Thomas C. Lavallee, COO, Alliance Health Management Services

Today’s guest is Thomas Lavallee, the Chief Operating Officer of Alliance Health Management Services. As the COO of Alliance Health Management Services, Tom oversees four skilled nursing facilities that provide both short term rehabilitation and long term care. In his role, Tom is charged with both running the day-to-day operations of the organization as well as exploring growth opportunities.

In this podcast we talk about Tom’s 25 year journey in skilled nursing and long term care, and discuss the future of both the industry and his organization.

I really enjoyed my conversation with Tom because he gives a view of the competitive nature of the long term care market and how the health reform is impacting the industry. He makes a compelling argument for early careerists to consider the field of long term care. I have produced two versions of this podcast – an extended version that includes are complete conversation, and an abridged version.

Links to the Podcast:

Soundcloud: 

Extended version: https://soundcloud.com/healthleaderforge/thomas-c-lavallee-coo-alliance-health-management-services

Abridged version:  https://soundcloud.com/healthleaderforge/abridged-thomas-c-lavallee-coo-alliance-health-management-services

Stitcher: http://www.stitcher.com/podcast/the-health-leader-forge

iTunes: https://itunes.apple.com/us/podcast/healthleaderforge/id981989377

YouTube: https://youtu.be/p56X84xp2j4

Transcript of the interview is here.

Podcast Outline (this timeline refers to the extended version)

Time         Topic

0:01:44 education
0:02:44 working with individuals with intellectual disabilites
0:04:37 Social Worker - LSW-A, Liberty Commons
0:10:27 Director of Social Services, Liberty Commons
0:12:37 Administrator in Training (AIT) Program
0:14:25 becoming the Administrator for Liberty Commons
0:17:18 making the transition from supervisor to manager
0:19:53 most difficult part of becoming an administrator
0:20:43 organizational transitions, seeking growth
0:24:10 transition for for-profit/family-owned to not-for-profit
0:26:02 becoming the VP of Operations for Oakwood Living Centers
0:26:44 leading through a corporate bankruptcy
0:30:29 transferring to Radius through the bankruptcy process
0:33:44 managing multiple facilities
0:36:23 LTC - a people business
0:37:13 when did he know he was committed to LTC?
0:38:09 Regional Director for Radius
0:39:31 the Radius portfolio
0:40:09 starting a new facility
0:42:49 skilled nursing vs. assisted living
0:45:38 VP of Operations for Radius
0:47:09 senior leadership team at Radius
0:48:11 Alliance Health Management Services
0:52:00 foster care services
0:53:03 finding organizational synergies
0:54:06 role of COO, Alliance Health Management Services
0:56:22 plans for growth
0:57:35 extensions of the business - home health, hospice
1:00:08 the changing nature of LTC
1:03:22 influence of ACOs on LTC
1:06:31 vertical integration into home health
1:07:28 competitive environment
1:08:39 sources of admissions
1:09:35 what makes a good LTC facility?
1:10:55 what makes a good nursing home administrator?
1:11:32 how has the industry changed?
1:12:37 strategic concerns around industry consolidation
1:13:54 leadership philosophy
1:14:56 what he looks for in a leader
1:16:48 organizational culture
1:18:19 mentors and mentorship
1:21:33 importance of certification and professional organizaitons
1:22:49 why LTC for an early careerist?

Links to Topics Discussed

Alliance Health Management Services

Bourne Manor

Liberty Commons

LSW-A

Worcester State

University of Massachusetts, Amherst

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Michael D. Peterson, FACHE, President of Androscoggin Valley Hospital

Today’s guest is the Michael Peterson, the President of Androscoggin Valley Hospital in Berlin, New Hampshire. Androscoggin Valley Hospital is part of North Country Healthcare, a system of four critical access hospitals in the North Country of New Hampshire.

In this podcast, I talk with Mike about his career, which included 28 years of service to the Eastern Maine Health System, where he worked his way up from part time work while in college, through being a licensed social worker, moving into information systems, and then back to operations, to ultimately being the chief operating officer at Sebastacook Valley Health before coming to Androscoggin in 2015.

I really enjoyed talking with Mike and I think you will especially enjoy his insights about leadership and the experience of being a new hospital president. I have produced an extended version of the interview that covers Mike’s career leading up to and including his work at Androscoggin. An abridged version of the interview begins with his work at Androscoggin.

Links to the Podcast:

Soundcloud: 

Extended Version: https://soundcloud.com/healthleaderforge/michael-peterson-president-of-androscoggin-valley-hospital

Abridged Version: https://soundcloud.com/healthleaderforge/abridged-michael-peterson-president-of-androscoggin-valley-hospital

Stitcher: http://www.stitcher.com/podcast/the-health-leader-forge

iTunes: https://itunes.apple.com/us/podcast/healthleaderforge/id981989377

YouTube: https://youtu.be/I-tgf-g1ZVQ

Interview transcript is available here.


Podcast Outline

Time       Topic
0:01:57 education background - deciding on healthcare
0:06:48 early experience in healthcare
0:07:48 1st full time job in healthcare - Aspen Ledge and Acadia Hospital
0:09:09 moving into project management through information management
0:11:54 Y2K project manager for Eastern Maine Healthcare (predecessor of Eastern Maine Health)
0:14:55 what was Y2K --> disaster drills
0:18:47 learning large scale project management
0:20:17 the origin of the Eastern Maine Health System
0:22:07 moving to Eastern Maine Medical Center - director of surgical and imaging systems
0:26:52 cultural conflicts between administrative and clinical 
0:28:49 Director of e-Business of EMHS
0:33:15 Corporate Director for Information Systems, EMHS
0:35:10 Chief Administrative Officer of Sebastacook Valley Hospital
0:39:34 learning to ask the right questions
0:41:03 detecting problems when you are not the expert
0:43:01 responsibilities of being part of the senior executive team
0:44:00 Lean management
0:48:41 promotion to COO of Sebastacook
0:49:55 Androscoggin Valley Hospital and Berlin, NH
0:55:08 the North Country Healthcare - a unique affiliated system of four critical access hospitals
1:01:42 governance and the Board of Androscoggin Valley Hospital
1:06:17 the work of the Board of Trustees
1:07:19 strategic planning at Androscoggin Valley Hospital
1:08:47 how does the Board evaluate the President
1:10:31 challenges of running a hospital in a rural environment?
1:12:42 payer mix
1:14:38 what are the skills required to be president of a critical access hospital
1:16:15 how did COO experience prepare for the President role?
1:17:41 what was surprising about becoming the President of a hospital?
1:20:59 what keeps you up at night?
1:22:05 leadership philosophy
1:22:41 what are the characteristics of a good leader
1:24:32 leadership lesson - letting people make mistakes
1:27:57 where do junior leaders make mistakes?
1:29:05 leadership advice to junior leaders
1:30:08 mentors and mentorship
1:32:04 being a mentor
1:33:21 role of professional organizations in development
1:35:10 book recommendations
1:36:42 advice for early careerists

Topics Discussed:

Androscoggin Valley Hospital

North Country Healthcare

Eastern Maine Health System

Sebastacook Valley Health

Eastern Maine Medical Center

Acadia Hospital

Lincoln on Leadership

The Servant

If Disney Ran Your Hospital

American College of Healthcare Executives

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Luanne S. Rogers, President & CEO, The Courville Communities

Today’s guest is Luanne Rogers, the President and CEO of The Courville Communities, a long term care system in southern New Hampshire. The Courville Communities include two nursing homes, assisted living communities, and retirement apartments. The Courville Communities is a private, family owned organization, something that is becoming less common as corporations have come to dominate the competitive landscape.

In this podcast, Luanne talks about her thirty-year journey through a field that has gone through many changes. Her career began as a nursing assistant in Chicago, Illinois, working to put herself through college and has included working for privately owned facilities as well as national chains. I really enjoyed my conversation with Luanne. Her passion and commitment to the field is remarkable. 

Links to the Podcast:

Soundcloud: https://soundcloud.com/healthleaderforge/luanne-s-rogers-president-ceo-the-courville-communities

Stitcher: http://www.stitcher.com/podcast/the-health-leader-forge

iTunes: https://itunes.apple.com/us/podcast/healthleaderforge/id981989377

Transcript: A transcript of the podcast is available here.

Links to Selected Topics Discussed

The Courville Communities

Kindred Healthcare

Loyola University

Genesis Healthcare

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John R. Fernandez, President and Chief Executive Officer, MEEI

Today’s guest is John Fernandez, the President and CEO of the Massachusetts Eye and Ear Infirmary in Boston, Massachusetts. Mass Eye and Ear is one of the world’s leading specialty hospitals dedicated to ophthalmology and otolaryngology care, or as John says, they take care of everything from the neck up except the brain, but maybe the brain too sometimes. 

In this podcast John talks about his journey to leading this world class organization, including his progress into the executive ranks at another world class Boston organization, the Brigham and Women’s Hospital. Throughout the interview, John talks about his management approach, which focuses on the fundamentals: plan, execute, follow up. While this sounds like a fairly simple formula, I think anyone who has tried it knows that simple isn’t always easy. John tempers his management approach with a focus on kindness, which was something heartening to hear from a senior executive. 

One of the things that is clearly important to John is work life balance. We talked about work-life balance both before and during the interview, and one of the pieces of advice he gives to early careerists is to get your personal life sorted out first, and then figure out what you want from work, which was interesting advice. John has a series of questions that he gives people to help guide them through that process. You can find a reproduction of the slides he shared with me with the questions here.

Links to the Podcast:

Anchor:  https://anchor.fm/healthleaderforge/episodes/John-Fernandez--President-and-CEO-of-Massachusetts-Eye-and-Ear-Infirmary-egra8i

Stitcher: http://www.stitcher.com/podcast/the-health-leader-forge

iTunes: https://podcasts.apple.com/us/podcast/john-fernandez-president-and-ceo-of-massachusetts/id981989377?i=1000374180816 

 YouTube: https://youtu.be/hyIph9y97zc

  

Transcript: A transcript of the podcast is available here.

Podcast Outline

0:02:19 Education the College of Wooster

0:04:41 starting out in management consulting

0:08:11 University of Pennsylvania, Masters in Government Administration

0:11:02 starting in healthcare at Boston City Hospital

0:15:50 learning healthcare, discovering management problems

0:18:27 watching the "craziness of healthcare", up close

0:19:50 planning and following up - the secret of management

0:20:40 The One Minute Manager - giving feedback

0:22:04 Are leaders made or born?

0:24:43 Management is difficult - not everyone is cut out for it

0:27:17 about Brigham and Women's Hospital, "a young organization"

0:29:45 "The Pike" - how physical plant affects culture

0:31:07 Dr. Michael Zinner, new Chief of Surgery and new opportunity

0:34:10 becoming Vice President for Surgical Services, Brigham and Women's

0:35:37 relationship between the administrative and clinical leadership

0:44:14 leadning up to VP - honing people skills, planning skills, space planning

0:45:56 the responsibilities of being a Vice President at Brigham and Woman's

0:50:53 expanding VP portfolio - 2100 FTEs and $300M budget - changes to leadership

0:57:34 the importance of not appearing too busy - special projects

1:00:17 Massachusetts Eye and Ear Infirmary - background

1:02:17 what is a "specialty hospital"?

1:03:27 basic research vs. clinical trials

1:04:20 how do patients come to be seen at MEEI?

1:06:52 Affiliate of Partners Healthcare

1:08:41 Governance and the Role of the MEEI Board

1:14:47 a day in the life of the CEO

1:15:40 assembling the right team as CEO - it's about fit

1:18:18 organizational culture

1:20:01 leadership philosophy - plan and execute, how can we be kind

1:21:34 advice to early careerists

Links to Selected Topics Discussed

Massachusetts Eye and Ear Infirmary

The One Minute Manager

Partners Healthcare

Brigham and Women's Hospital

Boston Medical Center

University of Pennsylvania, Government Administration

College of Wooster

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Patricia "Patsy" Aprile, Senior VP and COO, Southern Maine Health Care

Today’s guest is Patricia "Patsy" Aprile, FACHE, the Senior Vice President and Chief Operating Officer for Southern Maine Health Care in Biddeford, Maine. Patsy started her career on the clinical side as a medical technologist, working her way up through leadership positions in the laboratory, then clinical operations. In this podcast she talks about her experiences in a variety of organizations, including her time as CEO of Goodall Hospital during its merger with Southern Maine Health Care, as well as her role today. I think this podcast is especially useful for the insights Patsy offers on leadership and organizational culture, both in the context of leading through a merger as well as how she leads for operational excellence today. Patsy also talks about her service as the American College of Health Care Executives Regent for the state of Maine, and concludes with advice for early careerists.

Links to the Podcast:

Soundcloud: https://soundcloud.com/healthleaderforge/patricia-patsy-aprile-senior-vp-and-coo-of-southern-maine-health-care

Stitcher: http://www.stitcher.com/podcast/the-health-leader-forge

iTunes: https://itunes.apple.com/us/podcast/healthleaderforge/id981989377

Transcript of the interview.

Podcast Outline

Time Topic
0:01:42 welcome, educational background
0:03:32 beginning in leadership at The Elliot Hospital
0:05:02 Executive director of clinical services, Catholic Medical Center
0:06:42 Coming to Goodall Hospital, in Sanford, ME
0:07:37 VP of Operations at Goodall Hospital
0:18:32 Goodall Merger
0:22:09 CEO of Goodall Hospital
0:26:58 Governance during the merger
0:31:52 Working with the Goodall staff during the merger
0:33:35 Merging the cultures of SMHC and Goodall
0:35:17 Being part of Maine Health
0:37:17 Board composition at SMHC, role of physicians as trustees
0:38:33 SMHC locations and operations
0:41:26 Senior Vice President and COO of SMHC
0:43:01 Lean Daily Management
0:48:22 Leadership
0:55:50 Organizational culture
0:57:15 Mentorship
1:00:13 Experience as a woman leader
1:01:03 Being the ACHE Regent for Maine
1:04:09 Advice to early careerists

Links to Topics Discussed:

Southern Maine Health Care

Colby-Sawyer College

Elliot Hospital

Catholic Medical Center

American College of Healthcare Executives

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Karen F. Clements, RN, FACHE, Associate Chief Nursing Officer, Dartmouth-Hitchcock Medical Center

Today’s guest is Karen Clements, the Associate Chief Nurse for Ambulatory and Primary Care Nursing, Emergency and Patient Placement Services, and Care Management and Psychiatric Services for the Dartmouth-Hitchcock Health System, or as her staff prefers, she is the Associate Chief Nurse for Team Awesome.

Despite its rural location, Dartmouth-Hitchcock Medical Center is the largest hospital in New Hampshire, taking referrals from over forty other hospitals in New England. It is also a major teaching hospital associated with Dartmouth College’s Geisel School of Medicine.

Karen is also the President of the Northern New England Association of Healthcare Executives, one of the sponsors of this podcast.

Karen is a nurse-executive whose roots are in emergency and trauma nursing. Her career began with an active duty tour in the Army’s Nurse Corps, then she returned home to Bangor, Maine where she progressed through the nursing ranks to become the Chief Nursing Officer of Acadia Hospital, a 100 bed freestanding psychiatric hospital. After 23 years with the Eastern Maine Healthcare System, she followed professional and personal opportunity to Dartmouth-Hitchcock, where her leadership skills quickly led her to the Associate Chief Nurse position.

In this podcast we talk about Karen’s career leading up to her current position at Dartmouth-Hitchcock, how Dartmouth-Hitchcock is changing to meet the challenges of an evolving health system, and how nursing is playing a role in that transition. We then talk about leadership, and Karen’s role in the Northern New England Association of Healthcare Executives and conclude with Karen’s recommendations for early careerists.

Links to the Podcast:

Soundcloud: https://soundcloud.com/healthleaderforge/karen-f-clements-rn-fache-associate-chief-nursing-officer-dartmouth-hitchcock-health-system

Stitcher: http://www.stitcher.com/podcast/the-health-leader-forge

iTunes: https://itunes.apple.com/us/podcast/healthleaderforge/id981989377

Transcript of the interview available here. 


Podcast Outline

Time Topic
0:02:36 background, Army Nurse Corps
0:08:08 working up through the ranks, Eastern Maine Medical Center
0:18:49 Chief Nursing Officer, Acadia Hospital
0:25:34 coming to Dartmouth-Hitchcock Medical Center
0:30:52 Associate Chief Nursing Officer, Dartmouth-Hitchcock
0:33:55 role of Chief Nursing Officer and practice of nursing
0:37:44 use of advanced practice nurses (APRNs) at Dartmouth-Hitchcock
0:39:22 structure of nurses in the facility
0:40:18 Karen's professional growth at Dartmouth-Hitchcock
0:43:38 strategy
0:47:25 the future of health care and Dartmouth's approach
0:50:00 leadership
0:53:57 mentorship
1:00:32 women in leadership
1:05:30 ACHE/NNEAHE
1:10:36 advice to early careerists

Links to Topics Discussed:

Dartmouth-Hitchcock Health System

Dartmouth-Hitchcock Nursing

we joke about Karen following her husband Peter, a previous guest, to Dartmouth-Hitchcock. 

Eastern Maine Medical Center

Acadia Hospital

Army Nurse Corps - see also my interview with the Chief of the Army Nurse Corps 

Northern New England Association of Healthcare Executives (NNEAHE)

American College of Healthcare Executives (ACHE)

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Patricia Cummings, Administrator, The Edgewood Centre

Today’s interview is with Tricia Cummings, the Administrator of The Edgewood Centre, a 150 bed family owned nursing home in Portsmouth, New Hampshire. Tricia received both her bachelor’s and master’s degrees from the Department of Health Management and Policy here at UNH. Tricia’s career story shows how early job experiences often generate skills that become critical later in one’s career, and that working hard every step of the way has its payoffs. In this podcast we talk about the road Tricia took to find her true passion – taking care of older adults. We also discuss how someone becomes a licensed nursing home administrator, the services offered by long term care facilities, the challenges and opportunities facing long term care today, and conclude with a discussion of opportunities for the early careerist who might be interested in pursuing a career in long term care.

Links to the Podcast:

Anchor: https://anchor.fm/healthleaderforge/episodes/Patricia-Cummings--Administrator-of-The-Edgewood-Centre-Unabridged-egra90

Stitcher: https://listen.stitcher.com/yvap/?af_dp=stitcher://episode/39991564&af_web_dp=https://www.stitcher.com/episode/39991564

iTunes: https://podcasts.apple.com/us/podcast/patricia-cummings-administrator-of-the-edgewood/id981989377?i=1000348507636

The following times apply to the unabridged version of the podcast:

Time                               Topic

0:01:43	-	0:07:52	background and education
0:07:52	-	0:18:11	early career
0:18:11	-	0:29:17	Edgewood Centre
0:29:17	-	0:34:44	becoming a Licensed Nursing Home Administrator
0:34:44	-	0:57:48	Edgewood Structure and Services
0:57:48	-	1:11:33	Challenges of payment and Medicare/Medicaid
1:11:33	-	1:16:12	Thoughts on leadership and Culture
1:16:12	-	1:20:27	Thoughts on mentorship and growth
1:20:27	-	1:25:10	advice to early careerists

Links to Topics Discussed:

Department of Health Management and Policy

Harvard Pilgrim

MedBill

The Edgewood Centre

Tricia mentions previous guest, Kevin Callahan, CEO of Exeter Health Resources

New Hampshire Board of Nursing - Licensed Nursing Assistant (LNA)

New Hampshire Board of Examiners of Nursing Home Administrators

NHA Examination for Nursing Home Administrators

Medicare - Long term care coverage

NH DHHS Medicaid Medical Eligibility Determination for Long Term Care