The once-booming local economy, largely dependent on the hospitality industry, has seen the number of visitors slow in recent years. Construction cranes along the famous Strip sit idle, Las Vegas' home foreclosure rates are among the nation's highest, and unemployment hit 13.1 percent in December.
So when the Clinic accepted the brain center as a gift last year and decided to expand the health system's neurological research and clinical practice there, local leaders immediately began to ask for an even stronger marriage.
Mayor Oscar Goodman, who had been trying to lure the Clinic to Las Vegas for nearly a decade, envisions a medical mecca with the Clinic at the helm. Clinic executives are mulling the idea, reviewing how adding to operations there could enhance its ability to serve patients, grow revenues and elevate its brand.
After frequent get-togethers and positive public dialogue this past year, Goodman describes his current relationship with the health system and its leader Dr. Toby Cosgrove as "a love-fest."
One Cleveland Clinic executive involved in the discussions characterizes local desire for the health system to expand as "rabid."
The Clinic beyond Cleveland The nearly $80 million Cleveland Clinic Lou Ruvo Center for Brain Health anchors the south end of the city-owned Symphony Park development and includes medical offices as well as an events hall for fundraising.
The Clinic has a confidential "exclusive negotiating agreement" with the city of Las Vegas' redevelopment agency to build on an additional 12 acres adjacent to the brain center.
Las Vegas officials say they expect the Clinic's site plan and development agreement to be submitted to the city by Oct. 1. The Las Vegas City Council could approve a plan by the end of the year.
"Having the western outpost for the Cleveland Clinic, in whatever form it ultimately takes, is huge," said Rita Brandin, development director of Symphony Park.
In many ways, the brain center and the Clinic's possible expansion in Las Vegas illustrates the health system's strategy to grow outside Greater Cleveland.
The project is low-risk on three fronts:
First, the building was a gift and that means the cost was low, with the Clinic only paying for staffing and medical operations. The Clinic's role in developing and managing a 360-bed hospital in Abu Dhabi, United Arab Emirates, echoes this financial strategy, as the hospital slated to open there in late 2012 will be paid for and owned by the government-sponsored Mubadala Healthcare.
Second, the Clinic has been able to leverage the existing expertise of its doctors and staff and expand its neurological operations -- a medical specialty that is a growing field, much like cardiovascular medicine was several decades ago.
Finally, because the brain center is part of a planned 61-acre luxury development and was designed by world-renowned architect Frank Gehry, it enhances the Clinic's branding strategy of "world-class care."
But, for a health system, the unsteady Las Vegas economy also poses challenges.
One doesn't have to look far to see that developing Symphony Park will be a Herculean effort. Within walking distance of the largely empty development is a dingy X-rated adult store and, nearby, an abandoned building with a bright yellow sign that reads: "This city block for sale."
The owner of that 3.25-acre block, Kevin Plencner, vice president of Oak Brook Realty Investments of Chicago, said it seems like the city is the only entity spending money. Plencner's land has two shuttered casinos and a closed convenience store on it.
Indeed, with the exception of historic casinos like the Golden Nugget on Fremont Street, there are few signs of any private investment in the downtown district that sits a few miles from the Strip.
If the health system decides not to expand, Goodman said: "I'll cry in my gin."
Local gossip columnist Robin Leach -- of "Lifestyles of the Rich and Famous" fame -- insists he has it from good sources that the Clinic plans to build a medical school and wellness institute at Symphony Park.
Clinic executives, so far, have not provided any public confirmation. They have held some meet-and-greet sessions with local health systems and are developing a small internship program with the University of Nevada School of Medicine.
Meanwhile, the Clinic is studying the market with a consultant and "finding out what specialties would make sense," said Clinic Chief of Operations William Peacock III during a recent interview with others at the center.
"When we conclude that effort we'll have a better idea of what might fit in some expanded presence out here," Peacock said.
Without missing a beat, Dr. Michael Modic, chairman of the Clinic's neurological institute, and chief emerging business officer, jumped in quickly, adding, "If any."
"We're going to do brain health, there's no question about it," Modic said. "It's still very open as to whether we go beyond this or just stay with what we're doing."
Of all the rumored ideas, an expansion of the Clinic's wellness business, and specifically the Lifestyle 180 program, seems most feasible, said Clinic Chief Wellness Officer Dr. Michael Roizen in a separate interview. The program, which is now offered at the Cleveland Clinic Wellness Institute in Lyndhurst, is designed to treat chronic disease through lifestyle changes.
In addition, said Roizen, the health system has learned a lot from wellness programs used by its own employees in Ohio -- from smoking cessation to weight-loss programs -- and hopes to be "able to bring that expertise to other businesses in Las Vegas."
The Clinic's Vegas outpost For now, though, Clinic officials are busy with a brain center that is busier than expected.
After opening a clinical floor in the brain center's office area in July, the Cleveland Clinic served 1,500 new patients in a little more than five months. It's on track to serve nearly 6,000 in 2010, said Dr. Randolph Schiffer, the Clinic's medical director for the brain center.
The center treats patients who suffer from a spectrum of neuro-degenerative disorders like Alzheimer's and Parkinson's diseases. So far, most patients are from the Las Vegas region with some from nearby states, such as Utah and California, though the center could eventually draw patients from across the West and even globally.
The building and all construction costs are being paid for by entrepreneur and brain center founder Larry Ruvo and his Keep Memory Alive organization.
The brain center was already under construction when Ruvo scored a last-minute meeting with Cosgrove, who happened to be in Las Vegas exploring the idea of opening a separate outpatient center. The two men hit it off so well that Cosgrove set aside ideas for the outpatient center and within months accepted the center as a philanthropic gift.
Clinic executives have been active partners in the design. Schiffer insisted, for example, that clinical floors have calm tranquility rooms to help patients and their families relax. The building also is equipped with electronic medical records, which means tests and scans of Las Vegas patients can be viewed and analyzed by Cleveland specialists.
The center's staff, as well as research, will link to the Clinic's larger neurological institute operations in Cleveland, Lakewood and Florida
But, for now, the building is recognized just as much for its celebrity trappings as it is for its medical care. The Gehry building has attracted celebrities -- if not patients -- from around the world, including former Mexican president Vicente Fox, former U.S. president George W. Bush and hip-hop performer, producer and businessman Sean "Diddy" Combs.
The center's shiny steel exterior was put together like a puzzle from 550 pieces designed in Germany, fabricated in China, and then shipped from a port in Los Angeles to Las Vegas. Each piece weighed 2,000 to 8,000 pounds.
The interior of the events hall, still under construction, has nearly 200 windows and a white finish on the walls that looks like drywall, but is actually a specialized acoustic material that cost more than $500,000.
Vegas style The events hall, which is scheduled to open in a few months, is part of the original vision for the brain center that Ruvo began creating before the Clinic entered the picture.
Ruvo, whose father succumbed to Alzheimer's several years ago, wanted to create a center that would combat the disease and help others. The high-energy businessman and senior managing director of Southern Wine & Spirits of Nevada is one of the most networked people in Las Vegas and, thus, the entertainment world. So, it's no surprise that Ruvo's vision quickly became reality.
Ruvo remains a partner in the operation and runs his Keep Memory Alive organization out of the top floor of the brain center. Keep Memory Alive, in turn, orchestrates the annual Power of Love charity gala, which raises money for the brain center.
The charity gala, held last weekend at the Bellagio casino, is by any measure an over-the-top Vegas event, complete with a red carpet and scantily dressed showgirls. With Ruvo as their host, Cosgrove, along with his wife, Anita, and a handful of other Clinic executives, found themselves as welcomed members of the Las Vegas scene at this year's gala -- it's a scene that Cosgrove succinctly summed up during the charity auction by saying, "It's not Cleveland, is it?"
Table and seat reservations for the gala ranged from $15,000 to $75,000 per table and $1,500 to $7,500 per seat -- with five glasses of wine pre-served at each of the 1,000 place settings.
Tennis power couple Andre Agassi and Stephanie Graf, as well as celebrities Danny DeVito, and Brad Garrett of the sitcom "Everybody Loves Raymond," walked the red carpet to help raise money. Artists, dancers and legendary crooner Barry Manilow entertained guests.
By the end of the evening, $27 million in donations had been raised for the center and its research.
Cosgrove, who was introduced as "the newest friend in town," told the crowd:
"I promise you, you will see something happen here that will make a major difference."
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