A Partnership Transformed

How Northern New Jersey Center for Advanced Endoscopy Became a Three-Way Joint Venture

Joint ventures are challenging, and many attempts at them fail, but when all participants share a similar vision, amazing things can happen.

Northern New Jersey Center for Advanced Endoscopy (NNJC) is a three-way joint venture between Gastroenterology Group of Northern New Jersey (GGNNJ), Englewood Hospital and Medical Center (EHMC), and Physicians Endoscopy (PE).

While NNJC is considered to be a three-way joint venture, in actuality it is a four-way partnership.

When discussions about building a new ASC began, GGNNJ did not formerly exist. Rather, there were two separate, smaller GI practices running independently that were merged to form a larger group, but there was still one thing lacking.

Northern NJ Center for
Advanced Endoscopy

270 Sylvan Avenue, Suite 100
Englewood Cliffs, NJ 07632

(201) 408-5505

While our practice was running well, we wanted to become a state-licensed facility. With the growth of our practices, we needed to look beyond our existing operations.


A Shared Vision

United as a practice, the physicians united behind the idea of opening a multi-room licensed ASC–an opportunity that presented itself when the practices were approached by Physicians Endoscopy about the prospect of a joint venture with EHMC.

“We viewed this as a way for our groups to move further into the new environment of medicine. Our experience in working with EHMC made it a perfect partner for a new ASC. The missing piece was how it was going to be managed, and managed successfully,” said Kenneth Rubin, MD.

That missing piece was Physicians Endoscopy, Zingler says. “We really were looking for a company to help us not only open a licensed facility, but handle administrative responsibilities, provide us with expertise, and ultimately streamline the process.”

There were three moving parts: 11 gastroenterologists, EHMC, and also PE. While we all had the same goal, at various times, we felt these three pieces were going in different directions. PE helped everyone keep their eye on the ball to get this deal to closure.


Fitting the Pieces Together

The ability to work together was tested regularly as the project progressed.

“Throughout the entire experience, what made the practices successful was their openness to change. We took two different groups of individuals and pulled them together to become one body, with one governing board of the new ASC. PE helped them navigate through the process, and now they share a great facility with one another,” said Bob Estes, MPST, CASC, VP, Center Development & Implementation, Physicians Endoscopy.

On paper, the plan was just what EHMC wanted. The opportunity to partner with our physicians and with PE, a leading, very successful management firm that focuses on GI–that marriage of three parties met our needs and wishes.


Making a Deal

“Joint ventures between hospitals and physicians can be very rewarding but take a significant amount of trust building. It can be difficult to earn physicians’ trust, especially in an arrangement like this where PE had initially partnered with the hospital. It took a long time to maneuver through that relationship so the physicians felt like they couple appreciate PE as an impartial mediator. We needed to prove to that we wanted to help them achieve this win as much as we did for the hospital,” said Carol Stopa, SVP, Business Development, PE.

PE’s transparency was vital to securing an agreement that satisfied all of the parties, Pietrowicz says. “They are forthright, fair and honest partners. Those are very important qualities.”

Recognizing the direction where healthcare was headed, it economically made more sense to consolidate their business in a new ASC.


The PE Experience

Once PE was able to get EHMC and GGNNJ to agree on the parameters for the joint venture, it was time to move forward with turning the vision into reality. First step: finding a suitable location. After an extensive search, the site found was superb.

Before construction could begin, the necessary approvals were secured from the state. Then came the matter of designing the space. “We had to design the space so it was adequate enough to accommodate the physicians and their expected volume, and we wanted to have some room for future growth,” says MaryAnn Gellenbeck, VP, Implementation Services, PE.

“We wanted to transition from occupancy to state licensure as quick as possible as the state needs to come out and survey the facility in order for you to be able to see patients,” Gellenbeck says. “You enter a building that has no supplies and equipment, and have essentially a brand new staff of individuals you are hiring and training.

“In three weeks, we were totally trained and all of the competencies were completed.”

Inspection took place the first week in March. Ten days later, the first patient came to NNJC. Three weeks later, the ASC went through and successfully passed an unannounced Joint Commission Medicare-deemed state survey. Once NNJC was licensed by the Centers for Medicare & Medicaid Services, the physicians shifted all of their Medicare volume over to the ASC from their practices. The physicians continued performing non-Medicare procedures in their practices’ individual endoscopy suites.

This was the truly unique piece of this whole project. We are used to dropping all case volume into a new center regardless of payer contracting status. In addition, if you’re only operating a few days a week, the revenue coming in is minimal but there are certain expenses that are pretty fixed.


This place an impetus on obtained managed care contracts. The hospital’s relationships with insurance companies helped move negotiations along quickly. Once manage care contracts were secured, the physicians stopped performing procedures at their practices and shifted all of their column to NNJC.

Ziegler advises other physicians who are weighing whether to pursue a joint venture to strongly consider doing so.

If you are performing procedures in your office and think you are doing a good job, there may be a better way. Once you work with a group like PE, it makes you realize you should have made the change years earlier.


For more information on partner opportunities, learn about new center or joint venture partnerships with Physicians Endoscopy.