2015 - 2016
ANNUAL REPORT
The Shift in Healthcare Greater Focus on Preventive Medicine
Clark Fork Valley Hospital & Family Medicine Network
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
FAMILY FRIENDLY CARE
MESSAGE TO THE COMMUNITY In recent years hospitals across the nation have been challenged to rethink the fundamentals of the work each performs in its community. Focus is being placed on community health, preventive medicine and improving the coordination of care for everyone. The Affordable Care Act accelerated this shift that is now moving at a faster pace than ever thought possible. Clark Fork Valley Hospital has participated in this dynamic change by sponsoring Lifestyle Balance Programs, Chronic Disease Management education and physical activity and wellness classes. We believe this work will have a benefit to our communities with improved long term health and quality of life. We are participating in a Medicare program that is giving us the opportunity to learn how to operate under new value-based payment models. One of the most exciting aspects of the program is the addition of a Care Coordinator who will work with our providers to ensure Medicare patients receive the care they need. We remain committed to staying current with technological advances and offering additional services when it makes sense for our communities. A new 64 slice CTscanner was installed last year and we plan to upgrade our hospital monitoring system later this year. Pulmonary Rehabilitation Services are now being offered from our Thompson Falls Family Medicine office where new therapy equipment will also be added by year end. Most importantly, we continue to hire new staff that have the training and compassion to deliver the high quality care and personal attention you deserve. This year Jessica Valentine, MD joined our provider staff as a hospitalist and obstetrics provider, David Costner, APRN is now seeing patients at Plains Family Medicine and Eric Digby, PT and Stephanie McNulty, PT joined our Rehabilitation team. Each of these individuals strengthen our team of dedicated employees who work hard year round to serve you. As Clark Fork Valley Hospital celebrates 45 years of service to Sanders County we would like to thank you for the trust you have placed in us. We have been honored by your loyalty and we pledge to continue to serve you...our friends and neighbors, in a way that is deserving of your trust. - Gregory Hanson, President/CEO
45 Years of Service
To the Sanders County Community
COMMUNITY BASED BOARD 2016
Board Members
Jerry Pauli, Chairperson . Thompson Falls, MT Denise Benson, Vice Chairperson . Plains, MT Jeanne Williams, MD, PhD, Chief of Medical Staff . Plains, MT Gregory Hanson, MD, President/CEO . Plains, MT Erika Lawyer . Plains, MT Erin McCarthy . Plains, MT Don Damschen, MD . Plains, MT Devin Huntley . Missoula, MT Bina Eggensperger . Thompson Falls, MT Mike Baxter . Thompson Falls, MT Kevin Meredith . Plains, MT
AWARDS AND RECOGNITION FOR QUALITY CARE CMS 5 Star Quality Rating - February 2015 CFVH’s Long Term Care received an Overall 5 Star Rating from the Centers for Medicare and Medicaid based on health inspections, staffing and quality measures.
Andean Health 1500 Rural Health Award - June 2015 Andean Health works to improve rural health in the Americas and chose to recognize CFVH for its innovative approaches to rural healthcare.
Montana Rural Healthcare PIN Quality Improvement Award - October 2015 The Montana Performance Improvement Network (PIN) recognized CFVH for quality improvement in Medication Reconciliation and Emergency Department transfer communication.
iVantage Health Excellence in Quality Award - November 2015 iVantage Health Analytics recognized CFVH for overall excellence in quality, reflecting a standing in the top 25 percent of all acute care hospitals in the nation. The metrics used were based on quality indicators for patient care in acute heart attacks, heart failure, pneumonia, surgical care infection prevention and outpatient process of care scores.
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 10th year, the CFVH Foundation has raised over $350,000 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 2015 we focused our efforts on purchasing state-of-the-art fetal heart monitoring equipment for laboring mothers. This equipment will allow us to continue to provide a safe environment for both mothers and infants. This year our focus is to enhance Rehabilitation Services, particularly to update equipment utilized for therapy within our Thompson Falls Family Medicine office.
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.
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
Coleman Road Trip Propane Portable Grill LXE. Once you have confirmed your subscription, you will be entered into a drawing to be held September 30, 2016. The winner will receive a brand new Coleman Road Trip Propane Portable Grill LXE. With your subscription to CFVH Health Communications, you will receive the CFVH Health Connection E-Newsletter and CFVH and community health related special offers and event announcements.
INSIDE LOOK - FINANCIALS 2015
Gross Patient Revenue
Of each dollar in charges for healthcare services, CFVH collected approximately 67 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.
2015
Operating Expenses
In addition to over $11.3 million in staffing related expenses, CFVH paid nearly $1.5 million to local vendors for services and supplies during 2015. $519,184 $116,325
$1,004,126 $422,131
$267,033 $416,680 $11,342,966 $1,484,756
$2,014,609
Nearly $1.5 Million was paid to local vendors for services and supplies during 2015
Derek Halden, RN practices skills at Comprehensive Advanced Life Support (CALS) Training Course
2015 QUICK FACTS 25,293 Total Outpatient Visits
645 Mammograms
23,655 Operating Room Minutes
3,364 Emergency Room Visits
4,920 Rehabilitation Visits
1,328 CT Scans
17,182 Clinic Visits
25 Babies Born
573 Echocardiograms
49,515 Laboratory Tests
548 MRI Exams
FIRST HAND EXPERIENCE Pulmonary Rehabilitation Increases Lung Function for Thompson Falls Resident
In October of last year, I began Pulmonary Rehabilitation based on a referral from my Pulmonologist in Missoula. I had reservations as I have been fighting COP (Cryptogenic Organizing Pneumonia) for several years and nothing has really seemed to help except medication.
Patient Testimonial
Pulmonary rehab gave me the skills and resources I needed to drastically improve my quality of life. I learned valuable breathing and exertion techniques that have helped me regain lung function I never thought possible. At age 60, I have also adopted preventive measures while working in my woodworking and blacksmith shop that I should have done years ago to help me breathe.
To my surprise, after completing the class, I was able to work in my garden and stack firewood again...things I haven’t been able to do for a very long time.
More than anything, pulmonary rehab gave me hope of a better life moving forward. I now know I can keep making progress and I am happy to have felt the support of other community members facing similar life challenges. I will be forever grateful for the CFVH Cardiopulmonary Team who were so encouraging through the process of regaining my health. I have a long way to go, but they have been so helpful to show me the way. - Mark Hedahl . Thompson Falls, MT
Restless to Re-Energized with CPAP Machine Patient Testimonial
After ten plus years of getting up multiple times per night, never feeling rested and feeling the need to nap midday, I decided to have a Sleep Study done earlier this year. The sleep study showed I was suffering from Sleep Apnea and I have been using a CPAP machine ever since. I now sleep through most of the night, only waking one or two times and have so much more energy. An avid carpenter at age 57 and caregiver to my 76 year old mother, I stay quite busy. I don’t nap during the day anymore and I can do all the things I need to do and love with less breaks. The CPAP mask was hard to get used to at first but the Cardiopulmonary Team at CFVH worked with me to try a number of masks to see which would suit me best. They were thorough in my care and prompt to get back to me whenever I had questions. Now that I have used the CPAP machine for a few months, I don’t even notice it is there. I love it and won’t sleep without it. It has changed the quality of my life by changing how I function through the day and I’m not sure why I ever waited so long to get tested. - Robert Powell . Plains, MT
BEYOND HEALTHCARE 2015
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 charity assistance and sliding scale discounts to low income patients which amounted to $593,134 in 2015. 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 During 2015, CFVH employees tracked over 460 hours of work time dedicated to various community activities. In addition, those same individuals identified nearly 1,000 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 Chambers of Commerce Local Volunteer Fire Departments Sanders County Council on Aging Strong Women Courses School Boards Serve Safe Classes Youth Sport Leagues
Community Health Improvement Services $505
Financial & In-Kind Contributions $62,903
Community Benefit Operations $3,192 Community Building Activities $2,344
TaLoni DuBois, RT instructs Heron Resident, Hayli Jensen about breathing treatments during on-site visit.
Nearly $600,000 was provided in Charity Assistance and Sliding Scale Discounts in 2015
Medical Students Immersed in Rural Medicine WWAMI Students Join CFVH for Four-Week Elective Immersion Experiences CFVH partnered with the Rural/Underserved Opportunities Program through the University of Washington WWAMI Program to bring second year medical students on site for four-week elective immersion experiences in community medicine. Students worked side-byside our medical providers and specialists to provide healthcare to Sanders County residents in a variety of care settings. It is our hope that healthcare career exploration opportunities like these will increase interest in rural medicine and create lasting connections with students who may potentially return to our area to work.
Providers Serve as Emergency Medical Directors To Bring Continuity of Care to Emergency Medicine in Sanders County Clark Fork Valley Hospital providers, Dr. Ron Black and Ben Lindeman, PA-C, serve as EMT Medical Directors for Thompson Falls, Plains and Hot Springs to bring continuity of care to emergency medicine in Sanders County. Both providers spend a great deal of time ensuring local EMTs have the training they need to perform in trauma situations where time is of the essence. Pictured below: Dr. Ron Black trains local EMTs on intraoseous (IO) bone insertions which are utilized in trauma situations where the patient has undergone severe injury and needs lifesaving fluids like they would receive from an IV in a hospital setting.
QUALITY AS A CORE VALUE Hospital Average Mortality Rate Montana CAH Hospitals - 3.80%
CFVH - 0.25% Source: Performance Improvement Network of MT
Hospital Acquired Infection Rate Montana CAH Hospitals - 1.47%
CFVH - 0.016%
HOW DO WE COMPARE ON QUALITY INDICATORS?
Source: Performance Improvement Network of MT
Unplanned Return To ER Within 72 Hours Montana CAH Hospitals - 5.75%
CFVH - 3.1% Source: Performance Improvement Network of MT
Unplanned Return to Surgery All US Hospitals with Surgical Services - 2.57%
CFVH - 0.0% Source: Volunteer Hospitals of America
Overall Quality Measurement National Hospital Strength Index
CFVH - Top 3% Nation Wide Source: iVantage Health Analytics Hospital Strength Index
Ashley Hall-Hand, RN, Long Term Care Manager My grandparents raised me with the utmost love and compassion and showed the same to those around them regardless of their circumstances. As I grew, I saw how genuine care could impact a person’s life and I knew I wanted to give that same gift to others around me. It wasn’t until I was working at a group home for troubled teenage girls that I discovered I wanted to be a nurse. I believed nursing school would allow me to live out my true passion of caring for others and impacting their lives in a meaningful way. I returned to my hometown of Plains to begin work at CFVH fresh out of nursing school. Earlier this year, I transitioned into my new role as Manager of our
Long Term Care facility. I appreciate my team because we are able to learn and grow together. I have seen firsthand the support we show for each other while working towards a common goal‌the health and wellbeing of our community. Quality care requires a voice from our residents and I am proud to have the opportunity to advocate for them whenever possible. I hold myself accountable to our mission and hold my staff to the same so our residents get the quality care they deserve.
Aria Mangan, MS, CHES, Community Health Improvement Specialist At CFVH, I get to work with some amazing people‌ones that go the extra mile to provide exceptional patient care because they are genuinely invested in our patients who often are our very own family, friends and neighbors. I have felt especially fortunate to have had my own opportunities to make meaningful contributions to the Sanders County community. As the Community Health Improvement Specialist for the hospital, I primarily focus on community outreach with the goal of improving the health of Sanders County residents. I help patients gain the necessary tools and skills they need to manage their own health and slow down the progression of chronic conditions that can be costly to treat. Every day I aspire to connect with local residents to share with them information they can incorporate into their daily lives. Whether it be about diabetes prevention, chronic disease management or even strength training, I want to be a resource for people as they strive to be the best version of themselves. I love working with people and seeing them succeed. A number of individuals who have taken my classes have shared with me that they are making healthier choices, seeing positive change and feeling better than they have in years. Knowing that I can encourage them and show them a path to a healthier lifestyle will always be affirmation to me that I am in the right place and in the right career.
The Shift in Healthcare Greater Focus on Preventive Medicine
Typically, when you visit a healthcare facility, it is because you are already ill or are seeking treatment for a medical condition. Healthcare professionals do their best to diagnose you and treat the issue with the emphasis and focus on making you well again. Today, we are seeing a shift in healthcare where there is a much greater focus on prevention. Patients are encouraged to take necessary steps to monitor and enhance their overall wellbeing to decrease the progression of chronic conditions that are costly to treat and harmful to the patient’s overall health. More emphasis is being placed on self-care where patients take a larger role in their own health. CFVH assists in providing the necessary tools and skills individuals need to be successful in caring for themselves. As a result, we are seeing a decrease in hospital readmissions and an increase in patient compliance and better outcomes. Patients in today’s healthcare system are going to be encouraged to have an annual wellness visit with their primary care provider to address all of their relevant healthcare issues which will in turn save the patient and the healthcare facility money in the long run.
FAMILY MEDICINE NETWORK The Clark Fork Valley Family Medicine Network provides a comprehensive base of services to Sanders County residents through three Family Medicine offices and an expansive rehabilitation program.
Mental and Behavioral Health Services Mental and Behavioral Health Services are now being offered at 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.
Plains (406) 826-4810
Thompson Falls (406) 827-4442
Nick Lawyer, PA-C
Jennifer Strine, PA-C
Family Medicine
Family Medicine
David Costner, APRN
Raymond Nelson, MD
Family Medicine
Family Medicine
Jeanne Williams, MD, PhD
Erik Digby, PT
Family Medicine Obstetrics
Physical Therapy
Ronald Black, MD Obstetrics
Jessica Valentine, MD Obstetrics
Gregory Hanson, MD Obstetrics
Stan Stanhope, DPT Physical Therapy
Stephanie McNulty, PT Physical Therapy
Hot Springs (406) 741-3602 Kimberly Schwittay, APRN Family Medicine
John Drye, MD Family Medicine
Stan Stanhope, DPT Physical Therapy
Mental and Behavioral Health Services Available at all FMN Offices
Mary Russell, OTR/L
Kate Whipple-Kilmer, PsyD
Occupational Therapy
Mental and Behavioral Health
Elizabeth Johnson, MCSD, SLP
Diana Reetz-Stacey, MSW
Speech Therapy
Mental and Behavioral Health
QUALITY SERVICES Audiology Acute Inpatient Care Post Acute Swing Bed Cardiology Pacemaker Clinics
Echocardiography Lung Function Studies Sleep Studies CPAP/Home Oxygen
Plains, MT 59859
Cardiac Stress Testing
PO Box 768
Cardiac Monitoring
Clark Fork Valley Hospital
Cardiopulmonary Services
Diabetes Education Emergency Services Full Service Medical Laboratory Home Health & Hospice Care Imaging Services
Rehabilitation Services Aquatic Therapy Occupational Therapy Physical Therapy
CT/MRI Scanning
Pulmonary Rehabilitation
Digital Mammography
Speech Therapy
DXA (Bone Density) Ultrasound Long Term Care Mental and Behavioral Health Services Neurology Nutrition Counseling Obstetrical Care Ophthalmology Orthopedics Pain Management Prenatal Classes Primary Care Diabetes Management Immunizations Internal Medicine Medicare/Wellness Visits Physical Exams Pre/Post Operative Exams Treatment of Illness Women’s Health
Surgical Services Cataract Surgery General Surgery Orthopedic Surgery Pacemaker Surgery