2016 - 2017
ANNUAL REPORT
Top 100
Critical Access Hospitals in the Nation
10 Kruger Road . Plains, MT 59859 . (406) 826-4800 . www.cfvh.org
THE CORE OF CFVH Mission . Vision . Values Clark Fork Valley Hospital and Family Medicine Network will partner with our communities to improve the health of those we serve. We will create a caring and compassionate environment to deliver quality healthcare and meet our communities’ needs. A culture of individual ownership will foster innovative ideas and excellence in customer service, professional growth and fiscal health. We will be recognized as the premier employer and the healthcare provider of choice in Sanders County. To achieve our vision we must demonstrate the following core values:
Respect for all we serve Accountability for our decisions Integrity in our interactions Safety as our highest priority Excellence in all we do
QUALITY HEALTHCARE CLOSE TO HOME, FAMILY AND FRIENDS
MESSAGE TO THE COMMUNITY Thinking back to writing this report one year ago, I could not have imagined the tumultuous year that was ahead. We have seen world events that few would have envisioned including the Brexit vote, Korean Peninsula tensions escalating and even the outcome of our own country’s presidential election was a surprise to many. As prominent as these global events are, I think more of those individuals in Sanders County who experienced personal tragedies. Loss of a family member, home, or friend are a few of the events that bring suffering to our already complicated lives. It is in these times however that I see the best of our residents come out. The variety of ways we help one another is endless. It doesn’t matter if we give from our pockets, our shelves or from within our hearts, we find ways to be good neighbors. This kindness is one of the reasons I am proud to call Sanders County my home. The staff of Clark Fork Valley Hospital and our Family Medicine Network strive personally to be this kind of neighbor and they bring that dedication and sense of mission to their jobs. They frequently make sacrifices in their lives to be available when you most need them, and they dedicate much time to continuing education that their profession requires. As they carry out their duties, they do so with the desire to lessen the burden of those who have entrusted their care to them. It was a joy to see this dedication recognized by the “Top 100 Critical Access Hospital” designation this year. Such recognition comes because of the hard work, commitment and sacrifice of our staff. Their desire to bring quality care and compassion to their friends, family, and neighbors is the fuel and driving force that is so important to our work. They have been here when my family needed them. I know they have for many of you also, so please join me in thanking them for giving to our community. - Gregory Hanson, President/CEO
YOU HAVE THE CHANCE TO WIN CFVH Health Communications Challenge
Subscribe to CFVH Health Communications Today
at
www.cfvh.org for your chance to win a
Day Hikers Package. Once you have confirmed your subscription, you will be entered into a drawing to be held September 29, 2017. The winner will receive a 40L Waterproof Lightweight Camping Backpack complete with an Insulated Water Bottle and snacks.
COMMUNITY BASED BOARD 2017
Board Members
Mike Baxter, Chairperson . Thompson Falls, MT Erika Lawyer, Vice Chairperson . Plains, MT Don Damschen, MD, Chief of Medical Staff . Plains, MT Gregory Hanson, MD, President/CEO . Plains, MT Denise Benson . Plains, MT Erin McCarthy . Plains, MT Devin Huntley . Missoula, MT Bina Eggensperger . Thompson Falls, MT Ginny Holland . Hot Springs, MT Dan Claridge . Thompson Falls, MT
RECOGNITION FOR QUALITY CARE
Clark Fork Valley Hospital was named among the Top 100 Critical Access Hospitals in the United States by iVantage Health Analytics and The Chartis Center for Rural Health for 2017.
“This achievement is very gratifying and validates our daily commitment to providing the best healthcare possible to our community, while maintaining an efficient and effective facility,� said Dr. Gregory Hanson, CFVH President/CEO.
CFVH FOUNDATION The Clark Fork Valley Hospital Foundation is a non-profit organization whose sole purpose is to support CFVH and its related entities. These include our rural health clinics, home health and hospice programs, community education outreach efforts and our long term care resident living facility. Over the years there have been needs for equipment and programs that the operating budget didn’t have sufficient funds to purchase or support. We have utilized a variety of functions and outreach activities to raise needed dollars to support these outstanding and needed “extras”. Now in its 11th year, the CFVH Foundation has raised over $377,000 and has purchased everything from x-ray equipment to custom tables for our long term care to accommodate wheel chairs. From woodworking tools to fetal heart monitoring equipment, our projects are critical to deliver quality care close to home. The generosity of our participants, volunteers and sponsors has allowed us to raise funds for these special needed projects at Clark Fork Valley Hospital. In 2016 we focused our efforts on purchasing new therapy equipment to enhance Rehabilitation Services in our Thompson Falls Family Medicine office. Forging ahead, we are looking at purchasing a new ultrasound bed for our Imaging Department and a pediatric mannequin for training and the professional development of our staff to care for the youth of our community.
Please give thoughtful consideration to making an investment in the health of your family, friends and neighbors this year by placing a donation to the CFVH Foundation in the enclosed envelope. To learn more about investment opportunities, please contact Barry Fowler, CFVH Foundation Director at (406) 826-4858 or visit www.cfvh.org.
INSIDE LOOK - FINANCIALS 2016
Gross Patient Revenue
Of each dollar in charges for healthcare services, CFVH collected approximately 65 cents after discounts to government and private payers, charity discounts and bad debts. Resulting Net Patient Revenue was used to pay expenses. Inpatient Services $5,088,718 Long Term Care Services $1,992,678
Physician Services $2,647,644
Emergency Department Services $2,989,111
CFVH is a non-profit organization
Outpatient Services $13,859,848
Home Health & Hospice $499,612
Salaries, benefits and contract labor comprise approximately two thirds of the hospital’s total operating expenses. CFVH is the largest employer in Sanders County. When salary dollars are spent locally, it is estimated they generate a multiplier effect of six times as they circulate to support the local economy.
2016
Operating Expenses
In addition to over $12.2 million in staffing related expenses, CFVH paid nearly $2.7 million to local vendors in Western Montana for services and supplies during 2016. $493,049 $237,717
$997,426 $530,660
$398,830 $12,201,120 $1,420,149
$1,907,730
Local REACH students learn about bones at on-site visit.
Nearly $2.7 Million was paid to local vendors in Western MT for services and supplies during 2016
2016 QUICK FACTS 26,852 Total Outpatient Visits
698 Mammograms
23,009 Operating Room Minutes
5,170 Rehabilitation Visits
3,455 Emergency Room Visits
1,562 CT Scans
50,791 Laboratory Tests
34 Babies Born
448 Echocardiograms
492 MRI Exams
17,401 Clinic Visits
FIRST HAND EXPERIENCE Local Residents Regain Hope of Healthier Living All-star student Carol Thomas of Plains, MT never missed a single class in her year long journey to lose weight as part of the Lifestyle Balance Course offered by CFVH. She signed up for the course without hesitation from the suggestion of her neighbor. She had high hopes of losing weight and she did just that…she lost over 65 pounds and completed the course feeling better than she has in years. Carol’s sister died of Diabetes and at age 64 and Carol knew if she didn’t make a change, she could end up with the same diagnosis. Establishing new eating habits that included more fruits and vegetables in her diet was a must for her transformation. She also started to exercise on a regular basis. “The group atmosphere provided me the support I needed to make a positive change in my life. The classes also encouraged me to keep working hard so I could see my weight go down each time I had to weigh in,” explained Carol who said she would recommend the course to others in the area looking to lose weight. Matt Schrader, 42 year old Thompson Falls resident, also had a positive experience going through the course. He said, “Everyone was encouraging and supportive and every session offered essential information for me to make a true difference and change in my life.” Matt signed up knowing his health depended on losing weight and decreasing his blood pressure. Like Carol, he had a family history of diabetes that was at the forefront of his decision to join the program. Predominant lifestyle changes Matt made and that he said he would continue into the future were tracking the foods he consumed and incorporating consistent exercise into his daily routine. Both were essential to his success. “I really appreciated the class lasting for an entire year. This time frame helped me to apply what I learned with support through just about every life situation...holidays, birthdays, highs and lows,” said Matt who lost 44 pounds by the end of the course. “Each instructor was very knowledgeable and I appreciated their continuous support. All were available between classes for questions and additional support whenever I needed it.”
Retired Flight Nurse Finds Support in Care Coordination
In October of 2015, a fall resulted in a concussion, some bruised ribs, nerve damage to one of my ears and some short term memory loss. I hadn't considered my fall to be a major event but the fall in addition to a diagnosis of Congestive Heart Failure and Pulmonary Hypertension left me feeling more and more tired each day. My mobilPatient Testimonial ity and strength were so limited I could hardly leave my house or lift anything at all. I also had to be on full-time oxygen and had accumulated what they call interstitial fluid, leaving me with 50 extra pounds of excess water weight. I contributed many of my symptoms to old age but began accepting my deterioration as my new reality. In July of 2016, I began Care Coordination Services at CFVH which introduced me to Shelby Zenahlik, Care Coordinator. In our first few months of working together, I pretty much had accepted my fate and didn't think I would be around much longer. This mindset led to a lack of effort on my part to contribute much of anything to getting better. I was seeing five or six different providers and specialists at the time and my health was continuing to decline. An August family reunion left me even more dismayed about my situation as many of my relatives realized the severity of my condition and pushed my wife and I to get our affairs in order before I got worse. A few days later, I began Pulmonary Rehabilitation. This course in addition to the support of my providers and Care Coordination saved my life. I am back on track and feeling better than I did prior to my fall. Care Coordination in particular has helped ensure I don't get lost in this confusing world of healthcare. Even as a retired flight nurse and RN, I needed a representative and advocate within the medical community to intervene when necessary. Shelby has been instrumental in me getting my life back. She has worked with me and my providers to ensure I have the appropriate medications as well as get necessary appointments in a timely and efficient manner. More than anything...she motivated me to make the changes required to get better. For that, I will forever be grateful. My quality of life has been renewed. I am off my oxygen and have rebuilt enough strength to resume my active duty as a volunteer fire fighter. I would recommend Care Coordination to anyone but especially those who have chronic conditions and are faced with working with multiple providers and specialists. Let someone from the inside advocate for you and make sure you don't fall through the cracks. - Ronald King . Plains, MT
BEYOND HEALTHCARE 2016
Community Benefit
As a tax-exempt non-profit healthcare provider, it is an important part of our mission to maximize and measure the benefits we provide to the communities we serve. Some of the benefits we provide are more obvious in nature, such as financial assistance to low income patients which amounted to $333,221 in 2016. Other community benefits are not as well known, but are nonetheless diverse and include: Community Benefit Operations Community Building Activities Community Health Improvement Services Financial and In-Kind Contributions Health Professions Education Subsidized Health Services During 2016, CFVH employees tracked over 1,020 hours of work time dedicated to various community activities. In addition, those same individuals identified over 830 hours of their own personal time supporting various community endeavors like: Ambulance and EMT Services Cancer Network of Sanders County Chronic Disease Self-Management Courses Local Volunteer Fire Departments Meals on Wheels Sanders County Council on Aging Youth Sport Leagues
Subsidized Health Services $11,806 Health Professions Education $623
Financial & In-Kind Contributions $53,875
Community Health Improvement Services $18,012
Community Benefit Operations $3,256 Community Building Activities $3,979
CFVH was a proud sponsor of the Wildhorse Shootout 3 on 3 Basketball Tournament in Plains, MT last summer. Pictured left: The Four Aces - Plains residents, Aubrey Burrows, Ava Lawyer, Ashley Ferlan and Aly Roy.
Over $333,000 was provided in Financial Assistance to low income patients in 2016
Blue Heron Karate Academy Sponsored By Clark Fork Valley Hospital and Family Medicine Network The Blue Heron Karate Academy that features the art of Shorin Ryu within the Kobukan Karate Federation is going strong into 2017 after two years of classes led by Jason Williams, CFVH Environmental Services and Facility Services Manager and 2nd Degree Black Belt. Students mostly consist of hospital employees and their families but community members are welcome as space is available. Presently there are twenty-nine students enrolled with varying skill levels. They train weekly and focus on skills consisting of self-discipline, self-defense and self-development. (Pictured Right: Plains resident - Lyla Mortenson)
Bus Emergency Simulation Helps CFVH And County Agencies In Emergency Planing And Preparation Twenty-seven victims of a simulated bus crash were tended to the day of December 3rd to test emergency preparedness and mutual aid throughout Sanders County. The incident centered around a Thompson Falls bus crashing just north of Plains as a result of its driver having a heart attack. Passengers included mainly students but also consisted of three adults and inflatable victims for the use of training to address a variety of injuries with ranging severity. The hospital as well as the ambulance services participate in drills like this annually to meet requirements for emergency preparedness grants that help supply the county with a number of resources they wouldn't be able to afford otherwise. These could be items like triage tents, incident command training courses for staff all the way to hazmat cleaning stations. The drill also helped to identify efficiency between agencies which would be helpful in the event of a real disaster.
QUALITY AS A CORE VALUE Tim Johnston, CRNA, Anesthesia I’ve worked in hospitals from San Francisco to Boston and several in-between. In my experience, many patients wait three to six months to have their procedures scheduled and rarely see a familiar face on the day of their surgery. Surgical patients at CFVH are scheduled quickly, if not same day, and are often attended to by friends and neighbors. This provides convenience and an additional element of trust to the genuine and personalized care they receive here. Facing a surgical procedure is stressful for most patients. It’s gratifying to me to alleviate those fears and a privilege when patients rely on me to care for them. I help contribute to quality care through vigilance. There are so many variables and decisions to be made in anesthesia. Our primary focus is patient safety and this leads to the best care possible. My role within the facility allows me to work in cooperation with many departments and medical staff. Anesthesia and the OR team work closely with supporting departments like Imaging and Cardiopulmonary Services. In addition, the talent of our medical staff is an important component of surgical readiness as they optimize patients for surgery. Our medical providers ensure that the patient’s blood pressure is under control and respiratory ailments are properly treated. This results in a safe and balanced delivery of anesthesia.
Julia Ulvick, Acute Care RN As a busy wife and mother of two enjoying a rural lifestyle in Lonepine, I was fortunate to attend nursing school at Salish Kootenai College in Pablo while working close to home as a CNA at Hot Springs Family Medicine. I truly valued my experience in the clinic working alongside my mentor, Paula Stobie, MN, BSN, RN. My family is firmly es-
was natural so I could continue �n my journey to give back to my community. As a nurse on Acute Care, I am continually impressed to see my team share my same commitment to our community and dedication to patient centered care. CFVH allows me the opportunity to develop my skills in caring for patients of all ages. It has become my passion, not only to support the community by providing superior patient care, but also by acting as a mentor to others seeking to advance and achieve their career goals without venturing far from their homebase here in Sanders County. I recommend CFVH to all my friends and family for their primary, emergency, and labor and delivery care needs in addition to career opportunities.
Katie Kostelecky, R.T. (R)(CT), X/Ray, CT Technologist Human anatomy and physiology have always fascinated me so the choice to pursue a career in healthcare where I could combine those interests with a love for helping people just made sense for me. Becoming a radiologic technologist however wasn’t on my radar until my first year of college. My roommate broke her leg playing softball and when she showed me her x-ray films before and after her surgery, I was hooked! While I completed some of my hands-on training at CFVH as a student, I found I enjoyed working with smaller teams of technologists, nurses and providers in contrast to bigger healthcare facilities where no one knew who I was. The team atmosphere here was unlike anything I had experienced. Every department worked cohesively for the benefit of the patient and I knew I wanted to be a part of a team like that when I graduated. Once I began work at CFVH, I was immersed with continuing education opportunities at every turn and was able to advance my skills to include more complex imaging studies, bone density scans (DXA), and CTs with the necessary IV placement. For a rural community like Sanders County, the vast services offered at CFVH are impressive despite the limited resources. The Imaging Department in particular features state-of-the-art equipment that produces high quality images equivalent to if not better than larger facilities I’ve been to. This is a true blessing for residents of our county to know they can rely on our hospital for premier imaging services so close to home. My contribution to quality patient care goes beyond diagnostics and embodies the emotional support I can provide my patients, who are often hearing about a difficult diagnosis for the first time. Anticipating results during a lengthy exam can add to their uneasiness, so I make an exerted effort to comfort them, make them laugh or simply listen while they sort through their feelings.
24 HOUR EMERGENCY SERVICES Trauma Designated Facility Since 2008 - MT DPHHS From minor injuries to more complex medical emergencies and trauma care, CFVH is Sanders County's 24 Hour Resource. Below is our team of providers who perform both emergent and inpatient duties simultaneously. This trend of combining ED and Hospitalist provider roles has to do with streamlining operations and decreasing costs which is particularly important for CFVH as a critical access hospital (CAH). It also creates an opportunity to enhance patient care and safety as the same provider admitting them to the hospital, oftentimes is the one caring for them as an inpatient.
Emergency Department (406) 826-4875 Benny Lindeman, DHSc, PA-C Emergency Medicine/Hospitalist
Karyn Thornton, PA-C Emergency Medicine/Hospitalist
Robin Trull, PA-C Emergency Medicine/Hospitalist
Ronald Black, MD Emergency Medicine/Hospitalist Obstetrics
These providers represent a combined total of
115 YEARS
of experienced patient care.
Jessica Valentine, MD Emergency Medicine/Hospitalist Obstetrics
When Every Second Counts
FAMILY MEDICINE NETWORK The Clark Fork Valley Family Medicine Network provides a comprehensive base of services to Sanders County residents through three Family Medicine Network offices and an expansive rehabilitation program. Care Coordination Services additionally became available last year and help people with multiple chronic conditions navigate our complex world of healthcare. For more information about Care Coordination, search: CFVH, Plains, MT on YouTube. Mental and Behavioral Health Services are available from each of our Family Medicine Network offices across the county. Services include individual therapy for children, adolescents and adults as well as couples and family therapy. Dr. Whipple-Kilmer also provides a broad variety of in-depth diagnostic, cognitive, academic and other psychological assessments and evaluations. Additional services are offered by our network of specialty care providers to keep your medical care closer to home, family and friends. These services include Audiology, Cardiology, Endocrinology, Neurology, Orthopedics, Psychiatry and Pulmonolgy.
Plains (406) 826-4810
Thompson Falls (406) 827-4442
Nick Lawyer, PA-C Family Medicine
Jennifer Strine, PA-C Family Medicine
David Costner, APRN Family Medicine
Paul Haynes, MD Family Medicine
Jeanne Williams, MD, PhD Family Medicine Obstetrics
Erik Digby, PT Physical Therapy
Ronald Black, MD Obstetrics Jessica Valentine, MD Obstetrics
Nicole Feliksa, PT Physical Therapy
Hot Springs (406) 741-3602
Gregory Hanson, MD Obstetrics
Pamela Vecchio, APRN Family Medicine
Donald Damschen, MD Surgical Services
John Drye, MD Family Medicine
Stan Stanhope, DPT Physical Therapy
Stan Stanhope, DPT Physical Therapy
Stephanie McNulty, PT Physical Therapy Trent Harmon, PTA Physical Therapy Mary Russell, OTR/L Occupational Therapy Elizabeth Johnson, MCSD, SLP Speech Therapy
Care Coodination Services Available Upon Referral
Shelby Zenahlik, BSN, RN Care Coordinator
Mental and Behavioral Health Services Available at all FMN Offices Kate Whipple-Kilmer, PsyD Mental and Behavioral Health Diana Reetz-Stacey, LCSW Mental and Behavioral Health
QUALITY SERVICES Audiology Acute Inpatient Care Post Acute Swing Bed Cardiology Pacemaker Clinics
Echocardiography Lung Function Studies Sleep Studies Care Coordination
Plains, MT 59859
Cardiac Stress Testing
PO Box 768
Cardiac Monitoring
Clark Fork Valley Hospital
Cardiopulmonary Services
CPAP/Home Oxygen Dermatology
Orthopedics
Skin Checks
Pain Management
Lesion Removals
Prenatal Classes
Diabetes Education Emergency Services Endocrinology Full Service Medical Laboratory Home Health & Hospice Care Imaging Services
Primary Care Diabetes Management Immunizations Internal Medicine Medicare/Wellness Visits Physical Exams
CT/MRI Scanning
Pre/Post Operative Exams
Digital Mammography
Treatment of Illness
DXA (Bone Density)
Women’s Health
Ultrasound
Pulmonology
Long Term Care
Psychiatry
Mental and Behavioral Health Services
Rehabilitation Services
Neurology Nutrition Counseling Obstetrical Care
Aquatic Therapy Occupational Therapy Physical Therapy Pulmonary Rehabilitation Speech Therapy Surgical Services General Surgery Orthopedic Surgery