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Community is key at his hospital

John Galati is president and CEO of Clifton Springs Hospital & Clinic.
John Galati, the president and CEO of Clifton Springs Hospital & Clinic, makes an odd contrast with the institution he heads.
Compared to the harried pace of most hospitals, Clifton Springs seems decidedly laid back. A greeter cheerfully directs visitors and patients to their destinations. Staffers move at a deliberate but unhurried pace. Even the hospital’s emergency room seems calm.
Set on the site of a former golf course, Clifton Springs Hospital has parklike grounds. Green slopes set a tone of bucolic serenity. One crosses a footbridge over a stream to enter, passing a small pond in which ducks swim, clamoring for the breadcrumbs a small child tosses as her beaming mother looks on. A harpist comes in several days a week to play for patients.
“Most people don’t like to come to the hospital. People have fear,” Galati says. “We try to do our best to make them comfortable.”
Clifton Springs Hospital is a small, community hospital. It is licensed for fewer than 300 beds, takes in revenues of some $50 million a year and employs a staff of 840, or 640 full-time equivalents. Total visits to its emergency department in a year are roughly 12,000. By contrast, Highland Hospital in Rochester, with roughly the same number of licensed beds, employs more than 2,000, sees some 28,000 patients a year in its ER and takes in more than $200 million.
Galati, 57, cuts a trim and somewhat natty figure. He is roughly five feet eight inches tall, slender with a full head of salt-and-pepper gray hair. He walks and speaks quickly, radiating an intense nervous energy as he tosses off rapid-fire sentences.
Leading a visitor on a tour of the hospital, he strides through its corridors, greeting staffers. He seems to be on a first-name basis with all and is careful to introduce each one. It is Galati’s habit to make a circuit of the hospital at least once a day. Walking the halls keeps him in touch with the institution’s rhythms and on top of its problems, he says.
Each weekday, Galati makes a roughly 30-minute drive, arriving at 6 a.m. or so from Pittsford where he and his wife, Linda, have lived since relocating from Galati’s native Jamestown a dozen years ago. His workday generally stretches to 12 hours or longer.
“I live in Clifton Springs,” Galati says. “I only sleep in Rochester.”
Time spent at the hospital is not time he begrudges. In addition to the long workdays, Galati volunteers at fundraising events and at the hospital, working in the acute-care section or in the 100-bed skilled-nursing unit included among Clifton Springs Hospital’s 262-licensed beds.
His children-a daughter, 37, and son, 35-are married with children of their own, Galati says, so he feels less pressure to rein in his work time. Not that Galati eschews play. He and Linda are taking golf lessons. He also hikes, hunts and fishes.
Galati cooks, too, whipping up specialties such as a traditional Italian zucchini dish in which the zucchini’s innards are scooped and saut?ed in olive oil with other vegetables and sausage, replaced in the plant’s shell and baked. It’s a process Galati lovingly describes as he relates having prepared and served the dish to an elderly patient.
“John is old school,” one hospital staffer confides admiringly in a whispered aside. “When he sees a piece of paper on the ground, he bends down and picks it up.”
During a roughly 20-minute circuit of the hospital, Galati in fact pounces on five or six stray scraps. He seizes on the offending bits, crumpling and pocketing them without breaking stride or pausing in his running description of the operating rooms, office and patient rooms.
Galati stops briefly to confer with the maintenance team, a father and son who are two-thirds of a family trio employed by the hospital. The men are installing a bar on a wheelchair to keep the folding chair from folding. Lately, friends or relatives wheeling out a discharged patient seem to have been popping the wheelchairs into the trunks of their cars, Galati explains. When a chair is needed for an admission, too often none can be found.
“We’re experimenting,” Galati says. “Maybe this will keep people from walking off with them.”
He seems more puzzled that someone would steal a wheelchair from a hospital than resentful. Galati points out the operating rooms and the patient rooms, all of which, he says proudly, are private.

Berger Commission

Along with other Rochester-area hospitals, Clifton Springs last November escaped an ax that fell on many of the state’s hospitals with the release of the final report of the Commission on Health Care Facilities in the 21st Century, known as the Berger Commission.
Formed under the Pataki administration, the Berger Commission was charged with evaluating New York’s hospital-bed count with the understanding that the count was many beds too high. Unless the Legislature said no to the Berger recommendations, which it did not, the commission’s judgment would be final. If it said beds should be cut or a hospital should close, it would be so.
Except in the Rochester area, the Berger Commission called for large bed reductions and for hospital closings. Driving the recommendations: Low utilization drives up health care costs. Hospitals have to pay to maintain rooms that are not generating any revenue to pay their own upkeep costs. Fewer beds mean a more efficient system.
Rochester’s city hospitals were spared because they chronically are overbooked, a condition that makes them more financially secure but creates other problems. Clifton Springs Hospital, along with other smaller outlying Rochester area hospitals, got off with what sounded like a warning.
Clifton Springs Hospital, Canandaigua’s F.F. Thompson Hospital in Ontario County and Newark-Wayne Community Hospital in Wayne County sit within minutes of each other and habitually run occupancies as low as 40 percent. The medical staff from all three had said they would consider a plan to abandon the three community hospitals and move to a new, centrally located facility, the report states. It does not say that plan should be implemented, however.
Clifton Springs Hospital’s low occupancy figures are an illusion, Galati says. The hospital is licensed for 262 beds and uses only half of them for patient care. Galati ticks off the count: Routine patient care, an intensive care unit and a unit for chronic ventilator patients account for 64 beds. Another 100 beds are devoted to a long-term care, skilled-nursing unit, and 48 make up mental health and addiction recovery units. The remaining 50 rooms have been converted to offices or other uses, and are paying their way. Other medical uses might be found for some, Galati says.
Galati, like his counterparts at the other hospitals, is adamant: No consolidations are under consideration. The three hospitals cooperate regularly, Galati says. They share much of their medical staff, for example. F.F. Thompson and Clifton Springs have talked about merging, but they are not likely to do so.
“We talk about it all the time,” Thompson Health president and CEO Linda Janczak says. But any serious consideration of joining F.F. Thompson and Clifton Springs happened “a long time ago” and is not likely to re-emerge.
Her hospital and Galati’s work together on common issues and have good relations, Janczak says. Galati is “a very dedicated, committed health care CEO” who is “personable, talented and easy to work with.” But she sees the institutions as almost certainly staying separate.
There might be practical benefits to such a merger, Galati concedes. But in the end, he would never recommend it.
“What makes this place so special,” he says, “is the relationship among the board of trustees, medical staff, employees and volunteers.”
In a merger with even the most benign and friendly partner, Clifton Springs could lose the sense of community that drives it now, Galati fears.

Long history

Clifton Springs Hospital was founded in 1850 by Henry Foster M.D., an advocate of water cures. A therapy prescribing mineral, fresh and sea water baths as cures for a variety of ills, the water cure had a heyday in the 19th century, when curative baths at elegantly appointed spas were magnets for U.S. and European gentry.
Drawn to Clifton Springs by what he saw as a happy combination of sulfur and fresh-water springs and driven by a religious vision he compared to St. Paul’s on the road to Damascus, Foster enlisted investors to set up a small, private spa. He eventually grew the spa into a sanitarium, adding brick buildings, a gym, a solarium and a chapel. The hospital and spa drew many, turning it into a major economic engine in the village.
The baths continued to be offered by the hospital through all of its changes, but as the popularity of the water cure diminished in the 20th century, their use faded. In 2000, largely at the urging of Clifton Springs Hospital chairman Drew Morris, the hospital’s spa was revitalized.
Morris is a longtime Clifton Springs resident in his late 80s and a powerful figure in the Ontario County village. Galati calls Morris, with whom he confers at least once a week, “a personage.” Morris says of Galati, “He has done a lot for the hospital. I have complete confidence in him.”
Morris heads G.W. Lisk Co., a firm founded in Clifton Springs by his family in 1910 to make baking pans and hand-pumped fly sprayers. It now makes solenoids used in military and industrial applications and has plants in Britain and Ireland. Its largest facility, a 300,000-square-foot factory, is in Clifton Springs.
Clifton Springs Hospital’s newly revitalized spa is part of an integrative medicine center, which is headed by Les Moore N.D., a doctor of naturopathy. Naturopathy is a medical discipline that stresses natural treatments such as herbal medicines, sunlight and therapeutic exercise.
And the Clifton Springs integrative center has a distinctly new age feel. It offers acupuncture, chiropractic, homeopathic treatments, color therapy, light treatments and massage therapy as well as hydrotherapy featuring sulfur or plain spring water baths. The center includes an extensive herbal apothecary where a trained herbalist mixes infusions, powders and herbal medicines, including recipes taken from traditional Chinese and Indian ayurvedic texts. It also offers a menu of holistic spa treatments, including facials, manicures, pedicures and waxing.
Galati initially was not an enthusiastic proponent of the spa revitalization project, but once it became clear that the board wanted the project, he put it together efficiently and made it work, Morris says.
Galati sees the spa and alternative medical services as an attractive addition to the hospital but not a make or break feature. They turn a profit, he says, but the center contributes less than 1 percent of the hospital’s total revenues.

Jamestown roots

Galati has headed Clifton Springs Hospital since 1995, when the hospital recruited him from Woman’s Christian Association Hospital in Jamestown, where he had been chief operating officer since 1986. He had worked there since 1976, when, Galati says, the James-town hospital’s chief called him to suggest, “It’s time for you to come home.”
Not far from the Pennsylvania border, Jamestown, where Galati was raised, once was a furniture manufacturing center. Many of those companies are gone, leaving the Southern Tier town much diminished as a manufacturing center. Jamestown also is the hometown of Lucille Ball.
Galati’s father, who died at 80 in 2000, worked as a wool buyer and foreman for the National Worsted Mills woolen mill and later as a salesman for a restaurant supply firm. His mother, who is 90 and in a nursing home south of Buffalo, was mostly a homemaker but worked for a time for the Automatic Voting Machine Co. in nearby Gerry.
Galati is a twin. He is three minutes older than his brother James. Galati is convinced that he and his brother are not identical twins, even though his mother says otherwise. James Galati lives in Gowanda. An older sister lives in Arizona.
When Galati was in college during the height of the Vietnam War, he and his brother drew 26 in the Selective Service lottery, a number low enough to make draft notices upon their graduation from college a certainty.
An Eagle Scout who considers his father, a decorated World War II veteran, a prime role model, Galati did not consider avoiding the draft. Still, he says, neither he nor his brother was particularly anxious to see combat in Vietnam.
His brother joined the National Guard, whose members were then not sent to overseas duty, Galati says. And as a student at Ohio University in Athens, Ohio, Galati joined the Reserve Officer Training Corps, which let him choose a military assignment.
Galati met and married Linda, an Ohio native and fellow student, while they were in college. Their first child came in 1970. Galati majored in psychology and first imagined a career in counseling.
He chose hospital work as a military occupation, however. After serving two years as an administrator at the Watson Army Hospital in Fort Dix, N.J., he emerged from active duty as a first lieutenant and in 1973 immediately enrolled in a master’s program for hospital administration at SUNY Stony Brook, earning a degree in health services administration in 1975.
His first civilian hospital job was as an assistant administrator at Spencer Hospital in Meadville, Pa. He stayed only a year, decamping to Jamestown in 1976. Over 18 years at the WCA Hospital, he steadily advanced from assistant administrator to his final position as vice president and COO.

Expanding services

As Clifton Springs Hospital CEO, Galati has helped install an impressive range of specialty services, some of which are more often found at larger institutions. The hospital has a wound treatment center with hyperbaric chambers, for example, and is slated next month to open a joint-replacement center where patients will have artificial knees and hips implanted.
Clifton Springs Hospital this month applied to the state Department of Health for permission to install a 14-bed alternative long-term care unit. If approved, it would be the first in the state.
Such units treat patients who have needs too complex for regular short-term rehabilitation stays but are still not suitable for longer term skilled-nursing care. The Clifton Springs application is eagerly backed by Rochester hospitals. Such patients-people with stable but serious conditions on ventilators, for example-contribute to the city hospitals’ growing overcrowding problems, Strong Health COO Kathleen Parrinello says. Forced emergency room shutdowns in the city, known as code reds, are less often caused by too many ER patients than by too few rooms into which to move ER admissions.
Relocating extended stay patients to another facility would not solve all of the city hospitals’ overcrowding problems, but it would take much of the pressure off, she says. As it is, Strong Memorial Hospital, the more than 700-bed teaching hospital affiliated with the University of Rochester School of Medicine and Dentistry, too often has to keep patients admitted through its ER in temporary beds in hallways until space on a floor can be cleared.
Strong Health is anxious to see the alternative long-term care proposal move, but it did not come up with the idea, Parrinello says. Galati approached Strong more than a year ago. She and other Strong Health officials have been working with him since then.
Galati says he came up with the idea as a way of shortening waits for Clifton Springs Hospital patients needing transfers to city hospitals for care or services the hospitals provide.
The alternative facility is not a sure thing. Though such facilities are used with good results in other states, New York has put up bureaucratic roadblocks that have kept any from getting started here.
Securing Medicare payment, which would be essential to such a unit, is no easy task. The Center for Medicare and Medicaid Services requires such units to treat patients without reimbursement before it agrees to pay for anything. And suspicious that hospitals might use such facilities to improperly eke out extra payments, CMS scrutinizes all alternate long-term care unit applications closely.
Noting the payment and approval hurdles it faces and Galati’s high energy determination, Parrinello says, “I am really not sure how they are planning to get it all done, but I think John will do it.”
rbj@rbj.net / 585-546-8303

08/24/07 (C) Rochester Business Journal

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