Nappi Wellness Institute: Improving Healthcare Outcomes for Vulnerable Populations in an Accessible, Supportive Environment

By Daniel K. Brantley

Tuesday, October 25, 2022

Upstate University Hospital’s soon-to-open Nappi Wellness Institute introduces a new era of health care with a suite of patient-centered ambulatory services and provider benefits in one location.

The area shown under construction will transform into a light and bright reception area.

An increasing amount of data indicates an imperative need to improve healthcare equity for vulnerable patient populations — an issue that’s been evident for years — and hospital systems across the country are attempting to level the field. With a $70 million grant from the New York Department of Health, a $75 million bonding opportunity to match funds, and an $8 million naming gift, Upstate University Hospital has been working on a solution, and that work is about to come to fruition.

Scheduled to open in early 2023, the Upstate Nappi Wellness Institute is a five-story, 200,000-square-foot outpatient facility that will integrate multiple primary and specialty health services and a bevy of unique amenities under one roof. The new Institute is expected to remove many of the barriers that send patients to the hospital instead of getting timely, appropriate care in the lowest acuity setting.

As the new Institute gets underway, Upstate University Hospital anticipates fewer unnecessary emergency visits and inpatient stays, ultimately leading to more cost-effective healthcare delivery and improved quality of life for vulnerable community residents. Combined, the benefits offered meet the qualifications of the state’s Delivery System Reform Incentive Payment (DSRIP) program, an initiative aimed at restructuring Medicaid’s healthcare delivery system and reducing unnecessary hospital use by 25% over five years.

“The COVID-19 pandemic catalyzed a transformation in health care that was talked about for a long time but only dabbled in,” says Amy Tucker, MD, MHCM, Chief Medical Officer at Upstate University Hospital. “Fortunately, we’re ahead of the curve with the Institute, which introduces a new model of care focused on wellness.”

Left to right: Amy Tucker, MD, MHCM, Marylin Galimi, Chief Operations Officer, Marisa Desimone, MD, Nancy Daoust, EdD, FACHE, LNHA

“The remodeling of care to focus on wellness is not just promoted at the Institute — it’s embraced. Everything about the building and the services offered centers around helping people stay well, vibrant and functional.”
— Amy Tucker, MD, MHCM, Chief Medical Officer, Upstate University Hospital

Built for Optimal Health

An integrated model of care guided the design and construction of the Nappi Wellness Institute. And following the WELL Building Standard, the Institute’s design and layout will promote the good health of patients, visitors, clinicians and staff alike.

“We wanted to change what people perceive as health care to be proactive and focused on wellness,” says Marylin Galimi, Chief Operations Officer at Upstate University Hospital. “We didn’t want another facility with clinics where you simply come in and wait for an appointment. We wanted to build something that represented the idea of caring for your body and your family.”

WELL Building Standards include the following:

  • Air: The Institute features filters that circulate 100% of outside air throughout the building.
  • Comfort: Convenient break and lactation rooms allow providers to decompress or tend to personal matters in spaces designed with an intentional lack of work-related furniture or equipment.
  • Fitness: The interior of the building has a walking loop that includes stairs, so team members can get some exercise without leaving the grounds.
  • Light: Large windows bring ample natural lighting into waiting areas, which line the perimeter of the Institute. For patient privacy, patient rooms are inside the pathway, and staff members can control the light in these and other interior rooms.
  • Mind: Calming, digital art on walls and earth-tone colors serve to provide a calming environment for all patients. Outdoor seating surrounded by trees and lush gardens, and a meditation labyrinth provide additional on-site havens.
  • Nourishment: Family-style break rooms with large-capacity refrigerators and a café bathed in natural lighting offer patients and staff members wholesome meals featuring fruits, vegetables, lean proteins and whole grains.
  • Water: Hospital-quality water filtration ensures all water sources are properly filtrated. Handwashing stations throughout the Institute allow easy access within and outside of clinical spaces.

As a LEED-certified building, the planet’s health was also considered during its planning and construction. The energy-efficient space encourages recycling all eligible materials and appropriate disposal of debris. Supplies will be purchased locally or regionally when available and appropriate.

Upstate Nappi Longevity Institute Groundbreaking

Easier Access to Primary and Specialty Care Services

The Institute will be home to a variety of primary and specialty care experts that can reach further than any single clinician or specialty could. Before the Institute was established, Upstate University Hospital healthcare services were provided in numerous locations spread throughout the area, each with its own medical directors, nursing and business leadership in place. These healthcare professionals will still retain their governance while working at the Institute, though some will share clinical space. Everyone will work together to provide more efficient, comprehensive patient care.

Patients who visit the Nappi Wellness Institute will have access to:

  • Adult and pediatric medicine
  • Alzheimer’s disease care and research, which is a special focus of the facility (see sidebar)
  • Center for International Health
  • Connect Care/Upstate After Hours
  • Endocrinology
  • Family medicine
  • Geriatric medicine
  • Inclusive health services
  • Integrated care
  • Internal medicine
  • Joslin Diabetes Center
  • Laboratory
  • Osteoporosis care
  • Nutrition counseling
  • Outpatient pharmacy
  • Palliative care
  • Radiology
  • Social work

Should hospitalization or emergency services be necessary, a pedestrian bridge gives immediate access to Upstate University Hospital. The bridge also allows Institute clinicians to follow up with hospitalized patients in a timely manner.

“We want to be of service to the community and I think we can do that with this facility — not just with the building, which is special, but with all of our services coming together in a cohesive, comprehensive way.”
— Nancy Daoust, EdD, FACHE, LNHA, Chief Ambulatory Officer at Upstate University Hospital

Services for Behavioral and Social Well-Being

Behavioral health services will also be available on-site. In the event patients present with behavioral healthcare needs, they can visit each clinic’s on-site behavioral health professional — a valued and much needed development for clinicians. For example, the Joslin Diabetes Center, the largest clinic within the Nappi Wellness Institute, is housed on the fifth floor, and behavioral health is likely to be an important part of care.

“Diabetes is often a chronic, lifelong condition that carries a heavy mental health burden for many patients,” says Marisa Desimone, MD, Associate Medical Director of the Joslin Diabetes Center. “Beyond diabetes, lots of people are struggling after spending two and a half years facing the worldwide stressors of the pandemic and other issues.”

The Institute also will provide educational spaces for well-being classes, nutrition counseling, cooking lessons, community lectures and other health and wellness learning opportunities. As equity in health care takes center stage, social determinants of health have become a major focus. According to Dr. Tucker, population health factors guided the creation of the Institute and its services, including drop-off, valet parking and covered bus stops across the street. Upstate Ambassadors will personally greet patients at the door and arrange for an escort to take them to appointments if needed.

“Those touches are a big deal,” Dr. Tucker says. “For vulnerable patients, these can make the difference between coming to a healthcare appointment and not being able to do so.”

Sam and Carol Nappi are joined by family members as well as by Upstate University Hospital President Mantosh Dewan, MD; Eileen Pezzi, MPH, Upstate Foundation; and David Amberg, PhD, Upstate Research, as they paid a recent visit to tour the building while it’s under construction. The gift from Sam and Carol Nappi — the largest ever received by the Upstate Foundation and Upstate Medical University — will be used to expand the building’s services related to neurosciences, including a focus on Alzheimer’s disease. The Nappi Longevity Institute is named in recognition of the couple’s philanthropy.

Feedback Matters

Though population health inspired the Institute, those who will be working there played major roles in ensuring it also met provider needs. Hundreds of individuals assisted in the development of the Institute, including a physician advisory committee which worked alongside nurses, business and marketing executives, hospital administration, security personnel, and more.

The physician advisory committee’s influence is evident in the exam rooms. When physician leaders examined the desks designed for exam rooms, they agreed they were aesthetically pleasing but immediately recognized they weren’t functional. That physician feedback helped the architects create an updated plan featuring large, half-moon-shaped desks that allow clinicians to face patients while talking to them. Additionally, computer screens mounted on the desks move easily to meet the specific ergonomic needs of different providers.

In the geriatric clinic, physicians recommended table height adjustments to make it easy for wheelchairs to fit underneath. Plans to develop mobile workstations in the pediatric area changed when providers noted the potential risk for children climbing on and damaging them.

“Patient care comes first — 100% — always will. [You] can’t go into health care without that outlook. It has to come first.”
— Marisa Desimone, MD, Associate Medical Director, Joslin Diabetes Center at the Nappi Wellness Institute

Technology Upgrades

To ensure continuum of care between providers at the Nappi Wellness Institute and other Upstate locations, all services tie into the Epic electronic medical record system. In place for years, this connectivity allows providers to communicate seamlessly with one another and grants patients access to their health information and appointments via MyChart.

The Institute plans to leverage additional Epic functionality to benefit all users.

“The Institute represents the clinic of the future,” says Nancy Daoust, EdD, FACHE, LNHA, Chief Ambulatory Officer at Upstate University Hospital. “We’ve had great talks with Epic, and we hope to be a beta test site for them to test upcoming Epic functionalities.”

In addition to Epic, real-time location scheduling (RTLS) technology will remedy any scheduling and patient-flow issues. With RTLS, clinicians on one floor can identify available equipment and exam space on another to make use of them as needed. These and other high-tech functionalities will enhance the physical proximity providers experience at the Institute.

“Being in the same building will facilitate even closer collaboration when we pass one another in the hallway, garage or elevator,” Dr. Desimone says. This opens the door for clinicians to “strike up a conversation and brainstorm how to meet a patient’s needs.”

Prepared for Growth

The Nappi Wellness Institute is presently large enough to meet a variety of health needs in the community, but Upstate administrators also had the foresight to plan for growth. The Institute currently has five floors but can accommodate an additional three stories if clinicians, administrators and other team members see a need.

“We want to decant all ambulatory services out of the hospital, which is cramped for space,” Dr. Daoust says. “Doing this presents us the rare opportunity to scope out incoming practice needs and ensure they have more space that allows them to grow further in the future. Think about the impact we can have on a real-time basis instead of a patient having to wait in the ED.”

To ensure the appropriate allocation of areas within the hospital and stand-alone clinics, Dr. Daoust and others are closely monitoring department communications so they can successfully meet future requirements and build on their success.

“By making services accessible and convenient, co-located in a one-stop shop and affordable, we’re positioned to move the needle on our community’s health,” Dr. Tucker says. “The services we offer will be robust, in addition to a very nice experience for patients who go to the Institute, and for the clinicians and staff who practice there. We’ll have a model that is welcoming and easy for referring providers as well.”

A Naming Gift of Lasting Impact

The naming gift from Sam and Carol Nappi will be used to provide services related to the neurosciences inside the new Nappi Wellness Institute, including a special focus on Alzheimer’s disease. The Nappi Wellness Institute is named in recognition of the couple’s philanthropy.

“The Nappi’s support, with its focus on Alzheimer’s disease and brain health, is a down payment on creating healthy futures for all of us as we age,” says Sharon Brangman, MD, Distinguished Service Professor and Chair of Geriatric Medicine at Upstate University Hospital, and a former president of the American Geriatrics Society.

“Sam and I want to continue our commitment to Central New York in both deed and funding,” Carol Nappi says. “We will work with Upstate Medical University to build a world-class facility, assemble a renowned medical team and fund groundbreaking research.”

“We’re encouraged and excited about the 21st century vision the team at Upstate Medical University and the Upstate Foundation have shown in their commitment to medical research and proactive medical care,” Sam Nappi says. “Carol and I look forward to working with them.”

The Nappis have a long history of supporting local causes, focusing much of their philanthropic initiatives on medical research and community medical care. Sam Nappi is founder and chairman of Alliance Energy. Carol Nappi, a former psychiatric therapist at Community General Hospital, now Upstate Community Hospital, is active with numerous local and national charitable organizations. She is a 2000 Jefferson Award winner, a national recognition honoring community and public volunteerism.

Visit to learn more about the groundbreaking approach to care at the Nappi Wellness Institute.

Comprehensive Breast Care at Oneida Health

By Becca Taurisano
Tuesday, October 25, 2022

Breast surgeon Mary Ellen Greco, MD, FACS, and Physician Assistant Kristen McNeil bring expertise and a personal touch to Oneida Health’s new breast care subspecialty.

Mary Ellen Greco, MD, FACS, and Kristen McNeil, PA-C joined Oneida Health in February after working together for the last five years in Syracuse. Their arrival launched the new Oneida Health Breast Care service line.

Both from Central New York, the pair says it was a natural next step for them to bring high-quality, comprehensive breast care to a community setting.

Together, Dr. Greco and McNeil provide the complete spectrum of breast care including abnormal imaging findings, known diagnoses of breast cancer, screening for patients with a strong family history of breast cancer, patient-related complaints of a self-detected lump, in-office ultrasound-guided biopsies, surgery, genetic counseling and testing, and benign conditions of the breast.

Built on Experience

A graduate of the SUNY Science Center at Syracuse and fellowship trained in trauma and surgical critical care at the University of Maryland Medical System, Dr. Greco brings over 20 years of medical and surgical breast care experience to Oneida Health. She says at the time she finished her surgical training, there was no breast care specialty.

“As the only female surgeon in the practice, I ended up seeing our breast patients because the patients felt more comfortable with me,” she says. The end result was a career with a sole focus on breast care which Dr. Greco calls both exciting and rewarding.

McNeil spent two years in urgent care and 12 years in family medicine before working with Dr. Greco at her Syracuse office.

“Breast care is a subspecialty that became very important to me,” says McNeil, having lost a close friend to metastatic breast cancer at 31 years old. “It’s my goal to provide patients the piece that [my friend] felt was missing from her care.”

Personalized Care

Patients from Oneida and Rome were being referred to their practice in Syracuse, so it made sense to bring care closer to them.

“Here at Oneida, we have all of the technology and pieces of the puzzle to provide the highest quality of personalized care to our patients,” Dr. Greco says.

Plus, many patients prefer going to Oneida because of the convenience or proximity to family members who can provide support. Continuity of care is the key, says Dr. Greco, noting that she has had some patients for 20 years no matter where her practice is located.

Other members of Dr. Greco’s staff have been with her for 10 years or more and that consistency is important for patients.

Mary Ellen Greco, MD, FACS

“A lot of what we do isn’t surgical — it’s care, education, follow-up and reassurance,” Dr. Greco says. “It makes patients very happy to have consistent people be a part of their health care.”

An essential part of providing personalized care is Oneida Health’s certified nurse navigator, Linda Lyon, CN-BN.

“With a breast cancer diagnosis, we are just one pillar of a patient’s complete care,” McNeil says. “The nurse navigator is critical in holding a patient’s hand every step of the way.”

Lyon helps patients get the necessary support they need, whether it’s financial assistance, transportation, access to social workers or supplemental care. “The nurse navigator is the key to keeping the whole system moving effectively,” Dr. Greco says.

Network of Support

When surgery is required, Dr. Greco’s patients have the advantage of receiving all pre- and post-operative care from Roswell Park, an awarding-winning hospital in Oneida. When other treatment options are needed, patients don’t have to go far.

As a member of the Roswell Park Care Network, Oneida Health Breast Care patients have access to the latest developments in cancer treatment if they require medical or radiation oncology.

“We are very happy to be affiliated with Roswell Park and to collaborate with them in caring for our patients,” Dr. Greco says.

Roswell Park’s expertise can be accessed by Oneida patients quickly and easily, either by on-site providers or by using telemedicine if necessary, eliminating the need to travel to Buffalo in nearly all cases.

The Oneida Health Gorman Imaging Center is essential to breast care in Oneida as well. Patients have access to robust imaging right on campus, such as 3D tomosynthesis, screening sonogram, 3 Tesla MRI, and an advanced PET CT. Dr. Greco and McNeil coordinate biopsies with the Gorman Imaging Center, if it is not something they can do in the office.

According to McNeil, providing convenient access to regular screenings is an essential part of providing comprehensive care.

Kristen A. McNeil, PA-C

“Having convenient access to a facility like Gorman Imaging is really important, so patients can easily get their annual mammograms,” she says.

Dr. Greco agrees and adds, “There are people who are motivated now to get their care because they can go to Oneida. All patients want to have their care close to home.”

A Rapidly Changing Field

Collaborating with other physicians and staying up to date with the latest techniques is essential to providing patients with the best possible care. Breast care is one of the most rapidly changing subspecialties of surgery and medicine, which Dr. Greco finds exciting.

“More than ever, women are very invested in their own health care,” she says. “They come pre-educated with questions and have discussed options with their friends and family. Our team takes great pride in not only discussing their concerns but sharing with them the advanced treatment options, many available right here in Oneida.”

Dr. Greco uses advanced surgical practices such as oncoplastic closure for more cosmetic healing, and sentinel lymph node biopsy after neoadjuvant chemotherapy, to help reduce lymphedema complications. She is hoping to soon have plastic surgery available at Oneida Health to do simultaneous mastectomies and reconstruction, eliminating the need for patients to travel.

New Developments

“In order to be a specialist, you have to stay on top of all of those changes and be aware of the most current recommendations and standards of care,” Dr. Greco says.

She and McNeil work closely with medical oncology and radiation oncology to for treatment planning, as chemotherapy and radiation therapy indications continue to change and evolve.

Determining which patients qualify for genetic testing is changing too. Anyone with a history of breast cancer is now eligible for genetic testing, a change from what was recommended three years ago.

“We are happy to see those patients, counsel them and test them,” Dr. Greco says.

Oneida Health Breast Care Staff: Jayme Lohr, Dawn Leduc LPN, Karisa Zuke, Linda Lyon RN, Kim Sabatino LPN, Mary Ellen Greco, MD, FACS, and Kristen McNeil, PA-C

Gun Violence in Central New York

By Kathryn Ruscitto

Tuesday, October 25, 2022

It’s time to focus on solutions.

Every morning, as I read the news, there’s more and more reported gun violence. I’ve been reading — but not acting — for far too long, and I have to ask myself why. Gun violence is getting worse and more violent, and everyone involved suffers from this epidemic: the shooter, the victim, the families and the community members lost to death or incarceration.

In August, Syracuse police reported a 35% increase in those injured or killed by gunfire over the last year, from 81 individuals to 110. 

Many of these deaths were among teenagers, and nationally, gun violence is now the leading cause of childhood death. The issue — which has become a political football — is clearly based on fact: Guns are causing deaths.

What are we going to do to reverse this trend? Many other public health threats, from smoking to driving under the influence to COVID-19, have prompted research and program interventions. They may have taken time, but slowly, progress was made and public health improved.

Many experts are concluding, similar to how infant mortality rates are viewed, that we have a deep societal problem on our hands, one that requires us to look closely at the social determinants feeding this crisis. Inherent racism in our systems, a proliferation and lack of controls on firearms, poverty, and lack of programming and resources for children are certainly factors.

Standing Up To Do Something

This epidemic needs a different kind of partnership to break through to faster results. Engaging the communities and the leaders closest to the problems, and listening to their recommendations for investment, often referred to as place-based decision-making, would help.

What is somewhat hopeful is the call to action building across the healthcare community with research, funding and best practice innovations.

Michael Dowling, CEO of Northwell Health, launched an initiative this summer called The Gun Violence Prevention Learning Collaborative for Health Systems and Hospitals, and 1,000 healthcare organizations and clinicians have joined the effort.

“This is about protecting people’s health. This is about protecting kids’ lives,” Dowling says. “Have some courage. Stand up and do something. Put the interest of the community in the center of what you think about each and every day.”

We each can contribute in ways that move the conversation forward. Discuss the issue with your family and social and professional organizations. Support funding for research and programming that keep children engaged and safe. Understand the social determinants and attitudes we can change in health care.

This issue won’t get better with hope alone. It requires outrage and action, as Dowling reminds the healthcare community.

“Our job is to save lives and protect people from illness and death,” he says. “Gun violence is not an issue on the outside — it’s a central public health issue for us. Every single hospital leader in the United States should be standing up and screaming about what an abomination this is.”

Kathryn Ruscitto, Advisor, can be reached at or at