Xavier Richardson

Xavier R. Richardson, a native of Fredericksburg, joined MediCorp Health System in 1997 and currently serves as the Executive Vice President, Corporate Development and Community Affairs for Mary Washington Healthcare. He also serves as president of the Mary Washington Hospital Foundation and the Stafford Hospital Foundation. Prior to joining Mary Washington Healthcare, Richardson worked on Wall Street and served as an assistant director of the U.S. General Accounting Office in Washington, D.C. He has a bachelor’s degree from Princeton University and an MBA from the Harvard Business School.

Xavier R. Richardson was interviewed by Jess Rigelhaupt on June 12, 2013.

In addition to the transcript below, a full transcript of this interview is available as a PDF file in the University of Mary Washington’s Digital Archive.

Discursive Table of Contents

00:00-15:00
Born at Mary Washington Hospital (2300 Fall Hill Avenue) in 1957—Segregation at Mary Washington Hospital—Mary Washington Hospital’s connections to African American communities in the region—Relationship with Mary Bridgewater, a nurse at Mary Washington Hospital—Memories of attending James Monroe High School in Fredericksburg, Virginia—Considered working in hospital administration as a teenager—Shortage of health care professionals in the 1960s—Few African American physicians in the late 1960s—Dr. Ellison and Dr. Payne, prominent African American physicians in Fredericksburg—Local African Americans choosing to seek medical care at Freedman’s Hospital in Washington, D.C.—Desegregation of Mary Washington Hospital—Tuskegee Experiment and distrust of medicine and health care processes in African American communities—No memories of specific issues or distrust of Mary Washington Hospital

15:00-30:00
Process of beginning to serve on the Mary Washington Hospital (MediCorp) Board of Trustees—Relationship with Marguerite Young—Bombarded with board opportunities after moving back to Fredericksburg—Accepted board position in 1993—New hospital opened—Strong community leaders on the board—Decision making based on serving all segments of the community—Mission-driven organization—Non-profit running with the efficiency of a for-profit—Mission is to “improve the health status of all people within the community”—“It’s truly owned by the community”—Community values—Making difficult decisions in line with the mission—Expansion of service and operations—Growth in the region—Extend care to more people—Relationship between physicians and administrators early on at MediCorp/Mary Washington Hospital

30:00-45:00
Improving trust between physicians and administration—Competition with large, corporate health care systems—Visionary board members—Board leadership and focus on the community—Decision to build a new hospital rather than renovate the 2300 Fall Hill building—Differing opinions on the decision to build the new hospital—The need for the new hospital—Different perceptions of the new hospital in the community—Enhancement of cardiac and cancer services—Work and campaigns at the Foundation—John Fick, III, board chair, advocates for a campaign for the Moss Free Clinic—Raised $10 million for a new Moss Free Clinic facility on the hospital campus and an endowment—Fundraising for the Moss Free Clinic—Community Services Fund campaign in the mid-1990s—Fundraising for departments at the hospital

45:00-01:00:00
How MWHC is a community-focused organization—Moss Free Clinic history—Dr. Moss’s vision for a free clinic and integrated health care—Importance of volunteers—Working with safety net providers in the region—History of mobile health care services—Decision to build the Moss Free Clinic on the Mary Washington Hospital campus—Providing electronic medical record system to the Moss Free Clinic—The role of free clinics and community health centers—Importance of partnerships—Pharmacy at the Moss Free Clinic—History of Community Service Fund at the Mary Washington Hospital Foundation—Awarding grants to the community

01:00:00-01:15:00
Community health needs assessment—Societal factors that have an impact on health care—Coordination between the Moss Free Clinic and other safety net providers—Support for the FRED bus system—Importance of access to health care—Private physician practices volunteering and donating care—Physician practices and relationships with MWHC—Development of new specialties and relationships with physicians—Hiring process in 1997

01:15:00-01:30:00
Strong and engaged at the foundation—Strong donor base—The job as a “true calling”—Synergies between the hospital and the foundation—Community Benefit Oversight Committee (CBOC)—Grants for community health needs—Foundation board committed to learning about health care policy and financing—Importance of education for the board—Philanthropy and funding—Building a donor base—Hospital as a non-profit that needed philanthropic support as well

01:30:00-01:45:00
Candy stripers—Explorer Post—Auxiliary and Red Cross volunteers—Importance of volunteers—History of Citizens Advisory Council—Healthcare Assembly—Working with Head Start in the region—Providing free dental care to children—Narrowing margins in health care and hospital reimbursements are increasing the role of the foundation—MWHC is owned by the community—Being a good corporate citizen—“An ounce of prevention is worth a pound of cure”—Preventative medicine—Community Health Needs Assessment—Cancer treatment—Access to the health care system

01:45:00-02:00:00
Cancer—Primary care—Importance of prevention and primary care for limiting emergency room utilization—Government relations—Working with the Virginia Hospital and Healthcare Association (VHHA) and the American Hospital Association (AHA)—Importance of governmental relations—Different positions of the American Hospital Association (AHA) and the American Medical Association (AMA)—Reimbursements—Relationships with MWHC and physicians—Prior job experience on Wall Street and the U.S. Government Accounting Office

02:00:00-02:04:15
Personal and organization legacies—Community benefit—Community Benefit and lasting legacy

Transcript

00:00:04
Rigelhaupt:
It’s June 12, 2013. I’m in Fredericksburg, Virginia on the campus at Mary Washington Healthcare doing an interview with Xavier Richardson. And, to start, well, you can’t talk about your first day at Mary Washington Hospital—

00:00:27
Richardson:
I can.

00:00:28
Rigelhaupt:
In much detail. So, though it would be hard to talk about your first experience there, in terms of first-hand memory, what are some of your earliest memories of Mary Washington Hospital?

00:00:38
Richardson:
Okay. Some of my earliest memories of Mary Washington Hospital include going to visit family members at the same location where I was born [in] 1957. And that’s at the 2300 Fall Hill location, where we now have many of our corporate offices. As a child, I remember going to what was called the colored ward. In the early ‘60s there was a special section which was reserved for persons of color, in particular African Americans, primarily at that time. That ward included persons who were there for any range of conditions, anywhere from bullet wounds to births. That’s where the segregated portion of the hospital was. We would go and visit family members. But you could only go up there if—as a child—if it were a close family member. There were visiting hours, et cetera, but we went there also for, I believe, some screenings as well. I remember taking this sugar cube for, I guess, it was a polio vaccine. You had to take a number of different sugar cubes and I think that’s the way they vaccinated us back then, if my memory is correct.

00:02:04
Rigelhaupt:
Thinking about—and this would be hard with first-hand memory—but in terms of your impression, was Mary Washington Hospital seen as connected to the community in which you grew up?

00:02:18
Richardson:
Yes, it was very connected. I mean, it was a major employer. I had many family members and members of our local community who were employed at the hospital, primarily in the cafeteria and some of the service occupations. I have some distant relatives who now are in their fourth generation, at least, of hospital employees, including persons who’ve served in supervisory positions in the kitchen. Then there were some other persons who were very close to me who also were employed at the hospital over the years. [03:00] In fact, one of the nurses who was present when I was born became a very close friend and a second mother to me. She frequently would remind me that she was there and helped to bring me into the world, and if I acted up she would help to take me out, jokingly. But more importantly, we developed a very close relationship and I’m proud to say that things went full circle in that in her latter days. I wasn’t exactly a caregiver, but I was a very close family friend. Her daughter was a US ambassador, so she was out of the country. I was listed as sort of a next of kin. And so on that morning when she passed, I was the first person to receive the call because her daughter was out of the country. I felt good that things had come full circle. She had helped to bring me into the world and I was there towards her latter days to provide support to her as she later passed. It was a unique relationship that I got to develop with one of our long-term associates who was there when I was born and I was there when she passed, in some sense.

00:04:18
Rigelhaupt:
What was her name?

00:04:19
Richardson:
Her name was Mary Bridgewater. Miss IB. She later went to work for the National Bank, but she was a practical nurse for many years and worked in Mary Washington Hospital.

00:04:37
Rigelhaupt:
So were there other people that you knew growing up who worked in the medical profession—other nurses or physicians—at Mary Washington Hospital?

00:04:46
Richardson:
Certainly. Another close family friend worked in the lab. She started off in the nursing program as an LPN and then she began working in the lab. As a child, we did not have a car. I attended James Monroe High School and I remember vividly that I would cross the street when she got off at 3:00 p.m. and I would take her home and would pick up her children—she was a divorcee at the time. Then I would have use of her car for the rest of the evening. I spent many days waiting outside of the hospital. It was a great career path and I had many friends who went through the LPN program—licensed practical nurse program—as seniors in high school and then completed an additional year. Then they went on to become an RN later. There were many persons who I got to know over the years who worked at the hospital. It was a very stable employer. I know many persons who worked here for many years and retired. Many of the grandparents of my friends worked here for many years. Relative to being a stable employer and a fair employer—relative to persons of color—Mary Washington Hospital was one of the major ones in this community. [06:00]

00:06:05
Rigelhaupt:
And you mentioned—when we spoke last week—that you visited Mary Washington Hospital fieldtrip in seventh grade.

00:06:15
Richardson:
Yes. Actually, what occurred was back in the early—I guess it was the late ‘60s. Apparently there was a strong push to get young people to consider careers in health care because there was a feeling that there was going to be a shortage of certain health care professionals. We all had to study the various career options. We had to learn what the requirements were, the roles and responsibilities, educational requirements, and what the opportunities might be in the future. Upon studying them, at the end of that module, we were required to write a report on a chosen career path in health care. I chose hospital administration. I recall writing a ten-page paper—back then we did not have the word processing function—and it was hand-written. I can still see that report. It’s probably in the attic of our former home there somewhere. I thought that could be a career option for me, if I considered a career in health care. I considered becoming a doctor. But it’s like in any other field that I considered including law and education. I always thought it had one level and then I always wanted to become, in the end, the boss. I wanted to be a teacher, then I wanted to be the principal. I wanted to be a lawyer, then I wanted to be a judge. I wanted to be a doctor, then I wanted to be a hospital administrator. So it was natural that I would choose that particular field, but I thought that the opportunities would be very limited, particularly at that time. Mary Washington Hospital only had one administrator, Mr. Harry Bach. I remember the name because his son was a grade ahead of me in high school. I said, “That would be a great job to have, but there will probably be very limited opportunities.” And also, quite frankly, I didn’t know what the opportunities would be for an African American at that time. Nevertheless, it was in the back of my mind. I just thought, “Things once again have come full circle for me to end up in hospital administration.”

00:08:26
Rigelhaupt:
So you made a visit, then, in seventh grade as part of the research, and—

00:08:31
Richardson:
As part of the research, we did visit the hospital, but most of it came from reading the various modules. That’s what gave me some inspiration to consider hospital administration. And then, as I said, even back then I knew who the hospital administrator was, as a seventh grader. I must have had a lot of time to think about a lot of things to concentrate on even knowing who the hospital administrator was back then.

00:09:00
Rigelhaupt:
I figure you were about twelve—1969—it was between those years of 1957 and 1969—

00:09:08
Richardson:
Yes.

00:00:28
Rigelhaupt:
—this part of the country, being the American South, went through profound changes.

00:09:13
Richardson:
Indeed.

00:09:14
Rigelhaupt:
And can you recall on that hospital tour if there was still a segregated space?

00:09:22
Richardson:
I don’t recall. I think that there was no longer a separate hospital space in itself. Although, there were a significant number of African Americans working in certain departments. At the professional level, there really were not as many. There were a number of nurses and then some began to work in the lab. There were a few African American physicians and I can practically name—there were two that I can think of: Dr. Ellison and Dr. Payne. They were the only African American physicians that I recall at that time. That was a time in which not everyone in my community—I lived in the segregated part of town, Mayfield—would come to Mary Washington. Many persons did come to Mary Washington and others went to Howard University, to Freedmen’s Hospital. For many years some of the residents in the community—African American residents—preferred not to go to a colored ward or a segregated portion of it. Particularly persons who had lived in Fredericksburg when the hospital was down in the Sophia Street and Fauquier Street areas. Apparently it was a very small portion of the hospital and there were, in theory, a setting. Those persons who had the means would often go to Washington, D.C. to Freedman’s Hospital, which was a part of Howard University and where the physician staff was predominantly African American.

00:11:05
Rigelhaupt:
Do you remember about this time period that it changed, the hospital desegregated? Discussion about it? Was it something that was noted in the community?

00:11:18
Richardson:
I don’t recall the discussion itself. The schools began to integrate. In fact, by the time I was writing that paper in the seventh grade, it was the second year of desegregation of the schools. Prior to that, there were elements of desegregation and isolated ones where a student would go to a particular school. But, actually, all of the schools were desegregated by that time. Likewise, I’m pretty sure that the hospital rooms and wards were no longer segregated. [12:00] Eventually we began to see more African Americans in some of the other areas, in the X-ray labs. And eventually, there were African Americans on the hospital board. That’s when you could see governance change, and that’s when you knew there were significant changes that had taken place. I don’t recall anyone challenging, for instance, the level of care for African Americans during my lifetime. I never recall anyone suing the hospital for discriminatory practices, as you would hear in other parts of the South. People were pretty comfortable with the level of care that they received there.

00:12:52
Rigelhaupt:
But do you recall any broader discussions in this time period about the interconnections between health care and medicine, and civil rights, in the sense that hospitals up until around this era had been segregated?

00:13:10
Richardson:
Right. Certainly not among my peers: we were twelve years old and we didn’t discuss these things. It was less of a discussion on the part of our parents. But I would say that some of our grandparents who still remember those inferior facilities—when there was a separate, very small area of the hospital—designated for coloreds. There were some concerns there. Then those persons who were familiar, for instance, with the Tuskegee experiment. I think for some who grew up in an era like that, there may have been a slight degree of a feeling of mistrust, a lack of trust in the health care process. It was not directly focused at Mary Washington Hospital, but just from a more global sense, in terms of what one would read about. Even to this day, I think that there are probably some older African Americans who are somewhat leery of experiments. For instance, seeing an experiment such as the syphilis experiment at Tuskegee—it took place at an African American institution. It really caused many persons to not necessarily totally trust the health care system. I think it’s less of an issue now. I think that even among many of the older persons that I know in this community, I’ve never heard anyone say, “I can’t trust Mary Washington. They’re racist. They don’t treat people fairly.” If there were any fears, it would be from people who are not familiar with this community, who may have moved here, and had those recollections of the Tuskegee experiment. [15:00] But from persons who were born and raised here, there’s not much of it. I’ve never heard any of my family members—and there are certainly two large families from which I come—I’ve never heard that fear.

00:15:16
Rigelhaupt:
We’ll skip over a large portion of your life and perhaps come back to it. But you began serving on the board in 1993.

00:15:29
Richardson:
Yes.

00:15:30
Rigelhaupt:
Could you describe that process by which you began serving? How you were contacted and your decision to begin serving?

00:15:38
Richardson:
Certainly. I had long admired the work and the major changes that were taking place in health care and, more importantly, the major role that Mary Washington was playing in our community when I returned. One of my mentors, Ms. Marguerite Young, who was my assistant principal, was a board member. Reverend Mayor Davies had served as a board member of the hospital. I just thought it would be a fascinating opportunity to be involved in the governance of an institution that I had great admiration for. Typically potential board members are nominated by other board members. That’s how I had come to become a member, by the nomination of other members of the community who were so glad to see me back. Pretty soon I became bombarded with many board opportunities. But the good thing is when I returned to this community, I was well-received and many people wanted me to get involved. They wanted me to become the president of an alumni association of an organization—a school—that I didn’t attend, and to run for city council in a city I didn’t live in. It was great to come back. It was natural that perhaps I might be considered for a seat on this board, just as I now serve on the University of Mary Washington’s board. These are the major institutions in our community and many of them welcome the opportunity to have someone who grew up in the community and who is well-connected with the community to serve in that capacity.

00:17:26
Rigelhaupt:
Were there discussions before, say, getting an official phone call and being offered the position, or did someone call you and say you’ve been nominated?

00:17:39
Richardson:
Typically with any board seat, there are usually some information conversations with persons who might be interested in nominating you. They don’t want to go through the whole process of nominating you and then you’re not interested. I had some conversations, for instance, with Ms. Young about the role of the board, the responsibilities, and obligations, et cetera. [18:00] Then I received a formal letter. It was not an immediate thing and it was not a guaranteed thing because this seat on the hospital board was one that was, I wouldn’t say highly competitive, but certainly one that was carefully scrutinized. They did not just simply give the seat to someone who had expressed interest in it. First of all, there had to be a vacancy, and secondly, there had to be a vetting process by which the board members considered one’s credentials, availability, and what the individual might be able to bring to the table.

00:18:48
Rigelhaupt:
So once you received the letter, you said yes, you began to serve.

00:18:54
Richardson:
Indeed, indeed.

00:18:56
Rigelhaupt:
At what point was this in 1993? Had the new hospital opened?

00:19:02
Richardson:
Yes. The new hospital had opened. Yes. And I know that because I was not a part of any of the celebrations that I hear so much about. I know the timing. I wasn’t exactly certain of the year in which I had joined, but I know that we were already in the new hospital by then

00:19:23
Rigelhaupt:
So thinking back to the first few months of your serving, or maybe the first meeting, what did you see as the strengths of the board, and Mary Washington—the hospital and MediCorp, at that point—as you began your service?

00:19:38
Richardson:
There were many strengths. You had a dynamic group of local community leaders who are truly vested in the success of the institution and very committed to maintaining local governance of this important institution. They were firmly committed to improving the health status of all of the people in the community. It wasn’t one of these things whereby they were only concerned about ensuring high-quality health care for a specific segment of the population, or those persons who could afford the care. They were keenly interested in assuring that there was a focus and emphasis on quality health care available to all persons. Decisions were always made bearing in mind all segments of the community. The other interesting thing is that you had persons who were managing major companies and corporations, entrepreneurs, and educators—a good variety of persons—who brought their respective skillsets to the table. They valued the opinions of all persons. [21:00] They always had the opportunity to hear diverse views, and all of those factors were taken into consideration when decisions were made. It was very much a mission-driven organization, where in the end the litmus test was always, does it fit the mission? That was very impressive. The other thing is that it’s a non-profit organization. By the same token, you have to operate like a major corporation because we’re the largest organization in the community. It was a good mixture between what I would call a non-profit that operated with the efficiency of a for-profit. In health care, if you’re a non-profit organization, technically you’re not making profits. But you have to have excess revenues over expenses to ensure that there are funds to be reinvested in the organization, whether it be for maintenance, new technology, or for capital expenditures, and all. If no-profit existed, then we would never be able to succeed and there wouldn’t be any funds to be reinvested into the community. When I say reinvested into the organization, it’s not only those expenditures that I mentioned, but also reinvesting in the well-being of the community as well. It’s the reinvestment in the associates, the employees, because there’s constantly a need for continuous training and new technology, et cetera.

00:22:37
Rigelhaupt:
You mentioned mission.

00:22:39
Richardson:
Yes.

00:22:40
Rigelhaupt:
What did you see as the mission when you started serving on the board?

00:22:45
Richardson:
It was literally—not literally—but it was to improve the health status of all people within the community. There’s a special emphasis on all. When you say all, you’re talking about people from various segments of the community: people who could afford the highest quality health care and to persons who had no insurance. The wonderful thing about this organization is that it’s always taken that mission very seriously. I think that unlike for-profits who are motivated by their shareholder returns and earnings, we were more interested in our stakeholders. Our stakeholders are all the community, which owns this. We are owned by the community. I tell people all of the time, the difference is between a for-profit and a non-profit in simple terms is that if a for-profit is sold, those returns, earnings, and profits go back to the individual shareholders or to the organization as a whole. If a non-profit is sold, the assets remain in the community and it belongs to the stakeholders. [24:00] It’s truly owned by the community. Yes, we have really been driven by this mission. Long before the recent attention that has come relative to the true community benefit that is provided by non-profits, we’ve always had a vested interest in providing tremendous community benefit by the tremendous amount of charity care we provide, the uncompensated care we provide, the donations we provide, the educational opportunities, and all of the special programs that we provide to the community. Long before it became something that the IRS began monitoring with a special form 990 for health care systems and hospitals, we were doing many things in the community. We’ve always been a community-focused organization.

00:25:06
Rigelhaupt:
Did the board reflect on its mission? In a sense, when you came on board, was it just clear? Was it talked about? Or how was it communicated?

00:25:17
Richardson:
Sure. It was clear. It’s something that I would say everyone, of course, on the board knew. I think all the employees knew. The mission statement was prominently displayed in the boardroom. And so sometimes there were tough decisions and it came down to that question: does this align with our mission? We had to have fierce conversations about that. I always call it to be the litmus test as to whether or not something should be a go or no-go, in terms of discussion. There are always the financial implications, societal implications, and all of it. Clearly, there’s always the question: does this align with our mission? Sometimes there were tough decisions that had to be made. Were things aligned with our mission?

00:26:15
Rigelhaupt:
So thinking about the first few months you were on the board, what were some of the issues and concerns that had the primary attention of the board?

00:26:26
Richardson:
Access has always been a major issue. And I say access from several points of view. Access in terms of ensuring that everyone in the community had access, particularly, I should say, the most economically disadvantaged. But also access in terms of ensuring a fully-integrated health care system. Because we were growing—our community was growing. We wanted to make sure that we could deliver as much health care as possible, right here in our community, through a fully-integrated health care system. [27:00] We knew that as more and more people moved into our community from other places and who are accustomed to a certain level of care, we knew that it presented an opportunity, with the growth in one of the fastest-growing areas, to expand our operations and to always remain competitive. Back then, we didn’t have a direct competitor in the community, but we did have other options for people to leave our community and to go to hospitals in Northern Virginia, or D.C., or even Richmond. We always wanted to provide as much quality service here in our community. Any opportunity for expansion or any opportunities in terms of insuring that we remained as advanced as possible, that was always important. Of course, you always had the concerns relative to what the future would be, relative to a sufficient number or adequate supply of nurses, an adequate supply of physicians, physician recruiting, and all of that as well were issues. I think we’ve done a great job on all of that.

00:28:19
Rigelhaupt:
So I’ve read that hospitals are run by three groups essentially—not-for-profit hospitals—administrators, board, physicians. How would you characterize the working relationships between those three groups when you began serving on the board?

00:28:42
Richardson:
Well, I think initially there may have been a little tension between the administration and the physicians. I wouldn’t say tension, but probably some uncomfortable-ness because many of the physicians were accustomed to operating in a traditional manner, as a sole provider. There was a single hospital without all of the other integrated services that come along with it. I think there may have been some concern that we were going from being a little, small community hospital to more of a corporation. There was a name, MediCorp, which caused some confusion in the community, too, because people thought it was a major corporation; many people thought it was not a locally owned organization. As we sought to more actively engage physicians in the leadership—with the chief medical officer, the vice president of medical affairs, and physician board members—I think that we’ve done a great deal to alleviate some of that tension that may have existed and that speculation that we really were a big business, as opposed to being a local hospital. [30:00] Then as we had more docs coming in from larger systems—where they may have done their training, or had grown up in communities, or worked in communities where there were even larger organizations for health care systems—then I think that the trust has improved. But that doesn’t mean that when things become tougher financially that there’s that potential for some tension. I always say that people frequently refer to us as big business, but I think in the field of health care—when we look at who our competitors could be and who can encroach upon our market—we’re small potatoes in some respects. When you look at these multibillion-dollar enterprises with multiple large hospitals, we have to be well-braced to compete with those as well. Sometimes it’s hard for a small community like ours to understand that. And so from that standpoint, I think, there’s some tension. In terms of the board and the administration, I think that they’ve always worked well together because we’ve had strong boards, which were compromised of visionaries, persons who were big thinkers, who could see things from a big picture, and who were visionaries. That relationship has always been good, but sometimes there’s been tension—as it is in many hospitals, health care systems—with physicians and administrators. Sometimes the priorities are different, particularly when you start talking about the changes in reimbursement and all. I think we’ve done a great job of working well with the medical staff, and certainly there’s a great relationship with our board members.

00:32:06
Rigelhaupt:
You mentioned visionaries.

00:32:07
Richardson:
Yes.

00:32:09
Rigelhaupt:
Who are you thinking about? And what are some of the examples of forward thinking and vision that are coming to mind?

00:32:18
Richardson:
Rather than single out any individuals, I would just say that the board leadership in general. When you think about the manifestation what you see today versus what I saw as a kid when there was a single hospital. The hospital was a hospital, and that was all that it was. We didn’t have the medical office buildings; we didn’t have the nursing homes that we owned at one point; we didn’t have the outpatient facilities. Fortunately, the board, leadership, and the physicians all saw that this was the way we were going to have to operate if we were going to remain competitive in the marketplace. [33:00] I think you could see the manifestation in all that we have today versus what I saw back then. It took visionaries to think outside of the box, because the community didn’t always understand. All they could see is that we were buying, building, expanding, and we were becoming big business. Fortunately, with the board that’s governed by local persons and persons who live in this community, we’ve never lost sight of the community focus. There are always board members who always remind us that we need to look at it from a perspective of a community and we try to always that. We try to do it and we’ve done a much better job now. Even in our communications and all, we always look at it: “What are the optics of this decision? How would it look to the community?” And any tough decision that we ever have to make, we always say: “How would the community view this? How do we convey this to them so they can understand the reasons why we are making these decisions?” Whether it be for expansion or if it’s for terminating a particular line of business. I was not there as a part of the discussion that took place, of course, with the decision to build the hospital here. Those were some tough discussions. Fortunately, the hospital board decided that they wanted to remain here in Fredericksburg. Some folks thought we never should have left 2300 Fall Hill Avenue. Why couldn’t you expand up? They were not understanding the implications of trying to build up and not having the total infrastructure that you need for a hospital. You can’t just continue to build rooms, rooms, rooms. If you build more rooms, you have to have a larger facility, larger labs—larger facilities that support that. There were some people, even when I first got here, who would talk about that it was not a good decision to build that new hospital. I always joke when they say: “All it would take was one hospital stay in that private room where the care was much better and you could convince your naysayers.” Whenever I encounter a naysayer I say: “All you need to do is get them here for a couple days as a patient and then he or she would change his or her mind.” That’s what I’m grateful for. That there were visionary board members who could see the importance of taking that bold step that sometimes was not popular in the community.

00:35:38
Rigelhaupt:
You mentioned finances. So certainly, it took a large investment to build a hospital of this size. And it was up and running at the time you began serving as a board member. Was there any apprehension from the board that this was too big of an investment? Was everything going as planned?

00:36:00
Richardson:
I don’t think it was so much the board that had the apprehension because the board understood the need for it. The administration understood the need for it. I’m sure some of the docs didn’t necessarily, and some of the community members who were not a part of the discussion didn’t understand it. You would hear people say, “Why do you have to build that new hospital? Maybe my hospital bills would’ve been less if they had not built it.” But they were not understanding what this larger, newer structure enabled us to do. It’s amazing that now this is an old building, although we still refer to it as the new hospital. We’ve had to do renovations in most of the parts of this new hospital. I don’t think that the board was so much concerned because the board did its due diligence relative to the making of the decision. It was the community that could not understand why would you build a brand new hospital up there with the cost of health care going as it is. But I don’t hear that anymore. I don’t hear that at all, in fact. People are pleased. That’s always a challenge, when people don’t have any basis for comparison. For people who have lived in Fredericksburg all their lives, they have no appreciation for the quality of care that we’ve provided. They have no appreciation for the facility that we have and the technology that we have here. It’s frequently people who come in from other parts of the country, who either come as visitors or people who’ve recently moved into this community, who are amazed at the facility that we have and the level of care that we have. Sometimes you’re not appreciating what is in your own backyard. In all honesty, I understand you have no basis for a comparison and therefore you generalize based on what you see.

00:37:54
Rigelhaupt:
So you said that the board should be forward-looking, recognizing the growth, expansion. Do you recall any other areas of expansion, maybe the first couple of years you were on the board, coming from the community or local physicians raising something to the board or the hospital administration, in terms of an area of practice, saying this would be something we would like to see happen?

00:38:29
Richardson:
There were a number of discussions relative to cardiac services. We’re constantly looking at enhancing cancer services. We do that by and part, not only with the discussion of the board members and administration taking the lead based on what we see as growth opportunities and by looking at migration of patients. We also assess the community and try to get a sense as to what they see as the needs for our community. [39:00] We get feedback from a number of different sources, physicians, the administration, the board, consultants, and most importantly, the community. From my perspective being responsible for community benefit, one of the opportunities I’m most proud of is the discussion that took place at the foundation. At the time we were considering possible projects for a campaign. In the fundraising business, just as you’re finishing up the last year of a campaign, you start looking at what the next campaign should be. We did our due diligence and sought some input from the board—the system board—as well as from my colleagues and other executives. By looking at what opportunities that other hospital health care systems were raising funds for, we came back to the foundation board with a number of options that they might consider for the next campaign. They were not interested in providing the funding for a new patient tower. They were not interested in paying for an expansion of a particular program or instituting a new program. They felt that it was the responsibility of the health care system to take care of those operational expenses. Instead, after all that work had been done, it was one of our board members, John Fick, our chairman of the board who also was serving on the foundation board at the time. It was a foundation board discussion. He said, “We need to raise money to build a brand new Moss Free Clinic. They need a better facility.” That took us all by surprise. But we realized that was really much aligned with our mission, our pride that we took in partnering with other organizations, and that was a real community need. Of course, some of us were saying, “Well, the Moss Free Clinic didn’t ask for a new place. They were content with the little space on Hunter Street. Why were we going to do that?” That was a real need. That’s part of what makes me so proud of being a part of this organization. We are very much mission driven. We are very much community centered. Out of that discussion, we determined that we would have a $10 million campaign to build a new facility for the Moss Free Clinic, and to build an endowment from which operational expenses could be taken. We were already providing that money. They had probably eight, nine hundred thousand, sometimes a million dollars a year to support the Moss Free Clinic, which is also something I’m extremely proud of. Because I’ll be honest with you, when I first got here I thought this was just what hospitals did. The more and more I shared it with other colleagues across the Commonwealth and across the country, they’re amazed at the level of commitment—financial commitment and in-kind support—that this hospital and health care system provides to our free clinics. [42:00] As a result, we were able to raise over $10.9 million to build and equip a new clinic, as well as to create an endowment. Frankly, it’s the envy of most free clinics, not only across this Commonwealth, but, I want to say, along the eastern portion of this country. We believe that all patients deserve a high-quality level of care and it needs to be done in an appropriate setting. Some of the docs, to be honest with you, were quite surprised when they began practicing over at the free clinic. They were saying, “These facilities are better than my own offices. Why should I be over here? Look at the dental and the laboratory.” It’s something we take tremendous pride in, and the community responded extremely well. That was a decision we made without any urging by the community and without anyone saying this is something that’s needed. John was also the former chairman of the Moss Free Clinic board. He’s also, still to this day, a volunteer pharmacist there. We’re very, very proud of that recommendation Mr. Fick made at that meeting, and the board unanimously agreed. We do look at need and you’d be surprised sometimes the way it comes out in such discussions. He had given careful thought and consideration of that and it’s a decision that we were extremely, extremely proud of.

00:43:48
Rigelhaupt:
Do I have this right, that it opened in 1993 or that the campaign took off? Is that about the timing, in terms of the new Moss Free Clinic?

00:44:00
Richardson:
The new Moss Free Clinic campaign. I joined here in 1997, and at that time there was already a campaign going on for our Community Service Fund, which is a grants program that also has quite an interesting history. Then the next campaign, about five years later, was for the Moss Free Clinic campaign. That’s the other interesting about us, because we value the community so much that even our fundraising oftentimes is centered around the community. We give so much in terms of grants and support, and then what we do for the Moss Free Clinic. So much so that when we began talking about the most recent campaign to benefit a cancer center, there were some docs that said, “Can you do that?” We replied, “What do you mean, can you do that? Can you raise money for departments? Of course, that’s what most hospital foundations do.” [45:00] We were so unique and were so community-centered that the first few campaigns that I operated were really community-focused, because we are such a community-focused institution. That was a very successful campaign, as I say, and with a lot of support from the community. Sometimes it creates an interesting reception in the community. On the one hand, you’re raising money, sometimes for the programs and services. And at the same time, you’re giving away monies and services. That is something that we as a non-profit hospital and health care system should always do. It’s a unique perspective.

00:45:51
Rigelhaupt:
So maybe I think I have some of the dates wrong. Because part of what I wanted to do was talk about some of the milestones that happened in the first years you were on the board.

00:46:02
Richardson:
Right.

00:46:02
Rigelhaupt:
And my notes have that the Moss Free Clinic had opened in 1993, but maybe that was—

00:46:07
Richardson:
The Moss Free Clinic was opened in that year, but at that time it had a couple locations before we had it here. The Moss Free Clinic, before they moved to their current site, was located at the former health department on Hunter Street, which is also a building that currently is occupied by the Rappahannock Emergency Medical Services. We still own it, but we rent it for a dollar a year. Yes, that date is correct relative to the Moss Free Clinic’s beginnings. Intentionally we supported it, but it had to be led by a separate body—we did not own it—in order to get the full appreciation and support of the physician community. It had to be a separate entity, as opposed to the perception that we were running things there. Fortunately, Dr. Moss, who was a visionary himself, felt that we needed to have a place that provided appropriate and good-quality health care for persons—adults in particular—who did not have access because they didn’t have insurance or could not afford it.

00:47:26
Rigelhaupt:
So earlier, you mentioned that the board is really thinking about integrating health care, and that explains part of the expansion in terms of moving to the new campus, some of the other facilities that were built. Is it also fair to characterize the discussions around the Moss Free Clinic as part of that vision of integrated health care?

00:47:55
Richardson:
It is. It is, indeed, fair to say that. [48:00] Certainly, as we said, when your mission is to improve the health status of all people we have to ensure that there is a place that all persons without insurance could come. It was not so much a separate facility for them, but it had to be in a place where physicians could come and maximize on that opportunity of volunteering. Many docs were still providing free services in their own respective offices. Even with the referrals for specialist services, sometimes those services are rendered in the physicians’ own private offices. We felt that it needed to be a coordinated delivery of some of these services and that’s why the free clinic was created. Subsequently, we’ve been instrumental in the development of community health centers in the community. There’s one on Princess Anne Street. We had the opportunity to submit a grant application for the creation of a community health center, and we intentionally partnered with other existing organizations on this application. We later partnered with an organization, the Central Virginia Health Services, which operates about thirteen community health centers. Those centers provide health care services to persons regardless of their ability to pay and they will do it on a sliding scale. They also receive a preferential reimbursement and a higher reimbursement for Medicaid and Medicare; therefore they are able to see more Medicaid patients. A lot of physicians certainly cannot see a total patient base of Medicaid patients because Medicaid does not pay the true cost of care. It is less than the cost of care. Through services rendered through a community health center, you get a higher reimbursement level. We were instrumental in the development of a community health center and then another location in Caroline. We’ve been very much involved in what I would call safety net services. Safety net health care services are those for persons who otherwise lack access. We provided grants to both of the community health centers, also to a couple of Christian health center, as well as to another free clinic in Colonial Beach. I’m extremely proud of that work because that aligns well with our mission, again, to provide health care for all persons within our community. For many years we had a mobile van service that went out into the community and provided free care. As more safety net providers—such as the Christian health centers and the community health centers—developed, there was less of a need to do that because community members preferred to come into a clinic setting as opposed to receiving services on a van. [51:00] When the van was first created—and we assumed operation of vans that had been operated through the school system—there was just the Moss Free Clinic that was a safety net. Now there are many others that are here, and we support all of them with grants, with clinical services, and other in-kind services as well. Again, this aligns well with our mission.

00:51:29
Rigelhaupt:
And is this something that you can recall specific discussions at board members, or with administrators that the kind of acute care and level of expertise that could be provided at this hospital would also play a role and be integrated with the free clinics that were receiving support from the foundation?

00:51:55
Richardson:
Certainly. One of the benefits of building a free clinic—and I will tell you, one of the discussions we had is where do we build this facility? We intentionally decided to build it on the campus of Mary Washington Hospital because we wanted to make sure that those patients had access to all of the ancillary services. We didn’t want them to receive their primary care at a location a couple of miles away and then would have transportation issues to receive services here. We gave up a prime piece of real estate for this clinic because we felt it was an integral part of our overall, integrated health care system. It provided primary care, which is the preliminary step to receiving some of those other services. Yes, it was a conscientious decision to do that. We feel that the Moss Free Clinic and all these safety net providers are an integral part of the integrated health care delivery system that we have here. That’s why we continue to fund them. We work with them to provide them some of the state-of-the-art technology. We’re working with the Moss Free Clinic so that they have the same electronic medical records system—EMR system—that we have, which is very important for coordination. We want to make sure that those patients, should they leave us by way of the emergency room and the primary care, we’re able to help to refer them to one of the safety net providers, or vice versa. When the patients come by way of those safety net providers and need referrals for other services, ancillary services, or specialist services, they can come here. It’s all right here together. We know that by having the hospital and the free clinic on the same campus it facilitates physicians’ ability to volunteer, and our own associates to volunteer. Yes, they are very much a part of our system. [54:00]

00:54:01
Rigelhaupt:
Did you have any models in mind? Did you have other evidence from other hospitals that had built free clinics? Or as president of the foundation at the time, did you just kind of know that having the proximity would make a difference?

00:54:23
Richardson:
Again, the free clinic existed before I got here. But when I got here, yes, I had some ideas. I visited other free clinics. I visited other community health centers. In fact, I had a model that I thought would work better, but we wouldn’t have to change the structure of the existing free clinic, which provides services only to adults. It’s an adult clinic and it’s a free clinic for persons who don’t have insurance. If you have any form of insurance, you cannot receive services there. If you have health insurance, but you don’t have dental insurance, you cannot receive services. Therefore, I sought out other opportunities to bring to the community a community health center. It is not a free clinic, but is very much similar to a free clinic because people pay on the sliding scale. They may pay $5 for a visit. Or you and I can go with our insurance and receive services there as well. Yes, we felt that this was an appropriate model, when the free clinic intentionally chose its mission to be—I wouldn’t say it’s so much narrowly defined—but to serve that niche. Eventually as our community grew and we found more uninsured persons, we sought other models to build on. Rather than putting the pressure on the free clinic to change its scope, we worked with the community health centers to bring a couple centers here. Concurrently, there were a couple of physicians who wanted to open something similar to a free clinic, but modeled closer to the community health center and through a Christian perspective. You have Dr. Tim Powell’s Fredericksburg Christian Health Center and then you have another Christian health center in Caroline. They see patients regardless of their spiritual beliefs. But we felt that we could support them, too. To really have a comprehensive safety net to provide care for persons who lack access, sometimes you need a combination of several different models. What we’re seeking to do now is to have better coordinated delivery of those services so there are no redundancies and we can see greater synergies. For instance—we see some of that now. You may have a Moss Free Clinic patient who has a child who doesn’t have insurance. Well, we would then recommend that they take their child to the community health center. [57:00] Or there may be someone at the community health center who has no insurance. They will qualify for the Moss Free Clinic. There are cross-referrals as well to ensure that’s it coordinated delivery of service. Once again, gets back to our mission. It very much supports our mission. We value partnerships. We realize we can’t do it all ourselves. We seek relationships with some of these existing institutions to provide some of the services and, in turn, we provide a lot of in-kind support and financial support. It’s also important that we make sure that our staff members are aware of these because there are a lot of referrals and discharges that could benefit from some of those programs. For instance, there’s a community pharmacy at the Moss Free Clinic. Rather than having our own program, we sought to provide some of those traditional resources in the community pharmacy and then we could refer our patients there. We’re always looking for efficiencies and we try to avoid redundancies, even in the grants that we get. That’s another thing that I’m extremely proud of. Sometimes we have given away as much as a million-and-a-half or more in grants to our community. The Service Funds that we now call our Community Benefit Funds. Those were created as a result of a windfall, as we say, from the government for some services that was unexpected. Once we were convinced that we could keep them, we decided that we would place them in a fund to provide services to non-profit organizations that help us to fulfill our mission. After a while, we began tithing. For many years, ten percent of our excess earnings over expenses—or profits, as some would say—went to create this and to enhance this endowment that’s now over twenty million dollars. We can take five percent of the average of the portfolio to award grants in a given year. That’s pretty unique because, again, most foundations are raising money for their own programs, scholarships, and their departments. We felt a tremendous desire to give back, so much so that when we first began structuring our program, we looked for models to emulate. We realized there weren’t many out there because there were only three or four out there. We were at the forefront. Now we have a very comprehensive program that others look to in terms of our grants program. Most hospitals are seeking grants—and certainly we want to seek grants as well—but not many hospitals are awarding grants to the community. [01:00:00] What we’re doing now is we are aligning the priorities of those grants with the priorities that were identified through our community health needs assessment. We’re required to do a community health needs assessment every few years as a non-profit hospital. Eighty percent of the grants that we award have to be tied to those identified needs and or other strategic initiatives of the organization. It’s a great feeling. I remember that first day I started at the job here. You’re talking about the first day—the first day I started a job here was the meeting for the Community Service Fund selection committee. After that day, I left here feeling great. We were giving over $500,000 away to local non-profits. It was a great feeling to come and work for an organization that was so generous and meeting the needs of non-profits who otherwise probably could not carry on some of those programs and the initiatives. They would not have been able to find and qualify for other grants through major foundations, or the government. It was a great, great feeling and it continues to be a great, great feeling to this day.

01:01:13
Rigelhaupt:
I’m going to come back, because I want to ask you more specific questions about some of the things you’ve chosen to fund and the priorities. But you mentioned this coordination from the hospital, to the free clinic, to the health care centers. How does that happen? What are some of the examples of the ways that you try and facilitate coordination?

01:01:43
Richardson:
Certainly. We have created our force behind integration and have something called a safety net council. It’s a little broader than we probably would have expected initially. But one thing I’ve learned, when you work with persons who lack access, you sort of have to take a holistic approach. Although you’re dealing with health care, health care can’t be effective unless all those other societal factors that have an impact on health care—such as housing, and transportation, income, et cetera—are addressed. We have some other providers in the community, non-profit providers as well. What we do is we look at some of the common roadblocks that create inefficiencies in the delivery of services. For instance, one of the things we’re looking at now is coming up with sort of a common application for persons who qualify for the services. Or a reciprocal relationship with the provider such that, for instance, that if a patient qualifies for the Moss Free Clinic, then they automatically will qualify for free service in this program as well, rather than having the patient complete another application that still is always a frustration for many of the patients. [01:03:00] Every time you’ve gone from one place to the other—and you’d been referred by an agency that had qualified you—you’d have to turn around and complete another application and provide all of that documentation. We’re looking at ways to do that. We’re sharing some of the experiences relative to cultural competencies, relationships, some of the strategies that are used by organizations to define what is culturally competent health care, and things relative to it, for instance interpreter services. We come in and share some of our best practices with one another. We have funded some initiatives through the United Way that provide a directory of services that safety net providers need access to so that it’s at their fingertips. Back when we first did it, it was a binder; it was a firm binder. Then pretty soon it was a loose-leaf binder because things kept changing. Now it’s an online resource, which safety net providers find to be extremely helpful. It’s just the communication and the networking that takes place because there are opportunities. Sometimes, a particular safety net provider might be qualified for that and they would not otherwise have known. We try to make sure that we’re not being redundant in the delivery of services. If a particular non-profit is considering going into another area, or another program, or service, that might be typical for other peer organizations in another community, if it’s already being met by a local organization, there’s no need for you to do it simply because other centers like yours in other communities are doing it because it’s already being provided here. We have much more coordination of referrals from one organization to another. The knowledge of what is being offered enables safety net providers to make the best referrals, as opposed to sending a patient to somewhere and saying, “Well, I think this sounds like you need to go over here.” Then the patient gets in and is frustrated because that is not the best place for the delivery of services. An understanding of what exists in the community and provided through this safety net council is very important as well.

01:05:42
Rigelhaupt:
Now thinking about that coordination in terms of the growth that has happened over the last twenty years, both in terms of the region, but also the medical campus. [01:06:00] Has that presented challenges in terms of the coordination, or has it provided some opportunities?

01:06:06
Richardson:
I would say both. Certainly challenges as our community has grown, but also some opportunities as well because we can offer more services. One of the things that we advocate for is the local FRED bus system, which provides greater access to these various services. At one point we probably would never thought to provide as many services as we do in the Massaponax area. Now with the ability for the most economically disadvantaged persons to have transportation there, we don’t feel that when we make these decisions we are reducing their ability to have access. There are some challenges but, like I said, there are many more opportunities as well. There are other health care providers who are coming into the community with whom we can partner as well. But we’re becoming a much more diverse community, which offers, I consider, opportunities—others may consider it to be challenges. I think it’s an opportunity to provide services to a different population and an opportunity for us to be sensitive to those changing dynamics in our community. Of course, there are changes as the population gets older, so it’s not just with the growth of the community. There are a lot of dynamics that are offering challenges. But there are a lot more opportunities, too, because of the technology and the other services that we are able to offer that we otherwise could not in the past. Sometimes, those of us who have the means could go out of town for specialist services, but now a lot of those services are coming to our community. If you made a referral to someone who could not afford health care and did not have a free clinic, and then you sent them to Charlottesville for specialist services. Chances are if they are at the free clinic, they can’t afford to get to Charlottesville. Now with more specialists here and more programs and services, we can provide more of the services right here, which is great.

01:08:30
Rigelhaupt:
So even going back to the mid-‘90s when you were on the board, there’s a lot of expansion in terms of specialization. I think cardiac surgery starts with those highly-specialized—I’m going to hate looking at this transcript later. I was going to say highly-specialized specialties. [01:09:00] But were there discussions among the board of ways that even as this highly technical specialization in the hospital was going, to decide to fund it and bring it in, would it also be accessible to the community, broadly?

01:09:23
Richardson:
Sure. Certainly, any services from the hospital perspective—we provide services to everyone and we have a sliding scale for persons who are economically disadvantaged. We have a great amount of free services that were provided. If it resulted in a hospitalization, certainly those services will be provided. Then when you talk about a physician for whom we have given a physician loan, they’re in private practice. Their policies would dictate what the arrangement would be to a person who’s economically disadvantaged. But certainly, we encourage any new specialists who are coming to the area to volunteer at the free clinic or to subscribe some form of financial assistance. By and large, for the most part, those services will be provided to all, particularly if they are provided here at the hospital. Some things that are done on an outpatient basis and we have no control over that.

01:10:32
Rigelhaupt:
Was there, even thinking both about the mid-‘90s when you were on the board and your years serving in the foundation, is there a pretty close relationship in terms of new physicians coming in, perhaps getting loans from the hospital? I know that in many communities, there’s a relationship between private physician practices and local hospitals. How would you describe that relationship?

01:10:59
Richardson:
I think it’s a great opportunity because it enables those physician groups for which there is an identified need—it has to be an identified need—to fulfill a shortage or a recognized need. It provides a great opportunity for them to recruit and then to have that financial support that they need during the onboarding process. In exchange for longevity and commitment, that loan is forgiven. It’s a great opportunity for the physician practices because I’m sure many of them would not have the opportunity to expand as much as they have if it were not for this.

01:11:40
Rigelhaupt:
For some of those areas of need that you described, that there has to be a recognized need, have ideas mostly come from physicians approaching you? Have ideas come from the community? Have ideas come from board members, administrators?

01:11:57
Richardson:
I think it’s a combination of all of the above. [01:12:00] Certainly, we have conducted analysis in terms of where the shortages are. That’s for the basic things that we know for ongoing purposes. Sometimes specialists might approach us based on changing technology, an enhanced specialty, something that they’re lacking, or something for which it’s difficult for them to recruit without such support. We, as executives, are aware of the changing trends, the delivery of health care, and the specialties that we are lacking, or ones that we see, perhaps, have a greater migration than we would otherwise expect. Sometimes that’s because we don’t have those specialties. We look at the market analysis and see there are X number of visits outside of our community. We see this is an ongoing trend and a great opportunity that fits well with our strategic initiatives and strategic directions. We recruit for that as well. Like I said, physicians have their own ideas about what is lacking and what they need in order to really enhance their ability to deliver services. They will recognize it and ask us for assistance in recruiting efforts for a specialty as well.

01:13:42
Rigelhaupt:
Well, if we could switch gears a little bit to starting your current position——which has a very long title—if it always did.

01:13:53
Richardson:
We added another foundation and another title. I didn’t ask for the additional foundation to get another title. That was a board decision. [laughter]

01:14:05
Rigelhaupt:
It’s okay. I’m wondering if we could go back to when you started in 1997, if you could describe the process of being hired in your current position?

01:14:15
Richardson:
Okay, the process. First of all, of course, I had to resign from the board because that would have been a conflict of interest. Then I applied. The board went through a process of determining which candidates they would want to interview and I had several interviews. After that, there was a process by which I had to go through an additional screening, which included taking a battery of tests. I thought all my tests were over—taking the battery of tests was a fascinating experience. Then I talked to, I think, it was an occupational psychologist. The major part of it was actually being interviewed. [01:15:00] It was interesting because you were being interviewed by people who formerly you were their boss, because you were a board member. Actually, it was quite an informative process because I got to know them from a different level, which reaffirmed my desire to work for this organization. I had seen it from the board perspective and I had seen it from the community perspective, but getting to know the executives who were actually interviewing me was fascinating, as well. I found that they were all great people that I knew I could enjoy working with. It was an extensive process. They interviewed candidates from not just the local community, but other parts of the country as well. I think they made the right decision. [laughter]

01:15:56
Rigelhaupt:
So what were some of the things you saw as real strengths of the foundation, in that first few months when you undertook the leadership role?

01:16:07
Richardson:
I thought the board itself. We had a very strong board, a very engaged board. That was a strength. The Community Service Fund was a unique part of the board. That was really the beginnings of becoming a model that was replicated by others. I had a pretty strong donor base. The ability for leaders within the organization and the board to be creative, strategic thinkers who were constantly thinking outside of the box—those were some of the strengths. I think there was a great reputation, and certainly a great office space, as you can see. Mostly it was a great alignment with the mission of the organization. The foundation had a separate board, but that board—I think they were aligned well. There was no tension between the boards, which is not always the case when you have a parent organization and a subsidiary board. I think there were lots and lots of strengths. Then from a personal perspective, it was the culture, the mission, the vision, and the values all were so aligned well with my own personal values. It’s a great, great place to work. I felt that the position, as president of the foundation, aligned well with my experiences, my strengths, and my skillsets. [01:18:00] I remember after the first week I said, “Wow, you get paid to do this? This is great.” When people ask me how I like working at the hospital, I still say to this day, “I feel like I’ve died and gone to job heaven.” I’ve never had a regret whatsoever. The young people with whom I have a mentoring relationship—I mentor many young people in the community—I always tell them that I hope that they too feel that the position that they find themselves in, at least by the time they reach my age, is one that is truly their calling. I feel this is part of my calling.

01:18:42
Rigelhaupt:
What you just mentioned about the synergies between the boards—the foundation board—clearly, in listening, the foundation board is not about just raising money for the hospital. And yet, the core, the mission, as you described earlier—patient care, health care, community health—what are some examples you can discuss about where you have seen synergy between the foundation board, MediCorp, and the Mary Washington Healthcare board that have benefited community health and patient care?

01:19:27
Richardson:
Of course. The major one is the one I described is the Moss Free Clinic because Mr. Fick was on the foundation board, the system board, and the Moss Free Clinic board. There were tremendous synergies there. There are a lot of synergies that occur naturally because sometimes there will be foundation board members who formally served on the system board, and sometimes the foundation board is viewed as a steppingstone to serving on the system board. There are a lot of cross-relationships there. Sometimes board members who have probably served out the maximum terms on the system board would then come over to the foundation board. There’s an appreciation and understanding of how the two boards operate. Therefore, there are a lot of natural synergies that occur as a result of that. The knowledge that comes from those two perspectives enables those synergies to occur. We try to facilitate that by having more board education sessions whereby the foundation board members are invited to attend as well because they need to have an understanding of the institution that they’re supporting. We’re a supporting foundation. If the hospital didn’t exist, the foundation wouldn’t exist. It’s important for them to understand what is taking place, not only from an organizational standpoint, but also just in health care in general. [01:21:00] The more education we can provide, the more synergies that can occur from those relationships. Sometimes there may be something that the board is considering and the foundation can provide some funding. Or the knowledge of some of those things can then assist us when we are presenting unique opportunities for the foundation board to consider, if there are some board members who are aware of the implications. We’re seeing a lot more of that coordination and the synergy through a board subcommittee, the community benefit committee, CBOC—it’s the Community Benefit Oversight Committee—which is a board subcommittee of the system, of Mary Washington Healthcare. It also has representation from both foundations so they understand the importance of the community focus and the things that we do relative to community benefits. When we need support from the foundation for funding, or when I needed the foundation to consider that strategic grant-making whereby eighty percent of the funds are for community health needs, identified issues, and or strategic initiatives, those foundation board members could support them and bring the other board members along because they understood how all of this worked and how the coordination of that is so important. It helped that at some point we may have had a husband on one board and a spouse on another, but that was just a unique opportunity. A lot of it has to do with, the more I think about it, the past experiences of board members who had served the parent organization in the past. The current chair of the Mary Washington Healthcare Board has served as a chair, some time ago, of course, of the Mary Washington Hospital and/or MediCorp Board.

01:23:16
Rigelhaupt:
The education meetings and sessions you described, could you say a little bit more about them and what they involve, what they’ve focused on?

01:23:23
Richardson:
Sure. We, as a system and as a health care organization, realize the changing dynamics of health care require that board members are constantly apprised of those changes. We’ve always done a pretty good job with the system board, but we now are reaching out to the foundation board so that they can have a better understanding of it as well. For instance, in the past, take health care finances and some of the challenges there. [01:24:00] In the past, from the foundation perspective, we were providing some of the ancillary services—the buildings all around us have been constructed without the foundation providing the funding for it. It is unlike other non-profit organizations where before the building can be constructed, you have to have the financial commitment through a campaign. We’ve had the luxury of not having to require that the foundation raise the funds for these things. Therefore, the programs and initiatives for which funding has been provided has been for some of those other things such as scholarships, occasionally for equipment, and a departmental fund where they can withdraw on resources on an as-needed basis. With the narrow margins that hospitals and health care systems are confined, philanthropy is going to play a more integral role, in terms of providing funding that will affect the bottom line. In order for us to be effective at that and to really engage the foundation board members, they need to, first of all, have an understanding of the changing dynamics of the financing of the hospital and the health care system and what impact, therefore, the foundations will have. They need to have an understanding of some of the things that are taking place within our own health care system. It’s both providing an understanding of the things that are unique to Mary Washington Healthcare, but also those things that are very much a part of health care financing in general. In order for us to have the board buy into that and understand the importance of their role, they have to be educated just as the health care system board is educated. There are a lot of opportunities to combine those education sessions. Now we invite foundation board members to come to those, so they have a better understanding of what’s taking place in health care.

01:26:15
Rigelhaupt:
Do you remember a particular session or class that attracted a lot of interest from the board or a lot of discussion thereafter?

01:26:24
Richardson:
Anything having to do with funding and financing in the future is always going to have a keen interest. From the standpoint of the foundation board, we really have not had one that has more of an interest than others. The roll out of this strategic plan—there was a lot of interest in integrated physician networks. If we did something on the impact of affordable care, looking at affordable care, things like that—board members are aware that it can have a significant impact on operational systems or anything like that, and they would be in attendance. [01:27:00]

01:27:09
Rigelhaupt:
So jumping back to when you started again in 1997, thinking about the first year, what did you see as some of the goals that you really wanted to bring to the foundation and try and implement?

01:27:27
Richardson:
I wanted to ensure that we had more strategic grant-making, rather than trying to be all things to all people. That we focus in on certain areas and initiatives, which we would fund. At that time, I came into a centennial campaign to benefit the Community Service Fund and trying to build a donor base. We were trying to find new board members as vacancies developed. I was trying to get the community to recognize that despite our obvious success as a major organization that we were, in fact, a non-profit that needed philanthropic support as well. When people look at our beautiful facilities it’s easy for them to say, “Well, they don’t need the assistance.” But we do need the assistance in order for us to continue to broaden our scope, to keep up with the technology and the changes that we are facing in health care, and to ensure that we are fulfilling our mission to improve the health status of all people. You can’t do that without additional support.

01:28:51
Rigelhaupt:
How would you characterize the role of volunteers and auxiliaries around the foundation and Mary Washington Healthcare?

01:28:58
Richardson:
Volunteers are very much an important part of the organization. In fact, it was volunteers who created the hospital and volunteers who continue to provide a tremendous support and tremendous labor pool. They’re important for all those things and all those services that they provide. They are very important for those fundraising activities that really provide a tremendous amount of support to the foundation. Even in some of our campaigns, they’ve committed as much as two-and-a-half million dollars over a five-year period. They are very important through their fundraising initiatives. They also are important ambassadors to our community because they represent diverse communities within our service area. The more such partners we have and the more well-versed persons who are affiliated with us, the better our story can be told. [01:30:00] They also are eyes and ears for us in some ways because they come back in to us and tell us how we’re perceived in the community and about opportunities for advancement. Volunteers play a tremendous role—the teenage volunteers have always had a major role. I remember when I was in high school we had the Candy Stripers who were volunteers. Now we have an Explorer Post, a co-ed program of the Boy Scouts of America. It is a community of volunteering young people who are here to learn about health careers and they’re looking for opportunities to volunteer. Our auxiliary and Red Cross volunteers provide a host of services. We have all volunteer board members. Then, actually, in between them we have what we call a Citizen Advisory Council, which is comprised of about 100 citizens in this community who are very much interested in helping us to implement our community benefit strategy. They also are goodwill ambassadors. They’re a sounding board as well. So yes, we could not exist without the tremendous support of our volunteers. There are, of course, the formal organizations, in addition to the two auxiliaries. They have their own leadership. We draw upon those auxiliaries for some of our board seats. Both foundations have members from the auxiliaries. Our community benefit—what used to be the Community Service Fund selection committee—both of those include volunteers. Any opportunity we have to engage and involve our volunteers, we certainly are receptive to consideration.

01:32:08
Rigelhaupt:
Can you think of any ideas in terms of practice—the health care part—that have come from the Citizens Advisory Council?

01:32:23
Richardson:
The Citizen Advisory Council is a relatively new council, but I will tell you that one of its predecessor organizations, the Healthcare Assembly, identified a need for mobile health services to provide access to health care for persons who otherwise would not have it. This was before we had all these safety net providers and that’s why it became a supporter of the mobile van program. [01:33:00] Medication access programs came out of the recognition that a lot of our citizens can’t afford pharmaceuticals and medicines, and we created those programs. We’ve taken it now—again, the predecessor organization was the Healthcare Assembly—on the road sometimes and we’ve gone out to meet with other groups. For instance, we met with the Fredericksburg area Head Start parent division. One of the things they told us was that there was a tremendous need for dental services for children in this community. They made it clear they were not looking for a handout, but a hand up. Through feedback that we received from them, we developed a strong partnership with the health department to enhance the delivery of dental services—free dental services—to children. We do get a lot of great ideas from them. Even the format of the meetings have an education session. They even pushed us and said, “You need to use us as a sounding board. You need to stop apologizing, start waving your own flag, and boast about some of the things you’re doing. Because you’re telling us things that we didn’t know. You need to tell us more. The more we know, the better-equipped we are to go out and be an advocate and an ambassador for you.” Now we have an education session before each of these meetings where we’ll talk about a particular service line or give them an update on what’s going on in the community. They are not a shy group, so we do hear suggestions all the time. We can’t always implement them because sometimes it’s a little bit more complicated than you think. But we certainly listen and can certainly glean something from each of those encounters.

01:34:44
Rigelhaupt:
So in the sixteen years you’ve been head of the foundations, now, there’s been tremendous growth of Mary Washington Healthcare and MediCorp. What sort of challenges has that presented for the foundation, to grow perhaps in a parallel way?

01:35:00
Richardson:
Certainly, there’s greater need and greater opportunity. The greater challenge has been the economy. You’re trying to raise funds in a small community and there are so many different organizations competing for the same dollars. When you are viewed as the more successful and better endowed charity, it sometimes makes it a harder sell. People think the things which you are raising funds for may exist with or without their support. Oftentimes they want to give to an organization for which they know they are making a significant difference. When, in fact, they really are in all the things we do. But it’s sometimes harder for them to understand when the piece of equipment that you’re looking at is a couple million dollars. [01:36:00] What would that $50,000 do, as opposed to something else? It’s provided some opportunities and more challenges, and will certainly provide more challenges in the future. As I said, with the narrowing of the margins that we enjoy, it’s going to mean that we’re going to be counted upon to provide more support than ever.

01:36:33
Rigelhaupt:
One of the things that I’m interested in having you talk a little bit about is trying to understand the dynamics between public health, community health, community benefit, and what hospitals traditionally have been very good at, which is acute care, sick care. And certainly, I’ve read that generally speaking—except for charity hospitals, medical schools—most hospitals have not been overly concerned with public health. They haven’t necessarily viewed that as their role. And yet, it seems like what you described and from what I’ve learned, that Mary Washington Hospital, MediCorp, Mary Washington Healthcare—all the names—for as long as you can remember, had public health as part of its mission. And I’m wondering if you can talk a little bit about how and why that’s happened, and why that might be different from other hospitals?

01:37:36
Richardson:
Sure. It’s a combination of factors. One, we are a non-profit organization. We’re not a public hospital, but we’re a non-profit organization and we serve the public. We are owned by the community. And again, we did this long before others were challenging non-profit hospitals to defend their tax-exempt status. It has to do with the visionaries who are board members. Even as we’re looking at things from a financial perspective, there are always board members who will remind us of our community role. Even successful, major corporations—for-profits—realize they have to be good corporate citizens. But when you’re a hospital providing a human service and you are owned by the people, it’s even more important that you always keep that community focus and that reminder that comes through that mission, that we’re doing this for all people. It’s also the commitment of the leadership. Fred Rankin is very much committed to the community, and it’s obvious in the work he does on a personal level and what he expects out of the organization. [01:39:00] By the same token, we, as leaders, realize that we cannot be all things to all people. We have to stay focused on our mission. If you get overly concerned with trying to be all things to all people, you end up being nothing to anyone. There are limited resources. But by and large, it’s the people and it’s the culture that we have developed here. It’s a recognition for the need to be proactive and preventive. Because we know that old adage, an ounce of prevention is worth a pound of cure. Certainly in health care that’s true. The more that we can do from the preventive standpoint—whether it be through education or through partnerships with other organizations and other health care providers—the healthier the community and the less need for some of the acute care. I think even before it became popular to talk about preventive medicine and all we were doing some things in that area. That’s the beauty of being in a small town and a small operation. It’s much easier to have people more on the same accord, as opposed to larger organizations with many factions and many different agendas. Fortunately, many of our physicians are aligned with this, relative to those things as well. I think that we’re doing a better job of recruiting. It’s important that the people that we bring on staff and physician leadership that they are aligned with our mission, vision, and values. We try to make sure that we hire for that and recruit for that. We do that even for the board members that we bring on line, as well. I think that’s what accounts for a lot of that focus.

01:41:09
Rigelhaupt:
Well, some of the things you said, actually, touch on another question I have. You mentioned preventive medicine or preventive care. You mentioned smaller margins, that there are financial constraints, health care is expensive. And thinking about what you identify in terms of community health needs in the 2011 report, many things you identified are long-term, chronic conditions. And those traditionally have either been very expensive to treat in a hospital—based in a hospital—because they’ve gotten to the point end up in the emergency room. [01:42:00] Or something that hospitals have said, “This isn’t our mission. We do acute care.” How or why do you think there’s been the level of integration that a hospital has put preventive medicine—which may or may not be reimbursed—as part of its mission here at Mary Washington Healthcare?

01:42:26
Richardson:
I think that you’ve articulated it well. Part of it has to do with that type of preventive care can help to preclude or reduce the need for acute services. You said, when you look at the different health needs that were identified—and again these were identified by community members. These were not identified by Mary Washington Healthcare staff. To be a true Community Health Needs Assessment it has to involve the community. It was community led and driven. Now, when we looked at the list the thing that I challenged everyone to look at from the broader perspective is: what is the single priority if you were to look at those things? Of course, the initial response was that cancer. Cancer keeps ranking high. It was ranked high when we talked to our citizen members. It was ranked high when we did the needs assessment. You look at the data and it all says it. But from a community health perspective, I felt and I advocated for us identifying access as a major issue. If you have access, you will have the care that you need from a preventive standpoint. Access will help to identify those things and help to prevent those things. Even if you were to diagnose those conditions—if we were to say, for instance, choose a particular type of cancer and then say we were going to do screenings for this. If you screen for it and you identify it, what are you going to do if the person doesn’t have access to health care? Everything pointed back to access. If we have increased and improved access, all of those different health conditions that you see listed as identified needs can be addressed from a preventive, as well as an acute, standpoint. More individuals will have a family practitioner. I don’t want to use the term medical home because medical home has gotten to mean something different. But they will have their own doc, or a place where they can go and receive basic, primary care. If you get that, and you get those screenings, and you have regular visits, and you have education, and all those things that come with access—whether it be through the free clinic, whether it be through the community health center, or primary care providers—the less likely that you’re going to see patients with those conditions or a need for such significant acute care. [01:45:00] It’s not going to solve all of it, but certainly it should help to reduce the incidence of all those things. Cancer, for instance, was a major one again because we have a higher-than-average rate of cancer than other parts of the state. If you have a primary care home or provider, then detection and screening will identify these things much earlier. Even if you can’t prevent it, you can minimize the continuance or the spreading of it and perhaps provide some treatment that will help to put it into remission. So, yes, it’s all related, clearly.

01:45:51
Rigelhaupt:
So if I take the interrelation of health care, medicine, hospitals being concerned with their costs and providing health care in the acute setting, preventive medicine. But if I try and circle this back to one of the questions I asked early on about the hospital having the three major groups—in terms of the board, the administration, and physicians. Now I can see how, quite clearly, from a community benefit perspective, integrating these things makes a lot of sense. Has it been challenging to take that perspective to those other parts of Mary Washington Healthcare in terms of the administration, the board, and the physician community to understand why prevention and integration could be beneficial?

01:46:51
Richardson:
No. Certainly not from the standpoint of the leadership, the administration, or the governance. I think many physicians understand it, too. It’s a much better understood premise, that prevention is important in health care delivery. It’s also, I think, everyone realizes that prevention and, more importantly, access—access is so important because without access the primary care provider for the average person would become the emergency room. These are persons without insurance, and it’s a financial implication. There’s also a delay in detecting and treatment, which then becomes a much more expensive proposition. From a financial standpoint, it makes good sense. It also makes good sense from stewardship of resources, and we have a limited number of resources. The more that we can do in terms of prevention and the more persons we can treat when it comes to acute care, then the less clogged emergency room services are. [01:48:00] The entire community benefits from this preventive care. I think everyone is on one accord there, and they understand. Pay now or pay later.

01:48:23
Rigelhaupt:
I mentioned your job title, and government relations is part of that. Could you describe what that means and how that has perhaps changed over the sixteen years you’ve been here?

01:48:36
Richardson:
Sure. I am not a lobbyist. Because we are non-profit organization we don’t do the formal lobbying that a lot of for-profits do. A lot of our health care advocacy work is done through the Virginia Hospital and Healthcare Association (VHHA), as well as the American Hospital Association (AHA). But we still do some intervention, primarily at the state level. But there have been a number of different issues—certificate of public need, Medicaid expansion—which we’ve had to take on a more active presence in terms of our engagement with our local elected officials. In the past we’ve had many local leaders at the state level who have held significant roles, major roles of leadership. It’s been important for us to convey the position of our organization. More importantly, we have to convey the position that it represents in the interest of this community, relative to some of the legislation. I would typically spend parts of a couple of days a week during the General Assembly to go down and serve as an advocate—a part of the health care advocacy group. We’re now beginning to do more at the federal level, visiting legislators and supporting some of the positions of the American Hospital Association, the AHA. If we don’t, because this is a norm, our legislators will misinterpret it to mean that it’s an issue that’s not important to us. It’s important for us to have a regular presence, particularly during the General Assembly session. We’re trying to meet with some of the elected officials prior to the beginning of the session. We also try to take our board members at least once or twice during the session to meet with these elected officials and to share, sometimes, a perspective that they may not otherwise hear. [01:51:00] Governmental relations are very important. From time to time, we have done things with some of our local elected officials from the local governing bodies as well. We are a major player in each of these communities and sometimes we do it to remind them of the things that we do and to express our appreciation for their cooperation and partnership. Sometimes it may have to do with real estate issues in a particular area because we’re a landlord. Or sometimes we may have to deal with transportation issues relative to highways. We try to keep an active presence and engagement with our officials who represent this area, whether it be at the local, state, or national levels.

01:52:07
Rigelhaupt:
So let me pose a question: in terms of policies—and this is completely hypothetical—but the American Hospital Association might not be lined up with, say, the American Medical Association, and doctors. And two very powerful organizations—

01:52:29
Richardson:
Certainly, certainly. And you’re absolutely right. There are frequently challenges at the state level whereby there may be an advocacy group or a trade association representing a particular profession within our organization—whether it be nurses, or therapists, et cetera—whereby a position of that particular organization may not represent the position of our organization. That’s where I provide the coordination and let our staff members see the bigger position and to let them know that if they are representing this organization, this is the organization’s position. Frequently, the position is not just one that’s taken by the state association, but one that is approved and reviewed and approved by the board. From time to time, we will take a position to the board and ask that they make a recommendation. Do you support this or do you want to state that we are in to support it? This is our position. Yes, it can and sometimes it will be a challenge. As you said, the AMA or even the state medical society. We have to remind our physicians—our employed physicians—and our board members who are physicians that if they’re going there in our name, that we’re wearing this jersey. [01:54:00] It makes for some interesting conversations. But by and large, for the most part, for most of the major issues, we’ve been on the same page with the medical society. If they’re not employed by us, they can choose to have whatever position they choose to. But they cannot go out and say, as a board member, for instance, at Mary Washington, I, Dr. so-and-so, support—. You may do it if you own the practice. We can’t control that. But certainly do not misuse the representation of this organization because that implies that the system has taken this approach.

01:54:56
Rigelhaupt:
Are there any instances that come to mind where there’s been disagreements with physicians, for example, they often are private practices?

01:55:04
Richardson:
Right. Sometimes it’s based on a specialist, a particular area or specialty. Some of those issues have to do with scope of practice because the state legislature will sometimes recite as to what a particular professional category can do, and that can be controversial sometimes. Other than that, with things like reimbursements for Medicaid and things like that, we’re usually on the same page. There’s the certificate of public need. Sometimes there may be a specialty that believes that they shouldn’t have to go through this process. But we, as an organization, believe in and support this particular approach. When we see that there’s a potential for such based on a differing position, fortunately we tend to be well aware of that. We will tend to meet with the representatives to say, this is our position and to try to help them to understand it from the broader perspective and why it is. If they choose to advocate for a different position, do not do it in the name of our organization.

01:56:31
Rigelhaupt:
I mentioned that I was going to skip over a lot of years and time, but I do want to ask at least one question to really try and probe a little bit some of the things that you learned in previous working experience and career in the Government Accountability Office, and you worked on Wall Street after you went to Harvard. Are there things that you can think of that you learned in those jobs [01:57:00], and gained experience in, that you brought to the foundation and to Mary Washington Healthcare?

01:57:09
Richardson:
Through the Government Accountability Office, formerly the General Accounting Office, I had several experiences that were helpful to me. I spent nine years there. Actually, I did some fundraising. I had a detail assignment for the Combined Federal Campaign—which is a part of the overall United Way campaign—and I learned a great deal about fundraising there. I learned about and gained a better understanding of the federal system, in terms of the legal system and the legislative branch, because we [the Government Accountability Office] were the think tank for Congress. I learned a great deal about writing. My staff suffers from it now because I am a keen editor. When you write for the General Accounting Office, you have to be able to document every word that you state and reference back to some documentation, which an auditor will go back and review before the report is released to the public. The reason for that is that the things that we wrote there really were the basis for legislation, and it had such a significant impact. Therefore, I learned to be a keen writer. Managing people—I learned from those particular resources and those particular experiences, as well. There was a lot that I gained from each of those experiences. Working on Wall Street, I gained a little bit of an understanding of the financial markets, but they’re just a complicated, ever-changing thing that I’m not sure anyone understood. If they really understood, the market would be in a much better position. Yes, there were certainly things that I’ve learned from each of those. The critical thinking and analytical skills that I gained from all of my jobs are very important in my work here as well.

01:59:25
Rigelhaupt:
I think that largely covers a lot of the questions I’ve prepared today.

01:59:32
Richardson:
You certainly are welcome to come back anytime.

01:59:35
Rigelhaupt:
Well, part of the way I like to end an interview session is to ask two questions. One is, is there anything you’d like to add? And two, is there anything that I should’ve asked and I didn’t?

01:59:55
Richardson:
No. I think through my extensive interviewing experiences I’ve learned how to weave things in that I need to weave in. [02:00:00] I’m not sure if I’m prepared to answer this. I think it’s good when you’re interviewing individuals to ask, what do you think your legacy is? And you can do it from the organizational perspective as well as the individual perspective. I guess if you asked me what would my legacy would be, I would say the tremendous work that I’ve done and we’re doing in community benefit, which, to me, is so closely aligned with our mission. The great things that we’re doing to create a comprehensive and well-coordinated community benefit strategy. Prior to this, we were doing a variety of different programs, but it was not really well-organized. I would joke, they would say sometimes it appeared as just the flavor of the month. Whatever great idea someone had, we would do this something in this area. Community benefit is such a core competency and one of our competitive strengths that it was so important that we create a very comprehensive and well-coordinated delivery of community benefit. We had to ensure that there was a culture that valued it. As a result, I think we have an outstanding program that’s now being recognized throughout the state and hopefully, eventually, throughout the country. We’re being called upon from time to time to present it to others and to share our experiences. This is something that has happened under my watch. I’m very proud of where we’ve come [to in terms of community benefit]. It’s also become something that permeates throughout the organization. It’s not limited to one department. When I first came here, community benefit was the purview of one department, meaning community programs. Now, community benefit is being conducted throughout the organization and we’re no longer operating our community benefit in silos. Instead, we’re coming to the table and coordinating things in a much better way. The work of the Foundations is certainly a part of my legacy. The great work we’re doing relative to our community benefit funds, community services funds, I think, is an important part of my legacy. When I ride by the Moss Free Clinic, I see what we’re doing with the safety net providers and making that a much more comprehensive, and again, a well-coordinated program. [02:03:00] We’re not just throwing money out, but holding the grantees to measurable outcomes. I think that’s another part of my legacy. The work that we’re doing with our volunteers is an important part. Just being a good corporate citizen, I think that that’s my contribution to our organization. I think it is part of my legacy. And of course, my involvement in the community, which has been supported and recognized by this organization. In fact, the award there for the meritorious service award, which is given by VHHA and is the highest award that can be given to a non-CEO. I was nominated through my organization in recognition of the work that I do in the community. Those are parts of my legacy. I’m fortunate that you didn’t ask me to choose one.

02:04:04
Rigelhaupt:
I think that’s a nice place to stop for today.

02:04:06
Richardson:
Right. I tell people all the time, you may find an organization just as good, but you won’t find one any better than Mary Washington Healthcare.

02:04:15
Rigelhaupt:
Thank you.

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