For the past 17 years, he's led the nonprofit Catholic hospital system, earning awards and recognition for customer and patient satisfaction, professional excellence, overall cardiac services and surgery, quality outcomes, and others.

The hospital system is a subsidiary of Catholic Healthcare West.

Before his tenure at St. Rose, he served in several hospital positions, including chief operating officer for nonprofit Intermountain Healthcare's McKay-Dee Hospital Center in Ogden, Utah.

St. Rose's history stems from Henderson's establishment as an industrial town. In 1942 it opened as Basic Magnesium Hospital to care for the workers (and their families) of Basic Magnesium Inc., a World War II metals manufacturer. The Adrian Dominican Sisters of Adrian, Mich., bought the clinic in 1947 from the federal government for $1 a year for 25 years and renamed it Rose de Lima Hospital (now the de Lima campus). More than 60 years later, that foundation has sprung into three hospital campuses in the southern Las Vegas Valley.

Davis talked with In Business Las Vegas about health care reform, plans for the hospital group and the role of the nonprofit hospital in the community.

Rod A. Davis LEILA NAVIDI / STAFF PHOTOGRAPHER

Answer: I think that they're alike in the sense that we operate one system. In other words, we operate St. Rose Dominican Hospitals. We have three locations, and our campuses are highly integrated. We work with similar systems, we have the same policies and procedures, the same hiring and pay practices. We develop systems so employees can cross-train in all facilities, and that really helps us to manage patient volumes much better and more effectively.

We have a bed-management system, which is really state-of-the-art in the industry. We have a control center located here at the center of Siena Campus, so at any single point in time we know exactly what the bed utilization is for all three campuses when we manage the flows in our emergency departments. So, for example, a patient comes into our emergency department here and our (intensive care units) are full, we know exactly what beds are available at the other campuses and at what stages of readiness they're available. In other words, if one bed has been recently vacated, but it's not clean, we know that. If a room is out of service and needs repair and there's a time that it will come back online, we know that. It's really a very sophisticated way that we can manage volume patient utilization at all three campuses.

We're integrated in other ways. We have one single switchboard, we have one integrated security system. Our computer systems are all integrated, so we really do function as one organization.

I think the overriding integrator, if I could use that term, is our values and the mission of how St. Rose operates and that is completely consistent across all three campuses.

Our objective is, even though maybe bricks and the mortar and the appearance may be different at each campus, when you walk in the door it's imperceptible which campus you're at in terms of how you're treated, and that's what's consistent with our mission and values.

The primary challenge is, No. 1, that we are the only not-for-profit, nontax-supported and religiously sponsored system in Southern Nevada. In many metropolitan areas across the country, there are multiple not-for-profits. One of our overriding missions is to provide a community service. We're here for the sole purpose of serving the community. In many cities across the country, there are multiple not-for-profit health systems that provide that service. Each of those health systems have outreach programs, multiple community benefit programs that provide services for the poor and the underprivileged and disadvantaged who live within our communities.

In this valley, we don't have as many programs because the predominance of health care providers are for-profit. Their objectives are slightly different from ours. So, in that sense, we feel that we carry a larger burden of that responsibility for this community.

The San Martin Campus of St. Rose Dominican Hospitals is on Warm Springs Road in the southwest valley. ULF BUCHHOLZ / RESEARCH DIRECTOR

We work very, very hard to try to enhance and improve and analyze what our community services are. One thing that we do every three years is we put together a very comprehensive community assessment and we utilize over 20 different governmental and other agencies to work with us. It's a very detailed analysis of what services are needed throughout our communities. We work in partnership with other organizations to try to address what the needs of some of those disadvantaged populations are. I think that's a challenge in this market.

The second challenge is that health care as an industry is painted with one single broad brush. If one organization behaves in a certain way in Las Vegas, all of us are viewed with that similar behavior. In reality, our organizations are all different. They have different characteristics, they have different behaviors, they have different objectives, and we like to be recognized for what St. Rose really stands for and not what may be a collection of (what) hospitals (or) providers throughout Las Vegas are recognized for.

Well, I think it works to our advantage in the sense that we believe we are a little bit different. Now let me back up and make another comment. I'm the chief executive of the largest Catholic health system in Southern Nevada, but I'm not Catholic. There are many employees in this organization who are not Catholic, but what is truly important is that we have a Catholic value set and a historical perspective of how we provide care in this valley.

I have been in health care for over 30 years. I've been in various different systems and ... I think one thing we see in health care today is that many hospitals have become too institutionalized. We've become too focused on technology, and there's nothing wrong with that. There's been tremendous advances in technology and for us to be truly a state-of-the-art facility, we have to have that technology available so that we can provide high-quality care. But in many places, it's turned into a system of bringing people in, stitching them up, putting bandages on them and sending them back out and treating them more like a commodity - maybe too harsh of a word - but not treating them like a real person.

Now, at St. Rose one thing that sets us apart is that we treat not only the clinical condition, but we believe it's important to recognize the psychological needs, the social needs, the emotional needs, the spiritual needs of our patients and be able to address all of those, so we offer what we believe is a wholeness of care. We define that as a healing environment. It's interesting to me that empirical evidence and scientific studies in the '80s and '90s have actually demonstrated that if you can make a person feel safe and valued, and communicate with them so that they're listened to, and increase their level of hope and optimism, that there's a direct correlation between that and the actual healing process.

I love telling people that it's wonderful that science finally caught up with the (Dominican) sisters, our Catholic sisters. They've had that philosophy for hundreds of years. That's what sets us apart: We believe we're different because we provide care in an environment with compassion, respect and dignity, with a special focus on those with special needs. And there is nothing more important in our facilities than safe patient care. Every single decision we make in this organization revolves around that: How will this decision affect safe patient care?

Well, it's changed fairly dramatically. We have five or six brand-new health care facilities, so we have many more places to provide health care. But, at the same time, the population has nearly tripled in the past 17 or 18 years in the valley. So we needed more facilities. We need more health care providers. We have over 20,000 employees now in health care: We have several thousand physicians, so we have more physicians, more nurses, more clinical specialists in a number of different areas. We offer services that we didn't have here 17 years ago, and I think that's important. You hear once in a while that maybe you can receive better health care elsewhere than in Las Vegas and there's been a bad rap on health care in Las Vegas. You can receive as high level care in most areas of medicine in Las Vegas, as high quality as you can anywhere in the country. Now there may be certain diagnoses that are seen on a very rare basis based on a large population and those are better seen, better served, at centers that may draw from a larger area of 30 (million) to 50 million (people), for example, that can support a center of very rare disorders. But, by and large, 95 percent or higher of all medical disorders can be treated with a high level of confidence, and a high level of quality, in Las Vegas.

I think in 17 years we've improved in that direction dramatically. We've also improved in the types of technology and diagnostic equipment and imaging equipment that we have here, and in many cases, it's second to none in the country.

Rod Davis, president of St. Rose Dominican Hospitals, talks during an interview. LEILA NAVIDI / STAFF PHOTOGRAPHER

I think, No. 1, being a Catholic hospital we're governed under the ethical and religious directives for Catholic facilities. What that means is, there are certain things that we won't do that we believe are borderline problematic from an ethics perspective. There have been movements in certain parts of the country - about euthanasia, for example, a lot of dialogue in the public. We believe, very strongly, in the sanctity of life, and in our facilities that would just be something that would never be considered, under any circumstance. There are certain types of research that may be borderline in terms of the ethical implications - we would not be involved in those. There are other facilities to provide that service, so we just elected not to be involved.

We will never do an elective abortion in our facilities. We may do an abortion to save the life of a mother. We have no need to do elective sterilizations. There are plenty of opportunities for people to do those procedures elsewhere. It's part of the belief system of the Catholic Church, and we believe that this organization ought to be operated in a way that's compatible with that belief system.

Now, having said that, I think the most important area that we reflect what a Catholic facility is goes into how patients are treated. It goes back to our mission statement, where we believe in providing high-quality care in an environment with compassion, respect and dignity; with a special focus on those with special needs.

We have a model at St. Rose that I think reflects very well what we stand for, and that model is: Technology mends - and so we believe we have to have the very best in technology with state-of-the-art equipment and ... highly trained staff so we provide high-quality care. Technology mends, but compassion heals.

So we think that the thing that really sets us apart is the environment. The positive, respectful environment in which we treat employees, in which we interact with physicians and patients and families - the honorable, ethical ways in which we believe we conduct business and try to create a very positive environment for our patients as well. And I think that is somewhat different.

We have a very serious systemic problem in our health delivery system in the United States. On one hand you hear all the statistics about other countries: How their death rates are lower, how their citizens have better access to care. There are two major problems, maybe three, in our health care delivery system.

One of those is we have - depending on whose numbers you're looking at - anywhere from 45 (million) to 48 million people who are uninsured at any one point in time. Now, the costs of those uninsured get shifted to the backs of our insured patients and most of those are commercially insured. So large employers who have a work base of employees are actually subsidizing the care for that large number of uninsured patients.

The second problem we have is (that) under the policies of Medicare and Medicaid that have evolved over 40 years - it hasn't happened overnight - it has evolved into a system that doesn't pay the cost of those patients being treated in hospitals - very rough numbers we received - about 75 percent of the cost of a Medicaid and Medicare patient, so a portion of their care is shifted on the backs of employers. I think that's a very difficult cycle to be in. As costs increase, as the uninsured numbers increase, as Medicare and Medicaid continue to ratchet down reimbursement, we continue to shift more of that burden on the backs of employers, and I think that's a fundamental challenge and a serious problem in this country.

The solution is, No. 1, there has to be a way to address the uninsured, and there are good ways out there. The plan in Massachusetts has many elements that I think would be applied to many states across the country. The plan that Gov. (Arnold) Schwarzenegger was looking at in California had many catalysts to that plan that would help in that regard in a very significant way. There has to be some kind of an impetus and hopefully not a health care crisis across the country that forces action into developing a more fair and more justified health care reimbursement system.

Las Vegas has an additional problem. If you look at other metropolitan areas, we tend to be even more underfunded from the commercial payers than many areas across the country, which puts more pressure on our health delivery system.

It's a huge challenge. The federal deficit, the state budget problems, are huge challenges, and you're not going to solve this health care dilemma overnight. But if we continue to have reductions in reimbursement, it's only going to make the situation more challenging.

Well, I think one of the problems - and this is very personal, I'm giving you my philosophical views on this - one of the problems that face us in this country: the heroic measures we take in every situation. Our physicians and nurses and hospitals and our delivery system is focused on if there is any chance of saving this person. We need to pour whatever resources are necessary into saving this person, and sometimes we lose sight of their quality of life. There are many, many cases where we take heroic measures for patients, and then their lives may not be extended in a significant way. So we pour a lot of resources, and we've actually diminished in many cases the quality of their lives for that last year or so - and at tremendous cost to the health care system. It's been stated that approximately 75 percent of all of our Medicare costs are spent on the last year of life of a patient.

I believe that to really assist in this dilemma of limited resources and unlimited expectations, we ought to change expectations for health delivery in our country. This is a long-term, philosophical debate. But, for example, if I were someone who had reached the end of my life, and I had a choice of some heroic measure, but I fully understood what that meant, that I might survive but what would the quality of my life be after that procedure or after that process? In many cases, I believe, when I get to that point, that I will elect to say, "You know, I've lived a good life, a full life. I feel satisfied with the life I've lived. I want to receive medications so that I can maintain the quality of life. I want to go spend time with my family and with my grandchildren and not be in a hospital for four or five months and maybe 40 to 50 percent of the remainder of my life." We have to have a decisionary discussion about that. And it's difficult. I'm not saying it's easy. But if that issue could be resolved, we could balance the budget of Medicare.

The second issue is in terms of tort reform. It's a challenging issue. There are patients who through no fault of their own are inadvertently damaged in the health care process and they need to be compensated for that. All of us believe that in our hearts. But at the same time I believe the system's gone too far out of balance to the point where many people don't have serious outcomes but they are receiving inordinately high awards because of the way it's being presented to juries, because it's being dramatized in certain ways. We shifted to a lottery mentality that if something happens there's a way that we can all get rich. But it's on the backs of the rest of the health care delivery system.

So if we could solve the problem of this philosophical approach to life and end-of-life and how we end our lives or live out our lives with dignity, and if we can get some rational balance to the tort reform issue in this country, I believe that this health care delivery system, the costs will be balanced and we'll have the resources so we can pay for the uninsured as well.

I think the issue most pressing for the moment is the uninsured issue. Nevada has one of the highest uninsured rates in the country. That continues to be a tremendous burden on health care facilities in Nevada. I think, secondly, there are reimbursement pressures. It's challenging in Washington and in Carson City, but as we try to balance our books and we put pressure on the health care delivery system, that makes our jobs that much more difficult.

One challenge is in manpower development: The shortage of nurses is one major challenge. The shortage of physicians is a major challenge. So we have to work very, very hard to make sure that we have adequate numbers of well-trained doctors and nurses in the future, especially with the retirement of the Baby Boomer era and the huge numbers of health care services that will be required in the future.

Then, in Nevada, we also have a problem that is experienced in other parts of the country, but it's to a critical state here, and that's the problem of the mentally ill. We really don't have adequate resources and facilities to care for that segment of the population. The new psychiatric hospital (Seven Hills Behavioral Institute) relieved a great deal of pressure, but we still, at any given point of time, will have seven to 20 psychiatric patients in our emergency facilities who shouldn't be there, and they're just waiting for some mental health facility to open up.

In this valley, it's over 20 percent, which is very high. One of the highest rates in the nation.

I think it's a belief system, No. 1, you want to ensure you're providing high-quality care to your patients. Second, if you believe that you want to provide high-quality care, then you want to have an environment that does not inordinately fatigue or overwork your nurses; that the work rules that they have are adequate, based on their skills and the acuity level of the patients who they take care of. So, there ought to be a balance. On one hand, you have to be effectively and efficiently managed, otherwise you ultimately would go out of business. On the other hand, you need to make sure that you have adequate staff to take care of patients.

Now there are some benefits. We believe in having an adequate ratio of nurses to our patients, and the benefits are if we create a less stressful environment for our nurses, it's easier to retain nurses so we don't have to recruit as many nurses to replace those who leave the field. We think it's important that nurses have a satisfaction level that is very high in their career so that we can retain really well-trained and very bright nurses in our facilities.

In terms of quality of care, there is a correlation between having adequate nurses who are not fatigued, who are fresh and can recognize symptomatic issues in patients, that the outcomes are improved.

Those plans have been developed to the point now where we have site plans, we have architectural planning, we have the business plan developed for those facilities. We haven't made a formal announcement, but we're hoping to be able to make a formal announcement by the end of this year.

Well, we expect over the next 10 years or so that we will be adding almost 300 beds to the St. Rose system. The Siena Campus, which is our centralized, primarily, tertiary care campus, will be able to compete effectively with any facility within this community. In fact, we do now.

We have many tertiary care services where the outcome levels are on the same level of some of the best programs in the country. Our objective is to make sure that this community has access to health care, to a broad variety of different types of specialties and services, and that level of health care is second to none in the country. So we're developing a system where we have a relentless pursuit of quality. We have a very structured, systematic approach to look at quality and continue to improve quality. We compare ourselves with a number of majors nationwide to make sure that we're continuing to improve on national comparative data.

We're going to continue to grow based on the needs of the community. We're going to continue to offer our style of health care. We think it's good to have an organization whose singular focus is on safe patient care and has the resources to really look at best practices across the country, analyze how those are developed and then develop implementation plans so that we can transfer that knowledge to our facilities, and to have the critical mass where we can provide that level of service. We see ourselves as being a major and a very highly recognized and respected health care delivery system for decades into the future.

Well, the economic slowdown is a challenge. We all wonder how long will this last, when will we have a robust economy again in the future. What's unique about Las Vegas is we have a tremendous amount of investment taking place. There continues to be a great deal of demand. We don't know how the cost of fuel, the cost of energy, will impact that (and) air travel in the future. But we believe that even if there is a slight downturn in the economy here, which we've experienced, that even when you subtract that out, we have a very robust economy that will continue in the future.

Now it may be more difficult to hire people and recruit people if there's uncertainty in their minds about the future. We're always concerned about housing costs and the cost of living in Las Vegas and our ability to recruit people from outside of the state. So, those factors may impact us. Certainly, as employers feel more pressure from the economy, and they cut back on their insurance benefits, or smaller employers eliminate those altogether, that has a ripple effect through the health care system where we have more uninsured we have to deal with.

In our long-term plans for future growth we look at all areas in the Las Vegas Valley, and we make long-term decisions based on what we believe the projected needs are and what we believe our role is in helping to satisfy those needs. But, at this time, we don't have specific plans for the north, north-central or northwest parts of the valley in terms of a hospital facility. We are looking at programs that are more of an outpatient service that we might be able to expand into those areas of the valley. But we haven't made any announcements in those regards at this point.

You know, I don't know. We can debate that question, but the challenge of trying to reduce utilization and manage utilization for health care is a very difficult challenge in this market. On one hand you don't want utilization to not be managed and go unfettered or health care costs would continue to rise. So managed care systems do have to have some oversight and some management ability to make sure the services needed are being received, that the excess services beyond that aren't unnecessarily being employed. I think there's a need for managed care in our market. It's like anything: If the pendulum swings too far in either direction, then, I think, there's a negative trade-off, and in some cases there have been examples of patients who needed services but have been stopped at a gatekeeper's door and for whatever reason haven't been able to access that other level of service. I think there ought to be safeguards built into the system so that doesn't happen.

The issue of too much power in the market - the recent merger of (UnitedHealthcare) and (Sierra Health Services) has caused a great deal of concern to many consumers in this market. We'll have to wait and let that play out to see if there really is a negative impact in the market.

I know the individuals, the executives, involved at United. I have a very close relationship with the executives who operate Sierra, and they have a vested interest to make sure that the delivery of health care doesn't suffer because of that merger. I believe there are good intentions, so I think time will tell as to the real impact to our market of that potential merger.

We continue to see great strides in imaging services, in computer imaging, in our ability to diagnose disease. We're seeing new developments on the research side in terms of modification of genes and how that may help us in the future. We're seeing some dramatic new research in pharmaceuticals and what the potential for that brings. In my mind I think the future for health care is very, very bright. There will always be people in need of some form of health care. We have to be flexible to understand what our health care delivery system will look like in 10 years, 20 years down the road as best we can, and then prepare for that. But I think ultimately you're going to see more people involved on a personal basis in their health care. I think there will be more options for people to access health care on a broader scale. And if we have creative reimbursement plans, I think that that will only facilitate higher-quality outcomes.

There will be a lot of changes coming in the electronic medical records system. That alone will help reduce the error rate in hospitals because we'll be relying less on individual manual intervention of individuals and letting more computerized systems monitor and help us to make sure that we're providing high levels of quality.

No. We have a Level 3 trauma center at our Siena Campus. We invited the American College of Surgeons surveyors, who survey trauma centers across the country, to come in and do a review. We didn't have to. It was optional, but the county has asked that we have those reviews. We believe that it was worthwhile to have experts come in from across the country and review every element of our trauma services. We actually passed that review with flying colors. So, our trauma centers have been verified, found to factually comply with the standards of Level 3 trauma centers, and we're very, very proud of that survey, of the survey results.

I think my biggest frustration is that we still have major challenges in the health care delivery system that I've talked about earlier. I wish that I possibly could have had more of an impact in somehow changing that structure so that more people were insured and more people had access to health care.

The second thing is, Las Vegas has grown so rapidly, and the St. Rose system and Catholic Healthcare West that we're a part of, has invested in excess of $500 million in this market in the last five to seven years. It's unfortunate we didn't have more dollars because there are other opportunities that we could have invested in this market had we had access to those funds.

So, one of my frustrations is the system isn't set up to be generating funds for reinvestment in high-growth markets like Las Vegas. In many markets across the country, the health delivery system is set up in a maintenance mode. We'll continue to maintain what we're doing. I'm a believer that to continually get better, you have to work at it. But you also have to have some resources that you can invest in people and in technology and in facilities, and you can bring the very best people in the industry to a problem to resolve and to solve. I think the lack of significant access to the resources that would allow us to make even more advances has been somewhat of a frustration.

On the other side of that I am immensely proud of St. Rose. I'm proud of what St. Rose stands for. I believe that when the (Dominican) sisters came here over 60 years ago and brought with them a philosophy of how you take care of, not only patients and families, but employees and doctors and other staff members, it's a philosophy of how you operate with a high level of ethics and integrity. I believe in that system. So a sense of satisfaction is that St. Rose has expanded to the point that more patients, more members of our communities, more residents, have access and have a choice to be treated in a St. Rose facility if they would like. More employees have an opportunity to work in that environment, and more physicians have an opportunity to practice in that environment. I believe we are making a difference on the overall health delivery system. I believe we're making a significant difference in the quality of care being provided to Southern Nevadans. It's my hope that we'll continue on this record and in a very strong way, continuing to improve the health care delivery system in Southern Nevada.

I am most proud of the quality, the level of education, the level of training and the level of commitment and dedication that our people have to provide care to our patients.

I am most proud of that.