Erlanger Health System

The Spark

Erlanger Health is a seven-hospital nonprofit system based in Chattanooga and the region’s only Level 1 trauma center and children’s hospital. Hospitals don’t close and neither do the child care needs of the hospital staff who keep them running. Employee requests for on-site child care had been building for years before Erlanger’s leadership acted. In 2002, they opened the first eKids Learning Center directly adjacent to the downtown hospital. A second location followed on Volkswagen Drive, serving Erlanger’s east-side employees, Volkswagen workers, and the surrounding community. More than two decades later, both centers are still operating and still central to how Erlanger attracts and keeps its workforce.

The Solution

Erlanger operates two eKids Learning Centers serving children from six weeks through age 12, with a summer camp program for school-age children that includes weekly field trips, the most expansive camp offering in the region. The downtown center is open from 6 a.m. to 7:30 p.m. and serves about 185 children, predominantly from Erlanger families. The Volkswagen Drive center opens at 5 a.m. and serves roughly 100 children, split in thirds among Erlanger employees, business partners like Volkswagen and Sodexo, and community families.

One decision set Erlanger apart from nearly every other employer-affiliated center in the state: they petitioned the state for permission to keep children in care beyond 12 hours in a 24-hour period. Most licensed centers can’t do this, which makes them unusable for 12-hour shift workers, exactly the nurses and clinical staff a hospital needs most. That exception, combined with extended hours and holiday coverage on days most centers close, means Erlanger’s child care matches the reality of healthcare schedules rather than defaulting to a 9-to-5 model.

Enrollment runs on a three-tier pricing system. Tier 1 (Erlanger employees paid directly by the system) receives the deepest discount. Tier 2 covers affiliates and business partners. Tier 3 is the community rate. All Erlanger employees are eligible, and Erlanger families receive priority placement at both locations. Currently, about 165 Erlanger families are served across the two centers.

The centers also function as a workforce pipeline. College students from the University of Tennessee at Chattanooga work at eKids during school, then transition into nursing, child life, or other healthcare roles at Erlanger after graduation. According to Director Patti Smith, Erlanger provides its child care employees with the same comprehensive benefits offered to hospital staff, including insurance, paid time off, and meals from the commercial kitchen. She believes this is one primary reason the centers experience remarkably little staff turnover. Some teachers have remained with eKids since its founding in 2002.

The Results

Erlanger has not measured formal ROI on the centers, and Robert Sandlin, who oversees both locations, is candid about it: the operation runs at a loss. Annual operating costs are approximately $3 million, with an annual deficit of about $500,000. But Sandlin frames the return differently: this is a multi-generational investment. Former eKids children have come back as Erlanger residents, physicians, and even a state public health examiner. The center’s lead robotic surgeon told staff that the child care center was his primary reason for choosing Erlanger.

Parents on 12-hour shifts can clock out at lunch, walk across the street, and sit with their child. Resident mothers can visit their babies and come back to the floor. Patti describes the relationship as family care as much as child care. Her team knows the families, encourages the parents, and provides stability during the most demanding years of a healthcare career.