Six Pertinent Provisions of the OBBBA for Construction Companies

Nicholas L. Shires, CPA, Dannible & McKee, LLP

The One Big Beautiful Bill Act (OBBBA) introduces sweeping changes with significant implications for construction business owners and their leadership teams. As companies evaluate the legislation, it’s important to focus on the provisions most relevant to day-to-day operations. Here are six key areas to study.

  1. Accounting Exemption

For tax years beginning on or after July 4, 2025, contracts entered into for residential construction projects, per the amended definition under the OBBBA, generally qualify for an exception to the percentage-of-completion method of accounting.

That means, if eligible, you can use the completed-contract method (CCM) or other permissible methods. Under the CCM, for example, you can defer income until a project is substantially completed, which generally improves cash flow.

  1. Accelerated Depreciation

The OBBBA includes multiple provisions that will allow you to accelerate depreciation on eligible capital expenditures. These breaks can also improve cash flow, as well as make new investments in equipment and machinery more viable.

The law makes permanent 100% first-year bonus depreciation for qualified new and used assets acquired and placed in service after January 19, 2025. It also increases the Section 179 expense deduction limit to $2.5 million, with the phaseout threshold raised to $4 million. Those figures are effective for 2025, with annual inflation adjustments going forward.

In addition, the OBBBA creates a temporary 100% deduction for the cost of building “qualified production property” — for instance, facilities used to fabricate materials. This could boost demand for projects related to manufacturing. Construction must have begun after January 19, 2025, and before January 1, 2029, and the property must be placed in service before 2031.

  1. Bigger Business Interest Deductions

If you finance capital purchases, you may be able to deduct more of the interest under the OBBBA. The business interest deduction is generally limited to 30% of your adjusted tax income (ATI). Since 2022, though, deductions for depreciation, amortization or depletion were not added back to taxable income when calculating ATI. So, ATI was effectively measured based on earnings before interest and taxes, not earnings before interest, taxes, depreciation and amortization (EBITDA).

Beginning with the 2025 tax year, the OBBBA provides that ATI will again include depreciation, amortization and depletion in the calculation. In other words, ATI will revert to being calculated based on EBITDA. This will effectively increase the ATI base, generally raising the allowable business interest deduction.

  1. Distressed Community Construction Incentives

The quality opportunity zone (QOZ) program generally allows taxpayers to defer, reduce or exclude unrealized capital gains reinvested in qualified opportunity funds (QOFs). These funds invest in designated distressed communities across the country.

The OBBBA establishes a permanent QOZ policy that enhances the original program, which had been slated to sunset after 2026. The law also creates a new type of QOF for rural areas. Plus, the OBBBA permanently enhances the low-income housing tax credit. In sum, these programs could drive higher construction activity — including affordable housing and commercial development.

  1. Reduced Taxation of Overtime

For tax years 2025 through 2028, the OBBBA allows employees to deduct up to $12,500 ($25,000 for joint filers) of qualified overtime pay. This tax break is available regardless of whether a taxpayer itemizes. However, it begins to phase out when an individual’s modified adjusted gross income exceeds $150,000 (or $300,000 for joint filers).

The boost to take-home pay may make overtime more enticing to existing construction workers and job seekers considering the industry. But it also requires employers to track and report the amount of qualified overtime pay. What’s more, overtime pay will remain subject to payroll taxes and state income taxes.

  1. Elimination of Clean Energy Incentives

The OBBBA targets many of the clean energy incentives created or enhanced by the Inflation Reduction Act — including some that have spurred construction plans and projects. For instance, it eliminates the Sec. 179D energy-efficient commercial building deduction for buildings or systems on which construction begins after June 30, 2026.

The new law also eliminates the Sec. 45L new energy-efficient home credit for eligible contractors. The credit was due to expire in 2033, but it’s now available only for homes acquired on or before June 30, 2026.

And That’s Not All

The provisions highlighted here are only a portion of the changes in the OBBBA that could impact your construction business. Acting now is critical to identify the most relevant tax-law changes and take full advantage of the tax breaks available before opportunities are missed.

Nicholas L. Shires, CPA, is the partner-in-charge of tax services at Dannible & McKee, LLP, a certified public accounting firm with offices in Syracuse, Auburn, Binghamton and Schenectady, NY, as well as Tampa, FL. With over 20 years of experience, Nick provides tax and consulting services to a wide range of clients, with a focus on the construction industry. For questions regarding the tax provisions of the One Big Beautiful Bill Act (OBBBA), contact Nick at nshires@dmcpas.com or (315) 472-9127. Learn more @ DMCPAS.com.

2025 Year in Review

Earl R. Hall Executive Director – Syracuse Builders Exchange

As the fourth quarter of the year begins, we at the Syracuse Builders Exchange (SBE) reflect on the success of the past 12 months, as we begin to focus on 2026 with optimism and excitement.

The past year marked another period of record growth and achievement for SBE and our members. Guided by our mission to acquire and disseminate important industry information, further the best interest of the regional building and construction industry, and to foster and develop relationships within the industry, SBE delivered measurable value across our wide range of membership benefits and services throughout the year.

Acquiring and Disseminating Information

Through Syrabex’s e-plan room, weekly e-bulletins, periodic emails, and Construction Contractor Magazine, SBE acquired and disseminated timely and important information construction industry employers and their employees rely upon every day.  Whether it’s construction projects in the planning stages, projects actively bidding, bidders lists, contract awards, new federal or state legislation, information from our many professional partners or other information contractors need to know, SBE delivered using a wide range of communication mediums.

Education and Safety Training

SBE’s education and safety training programs reached both record participation and course offerings, equipping members with the skills and knowledge to navigate evolving industry technologies such as Building Information Modeling, safety standards, and general business practices. The Association delivered workshops, seminars, and certifications that not only advanced individual careers but helped employers provide a safer and more efficient working environment both on the job site and in the office.

Safety remained a top priority, with new training modules, additional training resources and instructors, and industry-wide campaigns designed to reduce incident rates for our member firms and the industry in general. These efforts underscored SBE’s commitment to not only our member employers, but ensuring every worker returns home safely at the end of the day.

Membership Growth and Engagement

Membership significantly expanded this past year, led by the migration of 100 new members from the Mohawk Valley Builders Exchange.  Absent those new members, SBE still experienced membership growth, driven by out-of-area contractors looking to take advantage of the Association’s services and the abundance of future construction opportunities central New York will offer over the next decade.

Sustained membership growth reflects the value of SBE’s services, the strength of our membership and the tremendous services our staff delivers every day to our member employers and their employees. Engagement through events, emails, phone calls, and electronic/digital platforms fostered stronger business relationships between our staff and members.

Today, SBE remains New York State’s oldest and largest construction industry Association with approximately1,070 member firms.  Never in the 153-year history of the Association has SBE had more members or more benefits and services.

Networking and Social Event

During the year, SBE provided the most networking and social events in the history of the Association, delivering:

  • Multiple “meet and greets” in the Utica region
  • Two sold-out golf tournaments (Syracuse and Utica)
  • Clay Sport Shooting for Charity
  • Meet the Generals
  • Clambake
  • Meet the MWBE/DBE/SDVO Contractors
  • Cabin Fever (Utica)
  • Two Construction Career Day events (Syracuse and Utica)

These events are vital to SBE’s membership as they strengthen professional relationships, foster collaboration, and create opportunities for members to share knowledge and best practices. These gatherings help connect contractors, suppliers, designers, and industry leaders, often leading to new business partnerships and project opportunities. They also build a sense of community within the industry, allowing members to exchange ideas, discuss challenges, and celebrate achievements together. Ultimately, SBE’s networking and social events enhance the value of one’s membership by promoting growth, visibility, and long-term success for both individuals and companies.

Looking Ahead to 2026

As SBE celebrates this year’s successes, we remain focused on future opportunities and challenges. Our priorities include partnering and collaborating with industry partners to advance workforce development initiatives, embracing technology innovation and new industry standards in our education and safety programs, enhancing the functionality within the e-plan room by applying Artificial Intelligence features to deliver faster and more effective outcomes for our end-users, delivering quality social and networking events, promoting New York State’s only construction industry Multiple Employer Pension Plan (MEP) and continuing to be a strong advocate for SBE’s member employers and the industry.

SBE continues to have a meaningful impact on our contractors, their employees, and our regional community and industry partners.  As we look forward to building on this momentum in 2026, we are reminded that the success of the Association is the result of our loyal, diverse, and dedicated member firms.  On behalf of the SBE staff and Board of Directors, it has been a pleasure to service construction industry employers and their employees during the year.  

Benefits of Content Marketing

Increased Brand Awareness

Consistently publishing valuable and relevant content helps to increase visibility. As your content reaches a larger audience, more people become familiar with your brand.

Establishes Authority and Expertise

By providing high-quality, informative content, you position your business as an authority in your field. This helps build trust and credibility with your audience.

Improved SEO and Organic Reach

Quality content that is optimized for search engines (SEO) can help your website rank higher on search engine results pages (SERPs). This boosts your organic traffic.

Engagement with Audience

Content marketing encourages interaction with your audience, whether through comments, shares, or likes. This helps in building a community around your brand.

Lead Generation

Well-crafted content can help attract potential customers and drive them down the sales funnel. Offering valuable content, like whitepapers or ebooks, in exchange for email subscriptions can be an effective way to gather leads.

Cost-Effective Marketing

Compared to traditional forms of advertising, content marketing can be a more affordable long-term strategy. Once content is created, it can continue to generate value over time without ongoing costs.

Better Customer Relationships

Content allows you to directly communicate with your audience, answer their questions, and address their pain points. This strengthens customer loyalty and satisfaction.

Supports Other Marketing Channels

Content marketing supports various other marketing efforts, like printed media, social media, email marketing, and paid ads. For example, blog posts can be shared on social media, driving traffic to your website.

Increased Conversion Rates

Engaging and relevant content can help move prospects closer to conversion by addressing their specific needs and demonstrating how your products or services can solve their problems.

Long-Term Results

Content that continues to provide  value can work for you over time, generating leads and traffic long after it’s published. Blog posts, videos, and infographics can attract new audiences months or even years after they’re created.

Builds Trust and Relationships

By offering useful, honest, and relevant information, your brand can build long-lasting relationships with its audience. This trust can eventually convert into higher customer loyalty and advocacy

In summary, content marketing helps you build stronger relationships with your audience, boosts your printed and online visibility, and can be more cost-effective than traditional advertising, all while providing long-term benefits.

Upstate University Hospital: Building on Innovation and Growing to Better Serve the Community

Visits from New York State Governor Kathy Hochul with SUNY Upstate President Mantosh Dewan, MD, and Upstate University Hospital CEO Robert Corona, DO, helped to build understanding of the infrastructure needs of Upstate University Hospital. To serve the population being seen at Upstate, key elements of the annex are an expanded Emergency Department providing Upstate with between 55 and 75 bays, compared to the current 35. Also, planned: a new burn unit with between six and eight ICU beds and the addition of between two and four new operating room.

When an organization consistently focuses on innovation over a period, growth and expansion are often the result. This pattern certainly has been the case with Upstate University Hospital, which includes its main campus in Syracuse and many adjacent healthcare facilities located throughout Central New York.

As Central New York’s only academic medical center, as well as the region’s largest employer, Upstate has been exploring and utilizing new and innovative healthcare initiatives for years under the leadership of Robert Corona, DO, CPE, MBA, FCAP, FASCP, who has served as CEO of the hospital since 2018. A new throughput center, a new pathology institute presently under construction, cutting-edge drone technology, new clinical offerings and innovative, eco friendly buildings are just a few of the ways Upstate has been on the forefront of advancements in healthcare. Stemming from innovations in these varied aspects of healthcare, Upstate is now experiencing a period of immense growth.

Alongside these offerings, the big news announced in May 2025 was that Governor Kathy Hochul and the New York State Legislature had allocated $450 million in the state budget for Upstate to build a new and expanded emergency department, a more modern burn unit, and some additional operating room capacity at its downtown Syracuse campus. This support of a hospital “annex” represents the largest capital funding allocation in Upstate’s history.

“There’s just a ton of growth happening,” said Dr. Corona. “It’s exciting. And while it’s a challenge to stay on top of all the building and expansion we’re doing, overall, if you ask me how I feel, I’m very excited about it all.”

Expanding to Better Serve Patients in CNY

Dr. Corona described that prior to the capital funding announcement, Governor Hochul visited Upstate’s emergency department and recognized the need for expanded services to help meet the community’s needs. He also emphasized the immense support the Upstate team received from the state legislators who “all went to bat for us.” “The governor came and visited our emergency department a couple of times. She was very gracious. And when she saw the status of the physical plant and the contrast of that with the exceptional people who work there, she felt the people of Central New York need a better emergency department, especially when this is the go-to referral center. And she surprised us with the $450 million, which we’re so grateful for,” Dr. Corona said.

Elaborating on the demand for greater capacity to serve patients in the community, Dr. Corona stated that the Upstate healthcare system needs more capacity including operating rooms, and a bigger emergency department to support its level one trauma center. Additionally, an upgraded burn unit is needed because Upstate is the only burn unit between Rochester and Westchester County.


LOW-DOSE RADIATION THERAPY

Upstate Medical University now offers low-dose radiotherapy to treat osteoarthritis. This provides safe, effective, and non-invasive treatment for inflammatory and degenerative conditions of the tendons, joints, and other soft tissues of the body. It can significantly improve pain and stiffness, helping avoid the need for surgery. Anna Shaprio, MD, of Upstate’s Department of Radiation Oncology leads this program and is accepting patients for treatment


“We have a responsibility to our community to grow our capacity,” Dr. Corona stated.

Speaking about the timeline of the hospital annex, Dr. Corona said an aggressive timeline would be about five years. Selection of a design team is already underway, and the team is hoping to have a design company selected by the end of 2025. Following the selection will be collaboration with healthcare providers who work in the affected environments, analysis of demolition needs, and finally, construction.

Reflecting on the magnitude of this growth at Upstate, Dr. Corona said, “I think this has got to be one of the highlights of my career.”

Looking at Growth Through Various Lenses

Not to be overshadowed by the historic capital funding for the main hospital annex is the surge in growth happening within Upstate’s new and existing locations  throughout the wider rural Central New York region. The theme of “meeting people  where they are” has consistently driven the strategic vision of growth carried out by Dr. Corona and the C-suite team at Upstate. To further develop hospital services and facilities that meet patients’ needs closer to where they live, Dr. Corona explained how he views growth through several lenses, including both the  specific population and the geographic region being served.

“Those are the two main things we look at when we consider strategically where we’re going to grow,” he said. 

When looking at growth through the lens of the population, Dr. Corona explained that the group of people that’s presently the most prevalent is the mature population, who are living longer with chronic diseases such as heart disease, cancer, cerebrovascular diseases, diabetes and neurologic diseases such as Alzheimer’s. Looking to the future, Dr. Corona anticipates a younger demographic of patients that will create the need for a different set of healthcare needs.

REGION’S ONLY MULTI-DISCIPLINARY MELANOMA PROGRAM
The Melanoma and Advanced Skin Cancer Program at the Upstate Cancer Center is the region’s only multi-disciplinary team and treats melanoma, advanced basal and squamous cell cancers and rare skin cancers such as Merkel cell carcinoma and others. From left: Daniel Thomas, MD, Amar Suryadevara, MD, Scott Albert, MD and Jade Homsi, MD.


“If you look at the population we anticipate coming to the region, that’s going to be families that are going to be working at places like Micron and some of the other new companies that are coming in the area,” Dr. Corona said. “In Rome, Chobani Yogurt is building a large plant and so we anticipate that will also create high demand for our primary care services, family medicine, OB/GYN and pediatrics. W
e plan to expand the services we offer east of Syracuse, leveraging our success in Verona.”

Looking through the lens of geographic need, and helping patients access healthcare closer to where they live, Upstate is expanding its cancer care locations at the compass points North, West, and East, with expanded hours and physical locations. The new pathology institute near the existing Bone and Joint Center in East Syracuse should be completed in about 15 months.

“Many patients don’t want to come to downtown Syracuse unless necessary. If they live in rural communities, they want to stay for services in their communities,” said Dr. Corona.

To provide local care for the anticipated new arrivals near the Micron site in the North and needs in the West, additional expansions have been planned or were already completed at the Liverpool/ Clay Carling Road location, including pediatric care this year, and Upstate’s eighth location for physical medicine and rehabilitation that was finalized last year. Upstate also provides more than a dozen services in the Camillus area to help meet patient needs.

The Behind-the-Scenes Operational Side of Growth

Carefully coordinating and directing the operations of the many expansion projects at Upstate is Marylin Galimi, MS, CHOP, Upstate’s Chief Operating Officer. With a background in electrical engineering, Galimi came to Upstate in 2016 and now oversees the development and planning of construction projects in addition to support areas like physical planning, environmental services and supply chain, as well as ancillary services such as radiology, pathology and pharmacy.

Looking back on her almost ten years with Upstate so far, Galimi said, “It’s been a lot of fun to be honest. Just to see and be a part of the growth and the transformation at Upstate has been amazing. I think the community has embraced all the work that we’ve been putting into the community.”

While it’s difficult to give a specific number as projects are started and completed regularly, she estimates there are between 80 to 120 active projects that the Upstate team is working on at any given time. Galimi highlighted the teams involved in the various aspects of these expansion projects.

“We have in-house architects, construction managers, engineers, and the physical planners who work on critical maintenance,” Galimi said. “We even have our own mini construction team that works on construction and renovations.”

The operations leadership team has a unique name: COLT (Clinical Operations Leadership Team), which meets weekly to work through operational initiatives and to keep growth moving forward in-line with Upstate’s mission and vision.

“The group is unique and it’s effective. It really helps us stay on track,” said Galimi, adding that participants include other members of the C-suite: CMO Amy Tucker, MD; CNO Scott Jessie; CAO Nancy Daoust; CIO Mark Zeman and Laurie Nicoletti from the CEO’s office.

“The composition of the group is what makes it successful,” she added. “We elevate items to the CEO for final approval and, as needed, review financial impacts with the CFO or staffing with the CHRO.”

When planning new projects, such as the recently completed Interventional Radiology Suite, Galimi explained the most important considerations for her and the team are the people who will be working within the buildings – both now and in the future – so that care can be provided in the best way possible for patients.

MINIMALLY INVASIVE LUNG BIOPSIES
Manju Paul, MD, and Mansur Javaid, MD, are in the suite where they offer minimally invasive robotic-assisted lung biopsy which enables doctors to detect lung cancers much earlier than other methods. Upstate is the only hospital in the region to offer this procedure.

“It’s like we’re building the house, and the people who are going to be inside the house —those who will be providing the services and the patients who will receive care— are the most important part of the plan,” she said. “So, we work on how we’re going to create an environment that will attract new recruits to the area and make it more efficient for the people working inside the space to provide the services they’re skilled to do, and ultimately make it the best experience for the patient.”

Patient-Centered Expansion and Collaboration
No matter where the new projects are taking place, whether it’s the hospital annex in downtown Syracuse or brandnew healthcare centers in rural areas, Galimi emphasized how each area of growth that Upstate pursues is aimed at meeting patients where they are.

“We’re always looking at multiple growth paths in parallel,” she said. “We’re looking at how we get services to the patients where they are. We’re not just doing one thing in the Syracuse city area – we’re growing for the entire Central New York region.”

For Dr. Corona, an exciting aspect of Upstate’s mission to expand into areas that will help meet the needs of patients throughout the community is the opportunity to collaborate with other healthcare organizations.

“I see a tremendous opportunity for collaboration among the hospitals in the region to work as a system, for needs like load balancing and keeping patients in their own communities,” he said. “We support that. And the growth is big enough that everybody could grow. Competition can be healthy and move care forward but there is a lot of collaboration and that’s a really nice thing to see.”

As Galimi pointed out as well, such patient-centered collaboration benefits everyone. “I think what I value most about Upstate is that it’s looking at total health and wellness of the entire community,” she said. 

Health Care Cuts and the Impaction Communities

BY KATHRYN RUSCITTO, ADVISOR

I will not debate the politics behind the recent health care cuts, but I will share my concerns about their impacts.

The loss of Medicaid access for children and families, reductions in subsidies for those buying insurance on the public exchange, and cuts to programs that support families will be dramatic. 

Rural communities, in particular, may see hospitals and outreach clinics close, with providers consolidating into larger hubs. Larger health systems, already strained by COVID and workforce challenges, may also struggle to survive.

Communities must begin planning for these impacts. Providers and planners are starting to analyze consequences and explore alternatives. In the North Country, a coalition of physicians and nonprofits has already published a white paper outlining local concerns. At the state level, groups like HANYS and HCA have issued urgent calls to action.

While some rollbacks may emerge in future negotiations, most of these cuts are likely to remain. The result: more uninsured individuals, delayed care, reduced access, and community program closures. 

A small bright spot is the creative thinking now emerging. Some foundations are reassessing grantmaking and considering increased support. But no philanthropy can fully offset the scale of these cuts. Has your practice considered the impact— and the opportunities to collaborate on solutions? 

National Resources
• American Hospital Association (AHA) – Advocates for hospital viability and national policy solutions. https://www.aha.org/

• Alliance for Health Policy – Provides nonpartisan analysis on health coverage issues. https://www.allhealthpolicy.org/

• Brookings Center for Health Policy – Develops research-based recommendations on health reform. https://www.brookings.edu/centers/center-on-health-policy/ New York State Resources

• Health Care for All New York (HCFANY) – Grassroots coalition advocating for affordable, quality care. https://hcfany.org/

• Medicaid Matters New York – Statewide group defending Medicaid and raising awareness about cuts. https://medicaidmattersny.org/

• Healthcare Association of New York State (HANYS) – Represents hospitals and health systems in Albany and beyond. https://www.hanys.org/

Kathryn Ruscitto, Advisor, can be reached at linkedin.com/in/kathrynruscitto or at krusct@gmail.com

Leading With Compassion And Vision: Dr. Julie Moore, at St. Joseph’s Health Chief Nursing Officer

By: Kimberly Graf

Dr. Julie Moore, Chief Nursing Officer at St. Joseph’s Health, shaping the future of patient care through empowered leadership.

With a career shaped by compassion and a commitment to empowerment, Dr. Julie Moore is redefining nursing leadership at St. Joseph’s Health. In just six months as Chief Nursing Officer, she has launched initiatives to support nurses, strengthen patient care, and inspire the next generation of healthcare leaders.

When Dr. Julie Moore, DNP, MBA, RN, NEA-BC, CCRN, accepted the role of Chief Nursing Officer (CNO) at St. Joseph’s Health just six months ago, she brought not just impressive credentials, but also a deep sense of purpose, a passion for empowering nurses, and a vision for how compassionate leadership can shape the future of healthcare.

For Moore, nursing wasn’t her first career. She began in information technology, but a life-changing personal experience shifted her path entirely. “My father became ill and passed away very quickly,” she recalls. “It was a nurse caring for him who inspired me to pursue nursing as a second career. That encounter changed the entire trajectory of my life.”

That moment continues to guide her philosophy today: creating environments where nurses feel valued, supported, and empowered to give their best to patients. It is the foundation of her leadership at St. Joseph’s Health.

A Philosophy Rooted in Empowerment
Moore’s leadership style emphasizes collaboration, transparency, and listening. She believes nurses need more than direction; they need to understand the “why” behind change. “Healthcare is constantly evolving, and that can feel disruptive,” she explains. “But when nurses feel heard and included in shaping innovation, change becomes
progress.”

To strengthen communication and engagement, Moore has launched a weekly newsletter for nursing staff, cleverly titled The Moore You Know, a play on her last name. She also introduced “Ask the CNO,” a QR code on her business card that connects nurses with her directly, ensuring every team member has a voice. 

Shaping the Future of Nursing at St. Joseph’s
In her short time with St. Joseph’s, Moore has wasted no time launching initiatives to strengthen nursing practice and culture. Among them are enhancements to the Vizient/AACN Nurse Residency Program™ (VNRP) and mentorship programs, expanded professional development opportunities, and new shared governance councils that give nurses direct influence over policy and practice.

She has also championed technology solutions that reduce administrative burdens, such as virtual nursing, allowing clinicians to spend more time at the bedside. For Moore, these steps are not only about recruitment but also retention and well-being. “It’s important to invest in competitive compensation and flexible scheduling, but it’s equally important to recognize and support the emotional health of our teams,” she says. “When caregivers feel valued, they provide even better care to patients.”

Carrying Forward a Legacy of Compassion
Recognition and gratitude have been recurring themes in Moore’s career. She was recently named one of the Top 50 Women Chief Nursing Officers of 2025 by Women We Admire. She has also received honors such as the DAISY Award and the Dallas Great 100 Nurses Award achievements she humbly attributes to the patients and colleagues who nominated her.

“Those moments remind me of the nurse who inspired me,” she reflects. “You never know whose life you may be touching.” At St. Joseph’s, she is building a culture of recognition, including plans to expand the hospital’s DAISY Award program from quarterly to monthly, ensuring nurses receive the appreciation they deserve.

Beyond the Hospital Walls
Moore is equally passionate about community engagement. Recently named to the American Heart Association’s Executive Leadership Team for the 2026 Heart Walk, she sees the role as both personal and professional. “My father’s undiagnosed heart condition inspired me to become a nurse,” she says. “Being part of the Heart Walk is a way to honor his legacy while building connections here in Syracuse.”

Outside of work, Moore treasures time with her family—especially her grandchildren— and enjoys being on the water. A Massachusetts native who came to New York by way of Texas, she and her family are enjoying the Great Lakes and Thousand Islands and hope to return to boating on New York’s lakes. She also hopes to resume another personal passion: fostering and rescuing animals in need.

Looking Ahead
As she reflects on her first six months, Moore is energized by the potential ahead. “I want nurses to come join our culture, come join St. Joseph’s, and be part of the amazing things to come,” she says. “We’re building something special here, and I can’t wait to look back in a year and see the difference we’ve made.”

For Julie Moore, leadership is not about titles—it’s about lifting others up, empowering nurses, and ensuring compassion remains at the heart of healthcare. And at St. Joseph’s Health, that future is already taking shape. 

St. Joseph’s Health has a nursing recruiting program that includes a residency for new graduates and opportunities for experienced nurses. https://jobs.sjhsyr.org/ For questions for Julie Moore: AsktheCNO@sjhsyr.org

Q&A With Dr. David A. DiStefano: Returning Home To Care For Central New York

Dr. David A. DiStefano recently joined the Joint Replacement and Shoulder/Elbow teams at SOS and will be featured in the practice’s upcoming shoulder replacement webinar on November 12.

Syracuse Orthopedic Specialists (SOS) recently welcomed David A. DiStefano, MD, to its Joint Replacement and Shoulder/ Elbow teams. A fellowship trained orthopedic surgeon, Dr. DiStefano specializes in shoulder and elbow surgery, including arthroscopic and open procedures, fracture care, tendon and ligament reconstruction, and arthroplasty.

He completed his residency at the University of Rochester Medical Center, where he served as Academic Chief Resident, followed by fellowship training at the University of Colorado and Steadman Hawkins Sports Medicine Clinic. He also spent time during training at the Sydney Shoulder Research Institute in Australia. A graduate of SUNY Upstate Medical University, he is returning to Central New York to begin his practice.

We recently spoke with Dr. DiStefano about his background, expertise, and philosophy of care.

Q: What inspired you to pursue a career in orthopedics?
I was born and raised in Syracuse, so Central New York is home. When I was 12, I had an orthopedic surgery myself, and it showed me how much these procedures can help people get back to doing the things they love. At 19, I participated in a medical mission trip and again saw how powerful surgery could be. Later, during medical school, I rotated through many specialties, but I never had as much fun as I did on orthopedic surgery service. That made the choice clear.

Q: What made you decide to join SOS?
SOS performed the surgery I had as a kid, so I’ve known about their reputation for a long time. After residency in Rochester and fellowship training in Colorado, I explored opportunities all over. SOS stood out as the best group to support me as a new surgeon.
I also knew some of the physicians here— they’re excellent surgeons and great people. It felt like the right place to succeed and give back to my community.

Q: What types of patients will you be seeing?
Primarily patients with shoulder and elbow issues. That can mean athletic injuries in high schoolers, overuse injuries in adults, or joint replacements for older patients.

Q: Shoulder replacement surgery has grown significantly in recent years. Why is that?
It’s an exciting time in shoulder surgery. We’re seeing the same growth hip and knee replacements experienced 10 to 15 years ago. Implants and materials today are more durable, which increases both surgeon and patient confidence. Public awareness has grown too, and we now use advanced tools like preoperative planning software, computer navigation, and even robotics to improve outcomes.

Q: What can patients expect if they need shoulder replacement surgery?
Shoulder replacement is a highly effective procedure for the right patients. Most surgeries take about an hour, and many can be done on an outpatient basis, so patients often go home the same day. Recovery happens in phases with a structured physical therapy plan. Patients usually experience noticeable pain early in their postoperative course and can begin to gradually ease back into the activities they enjoy after just a couple months.

Q: SOS is hosting a Virtual Community Talk on Wednesday, November 12, from 5:00 – 6:00 pm on Shoulder Health: Exploring Arthritis Care and Surgical Advances. What can people expect?
All four of our shoulder replacement surgeons will be presenting. We’ll cover the basics of shoulder health, details about shoulder replacement, and share data from the SOS Shoulder Replacement Registry, which tracks outcomes and shows how much these procedures improve quality of life. Attendees will be able to ask general questions when registering for the webinar.

Q: What is your overall philosophy of patient care?
With shoulder surgery especially, these are elective procedures. Patients don’t always “need” surgery right away. I believe in listening carefully to each patient’s goals, discussing options, and helping them decide whether non-surgical care or surgery is best. My role is to provide guidance, but ultimately, it’s the patient’s choice.

Q: Is there anything else you’d like patients to know?
I’m very excited to be back in Syracuse. I trained across the country and abroad, but this is home, and I’m grateful for the chance to care for the people of Central New York.

Dr. David A. DiStefano is now accepting new patients at SOS locations in Camillus, DeWitt, North Syracuse, and Clay. For more information or to schedule an appointment, call 315-703-3449.

A Doctor at Heart: Steven Hanks, MD, President & CEO of St. Joseph’s Health and St. Peter’s Health Partners

By Elizabeth Landry

A native of Rhode Island, Steven Hanks, MD, has a substantial family lineage of first responders – both his father and grandfather were firefighters. Dr. Hanks developed a different yet related passion, however, and when he decided to follow that passion to study medicine, he took the tradition of his family line in a new direction.

“My passion to practice medicine was really driven by a couple of things: I had a science mind, but I also had a humanist heart. The two really come together in medicine and healthcare, and so that’s what drove me down that pathway. Being an emergency physician is kind of similar in a lot of ways to being a first responder, and it was only natural for me to gravitate toward a specialty that was in line with what my family background was, having grown up with first responders. It’s really kind of intertwined – that science background with that compassion for community is what led me into medicine,” Dr. Hanks explained.

Dr. Hanks attended the University of Rochester, where he received his training in internal medicine at Strong Memorial Hospital, and earned his master’s in medical management from Carnegie Mellon University, becoming a full-time physician executive in 1998. In 2016, Dr. Hanks joined the team at St. Peter’s Health Partners (SPHP) in Albany and went on to become the President and CEO of both SPHP and St. Joseph’s Health in Syracuse two and a half years ago when the two institutions were consolidated under Trinity Health. He shared insights from his experience working mainly on the not-for-profit side of healthcare, and how the faith-based foundation of Trinity Health sets it apart from other healthcare organizations.

“I’ve always been on the provider side; I’ve never wanted to go on the payer side of the industry because I’m a doctor at heart, and I’ve loved my career,” shared Dr. Hanks. “The reason I’ve spent my entire career on the not-for-profit side of healthcare is that commitment to our patients and our communities, understanding that our resources are limited, and they need to be used judiciously to assure the best outcomes for everyone. When I came to SPHP and now St. Joseph’s, I got the additional experience of working in a faith-based, not-for-profit health system. Trinity is one of the nation’s largest Catholic not-for-profits, and we’re committed to our communities and to the mission of our founding orders. We have that additional commitment and moral responsibility and I think that’s what makes us different than other healthcare systems and hospitals in the area.”

Dynamic Leadership from the Front Lines

In his role, Dr. Hanks is responsible for over 20 different organizations within Trinity Health, including hospitals, nursing homes, assisted living facilities, large physician practices, urgent care centers and more. He shared that one of the reasons he’s an effective leader is because he is often present at many different locations within the healthcare network, and he values open communication from all of his colleagues.

“The first part of my leadership style that I think is critical is I like to go out and about,” said Dr. Hanks. “I like to see things through the lens of the front-line staff. I’m very rarely in the same place – I move around our ministry quite a bit. You can find me working in Syracuse or Albany, or from Troy or Schenectady, or any number of places where we provide services. I’m very transparent and open and anyone can reach out to me at any time. We invite any colleague to participate in a live town hall with me on a quarterly basis where they can hear updates about our system and can ask any questions they have.”

Another critical component to Dr. Hanks’ effective leadership style is the fact that he still actively practices medicine and can be found at times working in the emergency department alongside his colleagues. For Dr. Hanks, not only does this practice help him boost the morale of the healthcare team, but it also gives him the best insights into how the organization is functioning, so he can make the best decisions for patients and caregivers alike.

“Recently, I covered three days in a row in the emergency department at SPHP in Albany over a holiday weekend. That gets around, and people know that I’m willing to get my hands dirty and get in the trenches with them. I think it improves the morale of our team,” Dr. Hanks explained. “Being trained as a physician brings some crucial advantages. First, it really grounds me in the reality of our front-line caregivers, providing a perspective that helps ensure we’re making the best decisions as an executive leadership team that keep the human impact front of mind. Second, it really gives me a lens into systems thinking. Everything comes together in the emergency department, and I can interact with the lab, radiology, pharmacy, patient flow, et cetera. I really learn more about the way our organization works from the time I spend working clinically rather than the time I spend in board meetings or doing rounds.”

Investing in Patient-Focused Technology and Accreditations

Exciting innovations and new accreditations at both SPHP and St. Joseph’s Health have been a focus of Dr. Hanks’ efforts as President and CEO, and they are further evidence of his effective manner of leadership. Specifically at St. Joseph’s Health, which has long been at the forefront of robotic surgery, the recent acquisition of the DV5, a next-generation, multiport surgical robot, has brought even more advancements to the technologies the hospital offers to its patients. The first healthcare system in the Syracuse area to fully embrace robotics, as Dr. Hanks explained, St. Joseph’s offers a full array of robotic approaches, including all generations of the Da Vinci robot, the Xi, and now the DV5.

“Minimally invasive, robotic surgeries offer many benefits to patients, including decreasing patients’ length of stay, decreasing the risk of complications, decreasing the pain patients experience and lessening the need for narcotics after surgery. Many may be surprised to learn that St. Joseph’s is one of the national leaders in robot-assisted, open-heart surgery. Right here in Syracuse, NY we’re a national leader, and really an international leader, in robot-assisted cardiac bypass surgery. So, we’re very, very proud of our investment in robotics, and we’ll continue to make those investments across all of Trinity Health in New York. It really allowed our surgeons to push the envelope and practice at the very highest of levels.”

St. Joseph’s Health was also recently named a Hernia Center of Excellence, an accreditation given by the Surgical Review Corporation after a lengthy review process. Dr. Hanks explained that this designation is a validation of the organization’s clinical excellence, as well as a signal of the team’s commitment to delivering the highest standard of hernia care.

“One of the things I’ve always insisted on is if we’re going to offer a service, like hernia surgery, I want to provide it at the highest possible level. And so, for areas where there are existing accreditations available, I like to push our organization to seek those accreditations, and that’s exactly what happened with our Center of Excellence for hernia surgery at St. Joseph’s. We’ve met rigorous standards for outcomes, safety, patient satisfaction, and continuous improvement of our quality. For patients, this means they can be confident in the care they’re receiving when they seek hernia care at St. Joseph’s Health. Hernias can be very complex and difficult to care for. We have a variety of approaches that we’ve brought together under the Center of Excellence that allow us to offer many options for patients with the best outcomes in the safest delivery of care possible.”

Perhaps one of the most top-of-mind technological advancements in the realm of healthcare is how healthcare institutions are taking advantage of artificial intelligence (AI). According to Dr. Hanks, AI has the potential to radically transform healthcare, both clinically and operationally, and the teams at St. Joseph’s Health and SPHP are staying abreast of the best ways to utilize this growing technology.

“If you give AI the right data set, it can do things like reduce diagnostic error, personalize treatment, improve the health of populations, and automate administrative tasks that cause burnout. We’ve just deployed ambient listening technology, where the AI system listens to when a doctor or nurse practitioner is speaking with a patient, and it creates a note. Now, the doctor or PA no longer needs to either dictate or type the note. This process decreases the amount of time the provider spends on documentation, so they can see more patients and spend more time face-to-face with patients. These are exciting things that are happening, which directly help us improve the experience of and care for our patients.”

Facing Challenges Head-On in the Future of Healthcare

Looking to the future, Dr. Hanks sees healthcare on an accelerated trajectory toward outpatient rather than inpatient settings, with more convenient, consumer-oriented care delivered at home in a model that’s more decentralized and data-driven. He also predicts the healthcare field will place more emphasis on the prevention and mitigation of social influences of health, like poverty and poor food access, and that there will be an increase of reliance on digital tools that can streamline and personalize care. Leading the team at SPHP and St. Joseph’s Health, Dr. Hanks is making sure the wider organization is tuned into these shifts and staying ahead of the curve as transformations occur.

“At Trinity, we’re already investing in these trends,” he stated. “We’ve deployed virtual nursing, and we’re leveraging telehealth for virtual visits with our physicians, including our specialists. We’re growing our home-based services, our value-based care models, and our population health models. We’re reimagining how we support the workforce of the future.

“But the biggest change we’re preparing for really is cultural. How do you embrace a mindset of high reliability, continuous innovation, and partnership? That’s the real engine of transformation,” Dr. Hanks emphasized.

Along with such changes, there will certainly be many challenges, as Dr. Hanks pointed out. These challenges include cuts to government funding, increasing government payer and decreasing private payer models, an aging population with higher healthcare needs, and more centralization of super subspecialities leading to a need for patients to travel longer distances for highly specialized care. To confront these challenges head-on, Dr. Hanks emphasized the need for transparent communication and collaboration across the entire healthcare system and beyond.

“Operationally, we have to be agile. We have to be disciplined and stay focused on long-term strategy while at the same time nimble enough to adapt to the short-term disruptions. We have to work across teams externally, with payers, policymakers, and community partners. No one organization is going to be able to navigate these waters alone.”

With Dr. Hanks at the helm, the providers, staff, and patients at St. Joseph’s Health and SPHP can rest assured the organization will tackle the coming changes and challenges by staying true to its foundational mission.

“We have to be clear about our mission and our values. In times of uncertainty, our North Star remains constant, and for us at Trinity, that mission is to be a compassionate and transforming, healing presence in our communities.”

 

 

Micron’s Arrival: A Once-in-a-Generation Opportunity for Local Manufacturers

By: James D’Agostino

When Micron Technology announced its historic plan to invest up to $100 billion in a semiconductor megafab in Clay, New York, it made national headlines. But for manufacturers across Central New York, this announcement isn’t just exciting, it’s transformative. Micron’s presence is expected to bring thousands of high-tech jobs, create a robust innovative ecosystem, and fundamentally change the regional economy. For small to midsized manufacturers, the opportunity is clear: Micron’s arrival will open the doors to new markets, new partnerships, and long-term, sustainable growth.

  1. A High-Tech Supply Chain Anchored Locally

Micron’s semiconductor plant will be one of the largest in the nation. With it comes the need for an expansive, reliable supply chain, which means sourcing many products and services from right here in Central New York. From tooling to packaging, testing, logistics, and facility maintenance, Micron will require a network of trusted suppliers to keep operations running smoothly. This is where local manufacturers can step up. Businesses that can meet Micron’s standards, especially those with quality certifications like ISO 9001, AS9100, or IATF 16949, have a real chance to secure long-term contracts as preferred suppliers. Many will be able to diversify into new service areas or scale existing capabilities to meet demand.

  1. An Innovation Ripple Effect

Micron isn’t just building a factory; it’s planting a technology hub in the heart of Central New York. Semiconductors are at the core of everything from smartphones and electric vehicles to defense systems and AI. Supporting a company like Micron creates technology-forward pressure across the supply chain, requiring higher levels of automation, precision, quality control, and cybersecurity. That pressure is a good thing. It will push regional manufacturers to modernize, adopt smart technologies, and invest in R&D. Those that embrace this shift will find themselves more competitive, not just with Micron, but across the broader high-tech and advanced manufacturing landscape. In many ways, Micron’s arrival can act as an accelerator for local innovation.

  1. Workforce Development That Benefits All

Micron’s growth means job creation on a massive scale: 9,000 direct jobs, over 40,000 additional jobs, and a workforce pipeline that must evolve quickly. To meet this need, Micron is working closely with educational institutions, trade schools, and regional organizations to build a training ecosystem, one that includes not only engineers and technicians but also skilled trades, machinists, inspectors, and plant operators. That’s good news for all local manufacturers. As training programs expand, particularly in STEM fields, manufacturing technology, and mechatronics, the talent pool available to all regional companies will grow. Manufacturers will benefit from a more qualified, job-ready workforce without shouldering the full cost of training and recruitment alone.

  1. Business Confidence and Infrastructure Investment

Micron’s multibillion-dollar commitment sends a powerful signal to investors, developers, and business leaders: Central New York is open for business. That confidence will lead to broader investment in infrastructure; roads, utilities, broadband, housing, and transportation, which supports not just Micron but the entire manufacturing community. This momentum creates a rising tide for local businesses, from machine shops and plastics manufacturers to metal fabricators and quality labs. Communities that were once shrinking or stagnant are now on the map for national attention and global investment.

  1. New Collaborations and Public Support

With Micron’s investment comes greater coordination between state agencies, regional economic development organizations, and technical support networks, like the Central New York Technology Development Organization (TDO). Manufacturers will have more access to:

  • State and federal funding opportunities
  • Export and market expansion support
  • Cybersecurity and quality management consulting
  • Lean and operational excellence training

Organizations like TDO are working directly with manufacturers to ensure they are “Micron-ready”—meaning they have the processes, certifications, and systems in place to capitalize on this opportunity. This level of support is unprecedented and offers smaller manufacturers the resources to grow smarter and faster than ever before.

  1. A New Era of Regional Collaboration

Micron’s success depends on a healthy, reliable ecosystem of partners, and that means stronger collaboration between regional manufacturers. We’re likely to see:

  • More co-manufacturing relationships
  • Shared use of specialized equipment and testing services
  • Joint training initiatives
  • Cross-industry partnerships

This kind of collaboration can reduce costs, increase capacity, and enable companies to pursue larger, more complex contracts together than they could alone.

Final Thoughts: Seize the Moment

Micron’s arrival is not just a headline; it’s a turning point. Central New York manufacturers have a rare opportunity to align with one of the world’s leading technology companies. But capitalizing on that opportunity requires intentional action: investing in certifications, developing workforce capabilities, modernizing systems, and strengthening business fundamentals. Those who prepare now will be positioned not only to work with Micron but to become stronger, more competitive players in the global marketplace. For local manufacturers, the time to act is not someday, it’s now. Want to learn more about the Micron opportunity? Connect with Central New York’s trusted manufacturing partner at www.tdo.org.

Central New York is Changing. Change is Good

By Pierre Morrisseau

We are witnessing what some are calling “generational change” in our region. Like most leaders, I view change as both inevitable and largely positive. But while change brings new opportunities, we also understand that it brings new challenges and risks. As leaders, we are compelled to consider how change will impact our communities and our companies. One way to manage through change is by playing out scenarios. Scenario planning enables you to prepare for multiple plausible futures by identifying key uncertainties, mapping out strategic responses, and monitoring leading indicators. Bringing together teams to play out scenarios allows for more creative thinking and development of solutions that anticipate challenges and smooth out volatility and risk.

Consider the impact of Micron Technology on Central and Upstate New York. The project will create 50,000 jobs, add 76,000 new residents to the region, and create a strain on our construction and infrastructure resources. According to Empire State Development (ESD), Micron will add over $16 billion in economic output in our region and more than $9 billion in real Gross Domestic Product (GDP) over the next 30 years. This is, by any standards, a massive impact on any region, particularly one the size and scope of Central New York.

Now imagine you are a manufacturer looking to grow your operations during this period.  Let’s consider some key uncertainties to monitor

Uncertainty

Possible Range

Labor Availability

Highly constrained → Moderately available

Material Pricing & Availability

Volatile and delayed → Predictable

Micron Project Timeline

Accelerated → Delayed

Infrastructure Readiness

Ready and expanding → Overburdened

Government Incentives

High support → Limited funding

To plan effectively, we can define three possible futures:

Scenario 1: “Surge Economy”

  • Micron progresses on schedule or faster.
  • Labor and materials become scarce.
  • Construction prices surge.
  • Local infrastructure struggles to scale.

Scenario 2: “Managed Growth”

  • Micron’s growth is steady and well-supported.
  • Labor and contractors are stretched but not overwhelmed.
  • Incentives and regional collaboration ease growing pains.

Scenario 3: “Delayed Uptick”

  • Regulatory or macroeconomic delays slow Micron.
  • Labor supply is temporarily looser.
  • Construction contractors become more available.

As we work through each scenario, we build strategic options for each of them.  Examples:

Strategy

Surge Economy

Managed Growth

Delayed Uptick

Lock in Contractors Early

Critical

Recommended

Optional

Pre-order Long-Lead Materials

Yes

Yes

Partial

Phase Expansion Projects

Start small, defer

Stagger phases

Accelerate

Build In-House Trades Team

High value

Medium value

Not required

Use Modular Construction

Maximize prefab

Selectively apply

Not a priority

Engage in Workforce Development

Urgent

Important

Opportunistic

Secure Government Incentives

Must-do

Strategic move

May be unavailable

We would identify early warning indicators to monitor such as:

Indicator

Signal

Union training center waitlists

Tightening labor

Non-responsiveness to RFPs

Contractor saturation

Micron’s quarterly construction updates

Timeline confidence

Material delivery lead times

Supply chain pressure

Local infrastructure project status

Readiness or delay

Considering all three scenarios we may identify immediate actions to take to prepare for the future such as:

  • Lock in key general contractors and specialty subs
  • Establish pre-negotiated supply agreements
  • Phase large projects into modular or manageable timelines
  • Partner with unions, trade schools, and apprenticeships
  • Apply for ESD, CHIPS Act, and workforce funding now
  • Monitor Micron’s pace and market saturation indicators

Scenario planning is highly effective because, according to scientific research, the brain struggles to distinguish between imagination and reality. Importantly, when dealing with reality we may be constrained by reality itself while the imagination is unbound and free to consider a fantastic range of scenarios.

From a risk management standpoint, working through these scenarios helps us to mitigate personal and business risk and associated costs. For example, we anticipate a considerable increase in the overall cost of living as higher-paying jobs arrive and wages increase along with the cost of goods, housing, property values, taxes and construction. Ultimately, to fully protect one’s assets, insurance costs will rise in step with the cost of repairing or replacing homes, autos and possessions, and for businesses, the cost of business continuation protection, insurance for facilities, inventory, transporting of goods, auto, liability, cyber, workers’ compensation and healthcare.

The bottom line is change is good. Change is necessary for healthy growth, but it is not without changes in risk. The next decade in Central New York will be transformational—but chaotic. Businesses who proactively use scenario planning can transform uncertainty into competitive advantage. By anticipating multiple paths forward and acting decisively when the time is right, they will position themselves as resilient, nimble players in the region’s industrial renaissance. We are wise to pre-plan and run through many scenarios to be prepared.