Beyond - ProMedica | Our mission is to improve your health ... Documents/our-communities/201… ·...

OUR WALLS2015 Mission and Community Benefit Report

Beyond

Contents

2 | BEYOND OUR WALLS

Table of Contents

Introduction ............................................................................. 4

Community Benefit Report ...................................................... 6

Clinical Excellence ................................................................... 8

Social Determinants ............................................................... 13

Economic Development ........................................................ 19

Innovation .............................................................................. 22

Education .............................................................................. 27

About ProMedica ................................................................... 31

Contents

2015 MISSION AND COMMUNITY BENEFIT REPORT | 3

Mission-driven. Community-based. Not-for-profit.These are more than words. They are the principles and philosophy that drive every decision that ProMedica makes as an organization.

With people as our foundation, we believe that health care is about delivering compassionate care, high-quality services, and exceptional experiences. We believe that building healthier communities extends beyond our walls and requires taking a broader view and greater role in the health of our communities.

The role of health systems, and how and when we care for individuals and our communities, is irrevocably changing. We can no longer think inwardly – we must go beyond the episodic moments of care individuals receive at our hospitals and provider offices to those moments where health is actually impacted – in our homes, our schools and our communities. As a mission-driven organization, ProMedica continues to focus increasingly on being the integrators of care for our communities, exceeding at clinical excellence and patient care, while helping to connect the dots and collaborate with other like-minded organizations to impact societal factors that determine health and well-being.

On the right:

Transforming Health Care – Where We Live, Learn, Work and Play As an anchor institution, ProMedica is committed to the long-term welfare of the city of Toledo and surrounding region. Our vision is for Healthy Individuals and Healthy Communities and we are committed to going beyond our clinical walls to achieve clinical excellence, address social determinants of health, advance education, and drive economic development and innovation.


$198.7 MILLION

Total Community Benefit

$119,812,000 Medicaid and Means-Tested Shortfalls (60.28%)

$572,000 Research (0.29%)

$34,059,000Health Professions Education (17.14%)

$1,795,000 Cash and In-kind Contributions (0.90%)

$18,272,000 Subsidized Health Services (9.19%)

$6,117,000 Community Health Improvement Services and Community Benefit Operations (3.08%)

$18,122,000 Financial Assistance (9.12%)

500 100 150

As part of this total, ProMedica contributed more than $6,117,000 for free community health services, such as diabetes testing, blood pressure testing, mammograms and immunizations.

$198.7 M

in millions


2015 Community BenefitIn 2015, ProMedica contributed $198,749,000 in community benefit through community benefit expenditures, financial assistance and government-sponsored, means-tested health care (income and capital “means” are below specified limits). These numbers not only indicate ProMedica’s long-standing commitment to the community, but also fulfill our not-for-profit status and Mission to improve the health and well-being of residents in the communities we serve.

Indeed, ProMedica goes beyond industry standards in meeting the goal of providing care to everyone, regardless of their ability to pay. We provide hospital care free-of-charge to all families without insurance with incomes at or below 200% of the federal poverty level. Additionally, ProMedica hospitals provide significant discounts to families with incomes of up to 400% of the federal poverty level.

As a leading advocate for the health and well-being of others, ProMedica provides and promotes community wellness, collaborating with more than 350 local nonprofit agencies and organizations in 2015.

200 250 300

In addition to the $198,749,000 identified to the left, ProMedica incurred an additional $132,599,000 in expenses that were not reimbursed.

$21,472,000 Bad Debt (cost of debt that is not collectible)

$21.4 M $111.1 M

$111,127,000 ProMedica’s cost not reimbursed by the government for treating Medicare patients


ClinicalEXCELLENCE

Building and maintaining a culture of safety, clinical excellence and exceptional patient experiences.


Clinical Excellence

Quality, Safety, Experience

Clinical Service Lines Academic Research

College/University Partners

School System

Initiatives

Investments in Startup Companies

Disclosures

IncubatorDowntown Development Corporation

Urban Revitalization

Public/Private Partnerships

Mental Health

Hunger

Shelter

Infant Mortality

Electronic Health Record

Generations of Care

Social Determinants

Economic Development

Innovation

Education

HEALTHY INDIVIDUALS

HEALTHY COMMUNITIES

Clinical Excellence




School System

Initiatives


Disclosures




Mental Health

Hunger

Shelter

Infant Mortality


Generations of Care

Social Determinants


Innovation

Education

HEALTHY INDIVIDUALS

HEALTHY COMMUNITIES


Lifesaving Intervention Leads to Miracle Patient

ProMedica employee Sandy Rice never thought she would have a stroke. In fact, she was even in denial when she had her stroke in October 2015. After her husband, Donald, called 911, Sandy told the paramedics that she felt

fine and didn’t know why they were there. She was transported to ProMedica Toledo Hospital, where she was diagnosed with a stroke. She was taken to the neuro-interventional lab where Syed Zaidi, MD, vascular neurologist at ProMedica Toledo Hospital, performed a mechanical thrombectomy. During this procedure, a device is used to physically break up a blood clot in the brain, the cause of an ischemic stroke.

After the procedure, Sandy’s symptoms started to improve dramatically. Her MRI results actually showed zero permanent damage, a very rare result. Typically, reduced oxygen to the brain can cause long-term or permanent effects. Dr. Zaidi referred to Sandy as his “miracle patient.”

Sandy was admitted to the hospital for the next four days to be monitored. Because she didn’t suffer any permanent paralysis or brain damage, she was not required to undergo rehab following her discharge from the hospital. However, she did later experience heart palpitations and made an appointment with a cardiologist. During her visit, she was diagnosed with a condition called atrial fibrillation (AFib). Her cardiologist informed her that the blood clots caused by atrial fibrillation may have actually led to her stroke.

Sandy attributes much of the reason she is still alive to the staff at ProMedica Toledo Hospital. Had it not been for their quick timing and the caring team of nurses and doctors, her outcomes may not have been so positive. Since her stroke and diagnosis, Sandy has a different perspective on life. She doesn’t take anything for granted and seizes every opportunity to visit her grandkids and loved ones. She is grateful for the opportunity to share her story, in hopes that it will help someone else.


Investing in Clinical ExcellenceStarting from a foundation of financial and clinical strength, ProMedica is committed to making investments in our facilities and services to ensure that we achieve highly efficient and effective operational performance. We applaud our dedicated employees and team of providers and caregivers who work hard every day to provide great healthcare outcomes and highly-reliable patient care and customer experiences.

• ProMedica and The University of Toledo College of Medicine finalized an Academic Affiliation Agreement with a goal to develop one of the nation’s leading academic medical centers. The academic and clinical medical model will recruit medical students, physicians and researchers to northwest Ohio and benefit our communities for generations to come. A multi-disciplinary Transition Steering Committee addresses overall planning of the resident transition, new residency development, facility changes/accommodations, and capital spending.

• ProMedica launched its new integrated electronic health record system (Epic). More than 20 providers and numerous clinical, billing and coding specialists were the first to use the new system. Additionally, six ProMedica physician practices participated in the pilot. By the spring of 2017, every ProMedica Physicians practice and hospital will share an integrated system designed to provide seamless patient care across our system.

• The first ProMedica Urgent Care opened in Oregon, Ohio. This new model of Urgent Care delivers exceptional health care to the Oregon community and offers a cost-effective, efficient option to the emergency room.

• The Heartland at ProMedica skilled nursing and rehabilitation care center opened on the ProMedica Flower Hospital campus in October. The joint venture between ProMedica and HCR ManorCare offers a comprehensive care model with additional healthcare services and support beyond what is offered in a traditional nursing home.

• ProMedica finalized a three-year agreement to provide on-site health and wellness services to nearly 1,000 employees and their eligible dependents at Owens Corning’s downtown Toledo world headquarters. Under the agreement, ProMedica operates an on-site employee health clinic and manages the corporation’s on-site fitness center.

• ProMedica teamed up with five other Ohio health systems to form the Midwest Health Collaborative. They include Aultman Hospital, Cleveland Clinic, OhioHealth, Premier Health and TriHealth. The organizations will work together to create a statewide direct-to-employer network product.


• As part of a joint venture, ProMedica and Harbor Behavioral Health began integrating mental health professionals into ProMedica primary care atmospheres including its autism and diabetes care centers. The organizations plan to co-locate more mental healthcare specialists and services into medical practices to improve access for patients in need.

• The new ProMedica Hudson Health Center opened in downtown Hudson, Michigan. The center provides patient care seven days a week and includes laboratory and radiology services.

• ProMedica and Adrian College have executed a Letter-of-Intent and Professional Services Agreement to build and operate a health and medical clinic on the campus of Adrian College. ProMedica Physicians will provide support for the Health Care Management, Sports Management, and Athletic Training programs at Adrian College.

• ProMedica and AARP Foundation created The Root Cause Coalition, a new nonprofit organization focused on building a national coalition of hospitals, health systems and other organizations to collaboratively address hunger as a public health issue and other social determinants of health.

• ProMedica opened its second early learning autism program in Adrian, Mich. ProMedica Bixby Hospital Center for Autism offers highly-specialized learning techniques including Applied Behavior Analysis that brings about meaningful and positive changes in behavior in autistic children as young as 18-months-old.

• ProMedica began renovating several departments on the campus of ProMedica Fostoria Community Hospital. The first floor of the hospital was expanded to accommodate a newly renovated and enlarged medical office space for up to 10 providers, plus an outpatient laboratory.

• ProMedica Defiance Regional Hospital completed renovations on a new surgery waiting room and six additional pre-operative bays to further improve surgical experiences for patients and families.

• Paramount became Ohio’s 5th largest workers’ compensation managed care organization with the purchase of a Cleveland-based consortium of companies called Advocare Holding Group. Advocare has tremendous experience in workers’ compensation and has expanded Paramount’s breadth and depth of services.

• ProMedica became the region’s first health system to offer vascular medicine as a medical specialty. Today these employed specialists are seeing patients in Toledo and at satellite locations in Defiance, Fostoria, Fremont and Wauseon, Ohio plus in Lenawee County, Mich.


SocialDETERMINANTS

Advancing the clinical care we provide by expanding our focus on societal factors that influence our health and well-being, such as hunger, housing and mental health.


Clinical Excellence




School System

Initiatives


Disclosures




Mental Health

Hunger

Shelter

Infant Mortality


Generations of Care

Social Determinants


Innovation

Education

HEALTHY INDIVIDUALS

HEALTHY COMMUNITIES

Clinical Excellence




School System

Initiatives


Disclosures




Mental Health

Hunger

Shelter

Infant Mortality


Generations of Care

Social Determinants


Innovation

Education

HEALTHY INDIVIDUALS

HEALTHY COMMUNITIES


A Hand Up, Not a Hand OutCatreva Brown has an infectious smile that exudes positive energy at ProMedica’s Market on the Green. It’s hard to believe that just a couple of years ago Catreva was homeless. Today she has a place to live, is enrolled at Owens Community College to earn her GED and has a part-time job at the market inside of ProMedica’s Ebeid Institute, a community health hub in central Toledo named after philanthropist Russell Ebeid.

In 2015, ProMedica opened Market on the Green, a full-service grocery market offering fresh and affordable healthy food choices to a designated food desert. Catreva is one of six employees who works

in the market through the Ebeid Training Program established to prepare trainees for careers in retail services and community programming. It offers a blended learning approach that includes on-the-job training and mentoring. Trainees work 22 hours a week for 12 months, starting in the market and then later transitioning to Ebeid’s administrative offices, as well as other business units within ProMedica. They also work with a financial advisor/coach who helps them achieve long-term financial goals. After they’ve completed the year, trainees are assisted in finding full-time employment at ProMedica or other local partner agencies.

“I am so thankful for this opportunity that is putting me a step closer to my dream of one day owning my own business,” Brown said. “My passion is dancing and teaching and I want to work with special needs children and introduce them to the world of dance and the arts.”


Treating Food as Medicine For Cynthia Martinez, ProMedica’s food pharmacy is more than a “food pantry;” it’s a “lifesaver.”

The mother of five children and nine grandchildren was referred to the food pharmacy in April 2015 by her nurse practitioner because she lives on a fixed income and was struggling to buy food. Since then, she has made 15 visits.

Martinez has Type 2 diabetes. In addition to taking Metformin, she stops by the food pharmacy once a month for fruits, vegetables and other pantry essentials. Among her favorites are canned peaches, pears, green beans, carrots, cereal, and 1% milk.

$150,000 INVESTED INFOOD PHARMACIES

2 PROMEDICA

FOOD PHARMACIES


“Since I became a diabetic, I have really cut back on carbs and hardly eat any sweets. My nurse practitioner said that I am doing very well,” Martinez said.

ProMedica is committed to addressing food insecurity as one of many social determinants of health in our community. In 2015, ProMedica screened more than 36,000 patients for food insecurity. Martinez is one of 1,300 patients referred to ProMedica’s food pharmacy based on their responses to the following screening questions:

We worried whether our food would run out before we got money to buy more. Was that often, sometimes or never true in the last 12 months?

The food that we bought just didn’t last and we didn’t have money to buy more. Was that often, sometimes or never true in the last 12 months?

Those answering “often true” or “sometimes true” to one or both questions may be referred to a food pharmacy. The referral is included in the patient’s electronic health record.

ProMedica is currently screening 51% of patients in its primary care practices. As a result, emergency department visits and avoidable hospital admissions are declining in patients using the food pharmacy.

“Through this program, we have learned more and more that hunger and food insecurity is a concern for our patients because patients who are food insecure often have a harder time maintaining their health and they’re at risk for many chronic health conditions,” said Chloe Plummer, ProMedica clinical dietitian.

ProMedica has two food pharmacies housed in medical facilities so they are easily accessible to patients. Martinez and other patients are given prescriptions for a two to three-day supply of healthy food and may visit once a month for up to six months and longer as recommended by their medical provider. They also receive nutrition counseling and referrals to other community resources.

“Hunger is very much tied into our patients’ health so we treat food as medicine and make it a part of their personal health regimen, in addition to other necessary medications that may be prescribed,” said Plummer.

Martinez is grateful for the food pharmacy and says her health has improved.

“It is such a huge support and help to me and my family, and I really appreciate it,” she said.


EconomicDEVELOPMENT

Through a focus on economic development we will not only help ensure the health of our communities, we will create jobs and help safeguard a sustainable future for ProMedica.


Clinical Excellence




School System

Initiatives


Disclosures




Mental Health

Hunger

Shelter

Infant Mortality


Generations of Care

Social Determinants


Innovation

Education

HEALTHY INDIVIDUALS

HEALTHY COMMUNITIES

Clinical Excellence




School System

Initiatives


Disclosures




Mental Health

Hunger

Shelter

Infant Mortality


Generations of Care

Social Determinants


Innovation

Education

HEALTHY INDIVIDUALS

HEALTHY COMMUNITIES


16ProMedica Downtown Corporate Headquarterswork

$60 MILLION INVESTMENT

1,000 JOBS

15% MINORITY-

OWNED CONTRACTORS

Positioning Toledo’s Economy for the 22nd CenturyAccording to a Federal Reserve Bank of Cleveland report, Toledo’s unemployment rate is rising, but the economy is still growing. The reasons – employment has grown, population loss has slowed and housing prices have grown modestly.

In 2015, ProMedica became a catalyst for Toledo’s economic upswing after it announced plans to relocate its system offices to downtown Toledo. Employees will be based in three buildings, including a 120-year-old steam plant. ProMedica began renovating the steam plant in late 2015. The approximately $60 million investment will bring more than 1,000 jobs to Toledo’s central business district. ProMedica is committed to keeping the project local and is working with Toledo-based firm, Rudolph Libbe. The company will also engage minority-owned businesses for at least 15% of contract and subcontract work related to the construction project.

Also in 2015, ProMedica helped spearhead the development of Toledo’s 22nd Century Committee. The group, comprised of leaders from private and public sectors, was formed to drive downtown Toledo’s

revitalization by developing a comprehensive Strategic Downtown Development Plan with a specific focus on priority areas of commercial development, including the arts, transportation, retail, housing, and infrastructure enhancements.

“In essence, the establishment of this committee is like dropping a stone in a pond; what we do will be immediately impactful in our approach, but its ripple effects will be far-reaching and felt for generations to come,” said Randy Oostra, ProMedica president and CEO.


16ProMedica Downtown Corporate Headquarterswork


Investing in new technologies and startups that will enhance care for future generations, create jobs and revenue, and find new and better approaches and models to care.

Clinical Excellence




School System

Initiatives


Disclosures




Mental Health

Hunger

Shelter

Infant Mortality


Generations of Care

Social Determinants


Innovation

Education

HEALTHY INDIVIDUALS

HEALTHY COMMUNITIES

Clinical Excellence




School System

Initiatives


Disclosures




Mental Health

Hunger

Shelter

Infant Mortality


Generations of Care

Social Determinants


Innovation

Education

HEALTHY INDIVIDUALS

HEALTHY COMMUNITIES


Inside the world of ProMedica Innovations In 2015, ProMedica Innovations opened a medical incubator that is already having a positive impact on Toledo’s economy. The purpose of the incubator is to foster area business startups and provide a gateway for new ideas and inventions. The incubator’s three startup companies are also helping to bring jobs and new companies to the Toledo-area, as well as driving business for existing companies.

VentureMed Group (VMG), a medical device company, was one of the first companies to move into the space. VMG was founded by John Pigott, MD, a vascular surgeon, to develop and commercialize innovative and cost-effective endovascular medical devices. In 2015, he received the green light to market his first invention in Europe, the FLEX Scoring Catheter® designed for treating peripheral artery disease (PAD).

The catheter was recently approved by the U.S. Food and Drug Administration for commercial distribution.

“Using FLEX prior to balloon angioplasty in our first-in-man trial, we were able to show statistically significant improvement within 30 days,” said Dr. Pigott, VMG chief science officer. “Benefits for PAD patients may include fewer dissections and improved results at procedure completion.”

The incubator is expected to bring more than 250 jobs to metro Toledo.

250 EXPECTED

JOBS IN TOLEDO


EducationHelping our communities recruit and retain the best and the brightest,

leading to a sustained future for generations to come.

Clinical Excellence




School System

Initiatives


Disclosures




Mental Health

Hunger

Shelter

Infant Mortality


Generations of Care

Social Determinants


Innovation

Education

HEALTHY INDIVIDUALS

HEALTHY COMMUNITIES

Clinical Excellence




School System

Initiatives


Disclosures




Mental Health

Hunger

Shelter

Infant Mortality


Generations of Care

Social Determinants


Innovation

Education

HEALTHY INDIVIDUALS

HEALTHY COMMUNITIES


EducationHelping our communities recruit and retain the best and the brightest,

leading to a sustained future for generations to come.


Partnership to improve health and well-being in Toledo-area elementary schoolsMackenzie James, a Byrne Elementary School sixth-grader, doesn’t let her Type 1 diabetes stop her from doing things she loves like cheerleading. She was diagnosed when she was 8-years-old and referred to a ProMedica pediatric endocrinologist who put her on insulin to manage the disease. It took some time to get Mackenzie’s diabetes under control and as a result, she spent several weeks of her summer break in and out of ProMedica Toledo Children’s Hospital.

At the start of the school year, Mackenzie and her parents met Registered Nurse Joan Baas (aka: Nurse Joan) at a Toledo Public Schools (TPS) open house. Since then, Mackenzie has seen Nurse Joan on an almost daily basis to check her blood sugar levels and to ensure she is receiving the right dosage of insulin. Mackenzie has

developed a special bond with Nurse Joan and they communicate throughout the day and take scheduled snack breaks.

Thanks to a partnership between TPS and ProMedica, Mackenzie and other students have access to an in-house school nurse. In 2015, TPS and ProMedica announced plans to work together to increase health services throughout the school district by funding nine additional school nurses in the elementary schools. ProMedica committed to a $600,000 annual investment for three years bringing the total to 40 school nurses, one for each elementary school.

Each year, there are a growing number of TPS students with Type 1 diabetes. Students who are diabetic reportedly miss as many as five more days of school compared to peers without diabetes. This supports research findings that indicate a direct correlation between a child’s health and his or her performance and attendance in school.


Nurse Joan believes this program is critical to ensure that medically-fragile students receive timely and appropriate care as needed.

“I am very fortunate and proud to be a school nurse for Toledo Public Schools so that I am able to help students like Mackenzie every day. Also, being at the school full time allows me the opportunity to assess the overall health needs of our students and community,” Nurse Joan said. “I have been able to connect our students and families with community resources including immunizations, glasses, diabetes education, and dental health.”

In addition to Toledo Public Schools, ProMedica also works collaboratively with other educational institutions throughout northwest Ohio and southeast Michigan at all levels, including Adrian College, Lourdes University, Owens Community College and The University of Toledo. In 2015, ProMedica finalized an Academic Affiliation with The University of Toledo College of Medicine. It is a 50-year commitment that includes a financial investment of $2.5 billion to establish a premier academic medical center. The affiliation will build a legacy model of health care that will benefit residents of our region for generations.


About ProMedicaEstablished in 1986, ProMedica serves 27 counties in northwest Ohio and southeast Michigan and is one of the region’s leading healthcare providers. Our stewardship of resources has enabled us to wisely invest in cutting-edge technology, innovative programs and family-centered facilities that help to ensure patients and area residents have equal access to high-quality, safe care in the most appropriate setting, regardless of a patient’s ability to pay.

Based on needs that we have assessed within the communities we serve, ProMedica launched new services and programs in 2015 to help meet the growing demands of local consumers across all spectrums of life, including those individuals who are often the most vulnerable when it comes to health care: the elderly, poor and underserved.

ProMedica and its affiliates comprise 332 sites, more than 2,300 physicians and approximately 15,000 employees and 2,700 volunteers. During 2015, ProMedica discharged more than 90,000 inpatients and served more than 1,535,310 outpatients, while handling 392,000 emergency visits system-wide.

Additionally, our physicians, leadership team members and employees individually contribute personal resources to the community in numerous ways—such as through tutoring elementary students in reading, providing monthly health lectures at local senior centers, generously contributing to community fundraising campaigns such as United Way, participating in medical missions, serving on local not-for-profit boards, and donating nonperishable goods to numerous local food pantries and churches—underscoring a key benefit of ProMedica being locally owned and operated.


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