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Mountain Empire Surgery Center, Johnson City, Tenn.
Teaming Up for Success


Vital Stats
Administrator: Ouida Klock, MSN, RN, CNOR
Types of surgeries performed: Orthopedics, podiatry and pain management services.
Number and type of staff: 6 business office staff, 12 RNs, 3 surgical techs, 1 LPN, 1 central supply tech, 1 x-ray tech, 1 material management/inventory specialist and 10 PRNs.
Number of procedure rooms: 2.
Number of operating rooms: 4.
Number of operating surgeons: 2 podiatrists, 4 pain management physicians and 16 orthopedic surgeons.
Monthly case volume: 397.
Years in operation: Almost 3.
Ownership structure: LLC with general partners: the local non-profit hospital system, a physician group and United Surgical Partners International.

Competitors coming together
Mountain Empire Surgery Center is a limited partnership joining Johnson City's two competitive orthopedic practices, the local hospital system and United Surgical Partners International (USPI) in a three-way joint venture. The physician partners envisioned a surgical facility specializing in musculoskeletal care.

Persistence pays
When Mountain Empire opened in April 2000, Ms. Klock didn't have the leverage to convince suppliers to bring their orthopedic implants in on consignment. Ms. Klock has renegotiated this arrangement. "With agreement from the physicians, we blocked new items from entering the facility unless on consignment terms. They now know that a product will not come into our facility except on consignment," says Ms. Klock.

Corporate partner
As the surgical facility owner and operator, USPI has used its group purchasing power to save the center on supplies and helped Mountain Empire re-negotiate its managed care contracts.

A competitive EDGE
USPI's Web-based EDGE (Every Day Giving Excellence) program lets Mountain Empire set goals in such areas as on-time starts, turnover times (Mountain boasts an 8-minute average), post-op phone calls and infection rates. Ms. Klock tracks her center's performance on a Web site and typically rewards staff when they've reached targets.

Anesthesia arrangement
The surgery center contracts with a 20-member anesthesia group. To assure they would only get ASC-minded anesthesiologists, Ms. Klock included in the contract that only four handpicked anesthesiologists could come to Mountain Empire. "Maintaining consistency with anesthesia providers helps improve the level of service that we provide to the patients and surgeons. In addition, standardizing medication and anesthesia supplies helps us contain costs."

- Kristin Royer

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