No More Status Quo

The worst phrase in any healthcare operation is:
"but this is how we've always done it."

FirstClass Healthcare does it differently: Let us show you how.

FirstClass Healthcare is Setting the New Standard For Correctional + Institutional Healthcare

FirstClass Healthcare is a physician owned and operated healthcare entity based in Atlanta, Georgia.

At our core is what we consider to be our DNA: excellent patient care, health equity, and humanism in medicine. Our unique edge is our widely varied experience: We have a sharp focus on operations, process improvement, and clinical quality.

Our belief is that all people—regardless of their legal status—deserve high-quality and humane medical care. We additionally recognize the unique medical and public-health touchpoint existing within correctional facilities and institutions, and view that as an opportunity to intervene in an individual's life and attempt to provide much-needed care for this often underserved population.

The managing partners of FirstClass Healthcare are a team of highly experienced professionals, 6 of whom are licensed medical professionals (3 board certified emergency medicine physicians and 3 board certified physician assistants), with collectively over 60 years of experience in clinical operations in large urban healthcare systems—including the Emory Healthcare System, Grady Memorial Hospital, the VA Medical Center, and the Orlando Health System, among others.

Our skills and knowledge involve adherence to lean management principles, eliminating waste, and streamlining workflows and operations. Specific examples of programs spearheaded by FirstClass Healthcare leadership include designing initiatives with objective and demonstrable improvement in patient outcomes: design of fast-track intake and patient processing; custom educational curricula that increased professional staff retention by 60%; as well as data-driven approaches to staffing and coverage.

From Left: Michelle Wan, MD, FACEP—Chief Medical Officer + Board Certified Emergency Medicine Physician; Benjamin Lefkove, MD, FACEP—CEO + Board Certified Emergency Medicine Physician; Ronald Sanders, Jr., PA-C—President + Board Certified Physician Assistant; Natalie Schmitz, MMSc., PA-C—Chief Strategy Officer + Board Certified Physician Assistant; Lamar Cochran, MD—Chief Clinical Officer + Board Certified Emergency Medicine Physician; Bernard Coxton, Jr., PA-C—Chief Operating Officer + Board Certified Physician Assistant.
From Left: Michelle Wan, MD, FACEP: Chief Medical Officer + Board Certified Emergency Medicine Physician; Benjamin Lefkove, MD, FACEP: CEO + Board Certified Emergency Medicine Physician; Ronald Sanders, Jr., PA-C: President + Board Certified Physician Assistant; Natalie Schmitz, MMSc., PA-C: Chief Strategy Officer + Board Certified Physician Assistant; Lamar Cochran, MD: Chief Clinical Officer + Board Certified Emergency Medicine Physician; Bernard Coxton, Jr., PA-C: Chief Operating Officer + Board Certified Physician Assistant.

FirstClass Healthcare is Led by Healthcare Professionals

  • Chief Executive Officer: Benjamin Lefkove, MD, FACEP—Board Certified Emergency Medicine Physician with over ten years of healthcare systems operational and executive leadership and clinical experience. He received his Doctor of Medicine (MD) from the Medical College of Georgia in Augusta, GA, and completed his residency training in Emergency Medicine at Grady Memorial Hospital/Emory University School of Medicine. Dr. Lefkove was previously a Chief Medical Information Officer for the DeKalb Regional Health System, as well as Vice-Chief of Emergency Medicine at Emory Decatur Hospital. Dr. Lefkove's professional interests include process improvement in healthcare, providing medical care for the underserved, medical education, and improving health outcomes through evidence-based practice.
  • President: Ronald Sanders, Jr., PA-C—Board Certified Physician Assistant with over ten years of healthcare systems operational leadership, medical staff training and education and clinical experience. Following his undergraduate studies at Augusta State University, Ron received a Master of Science of Physician Assistants from the Medical College of Georgia in Augusta, Georgia, and was Valedictorian for the class of 2010. He is passionate about medical education, process improvement, and mentorship
  • Chief Operating Officer: Bernard Coxton, Jr., PA-C—Board Certified Physician Assistant with over ten years of leadership and clinical experience. He received a Bachelor of Science in Biology from Morehouse College in 2010 and a Master of Science of Physician Assistants from the Medical College of Georgia in Augusta, GA in 2014. Before entering the field of medicine, Bernard was a high school biology and chemistry teacher in DeKalb County. He is extremely passionate about education and public health awareness.
  • Chief Medical Officer: Michelle Wan, MD, FACEP—Board Certified Emergency Medicine Physician with over ten years of healthcare systems educational leadership, medical staff training and clinical experience. Dr. Wan received a Bachelor of Arts (BA) from Florida State University and Doctor of Medicine (MD) from Case Western Reserve University. She completed residency in Emergency Medicine as well as an Emergency Ultrasound fellowship at Orlando Regional Medical Center in Orlando, FL. Dr. Wan is extremely passionate about reducing health disparities and improving access to quality care.
  • Chief Clinical Officer: Lamar Cochran, MD—Board Certified Emergency Medicine Physician with over ten years of healthcare systems operational leadership and clinical experience. He received his Bachelor of Science from Oakwood University in 2005, Doctor of Medicine (MD) from Howard University in 2010, and completed his residency training at Grady Memorial Hospital/Emory University School of Medicine. Dr. Cochran is passionate about preventative medicine and educating people of his community on how to obtain and maintain healthy lifestyles so that they can live long, enjoyable, and balanced lives.
  • Chief Strategy Officer: Natalie Schmitz, MMSc., PA-C—Board Certified Physician Assistant with over ten years of leadership, medical staff training and clinical experience. She received a Bachelor of Science and Master of Science in Physician Assistant from Emory University. Natalie has been practicing in the Atlanta community for 17 years, and is a past-president of SEMPA.
  • Chief Information Officer: Yair Strano—Tech Development leader with over ten years of operations and executive leadership experience. Yair's charge is to expand FirstClass Healthcare's' tech development and improve the overall organizational operational efficiency. He has held executive leadership roles in various industries and has extensive experience with launching and running startups, with a focus on integrating operations and technology. Yair is passionate about data science and optimizing processes.
  • Director of Pharmacy Services: Joshua Shoemaker, PharmD, BCPS—Administrative and Clinical leader of pharmaceutical services, operations, safety and management with over ten years of experience.

What Makes FirstClass Healthcare Different

Unlike other companies who may have a longer history in the correctional space, we do not have the mindset of following the status quo. The worst phrase in any healthcare operation is, "but this is how we've always done it."

Ron Sanders
Redefining the culture in the correctional + institutional medicine space.

FirstClass Healthcare, from its inception, has been successful because we have been able to change key aspects of the traditional operations of healthcare. We have been able to accomplish the same within the corrections healthcare system as well.

In 2022, FirstClass Healthcare was awarded the Medical and Behavioral Health Services contract for provision of care for patients at a 2,200+ population facility in Atlanta, Georgia. In addition to our experience as a Medical and Mental Health Vendor, in 2021 our company was selected by the Georgia Department of Public Health as the preferred COVID-19 vaccine and testing provider for prisons, jails and juvenile detention centers, and other confinement-setting facilities throughout the state, where we have provided over 56,000 COVID-19 vaccines and 20,000 COVID-19 tests for Georgia inmates.

Our decades of hospital leadership experience at large urban hospital systems has afforded us invaluable clinical and operational expertise that we have leveraged within the correctional medicine space to redefine the culture.

A specific example of this transformation is the drastic change in recruiting and staffing that occurred after FirstClass Healthcare became the Medical and Behavioral Health Service Provider for a large facility in Atlanta. At the contract commencement date, medical staff at the facility was understaffed by 60%. Within 90 days, we were able to recruit medical and mental health staff to increase staffing to 115%, and we have consistently been successful in recruiting and retaining qualified healthcare staff.

Clinical Protocols, Policies + Procedures: The Data-Driven Approach

Once objectives have been established and evidence-based practices are implemented, it is important to have a process for monitoring progress towards the established quality objectives and best practices.
Once objectives have been established and evidence-based practices are implemented, it is important to have a process for monitoring progress towards the established quality objectives and best practices.

FirstClass Healthcare maintains a robust compilation of site-specific policies and procedures for our current patient populations, and we are able to readily design and implement policies and procedures in compliance with small-to-large facilities. The customized approach works best.

Adherence to clinical protocols, policies and procedures is measured and monitored by our real-time Key Performance Indicator (KPI) metrics, which are reviewed by medical leadership and reported out to facility administration weekly.

This data-driven approach assures objective, measurable statistics and outcomes are the key drivers of the FirstClass Healthcare internal quality control and improvement review process. Additionally, providing the facility administration transparency and visibility into the medical staff's performance in KPI areas has been invaluable in developing trust and collaboration between FirstClass Healthcare and the facilities we serve.

Minimizing Unnecessary Hospital Transfers

Intake Team

Efforts to minimize unnecessary hospital transfers begin at the time of patient intake and receiving screening and continue through each point of contact between the patient and medical staff. Early identification of high risk medical and psychiatric conditions is paramount to preventing clinical decompensation through early triage, risk stratification, treatment, and observation.

Similarly, providing education and training for medical staff on the identification and management of clinical conditions supports timely medical care and reduces the need for higher level care and/or hospital transfer. FirstClass Healthcare's early intervention and educational approach has resulted in a reduction in the number of hospital transfers at facilities we serve. In situations where hospital transfer is deemed medically necessary, we have robust relationships with our Preferred Provider Network that provides additional services for our patients

Point-of-care Laboratory Services

On-site point-of-care laboratory testing is utilized for certain tests when clinically appropriate. Examples include glucose monitoring, urine pregnancy, and urine analysis. For laboratory services which cannot be provided on-site, STAT laboratory requisitions requiring send-out are sent the same day and laboratory result reports are furnished within 24 hours or less after specimen receipt.

In-House Radiological Services

FirstClass Healthcare has a custom-built radiologic program specifically designed to provide X-ray services within confinement facilities. We provide the necessary staff training, competency testing, radiation safety, and monitoring for the facility's radiology program.

Medical Services Program: Cost Savings

FirstClass Healthcare is able to reduce the numbers of unnecessary transfers for hospital or other off-site care through our extensive experience in providing emergency care, which has made us experts in determining what may be safely managed on-site versus what necessitates a hospital transfer. We have been able to bring this fresh perspective to correctional medical care, by building an "ER in a Jail" healthcare delivery model.

The development of a high-quality medical service infrastructure goes hand-in-hand with cost containment and savings. These considerations are applicable to both on-site and off-site patient care. FirstClass Healthcare's comprehensive medical training and onboarding programs facilitate the development of strong on-site medical support, which in turn reduces the numbers of unnecessary transfers, delayed diagnoses and poor patient outcomes.

FirstClass Healthcare's on-site medical services program includes clinical protocol and policy-driven patient evaluation and care processes for each respective clinical area (i.e. intake, receiving screening, health appraisal examinations, and sick call.)

These care pathways are designed to comply with accreditation standards and requirements as well as provide evidence-based care. Our protocols are crafted to mirror the assessment and evaluations protocols which we have fine tuned through years of experience providing emergency and acute patient care.

Staffing: The Strategic Approach

When creating our staffing matrix, our goal is always to staff beyond 100% of required full time employees (FTEs)
When creating our staffing matrix, our goal is always to staff beyond 100% of required full time employees (FTEs)

FirstClass Healthcare works to create systematic processes that are consistent, data driven, and redundant. This strategy is deployed in our approach to staffing. At a minimum, staffing hours will be set to adequately fulfill the responsibilities for each position. We will work closely with the facility to develop a customized staffing plan tailored to the facility's specific needs and requirements, while maintaining ideal patient to clinical staff ratios to provide high quality care. This plan will outline the optimal number of healthcare professionals, including physicians, nurses, and support staff, necessary to meet the healthcare demands of the facility.

When creating our staffing matrix, our goal is always to staff beyond 100% of required full time employees (FTEs), which allows us to set up a call schedule to cover staff call-outs for emergent reasons. Recognizing that low advanced-notice staff call-outs are one of the main stressors on any healthcare staffing enterprise, a reasonable staffing matrix will take this into consideration. In efforts to reduce the likelihood of unplanned absences and foster our culture of a healthy workplace and employee wellness, our work schedules are developed in our scheduling software and released at least a month in advance. This gives our staff ample time to make shift trades or plan for other personal needs without disrupting the schedule. Having said that, we recognize that call-outs and absenteeism is a reality of any employment structure, and a well-functioning entity will build schedules, processes, and models to accommodate that reality.

Within our scheduling process we include on-call/backup staff for each shift. In addition, FirstClass Healthcare's leadership consists of six licensed medical professionals who will be able to fill-in provider coverage duties if needed. We also have an extensive staffing pool(s) from which we are able to quickly recruit, hire and onboard as needed. To date, we have remained fully staffed or overstaffed for any contracted projects and/or procured services agreements and have never had to rely on staffing agencies to fill vacancies.

Staffing: Accountability

FirstClass Healthcare understands the importance of strong corporate support in facilitating efficient staffing operations. Our corporate team will work closely with the facility's medical leadership and administrators to provide ongoing support and oversight, including regular communication, performance monitoring, and prompt issue resolution. FirstClass Healthcare's corporate team maintains an open line of communication to address any staffing-related concerns promptly and ensure seamless collaboration between our corporate team and facility staff.

With the launch of any new facility, our corporate-level Executive Leaders are often working in the field, shoulder to shoulder with our workforce. One of the FirstClass Healthcare Core Values is "No Job Too Small." As such, our highest level leadership is very hands-on and our organizational hierarchy is relatively flat.

Internal Quality Improvement Plan

The FirstClass Healthcare Internal Quality Improvement Plan (IQIP) aims to establish a systematic framework to enhance patient safety and the quality of healthcare services we provide.
The FirstClass Healthcare Internal Quality Improvement Plan (IQIP) aims to establish a systematic framework to enhance patient safety and the quality of healthcare services we provide.

The FirstClass Healthcare Internal Quality Improvement Plan (IQIP) aims to establish a systematic framework to enhance patient safety and the quality of healthcare services we provide. This plan encompasses various elements, including assessment, audits and monitoring, feedback mechanisms, and continuous improvement initiatives. By implementing and following the initiatives of the FirstClass Healthcare IQIP, we have been able to optimize patient outcomes, ensure compliance with industry and accreditation standards, and continuously improve our service delivery.

When FirstClass Healthcare acquires a new contract, the first step in our IQIP is to conduct a comprehensive assessment of current practices within the facility. This assessment period occurs within the first 90 days and involves evaluating our policies, procedures, and clinical care protocols to identify whether or not modifications will need to be made for provision of care for that facility's particular patient population, geographical layout, facility schedule, or other considerations unique to that facility.

This data-gathering step also serves as a period of observation and identification of areas with opportunity for improvement. We gather data on key performance indicators, patient outcomes, healthcare staff experience, and compliance with accreditation and regulatory guidelines to gain a comprehensive understanding of our strengths and areas needing enhancement.

Establishing Objectives

After reviewing findings gleaned from the assessment period, we then establish clear quality objectives that align with FirstClass Healthcare's mission, vision and values as well as the established standards and requirements within the facility. These objectives, which are distinctly separate from and in addition to the minimum standards required by accrediting bodies, serve as specific, measurable goals to guide our continued improvement efforts. Examples of quality objectives may include reducing medication errors, improving response times to medical emergencies, enhancing communication between healthcare and facility staff, and improving targeted patient outcomes (i.e. improvements in diabetic patient blood glucose management, improved patient medication compliance, etc).

Implementing Evidence-Based Practices

Our IQIP is driven by evidence-based medicine. Our clinical leadership teams stay updated with the latest research, guidelines, and best practices in medicine. We proactively integrate evidence-based care pathways and protocols into our workflows to ensure the delivery of high-quality care. Regular training and education sessions are conducted to disseminate this knowledge among our healthcare staff. Additionally, following the rollout of a new clinical practice or initiative, facility leadership conducts leader rounds throughout the facility to ensure each team member has the opportunity to ask questions and receive one-on-one training in new processes at the time of implementation. This hands-on approach to process change and improvement has proven effective in compliance with established policies and procedures.

Establishing Quality Metrics

Once objectives have been established and evidence-based practices are implemented, it is important to have a process for monitoring progress towards the established quality objectives and best practices. We monitor and measure adherence through the development and tracking of relevant quality metrics. These metrics include both process measures (e.g., adherence to protocols, average time to completion of receiving screening exams, average time to completion of initial health appraisals, etc) and outcome measures (e.g., percentage of receiving screening and initial health appraisals completed within timeframe for compliance, etc). By collecting and analyzing these data, we gain insights into our performance and identify areas requiring improvement. We are able to pull and evaluate performance data to the level of granularity specifying date and time/shift where drops in compliance occur, which is an invaluable tool in providing meaningful employee coaching and feedback.

Information Systems: Data Collection + Trend Analysis

FirstClass Healthcare is unique in its nimbleness and sophistication with regards to tech development. Our in-house informatics team has developed custom technology applications that deliver real-time visibility into core operational metrics to provide meaningful insights that are synthesized through robust analytics. Additionally, through our storied experience working within several healthcare systems, FirstClass Healthcare's Executive Leadership Team is proficient in the use of multiple EMR and eMAR systems. Our team of advanced software developers has been able to achieve markedly improved data abstraction through our custom-built application.

This app, developed in-house, allows us to have visibility into key performance areas of high importance to jail administration such as average time to receiving screening, number of patients awaiting 14-day health assessments and time remaining to annual physical due date for each patient. Additionally, we routinely build-out custom modifications that layer on top of third party software, in order to meet the unique needs and workflows of our clinical team and our clients. As such, our facilities receive custom data reporting, with increased visibility into jail medical operations, overall population health, and areas of risk. Additional examples of such reporting might include week over week changes in infirmary visits, kiosk sick call visits, infectious disease or other clinic visits, trends in specific diagnoses, and other medical service utilization trends of interest to facility leadership and administration.

Tired of the Status Quo?
Let's Have a Conversation.

Are you ready to have a conversation about healthcare in your facility? Contact us and we'll get right back in touch with you to schedule a call.

FirstClass Healthcare Logo

FirstClass Healthcare Leadership Team

FirstClass Healthcare was founded by a group of Atlanta-based Emergency Physicians and Physician Assistants who are dedicated to setting the new standard for Correctional Healthcare. We pride ourselves on creating a team-based system that focuses on treating residents with compassionate care through operational and clinical excellence. As modern healthcare innovators, our company transcends boundaries common in medical institutions to deliver exceptional patient care.

2310 Parklake Drive NE, Suite 100, Atlanta GA 30345 • ‭(404) 500-6414‬