Health care executive pushes organization to embrace innovation

Jonathan Fleece’s path to the top of an $82 million nonprofit started in tragedy when he and his wife’s baby daughter, Catherine Bette Fleece, died of a fatal heart defect.

That path detoured for nearly 20 years, most of which Fleece spent at Blalock Walters, one of the largest and most established law firms in Bradenton. He was CEO and managing partner of the $11 million firm from 2001 to 2018.

But behind his daughter’s memory, Fleece also began volunteering for Tidewell Hospice. With a specialty in health care law — he wrote a book on the topic — he soon became a board member of Sarasota-based Tidewell, one of the largest hospice and palliative care organizations in Florida. Volunteering for Tidewell, he says, was partially how he recovered and started to heal from the family tragedy. (He and his wife currently have three teenage children.)

'We’re here to simplify the complicated for the community.’ Jonathan Fleece, Tidewell Hospice

Last October, Fleece, 51, took on a new role for Tidewell as president and CEO of Stratum Health System, the parent entity over Tidewell and a host of other organizations. Fleece was named to the post after nearly a year-long search to replace CEO Gerard Radford, who retired. In an interview with the East County Observer last year, Fleece cited a Mark Twain quote in landing the role: "'The two most important days of your life are the day you are born and the day you learn why.' Every day I get up, I want to change the world through health care, one patient, one family at a time."

Now, after a listening tour with every department and office — bagels and beginnings with Jonathan — the soft-spoken, easy-going Fleece has a for-profit-like challenge in front of him: to guide Tidewell into new areas of heath care by utilizing industry innovations without diluting the one-on-one customer service that made the organization so successful in the first place. In addition to the $82 million operating budget, Fleece oversees an organization that works with people in Manatee, Sarasota, Charlotte and DeSoto counties and has 535 full-time employees and nearly 1,200 volunteers.

“He has a real forward-looking kind of vision,” Tidewell board Chairwoman Jan Miller says. “It helps, too, that he knows the organization so well, and he really knows health care.”

That health care knowledge drives Fleece’s moves to consolidate services — much like big hospital chains are doing nationally in the face of rapid shifts in payment structures and regulations. Stratum’s subsidiaries, in addition to Tidewell, include two home health agencies and a medical services unit. “Part of the reason I have to add all the services is because of the change in reimbursements and the way facilities get paid,” Fleece says.

Although 2020 is a milestone year for Tidewell, when it turns 40, Fleece also spends a chunk of time planning what the organization will look like in five years. For that, he can dip into the book he wrote in 2011 with Sarasota-based futurist David Houle, “The New Health Age: The Future of Healthcare in America.”

Those innovations, which he plans to implement at Tidewell, include utilizing telemedicine and a total revamp of the organization’s electronic health records system. In growth, Fleece says he would like to see the organization double the amount of patients it sees, from 9,000 or so in 2018 to 20,000 by 2025.

Fleece says with all the potential innovations, and units under Stratum, one of his key tasks is to fend off mission creep and not, for example, to expand to other areas of health care. “We won’t get into senior living,” he says by one example. “That’s not our space.”

There’s plenty to do, he adds, in end-of-life care. “We have been seen as the community resource” in hospice services, Fleece says, “but we also want to be there for people for all challenges in life.”

That philosophy is behind Tidewell's move to have a one phone number system, where if you or a relative face something related to end-of-life care, Tidewell will direct you to a solution. That initiative will be part of a new branding campaign to coincide with the organization’s 40-year anniversary. “We’re here to simplify the complicated for the community," Fleece says.

Much like many other health care organizations, finding and retaining top people is a constant challenge at Tidewell. The organization recently started a nurse residency program and has increased the amount it provides for tuition reimbursement to help retain people.

The work is mentally challenging yet also rewarding, Fleece says. “It can sound scary, but helping people through that last corner of life can be an enlightening experience.”