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Crouse Health’s Unique Culture: Blending High-Quality Care, Career Longevity, and a Community Feel

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By Elizabeth Landry

Both Seth Kronenberg, MD, and Lynne Shopiro, RN, have deep ties to Crouse Health – they both used the word “family” when talking about their connection with the hospital.

For Dr. Kronenberg, Crouse’s President and CEO, Crouse was there from the very beginning: it’s the hospital where he was born, and where his four daughters were also born. The first clinical position of his career, before going on to become a private practice internal medicine physician admitting his patients to Crouse, was as a pharmacy technician at the hospital. Over the years, Dr. Kronenberg also served as Crouse’s Chief Medical Officer and Chief Operating Officer before following in his father’s footsteps, who served as Crouse’s President and CEO from 2004 to 2014.

For Shopiro, who has served as Crouse’s Chief Nursing Officer since 2019, her professional connection with Crouse dates to when she enrolled at the Crouse Irving Memorial Hospital School of Nursing in 1980, graduating in 1982 and beginning her nursing career in 1983 at Crouse as a bedside nurse on a medical floor – a role she held for half her career. She eventually went on to become the nurse manager of the cardiac care unit, then the director of the cardiac services line at Crouse, before stepping into her current role. She’s now enjoying the 43rd year of her career with Crouse.

“Even before I came to nursing school here, this was my family hospital. My father had multiple surgeries at Crouse. I kind of grew up here, so it’s very family-oriented to me,” Shopiro shared.

One aspect of Crouse that both Dr. Kronenberg and Shopiro identified as being an integral reason for their long-standing, successful careers at the hospital is the organization’s deep-seated culture of respect among providers. For Dr. Kronenberg, this important, community-based culture stems from Crouse’s unique position as a high-quality, regional medical center with a strong commitment to the local area.

“We’re the only locally-governed hospital in Syracuse – we’re the only community hospital in the state that has a regional perinatal center and a comprehensive stroke program,” explained Dr. Kronenberg. “Our stroke team is consistently meeting – and exceeding – national averages for door-to-treatment times, and we’re the only hospital in the region with two hybrid operating suites to provide the most advanced endovascular stroke rescue capabilities. To be able to balance the high-acuity, high-end clinical care with that community hospital culture is something we’re very proud of. We’ve spent a lot of time continuing to enhance that, and it’s why I love coming to work every day.”

A Culture Built on Respect, Support, and Teamwork

According to both Dr. Kronenberg and Shopiro, a key element of the culture at Crouse is the strong sense of teamwork shared among the various providers and staff members.

“We’re all part of the care team. We say it takes a village to take care of our patients, and the relationships that our nurses have with providers, therapists, our environmental services staff, our nutritional services staff – it takes all of us,” said Shopiro. “To be able to have that culture where we’re all working together for what’s best for the patient, it’s priceless.”

Dr. Kronenberg shared that although working in healthcare can be very stressful and challenging at times, Crouse’s culture rooted in respect helps overcome challenges so employees can enjoy coming to work.

“Our culture is our people, and it’s about how everybody treats each other with mutual respect. All of us play an integral role in the patient experience. Healthcare can be extremely challenging, but when relationships are based on mutual respect, you’re able to get through those challenges,” he said, adding that the collaborative relationship between physicians and nurses especially is critical for high-quality patient care and patient outcomes, and is one of the things that makes Crouse special.

Since stepping into leadership roles at Crouse, Dr. Kronenberg said he’s gained a stronger realization of how important culture is to an organization. “Crouse’s mission is to provide the best patient care and promote community health. You can’t do that without a vibrant culture; you can’t have high-quality health care, have engaged employees and continue to enhance the services the institution delivers without that amazing culture as the backbone,” he said.

Workforce Development Pathways for Retention and Success

Looking back over her decades-long career at Crouse, Shopiro emphasized how the supportive culture among nurses and providers made each step of her healthcare journey enjoyable.

“I can’t say enough about the people who have supported me and mentored me through my career, particularly the nurses and physician staff here at Crouse. As a bedside nurse, the providers supported me in my journey, taking those teachable moments and helping me become the best caregiver I could be that patients deserve,” said Shopiro.

Alongside mentorship of newer employees, Dr. Kronenberg and Shopiro shared that Crouse leadership has also prioritized hardwired workforce development pathways as a means of increasing retention and battling workforce shortages across global healthcare as well as specifically within nursing – leading to more career longevity.

“Workforce development is one of our most important strategic priorities. We are in a global health care workforce shortage. When someone starts their journey at Crouse, we want them to spend their entire career here. In addition to being a hospital, we’re a very large business with 3,500 employees. Anything you want to do in your career, you can do at Crouse. That’s why we say, at Crouse, grow with us,” said Dr. Kronenberg. “We don’t want anyone to have to figure it out on their own. We’re partners with our employees, and offering those hardwired career pathways to help people progress is extremely important to us.” A partnership with Crouse’s union, SEIU 1199, offers a training fund program to help employees advance in their careers, he added.

On the nursing side of the equation, specifically, the Pomeroy College of Nursing is an important aspect of helping employees progress in their professional journey at Crouse.

“We’ve had several of our employees attend our nursing school and now they’re working as RN’s though out our hospital,” said Shopiro. “Recruiting exceptional nurses is important – but retaining the talented nurses we already have is equally essential. We want to be an organization where nurses choose to build their careers, grow professionally, and feel valued for the meaningful work they do every day.” Experienced nurses play an important role in mentoring, developing, and inspiring the next generation of nursing professionals, she said.

“We really focus on listening to our staff. I believe we have a strong shared governance model here at Crouse, including a structure where nurses are part of the decision making. I think nurses really feel held to an organization where they know they can make a difference,” explained Shopiro. “We also do a lot of wellness initiatives here at Crouse, and recognition is really important, as well. We want to make sure our nurses are recognized for doing their jobs well, and we do that through participating in the Daisy Foundation.”

Expanding, Advancing and Caring for the Community

For Dr. Kronenberg and Shopiro, maintaining the unique culture among providers and nurses at Crouse and building and retaining a strong workforce is central to Crouse’s mission to provide the best care for patients. In many cases, this can start in the Emergency Department where Crouse has the shortest wait times.

Several recent expansions and enhancements of Crouse’s health care services are advancing this mission, as well, Dr. Kronenberg explained, including the Sunny B Would Care Center that opened in July of this year and the recently completed transition to the state-of-the-art electronic medical record system, EPIC.

Crouse plans to expand cardiac services at the Miron Cardiac Care Center in the near future, which currently includes interventional cardiology, an EP lab and the region’s only pediatric catheterization lab. As the largest group of employed cardiologists in the area, and the first to offer Heartflow technology and the first to implant a Watchman device, this expansion will continue to grow Crouse’s cardiology service offerings.

Additionally, Crouse plans to modernize and expand the neonatal intensive care unit (NICU). Providing high-risk care for moms and babies from 17 affiliate hospitals within a 14-county region, Crouse is a Regional Perinatal Center with the highest-level NICU. With an average length of stay of 33 days, the NICU at Crouse cares for approximately 900 babies each year, including about 300 transferred in annually. As a Regional Perinatal Center, Crouse is able to provide access to a continuum of timely, appropriate obstetric and pediatric specialized care for those moms and babies who are high-risk, helping to produce healthier outcomes for the region.

Crouse’s outpatient footprint will expand, as well, through a new ambulatory site that is planned for the old Switz’s and CXtec building on South Bay Road in North Syracuse. Alongside expansion of services, Crouse also plans to continue and grow its role as a pillar in the community.

“We greatly value the trust that the community gives to us to provide care, and we want to return that trust by remaining active members of the Central New York Community,” said Dr. Kronenberg. “Crouse is the only locally governed, independent hospital in Syracuse. We have the ability to make local decisions about what’s best for our patients here and what the community needs. We’re more than a hospital, we’re also a member of the business community. So, community engagement is something we spend a significant amount of time on, whether it’s providing a visit to Hospital Land for first-graders or partnering with the Syracuse City School District or working with the American Heart Association. We greatly value our role in the community.”

Looking back to the organization’s history and looking ahead to its future, Dr. Kronenberg is excited about how Crouse’s unique position in the Central New York community will continue to serve the region for years to come.

“Crouse has been here for 140 years and we’ll be here for another 140 years,” he said. “We’re active members of the community, and we know there’s no solution for health care in Central New York that doesn’t involve Crouse Health. We’re very excited for all the growth that’s coming to our region, and we know we’re going to be here to meet the demands of the community as we move forward.”

The Impact of the USA v Canada Tariff War on the NYS Construction Industry

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Earl R. Hall, Executive Director, Syracuse Builders Exchange

The continuing trade dispute between the United States and Canada is creating a significant level of uncertainty for the New York State construction industry. The issue is particularly important to New York because Canada is the state’s largest trading partner, and Canadian-sourced materials, such as lumber, steel, aluminum, plywood, cement, and other construction products, which are integrated into New York’s construction supply chains. Recent developments in September increased the potential for higher material costs, supply disruptions, project delays and greater financial risk for contractors and project owners.

New York’s construction industry is a major component of the state’s economy, employing more than 400,000 New Yorkers and contributing more than $66 billion annually. The state has previously identified steel, aluminum, and lumber as important construction material affected by tariffs and warned that higher material costs can result in fewer projects, delays, and increased project costs.

Impact on Construction Contractors

For contractors, the most immediate concern is price volatility. A contractor may develop a bid based on a supplier’s quoted price, only to discover that a tariff or retaliatory measure has increased the cost before the material is purchased. This creates substantial exposure, particularly on fixed-price contracts where the contractor has limited ability to recover unforeseen increases.

The problem extends beyond materials imported directly from Canada. A product manufactured in the United States may contain Canadian steel, aluminum, lumber, or other components. As a result, purchasing from an American supplier does not necessarily eliminate tariff exposure.

Contractors are therefore likely to place greater emphasis on early procurement, supplier commitments, escalation clauses, allowances, contingencies, and alternative sources of supply. Owners and contractors may also face more negotiations over responsibility for tariff-related increases after a contract has been awarded.

Impact on Material Costs

The construction materials most exposed to the dispute in New York include lumber and engineered wood products, steel, aluminum, copper, plywood, and cement. Existing tariffs on steel and aluminum can reach 50%, while additional tariffs imposed during 2026 have expanded the number of Canadian construction-related products potentially affected.

Canadian softwood lumber is particularly important because Canada has historically supplied a substantial majority of U.S. softwood lumber imports. New York contractors, homebuilders and remodelers therefore have exposure to changes in Canadian lumber pricing even when the supplier is located in the United States.

Impact on Construction Project Owners

For project owners, the principal consequence is increased uncertainty in establishing and maintaining project budgets. Public agencies, private developers, hospitals, universities, manufacturers, and commercial property owners may face higher costs between initial design, bidding, and construction.

Projects that were financially feasible under earlier material prices may require additional funding or redesign. Owners may also encounter longer procurement periods when contractors seek alternative suppliers or wait for pricing to stabilize.

For public projects, these issues can be particularly significant because funding is often established well before construction begins. A substantial increase in steel, aluminum, lumber, or other materials can create a gap between the original project budget and the contractor’s actual cost.

Contracting and Risk Management

The New York tariff environment reinforces the importance of carefully drafted construction contracts. Owners and contractors should consider clearly defining who bears the risk of newly imposed tariffs, establishing material escalation provisions, identifying notice requirements, and determining how changes in law will affect the contract price.

Contractors should also consider obtaining firm supplier quotations, identifying tariff exposure during estimating and purchasing critical materials earlier when economically justified. Owners can reduce uncertainty through early contractor involvement, design flexibility, and realistic contingencies.

Outlook for New York

The most significant issue may be uncertainty rather than any single tariff. New York contractors operate in a highly competitive market where bids are often prepared months before construction begins. Rapid changes in trade policy can make conventional estimating assumptions less reliable.

The U.S.–Canada tariff dispute therefore has the potential to increase construction costs, compress contractor margins, delay projects, and cause owners to postpone or modify planned investments.

For New York’s construction industry, the coming period will require greater attention to procurement, contractual risk allocation, material sourcing, and cost forecasting. Until trade policies become more predictable, both contractors and owners should assume that material pricing and availability can change materially between the time a project is estimated and the time construction is completed. Whoever bears the fiscal responsibility for such unexpected and unanticipated changes should be illustrated in a contract.

The U.S.–Canada tariff dispute represents a material risk to New York’s construction industry. Its effects will extend beyond the importer paying the tariff and can ultimately reach contractors, subcontractors, suppliers and most likely project owners through higher prices, reduced availability, and increased uncertainty. Effective risk management, early procurement, contractual protection, and realistic project contingencies will become increasingly important as New York’s construction industry navigates the evolving trade environment.

Note: Reviewed and amended with the assistance of Microsoft Word and Chat GPT

Caring for the Caregiver: How David’s Refuge Supports Families in Central New York

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By: Kate Houck, Chief Energy Officer/Executive Director

Airline safety briefings tell passengers to put on their own oxygen mask before helping anyone else. David’s Refuge uses that image to describe its mission: offering care to the caregiver. For parents raising children with significant medical or developmental needs, that advice is easy to agree with and nearly impossible to follow.

A Need That Is Easy to Overlook

One in every 26 American families is raising a child with a disability, and many of those parents provide round-the-clock care with little relief. Friends and family can pull away because they no longer know how to relate, and a child’s needs can dictate the family’s every move, leaving parents little say over how they spend their time. Self-care falls to the bottom of the list, and exhaustion follows.

David’s Refuge exists to interrupt that cycle. Its mission is to provide respite, resources and support to parents and guardians of children with special needs or life-threatening medical conditions, so they can be refreshed, restored and renewed in their role as caregivers.

The Heart of the Work

The organization’s signature offerings include an overnight weekend respite program, wellness programming and community events. During respite, caregiving couples receive a getaway at no cost, typically two nights at a Central New York bed-and-breakfast, made possible by donations from the community.  The weekends encourage social connection where several couples attend at once, allowing for parents to meet others walking a similar path. For families who often feel isolated, that connection can matter as much as the rest.

Because not every family can make a scheduled weekend work, David’s Refuge offers a reimbursement respite program allowing parents to plan their own one- or two-night break, on a weekday or weekend, pay up front, and apply for reimbursement afterward.

The wellness programming covers five areas (physical, emotional, spiritual, social and financial) and includes a monthly newsletter along with virtual and in-person offerings. David’s Refuge has also partnered with CNY Mental Health Counseling to support caregivers and their families with their mental health needs.

Community programming is hosted throughout the year, both virtual and in person, some for whole families and some for caregivers alone, and offers a private Facebook page where caregivers can connect. Each November, during National Caregiver Awareness Month, caregivers can find weekly wellness tips and education about caregiver burnout.

Growth and Recognition

David’s Refuge has grown considerably. What began in 2012 as a small start-up serving 43 parents a year has grown to support nearly 1000 families annually with extensive year-round programming.  The mission continues to draw wider notice and recognition.  In 2026, SUNY Upstate selected David’s Refuge as its Your Cause charity, which brings volunteer support and funding to expand support for caregivers and their children.

How to Help

Demand is high, and the organization relies on the community. It receives no state or government funding. Supporters can give monthly, volunteer, give through their business or attend one of many wonderful fundraising events.  Caregivers who need support, or anyone who knows one, can find the application and all event information at davidsrefuge.org. In a system that mostly focuses on the child, David’s Refuge reminds parents that they matter too, and that families and our community thrive when we do one simple thing- care for the caregiver.

Join us! Davidsrefuge.org

The Workforce Predicament

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For years, workforce conversations in Central New York and beyond have centered on a familiar question: How do we find more people? But today, business leaders should be asking an equally important question: How do we create an organization where good people want to come and want to stay? That distinction has become critical. Employers continue to face a difficult combination of skills shortages, changing workforce expectations, demographic pressures, and competition for talent. For manufacturers, where technical knowledge and experience can take years to develop, losing an employee can mean losing far more than just a name on the payroll. It can mean losing institutional knowledge, productivity, customer relationships, and future leadership potential. That’s precisely why workforce attraction and retention can no longer be viewed primarily as HR functions. They’re business strategies.

The Employment Relationship Has Changed
Compensation and benefits will always matter. But employees increasingly evaluate a potential employer based on the complete experience of working there, including the company’s leadership, communication, opportunities for development, workplace culture, flexibility where possible, recognition, and whether they believe their contributions matter. In other words, employees are evaluating the complete relationship.

That relationship is built, or weakened, through everyday interactions. Does a supervisor communicate expectations clearly? Are employees asked for their ideas? And when they’re asked for ideas, does the company respond to them? Does leadership explain why changes are occurring? Are people given opportunities to develop new skills and advance? Do employees understand how their work contributes to the organization’s success? None of these require extravagant employee programs, but they do require intentional leadership.

Retention Begins Long Before Someone Resigns
Unfortunately, many organizations discover an employee is unhappy only after receiving a resignation letter. By then, the opportunity to address the underlying issue may have passed. Retention should instead be treated as a continuous process. Regular conversations between managers and employees can uncover frustrations, career aspirations, and improvement opportunities long before they become reasons to leave. Supervisors should understand that managing people is not simply about assigning work and measuring output. It’s about developing the individuals responsible for producing that output.

This is especially important as experienced employees retire and organizations bring newer generations into the workforce. Transferring knowledge, building skills, and developing future supervisors require strong relationships between employees and leaders.

Your Culture Is Also a Recruiting Tool
The employer/employee relationship also influences attraction. Candidates have unprecedented access to information about potential employers through social media, online reviews, and personal networks. What current employees say about an organization can be considerably more powerful than what appears in a job advertisement. Companies that create environments where employees feel respected, challenged, supported, and connected to the organization’s mission develop a reputation as a place where people want to work, which is something that’s difficult for competitors to replicate. For Central New York manufacturers, that reputation will become increasingly valuable as companies compete for many of the same skilled workers.

Invest in the People You Already Have
At TDO, we regularly work with manufacturers to improve productivity, processes, leadership capabilities, and workforce skills. One lesson consistently emerges during our work: sustainable operational improvement depends on people. Organizations can invest in automation, equipment, and technology, but those investments reach their full potential only when employees are prepared and motivated to use them effectively. And when those employees are retained.

The companies that succeed in the workforce competition will therefore do more than just recruit. They’ll develop supervisors into leaders, communicate openly, invest in employee skills, recognize contributions, and give people meaningful opportunities to participate in improvement. In a competitive labor market, your strongest workforce strategy may not begin with the next person you hire. It may begin with strengthening the relationships you have with the people who are already there.

TDO is a consulting and training organization based in Liverpool, NY. Our mission is to grow the local economy by helping Central NY manufacturers and technology companies drive operational excellence and cultural transformation to reach their full potential. TDO’s support of the local mission generated $265 million in economic impacts in the last contract period supporting jobs, investments, cost savings, and profitable growth. If you would like to talk further, TDO’s team is experienced and fully certified to help. Reach out today to learn more and schedule a free consultation!

Culture in the Clinical Practice

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by Kathryn Ruscitto

I often wonder why the patient experience feels complete in one medical practice yet lacking in another. The answer usually lies in a collection of touchpoints: how the phones are answered, how staff greet patients, whether communication remains consistent between visits, and how issues are resolved when something goes wrong. These visible moments are only part of the story, but together they reveal the culture.

Exceptional patient care requires alignment across every department. Positive experiences reflect an organizational culture built on clear goals for every encounter, every person, and every time. Even when miscommunications arise, a strong culture ensures they are handled with courtesy, responsiveness, and accountability.

Leadership establishes this baseline and must hold itself to the same standards expected of everyone else. Hiring, training, and recognition programs should all reinforce the same core values. When expectations are transparent, team members flourish, morale improves, and retention is more likely to increase.  Mutual respect is also critical. A healthy culture must clearly articulate expectations for patient behavior, especially given the recent rise in workplace safety challenges. Patients deserve compassionate care, and staff deserve a safe, respectful environment in which to provide it.

The key elements of a strong culture include safety and trust, accountability and decision-making, feedback and innovation, and work-life balance and growth. These principles should be stated clearly and revisited as the organization changes. Culture is not a one-time announcement; it is something that must be reinforced every day through leadership actions, team behavior, and organizational systems.

As Michael Watkins noted in Harvard Business Review, “Culture is the organization’s immune system.” This idea captures the role culture plays in clinical practice: it helps teams respond to stress, navigate unexpected challenges, and access the right support when problems arise. It also shapes what the organization tolerates, what it rewards, and how it behaves under pressure.https://hbr.org/2013/05/what-is-organizational-culture

Looking back on a career in healthcare leadership, it is natural to think about how often l truly walked in the team’s shoes. While rounding can provide perspective, deeper listening often reveals whether an organization is living its values and whether the culture is supporting staff. Patient and client perspectives matter just as much. Surveys offer value, but in-person feedback creates a unique opportunity to ask follow-up questions, learn more deeply, and better understand what people are actually experiencing.

Finally, the empathy gap must be addressed. Many patients do not fully understand current workforce shortages or the administrative delays that affect care. It is helpful to provide that context and advocate for patience and kindness toward frontline staff. At the same time, the frustration patients feel when they cannot access care or communicate with providers is real. The challenge is to communicate these realities honestly while staying true to the organization’s values.

Resources for Building a Strong Culture in Clinical Practice

 

  • American Medical Association – Leading Change

https://edhub.ama-assn.org/steps-forward/pages/leading-change

 

  • National Center for Healthcare Leadership

https://www.nchl.org/

 

  • National Academy of Medicine – Culture of Health Program

https://nam.edu/our-work/programs/culture-of-health-program/–

 

please run with Kathy’s photo and normal contact info

Scott A. Berlucchi, FACHE, NHA: A Passionate, Purpose-Driven Leader Building Strong Healthcare Systems

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Almost 20 years ago, in 2007, Scott Berlucchi, FACHE, NHA signed a two-year contract to be the President and CEO of Auburn Community Hospital (ACH). He didn’t intend to stay in Auburn for very long, and certainly didn’t think he would relocate his family from Pennsylvania to Central New York – however, almost two decades and a successful career later, that’s exactly what happened. Today, Berlucchi leads the same hospital in the same capacity, although much has changed over those twenty years: he helped lead a financial and operational turnaround that brought ACH out of bankruptcy and has grown it into a bustling, multi-specialty healthcare hub.

Originally from Pennsylvania, Berlucchi developed the passion and skills for leading small, rural hospitals before he arrived at ACH. Serving as the President and CEO of a few different healthcare systems in Pennsylvania between 1995 and 2007, such as Elk Regional Health System and Lancaster General Susquehanna Division, Berlucchi developed a keen understanding of the importance of local access to quality, specialized care in a small hospital setting. One of the first projects he undertook at ACH was rebuilding and enhancing OBGYN and Women’s Health, which was on the verge of being eliminated.

“In Lancaster, I learned at the feet of some brilliant people who built one of the only women and baby hospitals in Pennsylvania. They were so ahead of the curve with their comprehensive dedication to women and maternal health,” Berlucchi said. In just one example of many, he developed and executed a plan that brought OBGYN and Women’s Health at ACH from the verge of nonexistence into a thriving and growing specialty within the hospital system.

In 2010, the Becker Report named ACH a top ten hospital turnaround, and in 2019 Berlucchi was featured on a list of the top 60 rural CEOs by the same publication. Helping to reinvigorate struggling hospitals is a passion and a skillset Berlucchi has embraced over the decades, he said.

“I’m not a doctor, but I can help heal broken hospitals and health systems. I’m able to take particularly small, rural hospitals that are struggling in any way, shape, or form, and strategically transform them into healthcare systems that meet the needs of the communities they serve,” Berlucchi explained.

Building Blocks of Success

Looking back over the transformation of ACH since he took the helm, Berlucchi highlighted several accomplishments that were achieved along the way. The recent opening of the hospital’s Cancer Center, the Auburn Cardiovascular Institute and the Women’s Imaging facility are all exciting specialty additions to ACH that were made possible by several years of hard work and strategy. ACH’s Leapfrog score, a safety grade given to hospitals across the nation, has improved from a D to a B, almost attaining an A rating, which reflects strong enhancements made over time. In addition, ACH’s nursing home, Finger Lakes Center for Living, recently received a five-star rating from Care Compare.

“These are just ratings,” Berlucchi said, “but the work that goes into them is all about patient safety and quality of care.”

The work to achieve these milestones is structured in a strategic way, Berlucchi explained. He and his team always have a three-year plan that guides their operations, which is updated each year. The one-year operating plans are then broken down into 90-day increments, in which accomplishments and successes are reported and analyzed. Berlucchi emphasized the role his team plays in making sure the work gets completed with quality and efficiency.

“I’m very, very proud of my management team, the board, the medical staff, and the workforce. In all of those regards we have very dedicated professionals, physicians, allied health, maintenance workers, and office staff. Our community of workers are extremely dedicated to ACH and to the Auburn community. I’ve learned you can build buildings, recruit doctors, and start programs, but it won’t work unless you have a dedicated workforce to make it all happen,” Berlucchi explained.

During COVID and in the years since the pandemic, he said, there have been many challenges facing the healthcare sector that ACH has had to navigate alongside other hospitals and health care facilities. Rising demands for medical care mean that many hospitals have been operating at or over capacity, leading to strain and stress on existing systems and infrastructure.

“In my 40-year career, the post-COVID years have been some of the most challenging,” Berlucchi said. “It just changed the landscape of traditional healthcare. We’re being asked to see about 30% more patients with the existing infrastructure, and therein lies the need for creativity and innovation because we don’t necessarily have more dollars to make things happen. The Cancer Center we recently opened is already at capacity. We’re only five months into our Cath Lab being opened and it’s tripled and quadrupled our volume estimates. Thankfully, we have a great group of doctors, nurses and personnel that rise to the occasion and meet the needs of the community.”

Growing and Innovating into the Future

In addition to meeting the needs of the wider community in Auburn, the needs of the 65-plus population are quickly increasing. Many of the added services and facilities ACH now offers have an eye toward the present and future needs of this specific, growing population.

“I see a tremendous growth opportunity in meeting the needs of the aging population, particularly around chronic illness and disease. We’re a full-service hospital, but our older community members are accessing cardiology-related services in particular,” said Berlucchi, highlighting a growing need for cancer services, orthopedics, neurology, and services related to movement disorders within this population, as well.

Alongside other small, rural hospitals, ACH is also innovating and growing to meet increasing patient needs by partnering with larger, academic medical centers. Berlucchi shared that ACH partners with several nearby health centers to enhance its service offerings. ACH partners with SUNY Upstate for several service lines including cancer care, intensive care, and critical care; with the University of Rochester for neurology and cardiology; and with Rochester Regional Health for anesthesia.

“No man is an island, and no small hospital is an island. It’s good to build those clinical affiliations, and sometimes those affiliations can mature into joint ventures along service lines,” Berlucchi said.

Finally, recruiting top talent for ACH is a major priority for Berlucchi as he and the team continue to strive to meet the community’s needs.

“You always have to be trying to recruit the best and the brightest to your community,” he stated. “At the end of the day, medical professionals rely on one another. It’s always a multidisciplinary approach. It’s very important for physicians that your colleagues are as strong as you are for the best patient care. Recruitment and retention of a quality workforce is critical to our core mission.”

Purpose-Led Community Leadership

Reflecting on almost four decades of leadership at small, rural hospitals and health centers, Berlucchi highlighted the men and women who shared their own experience and made it possible for him to bring success to hospitals in Pennsylvania and now ACH.

“I’m very proud of the role of mentoring in my career, particularly the men and women who mentored me and have made me the person that I am. My family, of course, and my faith, first and foremost, but there are a lot of men and women and professionals who have helped shape me along the way,” said Berlucchi.

Now, as he continues through a phase of his career where he has decades of experience under his own belt, Berlucchi enjoys passing on the knowledge he’s gained with young professionals who will take over the reins in years to come.

“I’m trying to pave the road forward now, where I get young professionals or middle-aged professionals who are new at ACH or in a new role, and I try very hard to mentor the next generation. My thought process is that once upon a time, somebody was kind enough to show me the ropes, and in turn I became a better professional to serve the community. At this stage of the game, I feel a duty and a responsibility to coach, train, and mentor the next generation of healthcare leaders. All the trials and tribulations and the experiences I’ve had cannot be learned in a book. I think all professionals owe that to their profession, to not hold onto knowledge, but to release it for others to pick up,” he said.

However, Berlucchi is not yet ready to leave his work behind and for a very simple reason: he loves it too much. Roughly quoting a phrase from the Pennsylvania Dutch, he said, “If you’re fortunate enough in life to wake up one day and know what your purpose and your passion are, and if you’re lucky enough to find work that is synonymous with your purpose and your passion, then you’ll never work another day in your life.

“I’m just very blessed to understand what my passion is and what my purpose is, and very lucky to be afforded an opportunity to have a leadership role in a healthcare organization,” Berlucchi continued. “I’ll be providing healthcare leadership in some way, shape or form for a very long time because I love what I do, and it doesn’t feel like work.”

And although he never intended to stay in Auburn for longer than two years, let alone two decades, his love for the community and for ACH also keeps him going.

“I guess I’m right for Auburn and Auburn’s right for me,” he said. “Look at all the wonderful things we’re doing together. ACH has been here for 150 years, and I’m sure it’ll be here another 150 years because we’ve built a strong program and a strong legacy, and we’re doing very good work for the community.”

2026 Mid-Year Report to the Upstate New York Construction Industry

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Earl R. Hall, Executive Director, Syracuse Builders Exchange

Reflecting on mid-year data, including membership utilization, I am pleased to report that the Syracuse Builders Exchange continues to demonstrate exceptional strength, stability, and growth. The Association remains well-positioned to serve the regional construction industry today while preparing for future opportunities.

The Syracuse Builders Exchange is proud to be the largest construction industry association in New York State with approximately 1,100 member firms. For more than 150 years, our mission has remained unchanged—to provide the resources, services, advocacy, and professional relationships that help our members succeed in an increasingly competitive marketplace.

Membership continues to grow as more construction firms recognize the value of belonging to an organization that delivers measurable benefits. New members are joining because they see an association that provides a wide variety of services, is financially sound, professionally managed, and committed to helping their businesses succeed. Our continued membership growth reflects the confidence the construction industry has placed in the Syracuse Builders Exchange and the value our programs provide every day.

The Builders Exchange is financially sound, generating strong operating revenues, maintaining adequate financial reserves, and operating with no debt – all while maintaining the fiscal goals and objectives of a 501c6 not-for-profit trade Association. This conservative financial stewardship ensures that the Syracuse Builders Exchange remains independent, sustainable, and capable of investing in new programs and member services without compromising our financial security.

The Syracuse Builders Exchange Electronic Plan Room is one of the Association’s most valuable member resources, providing contractors, subcontractors, suppliers, and construction professionals with immediate access to current bidding opportunities throughout the region. Members can easily view project plans, specifications, addenda, and other bidding documents from any location, allowing them to identify and pursue new business opportunities efficiently.

In addition to convenient access to bid information, the Electronic Plan Room offers powerful estimating and digital takeoff tools that help members improve the accuracy and speed of project estimates. These features enable users to measure quantities directly from electronic drawings, streamline estimating workflows, reduce costs, and enhance competitiveness. By combining comprehensive project information with advanced digital tools, the Electronic Plan Room helps members save time, increase productivity, and position their businesses for continued success in today’s competitive construction marketplace.

One of the Builders Exchange’s highest priorities continues to focus on education and safety training. Over the past year, we have expanded our schedule of education, professional development, and safety training classes, providing members with practical knowledge that enhances productivity, strengthens knowledge of regulatory compliance, and improves workplace safety. These programs have become one of the defining benefits of membership and reflect our commitment to helping member firms remain competitive and safe.

Equally important are the opportunities the Builders Exchange provides for members to build lasting and meaningful professional relationships. Throughout the year, the Association has hosted a wide variety of social gatherings, networking events, awards programs, and industry meetings that strengthen connections among contractors, subcontractors, suppliers, design professionals, and project owners. These events foster collaboration, encourage new business opportunities, and reinforce the sense of community that has always distinguished the Syracuse Builders Exchange.

Looking ahead, the Builders Exchange remains focused on innovation and continuous improvement. We will continue investing in education, safety training, technology, networking opportunities, and member services while maintaining the financial discipline that has made the Association one of the strongest and most respected trade organizations in the State.

None of these accomplishments would be possible without the support and engagement of our members, volunteer leadership from the Board of Directors, committee members, and dedicated staff. The Builders Exchange’s membership participation, ideas, and commitment have helped build an organization that serves as the voice of the construction industry throughout Upstate New York.

The future of the Syracuse Builders Exchange is bright. With consistent revenues, no debt, growing membership, expanding educational and safety programs, vibrant networking opportunities, and adequate financial reserves, our association is well prepared to meet the challenges and opportunities long into the future.

Operational Excellence: The Competitive Advantage Hidden in Plain Sight

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By: James A. D’Agostino, CEO, MEP Center Director

Across every industry, executives are facing unprecedented pressure to do more with less. Economic uncertainty, workforce constraints, rising costs, supply chain volatility, and accelerating technological change have become permanent features of the business landscape. While organizations can’t control many of these external forces, they can control how effectively they operate. That’s why operational excellence has become one of the most important strategic priorities for organizations seeking sustainable growth.

Too often, operational excellence is viewed as a collection of improvement projects, cost-cutting initiatives, or manufacturing-focused methodologies. In reality, it’s far more significant. Operational excellence is the deliberate pursuit of creating systems, processes, and cultures that consistently deliver value to customers while enabling employees to perform at their highest potential. Organizations that achieve operational excellence don’t simply become more efficient. They become more resilient, adaptable, and capable of executing strategy in a rapidly changing environment.

One of the most common challenges leaders face is the tendency to focus on symptoms rather than root causes. Missed deadlines, quality issues, employee turnover, customer complaints, and rising costs often appear as isolated problems. In reality, these outcomes are frequently connected to underlying process weaknesses, communication gaps, unclear accountability, or inconsistent leadership practices. High-performing organizations recognize that sustainable improvement comes from strengthening the systems that drive results. Rather than relying on heroic efforts from individuals, they build repeatable processes that create predictable outcomes.

Technology certainly plays a role in operational excellence, but technology alone isn’t the answer. Across Central New York and beyond, organizations are investing heavily in automation, artificial intelligence, data analytics, and digital tools. The greatest returns, however, are realized when technology is implemented within a strong operational framework. Without disciplined processes and engaged employees, even the most sophisticated systems can fail to deliver their promised value.

The human element remains equally important. Organizations that excel operationally invest in developing leaders at every level. They create cultures where employees are empowered to identify problems, suggest improvements, and contribute to organizational success. Continuous improvement isn’t a program; it becomes part of how work gets done every day.

Operational excellence also provides a powerful competitive advantage during periods of growth. As organizations scale, complexity increases. New customers, products, technologies, and employees can strain existing systems. Companies with mature operational practices are better positioned to absorb growth without sacrificing quality, customer satisfaction, or profitability.

For Central New York, this conversation is particularly timely. Significant investments in advanced manufacturing, technology, infrastructure, and economic development are creating new opportunities across the region. Organizations that have built strong operational foundations will be best positioned to capitalize on these opportunities and sustain success over the long term.

At TDO, we’ve seen firsthand that operational excellence isn’t about perfection. It’s about creating an organization that continuously learns, adapts, and improves. Whether through leadership development, process improvement, workforce training, strategic planning, or cultural transformation, the goal remains the same: helping organizations build the capabilities necessary to thrive in an increasingly competitive world.

The organizations that’ll lead tomorrow aren’t necessarily those with the largest budgets or the newest technologies. They’ll be the ones that execute consistently, improve relentlessly, and create cultures where excellence becomes the standard rather than the exception. Operational excellence isn’t simply an operational objective. It’s a business strategy.

TDO is a consulting and training organization based in Liverpool, NY. Our mission is to grow the local economy by helping Central NY manufacturers and technology companies drive operational excellence and cultural transformation to reach their full potential. TDO’s support of the local mission generated $265 million in economic impacts in the last contract period supporting jobs, investments, cost savings, and profitable growth. If you would like to talk further, TDO’s team is experienced and fully certified to help. Reach out today to learn more and schedule a free consultation.

People and Talent: Building a Workforce That Drives Business Performance

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For many organizations, the most difficult business challenge is no longer finding customers, securing capital or adopting new technology. It is finding and keeping the right people.

Talent has become a strategic issue that reaches well beyond the human resources department. Hiring decisions affect productivity. Retention affects institutional knowledge and operating costs. Employee performance directly influences customer service, innovation and profitability. And the evolution of remote and hybrid work has changed what employees expect from their employers—and what employers expect from their workforce.

In this environment, successful organizations are taking a broader view of people and talent. Rather than treating employees simply as a cost of doing business, they are recognizing that a capable, engaged workforce can become one of an organization’s most important competitive advantages.

Hiring: Look Beyond the Resume

Hiring the right person begins with understanding what the organization actually needs.

A common mistake is to define a position primarily by its list of responsibilities. A more effective approach is to identify the business outcomes the person will be expected to achieve. What problems will this individual solve? What skills will be essential six months or one year from now? How will success be measured?

This shift can make the hiring process more precise.

Organizations should evaluate candidates based not only on technical qualifications, but also on adaptability, communication, judgment, collaboration and willingness to learn. In an economy where technology and business practices continue to change rapidly, the ability to learn may be just as valuable as what a candidate already knows.

Culture also matters—but it should not become a vague hiring criterion. Companies should clearly define the behaviors and values that contribute to success within the organization. Candidates should understand those expectations before accepting an offer.

The best hiring process is also a two-way evaluation. Employers are determining whether a candidate is right for the organization, while candidates are deciding whether the organization is right for them. Transparency about responsibilities, compensation, advancement opportunities, workplace expectations and company culture can reduce costly hiring mistakes.

Retention: Give Employees a Reason to Stay

Hiring is only the beginning. The real return on a hiring investment comes from developing and retaining good employees.

Employee turnover can be expensive, but the financial cost tells only part of the story. When an experienced employee leaves, organizations can also lose customer relationships, institutional knowledge, productivity and momentum. Other employees may have to absorb additional responsibilities while a replacement is recruited and trained.

Retention therefore requires more than competitive compensation.

Employees want to know that their work matters and that they have opportunities to grow. They want managers who communicate clearly, recognize good performance and provide meaningful feedback. They also increasingly value flexibility and a reasonable degree of control over how work gets done.

Career development can be particularly powerful. An employee who sees a future within the organization is more likely to remain engaged. Professional development does not necessarily require expensive executive programs or formal degrees. Mentoring, cross-functional assignments, training, expanded responsibilities and exposure to senior leadership can all contribute to employee growth.

Perhaps most importantly, managers need to understand why individual employees stay. The reasons are not always the same. One employee may value advancement, another flexibility, another professional recognition and another the opportunity to work with a strong team.

Retention begins with listening.

Performance: Accountability and Engagement Go Together

Employee performance is another area where organizations need to move beyond traditional annual reviews.

A once-a-year performance discussion is rarely sufficient in a fast-moving business environment. Employees need ongoing communication about priorities, expectations and results. Managers should establish clear objectives and regularly discuss progress, obstacles and opportunities for improvement.

Effective performance management should answer three basic questions:

What is expected? What is being accomplished? What needs to change?

The strongest organizations combine accountability with support. Employees should understand that results matter, but they should also have the resources, training and authority necessary to achieve those results.

Recognition is equally important. Compensation is an important component of employee satisfaction, but people also want to know that their contributions are noticed. A thoughtful acknowledgment from a manager, an opportunity to lead an important project or recognition in front of colleagues can have a meaningful impact.

Technology can also improve performance management. Digital collaboration platforms, project-management systems and analytics can help managers understand workloads, identify bottlenecks and measure progress. But technology should support management—not replace it.

Numbers can tell a manager what happened. Leadership is required to understand why it happened.

Remote and Hybrid Work: Focus on Results

Remote work has permanently changed the conversation about where work gets done.

For some organizations, remote work has expanded the talent pool, reduced geographic limitations and provided employees with greater flexibility. For others, certain functions still depend heavily on face-to-face collaboration, physical facilities or direct customer interaction.

The important question is not whether remote work is universally good or bad. The question is which work arrangement produces the best results for a particular organization, function and employee.

A successful hybrid or remote strategy requires clarity. Employees need to know when they are expected to be available, how communication will occur, which meetings require participation and how performance will be evaluated.

Managers also need to resist the temptation to measure activity instead of outcomes. An employee sitting at a desk for eight hours is not necessarily more productive than someone working remotely. Productivity should be measured by results, quality, responsiveness and achievement of clearly defined objectives.

At the same time, organizations should recognize the potential disadvantages of remote work. Informal communication can decline. New employees may have difficulty learning the organization’s culture. Collaboration can become more transactional, and employees may feel disconnected from colleagues.

Hybrid work therefore requires intentional leadership. Companies need opportunities for employees to collaborate, build relationships, exchange ideas and develop professionally—whether those interactions occur in an office, virtually or through a combination of both.

The Manager Is the Critical Link

Regardless of where employees work, managers remain central to the talent equation.

An organization can offer competitive salaries, sophisticated technology and attractive benefits, but a poor manager can undermine all of them.

Effective managers communicate expectations, provide feedback, address problems quickly and give employees opportunities to succeed. They also recognize that management is not simply about assigning tasks. It is about developing people and aligning individual performance with organizational objectives.

That requires training managers to manage.

Many organizations promote technically talented employees into supervisory positions without providing them with the skills necessary to lead a team. Communication, conflict resolution, coaching, delegation and performance management are disciplines that can be learned and developed.

Investing in managers is therefore an investment in the broader workforce.

People Are the Strategy

Technology will continue to transform the workplace. Artificial intelligence will automate certain tasks and create new ones. Demographic changes will influence the available workforce. Employees will continue to reassess what they expect from their employers.

But one fundamental reality will remain: businesses are built and operated by people.

Organizations that succeed in the years ahead will be those that view talent as a strategic priority rather than an administrative function. They will hire for both current capability and future potential. They will create compelling reasons for good employees to stay. They will establish clear expectations and hold people accountable while giving them the support to succeed. And they will develop workplace models that balance employee flexibility with organizational performance.

The competitive advantage may not always come from having more employees. It may come from having the right people, in the right roles, with the right leadership and the right environment to perform at their best.

In the end, people and talent are not simply an HR issue.

They are a business strategy.

AI Generated, Edited by K.C. Roberts

Affordability in Health Care

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Interesting conversation with a patient last week about their mounting health care debt. Higher premiums, higher deductibles, higher co-pays, more out-of-formulary uncovered meds all adding up to $45,000 in annual out-of-pocket costs. 

Which led me to examine, what are the themes emerging nationally in health care and is anything different in the projections.  The same top issues appeared in all my research, with health care affordability moving to the top of concerns.

Affordability has become the defining health care issue in 2026, more than technology or even access. National polling shows most people now describe health care costs as unaffordable, and about half of adults report difficulty paying their medical bills, even with insurance. 

Families feel squeezed at every point: paying premiums, meeting deductibles, and then facing co‑pays and surprise bills when they actually use care.

These financial pressures directly shape behavior. Patients delay tests, skip follow‑up, or change providers based on what they think they can afford, while health systems under strain shorten visits, reduce staffing, or close services. 

The result is the uneven care seen locally: some days the health system looks seamless; other days, cost and coverage barriers quietly derail care.

Medical debt is widespread and not limited to the uninsured. Tens of millions owe medical debt, and a substantial share of Americans experience “catastrophic” health costs where medical bills consume a large share of income after basic needs.

Managing Your Money states, “Healthcare providers, government programs and debt relief organizations offer various pathways to reduce or eliminate medical debt, but to take advantage of this type of relief, you’ll need to know which options are available and how to navigate them effectively. “ What options do you offer patients to pay for care over time, seek outside relief,  or navigate the programs that can help them? Do patients know who to speak with in your practice?

Insurers , and providers have multiple theories on what’s driving these increases, but the final impact rests with the patient.  This picture looks unsustainable and calls us to look at how to reduce the patient impact. More preventative care without cost, better access using technology, employers creating purchasing of care and drugs? What are your associations advocating for the future?

 

Resources

https://www.commonwealthfund.org/topics

https://unitedstatesofcare.org/pr-2026-predictions/