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Despite big partners, Lake Health Beachwood Medical Center takes its own path

From its inception, Lake Health Beachwood Medical Center has been about relationships.

Relationships between the two dozen or so doctors who came together with a single vision of a specialty, for-profit, physician-owned hospital.

A relationship with a private equity partner and another with Walden, a luxury inn and spa in Aurora that collaborated with these docs to help bring to life an intimate, calming hospital setting.

Relationships with Lake Health as a health system partner and, more recently, a relationship with University Hospitals, which joined as a minority partner.

And, beginning the week of April 8, relationships with patients when the full-service, acute-care hospital opens its doors at the corner of Richmond Road and Chagrin Boulevard.

“The relationships are really important, and if you lose that in a small or big organization, you lose sort of everything,” said Dr. Reuben Gobezie, president of the medical staff at Lake Health Beachwood Medical Center.

Gobezie, a local physician and surgeon who’s started various practices and has operated in many of the region’s health systems, is confident this new hospital will be different for patients and for physicians.

Lake Health Beachwood Medical Center will specialize in orthopedics, urology, spine and pain management. It features 24-hour emergency room services, diagnostic services and physical therapy.

The 69,000-square-foot, two-story facility holds 12 exam rooms where physicians will practice and 24 in-patient rooms. Eight operating rooms and two procedure rooms are positioned in a ring around a central core that aims to improve efficiencies.

The facility’s soft opening is set for the week of April 8. Leaders expect the hospital will be fully operational in June, by which point it will have completed the number of cases required for full accreditation by the government.

Lake Health joined the project in late 2017 and developed it in partnership with the physicians and Manna Isle Ohio. As a majority owner, the system will manage the day-to-day operations along with the partner physicians. Leslie Manzo was appointed chief administrative officer.

Bringing Lake Health into the project was “easy,” Gobezie said.

“It made sense for the physicians to look for a partner in the city of Cleveland because you have big hospital systems, as you know, who would not initially welcome competition,” Gobezie said. “And Lake had a reason to be in Cuyahoga County in their expansion and most importantly, again, their culture, their demonstrated culture is they have partnered — in their surgery center, the medical office building there — they partnered with private practice physicians historically.”

Last month, University Hospitals acquired a minority interest in the hospital by purchasing a portion of Manna Isle’s interest, a move that Gobezie said he believes will be “really symbiotic and mutually helpful.”

Although the hospital is now working with two of the region’s health systems, it has the potential to afford physicians a level of independence for which many have been searching. The physicians own the facility itself and the management service organization that handles the administrative functions for the hospital, said Phillip Ciano, a partner in the law firm of Ciano and Goldwasser who represented the vast majority of the physicians involved in this project.

“Many of these came from other systems or they had their own independent practices or still maintain their independent practices,” Ciano said. “But for the first time in their professional existence, they have the opportunity to actually own a $40 million hospital asset and, also for the first time in their physician practice, have the opportunity to actually own the managed service organization that is going to provide services and billing to the hospital. So there’s a tremendous amount of independence that’s still available and investment opportunity for these physicians, which they’ve never had in their prior employment either working independently or working with one of the big systems here in Ohio.”

Gobezie has taken what he’s learned in other hospital systems, as well as what’s worked in systems across the country and abroad, and applied it to Lake Health Beachwood Hospital, such as telemedicine within the building, so he can consult with families in a conference room from the operating suite. He’ll have the ability to not simply send patients home with a stack of papers, but to email them their images and annotate what they’re seeing.

The hospital was designed to minimize patients’ movement from room to room before and after surgery. Radiology will work closely with physicians, so they know quickly when a patient is done with their testing.

With a goal of infection control, OR staff won’t be allowed to wear scrubs outside of the operating suite without first covering them up. Plus, they’ll wear sterile shoes that are washed regularly, rather than the shoes they wear outside the hospital.

Because the hospital sits in an Orthodox Jewish area, leadership worked with local organizations to provide kosher food and offer a dedicated space for patients and families of that community.

In every area of the hospital, Gobezie can point to how Lake Health Beachwood Medical Center is different. Central to all of it will be its relationships.

“You’re only good as the strength of the relationships we have, whether it’s between the hospitals, between the leadership, between the patients, between the staff,” he said.

Leadership hopes that patients will notice the difference.

“The entrepreneurial spirit of this project, I think, is going to permeate through every aspect of the health care delivery system that you’ll see in this hospital, which will make it very unique from the typical institutional delivery of medicine here in Ohio,” Ciano said. “I think you’re really going to see and feel that, which is going to distinguish from what the consumers are used to in Ohio in health care delivery.”

Source Lunch with … Phillip Ciano

Principal, Ciano & Goldwasser LLP

Crain’s Cleveland Business

About one-third of Phil Ciano’s legal work is spent representing sports agents and agencies. Another third is spent working with doctors and physician practice groups. You could say Ciano has some experience dealing with headstrong individuals.

“My partner (Andy Goldwasser) always laughs at me,” Ciano said. ” ‘You have your conference calls at like 5 in the morning with doctors, 11 at night with these agents, you’re texting 24/7 … You gotta change up your clientele.’ “

That’s not in Ciano’s plans, since he loves the work. Ciano and Goldwasser have been in business together for 17 years, and the pair also has a 50% stake in another Cleveland law firm, Rumizen Weisman. All told, the firms employ 10 attorneys, plus “a bunch” of staffers, Ciano said.

The latter was involved in a 2016 case that featured the agent for Toronto Blue Jays slugger Jose Bautista.

Q&A

You’re going to Los Angeles (the week of April 3) for an arbitration case. Tell me about the work you do in baseball.

The work I do is very nichey. It’s really the representation of agents and agencies in agent vs. agent disputes or agent vs. player disputes, which is all governed by the Major League Baseball Players Association. So it’s all binding arbitration that’s part of the MLBPA. The same sort of structure applies for the NBAPA and the NFLPA. That’s a big part of my practice.

⇒ Read the entire article in Crain’s to learn more about how Phil got into this specialized field as well as his biggest challenges and wins!


Phil Ciano is highly quoted in Crain’s Cleveland Business article about Cuyahoga County’s commercial docket.

Read Phil’s earlier comments in an article on commercial dockets posted by Crain’s Cleveland Business in February, 2016.

Cuyahoga County commercial docket could have life

Attorneys are encouraged that the Ohio Supreme Court is reviewing the specialty court’s process

By Jeremy Nobile / Crain’s Cleveland Business

crains-cleveland-businessCuyahoga County’s commercial docket may be dead, but it won’t lie down.

The most recent developments transpired over the summer, when the Ohio Supreme Court, which oversees the state’s specialty dockets, requested public commentary on some proposed rule changes, many of which were posited by a team of Cleveland attorneys and judges.

Phillip Ciano, principal at Ciano & Goldwasser and a leader of that local team, said he’s heard of no updates from the Supreme Court since commentary on the changes was solicited this summer.

However, a spokesman for the Supreme Court told Crain’s last week the issue will be revisited after two new justices officially join the court in the new year.

That was welcomed news to Ciano.

“It’s not surprising that the process, which is quasi-legislative, is going to take its due course to run,” Ciano said. “But I’m encouraged to know that at least it will be reviewed when the new term starts in January.”

He added that the subcommittee he leads is “ready and willing to provide whatever support and feedback we can provide to see if there’s a form of the commercial docket, or commercial track as we suggested, that could be reinstated in Cuyahoga County.”

Ciano said it’s hard to say whether fewer cases have actually been filed since the local docket dissolved.

“And I wouldn’t say it’s more difficult to practice without more predictability of a commercial docket,” he said. “But I would say that having a commercial docket makes for a more predictable and effective litigation process for businesses. That’s the primary reason we’d like to see it back in some form or fashion.”

⇒ Read entire story here


Sources: Proformance agency wins ruling to receive $1M in back fees

The agency once represented Jose Bautista and Ervin Santana

By Ken Rosenthal / Fox Sports

screen-shot-2016-11-15-at-10-54-09-amProformance, the baseball agency that once represented Jose Bautista and Ervin Santana, will receive approximately $1 million in back fees based upon the ruling of an independent arbitrator, according to major-league sources.

“Jeff and Bean are pleased to be getting on with their lives and having this concluded,” said Proformance’s attorney, Phil Ciano.

⇒ Read full story here

Hall of Fame rep says David Baker ‘absolutely’ didn’t tell players to keep quiet about cancellation

Crain’s Cleveland Business

 Michael Avenatti, as you might expect from an attorney who is trying to get a high-profile case certified as a class-action complaint, didn’t pull any punches when we spoke with him for a Crain’s cover story on the debacle that was the 2016 Hall of Fame Game.

Ciano, a licensed agent, didn’t seem to think Avenatti’s case was as strong as the California attorney believes.

One of the complaints Ciano believes will be difficult to prove is the costs associated with items purchased on the day of the game. Would fans who traveled to Canton and attended the Hall of Fame enshrinement ceremony on Saturday had purchased souvenirs anyway?

“The NFL is a multibillion-dollar enterprise,” Ciano said. “That will be a hard one to prove — that the league was holding people hostage for a few souvenirs and beer on the NFL’s bottom line. That’s a tough one.”

“I think it’s wise to note that the potential of (this case) going four or five years or more,” Ciano said. “These are not quick litigations when you get in the class(-action) world.”

⇒ Read the full story at Crain’s Cleveland Business


Hall of Fame Game cancellation could paint NFL, Canton landmark into a corner

Crain’s Cleveland Business

Avenatti said “hundreds” of plaintiffs are already involved in a lawsuit he is trying to get certified as a class-action complaint against the NFL and the Hall of Fame.

“He’s sort of an internal thorn in their side,” said Phillip A. Ciano, principal of the Ciano & Goldwasser law firm in Cleveland, of Avenatti and the NFL.

⇒ Read the full story at Crain’s Cleveland Business


An Interview with Andy Goldwasser on Channel 3 WKYC – Live on Lakeside

Investment Claims

Making an investment can be a very difficult decision to make and most people seek advice about this. However, sometimes they’re not always given the best advice. If someone loses a lot of money because of bad investment advice they can file a claim. Andy Goldwasser, Principal for Ciano & Goldwasser, joins Channel 3 WKYC – Live on Lakeside – with more information about doing so.


Working for Two Firms Keeps Andy Busy…

An Interview of Andy Goldwasser

by Kristen Mott, Staff Reporter
Cleveland Jewish News

⇒ Read full article…


Commercial Docket’s Backers Keep Up Fight

A Discussion of the Disbanded Commercial Docket with Phil Ciano

by Jeremy Nobile
Crain’s Cleveland Business Staff

⇒ Read full article…


Make Sure to Notice Pivot Opportunities

Turning Abstract Discoveries into Business Opportunities

Originally published in the August 30, 2015 Crain’s Cleveland Business by John Campanelli.

⇒ Read full article

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Cuyahoga County commercial docket could have life

Attorneys are encouraged that the Ohio Supreme Court is reviewing the specialty court’s process

By Jeremy Nobile / Crain’s Cleveland Business

crains-cleveland-businessCuyahoga County’s commercial docket may be dead, but it won’t lie down.

The most recent developments transpired over the summer, when the Ohio Supreme Court, which oversees the state’s specialty dockets, requested public commentary on some proposed rule changes, many of which were posited by a team of Cleveland attorneys and judges.

Phillip Ciano, principal at Ciano & Goldwasser and a leader of that local team, said he’s heard of no updates from the Supreme Court since commentary on the changes was solicited this summer.

However, a spokesman for the Supreme Court told Crain’s last week the issue will be revisited after two new justices officially join the court in the new year.

That was welcomed news to Ciano.

“It’s not surprising that the process, which is quasi-legislative, is going to take its due course to run,” Ciano said. “But I’m encouraged to know that at least it will be reviewed when the new term starts in January.”

He added that the subcommittee he leads is “ready and willing to provide whatever support and feedback we can provide to see if there’s a form of the commercial docket, or commercial track as we suggested, that could be reinstated in Cuyahoga County.”

Ciano said it’s hard to say whether fewer cases have actually been filed since the local docket dissolved.

“And I wouldn’t say it’s more difficult to practice without more predictability of a commercial docket,” he said. “But I would say that having a commercial docket makes for a more predictable and effective litigation process for businesses. That’s the primary reason we’d like to see it back in some form or fashion.”

⇒ Read entire story here

By Jeremy Nobile

Crain’s Cleveland Business Staff

Next month will mark a year since Cuyahoga County Common Pleas Court judges disbanded the generally popular commercial docket, but the movement to restore the specialty business court continues.

“It may appear to be dormant, but it’s not dead,” said Bruce Hearey, former president of the Cleveland Metropolitan Bar Association who has been leading the committee of litigators working to see the docket restored. “People should not interpret a lack of news as a lack of activity.”

Attorneys are currently finishing a proposal for changes to the docket they expect to submit to judges before year’s end, Hearey said. He declined to speak to what changes could be in there since the proposal isn’t completed yet.

A commercial docket’s intent is to resolve business-to-business disputes faster and establish both consistency in the legal process and expertise among judges who would hear those kinds of cases, which include liquidations, trade-secret disputes, noncompete contracts and shareholder disagreements.

Hearey was president of the Cleveland bar when the docket was eliminated in January, a decision that followed the disqualification of Judge Cassandra Collier-Williams from the docket by the Ohio Supreme Court’s Commercial Docket Subcommittee, which affirms the appointment of judges to the specialty court in a process unique to the business court.

Hearey intends to keep involved with the initiative until the issue is settled.

Judges will review potential solutions with the attorneys once the latter group submits its suggestions. The next steps will be considered from there.

Administrative and presiding Judge John J. Russo said there’s no hard timeline imposed anywhere in the process, though.

“That proposal-writing process has been slower than expected as members of that subcommittee have been busy in court and because there are a lot of cooks in the kitchen,”
– said Phillip Ciano, principal at Ciano & Goldwasser who is leading that proposal subcommittee.

Lawyers simply want to see the docket restored, and they’re pitching solutions they think judges could be open to.

Meanwhile, exactly what judges want from the docket remains murky at this point. Russo declined to speak to what judges desire considering where the process currently stands.

“We are still looking at what might be feasible and necessary,” Russo said. “We have some thoughts … But we are waiting to see what the bar recommends.”

That proposal-writing process has been slower than expected as members of that subcommittee have been busy in court and because “there are a lot of cooks in the kitchen,” said Phillip Ciano, principal at Ciano & Goldwasser who is leading that proposal subcommittee.

The last 11 months have been a quiet back-and-forth between judges who seem to want more autonomy over how the commercial docket would operate, including the selection of judges, and lawyers who never wanted the docket to go away. Commercial litigators generally appreciated everything the docket set out to do, which is why they continue to pursue the issue, Ciano said.

“I think our main objective is to create a cooperative procedural process that makes sense for the business owners in Cuyahoga County, that makes sense for practitioners and makes sense for the judiciary,” he said.

Jumping through hoops

Ultimately, there are only three possible outcomes.

The first two are intuitive. Either the docket stays dead and all business-to-business cases continue to be assigned to the full bench of 34 attorneys, or it’s restored under the parameters of the Supreme Court.

The county court’s other option is to create what is essentially a special track for business cases.

That technically wouldn’t be considered a commercial docket as defined by Ohio’s high court, though. And it couldn’t actually be called a commercial docket.

In that case, there would be no direct oversight by the chief justice. It’s not an uncommon process, as that’s the way most other specialty courts are operated, but it would be a special solution in this case. Hamilton and Lucas counties are the only ones in Ohio right now with true commercial dockets.

There are some potential downsides to taking that alternative route, particularly in terms of case flow.

Bret Crow, director of communications for the Supreme Court of Ohio, explained that under the high court’s commercial docket, a judge on the docket assigned a commercial dispute moves another non-business case to someone else to keep the total workload in check. The timeline for dispositive motions is also automatically reduced.

The Supreme Court, naturally, promotes its model to encourage uniformity across the state. So the court itself and Chief Justice Maureen O’Connor have been paying attention to what happens next in Cleveland. The high court, however, declined to comment on its position regarding what the local common pleas court does simply because it’s “premature,” Crow said.

Joe Roman, CEO of the Greater Cleveland Partnership, has praised the docket as a positive for the business community.

And even though it’s been a year without the commercial docket, which was formally adopted in Cuyahoga County in 2013 following a three-year pilot program, Ciano said it’s not been enough time to determine if it’s truly had a measurably negative impact on clients or business for practitioners.

But that doesn’t diminish the lawyers’ efforts, he said.

“We want to craft a compromise that makes sense and works for everybody,” Ciano said.

“Our hope would be (to resolve this) in 2016, but there will be several hoops to jump through, and this is the first step to getting to something we all agree on at a local level.”

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Cuyahoga County Docket Case in the News

Phil Ciano is highly quoted in Crain’s Cleveland Business articles about Cuyahoga County’s commercial docket.