August 2016 Tri Cities Business Journal by The Business Journal of Tri-Cities TN/VA

Healthcare Heroes honoredâ&#x20AC;Ś including nine therapy dogs.

Plus:

Teleperformance to add 500 jobs in Bristol, Tenn.

and

Alpha emerges from Chapter 11; Contura begins operations

Gracie, a member of Holston Valley Medical Centerâ&#x20AC;&#x2122;s pet therapy team at Healthcare Heroes.

AUGUST 2016

$3.00 Volume 28 Number 10

Photo by Sweet Snaps Photography August 2016 bjournal.com

bjournal.com August 2016

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August 2016 bjournal.com

Inside this Edition

COVER STORY

2016 Healthcare Heroes

Twenty-five individuals and organizations that make us forget the headaches of health care long enough to appreciate those who provide the care. Photo by Tara Hodges, Sweet Snaps Photography.

of Tri-Cities Tennessee/Virgina

Office 423.854.0140 Publisher William R. Derby bderby@bjournal.com 423.979.1300 Co-Publisher Jeff Derby jderby@bjournal.com 423.306.0104 Managing Editor Scott Robertson srobertson@bjournal.com 423.767.4904 Associate Editor Jeff Keeling jkeeling@bjournal.com 423.773.6438

Features 10

Business Journal The

Staff Writer Sarah Colson news@bjournal.com 423.854.0140

Teleperformance to create 500 new jobs Bristol, Tenn., call center to grow in next five years.

No more milling around

Mullican to create 200 new jobs

Bringing a knife to a gun company

Grant and Rab Summers agree to purchase former General Mills property from Johnson City Chamber. Johnson City-based flooring company to expand local manufacturing and distribution operations.

Smith and Wesson purchases Kingsport-based Taylor Brands, maker of Schrade knives.

Unicoi County’s long road back

Alpha’s back; Contura’s starting

The Changing Face of Health Care

A site selection specialist tells community business leaders what it will take to bring in new industry.

Alpha Natural Resources emerges from Chapter 11 as a new company begins operating what had been Alpha’s key assets.

Director of Business Development and Marketing Jeff Williams jwilliams@bjournal.com 423.202.2240 Sales & Marketing Robin Williams rwilliams@bjournal.com 423.794.6938 Gena Anders ganders@bjournal.com 423.512.0531 Creative Derby Publishing, LLC Graphics Director / Judd Shaw jshaw@bjournal.com 423.833.2726

Second in a two-part series

Periodicals postage paid at Johnson City, Tenn. and additional offices.

Departments

ISSN#10406360

7 From the Editor

50 On the Move

8 Trends

51 Awards & Achievements

9 FYI

52 Med Briefs

54 The Last Word

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Business Journal of Tri-Cities, TN/VA 1114 Sunset Drive, Suite 2 Johnson City, TN 37604 Subscription per year $35.

bjournal.com August 2016

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This doesn’t create a healthy workforce. But access to primary and preventive care can. Healthy employees are some of your most important assets – they are more productive on the job, and they miss fewer days due to illness and injuries. And on the flip side, unhealthy workers can cost your business thousands of dollars each year. One of the best ways to keep your team in top condition is by ensuring everyone has access to a primary care provider for health screenings, vaccinations and the management of any health problems. A family medicine physician can also diagnose and treat illnesses and injuries and help facilitate care for other health issues and procedures. Through the Small Business Health Options Program Marketplace – shop – you can find high-quality health plans that will improve the health of your employees and their families. And Wellmont Health System’s certified health insurance navigators can help you find the best plan that fits your company’s needs.

Have SHOP questions? Visit wellmont.org/GetCovered or email GetCovered@wellmont.org to find out how the right insurance plan can help you and your team become healthier and more productive.

The project described was supported by Funding Opportunity Number CA-NAV-15-001 from the Centers for Medicare & Medicaid Services. The contents provided are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.

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bjournal.com August 2016

From the Editor

The BJ Proust Kobayashi Maru S

ince you are reading a business publication, let us, for the purposes of this column, assume you own or manage a business – or are working toward that end, and therefore are already aware of the difficulties involved in finding, hiring and keeping a qualified workforce. In recent years we have written about local employers’ difficulties finding workers who check several boxes: communication and other soft skills, situational analysis and problem solving, physical and mental health and drug-free lifestyle, to name but a few. I am here to tell you those difficulties affect our business just as much as yours. You may have read in this space last month that I recently attended a conference of business publication editors, publishers and sales managers. One conversation I found fascinating focused on the ways in which editors separate the wheat from the chaff in hiring writers. I have moved away from the standard interview process over the years into a more conversational approach to interviewing writers*. I think Marcel Proust had it right when he devised a parlor game with questions to reveal each of his guests’ true nature. As one local executive who handles hiring for a major employer said to me recently, “You can learn a lot just by listening.” That’s what I reckon too. Apparently I’m not the only one who reckons that way. Andy Owens, who edits the Charleston Regional Business Journal in South Carolina, shared with the editors at the conference a questionnaire he has written to divine not only whether writers are able to communicate clearly, but also to force them to reveal elements of their personalities, including how they react in uncomfortable situations. I won’t share it in its entirety, mainly because it’s another writer’s work, and I respect that. But I would like to give you just a taste of some paraphrased questions, in case you might be inspired to add a few new queries to your own hiring process. • Do you prefer to work far in advance on a long project, or do you do better work against a deadline? • Here is a list mixing five traits and five skills. Rank your traits and skills from 1 to 10 (with 10 being best) – USE EACH NUMBER ONLY ONCE ___Attention to Detail ___Communication Skills ___Diligence ___Initiative

___Judgment ___Leadership Skills ___Organization Skills ___Problem Solving Skills ___Speed ___Other Skill________________________ • What was the last book you read? What did you dislike about it? • What is the most important work you have ever done? What made it important? • In the list of traits and skills above, cite an example of your top trait or skill having made a difference in your previous work. • What trait do you appreciate most in a co-worker? In a manager? • What trait do you most dislike in a co-worker? In a manager? • What one thing did you learn in your last job that you believe will make the greatest difference in you being better at your next job? I use a couple of Proust’s questions in talking with writers… • Which words or phrases do you most overuse? • If you could change one thing about yourself, what would it be? …And I paraphrase a few as well. • Who, in our profession, do you most admire? • What is your greatest professional regret? • In what job to date have you been happiest? Finally, I use a few questions of my own. • Finish this sentence: In our line of work, I believe the first commandment is, “Thou shalt not…” • What do people who like you have to say about you? • What do people who don’t like you have to say about you? • If you’re having a problem doing something right, is your first inclination to: A) ask a supervisor for instruction B) ask a co-worker for help C) Google it D) keep trying to figure it out yourself by trial and error E) do something else for a while, then come back to it F) other _________________________ These questions all go toward checking those boxes we mentioned above. If you have similar questions you don’t mind sharing, post them to our facebook page. * While always avoiding questions that might force an interviewee to reveal his or her age, race, national origin, gender, religion, marital status and/or sexual orientation, of course.

August July 2016 bjournal.com

Trends

Northeast Tennessee June report shows strong home sales Northeast Tennessee’s housing market posted its 14th straight month of record year-over-year sales in June. Closings on single-family homes were up 19.4 percent in a market feeling the pinch of tight inventories. Northeast Tennessee Association of Realtors president Marsha Stowell said June last year was the first month the local market recorded more than 500 closings. The June 2016 count was 106 more. “That’s a strong market, and the mid-year sales report is the icing on the cake. Sales during the first six months of this year are 20.5 percent better than the first six months of last year.” The mid-year report is special because it offers a more reliable trend picture, she added.

The 11-county region monitored by the NETAR’s Trends Report recorded 652 closings on single-family home sales in June. Year to date, closings totaled 2,916. That’s the highest mid-year total since NETAR began collecting Trends Report data in 2008. The average sales price for homes was $165,506 in June, up $3,886 from last year. Stowell said the average price is underperforming the sales increase because most sales are in the $200,000 and below and $200,000 to $399,999 price range while the mid- and upper-priced market segments have yet to reach last year’s levels. Year-to-date average price is 2.1 percent higher than it was last year and 3.8 percent better than it was before the recession.

NOTE: NETAR counts city sales as those made in a city’s high school zone. City data is included in county totals.

bjournal.com August 2016

FYI

&Downs

Ups

A quick check of the conventional wisdom on who’s going what direction in Tri-Cities business

Bell Helicopter – The company issued a release this month announcing the opening of its new customization building in Piney Flats, Tenn. The completion of the new facility gives the company the opportunity to work on 200 more aircraft per year. Cantech Industries – A family-owned business that’s been operating in Johnson City since the 1980s, Cantech was recently honored as the East Tennessee Business of the Year by Tennessee Community Organizations. Cantech is a longtime partner and supporter of Dawn of Hope. The company currently employs five individuals who receive service from the Dawn of Hope. It’s good to see the recognition for a heritage business that enhances the lives of adults with intellectual and developmental disabilities. Home-grown stocks – The second quarter was not terribly kind to stocks of local interest. You know Speedway Motorsports didn’t meet its goals when it issues an earnings release that includes the phrase, “many…revenue categories continue to be negatively impacted by” and then goes on to list everything from “ongoing geopolitical events” to “healthcare costs.” Down the road in Kingsport, Eastman CEO Mark Costa made reference to “an especially challenging global economy” as earnings per share dropped from $1.98 in Q2 2015 to $1.71 in Q2 2016. Cabela’s, on the other hand, reported good sales numbers coupled with the positive effects of improved expense containment measures to paint a rosy picture. Rumors of a sale to Bass Pro Shops continue to drive interest in Cabela’s.

40 Under Forty nomination deadline near The deadline for nominations for the 2016 class of 40 Under Forty is close of business (5 p.m.) Friday, August 19. Nominations can be made quickly and easily at 40under. com. Most successful nominations in the past have also been accompanied by at least two full letters of recommendation (not just a short email), including one from someone who can speak to the nominee’s business acumen, such as a colleague, supervisor or client; and one from someone who can speak to the nominee’s community involvement. Letters of recommendation can be sent via email to news@bjournal.com or may be sent via U.S. Mail to The Business Journal 1114 Sunset Drive, Suite 2 Johnson City, TN 37604 Attn: 40 Under Forty All letters must be postmarked no later than Aug. 19. In order to be eligible to be a member of the class of 2016, nominees must be no older than 39 years of age on Oct. 14, 2016 and must live and work in the Tri-Cities, TN/VA market. For more information, call 423.854.0140 and speak with Jeff Williams or Scott Robertson.

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Features

The expansion will keep Teleperformance recruiter Melanie Setterhoff busy for some time. Photos by Scott Robertson

Teleperformance to add 500 jobs at Bristol call center By Scott Robertson

eleperformance has committed to creating approximately 500 new full-time jobs at its Bristol, Tenn., call center over the next five years. The center currently has between 700 and 800 employees. The company has also committed to investing $800,000 in new equipment for the facility. Tennessee Governor Bill Haslam made the announcement July 27. “One of the things that we love here in Tennessee is that most of our business growth comes from existing companies like this,” Haslam said. “It’s wonderful to have big announcements of new companies, but it means even more when existing companies decide to grow. It means they have learned this is a great place to build a business. It means the workforce is talented and loves living there as well.” Teleperformance Executive Vice President Greg Mormol confirmed Haslam’s statement that the company was eager to expand its Tennessee operations in large part because of the workforce it already has in place. “Bristol has been a tremendous market for Teleperformance for many years,” Mormol said. “The performance that comes out of this region is tops across the entire country. It has been tremendous. There is a lot of tenure here, which means a lot of really, really high performance. That speaks a lot to the area.” The company began operations as US Solutions in 2001. In July 2010 Teleperformance purchased US Solutions. It then moved from 10

bjournal.com August 2016

Bristol, Va., to the current location across the state line in 2012. Current Sullivan County Mayor Richard Venable was CEO of NETWORKS Sullivan Partnership, the county’s economic development entity at the time Teleperformance moved from Virginia. At the expansion announcement Venable recalled thinking in 2010 that the company was taking a chance by moving across the line. “It would be an understatement to say it has exceeded our expectations,” Venable said, telling Mormol, “We’re so happy that you took a chance a few years ago on Sullivan County. You’ve seen we don’t just have a great county here. We have a great region. It will provide you smart, ambitious, hard working people.” Venable’s successor at NETWORKS, Clay Walker, received kudos from the governor for the county’s role in making the expansion happen. “In this state, it makes a lot of difference who our local partners are,” Haslam said. “The local partners here in Bristol and Sullivan County have been outstanding and we are appreciative.” Walker deflected credit to city officials, the company’s existing employees and the BTES broadband system. “This was relatively easy,” Walker said, “because to be perfectly honest, this process started when Teleperformace first moved to Bristol and began experiencing this workforce, the city leadership, Tom Anderson and April Eads, the local team in Bristol taking such good care of them. All I really had to do was show up at a meeting.”

9:00am 9:05am 9:10am 9:12am 9:15am

Took an order for 100,000 extra units. Jumped up and down in celebration. Stopped celebrating. Started freaking out. Called Phil at First Tennessee.

Greg Mormol, Teleperformance executive vice president, thanked Bristol and Tennessee for their assistance.

“They knew they wanted to continue to grow here,” Walker continued. “The workforce and the community support is as good as they have seen. They echo that constantly whenever we speak to them. Today is just a testament to the workforce in Bristol and the region, plus the support team at the city of Bristol and BTES.” For a call center, the speed and breadth of a market’s communications network is a key to success. Bristol Tennessee Essential Services is in the process of upgrading from one gigabit to ten gigabit across its entire network, CEO Mike Browder said. “Ten gigabits is world class. It’s as fast as anywhere, any time, any way. We put the components in our system last week to make that work and we’re building it out now. That will be available anywhere on our system that has electric service.” The city has offered incentives in the form of a PILOT (payment in lieu of taxes) agreement, but the company has yet to formally request that incentive, said Tom Anderson, city economic development director. “What we have done is basically created the space for Teleperformance to expand as far as creating a better business environment. We have helped them with a hiring expo and have tried to attract a lot of new employees their way. If there is a local incentive it will be just on the new business through a PILOT agreement.” The state has also offered incentives to the company, with clawback provisions in place should the company fail to reach its stated goals for job creation. However, Walker said, the company’s approach leads him to believe it absolutely plans to meet every goal it has set out. “This company didn’t come to us with their hands out,” Walker said. “They just told us what they wanted to do and asked what it qualified for. These guys are very low maintenance. They just keep investing.”

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August 2016 bjournal.com

Features

Due diligence proceeding as Summers-Taylor looks to buy Model Mill By Jeff Keeling See the original article from when the said. “The public support is very strong, so contract on the Model Mill was announced we’re very happy about that.” at jcnewsandneighbor.com/model-mill-sale. He said Thomas Weems, a Johnson City-based architect who designed the y the end of downtown pavilion that houses the new July, just a Johnson City farmers market, is getting few weeks after well into producing renderings of what the announcing his restored building will look like both on the family company inside and outside. would purchase “That will really be some of the material and renovate that I can then go to prospective tenants Johnson City’s with,” Summers said. “Visuals are always historic Model very helpful in trying to illustrate what a Mill, Summersfinished product’s going to look like.” Taylor Inc. Summers said he and his project team are Grant Summers, Summers- President Grant continuing to crunch numbers and determine Taylor Inc. president, in front of the mill. Summers said what lease rates will need to be. Summersgood progress Taylor’s corporate offices will occupy about was being made in the due diligence process. 12,000 of the 40,000 usable square feet, and As crews from Burleson Construction East Tennessee State University is interested put some needed patches on the 107-yearin taking up to around 10,000 square feet, old building’s roof, Summers said an arprobably for arts-related functions. chitect was already working on renderings, Summers said he knew the building had initial talks about tax increment financing some significant issues that will make reno(TIF) aid had commenced, and a few vation a long and expensive process. The potential tenants were expressing interest work on the roof, which Summers-Taylor is in leasing space. The iconic building, which funding, is occurring because damage was a Summers-Taylor is buying from the Johnbit more significant than they had realized. son City-Jonesborough-Washington County “It’s starting to deteriorate the floor, Chamber of Commerce for $570,000, sits and we just wanted to stop that process. midway between downtown Johnson City While we don’t own it, we did want to go and East Tennessee State University and is ahead and try and shape that up where it considered a critical element in continued wouldn’t deteriorate any further.” downtown revitalization. Those impediments to renovation are Since Summers announced July 7 one reason Summers plans to seek TIF fundthat a contract was in place, he said public ing to help offset the high cost of renovation response has been enthusiastic. An earlier on the 4.8-acre property. A TIF could allow contract between the Chamber and Evolve Summers-Taylor to pay property taxes in the Development, a North Carolina company, amount due at the current tax assessment for drew significant criticism as Evolve planned a period of years after the renovation creates to raze the mill and put a student-oriented a new, much higher assessed value. apartment complex there. The Chamber “Nothing has been run through any bought the property for $400,000 in July committees by any means, but we’ve had 2008. The Evolve contract, inked in late initial conversations with both the city and 2013, had become the subject of multiple the county. People have been very receptive lawsuits when it fell through in mid-2015. and understand the issues that this project “We’re still very positive, and in general has and understand its historic significance. it’s been amazing how many people have Everybody in general has been very supjust walked up and said, ‘I’m really happy portive of the project, and we don’t have any about what you all are doing,’” Summers reason to believe we wouldn’t be able to get a

bjournal.com August 2016

Workers complete temporary roof repair on the Model Mill building July 26. Photo by Jeff Keeling

TIF put in place that would be very beneficial for us and the city and county as well.” The 90-day due diligence period runs through early October, and closing should occur in early December barring any impediments. Summers expects a two-phase process once that’s done: renovating the existing buildings and finding tenants, then building on outparcels or selling those to another developer. When he announced the project, Summers said Summers-Taylor was in talks that could lead to purchase of the adjacent, 1.9-acre Mize property. Since then, an “under contract” sign has appeared on the building. Summers said he was told someone was talking to TCI Group, which is marketing the property. “If that goes through, then we’re going to have to work with them and if it doesn’t of course we’ll do it, but I don’t have a whole lot that I can comment on that.”

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Features

Smith & Wesson purchases Taylor Brands for $85 million By Scott Robertson

mith & Wesson is best known as a manufacturer of firearms, but Kingsport, Tenn.-based Taylor Brands is bringing a knife to a gun company. The local knife maker has long been licensed to produce product lines under the Smith & Wesson brand. When the sale of Taylor Brands to Smith & Wesson Holding Company (SWHC)’s Battenfield Technologies Division closes later this month, $85 million will change hands and SWHC will control not only the 160,000-square-foot Taylor Brands facility in Kingsport, but also all the Taylor Brands product lines, including Schrade, Old Timer, Uncle Henry and Imperial. Taylor Brands manufactures several hundred products including knives, collapsible batons, tactical pens, handcuffs, tactical and survival accessories and flashlights. Under the terms of the sale agreement, BTI Tools, LLC, a newly formed, wholly

owned subsidiary of Battenfeld, will purchase substantially all of the assets of Taylor Brands. James Debney, Smith & Wesson president and CEO said of the deal, “Taylor Brands provides us with an ideal opportunity to further deliver on an important element of our strategic plan, which is to grow our accessories division by expanding into adjacent and complementary markets. “Taylor Brands has delivered solid growth as well as gross margins that are aligned with those in our existing Accessories Division,” Debney continued. ”Today’s announcement moves us closer to our vision, which is to become the leading provider of quality products for the shooting, hunting, and rugged outdoor enthusiast.” Jeffrey D. Buchanan, executive vice president and CFO of Smith & Wesson, said, “As a result of our strong balance sheet, we intend to complete the asset purchase of Taylor

Brands with cash on hand and we expect the transaction to close in three to six weeks. As of the date of acquisition, Taylor Brands’ trailing twelve months revenue was approximately $39.0 million. Without considering any of the significant cost savings that are expected to be realized in our next fiscal year as a result of an acquisition tuck-in of a major licensee, the purchase price represents an estimated multiple of approximately 11x the trailing twelve-month EBITDAS.” Morgan Taylor, president of Taylor Brands, said, “We are proud that the company my family founded in 1975 has grown to become a leading and highly regarded knife and tool provider. We look forward to achieving our next level of growth and continuing to serve our loyal customers as part of Smith & Wesson and with the benefit of Battenfeld Technologies’ extensive distribution network and product development processes.”

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Features

Mullican expansion announcement expected soon By Hunter Hall and Scott Robertson

he proposed expansion of Mullican Flooring’s Johnson City operations, promising to create 200 new jobs, has cleared what appears to be the final hurdle. A formal announcement is expected in early to mid-August. Following weeks of back and forth between the governments of Johnson City and Washington County regarding how to structure and fund a $1.2 million incentive package, the Johnson City Industrial Development Board (IDB) met July 28 to approve a package that utilizes $600,000 each from the two governments. Mullican already manufactures flooring in Johnson City. (file photo) The company says it has maxed out its growth potential at its existing Woodlyn Drive facility, but has de There are also a small number of early buymand for greater production. So Mullican plans out options if Mullican wanted to take ownership to purchase a 126,000-square-foot building on of the property early. Those options each provide Roweland Drive near the company’s current a return greater than 9 percent. Mullican has said headquarters and manufacturing facility. it plans to invest $7 million in the expansion. The company says it will move new product Mullican currently employs 231 people line production into its existing Woodlyn Drive in Johnson City. The company also operates facility and open the second building for warea manufacturing facility in Wise County, Va., housing and product distribution. The Roweland that was expanded less than four years ago. In Drive property is assessed at $1.324 million. addition, it could have taken the new jobs and “Mullican has negotiated a purchase price for investment to eastern Kentucky, where it already that property of $1.2 million,” says Mitch Miller, owns property. CEO of the Washington County Economic Once the IDB approved the deal, Mullican was Development Council. free to contact the property owners and arrange Under the terms of the agreement, the for closing the transaction. Toward the end of the Johnson City IDB would hold title for the process, time became tight. The Johnson City Comproperty, with Mullican paying rent beginning mission did not vote to approve its $600,000 input in the fourth year of its lease as part of a PILOT until July 21. The Washington County Commission (payment-in-lieu of taxes) agreement. held its vote July 25. Mullican’s option on the The payments made by the company to the Roweland Drive property expired July 31. IDB will then be split evenly between Johnson David Tomita, who voted for the project City and Washington County. At the end of the as the only member of both the city and county 15-year lease, the company will have the option of commissions, summed up the agreements by purchasing the property from the IDB for one dol- saying, “It’s a good deal for the employer, and it’s lar. That scenario would provide the governments a good deal for the taxpayers.” with a return on investment of around 9 percent. Miller echoed Tomita’s sentiments. “When It also allows Mullican to avoid paying rent for the you think about the economic impact that that can first three years of the agreement, allowing it to bring,” Miller said, “it shows that we are truly a concentrate its spending on growing the company place that can conduct business and the company in that time. “It’s a win-win,” Miller told the IDB. wanted the opportunity to grow here.” August 2016 bjournal.com

Features

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bjournal.com August 2016

Site selection specialist assesses Unicoi County’s industrial development prospects By Scott Robertson

f there is a silver On the opportunity lining to the cloud CSX to lure CSX back into the Railways’ departure left market or replace CSX over Unicoi County, it is with a similar operation, that the county’s applicaSchjeldahl told the crowd tion to the Select Tennesthat CSX cut its Erwin see Property Evaluation operations because the Program (PEP) has coal industry is down, and been accepted, creating on the way out. “Coal’s opportunities the county not coming back,” he said. otherwise would not have “It’s just not.” Schjeldahl had. also shut down talk of CSX PEP is a relatively being willing to donate its new program developed idled property to the local by the Department of government for economic Economic and Community development. “I’ve worked Development in Nashville. with (CSX) in the past, Schjeldahl said. “I have Its stated goal is to expand Don Schjeldahl speaks to Unicoi County business leaders. Photo by Scott Robertson a hard time envisioning the state’s inventory of a situation in which they industrial sites and existing buildings. But in Unicoi County July 19, there was would consider that.” much more interest in the secondary aspect of the Still, Schjeldahl said, with a more focused program: evaluating and reporting on not just the economic development strategy and planning, properties, but also potential economic developUnicoi County can leverage its strengths effectively. ment strategies for the community. “This has proven itself to be a good manufacturing Don Schjeldahl, principal of DSG Advisors town. You’ve had a history of companies staying spent the previous two days touring the county, here for decades and being prosperous. Now the which has branded its main residential and world has changed under them, so a lot of them commercial area, “The Valley Beautiful.” Followhave left. But in the world today, companies are ing that tour, he spoke about his observations much more aware of those impending changes, so to a joint lunch meeting of the local Rotary and moving into a town like this that has a tradition of Kiwanis Clubs in downtown Erwin. being hard working and productive – married with If local leaders were hoping to have someone better planning around workforce and infrastructell them jobs and investment would come quickly ture – manufacturing companies would come to and easily, they were disappointed. Schjeldahl’s a town like this to plan a long term investment. remarks were frank and, at times, may have been I could easily see metal-working operations, for difficult for local leaders to accept. instance, in the realm of possibility.” On the plus side of the ledger, Schjeldahl Schjeldahl said there are a couple of key quessaid, the county has what he called, “significant tions the county needs to answer in narrowing its untapped resources awaiting organization and economic development efforts to achieve concrete promotion.” However, he cautioned, when asking results. “What types of investment are you trying whether the county is on a sustainable economic to attract,” he asked, “and what are you doing to path, there are issues that have to be addressed. focus on job retention?” “The existing local industries are vulnerable to “All in all,” Schjeldahl concluded, “I have a closing or downsizing. There is a shortage of land good feeling about this community because workand resources needed to support job-creating force is the number one complaint of employers in investments. And finally, to date, the economic America today, and with the heritage of hard work development strategy has been poorly defined, in this community – in talking with employers with minimal outreach.” here, they’re pretty happy with the workforce.”

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Features

Alpha Natural Resources emerges from Chapter 11 as Contura Energy begins operations By Scott Robertson

Our long-term relationship with John and the Mitch Cox Realtor team and their reputation in the community made our decision fairly simple. Their knowledge and expertise were very instrumental in this process, which made it easy for us. They did a great job. Will Kelley

VP and Chief Administrative Officer at NN, Inc.

Since 1979, Mitch Cox Realtor has provided strategic and comprehensive commercial real estate brokerage services in Johnson City, Kingsport, and Bristol. Contact us today.

(423) 282-6582 • mitchcox.com

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lpha Natural Resources (ANR) fully completed this process without is back and Contura Energy has the loyalty and work of employees arrived. Alpha issued a statement across our organization. During the announcing it has emerged from restructuring, we reached important Chapter 11 bankruptcy July 26, the agreements with key stakeholders same day Contura announced it had that will create a more sustainable completed the acquisition of what business model going forward, and had been Alpha’s key assets. we appreciate their support, which Formed and majority-owned ensures our ability to continue by a group of Alpha’s former first serving our customers and playing a lien lenders, Contura was created to Alpha CEO David Stetson positive role in our communities.” Photo courtesy Alpha Natural acquire and operate what had been Kevin Crutchfield, Alpha’s Resources Alpha’s core operations, allowing former CEO, is now chief executive Alpha to emerge from Chapter 11 as officer of Contura. That company a smaller, privately held company. will begin operations with a workforce of more Contura acquired all of Alpha’s operations than 2,200 former Alpha employees. “Today and reserves in Northern Appalachia (including marks the successful culmination of a complex the Cumberland mine complex) and the Powder and arduous process, made possible by the River Basin, along with three Central Appalatireless work of countless employees, collaborachian mining complexes (the Nicholas mine tion among a diverse stakeholder group, and the complex in Nicholas County, West Virginia, and unwavering commitment of Contura’s managethe McClure and Toms Creek mine complexes in ment team and owners to achieve a positive Dickenson and Wise counties, Virginia). Contura outcome,” Crutchfield said. “The result is the also purchased Alpha’s interest in the Dominion creation of a strong operational asset base, well Terminal Associates coal export terminal in positioned to serve unique customer needs in eastern Virginia. today’s challenged coal market.” Alpha will now operate 18 mines and Contura’s initial board of directors includes eight preparation plants in West Virginia and Crutchfield; Albert E. Ferrara, Jr., retired senior Kentucky. The company is in the process of vice president and chief financial officer of AK vacating its former headquarters in Bristol, Va. Steel Corporation; Jonathan Segal, managing It will retain offices in Kingsport, Tenn., and director at Highbridge Capital Management, Julian, W. Va. LLC; and Neale Trangucci, principal at NXT David Stetson, who was appointed CEO of Partners, LLC. the reorganized Alpha, previously held leadership Alpha’s new board includes Stetson; John positions with Trinity Coal, RAAM Global Energy E. Lushefski, former senior vice president and and JW Resources. “By completing this restrucchief financial officer of Patriot Coal Corp.; turing, ANR emerges as a company with a solid James Martin, president of Martin Energy, LLC.; financial foundation and a strong team to continue Harvey L. Tepner, an independent corporate to mine and sell coal,” Stetson said. “We are now director; and Stephanie Timmermayer, vice also better positioned to satisfy ANR’s environpresident – Environment Health and Safety for mental responsibilities. I am confident ─ even Williams Companies. though coal markets continue to be challenged by The Chapter 11 process involved holders both competitive and regulatory pressures ─ the of more than $3.9 billion of debt obligations, company created by our Plan of Reorganization various federal and state government entities, will have the structure, resources, and talent to surety providers, union employees, pension successfully weather these challenges.” beneficiaries, trade creditors, and others. It was Stetson added, “ANR could not have success- completed in just under a year.

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| FEATURES

2016

PRESENTED BY THE BUSINESS JOURNAL OF TRI-CITIES TN/VA

bjournal.com August 2016

Photos by Tara Hodges, Sweet Snaps Photography.

or the last 23 years, The Business Journal of Tri-Cities, TN/ VA has called the attention of the business community to the individuals and organizations that have helped make the provision of health care the largest single industry in the region. It can easily be argued that health care is also the most important industry in the region. After all, without quality health care, no other industry can survive. Without healthy employees and customers, no business can succeed. What defines Healthcare Heroes? They have earned the respect and admiration of their colleagues, the individuals for whom they care, and the communities in which they work. Nominations for the program come from those populations.

The field of nominations this year was the largest it has ever been, and each nominee was, in some way, already a hero. Health care is a field that lends itself to selfless actions and dedication beyond most conventional societal norms. It is our privilege at The Business Journal to recognize these honorees, as we did at a luncheon at the Carnegie Hotel July 15, and to present the honorees to you. The Business Journal wishes to recognize the dedication and commitment of Frontier Health, the primary sponsor of Healthcare Heroes, and of co-sponsor Wellmont Health System. Without the participation of these companies, this program would not be possible.

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Back row: Karen Ervin, Gina Osborne, Jordan Masters Front row: Paula Masters, Dr. Kate Beatty, Kris Bowers, Janet Stork

Teresa Kidd, President and CEO, Frontier Health, presents Hughes Melton, Virginia Department of Health with his award.

Recipient Ron Renfro enjoys lunch with his family.

Photos by Tara Hodges, Sweet Snaps Photography.

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Honoring Our Health Care Heroes & All 2016 Recipients!

Tina Johnson

Sheila Talley, LMFT

Director of SAFE House Frontier Health

Adult Services Site Director Watauga Behavioral Health Frontier Health

Wendy Wampler

Psychosocial Rehabilitation & ID Day Program Services Coordinator Frontier Health

Janet Wolfe, RN

Watauga Behavioral Health Frontier Health

Frontier Health Continues to be on the Cutting Edge of Health Care Reform to Ensure the Behavioral Health Care Needs of the Community are Met The leadership and staff of Frontier Health are dedicated to consistently exceed your customer service experience as we assist individuals in their move towards recovery and success. We are committed to providing a fully integrated team of professionals with diversified clinical experience and training along with the latest advancements in technology to provide the highest quality of care. In short, our mission is to assist individuals in achieving their highest potential!

Join us www.facebook.com/FrontierHealth2

www.frontierhealth.org

423-467-3600 P.O. Box 9054, Gray, TN 37615

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CUP OF KINDNESS AWARDS The Community Service Award Dr. Randy Wykoff The Community Service Award is presented to an individual or organization for excellence in the area of public health. This year’s honoree is Dr. Randy Wykoff, dean of the East Tennessee State University College of Public Health. There may be no individual more focused on improving population health in Appalachia than Randy Wykoff. Under his leadership, ETSU has partnered with local health systems and other agencies to improve services to those most in need. His important concept of the “Three-Legged Stool: Economic Development, Health, and Education” has been featured across disciplines and in industry. Thanks to Dr. Wykoff, the region’s medical, education and business communities have a better understanding of what we’re facing, and of how we can succeed, as we work to improve population health in Appalachia.

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CUP OF KINDNESS AWARDS Distinguished Service Award

Debbie Britt The Distinguished Service Award is presented to an individual who has shown leadership and excellent service over what we refer to as a sustained period of time. This year’s honoree is Debbie Britt, an RN/LPN at Sycamore Shoals Hospital. Nurses are the front line of health care. And Britt has excelled on the front lines for 36 years now. Her co-workers speak of her work ethic, energy and bright personality. Britt is chair of the Team Member Advisory Group, which has organized a Thanksgiving fundraiser, benefitting 89 families in the last two years. Perhaps one incident best shows why her colleagues nominated Britt for this award. A co-worker’s husband had a heart attack and brain injury, and Britt took it upon herself to help in any way possible. She looked in on the family. She brought food. But then she took it a step further. She collected money for the family when they were at a high-level specialty hospital in Atlanta. Britt didn’t just mail it to them but made the trip to Atlanta to hand-deliver it.

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CUP OF KINDNESS AWARDS The Innovation Award

Dr. Mike Stoots The Innovation Award rewards innovative thinking in the region’s healthcare community. The 2016 honoree is Dr. Mike Stoots, one of the longest-serving faculty members in the ETSU College of Public Health. He is highly innovative in developing new ways of teaching, which can be seen in his development of the “Essential Skills, Strategies and Expertise Necessary To Improve and Advance Low-resource Settings,” or ESSENTIALS, course at ETSU. The ESSENTIALS course is part of Project EARTH, designed to train students in lowresource situations such as disasters, refugee situations or isolated regions how to use whatever resources are available to improve health. Late last year, Dr. Stoots hosted the Holston Valley Medical Center leadership team for an all-day “Refugee Experience” at the Valleybrook campus. HVMC President Tim Attebery praised it as an excellent innovative experience.

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CUP OF KINDNESS AWARDS The Meritorious Service Award

Sheila Talley The Meritorious Service Award goes to an individual who has shown excellence in administration or leadership. This year’s honoree is Sheila Talley, site director at Frontier Health. Talley supervises and manages the overall function of Watauga adult outpatient services, one of Frontier Health’s largest outpatient sites, serving about 8,300 individuals per year. Under her watch, Watauga became the first Frontier Health facility to have its own full-service pharmacy on site. Watauga employees have praised Talley for going the extra mile to help them make lives better, but Talley has also earned the respect and appreciation of the larger community for her efforts beyond the facility. She has worked for the last two years with the Qualuable accountable care organization in an effort to reduce hospital readmissions. She has also been a key Tri-Cities player in the US Department of Justice’s “Smart on Crime Initiative.”

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CUP OF KINDNESS AWARDS The Support Service Award

Ravan Krickbaum The Support Service Award goes to an individual for outstanding assistance in the field of health care. Over the years this award has been presented to everyone from financial benefactors to staffers to volunteers. This year’s honoree is Ravan Krickbaum, who has been both chair of the Hawkins County Memorial Hospital board and a longtime volunteer at the hospital. One nominator said, “if you live in Hawkins County, your life has been touched by Ravan Krickbaum.” Krickbaum has also served on the Wellmont Health System board and on its quality and audit committees. That focus on quality has paid off, with Hawkins County Memorial – a 50-bed facility – receiving national recognition for overall hospital care, quality in key measures, surgical care and room cleanliness. Krickbaum also spearheaded construction of the hospital’s chapel. But it’s not just at the boardroom level where Krickbaum’s desire to go the extra mile for her community shows through. Krickbaum recently developed a patient-family council to examine ways to make the hospital more “user-friendly” for patients and their families. For more than 20 years of helping improve the provision of health care in Hawkins County, the Support Service Award goes to Ravan Krickbaum.

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They go the extra mile. They make a difference.

They’re our heroes. Wellmont Health System congratulates its 2016 Health Care Heroes. • Bernie Buckles, a volunteer with Wellmont Hospice House in Bristol. Bernie can be found at the Hospice House every week without fail, pulling 12-hour shifts that start at 5 a.m. • Ravan Krickbaum, chairwoman of the Hawkins County Memorial Hospital board of directors and a Wellmont board member, who has established a lengthy track record of care and concern for people in the community. • The pet therapy team at Holston Valley Medical Center, whose four-legged friends and owners help patients relax, experience the holiday spirit or take just a moment to smile and enjoy life. • Dr. Sue Prill, a medical oncologist with Wellmont Medical Associates and the Wellmont Cancer Institute, who developed the comprehensive survivorship care plan Wellmont has in place for breast cancer patients and is constantly working to establish standardized procedures for patients. • Rosalee Sites, who founded Wellmont’s parish nursing program and pioneered several tenets of its trauma program, as well as much-needed community services and agencies that serve people in need, such as the ElderCall directory and Contact-Concern helpline.

wellmont.org /Wellmont /Wellmo @We wellmontphysicians.org wellmontphysicians.org August 2016 bjournal.com 29

Sandra Brown Sandra Brown is executive director of Asbury Placeâ&#x20AC;&#x2122;s Kingsport campus. Brown says she has known her own career path since she was a little girl. She still remembers being a Girl Scout Brownie, visiting nursing home residents. That memory has guided her steps since. Brown has worked her way up from part-time certified nursing assistant over the last 21 years, and today manages 180 employees and implements a $3.4 million budget. Said one nominator, â&#x20AC;&#x153;She is able to do what is best for people because she has been in the trenches on a daily basis and now takes this experience to the administrative level without forgetting her roots.â&#x20AC;?

Bernie Buckles Bernie Buckles learned about Wellmont Hospice House when his father and father-in-law both spent their final days there. Soon after his retirement, Buckles began volunteering at the facility. Three days a week he is in the facility, cooking breakfast at 5 a.m. for about 20 people, then making rounds providing comfort and reassurance to the residents. He plays multiple instruments and often fills the halls with song. And the relationships he forges with the families go outside the walls of Hospice House. Buckles often attends funerals and memorial services for those he has helped. He gives an example of grace that inspires those who work with him.

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East Tennessee State University

congratulates

our Healthcare Heroes for 2016

Randy Wykoff: Cup of Kindness, Community Service

Mike Stoots: Cup of Kindness, Innovation

Ginny Kidwell

Rob Pack

Patti Vanhook

Jennifer Whitehead

Thanks for all you do to enrich the lives of those you serve.

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Crossroads Medical Mission Crossroads Medical Mission provides free medical care to those in the region who can afford it least. Of the 1,100 unique patients cared for by Crossroads last year, 97 percent were under the 150 percent poverty level. The mission provided $1,269,000 of services with an out-of-pocket expense of $336,000, all at no charge to the patients. With only one full-time employee and six parttimers, the mission provided 160 scheduled clinics and took part in two RAM events. More than 100 volunteers gave more than 4,000 hours of their time to make the mission work. Care has been given at 10 remote locations and from a mobile medical center. And all this happened with zero dollars of federal funding, as the mission is supported by the members of the communities it serves.

Healing Hands Health Center Healing Hands Health Center has, in the last year, moved from its original quarters in Bristol to a 9,600-square-foot facility in Midway Medical Park to allow it to see more patients. Healing Hands provides charitable health care to residents of the region who work, are uninsured and underserved, and cannot afford to pay for these services. The clinic has more than 750 active patients. In the last 18 years, 48,000 volunteer hours have been logged at a value of almost $1.1 million. Prescriptions have been provided for free or for a nominal processing fee at a value of more than $22 million. Each patient is asked to pay $25 to see the doctor and a $5 processing fee for each medication, but no one is turned away for inability to pay.

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Tina Johnson In an industry measured by outcome metrics that are always changing through healthcare reform, Tina Johnson still measures success in the same terms she always has: by lives changed from terror and abuse to freedom and hope. Johnson helps victims of domestic violence get free and build new lives. It’s something she’s done for more than 13,000 people at SAFE House since 1999. Sometimes success comes for Johnson when she recruits a new volunteer. Sometimes it happens when she secures new funding. She has had great success at both. But the greatest successes are when someone breaks free of an abusive environment and begins living a better life.

Congratulations to The Highlands Physicians’ Members Named 2016 Healthcare Heroes!

Joseph A. Ley, M.D. Holston Medical Group

Sue J. Prill, M.D. Wellmont Medical Associates

David E. Schilling, M.D. Holston Medical Group

The 1,500 members in 148 practices of Highlands Physicians provide health care services of the highest quality and value to more than half the population across Northeast Tennessee and Southwest Virginia. Highlands Physicians’ members collaborate as a team – and payers, partners and patients all benefit. Our members are exceptional clinicians, dedicated to the communities where they live and work, and are passionately committed to enhancing the health of all our patients.

For more information visit our website at highlandsphysicians.com August 2016 bjournal.com

Ginny Kidwell Ginny Kidwell is executive director of the Tennessee Institute of Public Health. As such, she has built a coalition of check-writers to support mini-grants that bring together community leaders from health care, economic development, education and business from across the state. Recently, she was successful in enlarging a grant from Blue Cross Blue Shield to support 20 community-based health initiatives in rural counties of East Tennessee. Those initiatives address substance abuse, cancer, diabetes, cultural factors, lack of education and economic issues. Kidwell and the TNIPH are where the rubber meets the road in driving rural healthcare improvements, playing a major role in fostering measurable improvements through data-driven planning, health education, public awareness, and research and advocacy for effective health-related policy.

Dr. Joseph Ley Dr. Joseph Leyâ&#x20AC;&#x2122;s curriculum vitae says he is a pediatrician with Holston Medical Group. But his involvement in bettering the quality of life and health outside his office paints a much broader picture. Some readers may know him as president of the Downtown Kingsport chapter of the Rotary Club. If you do, then you already know of his involvement in programs like the Kresge Krew golf tournament, which raises money for autism. But even then you may not be aware of his medical mission work in Belize. A previous Healthcare Hero, Dr. Joe Smiddy, invited Ley to visit the clinic at Roaring Creek in 2009. Itâ&#x20AC;&#x2122;s become a regular trip, and last year, Ley invited two HMG nurses to go along. In one week, they treated 500 children.

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Hughes Melton Hughes Melton, chief deputy commissioner for public health and preparedness for the Virginia Department of Health, is recognized this year mainly for his contributions to addressing two of the region’s major health-related challenges: widespread prescription addictions and the area’s shortage of doctors. Until recently, Melton worked as Mountain States’ chief medical officer for its Southwest Virginia hospitals. He was instrumental in the creation and development of graduate medical education programs, including Johnston Memorial Hospital’s family medicine and internal medicine residency programs. Both Melton and his wife, Dr. Sarah Melton, a pharmacy practice professor at ETSU’s Gatton College of Pharmacy, work extensively in Virginia and Tennessee to educate medical students and staff on pain management in order to battle the huge problem of prescription medication addition. Both Hughes and Sarah are now Healthcare Heroes, as she was honored in 2015.

healing mind & body Prepare for a Healthcare Career

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graduate and professional studies August 2016 bjournal.com

Dr. Rob Pack Dr. Rob Pack is director of ETSU’s newly established Center for Prescription Drug Abuse Prevention and Treatment. Pack has spent years researching the issue of prescription drug abuse. In 2012, under his leadership, a group of ETSU scholars, regional health professionals, elected officials and other interested parties came together to discuss the dramatic increase in prescription drug abuse and drug overdose death rates in the Appalachian region. That group collaborated to generate a National Institute of Drug Abuse proposal that culminated in the five-year, $2.2 million grant. Much of Pack’s work over the past four years culminated in the recent announcement of the approval from the Tennessee Board of Regents for ETSU to create a Center of Excellence for Prescription Drug Abuse Prevention and Treatment.

The Holston Valley Medical Center Pet Therapy Team This year the Healthcare Heroes program has its first nonhuman honorees. Stories abound about how patients benefit from the presence of the animals of the Holston Valley Pet Therapy Team. A stroke patient who had not spoken for days had a visit from a therapy dog. The dog’s owner was telling the patient the dog’s name and immediately the patient looked up and repeated the name back, much to the surprise of family and medical staff. Of course not every story is of a great breakthrough. But every child who is less afraid of a needle and every anxious patient who takes comfort from the presence of one of the 43 dogs in the program is grateful.

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Dr. Sue Prill Dr. Sue Prill wears many hats and she wears all of them well. She is medical director of the breast center at Bristol Regional. She is also a member of the board of directors for Wellmont Medical Associates. And she serves on the Bristol Regional Physician Clinical Council. Soon after she assumed her role as medical director, Prill earned her physician executive MBA degree. When asked why, she said it was important to have a complete understanding of what it takes to run a hospital. Yet even as she has grown her understanding of administration, she has remained, as one nominator said, “someone who has literally dedicated her life to her patients and the field of oncology.”

Ron Renfro Ron Renfro is a hero because of how he inspires people to stay active, fit and healthy – even as he battles Stage 4 colon cancer. Renfro has worked as a personal trainer at The Wellness Center for 24 years, so he has personally helped hundreds of people improve their own health. Over the last two years he has also fought colon cancer, involving multiple surgeries and rounds of chemotherapy, yet he continues to come in to The Wellness Center to help train others and do his own workouts. Despite all he’s been through, Renfro stays positive. There are hardly any days he’s negative. He’s stubborn as a mule and he doesn’t like to take days off from working at The Wellness Center, or from working out. Just by being there he’s motivating everyone around him. Said one nominator, “If Ron can keep going, what’s my excuse?”

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Dr. David Schilling When Dr. David Schilling was first approached by another area physician about starting a free medical clinic in Church Hill, he never imagined becoming chief fundraiser and medical advocate. He also never envisioned learning to speak Spanish to better treat local Hispanic patients. Yet, that is exactly what he has done. As medical director of the Church Hill Free Medical Clinic, Schilling has logged hundreds of hours overseeing the clinic, which receives nearly 500 yearly visits, for 12 years. And because of his tireless work, the clinic was only the 11th in the nation to receive free malpractice insurance. Making it easier for patients to get care and for providers to give it - thatâ&#x20AC;&#x2122;s the goal of the entire healthcare industry. In Church Hill, Tenn., David Schilling just accomplished it.

Rosalee Sites Rosalee Sites has been a quiet, driving force in health care in the region for years. Without her work as director of Holston Valleyâ&#x20AC;&#x2122;s emergency department in the late 1980s, the hospital might never have become a Level One Trauma Center. Sites established the Trauma Nurse Tough Talk program to encourage teens to drive safely. She assigned a nurse to serve as a liaison between the emergency department and the EMS agencies. She helped found the Friends in Need Health Center in Kingsport to provide medical and dental care for the working poor. And she chaired the committee that founded the Childrenâ&#x20AC;&#x2122;s Advocacy Center in Blountville. Today Sites serves as director of parish nursing for Wellmont, a program she founded back in 1997.

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You can be a part of the recognition process by nominating a young businessperson who excels both professionally and in service to his or her community. Itâ&#x20AC;&#x2122;s never been easier to make your 40 Under Forty nominations. Just visit 40under.com and follow the instructions. All 40 Under Forty nomination materials are due no

later than August 19, 2016. Nominees must be 39 or younger as of October 14, 2016. Visit 40under.com for complete nomination rules and requirements. The 24th Annual 40 Under Forty Gala will be held at the Millennium Centre in Johnson City on Friday, October 14. Call 423.979.1300 for more information. Honorees attend at no charge.

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Dr. Jane Toothman Dr. Jane Toothman was the first female doctor to open a practice in Wise County, Va., paving the way for a generation of women in what had been a male-dominated field in a region slow to accept change. Regardless of her gender, Toothman was appreciated for bringing primary care to community members who wouldn’t otherwise have it – even those who couldn’t pay. She went on to open – and eventually retire from a private practice in Bristol. She helped found the Wesley Medical Clinic in Abingdon, Va., where she now serves as medical director on a volunteer basis. Toothman and her dogs, Lady and Maurice, volunteer in the Johnston Memorial Hospital Pet Therapy program.

Patti Vanhook Patti Vanhook, associate dean for Practice and Community Partnerships at ETSU, operates 14 nurse-led health clinics located from Mountain City to Sneedville. Together, these clinics provide more than 30,000 primary care and outreach visits to underserved clients. Since 2007 Vanhook has been responsible for attaining and administering more than $22 million in federal and state support for these clinics. A board-certified family nurse practitioner, she’s also a fellow in the American Academy of Nursing. Having started her career by opening a clinic in her hometown of Big Stone Gap, Vanhook was later instrumental in building a stroke management program at Mountain States, and played a key role in getting Nurse Magnet status for Johnson City Medical Center, the first hospital to gain that status in Tennessee.

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Dr. Amit Vashist Dr. Amit Vashist, Mountain States regional medical director for the hospitalist division, is dramatically improving the provision of health care in Southwest Virginia. His key areas of success – ‘Sepsis Care’ and ‘Order Sets’ – admittedly aren’t sexy, headline-making topics. But his results are. Under the guidance of Dr. Vashist’s team’s work on sepsis care, an estimated 84 lives have been saved and 448 hospital days have been avoided at Johnston Memorial Hospital. Likewise - without taking the time to explain the details of order sets - it’s impressive to note that with Dr. Vashist’s leadership, JMH hospitalists attempted to go from 50 percent order set compliance to 90 percent compliance in 90 days. What’s more impressive is that they achieved 95 percent compliance inside 60 days.

Wendy Wampler Wendy Wampler is Frontier Health’s services coordinator for Psychosocial Rehabilitation and Intellectual Disabilities day programs in Southwest Virginia. She’s also one of the most prominent, best-respected voices for psychiatric rehabilitation in the Commonwealth. Over the course of a 24-year career, Wampler has risen from case manager to a point where she was elected to serve as president of the Virginia Psychiatric Rehabilitation Association from 2012-2014, and then was elected to serve as the Virginia state chapter representative to the national Psychiatric Rehabilitation Association. For the last eight years, Wampler has been chair of the Southwest Virginia Clubhouse Director’s Association, dedicated to providing education and information in the field to psychiatric rehabilitation program directors, staff and program members.

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Jennifer Whitehead Jennifer Whitehead is not a provider who is preoccupied with her clients’ ability to pay. Her clients don’t have homes. Most don’t have jobs. Seventy percent of them suffer from some form of mental illness. At least half of them have a criminal history. They define the term “underserved.” Whitehead is coordinator of the Johnson City Downtown Day Center, a facility operated by ETSU’s College of Nursing. Between Whitehead and two other staff, the facility saw 1,100 different people in 2014 and has a group of about 230 “regulars.” Through a $1 million grant, the center will soon expand to be able to increase its patient resources by 400 percent. That’s good, because demand is expected to rise 150 percent when the doors open.

Janet Wolfe Janet Wolfe’s passion is taking care of teens and children in crisis, and that’s exactly what she’s been doing for the last 23 years. Wolfe’s key role is to provide assessment, medication counseling and support for youth at Nolachuckey Holston-Area Mental Health in Greeneville, Holston Children and Youth in Kingsport and Watauga Behavioral Health Services in Johnson City. But she views her role with Frontier Health as a ministry, not a job. Wolfe does not just act as a nurse, but as a care coordinator. She makes sure all members of the interdisciplinary team - as well as insurance companies, physicians or nurse practitioners, group home staff, foster parents, teachers, and any other parties who may be involved - are up to date and on the same page.

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Many heroes across our region provide compassion, loyalty and excellent service. These heroes are just a few of the individuals and organizations that support the growth of healthy communities throughout the Tri-Cities, Tennessee/Virginia region.

FRONTIER HEALTH AND WELLMONT HEALTH SYSTEM ARE PLEASED TO HONOR THE 2016 HEALTHCARE HERO AND CUP OF KINDNESS AWARD RECIPIENTS.

Cup of Kindness Awards

Healthcare Heroes Awards

Community Service Randy Wykoff

Sandra Brown

Hughes Melton

Rosalee Sites

Asbury Place

Virginia Department of Health

Wellmont Health System

Bernie Buckles

Rob Pack

Jane Toothman

Hospice House

Center for Prescription Drug Abuse Prevention and Treatment

Wesley Medical Clinic

East Tennessee State University

Distinguished Service Debbie Britt Sycamore Shoals Hospital

Innovation Mike Stoots East Tennessee State University

Meritorious Service Sheila Talley Frontier Health

Support Service Ravan Krickbaum Hawkins County Memorial Hospital

Crossroads Medical Mission Healing Hands Health Center Tina Johnson

Pet Therapy Team Holston Valley Medical Center

Sue Prill

Patti Vanhook East Tennessee State University

Amit Vashist Mountain States Health Alliance

Wellmont Cancer Institute and Wellmont Medical Associates

Wendy Wampler

SAFE House

Ginny Kidwell

Ron Renfro

Jennifer Whitehead

Tennessee Institute of Public Health

The Wellness Center

Johnson City Downtown Day Center

Joseph Ley

Church Hill Free Medical Clinic

Holston Medical Group

David Schilling

Frontier Health

Janet Wolfe Frontier Health

August 2016 bjournal.com

Features

Mary Snyder, who received outpatient care for a condition that once would have put her in the hospital, talks about the major shifts occurring in health care with Tennessee Congressman Dr. Phil Roe, a key architect of one law that’s accelerated many of the changes. Photo by Jeff Keeling

Payment reform: ‘Right thing to do,’ but ‘devil is in the details’ By Jeff Keeling Second in a two-part series. Read the first story at bjournal.com/payment-reform-spurring-sea-change-at-clinical-level.

“I really believe Dr. Dykes saved my life,” Mary Snyder says. Mary Snyder wasn’t just sick late last fall. She was really sick. The Jonesborough resident’s congestive heart failure (CHF) had hit her with a vengeance. She had fluid on her lungs (pulmonary edema), a common side effect of CHF. Snyder’s daughter and primary caregiver, Novice Snyder, took her to see Dr. James Dykes, her primary care physician with Johnson City Internal Medicine. For many years, the standard of care for CHF exacerbation has been hospitalization until a patient is well enough to go home. Thanks in no small measure to major shifts in how health care is paid for, that standard is changing. “Dr. Dykes said, ‘you know, instead of putting you in the hospital, I think we can take care of this in our acute care clinic,” Novice Snyder recalls. “We said, ‘if that doesn’t put her in the hospital, great.’” Snyder’s husband died several years ago, and Novice Snyder, an only child, has to take time away from her job when her mother is sick. During hospitalizations, Novice would usually stay over44

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night with her mom. The episodes were stressful, and they were costly. So the Snyders were all ears when Dykes told them State of Franklin Healthcare Associates (SoFHA) had recently opened a clinic where it was treating several conditions that had previously meant an automatic hospital stay. Mary Snyder started treatment around Dec. 1, 2015 and went in each weekday for about three weeks, usually for a few hours. She was on home health care for another couple of months, and it’s been smooth sailing since. “She is doing better than she has in years,” Novice Snyder says. “It was fabulous. She was able to be at home she was comfortable, she could sleep in her own bed.” The difference in how Snyder received treatment has everything to do with health care payment reform and the changes it is helping to drive in clinical practice. The different treatment approach also saved Snyder and Medicare a good bit of money. SoFHA CEO Rich Panek says for CHF exacerbation, treatment cost at the clinic typically will run roughly one-fifth or less the cost of an emergency room admission and the subsequent hospital stay.

SoFHA opened its acute care clinic just a couple of months prior to Snyder’s treatment. Along with massive “population health” infrastructure, including personnel to conduct much more in-home care and case management, SoFHA and its partners in the Qualuable Accountable Care Organization (ACO) have invested in data analytics, technology and other resources designed to meet payers’ expectations (primarily, CMS, the Centers for Medicare and Medicaid Services) in the new healthcare paradigm. “The first thing we wanted to do well on was access to care,” SoFHA’s chief medical officer, Dr. Rick Moulton, says. “If you don’t provide access to care, then your patient will end up in an emergency room or somewhere else outside of your care.”

Building the model Panek says Qualuable, having started in 2013, is in its second three-year term in what’s called a “Track 1 MSSP (Medicare Shared Savings Program) Model.” The approach is significantly tied to CMS and its Medicare Shared Savings Program. The model is tied to patients over a longer term. With Holston Medical Group – SoFHA’s co-founding partner – and other Qualuable members Mountain Region Family Medicine, Medical Care LLC, Highlands Physicians Inc. and now ETSU Physicians and Associates – SoFHA has built infrastructure designed to keep its patients like Snyder healthy, at the lowest reasonable cost. One crucial measure of success, Moulton says, is hitting a “minimum savings rate” that qualifies an ACO for a bonus distribution under the MSSP model. Only about 25 percent of MSSP programs are successful, Moulton adds. “That means 75 percent have built an infrastructure and

did not succeed in their contract, so that infrastructure build, they lost,” he says. Panek says the minimum savings rate each year comes from a predetermined benchmark set by CMS. Qualuable’s 2016 bar is 2.5 percent, with its preliminary spend benchmark “per attributed Medicare life” (patients in the program) set at $7,729. “To be eligible for shared savings we must save at least $193.23 per attributed life, and successfully report/perform for 33 quality measures,”

“

We’ll get this right and there will be hiccups, there’s no questions about that. But before they become tidal waves, we just want them to be little ripples in the pond.” - Congressman Phil Roe

Panek says. “The amount of any shared savings retained by the group is based on a formula that considers quality performance.” Qualuable’s quality performance rating was 91 percent for the 2014 performance year, Panek says. For all these efforts – if an ACO hits its shared savings target – it gets up to 45 percent of the shared savings. CMS gets 50 percent, Uncle Sam gets another 5 percent that is “sequestered,” and the ACO’s take is some portion of the remaining 45 percent, adjusted for quality performance. It hasn’t been easy, Panek says. From new employees to data infrastructure, SoFHA has spent more than $2 million helping develop Qualuable’s overall infrastructure to position its practices to succeed in the new paradigm. In 2016 alone, Panek says, Qualuable’s budget is $2,642,000, with

SoFHA covering 36 percent of the total. All told, SoFHA will spend at least $1.5 million for population health and MSSP participation infrastructure this year. And that’s in a model the government considers “no-risk,” because it doesn’t have a downside penalty for not hitting targets – only an “upside” opportunity for a bonus. “We would tell you we have the cost of the infrastructure at risk,” Panek says. Beyond the infrastructure spend is the matter of getting not just doctors from the same practice, but doctors from multiple practices buying into specific approaches and pulling on the oars together. “You need all the principals at the table relative to a physician consensus,” Moulton says. “After they reach the consensus that has to be disseminated to over 500 physicians in Qualuable, and it has to be implemented and physicians have to be trained on specific protocol, and it has to be monitored.”

Sharing best practices: An extensivist clinic by any other name… The people at SoFHA didn’t create the idea of an acute care clinic out of whole cloth. They modeled much of what they’re doing on a clinic HMG had started. HMG was the first practice in the ACO network to begin treating patients with what insurance companies deem “ambulatory sensitive conditions” inside what it named an “extensivist” clinic, as opposed to admitting them to hospitals. Moulton says among the conditions in this category are congestive heart failure (CHF) exacerbation; chronic obstructive pulmonary disease (COPD) exacerbation; urinary tract infections; and dehydration. Led by CMS, insurers want to see as SEE REFORM, 46

August 2016 bjournal.com

REFORM, CONTINUED

many as possible of the patients who manifest those conditions treated in a less expensive setting than the hospital. The theory, Moulton says, is this: “If a practice is advanced, it should be able to take care of them in its (clinics) instead of these patients ending up in the hospital.” Therein lay the rub, at least at first, Moulton says. “Most clinics do not have the setup to have a prolonged stay for patients that might need care three to four hours a day, and maybe have that two to three days in a row.” HMG’s chief medical officer Dr. Shelton Hager along with Drs. Eric Schwartz and Chris Neglia, told Moulton, Panek and Dawn Tipton, director of nursing – population health for SoFHA, about their system, the medications they used and other foundational information. “We used it as a best practice and brought it to SoFHA last October,” Moulton says. “Dawn helped with the nuts and bolts of staffing the clinic, getting the medicines for the clinic, and provided space.” From Oct. 20, 2015 through mid-June, Moulton says, SoFHA had avoided 100 hospitalizations, “just basically using one internal medicine group inside of SoFHA (Johnson City Internal Medicine).” It’s all working, Moulton says, because the SoFHA team learned from HMG’s model, then “created the culture” in which it became accepted at JCIM. “We did a test run for a month, and holy smokes, it worked beautifully, and the doctors liked it because they’d see their patients maybe two or three days in a row, treat them outpatient, and they’d

State of Franklin Healthcare Associates Director of Nursing – Population Health Dawn Tipton, Chief Medical Officer Dr. Rick Moulton, and Lead Patient Care Coordinator Carol Shrum. Photo by Jeff Keeling

go home and stay with the family. They’d finish the treatment, and sometimes three days the patient would have been in the hospital they will sleep in their own bed.” Indeed, Moulton says, the change in approach isn’t just about numbers, though that is largely what drove it at the beginning. The other key result, he says, is “patient comfort and well being” for people like Mary Snyder. Nonetheless, numbers play a key role in the equation.

“MACRAeconomics”: When is it too much, too fast? The Qualuable partners entered a three-year MSSP program in

COMING MARCH 2017

Kingsport Centennial Publication The Business Journal of Tri-Cities Tennessee/Virginia is excited for the opportunity to partner with the City of Kingsport to publish a commemorative edition celebrating Kingsport 100, an historical look back at the businesses and people that have made Kingsport a great place to live, work and play for 100 years! The glossy, color, magazine style publication will highlight Kingsport history over the past 100 years and will be filled with photos and editorial documenting the growth of the Model City from its charter on March 2, 1917.

The Centennial publication will be available in print and on-line at Bjournal.com, giving access to this keepsake history of Kingsport to virtually anyone, anywhere!

For questions or to reserve your space in the Kingsport100 magazine, contact: Gena Anders ganders@bjournal.com 423.512.0531 46

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Jeff Derby jderby@bjournal.com 423.306.0104

Jeff Williams jwilliams@bjournal.com 423.202.2240

Robin Williams rwilliams@bjournal.com 423.794.6938

2013, and reupped this year. In the interim, Congress passed a replacement for the long-loathed Medicare “Sustainable Growth Rate.” The SGR was a flawed law that had to be tweaked each year through the so-called “doc fix,” to avoid huge payment cuts to providers. It was also based mostly on the old fee-for-service model. First District Tennessee Congressman Dr. Phil Roe, R-Johnson City, helped author the MACRA law, which passed overwhelmingly in April 2015. The new law is complex, it’s designed in part to save the government money, and it accelerates payment reform. Its implementation isn’t sitting so well with many providers. The American Medical Group Association says the law changed the healthcare financing system, “in the most significant and far reaching way since (Medicare’s) inception in 1965.” The group’s Institute for Quality Leadership topic this year? “Succeeding Under MACRA and Risk-Based Payment.” Mountain States Health Alliance (MSHA) CEO Alan Levine said the law is accompanied by 900 pages of rules, and that data are showing 85 percent of small physician practices will be penalized under the new system. By 2018, Levine says, 90 percent of Medicare payments are slated to fall under value-based arrangements. “This thing isn’t even a final rule yet,” Levine says. “We’re talking seven months from now, their whole payment system changes. There are four sections: quality resource use, advancing care information and clinical practice and proven activities. Each of these buckets is an element of what your payment will be. I think they should be doing this a lot more slowly and a lot more incrementally.” Roe says he agrees, and as an author of the law, he’s doing what he can to convey providers’ concerns. Roe, who worked as an OB/ GYN physician for more than 30 years, keeps his finger on the pulse of providers, and says he’s developed good relationships with people at the Mayo Clinic, Johns Hopkins, Vanderbilt and other major medical centers. “They know they can come to me, and I know they’ll tell me the truth about what’s going on,” Roe says. Using what they learn in those conversations, he and colleagues in the Congressional doctor’s caucus have spent time with the man overseeing MACRA’s implementation: Dr. Pat Conway, CMS’s chief medical officer and deputy administrator for innovation and quality. “The devil’s in the details,” Roe says. “We brought (Conway) in and said ‘look, we want to help you get this right and when we’re hearing problems out in the field, for instance, if it’s an implementation issue where we need to wait a year, wait a year. Don’t cram it down and expect success when you know you’re going to get failure.’ So we’ve worked on that.” For all its difficulties, payment reform is the right direction for American health care, Roe says. “It’s the way to look at health care. A continuum of care from the time of healthy children’s lifestyles all the way through your life. And your patient becomes your partner in this. It’s to their benefit and to your benefit. Mainly, you want to get better outcomes to patients at lower costs. “We’ll get this right and there will be hiccups, there’s no questions about that. But before they become tidal waves, we just want them to be little ripples in the pond.”

“The right thing to do,” but it takes everyone Physician groups are adapting to healthcare reform, Panek and Moulton say. Hospitals are too, as well as they can while being hard hit by the continuing shifts to outpatient care. But two more important pieces will be part of a successfully completed puzzle, SEE REFORM, 48 August 2016 bjournal.com

REFORM, CONTINUED

provider representatives say. One is the payer community, led by CMS and the government. The other piece is the patient population itself. On the regulatory end, providers who speak to the Business Journal mention several points. Dr. B.J. Smith, who has a solo practice that dovetails well with the changes, says with the heavy reliance on data sharing between providers, some of the older privacy laws inhibit exchange of information. “We really depend on easy, quick information for those patients who are transitioning from the hospital to post-acute to home,” Smith says. “We need efficient exchange of information. Oftentimes privacy laws have, maybe unintentionally, gotten in the way of that exchange of information.” It’s also tough for smaller practices to meet the raft of reporting requirements necessary to meet CMS regulations under the new payment models. Smith expects small practitioners to align at some level with larger ones, or for entrepreneurs to help meet some of those requirements by creating

boutique services for smaller providers. But MSHA Chief Medical Officer Dr. Morris Seligman says with bonuses and penalties becoming more and more prevalent under the new model – and reporting requirements expensive to maintain – things could get as tough for small practices as they’re getting for hospitals due to the lower admission volumes. “If you are an independent physician, or even in a small group, the resources you will need not only from a tech perspective but also personnel for monitoring all this will be cost-prohibitive,” Seligman says. Beyond the pace of reform from above, the willingness for patients to take more responsibility for their own wellness is a critical issue. Moulton says a large part of SoFHA’s top line expense has involved home visits and case management under a team led by Carol Shrum, a nurse practitioner. Patients who comprise part of those “attributed lives” to which SoFHA CEO Panek refers are educated on their own disease processes, and cajoled to be part of the solution. “We have to create systems to make sure you will do well, and that means tracking you down when you don’t show up for needed

tests or needed appointments,” Moulton says. “That’s the paradigm shift that SoFHA has gone through over the last five years.” If Mary Snyder is any indication, some patients are responding well. She says she’s lost 80 pounds at the behest of her cardiologist, and does everything he tells her to in order to mitigate her CHF. “If he tells me to jump, I ask, ‘how high?’” Those kinds of responses will be imperative if the changes occurring are to be successful, providers say. Like Roe, they say the shift is the right thing. “It’s a major transformation for the hospitals, and it’s been a major transformation for our groups,” Moulton says. Panek says SoFHA and other physician practices have to consider the hospital systems a partner. “There’s things that we all agree on and we implement and there’s things that we approach differently, but we still talk and work through these things. We have to have the best hospital system, the best equipment, the best surgeons for us to do well. “Any link in the chain that’s weak, we’re in trouble. Because we’re accountable for all that.”

Market Facts You Should Know! Coming in October!

Market Facts includes charts, graphs, tables, numbers and statistics critical to commerce in our region. Eight sections will cover Real Estate & Construction; Business Resources; Employment and Economic Development; Education; Health care; Financial Services; Hospitality and Tourism and Market Demographics. As a member of our business community, you’ll want to see, analyze and keep the comprehensive information this annual publication provides: essential information about the people, the businesses and the local economy.

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Publication Date: October 2016 Advertising Deadline: September 2016 48

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On the Move Banking & Finance Matt Evans has been promoted to lead HomeTrust Bank’s new Portfolio Monitoring Group. Evans earned a bachelor’s in Corporate Finance from East Tennessee State University as well as an MBA with a concentration in Accounting from King University. Evans is active in the United Way of Washington County, Tenn., and is serving on the 2016 allocations committee. He is also a member of the Rotary Club of Johnson City, Tenn. HomeTrust Bancshares, Inc., the holding company for HomeTrust Bank, announced recently the bank has hired Corey Robert Webb as market president for the bank’s Tri-Cities Market. Corey Webb Webb has more than 15 years experience in the financial services industry serving in commercial loan, credit and client relationship management

roles, most recently as vice president, commercial banking relationship manager for First Tennessee Bank in Johnson City, Tenn.

Customer Service Mullican Flooring has promoted Kim Keys to customer service manager. A Johnson City native, Keys joined Mullican Flooring in Kim Keys 2005 as a customer service representative. In her new position, Keys will continue to work directly with Mullican’s distribution network while managing customer service operations for the company. “Kim has proven herself as a strong leader and skilled customer service professional,” says Brian Greenwell, vice president of sales and marketing. “Her expertise and depth of knowledge make her a tremendous resource for our customers.” Gena Anders has joined the sales team at Derby Publishing, parent company

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of The Business Journal of Tri-Cities, TN/VA. For the last 10 years Anders has been working in the manufacturing arena as a human resource manager, purchasing agent and Gena Anders program manager. It was there she learned the skills of taking care of the employees, employer and the customer. Anders enjoys meeting new people and working with them to achieve a common goal.

Management Todd Dale has been chosen as the new chief financial officer for the Friendship Family of Dealerships based in Bristol, Tenn. Dale has been controller for the company since 2014. Dale received bachelor’s degrees from both ETSU and King University and has an MBA from ETSU. He has more than 25 years of automotive dealership experience with 19 as a controller.

Awards & Achievements Walters named to Automotive News 40 Under 40 Dustin Walters, vice president, general manager and operating partner for Friendship Hyundai of Johnson City and Bristol has been named one of Automotive News’ 40 Under 40. This annual program honors 40 high achievers at new-car dealerships who are under 40 Dustin Walters years old. Automotive News evaluated nominations from across the U.S. and Canada and identified outstanding performers in a large field of top caliber talent at dealerships. This program recognizes leaders in the industry with significant business achievements at their particular dealerships. “I am delighted that Dustin has been honored with this prestigious award,” said Mitch Walters, owner of the Friendship Family of Dealerships. “He is a strong, well respected leader and puts 100 percent into every new and creative idea he comes up with,” he said. “Dustin continues to be an integral part of the success of the Friendship Franchise and I am very proud to see him be rewarded for his success.” Two BTES employees named TNCPE examiners Two employees of Bristol Tennessee Essential Services (BTES) have been appointed to the 2016 Tennessee Center for Performance Excellence Board of Examiners. Leslie Blevins, Customer Relation Representative, and Diane Smith, Supervisor of Customer Service, were appointed by the Board of Directors of TNCPE to the 2016 Board of Examiners. Blevins, in her seventh year with the program, will be serving as a Master Examiner and Smith will be serving for the second year. Each year, the TNCPE Award Program recognizes local, regional, and statewide organizations that demonstrate excellence in business operations and results. BTES received the top award – the Excellence Award – from TNCPE in 2012 and is one of only three organizations to ever receive the award twice, first receiving it in 1994. Baker Donelson named a Gold Standard firm For the second consecutive year, Baker Donelson has been certified by the Women in Law Empowerment Forum (WILEF) as a Gold Standard Firm. WILEF’s Gold Standard Certification emphasizes the leadership roles achieved by equity women partners, rather than the policies or practices of the firm or the overall number or percentage of women in the partnership. Law firms with 300 or more practicing lawyers in the United States are eligible for the 2016 WILEF Gold Standard Certification if they successfully demonstrate that women represent a meaningful percentage of their equity partners, of their highest leadership positions, of their governance and compensation committees and of their most highly compensated partners. Baker Donelson was one of only 31 law firms across the country to earn this certification in a year when WILEF tightened some of the criteria that firms were required to meet in order to demonstrate their commitment to promoting and fairly compensating women.

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Med Briefs Mountain States, Wellmont selected for CMS Oncology Care Model The Centers for Medicare & Medicaid Services (CMS) recently announced it has selected both the Wellmont Cancer Institute and the regional cancer centers of Mountain States Health Alliance as parts of nearly 200 physician group practices and 17 health insurance companies to participate in a care delivery model that supports and encourages higher quality, more coordinated cancer care. The Medicare arm of the Oncology Care Model includes more than 3,200 oncologists and will cover approximately 155,000 Medicare beneficiaries nationwide. This program kicked off July 1 and will run five years. “The Oncology Care Model encourages greater collaboration, information sharing, and care coordination, so that patients get the care they need, when they need it,” said Health and Human Services Secretary Sylvia M. Burwell. “This patient-centered care model fits within the Administration’s dual missions for delivery system reform and the White House Cancer Moonshot Task Force – to improve patient access to and the quality of health care while spending dollars more wisely.” The Oncology Care Model encourages practices to improve care and lower costs through episode- and performance-based payments that reward high-quality patient care. The Oncology Care Model is one of the first CMS physician-led specialty care models and builds on lessons learned from other innovative programs and private-sector models. As part of this model, physician practices

may receive performance-based payments for episodes of care surrounding chemotherapy administration to Medicare patients with cancer, as well as a monthly care management payment for each beneficiary. The two-sided risk track of this model would be an Advanced Alternative Payment Model under the newly proposed Quality Payment Program, which would implement provisions from the Medicare Access and CHIP Reauthorization Act of 2015. Practices participating in the five-year Oncology Care Model will provide treatment following nationally recognized clinical guidelines for beneficiaries undergoing chemotherapy, with an emphasis on person-centered care. They will provide enhanced services to beneficiaries who are in the Oncology Care Model to help them receive timely, coordinated treatment. These services may include: • Coordinating appointments with providers within and outside the oncology practice to ensure timely delivery of diagnostic and treatment services; • Providing 24/7 access to care when needed; • Arranging for diagnostic scans and follow up with other members of the medical team such as surgeons, radiation oncologists, and other specialists that support the beneficiary through their cancer treatment; • Making sure that data from scans, blood test results, and other tests are received in advance of patient appointments so that patients do not need to schedule additional visits; and • Providing access to additional patient resources such as emotional support groups, pain management services, and clinical trials.

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Account Executive Opportunities This is a perfect opportunity for a retired individual who is still interested in earning a good income as an independent businessperson and who enjoys being active in their community. We are seeking dynamic professionals to join the sales team of the region’s leading business-to-business publication, The Business Journal of Tri-Cities TN/VA. This is a commissioned flex-time position and is a great fit for a seasoned business professional with strong consultative sales skills. The desired candidate will have a high level of professional verbal, written and interpersonal skills. There are opportunities available in the Greeneville/Rogersville and the Abingdon/Bristol markets. For consideration please email a cover letter, resume and salary history to: Bill Derby, Publisher at bderby@bjournal.com. The Business Journal of Tri-Cities TN/VA is an equal opportunity employer. The company considers applicants for all positions without regard to race, color, religion, national origin, age, marital status, disability, veteran status or sexual orientation as protected by applicable city, state or federal law.

August 2016 bjournal.com

11/

The Last Word

Living, eating, sleeping and fighting as a team By Leton Harding

ne of my favorite movies is “Patton” starring Wise County native George C. Scott. I particularly like the scene in which General George S. Patton explains why he believes the Germans will attack (which they did at the Battle of the Bulge) and that he and his troops need to be prepared. “There is absolutely no reason for us to assume that the Germans are mounting a major offense,” Patton says. “The weather is awful and their supplies are low. The Germans haven’t mounted a winter attack since Frederick the Great. Therefore I believe that’s exactly what they’re going to do.” This was Patton’s moment, the Third Army’s moment, to show that if you are prepared you can win the battle. I could go on and on about the following scenes, about the unpreparedness of others (General Montgomery said he wouldn’t be ready for “some weeks.” Patton said his troops could attack in 48 hours.) and about how Patton’s being prepared carried the day. I think of this movie in the context of what our

bjournal.com August 2016

region, Southwest Virginia (SWVA), has already done to be prepared for the economic battle we face competing in a global economy. We have put in place broadband infrastructure that other areas in Virginia are just now addressing (see recent stories about Roanoke). We have 4G wireless services that are a must in retaining and attracting millennials in today’s smartphone-app-driven world. Credit for the aforementioned developments goes to our many economic development groups (Virginia Tobacco Commission, VCEDA, Lenowisco, County IDAs) that took a leap of faith, even when some did not see the value of the efforts. We have Colleges (UVA-Wise, MECC) and high Schools (John I. Burton) that have in place and are developing software engineering and cyber security programs that are leaders in the education community for the most needed jobs in the United States. We have come together as a region through the SWVA Economic Forum to put aside geographic boundaries in order to undertake and plan collectively for the economic growth and well-being of our citizens, and most importantly, for our children. We have had a governor tell us there are thousands of well-paying jobs ($80,000+ on average) that will come here if we develop and train our workforce. Think of the movie “Field of Dreams” – build it and they will come. Because of this preparation, we as a region now stand at the doorway to a new future. It would be an understatement, however, to say the moment may be fleeting if we all do not fully support this gift of change. I encourage and implore all influence-makers and leaders to grab hold of this lifeline. Make SWVA a bastion of economic growth and opportunity for our children and for those who will be drawn to a wonderful place to live. Over the years our ancestors came together to support their neighbors, from raising a barn to heeding the needs of families facing troubles. It is now time for us to come together to support our economic future. Leton Harding is CEO of Powell Valley National Bank.

NOTHING BEATS

CARE YOU CAN TRUST. The Wellmont CVA Heart Institute, a proven worldwide leader in clinical research, continues to be at the forefront of groundbreaking heart care with Absorb – the world’s only fully dissolvable stent. Absorb restores heart vessels to their natural states, leaving nothing behind but a healthy artery.

As the nation’s No. 1 enroller of patients in a clinical trial leading to this breakthrough technology and co-authors of an article in the nation’s leading health care magazine describing the breakthrough, the heart institute is our region’s most experienced team – and the only one to offer Absorb.

D I S S O LVA B L E H E A R T S T E N T S O N LY AT

Nothing beats the commitment of expert physicians. And to you and your family, August 2016 NOTHING CAN MEAN EVERYTHING. To learn more visit wellmont.org/absorb.

bjournal.com

bjournal.com August 2016