It was 1974 and a young Frank Sacco had just gotten out of the Army where he had served as a medical service corps officer. He was in a management training program with a subsidiary of Burger King, but “I had gotten the healthcare bug,’’ so he took a pay cut and accepted a low-level job at Memorial Hospital in Hollywood.
On Feb. 29, Sacco will retire after nearly 42 years with the Memorial Healthcare System (the South Broward Hospital District), the past 28 years as chief executive officer, during which time he grew the system from one hospital in Hollywood to six covering the southern part of Broward County — the nation’s third-largest public healthcare system. His accomplishment came as, he said, emphasizing “a culture of patient/family centered care.’’
In retirement, he has plenty to look forward to. His daughter is about to give birth to his first grandchild, a boy. His son is going to be married in April, and he plans to get a puppy. “I’m a dog lover and I haven’t had one for 12, 13 years — haven’t had the time.’’
In an interview with the Miami Herald at his office in Hollywood, Sacco discussed the many high points of his career with the hospital system — including developing a strategy to diversify the patient base in order to be able to care for low-income patients while still cutting the district’s tax rate to almost zero and also convincing baseball immortal Joe DiMaggio to lend his name to a children’s hospital.
Below is a partial transcript of that conversation:
Q. Were you originally from South Florida?
A. I was born in Akron, Ohio, and moved here when I was 15 with my father and stepmother, and I went to high school at Southwest Miami High. Then I went to Miami Dade [College] South Campus. I was in the first class at South Campus. The first year, we were at Palmetto High because they hadn’t completed it yet, and then I went to the University of Miami. I was in ROTC, so I graduated in December 1969 and then in February of 1970 I went into the Army as a second lieutenant as an Army medical service corps officer.
Q. I’ve heard that you started here as a janitor. Is that correct?
A. No, not as a janitor. I applied for a job as assistant purchasing director. I didn’t get that job, but they offered me a job as assistant director of the housekeeping department. Within 2 ½ months, I was director of security. I had a military background so I became director of security. Then they just kept adding assignments onto me, like patient escort services, transportation where you move patients around on stretchers and wheelchairs. Then I went back to Florida International University and got my master’s degree.
About 1977, I became the risk manager in addition to everything else and ran the self-insurance fund. By 1978, I was assistant administrator of the hospital, one of five. But then in 1982, I became the only senior associate administrator. And then in 1985, chief operating officer of the hospital. We were still only one hospital. Then in 1987, my predecessor, who had been here for 20 years, passed away. He was terminal and he had groomed me to take his place. So 13 years after starting as assistant director of housekeeping I took over as administrator and CEO of the hospital.
Q. You’ve been CEO for quite a while now. What would you consider to be your greatest achievement?
A. Developing a culture of patient/family-centered care and putting the patient first in everything, all the decisions we make.
Q. I’m sure all hospitals say they want to put the patient first. How do you feel that you do this better?
A. I’m sure that they all do, but when you come to us, the difference is palpable. Our patient satisfaction scores are high, our patient quality scores are high. Every one of the hospitals has been A-rated under the safety ratings from the Institute of Medicine. We have patient and family advisory committees at each of our hospitals. When we build a new facility like the Joe DiMaggio Children’s Hospital that we opened in 2011 we had the families involved in the design. We’ve been rated one of the best places to work for many successive years — in the top 100 places to work in healthcare in the country.
Q. What do you feel was your greatest challenge during this whole period?
A. Just the changes in healthcare that have occurred. My career spanned the inception of managed care. That was a challenge, so strategically we had to position ourselves for that. And growth, taking an organization of about 3,500 employees to about 12,000 employees wasn’t easy. Building a Memorial Hospital Miramar, Memorial West, building Joe DiMaggio Children’s Hospital, acquiring two hospitals during that period time. And now developing a very robust Memorial Physicians Group, where we went from about 25 employed doctors to about 200. I think we’ve employed 50 in the last year.
Q. In the past several years in particular, all public hospitals in Florida have had problems with being able to treat low-income patients because the state hasn’t expanded Medicaid and the [federal] Low Income Pool has shrunk and is about to disappear. How have you handled that?
A. Our strategy started off as first moderating and then eliminating our tax support because we could see that looking into the future that people were not going to want to be taxed for healthcare. Under my tenure, I believe that the highest millage rate was 2.17 mills and now is 0.17. We don’t keep a cent of that. It goes to the county as part of a Medicaid match for our patients.
Then when we looked at the regional hospital [the former Hollywood Memorial] — it was getting older and poorer around us. That’s why we decided to go out to the suburbs and start Memorial Hospital West to have a better pay mix. Memorial Hospital Miramar and Joe DiMaggio Children’s Hospital were also part of the strategy because Broward and Palm Beach counties didn’t really have a children’s hospital and we wanted to be the first. In a remarkably short period of time of 23 years, we went from a couple of [pediatric] units on the floor of a hospital to its own building. And we’re the only ones doing a significant amount of heart transplants in the entire region. Our strategy really was to bring in all these services, bring in some high-end physicians and bring in paying patients and keep those patients through our patient-centric care. That’s helped us be profitable. It’s going to hurt when we lose the Low Income Pool, but we’ll still be viable.
Q. I’m sure you had a lot to do with getting Joe DiMaggio involved with the hospital. How did that come about?
A. We were developing a very robust pediatric service and we were kind of bantering about that we needed a name because we didn’t have an identity. So somebody on my staff suggested Joe DiMaggio. He had just been the grand marshal of the Orange Bowl parade [in 1991]. We had that discussion that he was at an age where he wasn’t going to have a scandal where a name goes up and has to come down. So we made an approach through his attorney who happened to live and work in Hollywood.
I and our pediatric chief of surgery went to meet with [DiMaggio]. He said, “What do you want from me?’’ I said, “I just want your name. I’m not going to ask for any money and I’m not going to give you any money for it, and you can get involved as much as you would like.’’ And we brought him out and showed him our unit, and showed him our plan. And from the first meeting we had with him to when we had an agreement, it was only three weeks.
He and I hit it off. I told him my father used to say that Joe DiMaggio was the greatest baseball player of all time. And DiMaggio winked at me and said, “All the Italians used to feel that way.’’
[DiMaggio cut the ribbon at the opening of Joe DiMaggio Children’s Hospital in September 1992.]
Q. I understand that another of your main interests was establishing pet therapy throughout the hospital.
A. That actually was the idea of Maggie Hanson, our chief nursing officer at Memorial Regional South [principally a patient rehabilitation facility]. She felt that pet therapy was important to the patients. When she became the chief nursing officer at Miramar, she brought a dog, and then we got one for Joe DiMaggio’s Children’s Hospital because the kids love them and the staff loves them and the parents love them. So now, every one of our hospitals has a service dog.
Q. I saw a video made by a couple of the doctors at the children’s hospital. They were saying they couldn’t imagine you retired.
A. Well, I could. I’ve got a few things I want to do, but I’m not going to work. After everything settles down with the grandkid and the wedding, I’m moving to Ormond Beach. It will be about 3 ½ hours from Fort Lauderdale where my kids live.
Q. Why are you moving?
A. It gets pretty congested down here. Also I have a cabin in the mountains of North Georgia near North Carolina, and this will cut down the commute by about three hours.
Q. We had a terrible tragedy recently, the death, apparently by suicide, of Dr. Nabil El Sanadi, your counterpart in North Broward. What do you believe will be his legacy?
A. I think the preponderance of his legacy will be as a healer, as a physician, as an ER physician. I think he had a really long career and an impact as a healer.
An earlier version of this story incorrectly identified Memorial Healthcare System. Also, an earlier version incorrectly said that Florida has not expanded Medicare. That should have said ‘Medicaid.’
Current position: CEO, Memorial Health System (South Broward Hospital District).
Personal: Born in Akron Ohio; age 68. Divorced; has two children.
Education/experience: Sacco attended Palmetto High School, then-Miami-Dade Community College, and the University of Miami, graduating from UM with a sociology degree in 1969. He became interested in hospital administration while in the Army Medical Services Corps, 1970-73. In 1974, he returned to South Florida and became assistant director of housekeeping at Memorial Regional Hospital. He received a master’s in hospital administration from Florida International University, moved into administration and became president and CEO of Memorial Healthcare in 1987.
Honors: In 2012, Sacco was named Humanitarian of the Year by the American Red Cross South Florida region. He was also given the key to the city of Hollywood that year.
Boards, memberships: Fellow and past regent, American College of Healthcare Executives; past chairman, Florida Hospital Association; past chairman, Association of Community Hospitals and Health Systems of Florida Inc.; board member, Broward County Health Planning & Development Council; past chairman, board member, Hollywood Business Council; board member, former chairman, Coordinating Council of Broward.
Hobbies: Cycling in Florida and hiking in the mountains. He also collects baseball memorabilia: In his office, in addition to Joe DiMaggio-related items, he has a signed Sandy Koufax jersey, a replica of Ebbets Field signed by Duke Snider and a picture of Ted Williams hitting a home run at an All-Star game.
SOURCE: FRANK SACCO, SUN SENTINEL