Q&A: PRMC’s Peggy Naleppa — ‘It starts at the top’

Incoming President & CEO Steve Leonard gives testimonial remarks at Dr. Peggy Naleppa’s retirement ceremony held last month at Peninsula Regional Medical Center. Naleppa retired after 17 years of service at PRMC, including seven years as the top leader. On the screen behind them is a photo from when Naleppa worked as a young nurse.

Margaret “Peggy” Naleppa has been a part of our community for nearly two decades — and what a difference she has made.

As President and CEO of Peninsula Regional Medical Center, she led Maryland’s eighth-largest hospital through huge changes in the health care industry, adding outpatient facilities across the region and working to improve the not-for-profit hospital’s staffing, equipment and infrastructure.

Wednesday, Jan. 3, was her last official day as CEO. Her replacement, Steve Leonard, was promoted from her staff.

Naleppa was named the medical system’s boss in 2010, following Alan Newberry’s retirement. She first came to PRMC in 2003 as the Chief Operating Officer. The likelihood that she would become the chief was telegraphed in 2008, when she added the title of President.

A registered nurse by training, she has enjoyed a 40-year career in health care and has worked at George Washington University Medical Center in Washington, D.C., a hospital system in Southern Maryland, and has held leadership roles with the Maryland Hospital Association.

She is also a fellow of the American College of Healthcare Executives.

She presided over a $100 million campus expansion and renovation project that created the Layfield Tower, Hanna Outpatient Center, Guerrieri Heart & Vascular Institute and the Richard A. Henson Cancer Institute.

Under her watch came the construction of the Woodbrooke medical complex in Salisbury and the Delmarva Health Pavilion outlets in Millsboro and Ocean Pines. She also oversaw creation of the Peninsula Breast Center and the Peninsula Regional Weight Loss & Wellness Center.

Last fall saw the opening of a new Henson Cancer Institute in Ocean Pines.

While construction of the outpatient pavilions will be a major part of her legacy, Naleppa’s focus on patient interaction via hospital staff and nurses will be remembered. She made character a key element in how hospital employees performed their jobs and worked to ensure that patients always came first.

Q. Why did you go into nursing?

A. Well I my my cousin’s wife was had just graduated from Hopkins nursing program and my cousin was in the trades and he was in D.C. in the early 60s on a construction project and he fell 20 to 30 feet down an elevator shaft and he wound up at Georgetown University in a severe coma.

And for about three months she and I shifted off. I watched the kids she would go in to take care of him. We’re talking in the 1960s and someone who you’d never thought would have any kind of rehab potential.

And subsequently with her TLC and her skill set and the physicians — the teamwork that I saw — and his rehab. It’s an amazing story.

He went back to work a year later they had four kids. And the only impediment even though it was a severe head injury is a challenge in his tone of speech and the way he pronounces pronounce his words. But otherwise he’s fine.

It was an eye-opener for me. I was 14, 15, 16 years old, watching this entire team manage his life and make really tough decisions one way or the other.

And it was an academic center and it just was an energy that I said, “Wow this is a calling.”

His wife passed away from ovarian cancer three years ago and I was asked to speak at her funeral about the impact that Nancy had on me over the years in her career.

So that’s that was personal story.

Wor-Wic Community College President Dr. Ray Hoy, left, and Del-Mar-Va Boy Scouts Council Bill Garrett, present Dr. Peggy Naleppa with the Scouts’ Distinguished Citizen Award Dinner at an event last May.

Q. Even at that age, were you an emotional person or a serious person?

A. It was probably both. I don’t know what teenager you can meet who’s not emotional and not serious in the same area. But it’s probably a combination of both.

Q. It’s a heart vs. head question.

A. In my left and right right brain, absolutely. And I’ve always been had some sort of determination if you will I was the first female elected president in my elementary school and the person I ran against is now Dr. Paul Perlik (a U.S. Army major and noted hand surgeon at Walter Reed Hospital) who actually did the carpal tunnel work on (President)  Reagan.

He’s a great guy and we still joke to this day that I beat him out as president for the elementary student council.

But regardless there’s always been a side of me that’s very you know I guess you could describe it as tenacious and very focused and if I set my goal on something so.

But there’s also the side of the human side in terms of watching the caretakers and the physicians and Nancy, his wife, really involved in this very challenging process and you think you know what.

He was 23-, 24-years-old at that time was going to die. So very challenging. 

Q. What was your parental influence?

A. My dad was in the trades and then he he advanced to assistant vice president for the United States and Canada trade associations. And so he represented plumbers, steamfitters electricians and those trades.

He negotiated a lot for the power plants and worker rights — really big on worker rights. Huge impact on worker rights — Fair Wage, all of those elements that are associated with the blue-collar worker Very much so.

Q. So you’re a nurse. How long did you nurse before you went into the administrative side?

A. Pretty quickly. I was at (George Washington University Hospital) working as a nurse in the neurosurgical unit for about six months and the Director of Nursing, the (Vice President) for nursing at the time, contacted me and said “You know I hear a lot about you, and we have an opening for Director for Neurosurgical, and and I’d like for you to apply.”

Having not had strong management skills or leadership skills she put me into a program and then mentored she’s assigned a mentor to me and that was my first nursing leadership role.

I went back to nursing at the bedside when I was in graduate school and filling in gaps — like if I was (in school)  Monday through Friday at College Park, working on a master’s degree, I would be working weekends at Greater Southeast (Community Hospital) — 12-hour shifts those sorts of things — but I never went back to nursing full time.

Nursing is the foundation and it gives me the clinical exposure out of my five (academic) degrees.

My bachelor’s is actually in Health Care Administration. So the other degrees are in Finance and in Business and in Engineering.

But it gives me a good foundation for a different lens that I look through in making decisions and a different lens and walk into the shoes for the folks at the bedside.

Q. Where did you hear about the the Chief Operating Officer position here under Alan Newberry and what made you look at that job here in Salisbury?

A I had been a Vice President/Senior Vice President at a couple of other institutions. When I finished up at Hopkins, I was a COO for what’s called the Chesapeake Potomac Healthcare Alliance, which at the time was Charles County, St. Mary’s and Calvert. And then I was the COO at St. Mary’s, so dual hats. We worked on major projects as three hospitals in the alliance.

When I finished the second degree from Hopkins, the MBA in Health Care and Medical Services, I was not anticipating another COO position. I was looking at CEO options and the CEO possibilities.

Peggy Naleppa with Denise Billing, Director of the Peninsula Regional Medical Center Foundation, at a spring fundraising event.

Q. Did you want that yourself or did people say you should be a CEO.

A. A combination of both. My CEO, Christine Wray, she’s the MedStar executive now, she said “Hey, you need to be pursuing CEO opportunities. But it was also something that I had thought about.

So when this position came up, it was a sidebar conversation between the CEO of Calvert and the CEO here, which was Alan Newberry about a COO opportunity.

Alan actually called me and then officially they had a recruiter. The recruiter contacted me and I went into the formal queue, but I wasn’t looking for a CCO option — and Alan knew that.

He said to me at the time, “You know, over time, there’s no guarantees on anything. But over time, if you’re successful here, I feel pretty confident you would be selected as the CEO.

“And so, Peg, I know you’re considering different options whether to go out now and apply CEO (jobs) — or wait three to five years and, you know, wait for my retirement. And again, you know there are no guarantees, but I think I’m pretty confident from what I hear about you that you’ll be successful.”

So it was it was some degree of risk, but not significant.

We had had a place in Ocean City since 1975 that my parents bought And we’ve always vacationed up there in the summertime in the 1960s so it felt very comfortable.

Q. I never knew all of that. What was it like working for Alan Newberry? What did he teach you?

A.  Alan’s a classic Southern gentleman and I so thoroughly enjoyed that humility he was a he had a good listening skills his background was (Human Resources).

There was this quiet side to Alan particularly when it was a large group discussion but he was a classic gentleman and considerate of many people had a good sense of humor.

And he balanced when he would when he would coach or mentor me in a given situation he would balance that with a sense of humor.

For example, he called me right before my retirement — he said, ‘now Peg, every night is a Saturday night when you’re retired, and every day is a Sunday.’ He just had a nice sense of ‘we’ll work through this’ and there was always a calmness around him.

Q. It seems like the CEO role is either someone who’s like the hammer or someone who’s never a threat to the CEO. But you guys seemed like partners almost.

A. We relied upon each other. There was a tremendous amount of trust.

I knew what he’d asked me to follow through on something or to assume a given project whether it was a Layfield Tower he had had a good team so I inherited a team.

Now I made some modifications on reporting relationships and exiting some folks. But he gave me full reign with you need to build your team and he helped me to look for competencies and he was just always there.

And that’s extremely important. And he was not a person of a big ego. And so that was helpful because his door was always open.

Q. So you come down here you had some experience with Southern Maryland but how backward were we when you got here?

A. I don’t know that I would use the word “backward” because the board was not — and that was what was exciting to me that’s the first thing I looked for in the interview process.

Alan said to the folks who interviewed me, “Remember: She’s interviewing us as much as we’re interviewing her because this lady has opportunities elsewhere and and she’s from Washington D.C. You know she’s from Northern Virginia. She’s not from here.”

I found that the board’s ways of thinking was very contemporary. Alan had done an excellent job of really helping to build their current knowledge around hospital operations.

The community is conservative, yes, but it’s not any less conservative than other pockets throughout the nation.

Peninsula Regional Medical Center’s Executive Team: Seated, first row, Dr. C.B. Silvia, Vice President Medical Affairs/CMO; Dr. Peggy Naleppa, President/CEO; Cindy Lunsford, Executive Vice President/COO and Bruce Ritchie, Vice President Finance/CFO. Seated, second row, Karen Poisker, Vice President Population Health; Sheri Matter, Vice President Patient Care Services/CNO and Mitzi Scott, Vice President People; standing, Dr. Thomas DeMarco, Vice President Peninsula Regional Medical Group; Chris Hall, Vice President/CBO Strategy & Business Development; Timothy Feist, Vice President Patient Safety and Chief Compliance Officer; and Steve Leonard, Vice President Operations Optimization and Innovation.

Q. I feel like the hospital pulls the community in a direction needs to go, instead of the other way around. Do we have a good hospital?

A. Having worked at GW, having gone to school and worked at Hopkins having been at three community hospitals, I know and have seen enough to say we have an excellent facility. Absolutely.

I brought my mother here. My grandkids have been born here. My father was here. And I would have no problem getting treatment here.

All health care institutions — I don’t care whether you go to Duke (University Hospital) or the strongest academic ones — we’re humans and we make mistakes.

You know the well-known case of Duke taking out the wrong kidney. Those sorts of things happen. And so that’s why you’ve got to put the science and engineering in institutions to minimize that process.

But the physicians here the physicians at a tertiary large campus like this made the decision to come here to build their careers and they were top-notch in their classes — they were chief residents, etc.. They simply chose not to be in the political academic world.

So physicians who come to a 400-bed hospital at that time made that decision to come to a top-notch tertiary facility and that’s why we’ve always committed to making sure that they’ve got the technology that supports them, and be sure that we help to promote the award-winning concepts of those particular worlds, because they’ve got to recruit for their practices.

You take a Scott McGovern (a Salisbury-based orthopedic surgeon), for example, who is out of Mayo (Clinic) and UCLA. He was on the West Coast — he easily could have worked for one of the UCLA centers or whatever, or could probably have gone back to Mayo.

I know who was recruiting him in the Baltimore market — top notch institutions. And Peninsula Orthopedic Associates, between Dr. Tom Brandon and myself, we were able to recruit him because he wanted to build a career in an award-winning, top organization.

Q. Would an example of that be Dr. Mark Edney? Didn’t you basically buy the DaVinci (robotic surgery machine) to appeal to his skills?

A. You’re exactly right! We’ve got a new neurosurgeon, Sophia Shakur. She went to Bennett. She was a valedictorian in her class. She’s a highly trained neurosurgeon and she came home.

You’ve got to get her the technology that will support that. When somebody stays in academic medicine they may choose to stay in a heavily researched environment in an area where they can participate in the research.

And that’s why we try to make the connections like what we did with the Hopkins Clinical Research Network so you can practice here but still work with your colleagues and contemporaries easily.

Q. You are big on personal service, and how nurses are the first point of contact. Where does that come from?

A. I would suspect my probably my family values.

My dad always always was such an advocate for the working man. And and he made it very clear no matter how high he went up in the organization I mean to be for the United States and Canada is pretty impressive. But he was always very clear about we’re all equal and everybody puts your pants on the same way in the morning and no one should have the authority to be disrespectful to anyone else. No one.

Whether it’s a President of the United States or any one. It doesn’t matter who it is who walks in this door today, they be treated the exact same way.

We should we should have the exact same level of respect.

Q. Talk about how things are changing with all these Pavilion’s what’s the reason for that.

A. Because population health and because of the Maryland system we’re going to be responsible for what’s total cost of care. So typically in hospitals as you can imagine were hospitals tend to be the higher-cost setting.

If we’re going to be held accountable on a budgetary process we’re capped at the budget. So let’s say this region gets — let’s say we get a billion dollars to manage the population of the Eastern Shore. Then do you want all your procedures done at a high-cost acute care facility?

No. You want to go to where the patient is. You want to put those facilities out in those communities at the more lower cost less costly centers and make it a patient centered designed in a patient centered way where we go to the patient.

This concept of the mega-hospital-centric dynasty is a dinosaur. it’s something that I’ve preached on since 2010. Because those are the old days of the hospital being that mega-centric entity we need to be a health system that focuses on health and wellness.

That’s population health. We should be providing services all along the way for cancer and diabetes management and obesity and a whole slew of population health programs and be out there because wellness is not going to occur overnight.

It’s going to be a longitudinal discussion. It’s going to take 10 to 20 years starting with school systems and the kindergartens and a whole host of resources that are going to need to be necessary. So go out to the communities.

But if you think about it the way that health care was evolving today and will be in Maryland there’s a great discussion about how you’re responsible for people’s health care for people’s health.

You don’t screen anymore for who comes through your doors.

Where are you going to start that educational journey? You get started kindergarten. You got to put tutors out. You put centers up, tutoring around your facility to help build those academic skills and you’re going to want your teachers, your nurses and your physicians, to be top quality.

You’re going to want that person provide service because you want them to be successful, when you’re only going to get paid for the A’s and B’s.

Peggy Naleppa with her daughters Adrienne Naleppa-Perdue, left, Renee Naleppa, right, and husband Dan Naleppa. The family was attending the annual Moments in the Moonlight Gala fundraiser.

Q. That’s a good point. How healthy are we here on the Lower Shore? We seem to hear a constant set of facts: we have a high cancer rate because so many of our people work in the sun, we have large diabetes and heart disease numbers from bad diet. What are the things that are special to here in terms of health?

A.  I would say the dermatology issues and these skin cancer issues, I think because of the exposure and the watermen and so forth.

Prevalence is an interesting question because I don’t know that we take any particular award for major prevalence for diabetes.

I think diabetes and other chronic conditions like heart conditions and cardiovascular disease, that’s a national issue and every community has challenges with it.

Go up into some of the cities and towns in West Virginia and you’ll find major populations with exposure to environmental conditions — lung disease and idiopathic pulmonary fibrosis and really chronic conditions that are just horrible, all from their work environment.

I don’t know that we “own” anything special here other than we all need to target, as healthcare institutions, wellness programs around both avoidance prevention and improvement and hopefully not having the kinds of rates that we have as a nation.

I think we mirror the nation. I don’t know that we have any more smokers or whatever out there.

Q. What will you miss most?

A. Clearly the people and the patients.

Q. Anyone in particular? Anyone who you especially bonded with?

A. Yeah! This is a group of 3,500 folks and they “get it.”

They are energized. When you love what you do, no day is a work day. And I feel like I see that in so many people here.

Yes. You know we’re not perfect. Yes. We get tired and other things disappoint us. But in the end people that are in health  care know what that mission is about.

It’s very different than it in a widget factory, I think, because we deal with lives and you know, gosh, there’s nothing more personalizing and encouraging then to spend a day with an Emergency Room nurse or critical-caregivers or a labor and delivery nurse or a physician or a respiratory therapist —  anybody who’s at that bedside.

And then you see the Environmental Services folks who we’ve sent to them you know when you’re that bedside keep your ears open because folks are so comfortable talking with you and you’re such an important part of the care team.

Same thing with the dietary folks — the patients will share things with them that they might not share with their nurse.

Q. One compliment often paid to you is that you’ve been excellent in helping the hospital foundation raise money.

A. Well the reason why I think we’re so strong and fund raising is because it’s genuine.

This is this is our hospital. We know where those dollars are going to be used. And it’s going to directly impact the community and it is all from the heart.

I have an exercise which I use where I ask folks: “As smart as we are in the room, I’d like for you to take a moment and point to yourself.”

And when folks do that, they (point to their hearts). They don’t (point to their brains). And this means they care.

They’re very passionate. I think that’s the beauty.

When you ask what I love about this community, that is absolutely at the top of my list because they are very passionate about doing the right thing for this hospital and for the community. And it’s easy when you’re genuine — a genuine person is essential.

Q. Health care is changing so fast and not everyone is on board with the direction. How do you somehow lead those changes?

A. Health care is changing and I think that as a leader your responsibility is not to fixate on who is causing the problem but to fully understand what the issue is and not assign blame — it’s just that personality or that individual.

It’s a true issue and you’ve got to identify that what’s a contemporary way of thinking around it. And so that’s our premise is if it requires us to collectively work collaboratively on these work we’re partners with our physicians in our community and our members of our medical staff.

We should not be adversarial by any means. We’re all in this health care challenge and changing world together. We’ve got to work through solutions.

Q. Well, I have a feeling that, unlike Alan Newberry, I don’t think your every day is going to be Sunday for you.

A. When I announced my retirement was not news to the board — there were no surprises on that.

Succession planning has to be a key part when you’re a half-billion dollar organization. And if we had stockholders you would expect a succession plan — not this business of “three months from now I’m going to leave. Figure it out.”

(A leadership change) has to be a very planned process. Because it was announced 18 months ago, one of the national companies contacted me about doing executive one on one leadership coaching. So I said “That’s very nice.”

And they said “we have a lot a lot of opportunities.” I said I really want to work just part time, just maybe one or two clients a month. And they said we can make that work, and it’s your call how you want to handle it.

I told them that after 45 years of being a leader in some capacity that I’m not going to rest on my laurels and call myself a coach and executive coach. I’ll go and pay on my own for training.

So I did the research and Rutgers University has one of the best executive leadership coaching programs in the nation. I went there, starting in February. Then I took three or four days off a month and went up to New Jersey. It was the best program I have ever had all my education.

I’m like “wow this is the capstone program for me” — and it was.

It fundamentally changed me in terms of insight as a leader.

I took the exam in July, which was quite extensive, and passed that, so now I’m certified.

So I’ll be starting with this company in probably the end of January.

Peggy Naleppa works with Melissa Roehrig, a registered nurse on the third floor of the Layfield Tower.

Q. A local leader who is a woman told me never to ask the “So you’re the first woman …” question. They said it doesn’t matter if a man or a woman is in a particular role. But I have to ask about this: You and Dr. Janet Dudley-Eshbach — probably the two strongest female leaders in our community — are stepping down at the same time.

A. Well we’re both the same age. We’re both 1952 babies probably by just a couple months and she is a good friend.

I can’t speak for her and her decisions and it’s like we’re losing two great people at the same time.

Q. Did you call on her? You guys actually had some rapport.

A. Janet and I are our personal friends. Yes. She’s going to take a sabbatical and she’ll do her thing and and work through the system on that.

She’ll stay a dear friend. You know we’re both grandparents now.

Q. Was there ever a time when you felt like there was a chauvinist attitude toward you from the people here?

A. No, and I get asked that more so than I would like.

Never did I ever have to deal with that stuff. But it’s it’s real. I mean there are real issues I’m sure for women. I have no doubt about that.

But I have not had that issue and I’ve never felt like it was a glass ceiling.

I was offered great opportunities whether I had male CEOs or female CEOs and I’ve had both.

Q. Your business has a lot of very smart people, with egos that match their passion. And sometimes that spills out.

A. I think you covered servant leadership which is really what we’re talking about here and setting expectations for behaviors.

And so there is there’s no excuse. If a guy or gal is a top cardiac surgeon and they throw an instrument in my OR, they’re not throwing another instrument in my OR.

That’s just that’s just how it works. They have to respect the entire team.

Being authentic -— I think that pretty much describe.

You need to show role modeling and exhibit consistent behaviors.

It has to start on the top.

Greg Bassett is editor and general manager of Salisbury Independent. Reach him at gbassett@newszap.com

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