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Drakos Clinical Dynamics

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Enhances Healthcare Accessibility with Expanded Services in Central New York

In a healthcare landscape teeming with both challenges and opportunities, Drakos Dynamics has emerged as a pivotal player in Central New York, with successful healthcare services like a dedicated pediatric urgent care in Liverpool (Clay Medical Center). Drakos Pediatric Urgent Care opened in May as a unique option to help address the shortage of accessible pediatric healthcare in Central New York. 

The company is now furthering its commitment to the region with ambitious plans that are not only expansive but also strategically focused. The company will be opening Drakos Urgent Care in Cicero with an expanded portfolio that will provide comprehensive care for the entire community, including adults, as part of Drakos’ mission to continue addressing gaps in healthcare, one of those most critical being increasing access to high quality care. These services include urgent care services, a full vaccination program, X-rays, ADHD screenings, weight loss and metabolic health management, a comprehensive lab onsite, full respiratory panels, sexual health, and more.

“Since opening Drakos Pediatric Urgent Care in May, we’ve provided care for more than 1,000 patients,” says Drakos Founder and CEO Heather Drake Bianchi. “With the urgent care in Cicero, it’s not just about expanding our services, it’s about access. It’s about ensuring that we continue to fill crucial gaps in the healthcare system here in Central New York. This is a data-driven decision. We’ve reviewed the epidemiological trends and identified a need. It’s proactive healthcare delivery, aligned with regional demands, to help address current and future shortages.” 

As many local urgent cares are closing temporarily or shutting permanently, Drake Bianchi is passionate about the company’s responsibility to serve the community, especially as experts already see the start of another challenging respiratory season.

Drakos Pediatric Urgent Care observed an early uptick in both COVID-19 and strep infections, starting as early as the end of August – much earlier than normal. Local teachers shared that schools were grappling with significant numbers of students falling ill with COVID-19, strep throat, or influenza, even before October had arrived. This pattern immediately raised concerns about another potentially challenging respiratory season, impacting both kids and parents alike.

“We want to be a resource to truly anyone in our community in need of outstanding, convenient care, and to other healthcare facilities by helping ease the stress in emergency rooms and across the healthcare system at large,” says Drake Bianchi. “We’re here for the long haul to serve this community.”

Drakos has other major plans, too. The company’s ethos has always been to provide healthcare without walls— innovating to overcome barriers and bring quality healthcare to people when and where they need it. The company began in 2020 with its subsidiary, CineMedics, which focused on providing medical testing and services on medical sets.

Now Drakos is adapting what it learned with CineMedics and designing mobile care to reach underprivileged and remote areas, along with anywhere that suffers from access issues. According to the Urgent Care Association, 89 percent of the U.S. population can drive to an urgent care in 20 minutes or less, but only 15 percent of urgent cares are in urban areas and only 9 percent are in rural areas – a gap that contributes to healthcare
access challenges.

“Our origin story is rooted in mobile care. Mobile clinics are redefining healthcare accessibility,” says Drake Bianchi. “That matters in a community that has one of the highest rates of segregated poverty in the country and underserved immigrant communities and is surrounded by rural areas where regional hospitals have closed at alarming rates. The entire Drakos team is incredibly motivated to use our skills to serve people in our community who struggle to access healthcare.”

Despite being one of the most technologically advanced and affluent nations globally, the United States falls short in terms of healthcare access both locally and nationally. That’s why Drakos is also committed to using mobile healthcare, as well as the physical locations in Cicero and Liverpool, to address these healthcare disparities.

Data from the New York State Department of Health 2021 Behavioral Risk Factor Surveillance System (BRFSS) Health Indicators by County and Region reveal that 1 in 10 Central New Yorkers don’t have a regular health care provider, 1 in 7 struggles with mental health more than 14 days per month, and 1 in 10 report overall poor physical health. Additionally, of those who do have a primary care provider, nearly 25 percent don’t see their doctor for a checkup each year.

“If we really want to improve our fellow citizens and neighbors, everyone needs regular care for their physical and mental health,” says Drake Bianchi. “We understand that mobility issues, geographic hurdles, and other challenges can hinder timely and appropriate access to healthcare services for everyone. One of our lessons from working in Hollywood is that a lack of time can be a major healthcare access issue for everyone. Although their access to wealth and specialized care obviously differs greatly, one thing a parent working two jobs struggling to make a living and a movie star working on set for 16 hours per day often have in common is the feeling that they just don’t have time to see a doctor. We look at all the factors impacting healthcare access and think, ‘where can our skills help?’”

As Drakos works toward its goal of becoming a long lasting part of the region’s healthcare infrastructure, the team is working with local nonprofits and businesses to create new alliances that will increase healthcare for all.

“All of our plans focus on innovative solutions that incorporate a network of physical brick and mortar locations, mobile, and virtual care. We aim to set a precedent for agile, effective healthcare delivery,” states Drake Bianchi. “At our core, the Drakos team is passionate about bringing together data, science, and action to drive decisions and create a more accessible, convenient healthcare network in Central New York, so everyone can receive high quality healthcare when they need it.”

For healthcare leaders seeking to understand the future contours of healthcare in Central New York, Drakos serves as a case study in thoughtful expansion and effective communication. By strategically widening their services and using innovative technologies and approaches, they are not just serving the community —they are actively helping to shape it. Their data driven, communityfocused approach promises to make them a lasting fixture in Central New York’s healthcare. 

For more information, please see www. drakosdynamics.com

St. Joseph’s Health:Trailblazers in Robotic Surgery

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By Martha Conway

St. Joseph’s Health has always been an early adopter of technology, so it is no surprise they became the first facility in Central New York to acquire da Vinci robotic surgery technology and start a comprehensive program for patient care – not long after the FDA approved da Vinci for general surgery, such as cholecystectomy and Nissen fundoplication to treat foregut problems. Surgeons performed 43 robotic surgeries the first (partial) year, nearly quadrupling that number the following year. St. Joseph’s Health has performed 13,284 robotic surgeries to date. As a result, they have attracted the surgical expertise of a range of specialists who use the technology to improve the health of patients, and their robotic surgery program is second to none in the U.S. In addition to the above, St. Joseph’s surgeons are using da Vinci for revascularization (coronary artery bypass), heart valve repair, hiatal hernia repair and other gastric reflux procedures, as well as groin or belly hernias, gynecological procedures, urology (including prostate) procedures and colon procedures. They are the leaders in robotic general surgery cases in Central New York. 

The breadth and depth of surgeon expertise mean patients experience less scarring, shorter hospital stays, faster recoveries, less pain and few infections with da Vinci.

“To continue recruiting high quality surgeons – including our newest surgeon coming in September, we need to have robotic access availability,” said Chief Medical Officer Dr. Philip Falcone.

“Virtually everyone in a surgical residency and fellowship training receives robotic instruction and expects this to be available in the hospitals where they work. Robotics are now the norm, and access to this technology is an expectation for most surgeons.” 

The Heart of the Robotic Surgery Program at St. Joseph’s Health 

“St. Joseph’s started investing in robotic surgical technology at least 15 years ago,” said Dr. Zhandong Zhou, a cardiac surgeon who performs bypass and valve procedures using da Vinci. “Surgeons can do single bypass surgery, but not many people need single vessel revascularization, so we started doing robotic bypass to the left anterior descending artery, then PCI [percutaneous coronary intervention] to non-LAD territories, which we called ‘hybrid’ revascularization.”

“St. Joseph’s is dedicated to robotic surgery.” “We put resources into it, employ excellent robotic surgeons and lead the market in terms of technology… ”
Dr. Belfield

Defects in the LAD cause widow-maker (often fatal) heart attacks; PCI opens narrowed or blocked sections of the artery, restoring blood flow to the heart.

“One of the major benefits is that patients recover very well, and – after a couple of weeks – they can do pretty much everything,” he said. “The results from this procedure have been wellreceived, but most people need multivessel bypass. Not everybody can have hybrid revascularization bypasses, so we started the multi vessel bypass. Initially, it was stressful, difficult and took a long time. We recently revised the technique to get them done more quickly and achieve identical results to standard surgery. We just presented our results at the STS Coronary Conference and got very positive feedback.”

“There are only a handful of people doing this in the country, and that makes us stand out,” Dr. Zhou said. “We are showing the world we are one of the few hospitals with the technology and expertise to perform robotic revascularization as good as standard surgery and with quicker recovery. Now patients come in and ask for robotic bypass, but the robots are in high demand because there are a lot of specialties using them, so we just don’t have enough spots.”

Dr. Zhou focuses on coronary bypass surgery because so many patients need it. “About half of open heart surgery patients need coronary bypass, and about half need valve surgery,” he said. “Mitral valve repair can be done robotically, but with limited scheduling slots and minimally invasive surgery being very successful – also done through a very small incision – we can do those either robotically or standard using special instruments, and we can do as good a job as with the robot. For the coronary bypass surgery part, we can do more along the lines of bypass, if we have the [scheduling] spots. Down the road, one of the areas to explore is total robotics – make the incision even smaller.”

Dr. Zhou said while the priority right now is catching up on patients needing bypass, there are other things they can do. “If we can get bypass surgery caught up and I find more time, I can do more,” he said. “We do about 1,000 surgeries a year; 400 to 500 of them are coronary bypass surgeries. We have about 100 mitral valve surgeries, some of which can be done robotically, but I can use special instruments and do as good a job. We do about 400 to 500 coronary bypass surgeries; last year, we did about 20 to 30 percent of them robotically. ”

By avoiding sternotomy and using a rib spreader to access the heart, there is less trauma to the body, minimal scarring, very low infection rates, shorter hospital stays and quicker recovery times. Patients should still expect some discomfort for a few days because of the need for a chest tube.

“After that comes out, things are dramatically better,” he said, adding that cryotherapy is available. “I don’t think patients know the range of options available at St. Joseph’s Health. I’m operating all the time, so I don’t have time to spread the message, but anyone who needs these procedures can call my office. I am happy to talk to them.”

Not everyone is a candidate.

“Some patients are too obese, and that makes it hard,” he said, “and some patients have very small arteries.”

Dr. Balasubramaniam Siva Kumar, a general surgeon who has performed well more than 2,000 robotic surgeries to date, agreed.

“It’s a definite advantage in many surgeries, but it’s not the answer for all surgeries,” Dr. Kumar said. “It’s still not ideal for very large growths and tumors, because it’s riskier to maneuver around larger structures. The size of the patient is a consideration, too. It’s difficult to use robotic surgery in pediatrics because of the positioning required for smaller patients. There is a need to miniaturize the equipment to use robotic surgery in smaller people and on larger masses and growths, as well as extensive cancers.”

“Over the years, we’ve been able to maintain the highest standards through a committee approach to program oversight. The range of services is wide and very high-quality.”
Dr. Kumar

 

Infection rates are almost non-existent because they don’t do sternotomies, Zhou said.

“Chest wall incisions rarely become infected,” he said. “Occasionally, a large breasted woman gets an infection because the incision typically is under the breast, and moisture can collect there; but cosmetically for women, it’s very good. With large breasted women, we can make the incision above the breast to avoid chances of infection.”

Exemplifying the Range of Possibilities

Dr. Kumar started performing robotic surgery about 17 years ago when Chief of Urology, Dr. William Roberts, asked him to collaborate with the urology team to do laparoscopic urologic procedures.

“He asked me to lead an expansion into general surgery,” Dr. Kumar said. “I learned everything I could, and we were among the very first to adopt robotics for general surgery.”

Foregut and hiatal hernia surgeries top the list of robotic procedures Dr. Kumar performs today. He’s also done colon surgery, hernia repair and pancreatic surgeries.

“Robotic technology adds dimension to surgery,” he said. “We can gain a much wider range of access to more radius and with more precision, expanding the ability to do more precise surgeries.”

Dr. Kumar said there also are hybrid procedures that allow access to areas of the body that are difficult to reach and previously required large openings to access. “You can use  robotics to reach the areas, then do hands-on surgical procedures via very small openings,” he said. “I do quite a range of robotic surgeries and don’t plan to add any new ones; however, the technology continues to evolve, and St. Joseph’s Health is working on developing further services in this field.”

Like Dr. Zhou, Dr. Kumar said robotic surgery minimizes trauma to tissue. He said surgeons used to do exploratory surgery with a wide-open field to see inside the body. Now the same results are achieved without that trauma. He said there are benefits to surgeons, also.

“Surgeons can work in a comfortable, seated position and achieve better reach with robotic instruments,” Dr. Kumar said. “They can perform much more intricate procedures for much longer periods of time, and they experience much less fatigue doing laparoscopic surgeries than they did during traditional procedures that required great manipulation.”

St. Joseph’s Health Tailors Care to Each Patient

Dr. Beata Belfield is a minimally invasivetrained general surgeon whose fellowship was in robotic surgery; she was recruited by St. Joseph’s Health for precisely that reason.

“Robotic surgery was an absolute prerequisite for any hospital in which I chose to work,” she said, adding that the program is cutting-edge, and the staff are very happy to help create a great patient experience. “I specialize in gallbladder removal, hernia repair and anti-reflux procedures; I’m very happy with my niche, but I would like to do more acute surgeries – procedures we would otherwise do through a big open incision – emergency procedures I’d prefer to do robotically, if possible.”

Dr. Melinda Stevens, a general surgeon, said she’s been doing robotic surgery since about 2015, starting out with small hernias under the mentorship of Dr. Kumar.

“The smaller the incision, the less risk of infection,” Dr. Stevens said. “As for intra-abdominal complications, they are slightly less with the robot because of the 3D visualization and the ability to handle the tissue with instruments that move exactly like our hands. It’s so much better than standard laparoscopic cameras, which are very good, but it’s better with 3D visualization.”

Dr. Belfield said robotic surgery is a good option for appropriate patients. “Certain procedures are not conducive to being done minimally invasive, so robotic surgery is another tool in our tool kit,” she said. “There are certain hernia procedures I do mostly robotically, then at the very end do something open, such as scar revision or removal of excess skin. But most surgeries are either open or robotic.”

“I’ve since developed further skills with larger, more complicated hernias, colon surgery, emergency surgeries – including appendix – and also use the robot more now for doing gallbladders because of the superior visualization and tissue handling,” Dr. Stevens said. “Every year, I’m growing the list of things I do with robotics vs. what I used to do just laparoscopically.”

Dr. Stevens said she wants to add large, complicated hernias that normally are done with a component separation in open fashion.

“I’d like to do it robotically, which is a longer procedure, but in the end, it’s less post op pain for patients, so it’s worthwhile doing it that way,” she said, adding that certain surgeries are not ideal to be performed robotically.

“Patients who’ve had numerous surgeries and who have a lot of scar tissue may not do well with robotic surgery,” she said. “It is best to talk to your surgeon about whether you’re an ideal candidate, because it’s hard to know what your surgeon will think, even if you’ve had surgery before. Meeting with the surgeon helps patients understand their disease process and whether it is a good option for robotic surgery. We tailor our approach to individual patients.”

Dr. Stevens agreed. “It’s difficult to gain access to the abdomen,” she said. “You really need to be able to fully see everything in order to get in safely to avoid injury to the bowel, in particular. Sometimes we have to convert to open in those patients. Some patients are extremely petite – very thin. For a tiny umbilical or groin hernia, the openfashion incisions for those wouldn’t be much bigger than with the robot, so sometimes it doesn’t make sense to use the robot for those. It’s really patientby- patient. I sit down with my patients and  explain the ins and outs of standard laparoscopic vs. open vs. robotic, and we decide together.”

Drs. Kumar and Belfield emphasized that the robot is one of the tools the surgeon uses – it does not move independently of the surgeon.

Dr. Belfield said she believes robotic instrumentation will get smaller and less expensive as other companies enter the field, driving competitors to make more efficient, smaller, and less expensive technology.

“Years ago, robotic technology was focused on cardiac surgery, but so many specialties use it, there isn’t focus on particular specialties,” Dr. Zhou said. “In a few years when the patent expires, a lot of companies will likely try to come up with new and better technologies.” Dr. Stevens believes some of the instrumentation will result in smaller incisions; she also thinks the number of procedures surgeons are able to do with the robot will continue to increase as more physicians become proficient with the technology, which will allow them to increase the versatility of its use with time and experience.

Dr. Kumar added he thinks technological developments are going to focus on miniaturization for pediatric patients and imaging improvements that will allow 3D images to be overlaid on the patient’s anatomy to better target more precisely something like a tumor.

“Applications will widen,” he said. “Resulting enhancements could mean da Vinci isn’t just a surgical tool anymore, but possibly a treatment delivery method for something like precision radiation completed with surgery. The next 20 years we will see things very different from what we are seeing today.”

Why St. Joseph’s Health?

“St. Joseph’s is dedicated to robotic surgery,” Dr. Belfield said. “We put resources into it, employ excellent robotic surgeons and lead the market in terms of technology. We were the first to have a robot in an outpatient surgical center and the first to have the newer generation of Xi surgical robot in the main hospital. St. Joseph’s is cutting-edge on surgical robotic technology and a high volume center that leads to shorter hospital stays and fewer complications for patients.”

“St. Joseph’s has the longest and broadest range of experience with robotics in Upstate New York,” Dr. Kumar said. “Over the years, we’ve been able to maintain the highest standards through a committee approach to program oversight. The range of services is wide and very high-quality.”

“Our longevity in the field and ability to attract the most talented surgeons are the reasons we get superior results,” Dr. Zhou said.

“St. Joseph’s has been at the forefront of robotic surgery and particularly in the field of general surgery, which really got started doing upper abdominal surgeries, like hiatal hernias,” Dr. Stevens said. “St. Joseph’s has been doing this longer and in significantly higher numbers than any other hospital in the area, and we have continued to increase its use across the breadth of general surgery. We have numerous surgeons with various levels of robotic surgical expertise and experience.

In general surgery, we work as a team, and there’s always someone there to take care of any problem.”

St. Joseph’s:
• leads robotic general surgery cases in Central New York (9,300-plus cases vs. the closest competitor with 7,000);
• has the busiest cardiac robotic program in CNY;
• was the first in CNY to have a da Vinci system at an outpatient facility and the first to have an Xi at a surgery center;
• has performed more than 1,700 robotic cases in 2022 and more than 1,100 so far in 2023;
• have five surgeons who have passed 1,000 robotic cases each; and
• they are the leaders in da Vinci foregut procedures in Central New York, performing 153 cases in 2022 and 102 so far in 2023.

“I think it’s important for people to understand this technology will be the standard of care in many facets of surgery, and it isn’t offered everywhere,” Dr. Stevens said. “Having a hospital filled with surgeons very experienced with the robot is an important option people should know about.” 

Workforce Challenges, Part Two

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BY Kathryn Ruscitto, Advisor

Earlier this year, I wrote about nursing workforce challenges. As the year has progressed, I find myself bumping into deeper workforce challenges in rural communities; leading the list is housing. I don’t believe this is just a rural issue; I think it extends to urban areas, as well. A few times in my career, I was involved with large organizations that took on housing challenges from building senior and building workforce housing to improving a neighborhood. Some projects required direct involvement as a sponsor; other times, it was acting as a catalyst by attracting a partner. 

So whose responsibility is it to ensure a community has all levels of housing? As short term rentals have gained popularity, much of the low rent stock has been eaten up by more profitable ventures. Teachers, service workers, young families find themselves fighting for access to affordable rentals and first time homes. 

They often have to handle further distances from work, move in with their families or co share a more expensive rental.

Generally, not-for-profits have taken the lead in Central New York, such as Home HeadQuarters, Housing Visions and Christopher Community. Some for-profit builders have also taken on tax credit projects. Tiny Homes for Good addresses the needs of the homeless; others facilitate apartment rentals for special needs populations.

Home HeadQuarters CEO Kerry Quaglia is focused on the rehabilitation of older homes in Syracuse and new construction. Quaglia says new construction often offers a better option to reduce costs to a first-time homebuyer.

“Housing continues to be a major priority for our communities, especially helping low-income and first-time homebuyers access the housing market safely and affordably,” Quaglia said, adding that part of what is slowing his work at adding affordable housing units is finding contractors, who are facing workforce shortages.

Occasionally, I post blog thoughts on LinkedIn and recently issued a challenge to anchor institutions such as colleges and health systems to look at workforce housing as a challenge and strategic requirement. I took notice of the many comments and cheers from colleagues across the country. I hope it stimulated some thinking about next steps. 

While housing projects may not fit the priorities of a small practice, talking to elected officials and developers about locations and needs might. Use your voice to share what you are hearing from your employees and communities. If you sit on anchor institution boards, ask about their plans or conversations on this topic.
Communities that look at this issue and offer tax incentives or deed restrictions, or land banks dedicated to workforce development, will begin to solve workforce challenges at all levels.

Further resources on this topic:
“Adirondack Housing at a Threshhold”: https:// www.adirondackexplorer.o g/stories/adirondack- housing-at-a-crossroads

“In Vail, housing shortage threatens America’s ski wonderland”: https:// apnews.com/article/travel sports-colorado- sheep-vail-7a622d88e2678b32ce-
8be58be6884dd4#

Local resources:
Christopher Community https://christopher-community.org/
Home HeadQuarters
https://www.homehq.org/
Housing Visions
https://www.housingvisions.org/
Two Plus Four Construction
https://twoplusfour.com/


Kathryn Ruscitto, Advisor, can be reached at linkedin.com/in/kathrynruscitto or at krusct@gmail.com

 

Dr. Praveena Paruchuri, MD Joins Auburn Heart Institute

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Praveena Paruchuri, MD, is a cardiology specialist with 17 years of experience. She comes to Auburn Cardiology from St. Francis Hospital in Roslyn, New York. Dr. Paruchuri has also practiced in a number of the largest cardiology departments in New York City hospitals including NYU Long Island Hospital, as the Director of Adult Congenital Heart Disease.

Dr. Paruchuri attended Saint George’s University School of Medicine in Grenada, West Indies, and completed her residency program at Winthrop University Hospital in Mineola, NY. Additionally, she completed her General Cardiology Fellowship at Winthrop University. She is board certified in cardiovascular disease, Cardiovascular Computed Tomography, Nuclear Cardiology, and Internal Medicine.

Dr. Paruchuri is skilled in assessing conditions ranging from routine to complex adult congenital heart disease and devising treatments in line with the latest research and treatment protocols. She also is proficient in multi modality cardiac imaging including structural TEE, cardiac CTs, echocardiograms, and nuclear stress testing. Dr. Paruchuri is known for building excellent rapport with patients and colleagues to facilitate effective clinical care and has a passion for caring for women’s cardiology issues. “I am excited to join a growing cardiology practice at Auburn Community Hospital and to be able to practice in the Auburn community and be a part of building the Auburn Heart Institute,” she said.

“We are thrilled to have Dr. Paruchuri join the Auburn Heart Institute. She has an exceptional background and considerable experience in caring for patients in some of the most prestigious New York City cardiology institutions. By securing Dr. Paruchuri’s services, we are well on our way to achieving our goal of developing a world-class heart institute in Auburn. N.Y.,” said Ronald Kirshner MD, Chair and Medical Director of the Auburn Heart Institute (AHI). Dr. Paruchuri is accepting new patients now. 


Please call Auburn Cardiology
315-567-0540
17 Lansing Street, Auburn NY

Crouse’s Pomeroy College of Nursing Settles into New Location

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By Molly English-Bowers

After more than 100 years on University Hill, Pomeroy College of Nursing at Crouse Hospital has moved to the Crouse Medical Center at 5000 Brittonfield Pkwy., East Syracuse. In late 2021, Syracuse University purchased the Marley Education Center at 765 Irving Ave., which the college had occupied since 1991. The relocation, just nine miles from Crouse Hospital, benefits students and college staff with minimal adjustment. “It’s a win-win for our students,” said Patty Morgan, MS, RN, Dean of the College, adding that students attend Pomeroy to become registered nurses. “This is a new facility accessible to our students just off I-481, near the state Thruway and our general education partner, Le Moyne College.” The facility was intentionally designed to meet the needs of all students, creating an excellent student experience within a dynamic learning environment. Available to students enrolled at Pomeroy are:
• three classrooms of increasing size, equipped with smartboards, video/ audio recording capabilities and comfortable seating;
• a library with thousands of books, journals and videos related to nursing and medicine, including access to online databases and texts;
• a nursing skills lab with seven patient treatment bays and mannequins that parallel a hospital acute-care setting;
• a simulation center with two fully functioning patient rooms and three high-fidelity mannequins – adult, birthing mother and baby;
• a biology lab used for teaching microbiology and anatomy and physiology;
• several areas for quiet study, group study and a student lounge for relaxation and student interaction;
• a computer lab;
• a highly regarded nursing faculty, many of whom are graduates of the college; and
• ample free parking. 

The nursing skills and simulation center areas allow students the opportunity to work with faculty and one another to grow and develop. “These areas augment students’ education,” Morgan said. “We are not using these areas to replace the clinical experience gained only in a hospital setting, rather providing students with a safe space to develop and practice their skills.” 

The modern simulation center features various high-fidelity mannequins that can be programmed with more than 200 scenarios intended to represent real patient experiences often encountered in hospitals. Scenarios involving the birthing mother and baby allow students to learn about the management of two patients at once, accessing newborn health and the immediate needs of a postpartum mother simultaneously.

Faculty members and simulation staff control the scenarios via computer terminals located in a control room centered between patient rooms. Faculty are able to watch students complete simulation experiences via one-way glass, providing immediate feedback, if necessary. A debrief room completes the space, where students and faculty are able to view a video/audio recording of their simulation experience and discuss what went well and what requires further development – providing an excellent learning opportunity for students. 

“Simulation experiences are not graded,” said Amy Graham, Assistant Dean for Enrollment. “They are intended to help students gain knowledge and experience, as well as to learn to think critically and develop teamwork.” 

Extensive clinical experience is one of the strengths of the Pomeroy curriculum, said Morgan. Students begin clinical rotations early in their first semester/ term of study. Student-to-faculty ratios during rotations are typically nineto-one, with rotations taking place at Crouse Hospital, Upstate Golisano Children’s Hospital and Hutchings Psychiatric Center.

“The fact that the college is affiliated with Crouse Hospital means that our clinical education component is very strong,” said Graham. “Students develop professional relationships, often leading to employment opportunities.”

Another strength that Morgan touted is the nursing faculty. “They are knowledgeable, supportive and skilled in the classroom and clinical environment,” she said. In fact, many members of the faculty are Crouse graduates.

The college’s career placement rate, which measures the percentage of graduates who obtained a position as a registered nurse within 12 months of graduation, is consistently in the high 90s, noted Morgan. Many  graduates choose to begin their professional nursing careers at Crouse Hospital, while others choose to practice elsewhere, depending upon their desired specialty or geographic location post-graduation. The latest figures published on the college’s website show placement rates of 98 percent in 2019, 97 percent in 2020 and 95 percent in 2021. 

An important indicator of any associate degree nursing education program is the National Council Licensure Examination (NCLEX)-RN exam first-time pass rate. Pomeroy’s pass rate is consistently higher than state and federal rates, most currently at 92 percent, said Graham. Students prepare for the licensing exam in various ways throughout their matriculation at the college, including testing. Additionally, Morgan said, students complete a fourday NCLEX RN preparation and review course prior to graduation. 

Pomeroy College of Nursing at Crouse Hospital offers three options for students to earn their degree. The traditional day option gives students the opportunity to earn an associate degree in applied science with a major in nursing in four semesters. The evening/weekend option allows students to earn their degree in just 16 months and is ideal for those with daytime commitments. The Degree-in- Three option with Le Moyne College allows students to earn both their associate degree and bachelor of science degree in nursing in three years while studying simultaneously at Pomeroy and Le Moyne.

Beginning in 2017, New York state began requiring registered nurses interested in practicing in the state to earn their B.S. in nursing within 10 years of being licensed. The initial associate degree qualifies a graduate to work as a graduate nurse, sit for the licensing exam and then work as a registered nurse. The Degree-in-Three option provides a continuous pathway to the bachelor in nursing degree without the worry of the looming 10-year requirement. 

Students who choose to do so may complete their general education course requirements elsewhere and, if successful, transfer those credits into Pomeroy. Included are science courses – anatomy and physiology, microbiology and nutrition – and English and psychology courses. Completing general education courses prior to matriculation at the college is especially helpful to students enrolled in the evening/weekend option, though all students may begin their nursing education at Pomeroy with all or some of those courses completed elsewhere. 

Pomeroy College of Nursing at Crouse Hospital admission applications are reviewed on a rolling basis with target dates of April 1 for fall admission and Sept. 1 for spring admission. Applications and additional information can be found online at course.org/nursing. The college may be reached via phone at (315) 470-7481 or via email at pcon@crouse.org.

Clear Protocols as Important as Everamid Healthcare Staffing Shortage

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By Chris Zuccarini, Managing Director, National Healthcare Practice and Jennifer Negley VP National Healthcare Practice

Staffing shortages have hampered the United States economy since the onset of the COVID-19 pandemic. This shortage is particularly acute for the healthcare industry which faces a growing scarcity of trained professionals.

Healthcare employment has declined by 2.7% since the start of the pandemic. That exceeds the overall workforce decline of 2.3%. Low medical school admissions indicate that the situation won’t improve any time soon. The Association of American Medical Colleges predicts that by 2030, there will be a shortage of between 42,600 and 121,300 physicians in primary and specialty care. To make matters worse, nurses, home health aides, and medical assistant positions also have become difficult to fill. 

The staffing shortage has several causal factors. Baby boomer workers are retiring, with many choosing to retire early due to the pandemic. These exits combined with the shortage of trained professionals has led to numerous unfilled positions. This can lead to employee “burnout”— feeling exhausted and overworked— among those remaining employed. These employees are under greater stress as they have fewer peers to rely on for assistance.

Meanwhile, higher salaries are eating the payroll budget. The talent shortage has also given existing workers the power to demand higher salaries. For workers earning less than $60,000 per year, the reservation wage—the minimum acceptable wage for a job—increased by 26.4% from March 2020 to March 2021. Physician compensation has increased 29% since 2017, almost double the cumulative rate of inflation. Organizations must find creative ways to
enhance recruitment efforts when their payroll budget goes to fewer employees.

Measures to address staffing shortages

Many healthcare organizations enlist help from traveling professionals and clinicians to compensate for the scarce available talent. New employees may need to quickly learn an organization’s processes upon joining. However, rushing training can result in mistakes that could lead to costly outcomes.

All healthcare workers temporary and permanent—need to be thoroughly trained on an organization’s procedures so they adhere to precise protocols. Implementing an onboarding process that makes clear risk and responsibility is also beneficial

The risk of putting profits ahead of patient care

Another factor affecting the healthcare space is the rise in mergers and acquisitions. Some organizations engaging in M&A activity may take measures to cut costs to boost profitability. These measures may include laying off staff and eliminating positions. These organizations may pay the price, though. Scaling down a workforce can result in burnout for those who remain. 

Physician-related studies consistently show a strong association between medical staff burnout levels and errors that result in malpractice suits. Likewise, profit-driven decisions that harm patients can lead to costly lawsuits. Losses incurred in this manner are likely to be excluded from coverage under medical malpractice policies. 

Striking a balance with limited resources

Many healthcare organizations will have to implement creative recruiting techniques and benefits strategies as they struggle to fill open positions. Hiring candidates from outside the area can play a role in this. There is no evidence to suggest that someone from outside a region would be any less competent in their profession. Still, organizations should have firm onboarding protocols to assure that all employees are following standard procedures. Benefits are now an important part of job acceptance decisions. Benchmarking against the competition is a good way to see if some benefits enhancements could help with recruiting.

With creative recruiting and attractive benefits in play, organizations should then prioritize the mental and physical well-being of employees. Limiting hours and encouraging time off can keep employees from becoming overworked. Structuring departments to prevent any one individual from carrying too much stress or responsibility can also reduce burnout. Employees make fewer mistakes when they are rested and focused, decreasing the chances of legal action being taken against them. 

While the interplay between malpractice insurance cost and benefit offerings would not seem clearcut at first glance, we now know one can directly impact the other. Working with an experienced team dedicated to the healthcare space versed in both sectors can make all the difference. 

For more information on this topic and other insurance options, please contact Jenn Negley, Vice President, Risk Strategies Company, 267-251-2233 or JNegley@Risk Strategies.com.

What to do BEFORE considering a private equity transaction

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by Marc S. Beckman, J.D.

We have numerous clients who have completed private equity transactions and many more that are considering them. The allure of senior physicians monetizing a practice value together with the promise of fewer administrative headaches can be too great to ignore. Private equity transaction costs are particularly high and many physician practices are not prepared for some of the pitfalls and other surprises that await them. Some relatively simple advanced planning can save a practice a substantial amount in transactions costs, including attorney, accountant and other consultant fees. 

Private equity transactions for physician practices come in many forms. The most common structure involves the sale of the practice’s non-clinical assets to a buyer management services organization (MSO) and the sale of clinical assets to a new buyer professional entity (or the restructure of the existing professional entity) (collectively, the “Buyer”) in exchange for purchase price cash and rollover MSO equity. 

Compliance Audit

Far and away, the most important planning if a practice thinks it might consider such a transaction is to conduct a comprehensive compliance and billing audit. This should be done far in advance of any serious private equity transaction. Allow your counsel to manage this process in order to best preserve attorney-client privilege. The private equity backed Buyer is going to conduct extremely thorough due diligence. This process will involve much more than merely reviewing billing and coding history. This is especially true if the practice maintains ancillary revenue streams that might otherwise make it more attractive for private equity, such as imaging services such as ultrasound, MRI, PET, CT, clinical laboratory and/ or pathology services, radiation oncology, real estate, ASC and/or billing services. 

Among other issues, the due diligence process will undertake a critical review of the practice’s compliance with the highly technical and often misunderstood elements of the federal and state physician self-referral prohibitions (i.e. “Stark Law”). Accordingly, the practice’s historic manner and method of allocating revenue and expenses will be under the microscope (i.e. its compensation plan), including, for example, whether the practice is fully satisfying the myriad of elements involved in the Stark Law group practice and in-office ancillary services exception. Too many practices that do not undergo this self review presume they are in compliance but find that they are not when they are far into the expense of the transaction. Another common example is a heightened review of all real estate leases, particularly parttime and/or block leases with referral sources. Over time, some may have lapsed without executed renewals or the rents have fallen out of fair market value. Same issue applies for independent contractor relationships. 

Another common trap for the unwary involves excluded personnel. All medical practices participating with Medicare and Medicaid must ensure that no excluded persons are employed or contracted by their practice (whether as a billing provider or administrative staff person) and regular review of the excluded provider lists must be conducted to avoid utilizing such an individual, even if such person misrepresents themselves. While many practices have a vague familiarity with these issues, most do not engage in critical self-examination to ensure compliance. 

Why is this attorney guided advance review so important? Because the private equity Buyer will typically require the Seller practice to address these issues in the most conservative manner possible. That would include full self-disclosure and repayment of offers to pay penalties. In addition, it may also require significant escrows out of purchase price proceeds to secure future potential payments and indemnification obligations to the Buyer. Further, the advance review provides an opportunity for the practice to control the result based on its own risk tolerance and without being dictated by the Seller. We are aware of numerous instances when highly technical but financially insignificant compliance error resulted in literally millions of dollars of potential repayment and escrowed dollars significantly reducing the benefit of a private equity transaction.

Document/Contract Review
Regardless of whether a practice follows the above suggestion for an audit, a second significant cost-saving measure is for the practice to thoroughly prepare its paperwork in advance of the transaction. A substantial and often unnecessary cost of a private equity transaction is organizing and chasing down so much of the paperwork necessary for the Buyer and its counsel. Among the items most commonly requested is the evidence of admissions of all current practice owners and redemption of prior owners. Third-party payer agreements and vendor contracts are also notoriously hard to track down. Many will need to be terminated or assigned as part of the private equity transaction and therefore it is helpful to know the underlying terms of these documents. Longer term vendor or service contracts that may not be easy to terminate. Similarly, any liens or open lines of credit will need to be addressed. Even a zero balance line of credit needs to be closed so a lien termination can be filed, and this filing may take much longer than it should and hold up the transaction.

Employee census information should be maintained and kept up to date. The practice needs to ensure all contracts with employees and independent contractors are fully executed and maintained. Malpractice policies may need to be terminated, reporting endorsement (i.e. “tail”) may need to be priced and purchased including for the practice entity. If known in advance, some of these transaction costs can be more easily negotiated with the Buyer. There may also be planning opportunities for the practice as it will be terminating its defined benefit and defined contribution retirement plans. 

Another issue often overlooked until late into the process is patient and payer credit balances. This is money that the practice must account for to be refunded or turned over to the state register for unclaimed consumer credit balances. This can be an unpleasant surprise for practices that have allowed these balances to accumulate over a long period of time. A regular and routine process for reducing these balances can save a practice significant headaches and potential cash flow issues during the transaction process. 

Finally, before seriously entertaining a private equity transaction, physician practices are encouraged to have their corporate accountants collaborate in advance with their legal counsel. There are numerous potential tax implications to the transaction as well as the structure of the practice post-transaction that should be understood. Understandably, accountants are frequently concerned about the tax structure of the transactions promoted by the private equity backed Buyer, and will want the opportunity to weigh in before it’s too late.

Some advanced planning and consulting can go a long way toward saving a physician practice significant transaction expenses later. 

Marc Beckman is a member at CCB Law, a boutique law firm focused on providing counsel to physicians and healthcare professionals. He can be reached at 315-477-6244
or mbeckman@ccblaw.com.

Speed Saves Lives

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Comprehensive Stroke Center at Crouse Health Outpaces Targets for Stroke Rescue Treatments and Improves Patient Outcomes

By Becca Taurisano

David Padalino, MD – Medical Director, CMP Neurosciences, Elena Gabriel, Radiologic Technologist Team Leader, Jorge Eller, MD, Bri Tonzi, Radiologic Technologist, Evan Belanger, DNP – Director of Neurosciences, Intensive Care, Kaitlyn LaChance MSN, RN, Jason Phelps BSN, RN, SCRN Clinical Supervisor, Alex Maksymiw, Radiologic Technologist, Patrick Ogar, Radiologic Technologist, Angela Horan, RN, Julia Galipeau, Radiologic Technologist

In the United States, someone has a stroke every 40 seconds. Stroke is a sudden interruption in blood flow to the brain caused either by a blocked blood vessel (ischemic stroke) or a burst blood vessel (hemorrhagic stroke). Even a decade ago, there was not much that could be done to help stroke patients, but now stroke is a potentially treatable condition, allowing stroke teams to reverse symptoms, preventing disability and death. By utilizing stroke rescue therapies like intravenous thrombolytics and mechanical thrombectomies, the stroke care team at Crouse Health’s Comprehensive Stroke Center is preserving brain function and saving lives with the fastest response times in the region. “Crouse continues to maintain the highest level of stroke program quality, for which it has achieved national recognition,” said Crouse President and CEO Seth Kronenberg, MD. “We consistently achieve extraordinary outcomes by actively seeking the engagement of our high-caliber medical team and staff, all of whom are dedicated to the Neurosciences service line and the overall patient experience.”

There is a saying in the field of Neurosciences: Time is Brain. “Stroke care is perhaps the most time-sensitive field of medicine there is,” said Jorge Eller, MD, Crouse Health Neurosurgery. “The quicker people are connected to a health system that is used to dealing with strokes, the quicker they can get proper medical attention and hopefully recover with very few deficits.” The advances that have occurred in the field of stroke care in recent years are impactful. “Due to improvements in technology, interventional techniques, and equipment as well as increased awareness, the morbidity of stroke has begun reducing,” said Raghu Ramaswamy, MBBS, Crouse Health Neurology. “I have seen many of my patients who were carried into Crouse after having a stroke, walk back into my clinic a few weeks or months later.”

Recognizing the symptoms of stroke can be challenging, but the most important cues to look for can be summed up with the acronym FAST: Face – facial drooping or asymmetry; Arm – arm weakness, especially on one side; Speech – difficulty speaking or understanding speech; and Time – note the onset of symptoms and seek emergency help immediately. If a patient experiences any of these symptoms, they should not wait to see if they feel better or sleep it off, but should immediately call 9-1-1. By keeping blood pressure under control, taking blood thinners for atrial fibrillation or hypercoagulative issues, not smoking, and maintaining a healthy lifestyle through diet and exercise, people can prevent strokes, but genetics can play a part as well.

When an individual arrives at Crouse Health’s Emergency Department as a stroke patient, a stroke alert is activated and the entire stroke team is notified. Obtaining brain imaging is the first step. A CT Scan is completed to essentially rule out the possibility of a brain hemorrhage. Once that has been ruled out, CT angiogram and CT perfusion are the gold standard imaging modalities to determine what parts of the brain are potentially affected by an ischemic stroke and how much brain tissue is salvageable. When a stroke occurs, there is a part of the brain that is irreversibly damaged called the ischemic core. The area around the core where the blood supply is compromised but has not yet caused death of tissue is called the penumbra. The bigger the area of penumbra, the more successful a stroke rescue effort could potentially be.

“An ischemic stroke is essentially a permanent central nervous injury that results in a loss of some brain function,” said David Padalino, MD, Director of Neurosurgery Education for Crouse Neurosciences. The mission of the stroke care team is to limit the damage as much as possible. At Crouse Health, a neuroscience advanced practice provider is on site around the clock so that patients are seen within minutes of arrival. The provider can begin prepping the patient if it is determined that they are a candidate for one or both kinds of stroke rescue therapies offered at Crouse Health: intravenous thrombolytics or mechanical thrombectomy.

Intravenous Thrombolytics or “Clot-Busters”

According to Sami Abdul Malak, MD, Chief of Neurology at Crouse Health, the advent of intravenous (IV) thrombolytics or “clot-busting” medications (tPA or TNK) in the mid-1990s was revolutionary in the treatment of ischemic stroke in restoring blood flow to the penumbra. “The purpose of the thrombolytic is to try to dissolve the clot and open the vessel that has been occluded, which leads to the part of the brain that has been damaged,” said Dr. Malak.

Not everyone is a candidate for IV thrombolytics, however. If more than 4.5 hours have passed since they were last at their baseline function, a patient may not be a candidate for IV thrombolytic. Brain bleeding seen on the initial CT scan, a patient’s history of bleeding, being on blood thinners, or a large area of irreversible damage or core are all contraindications for administering thrombolytics.

Mechanical Thrombectomy

Mechanical thrombectomy is the other stroke rescue treatment available at Crouse Health. “2014 to 2015 was the beginning of a revolution in acute ischemic stroke care where these stent retrievers were absolute game changers and we started to see the benefit,” said Dr. Padalino. During a mechanical thrombectomy, the stent retriever is deployed using a microcatheter and the stent drags the clot out, or combined with aspiration, suctions the clot out, allowing blood to flow to the affected area.

It is not a procedure for everyone, but in patients who do qualify, they can see tremendous improvements in brain function. “As the technology gets better, we keep pushing the boundary for better and better results,” said Dr. Eller. “Patients who successfully undergo this procedure have a better outcome than they would have otherwise, and the faster we can do it, the more likely the patient will recover.”

One unique approach at Crouse is their use of conscious sedation to perform the procedure, which Dr. Padalino encountered while in medical school at the University of Buffalo. “The idea of doing a mechanical thrombectomy under conscious sedation is still a relatively rare thing,” Dr. Padalino said. “Other hospitals routinely do this under general anesthesia, which creates extra steps in the process, without significantly better results.”

Meeting and Exceeding Time Targets

Crouse Health has been a primary stroke center since 2007; in 2018, Crouse was designated a Comprehensive Stroke Center by internationally-recognized healthcare accrediting body DNV and in 2019, a Comprehensive New York State Stroke Center by New York State Department of Health, providing a full-range of rescue therapies to treat any kind of stroke. Oksana Kaskov, RN, BSN, Stroke Program Administrator, ensures that the program continues to meet targets set by the American Heart Association’s Get with the Guidelines, which recognizes hospitals that are achieving various performance metrics for stroke care.

Crouse Health’s Comprehensive Stroke Center has received the highest possible award for its speed in delivering stroke rescue therapies in both 2021 and 2022: Get With The Guidelines®-Stroke Gold Plus with Target: Stroke Honor Roll Elite Plus with Advanced Therapy with Target: Type 2 Diabetes Honor Roll. For IV thrombolytic, the guideline is 30 minutes for administering thrombolytic 50% of the time. According to 2022 data, Crouse Health is administering IV thrombolytic as fast as 18 minutes from patient’s arrival.

For mechanical thrombectomy, the guideline is for the stent retriever to touch the clot (called Door-to-First Pass) within 90 minutes of the patient’s arrival, 50% of the time. In 2022, Crouse Health overshot that goal and was able to perform the procedure within 90 minutes, 72.2% of the time. For the first quarter of 2023, they achieved this 94% of the time. The median time for mechanical thrombectomy at Crouse Health is currently 66 minutes.

“We looked at our entire process and determined what we needed so we could achieve these targets from Get with the Guidelines,” said Kaskov. “Right now the process is extremely efficient, but we are constantly looking for opportunities where we could shave time.”

Saving Time with Technology

The stroke care team utilizes the latest technology available to ensure they are delivering care quickly and efficiently. Using a communication system with ingrained artificial intelligence software, information is transmitted to the entire team in an expedient manner. “It is an amazingly good communication tool where we can talk to the entire team in one message,” said Dr. Padalino. “You can have coordinated discussions where everyone is looped in and it saves time.” Dr. Malak agrees. “By using this system, all attending physicians can get the imaging and decide on the management together. It is a collaborative, team effort,” he said.

Crouse Health’s two hybrid operating rooms (ORs) also help save time when it comes to stroke care, allowing for providers to perform an open surgery, if necessary. “When you access a blood vessel on an emergency basis, you can get persistent bleeding at the access site. If vascular surgery is required, you do not have to move the patient to another room, wasting time and risking infection,” said Dr. Padalino. “You can do an interventional case, an operating room case, and a hybrid of the two.” All of the necessary equipment is located in the hybrid ORs including surgical procedures, general anesthesia, and ultrasound. “It has everything we need,” said Dr. Eller. “We are providing comprehensive treatment in those rooms.”

A Well-Orchestrated Team

Caring for stroke patients takes a village. The team is made up of several departments including: Emergency Medical Technicians who are the first-responders on the scene of a stroke, Emergency Department providers quickly assessing and imaging patients in a chaotic setting, Neurology providers making the decision to give IV thrombolytics and/or to pursue advanced imaging, Neurosurgery providers determining if a patient is a candidate for mechanical thrombectomy, Registered Nurses and Surgical Technicians who prepare for and assist with procedures, and post-operative care like Rehabilitation, Physical Therapy, Occupational Therapy, and Speech Therapy. “All of these fields have to work together like instruments in an orchestra,” said Dr. Eller. “It is a very concerted effort that has to happen continuously, and we have to continue to perform at that pace time and time again.”

Educating the Entire Organization

Most stroke patients come through the Emergency Department, but some are already admitted to the hospital and later develop stroke symptoms. “We have to be prepared to respond to each one of these cases to provide the fastest and most effective care,” said Dr. Padalino. Crouse Health focuses on stroke education to ensure staff are able to recognize neurological issues and activate a Code B (for brain) which alerts the stroke care team. “We did a lot of stroke education throughout the organization, including the Emergency Department and beyond,” said Kaskov. Monthly stroke team meetings are held to discuss continuing to meet time targets and coordinate interactions with other departments to ensure everyone is on the same page.

Providing the Best Care for the Community

Stroke is one of the leading causes of disability and death worldwide. Having access to a Comprehensive Stroke Center is a tremendous benefit for Central New Yorkers. “We have a significant opportunity to impact a large population with this effort,” said Dr. Padalino. “The senior leadership at Crouse has done everything possible to keep this program going so we can continue to provide the best care for the community.” Providing comprehensive stroke care takes a significant investment in people, equipment, and resources and Crouse Health’s commitment to this program has not waivered even in the face of the global demands facing the healthcare industry. “The Comprehensive Stroke Center designation is evidence of Crouse Health’s commitment to serve the community,” said Dr. Eller. “Central New Yorkers can be very proud to have this program here.”

CALLOUT:

“All of these fields have to work together like instruments in an orchestra,” said Dr. Eller. “It is a very concerted effort that has to happen continuously and we have to continue to perform at that pace time and time again.”

The Crouse Health Comprehensive Stroke Center Core Stroke Team

Stroke Medical Director and Chief of Neurology – Sami Abdul-Malak, MD

Stroke Program Administrator – Oksana Kaskov BSN, RN

Director of Neurosciences, Intensive Care – Evan H. Belanger, DNP

Clinical Director, CMP Neurosciences – Jameson Crumb, PA

Medical Director, CMP Neurosciences – David Padalino, MD

Chief Medical Officer and Medical Director, ICU – David Landsberg, MD

Medical Director, Hospitalist – James Leyhane, MD

Medical Director, ED – David Mason, MD

ED Physician and EMS Representative – Michael Jorolemon, MD

Jorge Eller, MD

Raghu Ramaswamy, MBBS

Hassan Elnour, MD – Medical Director of Neurophysiology and Epilepsy

Dr. Ronald L. Kirshner Appointed Chair & Medical Director Of The Auburn Heart Institute (AHI)

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Auburn N.Y. – May 1, 2023, Auburn Community Hospital (ACH) announced today that Dr.
Ronald L. Kirshner has been appointed Chair and Medical Director of the new Auburn Heart
Institute (AHI). Dr. Kirshner’s appointment coincides with a multi‐million investment the
hospital is making to expand its cardiovascular services to meet the needs of patients in the region.

Dr. Kirshner is a renowned cardiothoracic surgeon who comes to the Auburn Heart Institute from Rochester Regional Health Sands‐Constellation Heart Institute where he served as the Chief of Cardiac Services and Cardiothoracic (heart) Surgery for over 30 years. Dr. Kirshner is a graduate of Temple University Medical School and completed his internship and residency at the University of Rochester Medical Center. He has also completed fellowships in Vascular Surgery and Cardiothoracic Surgery at the University of Rochester Medical Center. He has been practicing as a cardiothoracic surgeon at Rochester General Hospital since 1985. He is board certified in Cardiac and Thoracic surgery. Dr. Kirshner’s clinical interests and expertise include Cardiac and Thoracic Surgery and creating systems to drive healthcare efficiency and quality.

“I speak on behalf of Auburn Community Board of Trustees in warmly welcoming Dr. Kirshner
to our health care system,” stated Anthony Franceschelli, Chairman of the ACH Board of
Trustees. “Dr. Kirshner is known far and wide as a leader in the specialty of Cardiac Services
and brings with him a wealth of expertise that will be invaluable to, not only to our hospital,
but to our patients and community as well.”

“We look forward to Dr. Kirshner advancing our cardiac services for our community. With the
help of New York State and Senators Schumer and Gillibrand Auburn Community Hospital is
experiencing a significant transformation of healthcare in our community that includes our
new $15 million comprehensive cancer center, a multi‐million‐dollar heart institute and a
robust orthopedic practice, combined with a five‐star nursing home, 3 Urgent Care Centers,
along with primary care and specialty care services,” stated Scott Berlucchi, President, and
CEO.

Patients Traveling to Central New York

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By: Kathryn Ruscitto, Advisor

Recently a tragedy in another community brought patients and family members to Syracuse. A question was asked, where should they stay? This reminded me of several unique options that help families coming to CNY for health care and in need of housing. Not every community has these resources, and they are valuable parts of our health systems. How do we as health leaders support these organizations and find ways to assist their volunteers.

Sarah’s s Guest House on Roberts Ave. provides lodging, transportation, meals, and a
comforting atmosphere to patients and or family members above the age of 18. Completely
operated through donations, no stay requires a payment, although donations can be made if a
family can manage. All a patient or family member needs to do is contact Sarah House at
315-475-1747 to make a reservation, and ask they have a medical referral from a social worker or hospital staff.

Over 1000 people stay at Sarah’s House each year, which has led to an expansion effort to move from 11 to 22 rooms that will provide more accessibility including an elevator. 

David Haas , the Executive Director , projects the caring and concern this organization has for those facing a crisis for themselves or a family member. He noted that stays range from several days to months depending upon each persons needs. What a gift for a patient to know they and their family will not face major housing expenses in the midst of a health crisis.

The Sarah’s House website includes ways in which individuals or organizations can help them through gifts or donations on their wish list. https://sarahsguesthouse.org/

David also noted that for patients and families in CNY who need to travel elsewhere there is an online network. Heathcare Hospitality, includes many other homes across the country that provide similar care. https://www.hhnetwork.org/

In addition the Ronald McDonald House provides housing for families coming to Syracuse with seriously ill children. https://rmhcny.org/what-we-do/stay-with-us/

A referral is needed and reservations are coordinated through their intake process.The Cancer Society has several efforts to help locate housing through their Hope Lodge program with houses in Rochester and Buffalo. They also maintain discounted medical lodging rates with many major chains.

In summary do your offices have this information on your websites and available to patients?

How might you support this work in your giving plans?

As regional access continues to be challenged more out of town patients may be presenting to your practices.

Housing resources for CNY:

Sarah’s Guest House: https://sarahsguesthouse.org/

Ronald McDonald House: https://rmhcny.org/

Hope Lodge: https://www.cancer.org/support-programs-and-services/patient-lodging/hope-lodge.html

Transportation resources: https://www.mercymedical.org/