It all started, as many big projects do in Southwest Florida, with Patty and Jay Baker.
The Bakers, one of the region’s most active and recognized philanthropic couples, had high praise for the Hospital for Special Surgery in New York City — the world’s leading academic medical center focused on musculoskeletal health — after he was a surgical patient there.
As a member of the board at Naples Comprehensive Health, he offered to connect the healthcare system’s President and CEO, Paul Hiltz, with the powers-that-be at HSS. The rest, as they say, is history.
Hiltz, who came to Naples in 2019 to take the CEO role at NCH, said Baker offered early on to make the introduction at HSS.
“When I came here and started talking about partnerships, Jay said, ‘Hey, if I can help, I know the people up there [at HSS] really well; that’s the number one orthopedic hospital in the country and if you’re interested, I’d like to make an introduction,’” Hiltz recalled during a recent interview. “I was very interested. Jay and I flew up [to New York] with a couple of others on our leadership team. We toured the facility, met the leadership, looked at the data and just felt that the partnership would be perfect for us.”
A $20 million fundraising challenge grant from the Bakers got the project off the ground, and in November 2023 NCH broke ground on the Patty & Jay Baker Pavilion, a 100,000-square-foot facility on the NCH North Naples Hospital campus that will be the home of HSS at NCH.
The new hospital is expected to open this spring.
Hiltz said the goal set by Jay Baker and the rest of the board was to make HSS at NCH one of the best orthopedic hospitals in the country, offering state-of-the-art facilities that will become a “destination” for comprehensive outpatient and inpatient musculoskeletal services, and make it possible for those who live here not to have to travel for specialized surgery.
“We believe we’ve done that. We believe it’s got the very latest and greatest; Arthrex has also been involved in helping design and equip the building,” Hiltz said, referencing the role of the privately held Naples-based medical devices company in the project. “We’re really excited about how that is changing orthopedic care in this region.”
In a late 2023 statement announcing the collaboration, Dr. Bryan T. Kelly, HSS president and CEO, noted the commonalities between HSS and NCH.
“NCH and HSS are both patient-centric organizations committed to high-quality care, and we are aligned in our goal of making the highest quality orthopedic care more accessible to the people of Southwest Florida,” Kelly said. “This is especially important to us at HSS, where we feel a great sense of responsibility not just to help more people, but to consistently achieve the highest quality outcomes for patients.”
Building a ‘world-class’ orthopedic center
In addition to the latest in technology and equipment, Hiltz said NCH has also been recruiting doctors from around the country for what he said will be a “world-class” orthopedic center.
One of those physicians, Dr. David Backstein, was recruited to be the medical director for HSS at NCH; he was formerly at the University of Toronto where he led the division of orthopedics at Mount Sinai Hospital. Dr. Sheeraz Quireshi, based at HSS in New York City, serves as chief medical officer of HSS Florida.
Backstein, a surgeon specializing in primary and revision total knee replacement, said in an interview that he was drawn to the project because of the opportunity to help build it from the ground up.
“As a surgeon, the number one thing for me is to have a self-contained orthopedic center,” Backstein said. “The hospital I was at before was 25 stories. We had every single surgery specialty … This is an opportunity to have an exclusively self-contained orthopedic facility that we, for lack of a better word, can control. We can control the patient experience better. We can control the type of surgery that’s being done, and we can control our quality. And we’re not going to be bumped by somebody whose aorta ruptured and our whole [surgical] day is canceled. It’s going to be our facility, and we’re going to do the volume that we feel we can do safely.”
Backstein said the project has recruited a group of nine physicians “cherry-picked” from around the country with “excellent educational backgrounds and training backgrounds,” to add to two longtime Naples orthopedic specialists.
Available procedures at the new hospital, according to information from NCH, will include spine and interventional spine surgeries; foot and ankle surgeries; hip and knee arthroplasty; sports medicine surgery; non-operative sports medicine; physical medicine rehabilitation; and musculoskeletal injury care.
According to his HSS at NCH online bio, Backstein has special expertise in minimally invasive and robotic techniques. And while the facility will include the very latest in technology, including robotic capabilities, he said it will be the surgeons who make the difference.
“More important than having the machines is that we’ve got surgeons that are adept at using them,” Backstein said. “And in terms of the building, we’re going to have some pre- and postoperative computer technology that allows us to assess the way people move and walk in a non-invasive way that’s extremely accurate. We’ll be able to better determine exactly what the problem is and then assess postoperatively if we fixed the problem.
“We’ll also be able to use that for research, and we’re going to have a lot of educational facilities; we’ve designed the building so that it’s really adept at educational experiences [for physicians].”
‘Elevating the experience’
On a late January hard-hat tour of the active construction site, HSS at NCH Vice President Justin Blohm provided The Naples Press a behind-the-scenes glimpse at some of the areas of the hospital that will make it unique, including the ambulatory surgical center that will incorporate Arthrex designs and equipment, and an observation theater for physician education.
Even with construction ongoing, the scope and scale of the project became clear.
On the first floor, the 100,000-square-foot Baker Pavilion includes the 20,000-square-foot Kapnick Foundation Ambulatory Surgical Center, with five operating rooms. The remaining 80,000 square feet includes clinic space, outpatient and inpatient rehabilitation, 15 private inpatient beds and five additional operating rooms on the second floor; the third floor will contain the imaging area for MRIs, CTs and two X-ray suites, with two additional rooms for office-based procedures, according to Blohm.
Asked what will make the new facility different from what is currently available for orthopedic patients in Southwest Florida, Blohm said it is the partnership with New York-based HSS, which he said has been ranked number one in the world for orthopedic care for the past 16 years.
“We’re elevating the experience and also the expertise for our patients, meaning there are no generalists in this facility,” Blohm said. “All of our surgeons have fellowship training, which is additional training to focus on their sub-specialty, such as knees or hips, or foot and ankle, hand, upper extremity, sports or spine. So, you are getting the surgeon that does only spine procedures, not the surgeon that does spine and elbow and knee.
“Having surgeons here that are hyper-focused on the types of surgeries they do just elevates the quality and level of care that we can provide. There are phenomenal orthopedic surgeons in this community; however, with our growing community and our active population, the need for specialists in the orthopedic realm is growing every day.”
Blohm also pointed out some of the special capabilities of the ambulatory surgical center, including the Arthrex-supported observation theater that looks into two operating rooms for educational purposes.
“We can also broadcast the cases that are going on in those operating rooms anywhere in the world,” Blohm said. “If one of our surgeons is presenting, they could be operating here in Naples and presenting in Germany.”
He said one of the most recent purchases is a minimally invasive spine robot — the first in Collier County — and two joint replacement robots.
“Going beyond that, with our partnership with Arthrex, they have dedicated to us that we will be some of the first surgeons in the world to utilize any new technology or equipment they come out with,” Blohm said.
Arthrex’s role
Asked about the role Arthrex — a global medical device company and leader in new product development and medical education in orthopedics — is playing in the project, the company said in a written statement from Dennis O’Keefe, vice president of communications, that it “collaborated with HSS at NCH to help design and equip their operating rooms and procedure rooms with the most advanced and efficient technology in the world.”
Furthermore, “In addition to our surgical imaging and data integration technologies, Arthrex products and minimally invasive surgical techniques will also play a critical role in supporting the HSS at NCH team as they deliver care and offer the community access to the latest innovations,” O’Keefe said.
Regarding any designs or equipment that will be unique to HSS at NCH, O’Keefe’s statement described modular glass walls inside one of the operating rooms and two of the procedure rooms in the ambulatory surgical center “that include beautiful beach scenes of Southwest Florida.
“Aesthetics and functionality are combined in the glass and set new standards of hygiene, as well as generate a unique atmosphere. The surface of the glass is microscopically flat and free of pores, making it resistant to living organisms. The modular glass room system provides the highest hygiene standards.”
O’Keefe said this partnership is the first of its kind for Arthrex in Southwest Florida, and that education is at the core of it.
“Arthrex takes great pride in offering both physicians and surgical staff access to world-class education and training opportunities on a regular basis,” he said in the statement. “Ultimately, we know that patients want to have their best chance for an optimal outcome, and the level of education and training of the team will impact that. Locally, we have a dedicated team of Arthrex Technology Consultants for HSS at NCH that will provide surgical service support at the highest level.”
Asked if the Arthrex contributions to the project were donated by the company or paid for by NCH, and the approximate value/cost, the company declined to provide a cost estimate at this time but said in its statement that “services and equipment were purchased by NCH at a fair market value.”
Business model, remaining funding goals
With regard to the business model for the joint venture in HSS at NCH, both HSS in New York and NCH are nonprofits, but Blohm pointed out that the ambulatory surgical center — which he described as a “building within a building, with a dedicated entry and exit” — will operate as a for-profit entity.
“A lot of hospital systems are going to the ambulatory surgical center model as a way to diversify and to have new revenue streams with physician partners,” Blohm said.
Blohm described the ambulatory surgical center as “an investment opportunity” for HSS, NCH and physician investors to purchase shares in the entity. He said HSS will own 29% of the entity, NCH will own 31% and physician partners will own 40% of the entity.
“Initially we’ll have 10 physician partners, and as we recruit more orthopedic surgeons and as they begin building their practices, eventually they will have the opportunity to purchase shares in the ASC,” he said.
Asked about possible perceptions from patients that their physicians might want to recommend ambulatory surgery — where the patient typically goes home the same day — because of their financial interest in the center, Blohm said there will be strict guidelines on patient criteria for same-day surgery, and decisions will be made based on what is best for the patient.
For example, he said, it is typically for “very healthy patients, with low BMI [body mass index] and not many co-morbidities,” which occur when two or more medical conditions exist simultaneously in a patient.
“We [will] also disclose the physician’s ownership and investment in the ASC to all the patients,” Blohm said. “And a lot of it is dictated by insurance payors that are not providing inpatient stays for certain types of patients in certain types of cases. So, they are really also driving patients to the same-day ASC model, as well. But first and foremost is the patient, what is safe for the patient and what the best outcome will be for them.”
Blohm said much depends on whether or not a patient has someone to help them at home or to provide transportation for same-day surgery, which he said is increasing in popularity if patients meet the criteria.
“All over the country, ASCs are growing by leaps and bounds because patients love the opportunity to wake up in the morning, have surgery at 8 o’clock, and they’re back home recovering by 11 o’clock,” Blohm said. “It’s just a much better, more efficient process for surgery for the appropriate patient and appropriate types of surgeries.”
When it comes to total project costs, Blohm estimates that number at $140 million. And as The Naples Press previously reported, the Bakers’ initial $20 million challenge match was met this January.
According to NCH Chief Impact Officer Mara Hammond, NCH has raised $40.5 million from 272 donors to date of the $76 million in philanthropic funds needed for the project; she said the balance of non-philanthropic funding is from permanent bonds.
Hammond said in a written statement that a $7.5 million gift from The Kapnick Foundation, announced by HSS in late January, brought the total for the Baker challenge grant to $18.5 million.
“[Two] $1 million gifts, from Verne and Judy Istock and Paula Jo and Robert Boykin, pushed us over the finish line [for the match],” she said. “To continue momentum and strengthen community participation in this important project, Ann and Tom Stallkamp launched another challenge grant for gifts up to $50,000 each until their $1 million match is met, which has inspired more than 30 new donors to date.”
This story was originally published in The Naples Press.
