Caring for Each Other with Buffy Key

Show Notes

Join Kosta and his guest: Buffy Key, CEO of Cookeville Regional Medical Center, and newly appointed member of the Tennessee Medical Laboratory Board.
32 years ago Buffy started her career in healthcare as a medical laboratory scientist at Vanderbilt University Medical Center while serving in the Army National Guard.

Better Together with Kosta Yepifantsev is a product of Morgan Franklin Media and recorded in Cookeville, TN.

Find out more about Buffy and Cookeville Regional Medical Center:
https://www.crmchealth.org/

Find out more about Kosta Yepifantsev:
https://kostayepifantsev.com/

What is Better Together with Kosta Yepifantsev?

Better Together with Kosta Yepifantsev is a podcast about business, parenting and living life intentionally. We're here every week to bring you intentional conversations on making your own path to success, challenging the status quo, and finding all the ways we're better. Recorded in Cookeville, TN, Kosta joins guests from all walks of life to bring fresh perspective and start your week with purpose. We're better together.

Buffy Key: When you look at our
bottom line, obviously, any

business, no margin, no mission,
the regionals a little bit

different than that in the fact
that we truly are servant

leaders for our community
servant leaders for the health

care of our community. And so we
obviously want to make just

enough margin to have our
mission which is building

healthier communities, but at
the same time, our goal is what

do we need to provide to keep
them here to keep them local to

keep them with their loved ones
instead of having to travel 80

miles east, west or south
whatever the case may be? The

difference in the city on
hospital is just that this is

our people's hospital.

Morgan Franklin: Welcome to
Better Together with Kosta

Yepifantsev, a podcast on
parenting business and living

life intentionally. We're here
every week to bring you

thoughtful conversation, making
your own path to

success,challenging the status
quo, and finding all the ways

we're better together. Here's
your host, Kosta Yepifantsev.

Kosta Yepifantsev: Hey, y'all,
it's Kosta. Today I'm here with

my guest, Buffy Key CEO of
Cookeville Regional Medical

Center and newly appointed
Member of the Tennessee Medical

Laboratory board. 32 years ago,
Buffy started her career in

health care as a medical
laboratory scientist at

Vanderbilt University Medical
Center while serving in the Army

National Guard. First of all,
congratulations on your

appointment as CEO of Cookeville
Regional Medical Center.

Needless to say, this is a huge
accomplishment personally and

professionally. When you heard
the news, you were unanimously

selected by the Board of
Trustees. How did you feel?

Buffy Key: Thank you, first of
all for having me today Kosta.

But secondly, honestly, I think
when I heard all of those eyes

that night, it was probably one
of the most humbling moments of

my career, if not the most
humbling moment in my career, to

feel and to know that these
community leaders and leaders

that the city council and
trusted to guide the hospital,

through our ups and downs had
that much confidence in me was

just just unbelievably humbling
for me. But also more than

anything, it made me proud, not
of myself so much. But for every

person that works in that
hospital, I started my career at

Cookeville. Regional in 1990.

For the first time, I've spent
most of my career between Cutler

regional and Vanderbilt
University Medical Center. So I

remember being that third shift
person entry level working in

the laboratory. And I'm still
that person. You know,

Kosta Yepifantsev: I read a
little bit about you in

preparation for this episode.

And when you started, you were
making like $11 an hour I was

Buffy Key: and I was the richest
person in the universe. I truly

believe that I bought a house
and a car, I thought that I was

the most incredibly well off.

And I think it's because I just
loved it. I loved everything

about what I was doing, and
healthcare Slyke that, yeah, you

really have to love healthcare,
because it's both exciting. It's

exhilarating. And it's
heartbreaking sometimes all in

the same day, and every day is
different.

Kosta Yepifantsev: You felt
validated? Absolutely. You have

a long history working in
healthcare, not only in

administration, but on the front
lines as a lab technician,

medical technologist, lab
manager and lab director, how

did these experiences prepare
you for the role of CEO and

shape your view of healthcare
operations?

Buffy Key: Honestly, like I said
a minute ago, I'm still that

person I think I've never
outgrown my thoughts of, I

remember being that 20 year old
or 22 year old kid at three

o'clock in the morning, looking
in a microscope reading a

differential blood smear and
saying, I wonder if anybody even

knows I'm down here. But more
than anything, I think it's just

an I know, this is cliche, but I
think just coming through coming

through all of it, experiencing
all of it. And I continue to be

I learn every day, I still learn
every day, I think just coming

through all the different ranks
through all the different roles.

And I gotta be honest with you,
let me go ahead and tell you

never before have, I thought
that I would be sitting in a CEO

seat of a medical center. My
goal was always I want to do all

that I can, as much as I can, as
long as I can, in whatever that

is, at the end, I will be
thankful. And I think that's

kind of just how I've done it.

And I've never said no to an
opportunity never applied for

this particular job or
supervisor, you know, types of

things coming up. But if they
said, Well, why don't you think

about that? I was like, okay,
you know, let's try it. Let's

see what happens. Let's see what
we can do. Let's see what we can

make better.

Kosta Yepifantsev: I think in
healthcare, probably more than

most industries because you're
dealing with such emotional

dynamics. I mean, it's
essentially people's lives and

their overall health and that
has an outsize effect on the

entire family and their
communities. Having a servant's

heart, leading with compassion,
but then also the what I love

about what you've been able to
accomplish is you've absorbed

everything like a spa. bunch
throughout your entire journey,

when I read a little bit about
kind of the tactics and the

mantras and the direction that
you want to take the operation

and in Cookeville, regional as a
whole, I think, okay, she's

doing it with all of the years
of experience of working with

people from the very bottom to
the very top, but also putting

the quality of the services that
you provide first and the

experience of not just the
patients, but also of the people

that you work with first,
absolutely, it matter. Yeah,

this is probably the
understatement of the decade.

But ruler and local hospitals
are having a rough time, a large

majority of hospitals, the size
of CRMC, are owned by private

equity groups, and their sole
purpose is to generate as much

profit as possible, often at the
expense and health of their

patients. Cookeville regional is
a city owned hospital, for

anyone that doesn't really
understand what that means. Will

you explain the importance?

Buffy Key: Sure, I think I can
really break that down very

simply, when you look at our
bottom line, obviously, any

business, no margin, no mission,
but Cutler regionals a little

bit different than that in the
fact that we truly are servant

leaders for our community,
servant leaders for the health

care of our community. And so we
obviously want to make just

enough margin, obviously, to
have our mission, which is

building healthier communities.

But at the same time, our goal
is what do we need to provide

for the surgeon to the services
for the community, to keep them

here to keep them local to keep
them with their loved ones,

instead of having to travel 80
miles east, west or south

whatever the case may be. The
difference in the city on

hospital, obviously, is just
that this is our People's

Hospital. And someone asked me
one time what our core

competency was, if you really
look at global regional, and I

had never thought about it, and
I sit down and I said, Oh, it's

simple. It's our people taking
care of our people. Exactly. And

how that that extrapolates out
is, is we're not part of a

private equity or a larger
health system and where the

stockholders are in Washington
State somewhere and saying, wait

a minute, cut this by noon
tomorrow, because we need to

make this profit margin like
this much better. Let's face it,

we do things every day, that may
be a financial loss. But man,

what an emotional and human gain
for the community that were

being able to do that here. And
you create

Kosta Yepifantsev: a healthcare
pipeline. For people that are

wanting to be in the healthcare
industry at a young age, you are

able to facilitate the entire
pipeline, and it helps

businesses that are in you know
long term care that are working

with people that are just
entering the healthcare field

Sure, to all the way up to you
know, CRMC hiring doctors and

medical professionals. I mean,
when it comes to hospital

systems, like you said, that are
in Washington state that own you

know, a hospital system in
Tennessee, or a Regional

Hospital in Tennessee, they
don't have that same emphasis on

because when you have that
pipeline, and I know I'm getting

a little bit in the weeds here,
but when you do, it creates a

better outcome health outcome
for all individuals who live

here. Oh, absolutely

Buffy Key: the and the impact,
not just financial impact, but

the emotional impact the
healthcare impact of what we can

do for each other. Remember,
these are the same people that

we see every day when we go to
the grocery store, or when we go

to church on Sunday, or when
we're just driving down the road

and saying hello, and it means
something to us. Yep.

Kosta Yepifantsev: As we've
discussed, one of the greatest

strengths of Cookeville.

Regional is the self supporting
fiscal responsible nature of our

hospital. As you transition into
this role, how do you plan to

continue this tradition, while
growing the services quality and

reach of the hospital?

Buffy Key: I think the future of
healthcare is a little

different. Now post COVID, if
you will, prior to COVID. I know

that larger health systems have
been able to adopt or if you

will, or move into smaller
communities and take over those

systems. But I think the future
for us, obviously, is to

increase our revenue
opportunities at every

opportunity. And that's not just
taking money out of the

community's hands. I don't mean
it like that. But when I'm

talking about that, I'm talking
about partnerships. It's time

for us to look at partnerships.

What does that mean? Do we have
a service line that we could do

better if we partnered with, say
Vanderbilt, for example, or

whoever that may be? You know,
currently we have a great

partnership for Pediatric
Hospitalist medicine and the

nursery with Vanderbilt
University Medical Center. And

that was a no brainer to me
because first of all, are sick

children that are born that are
not as healthiest as we would

love for them to be. That's when
we send these kids and tell you

at Children's Hospital at
Vanderbilt does an amazing job.

It's one of the biggest
blessings I had working for

Vanderbilt actually was working
in that hospital. I have a

little niece actually that was
born with a heart defect and she

actually went there in his head
to open heart surgeries and

having her last one next year.

So it's amazing the things they
can do. I'm thankful that we

have that in our community.

Other partnerships, it's time
for us as a governing body and

as well as our Board of Trustees
and city council. And we're

hoping to this fall, get
together and say, what does our

future look like? What kind of
service line? Do we have that we

need to partner with long term
care facilities a little bit

more or other acute care
facilities? And thanks meant,

oh, my gosh, I mean, get me
started.

Kosta Yepifantsev: You're saying
and you say, partnerships, and

you know what I hear I hear
diversification. Absolutely. And

in my opinion, especially in
this day and age of healthcare,

if you want to stop
consolidation, you have to

diversify your services. Right.

And the governor, you know, I
was reading some of the notes

from a special session, and he
is going hard in the paint when

it comes to mental health. And
this is a great opportunity for

us to meet a significant share
in our area. And what better way

within I mean, CRMC already has
some experience with 10. Brooke,

you know, having health
services. So there is so much

that you can do. And I think
that you want to do to

vertically integrate the
healthcare sector as a whole to

make CRMC not just a hospital,
but a one stop shop for health

care in general. Absolutely. All
roads lead through CRMC.

Buffy Key: Absolutely. And not
just behavioral health and

mental health, but also
addiction counseling and those

kinds of things. If we can
support others in those needs,

hey, we're seeing those people
every day. And it's

heartbreaking to us, because
we're not addiction counselors,

how can we help them get them to
where they need to be?

Kosta Yepifantsev: Is it
possible to expand to other

communities? Like is it possible
to make this work in salida or

in Fentress County?

Buffy Key: Well, as you know,
Solana we had this is before

obviously my time in this
channel, but we had a Critical

Care Access Hospital in Solana.

And for whatever reason, you
know, it just it's hard to

timing, the timing more than
anything. I will tell you I'm

from Pinterest County,
originally, we moved to

Kosta Yepifantsev: Cookeville
when I was in the seventh grade.

So everybody from Fentress
County, as well, you should ask

people I've ever met,

Buffy Key: you know, but let me
tell you that's that's a prime

example talking about the scope
original look at that we're

actually working right now with
UT Medical Center on their

freestanding ER that opened up
on July 19. And not when I say

working with them, we don't have
a formal partnership or anything

else. But we want to make sure
that all those transitions work

so we can keep the community
healthy there. And if they need

to come to us, we will same type
of thing for Solana, you know,

it's never out of the question
to look at, hey, are there other

urgent care opportunities for
those immediate needs, you know,

for that community and
everything else, small

communities obviously have a
special place in my heart. And

that's why I reached out to UT
and said anything could original

can do to help you guys, or
emergency room physicians or

hospitals, physicians, we're
ready to help you all with any

of that.

Kosta Yepifantsev: You were
promoted from senior vice

president of quality and
operations to Chief Operating

Officer in January 2021. For our
listeners who don't remember,

that's about 11 months into the
COVID pandemic, and in my

experience, one of the most
stressful and demanding times to

be in healthcare. What's changed
the most since you became CEO.

Buffy Key: Honestly, it's the
reinvention of healthcare and

the need and just the inner
drive for all of us to remember

to reinvest in our staff
reinvest in our teams, if we

don't reinvest in our people.

And when I'm talking about
people to take care of you every

day, when you come to the
hospital, how are they going to

take the best care that they
possibly can of that patient or

their family member? And like I
tell our staff all the time, the

only way to get past COVID. And
through that horrific pandemic

unprecedented, is to learn, what
did we do wrong? And we did a

lot of things wrong, I gotta
tell you, we did a lot of things

wrong we were talking yesterday
about. And when I say we, I'm

talking about the entire
healthcare community across the

country, you know, keeping
people away from their family

members, we were required to do
that. No, we had infection

control guidelines that we had
to follow. And we're one of the

few hospitals in the country
that did allow people to be with

their loved ones. During their
passing, a lot of hospitals

didn't. But it's so much more
than that. It's just reinvesting

in those people. And I gotta
tell you, we had nurses, we had

some nurses, and that breaks my
heart to this day, that probably

saw more deaths during that
period than they will see in

their entire career. And it's
heartbreaking. And so we have

got to remember, they are our
hospital, they make everything

about our hospital and every
patients experience and so

reinvesting in our staff. And
then, like I said, reinvestment

in health care system, and that
is looking at partnerships. What

is the future look like? How can
we make it bigger? How can we

make it better? Obviously,
capacity is an issue across the

country during COVID. Things
shut down. Right and so

healthcare facilities didn't
grow. Man, we're paying for that

now. Oh, absolutely. Luckily,
our economic growth in in

Cookeville has been amazing, and
I'm so proud of that. But we

have to keep up. We're a little
bit behind on that and we need

to we need to grow to meet that
capacity.

Kosta Yepifantsev: So, obviously
COVID taught you a lot of

lessons. It taught me a lot of
lessons, I think, like you said

it taught everybody in
healthcare. But something tells

me that the things that you do,
the way that you handle that you

approach your job, and this
endearment that you feel for

your staff, I feel like you
didn't necessarily learn that

just from the pandemic. And so I
want to understand, because I

meet a lot of people that work
in healthcare, and you can kind

of see the ones that you know,
are sincere and the ones that

are not sincere, and everybody
may very well have the exact

same message that you're saying.

But what caused you to enter
into the healthcare field and

doubled down on leading in the
way that you are?

Buffy Key: Honestly, I gotta
tell you, I've just grown up in

healthcare and not in a way that
my parents were physicians or

anything like that, or nurses or
any health care worker. My

father actually was, who passed
away in 2020. But my father

actually was a paraplegic. He
actually had a fall when I think

my mother was pregnant with me
in 1965. And I think I just told

everybody how old I was, you
look great, by the way, thank

you. My earliest memory of him
is sneaking up the back steps

with a nurse who was not
supposed to bring me up those

back steps to see him. I think
he had 20 Plus surgeries, my

first three years of my life.

And that's what I remember of
him. That's my earliest memory.

And I remember from that moment,
I wanted to work in healthcare.

Now at that point, it could have
been doing anything at cared,

right. But that's what I always
wanted to do. I wanted to be a

physician, to be honest with
you, and that didn't work out,

tried to get into medical school
did not make it obviously, I

wasn't smart enough. And those
are some great guys. And I

applaud them for that. But I
think, especially with the

latest promotion and everything
else, I just think God every

day, I think I'm where I'm
supposed I was made to be. And I

think it's just that passion.

And like I said, That's my
earliest memory. I don't know

anything else. I remember
playing the old maid with him in

the hospital when I was like
three years old. I don't know if

he won, or I wonder I may have
cheated. I'm not sure. But

that's just what I know. I just
don't know anything else

Kosta Yepifantsev: was serving
in the in the National Guard

that contribute?

Buffy Key: Absolutely. I mean,
serving in the National Guard.

Again, I think it's that servant
leadership. I mean, I'll be

honest with you, I never wanted
to join the military in any

shape, form or fashion. And then
I got after I started college

and couldn't play basketball
anymore. It was kind of one of

those things. Oh, well, what can
I do to to help get me through

school because I hate for my
parents to have to do that. And

honestly, it was, I loved it. I
mean, it was I really loved it.

Again, I think those people put
their lives on the line every

day, whether they're in the
medical arm of the military or

of the frontlines. And again,
it's just that servant

leadership, it teaches you that
from your core, and you either

have it or you don't

Kosta Yepifantsev: CRMC clearly
plays a crucial role in the

local economy, from direct
employment to the indirect

influence it has on job creation
in the community. How do you

plan on cultivating and
expanding this economic impact?

And why does it matter to our
community? Overall?

Buffy Key: That's a great
question. And I will tell you

that recently, we have just
kicked off a renovation project

in the hospital, it's an $18
million project, one of our

primary goals is that as much
money of that renovation project

as we can, goes back into the
economic impact of our

community. So we can guarantee
you right now that at least 50%,

nine 9.2 million obviously, will
go back into our local

community, suppliers, vendors,
electric companies, whoever that

may be. And that is so important
to us. We always look local

first. And again, I think that's
just part of our mission

building right here,
communities, it's not just about

our health, it's making sure
that everybody is viable.

Kosta Yepifantsev: And that may
very well go away if it wasn't a

city run hospital, you know,
because there is a partnership

to use your term between you and
local businesses. He absolutely

it matters. I want to ask
because we're about to get to

the end of the episode. But
there's a couple of questions

that I'm very curious about.

First off, I don't think that
anyone has any concern or any

reservations about you being the
CEO, because as you're

explaining your mission, spot on
the challenges that you face

throughout your life and the
different areas of focus that

you've had, you can be just
fine. If anything, I think that

you are kind of the saving grace
to our hospital system. I really

do. I really believe it because
nowadays you have to have

somebody who understands people
and quality of care above all

else, because the money will
come but you got to have those

two components first, right?

This Second thing in your
vision. So if you look, let's

just say you know, 40 years down
the future and you're still CEO

in Tennessee, you are going to
have HCA Vanderbilt, UT? And is

your goal to have CRMC on the
same plane?

Buffy Key: Absolutely.

Absolutely. I think our
community deserves that our

region deserves that. And
honestly, we work so closely

with all of those guys already
anyway, it would be ridiculous

of them not to scoot over.

Honestly,

Kosta Yepifantsev: I want to end
this episode with a question

about health, specifically the
health of the upper Cumberland

as someone that can see all the
data before them, where we've

been and where we could go.

What's your advice to our
community on building a

healthier tomorrow?

Buffy Key: Honestly, I think I
could learn from this advice

more than anyone. But I do
believe that for our community,

because we are growing, and
we're growing at leaps and

bounds and in such a rapid
fashion. I think everybody

should take at least five
minutes every day and

concentrate on themselves. What
does that mean? Honestly, I

think it's their mental health.

I think it's their emotional
health. Remember, our own

emotional intelligence? I think
it's, again, just focusing on

themselves. How can I take
better care of me today? I know

that the other 23 hours or 50
minutes of today, I'm taking

care of everybody else. But for
this 10 minutes? How can I focus

on me? What does that mean?

Whether that's quietness,
meditation, thoughts of how can

I be physically more healthy?

How can I be mentally more
healthy, but just focus on you,

Kosta Yepifantsev: ladies and
gentlemen, Buffy key. Amazing.

So we always like to end the
show on a high note, who was

someone that makes you better
when you're together?

Buffy Key: Other than my family,
and I gotta say them first and

foremost, or they'll never let
me back in the house for Sunday

dinners, I bet but honestly,
it's our senior leadership team.

I think we have the best team at
Cookeville regional right now

senior leadership team that
we've ever had, there is nothing

that we can't share with each
other about the growth of each

other. And more importantly, our
mission every day is to turn the

org structure upside down. We
serve everybody else. We are at

the bottom of that and everybody
else is at the top. I think we

force each other to do that. And
we're kind of like family, it's

the CRMC family. And you know,
you can't choose your family. So

you got to be sure you love them
love each other through it and

all of that, but we are really
good for each other and I'm very

proud to work with them.

Morgan Franklin: Thank you for
joining us on this episode of

Better Together with Kosta
Yepifantsev. If you've enjoyed

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and editing by Mike Franklin.

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