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Major Healthcare Construction in Birmingham By steVe sPencer
After the completion of the new UAB Medical West hospital and Cooper Green Outpatient Clinic in late 2024, healthcare construction continued at a fast past in 2025 with several major projects reaching the finish line. In August, Southern Research opened its new biotechnology center. The 150,000 square foot building is the first major addition to the institute’s campus since 1987. The facility will enable Southern Research to accelerate the development of therapies using highthroughput chemistry with screening facilities capable of rapidly testing thousands of drug candidates to find the most
promising treatments. The biotechnology center will also host the institute’s new genomic research program, Catalyst, which will offer free genetic testing to identify risks for chronic diseases like, type 2 diabetes, heart disease and certain cancers, empowering individuals to make informed decisions about their health. Construction for the $98 million project began in May 2022, and created 124 project-related jobs and generated more than $80 million in economic activity. The project was financed through several sources. Southern Research, itself, committed $25 million toward the project. The Alabama Legislature appropri(CONTINUED ON PAGE 9)
The new Southern Research biotechnology center.
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Tips Based on Neuroscience Can Help Break Bad Habits or Develop Healthy Ones By marti WeBB sLay
Medical science offers a great deal of guidance on what to do for more healthy living: eat right, exercise, stop smoking, and cut down on alcohol, to name a few. But when patients need advice on how to do these things, physicians are often at a loss to provide guidance. UAB-educated neuroscientist Lindsey Smith, PhD offers insights into habits - good ones and how to develop them, as well as bad ones and how to break them. First, Smith dismantles the myth
that it takes 21 days to develop a new habit. “That’s a made-up number,” she said. “It could be anywhere from eight to 265 days. It depends on how much the habit is ingrained and what pressures the individual faces. Understanding how we develop habits is key to succeeding. Habits get established with repetition and because of our brain’s reward system. If it’s something you enjoy, it gets hardwired very quickly. Acknowledging the difficulty of habit change is important in order to manage expectations and remove guilt Lindsey Smith, second from left, at the 2024 US and Canadian Pathology Conference.
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Tips Based on Neuroscience, continued from page 1 from the process.” Smith offered the following tips as part of a habit-changing plan: • Narrow the playing field by breaking the desired new habit into micro-steps. Tackle habit change in the smallest steps possible. “If you want to eventually run a marathon, you don’t start running two miles every day,” she said. “The first step in running a marathon isn’t actually running. It’s getting used to the idea you are going to be running and reframing it to take fear out of the equation. Make it manageable and unthreatening. “Try putting shoes by the door, getting used to seeing them there, and adapting to the idea of putting the shoes on. The next step is to put them on and walk out to the mailbox. Now you are getting used to wearing them. Eventually you will start walking, and then jogging, and then running.” • Make a plan. Know what the steps will be to move from the first small step to the final goal. • Make it enjoyable. “If you dread what you are about to do, it’s going to be harder,” she said. “Focus on the positive outcomes of your intended habit change. That can help short-circuit the automatic reflex to
going to work. The first step is to start reworking your relationship with the new habit.” “Telling yourself you don’t like a new habit activates stress in the brain. Focusing on how good it will make you feel instead helps activate reward centers in the brain. Those are two very different narratives in our head, and they do different things in our body. The first one causes a stress response. The second one brings on the reward systems. If you think about how great you’re going to feel, you’re activating a different set of molecular signaling cascades that support your success.”
Smith, with a friend, on her daily morning walk.
negative information, so your body is more capable of handling the change without added internal stress. “Your brain loves reward, and it doesn’t like harm. You have to give your brain data points, so go look up data. See what it’s doing to your body to eat junk food. Learn about it, make it less appealing. Then make the healthier choice easier by making it more rewarding. If you are telling yourself you don’t like it, you’re telling your brain this is harmful, and it’s not
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After being diagnosed with cancer a few years ago, Smith knew she needed to walk more, but she didn’t enjoy it. Then she started applying principles of adaptive neuroplasticity. “I was telling myself every time that I didn’t like it. My brain remembered that and I didn’t want to do it, so I started reframing it, practicing positive affirmations while I walked. I could keep my mind positive while doing some guided visualization in my head. I imagined being successful. That felt really good, and all of a sudden five minutes would go by, then 10 minutes, and now I do 20 or 30 minutes without even thinking about it. I was approaching the reward
instead of moving away from harm.” • Fuel vs. Friction. The idea is to fuel good habits by making the change more appealing and eliminating friction that slows down progress and makes the change unappealing. “Fuel would be adding alarms and cues to remind yourself,” she said. “Reminders are important in retraining the brain. Sticky notes placed in home, office, and car, and notes on the mirror in chalk are some creative ways to be reminded of new goals and reinforcing in the brain why the changes are necessary. If you write it on your mirror, it’s the first thing you see in the morning and the last thing you see at night.”
In the end, striving to eliminate guilt is a key part of the process. “Do you really think that you’re going to change a 20-year habit overnight, when it’s already automated and ingrained in your brain? Practice a positive internal dialogue,” Smith said. Smith is developing classes on habit change, neuroplasticity, and stress resilience through her company, Synaptic Harbor LLC. For more information go to synapticharbor.com.
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Dartmouth Healthcare Delivery Program Accepts First Alabama Student Pallotta is One of Only 30 Out of 100 Applicants Accepted By Laura Freeman
Not so long ago, a healthcare delivery system was a doctor, a medical bag and perhaps a horse-drawn buggy for making house calls. Delivering health care in America today has become far more complex. Even a small practice requires a staff with the expertise to deal with multiple payer requirements and government regulations. New layers of nuance are being added daily as biosciences, technology and AI continue to evolve. Multiply that by the number of patients a larger practice or medical facility serves and the challenge grows. Practice management and hospital administration have become specialties in themselves. To meet the need for professionals with in-depth knowledge and the skills to manage the business side of health care, major universities and medical schools have been expanding their degree programs in health care delivery. One example that has been receiving high marks is Dartmouth’s Master of
Anthony Pallotta, MSHQS
Healthcare Delivery Sciences program (MHCDS). This year, out of 1,000 applicants, the first student from Alabama was among 30 who were accepted. Anthony Pallotta, MSHQS, Practice Administrator of Birmingham Pulmonary Group, is already well into the fall semester. “The program is a hybrid course of study that begins with an immersive two-week residency followed by live online classes and an ongoing collaborative project with your six-member study work group,” Pallotta said. “There’s another
residency early next year, and as we develop and complete our project, we will be presenting our solutions to real care facilities that are seeking help with the problem.” At the beginning of the term, students were given a list of projects and allowed to rank their order of preference. Then study group leaders were selected and they in turn chose five other members from those interested in the project. “I was pleased to be able to with my first choice,” Pallotta said. “We are working on ways to improve access to care for cancer patients at the Mayo Clinic.” Cancer treatment is a specialty that the Mayo Clinic is noted for and has a long track record providing. However there are still challenges. “Basically it’s a matter of coordinating timing,” Pallotta said. “Many patients seek treatment at the Mayo Clinic. We want to make openings for new patients available in a way that considers both the urgency of their need and when in the course of the disease patients are best
able to receive the maximum benefits from care. At the end of the term, we’ll be presenting our plan on-site in Minnesota, and then again at the Dartmouth College MHCDS Panel.” This year’s Dartmouth class is made up of 16 physicians and 14 students in areas related to practice management who already have advanced degrees in the field. “Many of the physicians are looking toward careers as chief medical officers of large institutions,” Pallotta said. “Practice Administrators like me want to be ready for the changes we see coming as advances in health sciences, technology, shifts in the populations we serve and influences like AI become a factor. “We learn so much from each other, seeing how people from different areas and different skill sets approach things in different ways. You notice things you may not have considered before. It broadens our perspective so we are able to get in the habit of thinking outside the box.” In addition to working full-time as (CONTINUED ON PAGE 9)
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OCTOBER 2025 • 5
GASTROENTEROLOGY FOCUS
Motorized Fine-needle Biopsy Device Makes Collecting Tissues Samples Easy and Efficient By Lauren Johnson
In August, Mohamad Eloubeidi, MD, a gastroenterologist at Regional Medical Center (RMC) in Anniston, became the first physician in Alabama to perform a groundbreaking gastroenterology procedure using Limaca Medical’s Precision GI™ motorized fine-needle biopsy device. This device allows physicians to collect more accurate, intact tissue samples from a potentially cancerous mass guided by a motor instead of by hand. With more intact tissue samples to work with, physicians can run tests for specific therapies to find the most effective options for patients, which minimizes the need for repeated procedures, saving time, money and resources. Moreover, this will provide patients with more precise diagnoses, another step toward personalized medicine. “Although this was the first time I’ve used it, it was seamless. It felt natural,” Eloubeidi said. “It wasn’t complicated. Anyone potentially could use it because the instructions are simple. You use it like any other needle. The only difference
is you use the motor to drive the needle inside the lesion, rather than move the needle with your own hand.” Eloubeidi, a pioneer in gastroenterology techniques and technology with 31 years of clinical experience and over 300 peer reviewed publications, is the director of Endoscopic Ultrasonography and Advanced Therapeutic Endoscopy at RMC and is the president of the Alabama Gastroenterology Society. He established the first endoscopic ultrasound program at UAB 25 years ago. Precision GI’s fine-needle device can be used to collect tissue samples on masses in the liver, pancreas, and adrenal gland as well as from large lymph nodes around the GI tract and masses around the rectum. Going through the esophagus also gives physicians a window to look at lymph nodes on the lungs, which is helpful for diagnosing lymphoma or lung cancer. “With this device, we’re able to sample any mass that we can see. The implications are many, not only in GI but also in oncology,” Eloubeidi said. Throughout his career, Eloubeidi has seen technologies and new proce-
(L to R) Assaf Klein, CEO Limaca Medical; Mohamad Eloubeidi, MD; Jami Stubbs, nurse assistant.
dures improve patient outcomes. One of these new procedures was the endoscopic ultrasound-guided fine needle aspiration device, which is technology that he introduced to UAB in 2000. Gastroenterologists, including Eloubeidi, have used this device since then to collect tissue samples
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The Precision GI™ motorized fine-needle biopsy device.
to diagnose cancer. Now, as the technology has developed into a motorized, automated device, the procedure is easier, more targeted and more efficient. “The difference is now you put the needle at the edge of the target, and you (CONTINUED ON PAGE 10)
GASTROENTEROLOGY FOCUS
Alabama Gastroenterology Association Hosts Annual Conference By Lauren Johnson
Medical professionals, fellows and residents gathered together in August for a conference to learn about new techniques, technologies and treatments for a variety of procedures and disorders seen by gastroenterologists. Mohamad Eloubeidi, MD, president of the Alabama Gastroenterology Association of Alabama, put together the program with speakers from across the country and had a record high attendance. “Every speaker was an expert in their field,” Eloubeidi said. “Conferences like this are important because it allows us to stay up to date and get continuous medical education credits. It also helps to have camaraderie with your colleagues, and to educate the next generation. Overall, it was a very positive experience.” Over the course of the three-day conference at the Renaissance Birmingham Ross Bridge Resort, attendees listened to 12 speakers and 17 poster presentations on a variety of topics. Gastroenterology Fellows also got to participate in three different workshops.
Attendees received CME credits.
“We had, for the first time, a novel symposium to enlighten the Fellows on what it’s like to be in private practice,” Eloubeidi said. The lecture line up included the following speakers and topics: Paul Feuerstadt, MD, associative clinical professor of medicine at Yale
Gastroenterologists view vendor tables during a break.
University School of Medicine, discussed management of recurrent C. difficile colitis in 2025. “The goal for treatment is to attack the vegetative phase and to boost the immune system,” Eloubeidi said. “Fidaxomicin is the preferred treatment followed by Vancomycin taper and pulsed
regimen.” Additional treatment includes Bezlotxumab or fecal microbiota transplantation for a second CDI recurrence. Nicholas Shaheen, MD, professor of medicine at the University of North Carolina at Chapel Hill, talked about management of Barrett’s esophagus, dysplasia (CONTINUED ON PAGE 10)
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OCTOBER 2025 • 7
FDA Enforcement Against Dental Lab Could Have Broader Implications By Sara M. Klock and Michael J. Werner
The U.S. Food and Drug Administration (FDA) published a Warning Letter targeting a dental laboratory after a lengthy inspection found that the dental laboratory’s operations, which offer directto-consumer dental products, fall directly under FDA medical device oversight. The dental laboratory industry has long held the view that dental laboratory operations do not trigger FDA oversight because of a narrow, albeit ill-defined, exemption for certain medical device establishments. As stated in 21 C.F.R. Section 807.65, “[p]ersons who dispense devices to the ultimate consumer or whose major responsibility is to render a service necessary to provide the consumer (i.e., patient, physician, layman, etc.) with a device or the benefits to be derived from the use of a device” – for example, a “dental laboratory whose primary responsibility to the ultimate consumer is to dispense or provide a service through the use of a previously manufactured device” – are exempt from the medical device registration and listing requirements under 21 C.F.R. Sec-
products were not in compliance with FDA’s quality systems and current good manufacturing practices. Moreover, FDA found Reset’s complaint handling and investigation systems and its procedures for implementing corrective and preSara M. Klock Michael J. Werner ventive action inadequate. tion 807. FDA also found the company’s ReThe industry has viewed this exsetSmile Partial Denture and the at-home emption to shield dental labs from FDA ResetSmile Impression Kit Devices aduloversight, including quality system reterated because they lacked premarket quirements and device approval. approval (PMA) or approved applications FDA’s Warning Letter to Reset Techfor an investigational device exemption. nology Corp. (Reset) signifies that at least In addition to finding Reset’s prodthis dental laboratory’s services were in ucts adulterated, FDA also found the fact not exempt from registration and company’s ResetSmile Partial Denture listing, nor were they shielded from FDA Devices to be misbranded under the oversight. FDCA because it failed to timely submit to FDA a report identifying the mediWarning Letter to Reset cal device correction the company took FDA found Reset’s products both after initiating a correction to remedy adulterated and misbranded under dentures that were not performing as the U.S. Food, Drug and Cosmetic Act intended. FDA also argued Reset’s prod(FDCA). The company’s products were ucts were misbranded because it had not adulterated because the manufacturing, registered its facility or listed the products packing, storing and instillation of the it manufactures. FDA stated that exemp-
tion under 21 C.F.R. Section 807.65 was not applicable because Reset “manufactures and distributes partial denture devices using devices that lack required approval/clearance and manufactures and distributes impression kits comprised of devices that lack required approval/ clearance.” Takeaways Although FDA’s Warning Letter is specific to Reset, it could have broad implications if the agency now interprets those provisions in this manner. Other dental laboratories and additional facilities or providers – such as hearing aid dispensers, opticians, clinical laboratories and assemblers of diagnostic X-ray systems, as well as personnel from a hospital, clinic, orthotic or prosthetic retail facility that engage in direct-to-consumer practices or provide a service through the use of previously manufactured devices – should ensure that they are complying with applicable FDA requirements based on their operations and business. Sara Klock is an associate and Michael Werner is a partner based in Holland & Knight’s Washington, D.C., office.
UAB Medical West welcomes Dr. Erin Hall-Minnie to our team of OB/GYN physicians. UAB Medical West is thrilled to welcome Dr. Erin Hall-Minnie to our team of OB/GYN physicians. Dr. Hall-Minnie received her undergraduate degree from Baylor University and her medical degree from The University of Arkansas. She At the UABher Medical West Women’s Center, we provide pregnancy care and delivery completed residency at Texas A&M. Dr. Hallservices. Whether you’re experiencing a normal or high-risk pregnancy, we have
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Birmingham Medical News
Major Healthcare Construction in Birmingham, continued from page 1 ated $45 million in the 2023 state budget, which was the first direct state investment into the Southern Research campus. A combined $10 million was allocated by the City of Birmingham and Jefferson County. They also received financial support through a U.S. Economic Development Administration grant, although part of this was later rescinded by the Trump administration. Also in August, UAB opened the new $156.7 million inpatient rehabilitation pavilion. With 134 beds, the 11-story facility is equipped with advanced technology in order to provide specialized neurorehabilitation care for stroke, brain injury, spinal cord injury and other conditions. Each floor is designed to treat specific patient populations, and the rooms all include overhead lifts. Patients also have access to technologies like robotic arm devices, tilt tables and virtual reality gait treadmills. A multisensory room helps reduce anxiety in patients with brain injuries, using LED lighting and calming music to create a soothing environment. The building also houses therapy gyms, private therapy rooms and speech therapy suites. The new UAB Epilepsy Monitoring Unit is located on one floor. With 28 hospital beds, this unit will more than double patient capacity which will help
alleviate pressure on some of the 54,000 Alabamians with seizure disorders, many of whom are waiting six or more months for an evaluation. Outside, a rooftop garden helps patients work on mobility, while an outdoor park and simulated city streetscape allow safe practice on varied surfaces. An auto simulator prepares patients for car transfers, and there are recreational spaces that include a putting green and basketball court. A number of new projects got underway this year, as well. In January, Montgomery-based Baptist Medical Center South began work on an expansion of their emergency department, adding over 11,000 square feet and 30 new treatment areas with completion expected by early 2026. Also in Montgomery, Southern Orthopedic Surgeons started work on an outpatient surgery center that will feature four operating rooms and two specialized procedure rooms. Back in the Birmingham metro area, construction will start soon on the South Haven Surgical Plaza in Hoover. Located in Stadium Trace Village, the 80,000-square-foot medical campus will house an ambulatory surgery center with six operating rooms, two procedure rooms, along with imaging and diagnostic suites, and medical office space. Completion is planned for spring 2027.
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Dartmouth Accepts Alabama Student, continued from page 1
an administrator at a busy Birmingham pulmonary group that is part of the St. Vincent’s/UAB healthcare system, Pallotta is a father to two children under age six, and he sets aside at least 15 hours a week for his live online class plus extensive preparation, follow-up and project work. Classmates from all over the country and as far away as Manila stay in close contact as they work, and they will be flying in for another intensive residency at Dartmouth early next year. “The faculty has been very welcoming and supportive, and I’ve met some really terrific people in the class. They are
very talented, but also very human and that makes it easier to connect and exchange ideas,” Pallotta said. Next spring, when Pallotta adds a second masters degree to his CV, will the time, hard work, travel and multiple interviews in the rigorous selection process be worth the effort to become Alabama’s first graduate in Dartmouth’s Masters of Healthcare Delivery Sciences program? “Definitely. We’re working to bring home to our organizations things that can make a real difference in how healthcare is delivered to patients for years to come,” he said.
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hit a button,” Eloubeidi said. “Instead of the doctor moving the needle with their hand, the motor does the job for you. You watch the needle under ultrasound to see where it is going to end, and you stop it before the end of the mass. We believe this device is very promising because it will standardize the way you take biopsy, so the variability between beginners and experienced people, hopefully, will be less because the motor is guiding the needle to get to the tissue.” Eloubeidi’s goal is to continue improving patient outcomes by advancing GI diagnostics and bringing the latest technology and strategies to RMC. “It’s an honor to be able to help these pa-
tients, and to pioneer this technology in Alabama,” he said. “For RMC, innovation is not just about acquiring the latest technology— it’s about ensuring our physicians have the tools they need to deliver the best possible outcomes,” CEO of RMC, Keith Parrott, said. “And when patients in our community have access to the same level of innovation as the nation’s top medical centers, it changes what’s possible for their care. Being the first in Alabama to adopt this device underscores our role as a leader in advancing GI care and our dedication to raising the standard of care in community hospital settings.”
Alabama Gastroenterology Association, continued from page 7
and prevention of cancer. “Dr. Shaheen emphasized the role of non-endoscopic modalities to screen the population for Barrett’s esophagus using sponges, balloons and blood tests,” Eloubeidi said. “Screening for Barrett’s esophagus is extremely important since esophageal adenocarcinoma has been dramatically rising in the last several decades.” Bahahak Moshiree, MD, director of motility and professor of medicine at Wake Forest Medical University, gave a lecture on the evaluation and management of gastroparesis. “Dr. Moshiree explored the gaps in diagnosis and new interventions that may help us differentiate DBGI symptoms versus motility disorder,” Eloubeidi said. “She discussed the management of gastroparesis starting with diet, and she went over a step-up approach to augmentation management including prokinetics, neuromodulators, gastroelectric stimulation and pyloric therapies.” Jason Dominitz, MD, professor of medicine at the University of Seattle, discussed colorectal screening. Colorectal cancer is the second leading cause of cancer death in the U.S. In 2025, it’s estimated there will be 154,270 cases of colon cancer in the U.S., which will lead to 52,900 deaths. In Alabama, it’s anticipated that 2,630 people will be diagnosed with colon cancer with 920 resulting in death in 2025. On average, one in 23 men and one in 25 women will develop colon cancer. James Buxbaum, MD, professor of medicine and executive director of digestive health institute at the University of Southern California, discussed management of difficult duct stones. “Gallstones impact 20 million Americans due to high fat and high carbohydrate diets, and 10 to 20 percent of gallbladder stones have bile duct stones. 50 percent of untreated bile duct stones cause symptoms. 25 percent have serious complications including pancreatitis,” Eloubeidi said.
Paul Kwo, MD, professor of medicine at Stanford University, discussed non-invasive methods for liver fibrosis. Kwo listed simple and complex biomarkers that can be used to predict fibrosis. Mohamed Shoreibah, MD, director of hepatology at the University of Alabama at Birmingham (UAB), spoke on the management of decompensated cirrhosis. Decompensated cirrhosis manifestations are ascites, hepatic encephalopathy and variceal bleeding. Decompensation marks the progression of cirrhosis and is associated with a significant decrease in survival rates. Meagan Grey, MD, associate professor of medicine at UAB, discussed managing MASLD fibrosis, something one in three adults in the U.S. have. She stated that managing liver fibrosis includes lifestyle modifications like weight loss and cardiovascular disease prevention. The Mediterranean diet continues to be recommended. Amanda Cartee, MD, professor of medicine at UAB, talked about villous atrophy, celiac disease and mimics. Shajan Peter, MD, professor of medicine at UAB, discussed the evaluation of obscure GI bleeding. “The talk focused on the definition of obscure small bowel gastrointestinal bleeding and causes of small bowel bleeding,” Eloubeidi said. “We discussed the rationale for testing and management of these disorders, identified common findings on capsule endoscopy and devised an endoscopic and medical management strategy for treatment.” Kristin Vaughn, a consultant for Ask Mueller Consulting, discussed top coding and billing issues impacting GI practices in 2025. Lastly, Jamie Cannon, MD, professor of medicine at the University of Arkansas, discussed surgical management of IBD. For a comprehensive study on each of these topics, visit ALAGASTRO.org and find a complete printout of the lectures listed above.
Litigation Trends in Arbitration Disputes 2. Verbal Explanation and Acknowledgment of Understanding Require staff to verbally explain the key terms of the arbitration agreement in plain language: what arbitration is, how it differs from court, and that it is optional.
By: Ashton Brock
Picture this – you have just received correspondence from your lawyer about your facility being served with a complaint from a family of a resident so you begin to gather all of the resident’s file, including the medical records and the admission documents. As you are going through the admission paperwork, you see that the resident or resident’s responsible party signed the arbitration agreement and that there is a Power of Attorney (“POA”) signed by the resident’s responsible party in the paperwork. You send all of those documents to your lawyer and feel good about knowing that the case can move into arbitration. However, shortly thereafter, you are told that the resident’s responsible party is claiming that the arbitration agreement should not be enforceable because it does not comply with federal law and is therefore invalid under Alabama law. So, what now? This scenario is not frequent, but it is stirring up talk in the healthcare field because plaintiffs are starting to argue that the arbitration agreement they signed voluntarily violates 42 C.F.R. § 483.70 (the “Rule”) and is therefore void under Alabama state law. Although Alabama case law on this specific issue is undeveloped, courts are split on whether an insufficiency under the Rule makes the agreement void under state law. This issue is important because, depending on how this is resolved, arbitration agreements and admission protocol to healthcare facilities could be forced to change. Prior to giving some practice pointers, let’s take a look at the Rule and the elements that arbitration agreements must possess. The requirements under the Rule, 42 C.F.R. § 483.70(m), are that: (1) an arbitration agreement cannot be a condition of admission or requirement to receive care, (2) the facility must ensure that (i) the agreement is explained, (ii) the representative must acknowledge their understanding of the agreement, (iii) the agreement provides for a neutral arbitrator, and (iv) the agreement has a neutral venue, (3) the agreement must grant the right of rescission within thirty (30) days, and (4) the agreement must state that it is not a condition precedent to admission. The point of contention lies with the question of, “what happens if you do not meet the requirements of the Rule?” Does that failure automatically render arbitration agreements unenforceable? According to the Centers for Medicare & Medicaid Services (“CMS”), the Rule simply sets out requirements for long-term care facilities to participate in Medicare and Medicaid; it was not intended to render agreements unenforceable if the Rule was not met. In recent court filings, CMS points to the Rule
Ashton Brock
flowing from the FAA’s plain language that regulations that “d[o] not affect the enforceability of the arbitration agreement itself ”—or presumably its validity or irrevocability—do not implicate the FAA’s provisions. Instead of acknowledging the Rule for what it is, a regulation on facility participation in Medicare and Medicaid, we are seeing trends in litigation where a plaintiff will argue that a violation of the Rule should render an arbitration agreement invalid and void. In order to help defend against this stance from the plaintiff, here are some steps that facilities can take to help prevent challenges to their arbitration agreements. 1. Revamp Admission Protocols to Build in Time: Train admissions staff to slow down the process and give residents or their representatives ample time to read and ask questions about the arbitration agreement. Create a policy requiring staff to pause and explain the agreement, rather than simply collecting signatures with the rest of the admission paperwork.
3. Ensure Neutral Arbitrator and Venue Are Named Explicitly include language designating a neutral arbitration organization (such as JAMS) or similar neutral forum. Designate a neutral venue (e.g., arbitration will occur in the county where the facility is located or where the resident resides). 4. Include a 30-Day Right of Rescission The agreement should clearly state that the resident or representative may revoke the agreement within 30 days of signing. Provide a simple revocation form or instructions and keep any rescission notices in the resident’s file. 5. Clarify It Is Not a Condition of Admission or Care Prominently state that signing the arbitration agreement is voluntary and not a condition of admission, continued residency, or care. Admissions staff could offer the agreement after all other admission paperwork is complete to reinforce its voluntary nature.
guardianship order). Place copies of the authority documents in the resident’s chart.
7. Provide a Copy to the Signer and Keep a Signed Copy Provide the resident or representative a fully executed copy of the agreement immediately after signing. Have them initial that they received a copy and keep the original securely stored in the facility’s records. 8. Review Agreement Language Periodically Have legal counsel periodically review and update the arbitration agreement language to ensure compliance with: • 42 C.F.R. § 483.70(m) • The Federal Arbitration Act • Any emerging case law trends. By implementing these steps, longterm care facilities can build a clear record that: the arbitration agreement was voluntary, the signer understood it, it complied with the Rule’s elements (neutral arbitrator, neutral venue, 30-day rescission, not a condition of care), and the signer had authority to bind the resident. This strengthens the facility’s ability to enforce arbitration agreements and helps avoid arguments that they are void under federal regulations or Alabama law. Ashton Brock is an Associate at Burr & Forman LLP. Ashton may be reached at (205) 458-5340 or abrock@burr.com.
6. If Possible, Verify the Authority of the Signer Require admissions staff to confirm and document that the person signing has legal authority (e.g., through a valid Power of Attorney or
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OCTOBER 2025 • 11
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Becker’s Honors Bulgarella and Fox
Podcast
Dawn Bulgarella, MSHA, CPA, CEO of UAB Health System, and Natalie Fox, DNP, PNP-BC, interim CEO of USA Health, are both on Becker’s Hospital Review’s 2025 list of academic medical center CEOs to know. Bulgarella is the Chief Executive Officer of the UAB Health System, where she is responsible for a 16-hospital system with annual revenues approaching $8 billion. She earned a Bachelor of Science in Commerce and Business Administration from the University of Alabama and a Master’s degree in Health Administration from UAB. She serves on numerous health care boards, and was appointed by Governor Ivey to the Alabama Workforce Board’s Executive Committee.
Natalie Fox
Dawn Bulgarella
Fox earned her bachelor’s, master’s, and doctoral degrees in nursing from the University of South Alabama. She has served in numerous roles with USA Health since 2011. In 2022 she was hon-
ored with Alabama’s Top Nurses Lifetime Achievement Award, and Governor Kay Ivey appointed her to a three-year term on the state’s Certificate of Need Review Board.
Reynolds Honored by Alabama Psychological Association Nina Reynolds, PhD, a Pediatric Psychologist at Children’s of Alabama, has been named the Outstanding Early Career Psychologist by the Alabama Psychological Association. The distinction is awarded to a psychologist who has been working in the
Nina Reynolds, PhD
field for under 10 years, has shown outstanding dedication, and has made notable contributions in the area of science, teaching, association activities, or practice. In her nine years at Children’s, Reynolds has reenergized the Consultation/
Liaison Psychologist role for medical patients, which involves evaluating and intervening with patients and families when there is a significant psychological component to their medical presentation and care. She earned her undergraduate degree at Duke University, followed by her PhD at UAB, and her residency at Cincinnati Children's Hospital.
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A New Day in Healthcare. Even Better Together
We are brightening the future of healthcare with renewed purpose. Baptist Health is now strengthened by award-winning healthcare leader Orlando Health. As a private, not-forprofit healthcare organization, we are committed to providing expert medical care with a patient-first approach — and we are reinvesting in exceptional, faith-based care for Central Alabama. Giving you more reasons to choose well. BaptistHealthAL.com Brookwood Hospital | Citizens Hospital | Princeton Hospital Shelby Hospital | Walker Hospital
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Orthopaedic Surgeons Join Southlake Orthopaedics Two orthopaedic surgeons joined Southlake Orthopaedics in September. Jonathon Whitehead, MD is a fellowship-trained orthopedic surgeon who specializes in hand and upper extremity, including the shoulder, elbow, wrist, and hand. A native of Hoover, he attended Auburn University and graduated Summa Cum Laude with bachelor’s degree in biomedical sciences. He earned his medical degree from The University of South Alabama College of Medicine and completed his residency training at the Medical College of Georgia. Following
residency, Whitehead completed a Hand and Upper Extremity Fellowship at UAB. He is available to see patients at the Southlake Orthopaedic Grandview and Hoover locations. Adam Lukasiewicz, MD is a fellowship-trained orthopedic surgeon who specializes in foot and ankle surgery. A native of Toronto, Canada, he attended Yale University and earned a bachelor’s degree in molecular biology. He completed medical school and his orthopaedic surgery residency at the Yale School of Medicine, in concert with a MSc in Epidemiology from the Imperial
Gutman Joins OrthoAlabama Ilya Gutman, MD, a fellowship-trained spine surgeon, joined OrthoAlabama Spine & Sports in September. Deanna Kyrimis Gutman earned his Doctor of Medicine degree from the UAB Heersink School of Medicine. He completed his orthopedic surgery residency at Campbell Clinic in Memphis followed by fellowship training in orthopedic spine surgery at Indiana Spine Hospital.
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Birmingham Medical News
Jonathon Whitehead, MD
Adam Lukasiewicz, MD
College London, United Kingdom. Lukasiewicz completed his Foot and Ankle Fellowship at the Institute for Foot and Ankle Reconstruction at Mercy Hospital in Baltimore.
Lukasiewicz is available to see patients at the Grandview and Hoover locations. And he’s available at a new outreach clinic at UAB St. Vincent’s Chilton in Clanton.
New CEO at Springhill Medical Center In October Deanna Kyrimis, DSc(c), MBA, MS joined Springhill Medical Center, a 270 bed hospital in Mobile, as Chief Executive Officer. Kyrimis earned a master of science degree from the University of Oxford in England and a bachelor’s degree in psychology from Arizona State University, followed by a master's in business administration from the University of California. She has 20 years of health system experience at the executive level, most recently as the CEO at Arizona Asthma & Allergy Institute.
GRAND ROUNDS
TriaVision Opening ASC in 2026 EDITOR & PUBLISHER Steve Spencer
VICE PRESiDENT OF OPERATIONS Jason Irvin
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After receiving their Certificate of Need in May, TriaVision is moving forward with work on their first ambulatory surgery center (ASC), which will be located in the Colonnade and will feature two operating rooms. “Ambulatory surgery centers allow us to deliver the highest quality care in a fraction of the time and at a lower cost to the patient,” said Virginia Lolley, MD, an ophthalmologist with TriaVision. The decision to move into the ASC space was driven in part by the projected increase in cataract cases from 151,000 cataract diagnoses in Alabama in 2018 to 220,000 in 2030. “There’s a huge need in the state for cataract surgery,” said Amanda Moorefield, vice president of operations at TriaVision. “And hospitals don’t meet the efficiency needs to handle that kind of volume.” TriaVision currently operates 11 eye
Artist rendering of the new ASC.
care clinics across central Alabama with 11 ophthalmologists and five optometrists, along with nearly 50 ophthalmic
Gilbert Named President of Baptist Health Brookwood Sarah Gilbert, PT, MSPT, MHSA has been named president of Baptist Health Brookwood Hospital. She earned her Bachelor’s of Science in Physical Therapy from the University of Evansville, and her Master’s of Science in Physical Therapy Administration from the University of Indianapolis, followed by a Master’s of Health Services Administration from the University of Michigan. She spent 24 years with St. Mary Mercy Hospital in Livonia, Michigan where she held a number of roles, includ-
ing Senior Vice President of Operations and Administrator of Cardiovascular Services. She joined Orlando Health in 2021 as chief operating officer at Orlando Health Bayfront Hospital. While serving at Bayfront, she oversaw the successful recruitment of physicians across several subspecialties, including bariatrics, breast radiology, electrophysiology. She also contributed to a 20 percent growth in surgical services volume and spearheaded an initiative aimed at improving corporate surgical services efficiency. “Sarah is a dynamic and creative
Sarah Gilbert
healthcare executive,” said Thibaut van Marcke, president of Baptist Health. “She will be an outstanding leader for the hospital, its team members and the Birmingham community.”
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technicians. The new ASC will open in 2026.
TIFFANY SCHWASINGER-SCHMIDT, MD, PhD
OCT 27 Jonathon Whitehead, MD on Hand Surgery NOV 10 Chris Davis, MD Treating Chronic Rhinitis
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