Health Care Sector Invests, Stays Healthy

YOUNGSTOWN, Ohio – Health care providers in the Mahoning Valley are forging ahead with new projects and investments, opening the doors to new clinics and breaking ground on multi million-dollar projects.

Others introduced new services, invested in new equipment and adapted their strategic plans amid COVID-19.

These are the latest advances in an industry that is essentially recession-proof, particularly in areas such as the Mahoning and Shenango valleys where the aging population ensures growing demand.

The most recent data from Team NEO showed GDP generated by the health care sector in the 18-county northeastern Ohio region increased 37% since 2001 to $22 billion – about 2.5 times the state average. In 2019, more than 270,000 were employed in health-care jobs in the state.

While the health care economy is strong, it isn’t immune to outside forces. The disruptive last two years have forced the industry to adapt its business model to the pandemic and address workforce shortages that plague all economic sectors.

Expanding Services and Capacity

To expand its service capacity, Mercy Health – Youngstown invested in new equipment and facilities for oncology, radiation therapy and, in July, opened a new ambulatory surgery center at 4147 Westford Drive in Canfield, says Dr. John Luellen, market president. The center offers orthopedic, podiatric and plastic surgeries, among others.

Adding the surgery center to operating rooms at St. Elizabeth Youngstown, St. Elizabeth Boardman and St. Joseph Warren, and its Howland surgical center, Mercy can meet increased demand. “We expect that to grow in 2022 as well,” Luellen says.

The surgery center is one of several health care construction projects completed or started in 2021. Steward Health added an orthopedic suite at its Elm Road center and completed renovations at Trumbull Regional Medical Center in Warren, notes Kevin Reilly, executive vice president of The Builders Association of Eastern Ohio and Western Pennsylvania.

“We’ve certainly had a lot of assisted living type work going on,” Reilly says.

The new $12.7 million, 50,000-square-foot Briarfield Place skilled nursing and rehabilitation center at 8400 Market St., Boardman, opened its doors last year. In May, the Youngstown Area Jewish Federation broke ground on a $3.7 million expansion at its Heritage Manor Rehabilitation & Retirement community at 517 Gypsy Lane, Youngstown.

DeSalvo Construction Co. Inc., contractor for the Heritage Manor project, completed its first phase, which includes 12 private rooms, says Joe DeSalvo, owner and president. Work on the second phase is ongoing and the third phase is set to begin, he says.

After a brief halt during the pandemic, health care construction and renovation projects have picked back up, according to DeSalvo.

“There was a noticeable pause while the world was trying to come to grips with the pandemic,” he says. “As time went on, and the economy reopened, things were back to ‘normal’ in terms of projects.”

One of DeSalvo’s largest health care construction projects is the Akron Children’s Hospital Mahoning Valley emergency department expansion, named the Leonard J. Fisher Family building. “We’ve already completed several phases,” he says.

Ground was broken in October for the project, which will expand the emergency department to 34,700 square feet. This spring, DeSalvo will begin an addition to the Youngstown Orthopaedic Associates building in Canfield, he adds.

Other projects completed in the Valley last year include the Southwoods Health Express Care at 225 E. State Route 14 in Columbiana, a $1.63 million ER unit at Trumbull Regional, a Steward Primary Care center at 1440 S. Canfield-Niles Road in Austintown, and the Salem Regional Medical Center’s immediate care center at Firestone Farms TownCenter in Columbiana.

SRMC Immediate Care provides walk-in care for minor, non-life threatening illnesses and injuries, says Dr. Anita Hackstedde, president and CEO of Salem Regional. It was particularly beneficial as an alternative for those seeking non-urgent care during the pandemic, she says.

The hospital system also began telehealth services and opened a flu and respiratory clinic for those with COVID symptoms and other respiratory illnesses, as well as an outpatient infusion clinic for monoclonal antibody treatment, she adds.

“Salem Regional Medical Center has continued to be mindful of the health care needs of all of our patients, including those who are experiencing chronic or serious medical conditions in spite of the pandemic,” Hackstedde says.

And the system looks to expand its footprint at Firestone Farms TownCenter with an outpatient medical pavilion there, she says. The three-story, 76,600-square-foot pavilion will include a surgery and procedure center, advanced imaging, and infusion center and physician offices. The project should be complete by mid-2023.

“The Columbiana project is part of the hospital’s strategic plan to address the region’s increased demand for more convenient and cost-effective access to advanced procedures and treatment,” she says.

The Cost of the Pandemic

The start of the pandemic saw many patients avoiding elective procedures and some providers postponing them altogether. That led to revenue shortfalls for some providers, forcing them to adapt and leverage state and federal assistance.

Through June 2021, Salem Regional lost more than $10 million in revenue from temporarily closing elective services, including surgeries, Hackstedde says.

Governmental relief programs, “when combined with our overall financial strength and stewardship, have enabled us to navigate through these unprecedented times,” she says.

Mercy weathered the pandemic with federal and state support amid a dip in revenue, Luellen says. “I’m not sure that any provider’s strategic plan they had going into the pandemic is the same,” he says.

After restrictions were lifted, hesitancy among some patients remained, stagnating patient volume, he says. While it’s rebounded, hospitals have seen a surge in patient diagnoses and outpatient procedures because they opted out of preventive care, particularly cancer screenings.

“It’s very concerning when people delay those procedures,” Luellen says. “We have entire teams dedicated to reactivating those patients who used our services historically and to let them know it’s safe to come in.”

Higher in-patient volumes are putting a strain on hospital staff. Since February 2020, hospital employment has decreased by nearly 94,000 nationwide, according to the American Hospital Association.

Staffing challenges were never a concern for Mercy, Luellen says. To make up for shortages, “we’ve been able to invest heavily in agency staffing when necessary to ensure we keep those beds operational,” he says.

COVID disrupted staffing at Salem Regional, says Hackstedde, particularly among clinical staff. “We continue to closely manage our staff resources in order to provide care safely and efficiently,” she says.

The hospital system offers competitive wages and has expanded its onboarding process for clinical staff, including a nurse residency mentoring initiative for new nurses, she says.

Building the Health Care Pipeline

Health care employment is projected to grow 16% from 2020 to 2030, much faster than the average for all occupations, according to the U.S. Bureau of Labor Statistics. This projected growth is mainly the result of an aging population, leading to greater demand for health care services.

The Youngstown-Warren Ohio MSA has nearly 38,000 health care and social assistance workers, according to 2020 data from BLS.

Area providers rely on local educational entities for new recruits, particularly in nursing.

“We’re working very closely with our local education colleagues to ensure that the pipeline of new students is robust,” says Mercy’s Luellen.

Registered nurses have consistently led job postings at OhioMeansJobs.com. For instance, from Oct. 14 to Nov. 13, there were 20,684 job postings for RNs in the state.

“The biggest need I know right now is nursing,” says Art Daly, senior vice president for the Youngstown campus at Eastern Gateway Community College. “We’re developing those pipelines with a lot of our health providers locally.”

EGCC enrolls about 130 in its associate degree nursing program and another 40 in its practical nursing program at its Youngstown campus. “We probably have another 100 students looking to come into the program,” Daly says

Such programs ensure new nurses are prepared for the work before continuing their education to become a registered nurse, says Barb Meyer, pre-nursing, phlebotomy tech instructor and STNA site coordinator for Trumbull Career and Technical Center.

“Not all students who go through here have all the capabilities to make it through nursing school,” Meyer says. “We’re giving them a good baseline of information to help them decide if this is something they want to do.”

Meyer connects her students with colleges and helps place them with local employers. Some of her graduates go on to work locally as STNAs – state-tested nursing assistants, she says, particularly in elder care.

Enrollment for TCTC’s pre-nursing phlebotomy tech and pharmacy tech programs both maxed out this year and there is a waiting list for the first time.

Other health care programs at Eastern Gateway are also popular, including respiratory therapy, radiography and central services technician, says Gina Augustine, dean of Health, Science and Public Service at Eastern Gateway.

Enrollment for Health Information Management is growing amid greater demand for medical coders, she says. Eight years ago, Eastern Gateway had two second-year health information management students and four first-year students enrolled. Now, it enrolls some 2,400 across its system, she says.

For individuals who completed a medical coding program earlier in life, but didn’t immediately enter the workforce, month-long boot camps at Eastern Gateway get them where they need to be.

“Our success rate has been phenomenal,” Augustine says. “Every person that has taken both the boot camp and a national certification exam has passed.”

Boot camps cost $250 and comprise five three-hour sessions. Last year, Eastern Gateway had nearly 100 complete a boot camp, she says. Graduates go on to work for hospitals, doctor’s offices, medical supply stores and ambulance companies.

Eastern Gateway is exploring programs for surgical technician and nuclear medicine. It started a radiography program Jan. 31 in Youngstown.

“We just ordered two brand new ultrasound machines with a grant that we got. So we’re really excited about that,” Augustine says.

Imaging jobs start around $20 an hour, she says. Health information management jobs tend to start around $18 to $20 an hour. Students who complete the central services tech program earn $14 an hour to start but can start at $16 after they earn their certifications.

Some area hospitals are paying nurses around $32 an hour to start, Augustine says, while nurses who go through an agency are earning between $80 and $95.

Pictured: Barb Meyer, an instructor at TCTC, trains Alexis Parthemer on how to draw blood.