Category: 2026

Crouse NICU: Extraordinary Commitment

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By: Martha E. Conway

There are a lot of moving parts in developing and sustaining a Level IV neonatal intensive care unit; at Crouse, it’s not only their deliveries that rely upon the NICU, but also babies from 17 hospitals across a 14 county region that spans the Canadian to Pennsylvania borders and from Albany to Rochester. Through its Regional Perinatal Center, Crouse also provides services for the region’s high-risk obstetrics. Crouse has the busiest labor and delivery unit in Central New York, welcoming more than 3,000 babies annually. The NICU serves about 900 babies annually, which includes 300 babies transferred in from the 17 regional hospitals. Staff care for an average of 56 babies daily. The average stay is about 33 days.

First in women’s and infants’ health

Seth Kronenberg, M.D., President and Chief Executive Officer for Crouse Health, said Crouse started as a women’s and infants’ hospital 140 years ago, making it one of its core services. “We’ve been the Regional Perinatal Center since the 1970s, and we’ve always been the market leader in obstetrics and NICU. We have a saying that ‘those with low-risk pregnancies can have great experiences at Crouse, but those with high-risk pregnancies can rest assured that the time from their baby’s birth to the time they see a NICU doctor is reduced, and the shorter that timeframe, the better the outcome.’”

Crouse recently was awarded a grant from the state Health Department to help modernize and expand the NICU, as well as other areas. “We’re working on the architectural drawings, with a plan to deliver stronger, more accessible support to our entire 14-county region,” Kronenberg said. “We’re excited to have more capacity and space and continue to have the latest and greatest technology.” He said Micron will cause an influx of people, which will skew younger. “Maternity is going to be a big part of that, and with fertility treatment access, we’re going to see more multiples. We’re anticipating continuing growth in obstetrics.”

Level IV NICU designation requires full-time onsite subspecialty care, complex imaging capability, and ability to perform major surgical procedures. “We offer complete surgical and medical support to the sickest babies,” said Dr. Boura’a Bou Aram, Medical Director, Neonatal Associates of Central New York. “We’re the ultimate destination for the most complicated cases.”

Crouse is the only NICU in the region that guarantees round-the-clock board-certified neonatologist support. When a regional doctor needs a direct link to a neonatologist in an emergency, they can speak to one immediately. “When a life is on the line, you want a direct line, 24/7,” Bou Aram said.

Crouse’s isolettes monitor and control temperature, oxygen, humidity and light, as well as a neonatal transport team that can pick up a baby born in any of its 17 regional hospitals, utilizing one of these highly specialized isolettes to help deliver treatment in a controlled environment during the return trip. “You want your team to arrive able to start 

treatment,” Kronenberg said.

Sicker moms, sicker babies

“We can have NICU staff in the delivery room if the baby is born here,” Kronenberg said. The hospital is seeing increasingly premature infants and more multiples. Obesity and diabetes have resulted in sicker moms, which can lead to babies being born more premature and ill. Babies are getting smaller and equipment is getting bigger. “We need to expand to meet those demands,” Kronenberg said, adding that the NICU is seeing more micropreemies – really premature babies who require a tremendous amount of lung support. “The NICU isolettes monitor temperature, humidity and light at a level that didn’t exist years ago.”

Director of Nursing Joan Dadey said neonatology is a relatively new field of medicine that has come a very long way since the 1970s. “Even since the 1990s and early 2000s, medication called surfactant was developed, which helps lungs absorb and transport oxygen,” she said. Some of the most impressive gains have been around ventilation therapy and ways to support the development of preterm babies’ lungs, which are the last things to develop.

“We are getting better at our craft every year,” said Nurse Manager Lisa Hatter. “Our babies are a lot sicker than they used to be. Babies we couldn’t save 20 years ago can be saved now. Our technology is amazing.”

Loving care in a high-tech environment

There are myriad challenges in the NICU. The babies are tiny and fragile or very ill, so special care must be taken to ensure interventions won’t hurt them physically. “There is great responsibility on us as a team to keep these fragile babies alive and well,” Bou Aram said. “We have every level of advanced respiratory therapy support, MRI and echocardiogram, and the ability to perform major surgical operations here,” Bou Aram said. Fetal surgery can now prevent severe damage from complex fetal problems such as spinal defects, blockages of blood flow into the heart, or severe twin conditions. Precision medicine options have exploded; the rapid use of genetic mapping and neonatal-specific imaging now provide highly accurate results. Crouse has all the necessary equipment to insert breathing and chest tubes and to put babies on heart-lung bypass. “Though comprehensive mapping may take longer than other options, such as the use of microarray or gene sequencing, advanced tools like MRI and genetic testing allow for quicker, more accurate determination of a diagnosis,” he said. “Early, accurate diagnostics give doctors the opportunity to tailor a treatment plan earlier in an infant’s stay.”

“It is very stressful, especially when babies are very sick and every minute counts,” Bou Aram said. “I am a father first, so putting myself in the shoes of these parents adds to the weight of the responsibilities. New parents are naturally overwhelmed, so information needs to be clear, direct and honest. Multiply this by a hundred when the baby is sick.”

Crouse also cares for babies born with surgical emergencies. Ultrasound detects a host of anomalies that may require surgical intervention or specialized care. “It’s really tough on the parents – they go through a lot of emotions,” Hatter said. “We try to reassure them that it’s going to be okay and include them in as much care as we can. Nobody wants to give birth to a baby they’ve been so excited about and go home without them. We try to save all the firsts for the parents – the first bath and bottle – because those milestones mean the world to those parents. We try to let them do the things they can – change the diaper, take a temperature or move a probe from foot to foot. We have them put little tape recorders in the isolettes and read them books, so the baby can hear their voice when they’re not there.”

“Because neonatology has advanced as a field of medicine, equipment has followed suit,” Dadey said. “We have all the equipment and the doctors and midlevel providers like nurse practitioners, physician’s assistants, nurses, and respiratory therapists who are all trained to use it. But some of our toughest cases are big babies who aspirate meconium during birth or might have an infection when they are delivered, so their lungs are compromised. The technology has evolved to improve survival rates so these babies can leave the hospital. We work very hard for every baby to make sure they have the best outcome.”

What the future holds

“We started as a women’s and infants’ hospital – a critical piece that makes Crouse Crouse,” Kronenberg said. “We will continue to enhance, expand and invest in those services. The highest-level NICU requires investment in the latest and greatest technology. We already have the best doctors and nurses.”

“Over the next decade, we will adopt new clinical tools,” Bou Aram said. “Promising technology includes AI and predictive monitoring. Tele neonatology lifelines will provide greater digital reach; onsite clinical experts will be able to virtually assist with the initial stabilization of a baby in any of the regional hospitals. Over the next decade, the need to stay on the cutting edge will only increase. I’d say the focus will be on diagnostic modalities, imaging, and bedside technology.”

Pride in the program

“Crouse delivers world-class medical care and high-end programs like the Regional Perinatal Center in a family community hospital culture,” Kronenberg said. “It’s that culture that separates us: It’s how we treat each other, how we treat our patients, how everybody interacts. It’s special. Our people aren’t just employees; they are family. We invest in workforce development, invest in them as human beings, and try to have fun at work because healthcare is very serious business. Everyone believes in the mission. At Crouse we say ‘every moment matters,’ and that’s the influence everyone has on patient experience – from environmental services to security to patient access – they are all equal. It’s not just the doctors and nurses; it’s our entire Crouse family. Walk down the hall, and you see smiling faces and people who enjoy being here. That doesn’t take away the stress of being in healthcare, but that family environment really sets up our culture.”

Bou Aram is proudest of building a multidisciplinary team and the thousands of families in Central New York whose stories started in Crouse’s NICU. “Our team of physicians, advanced practice providers, nurses, respiratory therapists, staff, and the administration that supports them act like one family to provide seamless care under one roof,” he said. “To go around Syracuse and know that a child in the park or a grown adult or high school or college student you see was once a one-pound baby lying in a bassinet in our nursery brings me so much pride. Neonatal care is truly a collaborative endeavor, and we cannot do it without the backing of our entire Central New York community.”

“I’m proud to be part of this team – the work that is done here is nothing short of miraculous every day,” Dadey said. “We get influxes of patients – it’s not uncommon to get three sets of twins in four hours – and the team pulls together. Then we respond to a transport in our region, and the team pulls together. They deliver the very best care, are passionate about what they’re doing and want the very best for every family and baby. Our neonatologists and nurses embrace excellence; they’re constantly looking to improve – evaluating research, new technologies and practices. Seeing that come to life every day is incredible.”

“We have a motto: ‘Nobody sits until we all sit,’” Hatter said. “As soon as a baby hits the bed, we have so many nurses at the bedside ready to help. Whether running to the pharmacy, the supply room, hanging fluids, helping with procedures – everybody’s invested in the success of every baby, and just being able to watch everyone work together toward a common cause is absolutely amazing.” “Crouse is the only independent, locally governed community hospital in
Syracuse, and we are here to meet the needs of the community,” Kronenberg said. “There isn’t a solution to health care in our region that doesn’t include Crouse, so to be able to deliver the highest-quality care and really high-end, highly technical medical services within that family community hospital culture – that’s what makes me most proud.”

Going to the Zoo

NICU holds an annual reunion at the Burnet Park Zoo. “When babies are nearing discharge, they sometimes decide to be a little naughty, delaying the discharge,” Dadey said. “So, we don’t use that word. We say they’re getting ready to go to the Zoo. Then they join us at the reunion with their parents, siblings, grandparents, aunts, uncles … you have hundreds of people. It’s a beautiful experience.”

Kronenberg said the reunion is one of the most rewarding things he participates in yearly.  “You see children who were tiny, tiny babies and were in Crouse for months and months, and here they are just like every other kid. It’s really rewarding for the doctors, nurses and families because they get very close when their babies are here for a long time. To reunite the care team with patients and families is very rewarding.”

“Going to the reunion every year and seeing the babies growing and healthy is just phenomenal,” Hatter said. “Babies bounce back. They’re amazing.”

“When a family seeks care for their baby at Crouse, they don’t just have a physician: they have an entire community dedicated to their child’s care,” Bou Aram said.

“Our NICU is a special place, Hatter said. “Every nurse here loves every baby like it’s their own. We give some pretty amazing care.”

Culture in the Clinical Practice

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BY KATHRYN RUSCITTO, ADVISOR

I often wonder why the patient experience feels complete in one medical practice yet lacking in another. The answer usually lies in a collection of touchpoints: how the phones are answered, how staff greet patients, whether communication remains consistent between visits, and how issues are resolved when something goes wrong. These visible moments are only part of the story, but together they reveal the culture.

Exceptional patient care requires alignment across every department. Positive experiences reflect an organizational culture built on clear goals for every encounter, every person, and every time. Even when miscommunications arise, a strong culture ensures they are handled with courtesy, responsiveness, and accountability.

Leadership establishes this baseline and must hold itself to the same standards expected of everyone else. Hiring, training, and recognition programs should all reinforce the same core values. When expectations are transparent, team members flourish, morale improves, and retention is more likely to increase. Mutual respect is also critical. A healthy culture must clearly articulate expectations for patient behavior, especially given the recent rise in workplace safety challenges. Patients deserve compassionate care, and staff deserve a safe, respectful environment in which to provide it.

The key elements of a strong culture include safety and trust, accountability and decision- making, feedback and innovation, and work-life balance and growth. These principles should be stated clearly and revisited as the organization changes. Culture is not a one-time announcement; it is something that must be reinforced every day through leadership actions, team behavior, and organizational systems.

As Michael Watkins noted in Harvard Business Review, “Culture is the organization’s immune system.” This idea captures the role culture plays in clinical practice: it helps teams respond to stress, navigate unexpected challenges, and access the right support when problems arise. It also shapes what the organization tolerates, what it rewards, and how it behaves under pressure.https://hbr. org/2013/05/what-is organizational-culture

Looking back on a career in healthcare leadership, it is natural to think about how often l truly walked in the team’s shoes. While rounding can provide perspective, deeper listening often reveals whether an organization is living its values and whether the culture is supporting staff. Patient and client perspectives matter just as much. Surveys offer value, but in-person feedback creates a unique opportunity to ask follow-up questions, learn more deeply, and better understand what people are actually experiencing.
Finally, the empathy gap must be addressed. Many patients do not fully understand current workforce shortages or the administrative delays that affect care. It is helpful to provide that context and advocate for patience and kindness toward frontline staff. At the same time, the frustration patients feel when they cannot access care or communicate with providers is real. The challenge is to communicate these realities honestly while staying true to the organization’s values.

Resources for Building a Strong
Culture in Clinical Practice

• American Medical Association – Leading Change https://edhub.ama-assn.org/steps-forward/pages/leading-change

• National Center for Healthcare Leadership https://www.nchl.org/

• National Academy of Medicine – Culture of Health Program https://nam.edu/our-work/programs/culture-ofhealth-program/–

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

Nurses: The Frontline Syracuse Community Health

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By: Molly English-Bowers, LPN

Traditional healthcare hierarchies placed physicians at the top with various nurses in supporting roles–nurse practitioners, registered nurses, licensed practical nurses, and medical assistants, in that order. But in today’s complex and increasingly specialized medical environment, a cooperative team approach becomes necessary. Quality physicians look to their nursing staff to work with them to promote better outcomes for patients.

That is clearly the case at Syracuse Community Health (SCH), where Ofrona Reid, MD, MBA, MS, president and chief executive officer, not only recognizes the value of the nursing staff but also supports them furthering their education. He wants them to jump from LPN to RN, if they choose, and has structured the work environment to achieve this.

“Dr. Reid has fostered a culture that encourages professional growth, and as a result has been able to build the next generation of healthcare professionals and has strengthened healthcare right here in Central New York,” said Jessica Yoxall, vice president and chief operating officer at SCH.

In fact, he is so cognizant of the importance of the facility’s nurses that he chose not to be interviewed for this article; instead, he wants the nurses to tell their own stories. This article is the result of those interviews.

Fifty Years of Serving the Underserved

Syracuse Community Health was founded in 1978 with the mission to provide high-quality healthcare to the residents of Onondaga County, especially those who are uninsured, disadvantaged or who face other obstacles to care.

Nearly 50 years later, the health center has cared for more than 100,000 residents of Onondaga County, 91 percent of whom live in the city of Syracuse. In addition, 78 percent of patients are covered by Medicaid, Medicaid Managed Care or are uninsured; 92 percent have an annual income below 200 percent of the poverty line, and 45 percent are under the age of 21.

SCH opened a new, 56,000 squarefoot facility in 2023 at 819 S. Salina St., Syracuse. Patients can access care at 12 other clinical locations, eight of which are located inside Syracuse City Schools, convenient for parents who are unable to either take time off work or transport their child to a medical appointment. In addition to the main site, the nonschool- based sites are 930 S. Salina St., 1938 E. Fayette St., 603 Oswego St., and on the Onondaga Community College campus.

“Our clinics are intentionally and strategically located along transportation routes and in zip codes that contain demographic challenges,” Yoxall said.

SCH employs 200 staff, 23 of them nurses, including eight Registered Nurses and 15 Licensed Practical Nurses. “Nurses are the center of our organization and create the first impression for our patients,” said Yoxall. “We may not be able to pay the highest amount, it’s not the easiest job, not the highest paying, but it is the most rewarding. Our nurses are working here because they want to be here.”

At SCH, nursing duties often extend beyond traditional clinical responsibilities- helping patients navigate their social needs such as food insecurities and housing. “You’ll see them helping out at check-in meeting the patients where they may need help, providing compassion, dignity and respect,” said Yoxall. “Our nurses’ dedication embodies SCH’s mission.”

Working as a nurse isn’t easy but it is incredibly rewarding, satisfying and motivating. Sherri Henderson-Mitchell began her career at SCH in 1991 as a volunteer in the pharmacy, a role she said, “ignited my passion for healthcare.” She began working at SCH in October 2000 as a certified dental assistant and earned her LPN in 2009; she is currently attaining her RN.

She cites as motivation the support SCH has given her as well as SCH’s patient population. “My commitment to my patients and my community remains a primary source of motivation for my continual professional development,” she said. “Over the years, the evolving demographics of our patient population have presented new challenges that, in turn, have created opportunities for personal and professional growth.”

Sarah Platt, RN, came to SCH as an LPN and currently works as RN supervisor in the Pediatrics Department. “What brought me to SCH was the opportunity to service the children in my community,” she said. “My motivation to stay with SCH while continuing to advance my career was knowing I was going to be able to continue doing something that I enjoy. Watching the children come in as newborns and reach each milestone as they grow up brings the workday extra brightness.”

Maizie Millwood’s first contact with SCH was as a patient and her first job there was as secretary even though she already was a Certified Medical Assistant. She is now an RN. Three factors fuel her desire to remain at SCH. “I am motivated by the organization’s mission, the supportive work environment, and the chance to continue learning, growing and contributing to a team that is committed to improving the health and well-being of our patients,” she said.

Bre Anna Odom came to SCH as an intern in the Medical Assistant program before she was hired in the same role in the Eye Care Department. She then worked as an LPN for approximately 10 years when she decided it was time to become an RN. Her motivation to stay at SCH is simple. “The patients,” she said. “I really love the community we serve here at SCH.”

Samrawit Legesse’s introduction to SCH occurred during the clinical rotation for her Medical Assistant certification. She remained after the facility offered her a job “and I have been here ever since.”

While Triana Henderson also started as a Medical Assistant at SCH, her desire to work there is rooted in her childhood. “I always wanted to work at SCH since I was younger,” she said. “I knew a couple of people who worked here before and had nothing but good things to say.” She made the impressive, and challenging, leap from MA to RN.

All six women credit SCH for bolstering their efforts to further their nursing careers, especially adjusting work schedules around class times. “SCH provided encouragement along the way,” Odom said, “and was very accommodating with any schedule adjustments I needed while in school.” 

Henderson-Mitchell called out three physicians who were particularly encouraging while she studied toward her LPN, Oris Moore, DDS, Wilson Sithold, DDS and the late Henry Chionuma, an adult medicine internist who started SCH’s Walk-In Care operation.

“They all recognized my potential even when I did not,” she said. “Their guidance inspired me to strive for improvement, pursue opportunities for growth and seek further education. This journey has empowered me to take on more significant roles within our organization, enabling me to make a substantial impact on our system of care and the community we serve.”

Stated Platt, “SCH was great with allowing me to have a flexible schedule while studying for my boards. SCH staff also gave me amazing encouragement to continue to work toward my goals when they noticed I was struggling; they offer a great support system.”

Millwood, at one time a Medical Assistant, said that SCH played a significant role in her decision to pursue her lifelong dream of becoming an RN. “Working at SCH exposed me to a diverse patient population and allowed me to see the impact nurses have on improving patients’ lives,” she said.

“That experience inspired me to realize that I wanted to do more and take on a greater role in providing patient care. I would like to sincerely thank the entire Syracuse Community Health team for their encouragement and support throughout my nursing school journey. Their kindness, patience and belief in my potential motivated me to keep going, even during the most challenging times,” Millwood added.

“SCH loves to see their employees grow,” said Henderson. “Management actually listens to your concerns and tries to meet you where you are to help you along your career path. If you’re willing to work hard and give your best effort and take constructive criticism, SCH is the place to be.”

Nursing school is rigorous and demanding. Add work responsibilities and family obligations to the mix, and nurses often think twice about continuing their education. The support SCH gives its nurses can’t ease the challenges of school itself, but it can help mitigate the stress of the balancing act.

“Balancing family responsibilities with work and school proved quite challenging,” said Henderson Mitchell. “However, the assistance and support I received from SCH were unparallelled compared to any other organization where I have been employed.”

Odom agreed. “It got difficult at times juggling being a full-time parent, student and employee,” she said. “There were a lot of long nights being super tired but still having to show up and push through. I had a great support system and SCH was accommodating with any schedule adjustments that I needed.”

Millwood said that handling it all was as challenging as pursuing her nursing degree. “Working three days a week while attending classes required careful time management, organization and dedication,” she said. “I often had to balance long work shifts with studying, completing assignments and preparing for exams, which left little time for rest or personal activities.

“Although balancing these responsibilities was difficult, the experience strengthened my resilience, improved my time-management skills, and taught me the importance of perseverance. It also prepared me for the demands of the nursing profession, where managing multiple priorities while providing compassionate, high-quality patient care is essential.”

Legesse agreed. “Time management was the biggest challenge I experienced while balancing work, school and personal responsibilities,” she said about her LPN journey. “I worked part-time, my family kept me motivated and SCH helped by giving me a flexible schedule.”

Further, she was prepared for the rigors of advancing her career. “I knew this would be challenging but completely worth it,” she said.

A single mother, Henderson faced financial challenges in her quest. “Trying to manage personal finances, paying for school, and juggling home life was tough. But SCH supported me with schedule changes, especially Erin Healy, Dr. C and Heather Scott-Levy, director of nursing. They supported me from day one. I am forever grateful for each person that played a significant role in my journey.”

Grow Our Own

SCH administers a program called ‘Grow Our Own,’

 designed to attract individuals who possess a desire to pursue a career in the healthcare field with an intent to serve in community health centers. The program aims to foster personal and professional development, thereby retaining top-notch staff and ensuring quality patient care.

“We’re dedicated to ‘Grow Our Own’ to address the future shortage of primary care providers and supportive personnel,” Yoxall said. “By helping our employees grow through personal and professional development we can fill critical positions with internal candidates or secure critical competencies for our team.

“We achieve this through educational opportunities, clinical rotations, internships, cross training, career ladders and flexible schedules that align with school demands.”

In 2025, seven employees participated in ‘Grow Our Own,’ including medical assistants who became LPNs, as well as LPNs advancing to RN roles while working at SCH.

For those LPNs who are content in their current roles, this year SCH implemented a competency-based program. “This model helps identify opportunities for additional education and professional growth, provides quarterly feedback for all LPNs, and supports progression through three levels of increasing responsibility,” Yoxall explained. “This supports those who are not enrolled in formal coursework but want to continue to grow within their role.”

A quality facility that provides excellent patient care requires staff that is fully dedicated to the patient population, and nurses are a vital part of that team. “We are a reflection of our community, with a diverse workforce, some of whom are bilingual. We are constantly investing in our workforce,” Yoxall said, “which leads to better outcome for our patients, which then results in a healthier community.”

 

Who’s Exempt? New York Labor Law and Fair Labor Standards Act Overtime Rules For Physicians, PAS, and Practice Staff.

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It’s easy to assume that anyone with an “advanced degree” is exempt from overtime. For physicians managing a practice, that assumption can be costly. The framework for determining which employees are exempt from overtime pay is established by the federal Fair Labor Standards Act (“FLSA”) and the New York Labor Law (“NYLL”).

What Is the FLSA and How Does It Apply to Overtime Pay?

The FLSA is the primary federal law governing minimum wage, overtime pay, recordkeeping, and youth employment standards. Under the FLSA, non-exempt employees must be paid overtime at a rate of no less than one and one-half (1½) times their regular rate for all hours worked over forty (40) in a single workweek. The NYLL has similar overtime provisions and generally follows the FLSA in areas its own provisions do not address.

What Individuals are Exempt from Overtime Pay Under the FLSA and the NYLL?

For an employee to be exempt from overtime wages under both the FLSA and the NYLL, the employee must pass three tests: (1) Salary Basis Test, (2) Job Duties Test, and (3) Salary Level Test.

The Salary Basis Test.

Under both the FLSA and NYLL, an exempt employee generally must be salaried and  paid a predetermined, fixed salary. However, the FLSA provides that licensed physicians engaged in the practice of medicine need not meet any of the three tests. “Physician” here includes podiatrists, dentists, veterinarians, and optometrists. This carve-out also applies to physician residents and interns holding a requisite academic degree (e.g., M.D., D.O., D.P.M.) but does not extend to pharmacists, PAs, NPs, RNs, or similar roles. Most PAs, pharmacists, and certain practice staff, such as practice managers, are salaried employees and therefore may be exempt if they meet the following two tests.

The Job Duties Test.

Employees properly classified as professional, administrative, or executive employees under both the NYLL and FLSA pass the Job Duties Test. These are not formal labels preassigned by a government agency; rather, an employer determines the classification by reviewing the employee’s actual job duties. The classification is based on general work duties, not job title alone, and is usually scrutinized only if an employee disputes their overtime status. Executive employees carry out managerial duties such as managing the practice or office, regularly directing two or more employees, and having sufficient authority and discretion to hire, fire, or make other employment-status decisions. Practice managers generally qualify because they oversee office operations, supervise staff, and hold hiring/firing authority.

Administrative employees’ primary duties involve performing office or nonmanual field work directly related to management or general operations, regularly assisting an employer or executive employee, and exercising significant discretionary powers in performing their duties. Compliance officers and human resources personnel generally qualify because they perform office work, assist their employer, and exercise discretion.

Professional employees must meet three criteria to pass the Job Duties Test: (1) their primary duty requires advanced knowledge in a field of science or learning customarily acquired through prolonged specialized intellectual instruction and study, (2) their work requires regular exercise of discretion, and (3) their work is predominantly intellectual and varied in character such that output cannot be standardized in relation to a given time period.

Whether an employee qualifies as a “professional employee” is determined on a case-by-case basis, and no job title alone guarantees the classification. The analysis focuses on whether the job’s primary duty requires specialized academic instruction and uses advanced knowledge typically acquired through prolonged study. “Advanced knowledge” means the employee exercises discretion and judgment characteristic of the profession at issue. Although the required advanced knowledge need not come from a specialized advanced degree, an employer’s minimum academic qualifications and whether most employees in that role hold such a degree are considered. Work is “predominantly intellectual and varied” when it is not routine mental, manual, mechanical, or physical work. 

Pharmacists, PAs, and RNs (not LPNs) are generally considered professional employees because of their advanced knowledge, routine exercise of discretion, and intellectual work.

The Salary Level Test.

The salary thresholds for the Salary Level Test differ under the FLSA and the NYLL. Employees working in New York must meet the NYLL salary level, while employees in other states must meet the FLSA salary level unless their state imposes its own test for overtime exemption. Under the NYLL, the Salary Level Test applies only to executive and administrative employees. New York defers to the FLSA salary level for professional exempt employees. As of this article’s publication date, for employees outside New York City and Nassau, Suffolk, and Westchester counties, the test is met at a minimum salary of $1,199.10 per week ($1,275.00 per week for New York City, Nassau, Suffolk, and Westchester County employees).

Under the FLSA, the Salary Level Test is met when an employee earns more than $684 per week, regardless of employee type. This means that New York salaried professional employees who satisfy the professional duties test and earn above $684 per week generally meet the salarylevel requirement for overtime exemption. 

If My Employee Meets the Criteria, Are They Exempt from Overtime Pay?

If an employee passes all three tests, they are overtime-exempt and are not required by law to be paid overtime for working over 40 hours in a workweek (although an employer can still voluntarily agree to pay overtime). If an employee fails even one test, they must be paid overtime. Failure to pay an eligible employee overtime could require the employer to provide back pay for owed overtime wages. For this reason, it is imperative that practice owners and managers understand these rules to ensure employees are properly compensated and the practice avoids liability for unpaid wages.

Practice owners with questions about the topics outlined in this article can contact Lippes Mathias LLP health care team members Jennifer E. Forward (jforward@lippes.com) or Marc S. Beckman (mbeckman@lippes.com).

Neivel Precision Plumbing: Skilled Craftsmen Building Strong Relationships Through High-Quality Work

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By Elizabeth Landry

When Sam Neivel was just five or six years old, he began learning the basics of plumbing from his father, Lawrence Neivel, a plumber who has worked in the trade for several decades. Neivel learned a lot from his father that has influenced how he progressed in the field – working first for DBR Plumbing in his teens, then Armani Plumbing for a few years, Town Mechanical in his early twenties, and for DBR Plumbing again in his late twenties.

“My father taught me faith, hard work, dedication, generosity and to stand up for what you believe in and what is right,” said Neivel. “He’s a man of few words, but one who teaches with his actions.”

Today, Neivel owns and runs Neivel Precision Plumbing, a company he began in 2015 – and his father is a service tech on the team. A couple of decades earlier, when he was working his second stint at DBR Plumbing and overseeing operations at the company, he decided it was time to venture out on his own. Once Neivel Precision Plumbing was up and running, one of the very first employees Neivel hired was Dan Franklin, an estimator who he had worked with for a few years at DBR. Franklin was brought on as the company’s Lead Estimator, a role he still holds today, and he and Neivel have grown to be close friends, both inside and outside of their careers.

“I think it was always Sam’s goal to start his own company,” said Franklin. “He’s the most brilliant plumber I’ve ever met, and I’m 72 years old. Sam is 30 years younger than me. He’s a very driven person and he honestly cares about each person in the company. We’ve been close friends for several years now. I would have retired a long time ago if it weren’t for Sam and this company. I enjoy working for Sam Neivel every day.”

Fast-Paced Growth and Expansion

In the early days of the company, Neivel and his four or five employees worked out of Neivel’s home in Baldwinsville. Franklin remembers having very tight quarters to operate in, but making it work. After several months, the team relocated to an office off Malloy Road in Syracuse for a few years. After utilizing a different office space on Arterial Road in Syracuse for a few more years, Neivel purchased a much larger building with office space and a warehouse on Butternut Drive in East Syracuse, where the company operates today with almost 80 employees. Franklin attributes the company’s growth and expansion to Neivel’s expertise, leadership, and focus on high-quality craftsmanship.

“Sam is a perfectionist. He’s driven by high-quality work – he takes a lot of pride in doing that kind of work. He takes it very seriously and he has a very high standard,” explained Franklin. “Sam doesn’t spend a lot of time in the office. He comes in when needed, but he prefers to be at job sites, in the trenches, working in crawl spaces, getting his hands dirty. He’s a very hands-on kind of boss. He’s happiest when he’s in the field.”

Neivel obtained his master’s plumbing license in Onondaga County in his late twenties – an accomplishment that speaks to his superior knowledge and skill, Franklin emphasized. “It’s a daunting task. It comes in three phases: an oral exam, a written exam, and a practical exam.”

Under the leadership of Neivel, the company offers mostly commercial and industrial plumbing for clients, working on job sites such as hotels, condominiums, hospitals, restaurants, and office spaces. The team takes on both new builds and renovations and can be found working on between 10 to 13 projects at any given time. Currently, the company is in the process of working on four different older buildings in the city of Syracuse, including job sites on South Salina Street, Townsend Street, and Harrison Street. One major project the team completed in recent years was the City Center building in downtown Syracuse, which was previously the Sibley’s Department Store.

“The City Center building has several floors and we did the entire building, turning it into office space. The Hayner Hoyt Corporation has offices there, and it’s still growing with new offices coming in. That’s one of our gems,” said Franklin.

Building Long-Lasting Client Relationships

Many of the other projects the Neivel team has completed over the years exemplify the company’s focus on building long-term, trusted relationships with clients. Neivel is the preferred plumber for all the Tully’s and Coppertop restaurants in the Central New York area, all the way from Albany to Buffalo, and down into Pennsylvania. The company has completed several projects for local hospitals, including St. Joseph’s Health, Crouse Hospital, and Upstate University Hospital. Neivel is also the preferred plumber for Visions Hotels, owned by Andrew Patel. The hotels are located all over New York State and Pennsylvania.

“We stay versatile. We can handle any type or size of job,” stated Neivel. “Our attitude is ‘there’s nothing we can’t do,’: from factories, commercial, and medical, to hotels and apartments.”

Franklin emphasized that since the beginning of the company, much of their growth and expansion has been due to their excellent reputation, based almost entirely on word of mouth. The extent of Neivel’s advertising has been company-branded trucks.

“Our reputation has really served us. We don’t advertise – we don’t do television or radio. We basically have our trucks that are all lettered up. A lot of our business is through word of mouth,” said Franklin. “I get several calls, texts or emails a week saying, ‘Hey, so-and-so recommends you. Do you think you can take this work on?’”

Focused on Employee Satisfaction and Success

For Neivel, though, the success of the company comes down to its employees. He focuses on creating a job setting where employees feel supported and appreciated.

“We have some of the best craftsmen in the industry. We have low turnover, which gives us consistency. We teach and train from within, which helps us pass the torch to ambitious employees. We do many events to reward our team for the outstanding service they provide. … It’s a family atmosphere. We are family, and we work together and are invested in each other,” said Neivel.

Franklin listed several ways Neivel aims to ensure his employees are well taken care of and feel like family, from sponsoring modified car races, to box seating at baseball games and hockey games, catered meals, the company’s annual clam bake, and multiple charity events. Perhaps the most important way Neivel focuses on the well-being of his employees is through investing in their skills and success, helping them advance in their careers.

“Sam honestly cares for the people in this company. He’s genuinely invested in teaching and promoting from within. We hire a lot of young people who need to be taught the trade, and they’re given lots of opportunities to advance themselves. We have kids that didn’t know anything initially and become foremen in six or seven years. We teach them blueprints, how to run jobs, and various aspects of plumbing and construction. It’s all part of Sam’s philosophy of caring for his employees,” said Franklin.

The company branched out four years ago and created a full service and construction HVAC side within which the same values toward quality craftsmanship and putting the customer first apply. Since starting, the HVAC department has grown both in number of talented and knowledgeable technicians as well as in a reputation for dependable service. Mick Mulcahy was key from the start for getting the department off the ground. Another organically grown key person is Bert Bentley, who has taken over the department and serves as both estimator and project supervisor in the field.

“They go into the field a lot, run jobs, and they have a crew of 26 individuals,” Franklin said. “We were fortunate to pick up good guys, technicians that know the business and the equipment. The HVAC side of our work has really taken off.”

Success that isn’t Slowing Down

What’s next for Neivel Precision Plumbing? Both Neivel and Franklin agree there’s no end in sight, with more relationships to be built and more projects in the pipeline.

“The vision for the future is just to continue with quality workmanship and building relationships within the greater Syracuse community. The community is going to grow, especially with Micron and related investments to infrastructure, and we’re looking forward to what it will bring to us,” said Franklin. “Sam’s not driven by making money. His goal is to be successful at helping others and building others’ careers.”

Neivel said he’s proud that two of his original employees have since moved on to start their own businesses. It’s his team of co-workers that have shaped the company into what it is today, he shared – including his original mentor, his father – and which fuels the business into the future.

“Our growth continues every year, and we don’t foresee an end,” Neivel said. “We learn, we adapt, and keep building relationships that are sustainable.”

“Piggybacking” is Not a Substitute for the Competitive Bidding Requirements under General Municipal Law § 103

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By: Chandler Barganier, Law Clerk, Sheats & Bailey, PLLC

In Lynch, Inc. v. Board of Education of the Maine-Endwell Central School District, the Appellate Division Third Department, affirmed the Broome County Supreme Court’s decision, holding that General Municipal Law § 103(16) excludes public works contracts from the practice of “piggybacking”.[1] This case stems from a multi-year and multi-phase capital project involving various buildings and facilities of Maine-Endwell Central School District. In the summer of 2023, Phase One was completed by Smith whose work pleased the district enough for it to want Smith to complete HVAC work on Phase Two. In October 2023, the District submitted plans for Phase Two to the State Education Department for review and approval as required by Education Law § 408 and 8 NYCRR § 155.2. Such approval was delayed, and the district decided to hire Smith directly by using cooperative purchasing though The Interlocal Purchasing System (“TIPS”), as opposed to undergoing the competitive public bidding process after approval.

In July 2024, the District awarded the Phase Two HVAC contract to Smith by piggybacking it onto their Phase One contract. Several local contractors later petitioned the court, alleging that they were denied the opportunity to competitively bid on the Phase Two HVAC contract pursuant to the competitive bidding requirements under the General Municipal Law. The Broome County Supreme Court granted petition to the extent of finding that the district’s use of TIPS constituted impermissible piggybacking for public works projects. The Supreme Court enjoined the district from using TIPS or any similar process to award further public works contracts and allowed Smith to complete their HVAC work without penalty as their work was already almost halfway complete.

The Third Department upheld the lower court ruling emphasizing that cooperative purchasing is a narrow exception under General Municipal Law§ 103 (16), not a substitute for the required competitive bidding process that governs public works contracts. The court went on to state that it was contemplated by the legislature that the piggybacking provision would facilitate procurement in the context of purchase contracts as opposed to construction and renovation projects.

Though in this case the court declined to impose disgorgement largely because the project was nearly halfway completed, that may not always be the case. Penalties to contractors for violations of competitive bidding requirements may be imposed at the Court’s discretion. While government agencies bear the burden of adhering to competitive bidding requirements, contractors bear the financial risk when these requirements are violated. The potential for disgorgement makes it important for contractors to exercise due diligence during the procurement process to safeguard their financial and legal interests.

Going forward cooperative purchasing cannot be used to avoid competitive bidding for public works. Public entities should exercise caution when considering using cooperative purchasing/piggybacking for construction related projects.

 Contractors who perform work on public works contracts in violation of competitive bidding laws potentially face significant financial risks including the possibility of forfeiting all compensation received under an improperly awarded contract. Therefore, contractors should be aware of how the project was awarded and should not blindly rely on the public entity’s procurement process. Contractors should verify the scope of the work and if the public entity correctly followed competitive bidding laws before entering into a contract and performing work.

If you need further assistance or have additional questions, please contact Sheats & Bailey, PLLC.  www.TheConstructionlaw.com; Tel. 315-676-7314.

The information provided above is not intended to serve as specific legal advice for any particular situation. Competent legal and experienced counsel should be consulted.

[1] Daniel J. Lynch, Inc. v Bd. of Educ. of Maine-Endwell Cent. School Dist., 2026 NY Slip Op 03209 [3d Dept May 21, 2026]

How Prevailing Wage Expansion and Workers’ Compensation Costs Are Reshaping New York State Construction

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Robert C. Reeves, CPA, CFE, Dannible & McKee, LLP

Many New York contractors continue to battle material inflation and labor shortages, but two less visible issues are increasingly affecting profitability: expanding prevailing wage requirements and rising workers’ compensation costs driven by experience modification factors. Together, these factors influence payroll administration, labor burden rates, job costing, bidding strategies and financial reporting, making them critical financial management issues rather than solely operational concerns.[/caption]

Prevailing Wage Expansion Creates New Compliance and Cost Challenges

Prevailing wage requirements now extend beyond traditional public works into certain privately developed projects. Under New York Labor Law §224-a, a private project generally becomes subject to prevailing wage requirements when:

  • Total project cost exceeds $5 million; and
  • Public funds represents at least 30% of project costs.

Public funding includes state subsidies, tax credits, abatements and certain clean energy incentives. As these funding sources become more common, contractors that have historically performed only private work may unexpectedly fall under prevailing wage requirements. Evaluating project funding early in the bidding process is essential.

Contractors should also monitor legislative activity. Although recent proposals to broaden prevailing wage coverage have not been enacted, the trend suggests continued expansion.

Operational and Financial Impacts

Prevailing wage compliance creates challenges in four key areas:

  • Certified payroll reporting and fringe benefit documentation.
  • Accurate worker classification to avoid back wages, penalties and potential debarment.
  • Proper fringe benefit accounting.
  • Detailed labor tracking and job costing.

Poor labor tracking can distort work-in-progress (WIP) schedules, margin reporting and project profitability.

The impact extends well beyond payroll. Prevailing wage errors can affect cost-to-complete estimates, overbilling and underbilling positions, indirect cost allocations, bonding capacity and bank covenant calculations, making compliance an important financial reporting consideration.

Rising Experience Mods Are Affecting Contractor Profitability

New York remains one of the nation’s most expensive workers’ compensation markets. Experience modification factors are rising because of increasing injury frequency, higher medical costs, heat-related illness claims, stricter classification enforcement and greater carrier scrutiny.

Higher experience mods increase insurance premiums while also affecting:

  • Labor burden rates.
  • Bid competitiveness.
  • Bonding capacity.
  • Financial reporting if labor cost accruals are not updated.

Failing to incorporate current workers’ compensation costs into labor burden calculations can understate project costs and reduce the accuracy of WIP schedules and profitability reporting.

Safety as a Financial Strategy

Leading contractors increasingly view safety as an investment rather than simply a compliance requirement. Strong safety programs help reduce claim frequency and stabilize experience mods through initiatives, including robust near-miss reporting, heat illness prevention, return-to-work programs and the use of job site technology, such as wearable sensors and AI-based monitoring tools that help identify unsafe conditions and worker fatigue.

These efforts often produce measurable returns through lower insurance costs, improved margins and stronger bonding capacity.

Where Prevailing Wage and Workers’ Compensation Intersect

Although prevailing wage compliance and workers’ compensation are often managed separately, they are closely connected.

Labor classification errors can create prevailing wage violations while also resulting in incorrect workers’ compensation classifications, higher premiums and costly audit adjustments.

Similarly, certified payroll errors and improper fringe benefit allocations can distort labor burden calculations, affecting job costing, bid estimates, WIP schedules and profitability analysis.

Safety performance also plays an important role on prevailing wage projects, which often involve larger crews and more complex work environments. Higher injury rates increase workers’ compensation costs, reducing competitiveness when bidding future work.

Practical Steps Contractors Can Take in 2026

There is still time left this year to make improvements, and several key strategies can help strengthen performance and reduce risk.

  • Strengthen certified payroll processes by reconciling payroll to job costs, documenting fringe benefit plans and reviewing subcontractor payroll compliance.
  • Update labor burden rates regularly using current workers’ compensation rates and experience modification factors.
  • Invest in proactive safety programs, including training, injury prevention and return-to-work initiatives.
  • Prepare for increased audit activity by maintaining complete payroll records, job costing documentation and supporting schedules.

The Bottom Line

Expanding prevailing wage requirements and rising workers’ compensation costs are reshaping the financial landscape for New York contractors. Organizations that proactively manage payroll compliance, labor burden rates, safety performance and financial reporting will be better positioned to protect margins, strengthen bonding capacity and remain competitive in an increasingly challenging market.

Rather than treating prevailing wage compliance and workers’ compensation as separate administrative functions, contractors should view them as interconnected components of a broader financial management strategy.

For contractors looking to strengthen their systems or validate their labor cost structure, Dannible & McKee can help. Contact our construction team to discuss how these changes may impact your projects and financial reporting.

 

Robert C. Reeves, CPA, CFE, is an audit partner at Dannible & McKee, LLP, a public accounting firm with offices in Syracuse, Auburn, Binghamton and Schenectady, NY, and Tampa, FL. He has over 10 years of experience at the firm, he provides financial audit, assurance and consulting services to clients primarily in the construction, manufacturing and architectural and engineering industries. Bob also specializes in employee benefit plan audits and forensic accounting services. For more information on this topic, you may contact Bob at  rreeves@dmcpas.com or (315) 472-9127.

Code Rule 59: Time to Restore Balance Between Safety and Fairness

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By: Wael Khalil, CPS, SSM, Vice-President/Safety Director Lovell Safety Management Co., LLC

For nearly three decades, New York State Industrial Code Rule 59 has served an important role in improving workplace safety and reducing workers’ compensation losses. Created in the mid-1990s as part of broader workers’ compensation reforms, the rule requires employers with poor loss experience to implement formal safety and loss prevention programs under the guidance of a certified safety consultant.

The concept behind the rule remains sound. Employers experiencing significant workers’ compensation losses should receive professional assistance to identify hazards, improve management practices, and reduce future injuries. In many cases, Code Rule 59 has helped employers strengthen their safety programs and improve their claims performance.

The challenge today is not the purpose of Rule 59. The challenge is that the rule’s triggering criteria have not kept pace with economic realities.

Under the current framework, employers become subject to Code Rule 59 when their payroll exceeds $800,000 and their workers’ compensation Experience Modification Rate (EMR) exceeds 1.20. When these thresholds were established in 1996, an $800,000 payroll represented a substantially larger employer than it does today. After decades of inflation, wage growth, and rising labor costs, many small businesses now exceed that payroll threshold despite operating with only a handful of employees.

As a result, employers that would have been considered small businesses when Code Rule 59 was enacted are increasingly being drawn into a regulatory process originally designed for larger employers with greater administrative resources.

At the same time, the EMR itself is a backward-looking measurement. Experience modifications are based largely on historical claims data and often do not reflect an employer’s current safety performance. An employer may have corrected deficiencies, replaced management, implemented new safety procedures, or significantly reduced claims, yet still trigger Code Rule 59 based on losses that occurred years earlier.

Recent changes in experience rating methodology have further amplified this issue. Smaller employers have fewer payroll dollars and claim exposures over which losses can be spread. Consequently, a single lost-time claim or moderate injury can have a significant impact on an employer’s modification factor. Larger employers generally experience less volatility because individual claims are diluted across a much larger payroll base.

In practice, this means that many small employers can find themselves subject to Code Rule 59 despite maintaining reasonable safety programs and having no ongoing pattern of poor performance.

Many of these cases stem from isolated incidents rather than systemic safety failures. A single claim involving an employee injured in a motor vehicle accident, a travel-related incident, or a public premises accident may significantly impact an employer’s experience modification rating. While such claims are compensable under workers’ compensation law, they do not necessarily indicate deficiencies in employee training, hazard control, supervision, or management commitment to safety.

Nevertheless, once Code Rule 59 is triggered, employers face substantial obligations. They must retain certified NYS consultants, participate in facilities/jobsite surveys and meetings, implement corrective action plans, complete documentation requirements, and certify compliance. Failure to comply can result in premium surcharges and the loss of policy discounts, creating additional financial strain for smaller employers.

None of this suggests that Code Rule 59 should be eliminated. Employers with persistently poor safety performance should continue to be identified and required to take corrective action. However, there is a strong case for modernizing the rule so that regulatory resources are focused on employers with current and demonstrable safety deficiencies rather than employers whose loss experience may be attributable to historical events or isolated claims.

Several practical reforms could accomplish this goal. The payroll threshold could be indexed to inflation or adjusted to reflect current wage levels. A tiered threshold could recognize the differences between small, medium, and large employers. Greater consideration could be given to recent safety performance, documented corrective actions, participation in safety groups, and ongoing loss-control efforts. The Department of Labor could also be provided with greater flexibility to distinguish between employers experiencing systemic safety problems and those impacted by isolated or non-preventable events.

Such changes would preserve the original intent of NYS Code Rule 59 while improving its fairness and effectiveness. Workplace safety would remain the primary objective, but the burden of compliance would be more appropriately aligned with an employer’s current risk profile and operational realities.

After nearly 30 years, Rule 59 remains a valuable tool. Updating it for today’s economy would ensure that it continues to improve workplace safety while avoiding unnecessary burdens on the small businesses that form the backbone of New York State’s economy.

For more information on Code Rule 59 please reach out to a Lovell representative at 1-800-556-8355.

The Hidden Costs Impacting Construction Risk in 2026

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By: Brett Findlay, Senior Vice President, Construction Practice Leader, OneGroup

Construction firms across Central New York are seeing some stabilization in the insurance marketplace after several years of sharp increases. In certain areas, rates are beginning to soften and capacity is improving. However, many contractors are still experiencing higher overall insurance costs, even when rate and premium increases appear more moderate on paper.

The reason is simple: while portions of the insurance market may be easing, the underlying cost of construction risk continues to rise.

From labor shortages and wage inflation to escalating material costs and larger claim settlements, contractors are operating in an environment where even a relatively routine loss can become significantly more expensive than it was just a few years ago.

Locally, the time a project takes to complete has increased, the cost of the materials for that project have increased and the pay scale for the employees executing that project have increased. All those variables can and do drive insurance costs.

What further amplifies those variables is the onset of large local projects like I-81 & Micron that are utilizing much of the local labor force. With companies struggling to find labor to complete their backlog, traditional infrastructure projects and other private projects face longer project timelines. Outside labor is going to become a necessity; subcontracting, is going to become a necessity. Those exposures have insurance costs as well.

One of the largest drivers is construction inflation itself. Material pricing remains elevated across many categories, particularly for electrical components, specialty materials, roofing systems, and mechanical equipment. Even when pricing volatility slows, replacement costs remain far above pre-pandemic levels. That has important insurance implications.

If property values, equipment schedules, or builder risk limits have not been updated to reflect current costs, contractors may unknowingly be underinsured. In a major loss scenario, that gap can become financially significant.

There is also growing concern around project delays tied to supply chain challenges. Longer lead times can extend project timelines, increase exposure periods, and ultimately increase the overall cost of claims.

Labor inflation is creating another layer of pressure. The construction industry continues to face workforce shortages, particularly among skilled trades. As firms compete for experienced workers, wage growth has accelerated. While higher pay can help attract talent, it also impacts claim severity, especially in workers’ compensation.

Medical costs are rising. Lost-time claims are becoming more expensive. Inexperienced workers may require additional training and supervision, which can also influence safety outcomes and insurance performance over time.

At the same time, contractors are managing increased auto liability exposure, rising litigation costs, and larger jury awards across the country. Even relatively small incidents now carry the potential for substantial financial impact.

Active claim management throughout these types of situations is critical. Timelines have slowed everywhere, including the judicial system. Legal costs have increased, which in turn inflates claim costs. Claim costs can also have a direct impact on insurance pricing. Workers’ Compensation EMR’s and Auto Experience Rating can be volatile, actively managing those claims can directly impact these variables, in turn, affecting the insurance pricing. This leads directly into proactive risk management.

For contractors, this environment reinforces the importance of proactive risk management rather than viewing insurance strictly as an annual transaction. Carriers are placing greater emphasis on safety culture, fleet management, subcontractor oversight, cybersecurity practices, and operational controls when evaluating accounts. Firms that can demonstrate strong internal processes are often in a better position to manage long-term insurance costs and secure favorable terms.

This is especially important as projects grow more complex and technology becomes more integrated into day-to-day operations. Drones, connected jobsites, digital project management systems, and electronic payments create efficiencies, but they also introduce new forms of risk that many firms are still evaluating.

While there are encouraging signs in portions of the insurance marketplace, contractors should not mistake a softening market for a reduction in exposure. The hidden costs impacting construction risk today extend far beyond premium percentages alone.

The firms best positioned for long-term success will be those that regularly reassess valuations, strengthen operational controls, invest in workforce development, and work closely with trusted advisors to identify emerging risks before they become costly problems.

In summation, insurance is becoming more complex by the day. But a good partner can walk you through the complexities of the industry and develop a plan that works for you as the contractor. Being active in your risk management program is now critical, and now is the time to do it, if not yesterday. Now is the time to reassess your risk strategy—before these hidden costs show up in your next claim or renewal.

Brett Findlay is a Senior Vice President and Construction Practice Leader at OneGroup, a subsidiary of Community Financial System Inc. OneGroup.com

2026 Mid-Year Report to the Upstate New York Construction Industry and Members of the Syracuse Builders Exchange

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Earl R. Hall, Executive Director, Syracuse Builders Exchange

Reflecting on mid-year data, including membership utilization, I am pleased to report that the Syracuse Builders Exchange continues to demonstrate exceptional strength, stability, and growth. The Association remains well-positioned to serve the regional construction industry today while preparing for future opportunities.

The Syracuse Builders Exchange is proud to be the largest construction industry association in New York State with approximately 1,100 member firms. For more than 150 years, our mission has remained unchanged—to provide the resources, services, advocacy, and professional relationships that help our members succeed in an increasingly competitive marketplace.

Membership continues to grow as more construction firms recognize the value of belonging to an organization that delivers measurable benefits. New members are joining because they see an association that provides a wide variety of services, is financially sound, professionally managed, and committed to helping their businesses succeed. Our continued membership growth reflects the confidence the construction industry has placed in the Syracuse Builders Exchange and the value our programs provide every day.

The Builders Exchange is financially sound, generating strong operating revenues, maintaining adequate financial reserves, and operating with no debt – all while maintaining the fiscal goals and objectives of a 501c6 not-for-profit trade Association. This conservative financial stewardship ensures that the Syracuse Builders Exchange remains independent, sustainable, and capable of investing in new programs and member services without compromising our financial security.

The Syracuse Builders Exchange Electronic Plan Room is one of the Association’s most valuable member resources, providing contractors, subcontractors, suppliers, and construction professionals with immediate access to current bidding opportunities throughout the region. Members can easily view project plans, specifications, addenda, and other bidding documents from any location, allowing them to identify and pursue new business opportunities efficiently.

In addition to convenient access to bid information, the Electronic Plan Room offers powerful estimating and digital takeoff tools that help members improve the accuracy and speed of project estimates. These features enable users to measure quantities directly from electronic drawings, streamline estimating workflows, reduce costs, and enhance competitiveness. By combining comprehensive project information with advanced digital tools, the Electronic Plan Room helps members save time, increase productivity, and position their businesses for continued success in today’s competitive construction marketplace.

One of the Builders Exchange’s highest priorities continues to focus on education and safety training. Over the past year, we have expanded our schedule of education, professional development, and safety training classes, providing members with practical knowledge that enhances productivity, strengthens knowledge of regulatory compliance, and improves workplace safety. These programs have become one of the defining benefits of membership and reflect our commitment to helping member firms remain competitive and safe.

Equally important are the opportunities the Builders Exchange provides for members to build lasting and meaningful professional relationships. Throughout the year, the Association has hosted a wide variety of social gatherings, networking events, awards programs, and industry meetings that strengthen connections among contractors, subcontractors, suppliers, design professionals, and project owners. These events foster collaboration, encourage new business opportunities, and reinforce the sense of community that has always distinguished the Syracuse Builders Exchange.

Looking ahead, the Builders Exchange remains focused on innovation and continuous improvement. We will continue investing in education, safety training, technology, networking opportunities, and member services while maintaining the financial discipline that has made the Association one of the strongest and most respected trade organizations in the State.

None of these accomplishments would be possible without the support and engagement of our members, volunteer leadership from the Board of Directors, committee members, and dedicated staff. The Builders Exchange’s membership participation, ideas, and commitment have helped build an organization that serves as the voice of the construction industry throughout Upstate New York.

The future of the Syracuse Builders Exchange is bright. With consistent revenues, no debt, growing membership, expanding educational and safety programs, vibrant networking opportunities, and adequate financial reserves, our association is well prepared to meet the challenges and opportunities long into the future.