presents a significant obstance for the hospital, to the point where the institution is putting together operational plans for it in its inpatient and procedural settings, says Jonathan Curtright, interim chief executive officer at University of Missouri Health Care.

“It is a stressor, to be real honest,” he says. “It’s a good problem to have, but we anticipate with normal turnover of nursing and our anticipated growth, that we’re going to have to hire probably 600 to 800 nurses in the next three to five years.” In addition to nursing shortages, challenges with facilities associated with growth, as well as with physicians and allied health staff, are also manifesting.

“But it’s a good time of growth,” Curtright adds, “and we’re seeing more and more patients coming from our 25-county catchment area around Columbia that are trying to come to Columbia for destination medical services.

“Growth is our friend; there’s no doubt about it. Certainly, at some point in the future, we’re going to be having more and different revenue models that are out there, but as it stands right now, the large majority of frankly all of health care in the United States is still some sort of feefor-service medicine … because of that, growth is absolutely your friend.”

Boone Hospital Center is also seeing growth, on the outpatient side in particular, according to Boone Hospital President Jim Sinek.

“There’s a lot of transformation going on in health care across the country, but it’s also happening here in Columbia,” Sinek says. “We happen to be in a geographic region where we’re in bundled payment programs already with hips, knees, ankles and entering into the same kind of bundle payments for cardiology and cardiac surgery. So we’re just moving in a direction where we have to provide care differently than we’ve ever done it before.”

Through bundled payments, insurance companies pay providers and/or health care facilities a single payment for all services relating to a specific episode of care. Those episodes may last up to 90 days or more.

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In the future, from a quality of care and reimbursement perspective, fewer inpatients will be more desirable, Sinek adds. “Post-acute providers are going to be significant relative to how we manage not only the quality side but the finance side so we can all be successful.” More integration with independent providers must happen, whether through an employment model, professional services agreements or contractual relationships.

It’s started already.

Health care today is different than it was two years ago, and it’s going to be significantly different two years from now, Sinek says. “Organizations that haven’t begun developing the infrastructure, the databases, the computer systems and the relationships that you need are going to have a challenging time.”

Much of the growth at the University of Missouri Hospital and Clinics and at Boone Hospital is a result of decreasing volumes at smaller area hospitals in the region, according to Sinek. Care providers in the mid-Missouri region must plan, with rural providers, on how to provide care and how to coordinate patients getting to the right location at the right time for the best care. “We’re working with our affiliated hospitals and we’re working with the hospital association trying to help support not just Columbia and the urban areas but the rural areas as well.”

CHALLENGES Dr. Lana Zerrer, chief of staff at the Harry S Truman Veterans’ Hospital (VA)

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in Columbia, faces the same growth challenges but with different operational and geographical challenges. In the last 12 years, she has seen the VA go from providing care for 28,000 veterans to caring for 40,000. The VA’s regional coverage extends from north of Kirksville to as far south as Marshfield in coverage of mid-Missouri.

“We are completely landlocked by the university,” Zerrer says. “We keep trying to go up, but construction projects, for us, take a long time to get approved by Congress, and we’re limited by funding levels, etc.

“But we’re facing some of the same challenges that everyone is,” she continues. “The nursing shortage is really hitting us hard … but we also are struggling with some primary care recruitment out in our community-based

(Top) For the past several years, Boone Hospital Center has focused on bringing quality care close to home by opening primary care, convenient care and specialty care clinics throughout mid-Missouri. The Nifong Medical Plaza, opened in February 2016 and features primary and convenient care, imaging, therapy and laboratory services as well as a retail pharmacy. (Bottom) Dr. Karen Edison, Dr. Lana Zerrer, Jim Sinek, Jonathan Curtright and Fred Parry.

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CEO ROUNDTABLE clinics, which we have eight of those throughout the state.”

Technology advances are slow, Zerrer adds, because of the approval process the VA must go through for funding.

“We can’t just say we’re going to start something and then do it. We have to get approval from on high.”

But Zerrer puts another challenge on the table: instant access.

“The biggest thing that I see is that patients now want instant access,” she says, “and if they don’t get it, they complain. Usually when they complain about the VA, it’s on CNN or somewhere like that. A lot of us are under the microscope for access, but that’s our number one priority right now.”

At the Columbia Orthopaedic Group (COG), Dr. Mark Adams, group president and an orthopaedic surgeon, sees growth coming at a challenging time.

“That challenge is on several fronts,” Adams says. “All the major insurers and patients, they want value medicine today.

In the last several months, COG has been doing total joint replacements as outpatient, but it’s late to the game. In many markets, that has been the norm for a couple of years.

“That value proposition is especially tough because we have such wonderful technology at our hands now, and that technology doesn’t come cheap,” Adams says. “In this market, we’re in such a premier medical market. We want the best of the new technologies, and yet that comes at a point in time where it’s hard to sometimes justify the cost of these technologies with what the remunerations are today. So on our side, the biggest shift and the things that we think about the most are trying to provide top notch, high-quality medicine in a value setting.”

Dr. Karen Edison, chair of the University of Missouri Department of Dermatology, medical director of the Missouri Telehealth Network and director of the Center for Health Policy, brings the conversation back to access.

“In dermatology, we are completely overrun with patients and have been for quite a long time now,” Edison says. “We could add 10 people and still not meet the access metrics.” Technology also plays heavily into the field’s strategy to meet the demand, but it also brings a unique quality and timeliness challenge.

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20 years,” she says, “but what we’re seeing in our field is this explosion of direct-toconsumer or direct-to-patient online care.” To gauge the quality of that care, she helped conduct a secret survey using medical students to query 30 online tele-dermatology offerings. The quality issues were quite concerning, she says. Since most Americans have multiple conditions and/or medications, a simple video or photo and a little information is not enough to provide proper care for a patient.

“We’re just in the wild, wild West when it comes to direct-to-consumer care,” Edison says. “Your standard of care does not change just because you’ve got their $59. It’s not time to make your best guess at what’s wrong with them. So in my field, because it’s a visual field, that’s been a real challenge for us.”

In addition, venture capital has gotten behind the direct-to-consumer market, Edison points out. “All of the direct-to-consumer companies are working with big business; they’re working with insurers. They’re working increasingly with health systems, but we still need to keep in mind that health care’s best if it’s regional, if not local. So we’re working to see how we can use this technology to deliver that care in a high quality way.”

TRAINING AND EDUCATING Dean of the MU School of Medicine and an interventional cardiologist, Dr. Patrice Delafontaine, also recognizes this is a time of real change in health care.

“We’ve heard about the movement toward different payment models. We haven’t spoken a lot about the innovation that is coming with that,” Delafontaine says. Taking cost issues into account and a perceived plateau in health care spending, if you look at that equation, there’s going to be increasing emphasis on the cost component of innovation.

“Of course, we all want value and we all want the best for our patients,” Delafontaine says. “The cost is going to become probably more and more important as we go forward.”

The university can help develop innovation applicable to health care, from new drugs to devices to clinical decision support systems to clinical infomatics. That’s part of the equation too.

The MU Health Care system is hiring, and it is also training new physicians. National trends indicate a shortage of physicians in the future, if not already on the cusp now and predicted to get worse with the aging population, according to Delafontaine.

Strategies to train more physicians are important but need to be done within reasonable costs on that front as well, given it’s well over $250,000 now on average that a medical student owes upon graduation.

But for MU, budget challenges are in the mix with the release of Gov. Eric Greitens’ 2018 budget.

Though costs are a factor, Kristofer Hagglund, dean of MU’s School of Health Professions, says growth is a good descriptor of where his school is at right now. With nine different accredited professional graduate programs and two more coming on board soon, they are seeing 100 percent job placement for professional program students. In the undergraduate program, students that finish without a professional degree still have success in getting jobs. Cerner and MU are the largest employers of graduates, currently.

The School of Health Professions has quintupled the size of enrollment over

“We’re blessed with an incredible educational community in central Missouri”

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Jonathan Curtright

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The CEO Health Care Roundtable was hosted at The Broadway hotel and sponsored by Peak Sport and Spine.

the past 10 years, according to Hagglund.

“It’s a success story right now.”

REMEDIES FOR SHORTAGES While growth is consistent across midMissouri institutions, so is the nursing shortage, and answers are complicated.

From an education perspective, “It’s really quite difficult to expand the size of programs,” Hagglund says. “There’s only so many clinical training sites available, and of course, nursing, like ours, needs these sites. To start new nursing programs or new nursing schools is expensive.

This is not a good time in the economy, especially in education, to start those kinds of programs, and we’re in for a bit of a rough ride for the next 10 years perhaps.”

Parry references Curtright’s aforementioned need of 600-800 new nursing hires in the next three to five years, but Curtright is hopeful.

“We’re blessed with an incredible educational community in central Missouri,” Curtright says. “Certainly, the University of Missouri’s Sinclair School of Nursing produces several hundred outstanding nurses every single year, but on top of all of that we have to think of new ways to train nurses and

innovate in non-traditional nurses as well.” Accelerated, online and later-in-life professional development are options.

“To this end, we work very closely with our colleagues at Central Methodist University and Columbia College. These schools are excellent and are partners in traning health care professionals,” Curtright says.

In meeting nursing needs, evaluating the level of nursing expertise for specific assignments should also be a constant question, he says. Can the same care being given by an RN be executed by an LPN with support?

At Boone Hospital, it’s a combination of things, Sinek says. Scheduling and staffing innovation is key to addressing any current shortages.

“New nurses, new physicians, like many of the younger generation, have different expectations,” Sinek says. “At Boone we’ve been really changing the way that nursing practice happens. It’s important to be a leader in addressing the nursing shortage. It’s one of those factors that’s pressuring the cost to go up.”

Competition also affects salary costs when multiple health care institutions compete for nurses from the same candidate pool. “What one does, the next

one does plus 5 percent more. Then the next one does 10 percent more,” Sinek says. “We’re kind of spiraling that cost to a certain extent beyond the shortage.”

Other innovative options for Boone include a BJC partnership in St. Louis to help produce more PhD nurses so there are more nursing school instructors to meet education and enrollment demands, though this is a longer term option.

BUNDLED PAYMENTS At Peak Sport and Spine, Phillip Smith, a physical therapist and outpatient CEO, says it all comes down to quality and cost in regards to bundled payments.

“It’s pretty much about the postacute program,” Smith says. “It’s about the second the surgery gets over, managing costs and getting the patient into the highest quality and lowest cost care center. There’s a move to transfer patients into the outpatient clinics faster.

Moving patients into outpatient settings should decrease the demand on higher cost centers like long-term acute care hospitals, skilled nursing facilities and home health agencies.

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CEO ROUNDTABLE opportunity for us,” he adds. “Peak Sport and Spine has been working on a transition system within its existing relationships with the University Hospital, Boone Hospital and Columbia Orthopedic Group. The management of these post-acute programs is in high demand. We’re set up well to move patients throughout the continuum of care.”

“My associations with skilled facilities across the region has helped me foster hundreds of relationships between nurses and therapists that help us progress the patient towards higher functioning and lower cost outpatient settings,” Smith says. “We’ve expanded relationships with multiple home health agencies including Orthopedic and Medical Home Health (OHH), which was set up specifically to help manage bundles for arthoplasty recipients. OHH uses some of the same outpatient therapists to see the patient in the home that will see them when they’ve been discharged to an outpatient center.”

“We’ve set everything up to move one direction, moving into the lower cost settings as quickly as you can get them,” Smith adds. “It’s all about communication and high quality care. We’ve been building this since the Affordable Care Act was voted in and the talks of Comprehensive Joint Replacement programs came out. We’re so far ahead because we’re involved in each aspect of the post acute care. I’m a believer that we will set new standards nationally that others states will follow.”

As a result, the nature of bundled payments influences a provider’s compensation.

“Bundled payment really is just a buzz word for shifting of risk,” Adams says.

Insurance companies used to fill the role of risk provider, but now those companies are grouping providers and services for an episode of care. This system has created a wealth of data for physicians and health care systems. That data is critical to determining the price of a low-cost, high-quality bundled payment. Early adaptation of bundled payments on the coasts got some providers into trouble.

However, bundled payments are an opportunity to provide that value medicine that everybody wants, Adams says, but you have to be smart. Eliminate the fluff for the patient and the system, for your physicians to provide that quality care. “The premier word is still ‘quality.’ ” 46

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University of Missouri Health Care will open the doors of a $40 million, four-story expansion of the Missouri Orthopaedic Institute in August. The year-long building expansion increases clinical space for surgical, inpatient, outpatient and physical therapy services from approximately 114,000 to almost 200,000 square feet. The main entrance will be relocated from the north side of the building to the east side.

The bundling experience will look much the same for cardiology, very careful consideration of transition care, according to Delafontaine. Because it will increase consideration in what is used in the cath lab, what stents are implanted, how many wires are used, “ultimately, that will be good because it’ll help us drive waste out of the system,” he says.

A seamless transition with efficient communication of all aspects of patient care is another critical part of the bundled model, says Vickie Pence MS,PA-C of Acute Consulting PLLC. Strong managed health care organizations have been using bundled payments for many years.

“When patients and families are in the hospital, we met with insurance medical directors every day as a team delivering quality treatment plans, which was then communicated on many levels ultimately providing a seamless discharge and plan after the hospitalization,” Pence says.

“The patients were transitioned out of the hospital, right into their primary care, and with follow up visits right into a specialty clinic within a few days of discharge. I think communication is very important and one of the reasons that we are able to propose this program in Columbia educating the medical systems how to improve functionality with our patients care in the systems.”

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Partnerships are important to Zerrer, as well, like the ones the VA has developed with Peak Sport and Spine and other home health care agencies. They help keep costs down. Of course, having a patient in one system is easiest, she says, and the VA’s been in a bundled payment system for a long time. So it’s better to keep the number of mediations, procedures and hospital stays down, but leveraging partnerships helps when external options are needed.

Curtright agrees. “The organizations that figure out that entire complex episode of care and figure out how a patient’s flow — from outpatient to inpatient post acute care back to their referring physician, back to their home — they’re the organizations that are going to be successful in this new health care paradigm.”

HERDING THE CATS Bringing all of the pieces together is the challenge, says Dr. Robin Blount, chief medical officer at Boone Hospital.

“One of the major transitions we’re seeing in health care now is the move from the family doctor, who does everything,

to the hospital medicine as a specialty,” Blount says. For primary care, gone are the days of efficiently attending patients at the hospital and patients in clinic.

The external pressures from payers, government and private, for more efficient care, documentation of quality, length of stay and other expectations, have led to the gradual separation of hospital medicine and outpatient medicine by primary care.

“That’s a huge transition in primary care,” she says. “Then you have to link the health care between the primary doc, what happens in the hospital, you have to link it with EMR (electronic medical records) and good communication. When the patient is discharged, the hospital physician needs to assure that the primary care physician has all the information, knows what took place and can pick up the patient’s care.”

In addition, physicians come out of medical school now with totally different expectations, Blount says. “In working with those expectations, like different hours, we’re not completely there. If it were a bigger organization, a Kaiser, it’s more seamless, but mid-Missouri is

still working on that. Bundled payments are our first real challenge to managing episodes of care that extend far beyond those few days in the hospital.”

Bringing more collaboration between hospitals is another perceived community desire, Parry says.

“Columbia has a unique opportunity because even in the private community, many of us went to the University of Missouri and there’s a natural affinity for this community and what this community has been,” Adams says. “Fourteen of my partners have ties to University of Missouri medical school through residency or such. I think you have to pick your way through it; there’s opportunities of lowhanging fruit in some fields. In others, it’s kind of high-hanging fruit, but I don’t think we’re any different than any other industry that’s going through a paradigm shift. The automotive industry went through an unbelievable shift 25 years ago; we’re just late to the game. Who won in that environment? Not the ones who were the stodgy, old, big industries that didn’t pay attention to quality or didn’t

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CEO ROUNDTABLE pay attention to their employees.

“Our paradigm is changing. The institutions, the physicians, the nurses, everybody is going to have to be entrepreneurs in their own way and find collaboration in places, find unique opportunities,” Adams adds.

“The great thing is there are so many ties in this community that revert back to good training, good situations. This community has a rare opportunity for those entrepreneurs to step forward and do some unique things between the systems, between the physicians and the ancillary and allied health care fields.

It’s just going to take some people with the right ideas, the right minds and the right ability to think in a new paradigm to move forward.”

Working through the possibility that Columbia hospitals could work more closely together to share more services, Curtright sees an opportunity to attract more sub-specialists if there’s further collaboration and further alignment. If a talented physician-in-training in St. Louis or Chicago sees that here, he or she might think Columbia would be a great place to work.

“We think that with greater collaboration, the entrepreneurial spirit that Dr. Adams described,” Curtright says, “there’s going to be more choice available and better ways to collaborate.”

“BJC supports our trustees evaluation all options, including the university,” Sinek says. There are legal challenges with the university option in terms of being current competitors; however, “there’s services historically that probably could have and should have been collaborated on that are high communityneed services.

“We’ve all done community needs assessment and behavioral health seems to always come out at the top. Childhood obesity comes out at the top as well.

Those are opportunities that have been missed between the hospitals and the other care providers in Columbia. We need to work together because a lot of those services, are not profitable. That’s where you get some leeway, legally, to be able to address community needs together to try to reduce your costs and provide greater care in a more comprehensive fashion.

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(Left to Right) Dr. Lana Zerrer, Jim Sinek and Jonathan Curtright.

This new parking garage, located off Monk Drive next to Hospital Drive, opened in mid-November.

The construction project addressed the number one concern for veterans receiving health care services at Truman VA.

our overall cost structure?” Sinek says.

“We talk about tourism or destination medicine and Columbia being a basis for that and you mention reimbursement methodologies like bundled payments; I don’t see a relationship between the two at all unless you can do two things: get your costs way down and get your quality where it ranks higher than your competitors.

“Our product is no different than any other product that you put on the market, and value. If you don’t have great quality, nobody’s going to buy it. If you don’t have competitive pricing, nobody’s going to buy it. So that’s the kind of collective product we’re going to have to develop to be a medical destination.”

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WRAPPING IT UP Kristofer Hagglund “The best outcome for this community is to be a destination medical center and to enhance our public health infrastructure so that our own residents are healthy and have enhanced well being so they don’t utilize the services of this group.”

Dr. Robin Blount “You have to be willing to change. If you hold staunchly to the old ways, you’re going to be left in the dust. We’ve got to have a lot of people willing to work together and recognize that our time has come. It’s our turn, and we need to be nimble.”

Dr. Karen Edison “This community has an opportunity to come together and recognize that health care is not about our doctors’ office or our hospitals. It’s about our patients, the social determinants of health, where patients live, learn, work, worship and play. We really need to look at how we can come together to make this the healthiest community and a vibrant place to live for all of our citizens, particularly our most vulnerable.”

Dr. Lana Zerrer “We talked a lot about shortages in health care — nursing, physicians — part of the problem is we don’t have enough people coming out of training. and part of the ideology for that is we don’t have enough schools and we don’t have the funding for the schools.

Sometimes we’re a bit shortsighted in how to fix those shortages. We talk about increasing pay and improving quality of life, but what we really need to do along with those things is

start being more politically active and lobbying our legislatures for increased funding for health care training.”

Jim Sinek “Health care’s starting to squeeze, and we’re all feeling it.

There will not be as many players in health care tomorrow as there are today, in particular on the post-acute side. Discussions like this, strategically planning together around community needs with organizations that are high-quality, low cost, is the right start.”

Jonathan Curtright “It would be great if we could quantifiably say that we have a goal that in the next 10-15 years that Boone County is the healthiest community in our state. People around this table have a passion around that, and our citizens deserve nothing less. It’s our stewardship responsibility to do that.”

Dr. Mark Adams “I trained in some big cities that had some world-renown medical centers, and I don’t think we, in Columbia, need to take a back seat to any of those places. We have a unique skill set here, between the administrations that are here, the physicians, the allied health care, and we need to remember how lucky we are. But don’t ride on our luck. Let’s continue to build on quality for our patients.”

Dr. Patrice Delafontaine “More collaboration between the physicians and the health care systems in our community is not only going to improve quality and reduce costs, but it’s also going to allow us

to offer services that we currently don’t offer in the community. We a significant out migration of patients.

With better alignment within our community of health systems, we’re going to offer the services we don’t offer, and it’s going to clearly impact the quality of life of our community and the quality of the health care.”

Vickie Pence “I believe, when a health care member focus fosters communication of care, those partnerships and relationships raise treatment effectiveness and the patient’s success which effects our families and communities. I’m hopeful that throughout these types of discussions, we will be able to organize and manage the fragmented and often duplicated services in Columbia providing more successful outcomes and productive lifestyles.”

Mark Dempsey “With the allied health professions such as physical therapy, athletic training and occupational therapy, we’re in the trenches with patients everyday. They might go back and see the doctor every year, maybe, but we’re in there with them everyday. We need to make sure that we play a part, not necessarily just for businesses but to help the community. In turn, it’s going to help the businesses. We’ll be there.”

Phillip Smith I agree with everything that everybody has said, especially about Boone County being this epicenter of medicine. But everywhere that Boone County touches, all those surrounding communities, is all going to be a part of it also. Not just making Boone County the most healthy, but the region as a whole. … It’s a need beyond a need. … A shared risk is an important part of everything that’s going on right now.”

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BUSINESS BASICS

HOW TO BE A BETTER LEADER It’s More Than Just Becoming A Better Manager

by CARLA LEIBLE

COMMUNICATE EFFECTIVELY Whether it’s speaking with employees about a job well done, explaining your expectations for their performance, or discussing improvements that can be made, strong leaders must be able to communicate with their employees in a way that accurately conveys their message and induces a productive response. Regardless of whether you have information to share with the entire staff, just the sales team or a single individual, communicating information and thoughts as a manager is a crucial step in becoming an effective leader.

Effective communication is also timely and doesn’t belittle or insult your staff.

Delivering timely information means addressing an issue with your team when it happens and not waiting until the third or fourth time to make your statement.

As a leader, this illustrates to your staff that you’re taking an active role in their performance and shows them you want them to succeed.

Yelling and talking down to your staff are also ineffective ways of communication. When delivering information, as a leader you need to communicate calmly and respectfully.

Aside from being disrespectful, yelling at your staff can be viewed as a loss of control, which ultimately will create a low morale and a negative environment in the workplace.

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Whether you recognize yourself as a strong leader or know you have room to grow, everyone can continue to improve their leadership skills.

“

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ot all managers are great leaders. Some have the strengths to lead and rally employees while others are stronger when systematically executing plans. The key to being an effective manager is to recognize your strengths and weaknesses and use them accordingly.

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Business thrives when there is a balance between these two personality traits. While you may already (or may not) recognize yourself as a leader, you can use this leadership advice for managers to help you take the steps toward becoming a better leader that your team members will want to follow.

ACCEPT FEEDBACK Managers who are approachable put themselves in a position to not only receive feedback from their employees but also take the information given and make appropriate changes. By creating an atmosphere where employees are comfortable offering suggestions on how to make procedures more efficient or how to address their concerns, you are

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allowing them to feel that their voices are being heard and their insight matters.

Each employee has a unique perspective and you may find that incorporating his or her feedback will help you learn how to be a better leader.

When you are unwilling to accept feedback from your employees, they may begin to feel like they are stuck dealing with inefficient procedures or uncomfortable situations. This can take a toll on employee morale and your unwillingness to be receptive may make your staff unwilling to respond to your feedback. You must lead by example and if you want your employees to be open to your suggestions, you must do the same.

SHOW YOUR APPRECIATION Few things are more effective in boosting morale in a workplace than showing appreciation for a job well done. This can be accomplished on a number of levels and it doesn’t have to cost you a ton of — or any — money. Recognize a salesperson 52

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for closing a big sale or reward your marketing team for a successful campaign. If someone is contributing to your business, even in a small way, thank him or her. Statistics show that employees who feel appreciated are more willing to go the extra mile for their employer.

CREATE A POSITIVE ENVIRONMENT The atmosphere of a workplace is often created and controlled by those in management positions. Following the recommendations above can contribute to creating a positive work environment.

Beyond communicating effectively, accepting feedback and showing appreciation for your employees, there are a couple of other tips to keep in mind.

If you are a high stress individual, it is more likely that you will bring that energy with you to the office. It is important to develop strategies for yourself to minimize the effect you have on employees when you are stressed.

Additionally, studies have shown that

offering development opportunities is a great way to boost morale in the workplace. When employees feel their employer is willing to invest in their advancement, they will put forward the effort to move forward.

Developing the skills to be a leader takes time but with these leadership tips you can begin taking steps towards making a positive impact in your workplace and in how your employees view their involvement within the company. Whether you recognize yourself as a strong leader or know you have room to grow, everyone can continue to improve their leadership skills. Taking the task seriously and investing your time into making changes will help both you and your company succeed.

Carla Leible is the market manager for Zimmer Radio & Marketing Group. She has spent 16 years helping managers become great leaders.

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DIVIDENDS

CEO AT PLAY

Three Questions It’s tax season and Columbians are getting their taxes in order. As April 15 approaches, these three local accountants share their insight and opinions on the tax season.

LOOK WHO’S TALKING

As an accountant, when do you typically get your own taxes in?

BALES: I have always filed my tax returns by April 15, but it is usually close to the deadline!

ROSS: There’s and old saying about cobbler’s children having no shoes...only in my case, it’s “the accountant doesn’t file her own taxes early.” It’s usually October before I file my personal return.

NELSON: Good question. I probably shouldn’t tell on myself like this but I typically don’t file my own taxes until September or October.

JODI BALES Shareholder/CPA Miller, Bales & Cunningham

What is the biggest mistake people make on preparing their taxes?

BALES: One of the biggest mistakes is simple math errors for those who prepare and file their own returns.

ROSS: One of the biggest mistakes I see people making is blindly relying on tax software without understanding the underlying filing requirements.

HEIDI ROSS Owner/CPA Gerding, Korte & Chitwood

NELSON: We see mistakes made on stock sales, dividends and related investment transactions. People also tend to short-change themselves on deductions such as non-cash charitable contributions and unreimbursed job expenses If you weren’t an accountant, what would your career path have been?

BALES: Is being a beach bum a career? That always sounds like a good career in March! Seriously, I love this career and the wonderful relationships built with clients throughout the years.

ROSS: If I weren’t an accountant, I would have been a writer. Now, I get to put those skills to work corresponding with the IRS. NELSON: I’d like to be an attorney — corporate law.

DENISE NELSON Owner/CPA Accounting Plus

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Ronald McDonald House 2017 Red Shoe Gala The annual Red Shoe Gala was held Feb. 16 to benefit Ronald McDonald House Charities® of Mid-Missouri. More than 300 guests enjoyed a cocktail reception and silent auction, followed by dinner, a robust live auction and entertainment. More than $140,000 was raised from the event to help cover operating costs of the Ronald McDonald House, supporting the charity’s mission of providing a “home away from home” that serves families of children being treated at area hospitals and health-related clinics. In 2016, 435 families stayed at the Ronald McDonald House 5,375 nights.

1. Kunal Malhotra and Garima Singh 2. Tom and Haley Schwarz 3. Chris Hausman and Terri Gray 4. Bryan and Nicole Bliven 5. Jeff and Kate Harris 6. Brian and Amy Hawkins 7. Sydnee Stottlemyre and Landon Burke 8. Peggy Johnson, Judy Schoonover, Sally Silvers, Lynn McIntosh, Harriet Yelon, Pam Massey and Mary Ebert

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PHOTOS BY CREATIVE PHOTO

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Children’s Miracle Network Radiothon The 2017 radiothon was held on Feb. 16 - 17 at the University of Missouri Women’s and Children’s Hospital. This year’s radiothon raised $250,502 in just two days, which was up almost $70,000 from last year. In 11 years, this radiothon has helped to raise more than $2,250,000 for the local children’s hospital, through the Children’s Miracle Network. No child is turned away because of inability to pay, and every dollar donated stays local. Last year, MU Children’s Hospital helped patients from every county in Missouri.

1. Cosmo and Jax from Y107 2. Scotty and Cara from Clear 99 3. Josh Ryan and Jamie Mac on Clear 99 with Declan and family 4. Katie Zimmer, Andrew Marcy and John Predmorez 5. Kristen Fritschie, Truman the Tiger and Katie Zimmer 6. Scotty Cox, Christina Stratton, Bob McCosh and Jeff Miller, 7. Carson and Jamie from Y107

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PHOTOS BY MITCH HILL

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MU Health Kicks Off American Heart Month With Mayoral Proclamation Columbia Mayor Pro Tem Clyde Ruffin officially named February as Columbia’s Heart Month at a community-wide mayoral proclamation hosted at University Hospital. At the event, University of Missouri Health Care, Boone Hospital Center and city leaders teamed up to raise awareness about the prevalence of heart disease.

1. William Fay 2. Amy Beggeman 3. Edward T.H. Yeh 4. Clyde Ruffin 5. Edward T.H. Yeh, Clyde Ruffin, Amy Beggeman and William Fay

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PHOTOS BY JEFF HOELSCHER

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ADVERTISING INDEX Accounting Plus................................................. 57 Achieve Balance.................................................21 Atkins, Inc. ...........................................................17 Automated Services.......................................... 51 Boone Hospital .................................................. 67 BrandsFormation.............................................. 6,7 Caledon Virtual.................................................. 24 Central Bank of Boone County....................... 33 Century Link.........................................................61 Christian Chapel Academy..............................15 City of Columbia Water & Light.................... 57 Coil Construction...............................................19 Commerce Bank...................................................2 EcoWater Systems............................................ 23 Evans & Dixon Attorneys at Law .................. 63 Hawthorne Bank................................................68 Image Technologies.......................................... 63 Inside Columbia’s Best of Columbia................15 Inside Columbia’s CEO Updates.......................15 Inside Columbia’s Instagram.............................19 Inside Columbia’s Subscriptions...................... 23 K & S Concrete....................................................10 Kia of Columbia................................................. 55 LammTech............................................................ 13 Landmark Bank.................................................. 27 Moresource........................................................... 9 Mutual of Omaha.............................................. 39 PCE......................................................................... 51 Postal Signs Express..........................................10 Pulse Medical Staffing........................................3 Strawberry Hill Farms........................................21 The Broadway, A Doubletree by Hilton.......65 Tiger Family Chiropractic................................ 35 University of Missouri Health Care.............4,5 University Subaru................................................11 Williams Keepers.............................................. 35 Zimmer Radio Group Eagle............................. 59 Zimmer Radio Group Man Show................... 53

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Our mission is simple:

helping our clients achieve success.

• LLCs and Corporations • Sale and Purchase of Existing Businesses • Real Estate and Construction Law • Contracts and Commercial Transactions • Comprehensive Business Services The choice of an attorney is an important decision and should not be based soley on advertisements

(573) 777-8823 | 501 Cherry Street, Suite 200, Columbia, MO 65201 SPRING 2017 I INSIDE COLUMBIA’S CEO

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PUBLISHER’S NOTE

MU Extension Fills Important Need

A

ny of our readers will remember Walter Johnson, the infamous Economics professor at the University of Missouri who reached legendary status on campus as a tough and spirited educator. Students feared Johnson, and for good reason.

Beyond just campus lore, Johnson was well known for his marksmanship, often launching a piece of chalk toward a sleeping student from the stage of his auditorium in Middlebush Hall.

Outside the classroom, Johnson often talked about Columbia’s recession-proof economy as being similar to a three-legged stool that was sturdily supported by education, healthcare and insurance. Johnson reasoned that these three industries were insulated from the factors that normally toppled economies.

Unfortunately, Johnson didn’t live long enough to see how his beloved university could be ravaged by a state legislature or to see how a plethora of natural disasters along with oppressive governmental regulations could wreak havoc on the insurance industry. And not even one of Johnson’s high-minded Econ 51 lectures could have ever predicted how the Affordable Care Act would change healthcare forever.

For a town that prides itself on having the second highest number of hospital beds per capita in the USA, we are, unfortunately, highly susceptible to the “perfect storm” that seems to be radically changing the healthcare industry in Missouri with every passing day.

What started out as an attempt to make healthcare affordable and accessible to all, has had nearly the exact opposite effect.

With recent news that United 64

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Healthcare and Aetna are abandoning Missouri’s marketplace exchanges, the future of the Affordable Care Act in Missouri is grim. Private insurance companies have discovered that it is nearly impossible to provide low cost plans to low income households. In an effort to recover their losses, these same companies have passed along double digit increases, as high as 34 percent, to their private sector customers to offset the costs associated with offering insurance to lower income individuals through the federally-initiated marketplace exchange.

At the same time, seismic shifts indirectly associated with healthcare reform have taken their toll on rural hospitals in Missouri. With as many as three more rural hospitals expected to close by the end of 2016, the healthcare crisis in the Show Me State deepens.

The widely reported struggles of hospitals in Cooper and Audrain Counties illustrate the harshness of the healthcare industry’s new realities.

Columbia is not insulated from these troubles, however, higher volumes at local hospitals and our standing as a regional healthcare hub have softened some of the impact.

Columbia’s hospitals are dealing with shrinking reimbursements and more red tape from Medicare, which accounts for almost 70 percent of total volumes at both Boone Hospital and MU Healthcare. On top of that, these hospitals are battling increased labor costs associated with the national nursing shortage. The bad news and the challenges far outweigh any positive developments.

Hospitals are responding to a revenue crisis by doing what they can to control the costs of delivering healthcare. With more scrutiny on labor and supply costs, hospital administrators are forced to

adjust staffing levels often erring on the side of caution. Surgeons are being told they can no longer have control over the devices they are using and are being asked to limit the breadth of their suppliers. At the same time, hospitals are putting the squeeze on device and implant companies insisting that they lower prices. It’s a high stakes poker game that, at times, requires both sides to blink.

To add to the evolving chaos, high insurance deductibles are causing consumers to postpone treatments and surgeries, often to their own demise.

By the time that consumers decide to proceed, their medical issues are far worse and require more extensive and expensive treatment. Revenues lag in July and August only to have demand exceed capacity in November in December.

Pundits will kick around Missouri’s failure to expand Medicaid as a root cause of these problems. But even the most objective, non-partisan bystanders will tell you that Medicaid expansion is, at best, a band-aid for a modern healthcare system that desperately needs to be overhauled. There are no easy answers in spite of what politicians may tell you.

The most rational among us will likely reach the same conclusion: it’s time to go back to the drawing board and take another stab at fixing America’s healthcare system. It would be interesting to hear Walter Johnson’s take on the matter.

Fred Parry

Publisher • fred@insidecolumbia.net

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CLOSING QUOTES

What Columbia’s Business People And Community Leaders Are Saying

“I don’t think we’re any different than any other industry that’s going through a paradigm shift … we’re just late to the game.”

– Dr. Mark Adams on the rapidly changing field of health care

“Really, the holy grail ought to be: Can we continue to improve quality and patient safety and can we reduce our overall cost structure?”

– Jim Sinek, president of Boone Hospital Center

“We’re in for a bit of a rough ride for the next 10 years perhaps.”

– Kristofer Hagglund, dean of MU’s School of Health Professions, on the immediate need for nurses

“THEY JUST DIDN’T HAVE THE FAMILY-DO ATTITUDE.”

– Bob Wood on why he ran the day-to-day operations of Dawson Shoe Repair himself before his son got involved. He tried overseeing employees in the past, but decided it wasn’t the same.

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“In planning and budgeting for the new tower, we are discovering large cost increases for land, general construction and furnishings for our proposed project as compared to just five years ago.”

– David Parmley, owner of The Broadway hotel

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INSIDE COLUMBIA’S CEO

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