HLM: It's hard to look back on your career without some distance, but you came to Mountain States as CEO of a single hospital, and at the time, Mountain States didn't even exist. What has been accomplished through your term?
Vonderfecht: It's been a team effort, but you have to have the leadership vision and hopefully that's what I've provided. When I came here in January 1990, we were a successful standalone community hospital with no outside relationships.
The first focus of business was becoming more than a community hospital, so that meant becoming a tertiary medical center. With the leadership at East Tennessee State University, we developed a number of programs that put us on the map from a regional basis, but the most important might have been the (Niswonger) Children's Hospital. That was one of the first things we did in 1992—open that hospital.
Another thing we attacked early on was our aim to be a regional referral center. We needed that Level 1 status. We developed several programs around transplant, rehab, and other things we didn't have. We built up cardiology and oncology programs. Along the way, we were also having discussions with smaller hospitals owned by for-profit companies to see if there would be opportunity to reduce costs through reducing duplication.
We were never successful in that, until a lot of these hospitals became acquired by Columbia/HCA, which then ran into legal issues and had a division of 21 hospitals they decided to sell. We became part of a consortium of eight hospitals that acquired those 21, so we acquired six of the 21 at one time.
The key was that we had a strategic plan of what to do with them should we ever have an opportunity to bring them in, so we were ready. That eliminated duplication of services, and one of those hospitals allowed us to reach into southern Virginia, so we became truly regional.