Big South Fork Medical Center CEO Hal Leftwich is shown with the hospital's new 64-slice CT scanner, which was put into service in September 2018. Ben Garrett | IH

It hasn’t been long since Hal Leftwich left the coast for the mountains, making the move from South Florida to Tennessee’s Cumberland Plateau, but that doesn’t mean he hasn’t been around long enough to formulate a vision for what he hopes Big South Fork Medical Center will become.

Leftwich was named the Rennova-owned hospital’s new administrator last month. From his office on the ground floor of the professional building on the hospital campus, he talks about his plans for the future — one that includes a projects list that is already “three to four pages long.”

But the first step to implementing that vision wasn’t implementing Hal Leftwich’s goals. It was putting a team into place that can provide the local community perspective the hospital needs to thrive. Since Leftwich’s arrival, the hospital has appointed an advisory board that consists of Oneida Special School District Director of Schools Dr. Jeanny Hatfield, Scott County Sheriff Ronnie Phillips, Mountain Peoples Health Council CEO James Lovett, First National Bank President Mark Kline and Tennessee Plateau Oncology’s Tracey Stansberry.

Leftwich describes the advisory board as being a group of people who can help the hospital set its course and provide vision for what the hospital can be — focusing on quality of care, patient needs and the services the hospital provides.

“Right off the bad, most of these people can start laying down things they think we should be doing,” Leftwich said.

One thing he is immediately sure of: Big South Fork Medical Center has no reason to be competing with local primary care physicians.

“There’s no reason for me to do that,” Leftwich said. “We should be an adjunct. We should be helpful and fulfilling the role that the local doctors need us to fulfill. We’ve got a good, strong group of physicians in this community. As I’ve met them, it’s obvious they care about the patients and that’s part of what has kept this medical community going even though the hospital has sputtered at times.” 

Unique Needs

Leftwich — who is a native of Central Florida but who attended undergraduate school at Eastern Kentucky University — is a career hospital administrator. He spent the past 26 years with a contract management company that included 16 years at a hospital on the Mississippi coast and another 10 years at a hospital in the Florida Keys. 

Along the way, he’s worked at hospitals large and small. His first full-time job in hospital administration was as an assistant administrator at a 411-bed hospital, which would dwarf the 25-bed Big South Fork Medical Center. But he’s also worked at smaller hospitals that are similar to Scott County’s; in fact, the most recent hospital he managed was a 25-bed facility in the Keys.

The diverse experience has shown Leftwich that every community is different, with unique needs. Thus, every community hospital requires a unique approach.

“We have different needs here than they have in South Florida and southern Mississippi,” he said. “We have some of the same chronic diseases, like COPD and diabetes, but the community needs are unique. It’s a matter of taking the resources we have here and using them.”

Leftwich points out that there’s a strong base to work from, beginning with the hospital’s respiratory therapy department, its radiology department, its emergency room and its inpatient care. From there, other things will be explored — getting the operating room back up and running will be an important early step, and Leftwich hopes to put more specialists to work.

“That’s an important mission for us,” he said. “We have patients we could take care of here locally if we had access to a few more specialists. We want to make sure our people don’t have to drive down the mountain to access a high level of care.” 

There are some things a rural hospital will never be able to do, of course. You will never see heart surgeries being performed at a facility like Big South Fork Medical Center. But that doesn’t mean cardiologists can’t care for their patients here. 

“We can’t do heart surgery, but we should be able to get you diagnosed, stabilized and ready if you need heart surgery,” Leftwich said.

From Florida to Tennessee

At first glance, the island life of the Florida Keys and the mountain life of northern Tennessee don’t seem to have much in common. But Leftwich fondly remembers his college days in Richmond, Ky., which is where he wound up after following some of his Central Florida buddies who were at EKU on football scholarship. And, all these years later, he wound up back in the Appalachians.

“I’m here because I wanted to live in this part of the country, and my wife (Paula) wanted to live here,” Leftwich said.

After obtaining his bachelor’s from Eastern Kentucky, Leftwich finished his master’s at Xavier in Cincinnati, did a residency in Florence, S.C. and later worked in Greenville, S.C. He’s been all around the eastern U.S. — and now he’s right back to where he first got started after high school, or at least near it.

“It’s amazing how nice the people are that you meet here, how well they treat you,” he said. “Paula said it, and I agree: Everybody acts like they’re your friend.”

As Leftwich has gotten settled in at work, his wife — who is a painter — has gotten settled in around town.

“She has started exploring, taking the dog for walks in the city park. We’re just amazed at some of what’s here,” Leftwich said. “The city park and the sports complex at Bear Creek are just incredible for a town this size.” 

As he and his wife get established in the local community, Leftwich wants to do the same with the hospital. The hospital is going to have a presence at the upcoming Fall on the Mall festival, he said, and he envisions taking part in health fairs, being involved in the schools and working in conjunction with Mountain People’s and other local organizations.

“It’s just like when you’re pursuing grant money,” he said. “If you have three or four agencies come together for a project, it’s a much strong application because they know there’s a much better chance that the project will succeed.” 

Then there’s the hospital campus itself. Leftwich jokes that he’s “quite fond” of the building, because “they started construction the year I was born.” He points out changes he would like to make to the hospital lobby to make it more welcoming, he’s looking at a fresh coat of paint on the outside of the building, fixing the long-out-of-service elevator — little things to make the facility stronger.

Combatting Attitude

There’s no denying that there’s a certain feeling of apprehension around Scott County when it comes to the local hospital — almost a sense of dread, a feeling that it’s just a matter of time. After all, people reason, the hospital has closed twice before. What can Rennova offer that Pioneer Health Services and St. Mary’s couldn’t? 

Leftwich isn’t oblivious to the attitude, and he doesn’t try to shy away from it. Instead, he says, the best way to change minds is to walk the talk.

“We plan to be here a long time,” he said. “Every time Seamus (Rennova president Seamus Lagan) talks to the employees here, he emphasizes our commitment to being here. Having the Jamestown hospital helps make us stronger. We might not be able to support having a surgeon on our own, but having two hospitals, we can support a surgeon between us.”

The bottom line? “We need to show people that we can provide darned good service and that we can do it consistently and we’re serious about expanding and meeting the needs of the community,” Leftwich said.

Getting the operating room back in order will allow surgeries to resume at the hospital. Fixing the elevator will allow the first and third floors of the hospital to be used more efficiently without limitations on wheelchairs and stretchers. The hospital is averaging eight-to-10 patients per day in its MedSurge unit — a level that Leftwich said will sustain the hospital, but he wants to grow for the future. And the hospital has made application with the state for a status change to a critical access facility, which will help with Medicare reimbursements going forward.

“I’m impressed with the number of people I meet that say, ‘We really need that hospital here,’” Leftwich said. “It’s been closed twice before so people know what it’s like to not have it. But now we have it. And if the community supports us, we can continue to grow.”

This article is the September 2018 installment of Business Spotlight, presented on the third week of each month by the Scott County Chamber of Commerce as part of the Independent Herald's Back Page Features series. A print version can be found on Page C8 of the September 20, 2018 edition of the Independent Herald.