Published Feb. 25, 2021 in Outlook
St. Mary’s Healthcare is multitasking at the behest of a soft-spoken man.
As unprecedented challenges rattle the health care industry, the newly independent ministry vies to tackle COVID-19, stamp out burnout, bolster the economy, address mental illness, attract diverse talent and re-embrace its Catholic roots. Those are bullet points on 54-year-old Scott Bruce’s ever-expanding short list of initiatives as president and CEO of St. Mary’s.
He’s been at command of the health ministry since longtime leader Victor Giulianelli retired in May. It’s a new chapter in Bruce’s career — a path shaped by community, faith and consequence.
“Professionally, I actually thought I was going to be in banking, believe it or not,” Bruce said. “I am just kind of a numbers-oriented person and that was that was kind of where I thought I would go.”
After graduating from Siena College some 30 years ago, he interviewed for and then rejected a position at a New York City banking firm. While forgetting the company’s name, he recalled that the path wasn’t what he wanted.
Bruce then brought his financial savvy to work at PruCare health maintenance organization in New Jersey. While working with health care facilities across the metropolitan area, he burnished his resume early on by climbing from underwriting to HMO operations.
Upstate New York was still on his mind.
“I grew up in Watervliet,” Bruce said. “Family and friends are here and yeah, I figured I would get some experience in a larger metropolitan area, but I always kind of knew I wanted to come back home.”
Upon his 1995 return, Bruce joined St. Mary’s as director of managed care contracting. Within 10 years, he became COO.
At that point, Giulianelli had led the hospital for about a year, succeeding Peter Capobianco as head of the ministry in 2004. The freshly minted leader had worked at St. Mary’s since 1980.
The two administrators developed a close bond over 15 years while working on a number of expansion projects, including the acquisition of Amsterdam Memorial Hospital in 2009 and the 2015 opening of the Rao Pavillion, an $18 million outpatient diagnostic and treatment center.
Bruce regards the 68-year-old retiree as a mentor. They still speak regularly.
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“He’s not, again, in a formal role here, but he’s always provided terrific counsel to me and to others here at St. Mary’s,” Bruce said.
Large operation
Giulianelli and now Bruce carry experience overseeing hospital operations, 10 outpatient facilities and a 160-bed nursing home, as well as 30 behavioral health programs in Montgomery County and Fulton County, all within an $180 million annual budget.
Overall, more than 1,400 employees serve about 500,000 patients across the Fulton County and Montgomery County area. St. Mary’s accepts upwards of 6,500 new patients per year, many of whom carry Medicare or Medicaid.
“I never would have imagined back in college, or even for a long time here at St. Mary’s, that I would be overseeing the hospital,” Bruce said. “It was just how it evolves.”
Bruce didn’t consider stepping into the role until his boss privately began discussing retirement in 2018. The then-CEO, a rocker who annually participated in the Amsterdam Rotary Club’s variety show, was more eccentric and charismatic than Bruce.
Matching Giulianelli’s energy and community involvement will be a joint effort within the administration after COVID-19, the CEO said.
So far, Bruce believes Giulianelli’s absence has gradually reshaped his own behavior. “I’m not as deep into the analysis and performance at an operational level as I used to be,” Bruce said. “But that’s all part of the change in the role, and frankly it’s a transition for me, but I’m embracing it.”
Under Bruce, the health ministry changed, too. Bruce ascended the ranks last year amid a divorce with the ministry’s parent company of 18 years, Ascension Health. At odds over expenses, governance and expansion goals, St. Mary’s Board of Directors and Ascension in 2015 agreed to explore the possibility of a break.
Upon announcing a split in March, Giulianelli told the Daily Gazette the partnership created financial hurdles.
Medicare and Medicaid reimbursements were scant in comparison to Ascension’s systemwide expenses, he added. Running 151 hospitals with 150,000 employees total, Ascension is the second-largest private health care system in the United States.
However, to the dismay of ministry officials in Amsterdam, Ascension wasn’t interested in extending upstate New York operations, according to Bruce. Disintegrated from much of the former parent company’s national network in September, St. Mary’s officially left Ascension.
COVID concerns
Bruce praised Ascension and members of the board of directors for cooperating despite resources ravaged by COVID-19. “It makes for a difficult transition like the one we’re going through — it makes it tough to work through this and do so effectively, and keep our staff and patients and our community safe,” Bruce said.
Montgomery County since March has faced 3,002 diagnoses and 97 deaths related to COVID-19, and neighboring Fulton County has seen 3,072 cases and 76 deaths. St. Mary’s has admitted 205 COVID-19-positive patients.
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When pressed on the total number of associates exposed to the virus, spokesperson Rick Hyde said he couldn’t “easily” access such records. Most St. Mary’s personnel have been eligible for the Moderna vaccine. As of January, about 70 percent of associates had been vaccinated.
Even with proper sanitary measures and investments in protective equipment, Bruce remarked that front-line workers are still susceptible to transmission. Additionally, he believes staff also risk burnout while taking new roles in the exhausted system.
“Our staff has been stretched to work in environments that are not their primary environments,” Bruce said. “Just having to shift staff to be more available at the bedside, and the incredible strain this has had on the organization and the staff in particular, [burnout] has been a very real part of this.”
Despite existing facilities and personnel being exhausted, the ministry’s $6 million Rao Pavilion expansion project remains slated for completion this summer. The project broke ground in October. Growing from 40,000 to 57,000 square feet, the upsized development will include a drive-thru retail pharmacy, three medical practices, 30 exam rooms and a meditation garden.
The facility is expected to ease demands for mental health services in the Mohawk Valley exasperated by rural poverty and the pandemic. By completion of the pavilion, Bruce expects telehealth calls, shaped by the pandemic, to become a standard practice.
“One of the things that I think is going to serve us well moving forward is the integration of behavioral health into a primary care setting,” Bruce said. “As we look through this pandemic, you know, the behavioral needs are really at the forefront here.”
Bruce is also interested in providing communities greater access to “very-difficult-to-recruit” specialists in dermatology, rheumatology, endocrinology and neurology.
The ministry recently hired a foot and ankle treatment specialist and a podiatrist to keep up with such demand.
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