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Annual Report & Community Benefit 2013
Changing The Caring Experience...
Message to the Community Healthcare is evolving. The implementation of healthcare reform is changing how healthcare is delivered. There is pressure to exceed quality standards while streamlining services. Hospitals are moving away from “fee-for -service” to “feefor- value” healthcare systems. Drivers are in place to eventually have continuum of care across all healthcare access points. And most importantly, the Affordable Care Act is expecting all of us to be knowledgeable, engaged and responsible for our own health.
Changing The Caring Experience...
Longmont United Hospital is rising to meet the challenges that the Affordable Care Act brings. We continue to exceed The Joint Commission quality standards (page 14). We have implemented several readmission reduction programs that provide full continuum of care, including post-hospital care. These same programs identify high-risk patients then intervene to prevent readmissions. The services of primary care physicians are offered in surrounding communities who needed medical services. Preventative practices such as annual exams or vaccinations are now easily accessed. This includes opening Indian Peaks Medical Center (page 6) to meet the needs of the Carbon Valley area. Communication of patient health through patient portals is gradually coming available. We anticipate completion of the Hospital and Milestone Medical Group portals by the end of next year. Patient portals are a secure online service that gives patients access to view his or her personal medical record.
In 2013, we also completed the first Community Health Needs Assessment. This allowed us to identify population health improvement strategies. This year we focused on reducing obesity and diabetes by teaching healthy habits at a young age when habits are still forming. (Healthy Learning Paths page 10). On a different note, last September the communities we support experienced a 1000 year flood. Our staff demonstrated their commitment to caring for the community by going above and beyond their responsibilities to help those in need. Unfortunately the Hospital, along with the other Front Range Hospitals, was impacted with a significant admission reduction during this recovery period (page 16). We look forward to continuing to serve our patients and communities with the high level of quality and respect that they have come to expect. We are also extremely appreciative of the dedication our employees, physicians and volunteers demonstrated during the flood and through evolving healthcare. Thank you for your interest in our progress. We welcome your suggestions in providing safe, excellent care. Mitchell C. Carson, President & CEO Richard N. Lyons, Chairperson, Board of Directors
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Longmont United Hospital’s Surgeon Removes Gallbladder through Belly Button Incision with da VinciŽ System
Changing The Caring Experience...
A surgical team at Longmont United Hospital performed their first da Vinci® Single-Site™ Cholecystectomy on February 15, 2013. The patient’s gallbladder was removed through one tiny incision in the belly button, making the procedure virtually scarless. Led by Robert L. Powell M.D., general surgeon at Longmont United Hospital, the team removed the gallbladder using SingleSite™ instruments on a da Vinci® System. The minimally invasive procedure is traditionally called a laparoscopic cholecystectomy (removal of the gallbladder). Using robotic assistance, surgeons removed the gallbladder through an incision of approximately one inch. Potential benefits of Single-Site gallbladder surgery may include virtually scarless results, minimal pain, low blood loss, fast recovery, a short hospital stay and high patient satisfaction. The surgery can be performed in about one hour with a typical hospital stay of less than 24 hours.
“Neither robotic surgery nor single-incision surgery is new, but combining the two to remove the gallbladder requires additional training and special equipment,” says Dr. Powell. “To be one of the first hospitals to offer this technically advanced surgery demonstrates Longmont United Hospital’s leadership in providing patients with the most up-to-date minimally invasive surgical options.” Dr. Powell is one of a small group of surgeons in the country who has received training to perform the surgery. “Single-Site instruments used with the da Vinci platform are the next step in the evolution of surgical technologies,” Dr. Powell said. “We are truly excited to be a leader today in the surgical treatment of tomorrow.”
Longmont United Hospital offers various types of robotic-assisted surgeries. In addition to gallbladder removal, Longmont United Hospital surgeons perform robotic-assisted surgery in general surgery, gynecology and urology. The Hospital also offers a wide range of minimally invasive conventional laparoscopic surgeries.
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Indian Peaks Medical Center opened in December 2013. Now offering quality healthcare, without the drive for those in the Carbon Valley area.
Changing The Caring Experience...
For years, people in Carbon Valley have made the drive for healthcare services. With the development of Indian Peaks Medical Center, healthcare services are coming to them. Indian Peaks Medical Center is beginning a four-phase plan that envisions the new facility eventually growing into a freestanding, full-service hospital. The present two-story, 36,000-squarefoot facility was built to be the home of Milestone Medical Group, Front Range Orthopedics & Spine, Health Center of Integrative Therapies. Routine exams and specialty services will now be hassle-free for the Frederick area. Its location and extended hours will add convenience for a long list of possible health services—offerings under consideration include nutrition consults and diabetes management services. Services available at Indian Peaks Medical Center: Family Medicine (Family Practice) services
• Experienced, caring physicians
• 12 exam rooms
• Laboratory Services
• L atest technology in patient medical records
• C onvenient hours including same day, evening and weekend appointments
Integrated Therapy services including acupuncture, massage, and more. Laboratory services – drop in
“Indian Peaks Medical Center was built to bring the best healthcare with the best technology to a community in need of healthcare services,” expounded Peter Powers, director, business development, Longmont United Hospital. “With the present medical professionals, preventative care and healthy lifestyle practices will be part of all our new neighbor’s lives. We are very excited to be part of this community”
Megan Grotefend MD and Derek Wright MD joined Milestone Medical Group at Indian Peaks Medical Center. Dr. Grotefend comes to Milestone Medical Group from Durango, Colorado after almost ten years in private practice. She has a strong interest in helping patients to become healthy and stay healthy. Dr. Wright was a faculty physician at Idaho State University Family Medicine Residency and also practiced in Cody, Wyoming. Milestone Medical Group is located in Berthoud, Frederick, Longmont, Lyons and Niwot.
X-ray imaging Orthopedic services
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Longmont United Hospital received the Healthyroads Fit Company Gold Award速 from American Specialty Health Inc.
Changing The Caring Experience...
The Healthyroads Fit Company Awards program recognizes organizations nationwide who are leaders in the areas of employee wellness and preventive health care and who demonstrate their commitment to wellness by offering exceptional employee wellness benefits and services. The Gold Award is the highest level of recognition for employee wellness programs by American Specialty Health Inc. American Specialty Health Inc. is a national health services organization that provides fitness, exercise and healthy aging programs, population health solutions and specialty health care programs for health plans, Medicare Advantage Plans and/or employer groups. Longmont United Hospital’s "Embrace Wellness" program includes employee biometric screenings, personal health assessments, company-wide weight loss and fitness challenges, health education, stress reduction, tobacco cessation and a web-based, integrated wellness portal that helps employees track their health improvement goals. The web portal provides employees with fun and educational opportunities to become engaged in wellness and personal health management through audio and video education, health quizzes and motivational reminders.
Employees who participate in the company wellness program can earn points for their health activities and preventative health checkups. Participating employees who reach their goals can receive a $1,000 premium discount annually on their medical insurance. The Hospital’s wellness program has achieved a participation rate of 77 percent of employees.
“We have seen employees actively participate in programs to decrease stress, increase physical activity and focus on nutrition,” said Keri Isernhagen, director of physical medicine, Longmont United Hospital. “The Hospital and its employees have been able to benefit from the financial rewards of leading a healthier lifestyle.”
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Longmont United Hospital commits to improving children’s health in the community with new health education program
Changing The Caring Experience...
Longmont United Hospital has joined forces with Healthy Learning Paths to bring health education to schools who are interested in empowering children with skills for health, as well as enhancing their science curriculum with the exploration of the science of the human body. Healthy Learning Paths is a non-profit organization that collaborates with medical professionals and educators to bring standardsbased health curriculum to children. This curriculum meets the Colorado Department of Education health education standards. Training of a group of Longmont United Hospital medical professionals and retired teachers begins next week with the Be Well, Learn Well® curriculum created by Healthy Learning Paths. Once trained, Longmont United Hospital will offer these services to schools who are interested in expanding their health and science curriculum.
“We have plenty of research that shows how to prevent diseases, now it is time to venture into classrooms where we can empower children with skills for health and happiness,” explains Dr. Marchioni. “With the help of Longmont United Hospital, we’re taking the best medical practices out of the doctor’s office and putting them in the classroom and community where we can make the biggest impact both in health and learning success for children.”
Healthy Learning Paths is creating a new field in the health care industry where best practices in medicine are delivered to children in schools.
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Longmont United Hospital is among the “Top 10% in the Nation” and is recognized as one of Healthgrades 2013 “Outstanding Patient Experience Award™” Recipients
Changing The Caring Experience...
Longmont United Hospital has been named one of a select group of hospitals identified as providing outstanding performance in the delivery of a positive experience for patients during their hospital stay, as evaluated by Healthgrades®, the leading online resource that helps consumers search, evaluate, compare and connect with physician and hospitals. To be eligible for the Healthgrades 2013 Outstanding Patient Experience Award™, Longmont United Hospital met the clinical quality threshold for this award and have data for a minimum number of HCAHPS surveys: • Clinical Quality Threshold – Longmont United Hospital ranked among the top 80% of hospitals for clinical quality as ranked by average z-score across the conditions and procedures that Healthgrades evaluates using Medicare data. • Minimum Number of HCAHPS Surveys Longmont United Hospital had data for at least 100 Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys to reliably assess performance.
“Our interdisciplinary team of healthcare professionals is focused on creating an excellent patient experience for all those we serve,” commented Nancy Driscoll, Chief Nursing Officer, Longmont United Hospital. “Patient and family involvement in planning for care ensures achievement of the goals that are important to the patient and builds a positive experience for everyone involved.” “Longmont United Hospital works hard “Longmont United Hospital works hard to create a caring, peaceful and comfortable environment for its patients,” said Mitchell C. Carson, president & CEO, Longmont United Hospital. “Being among the top 10% in the nation for patient satisfaction is an honor that is well earned by our staff, physicians, and volunteers.”
At Longmont United Hospital, patient experience initiatives stem from our commitment to practicing the Planetree components of patient-centered care. Longmont United Hospital encourages involvement of family and friends in the care of their loved one through patient education. Complementary therapies, art, music, and spirituality are just some of the Planetree components offered.
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Strong scientific evidence demonstrates that performing the evidence-based care process improves health outcomes (either directly or by reducing risk of adverse outcomes).
Providing Quality Care As a Joint Commission accredited hospital, Longmont United Hospital is proud to report we have exceeded all the target rate performance requirements of accountability measures as set by The Joint Commission. The program is based on data reported in the previous year about evidence-based clinical processes that are shown to be the best treatments for certain conditions, including heart attack, heart failure, pneumonia, surgical care, children’s asthma, inpatient psychiatric services, stroke, venous thromboembolism, and immunization. The graph on the next page shows performance on just a few of the areas we measure.
Changing The Caring Experience...
Core Measures
Year ended December 31 100
2011
96
2012
92 Percent
2013*
88
84
80 Heart Failure
AMI
Pneumonia Surgical Care * Through third quarter of 2013
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Statement of Operations For the Year Ended December 31 (In thousands)
2013 2012 Revenue Patient service revenue (net of contractual allowance & discounts) 185,487 179,315 Provision for bad debts (19,126) (14,851) Net Patient Revenue 166,361 164,464 Other Operating Revenue __4,273 __3,861 Total Operating Revenue 170,634 168,325 Expenses Salaries and Benefits 85,567 78,665 Supplies and Other Expenses 66,713 68,158 Professional Fees 7,072 6,373 Depreciation 11,040 10,306 Interest & amortization __4,419 __4,557 Total Operating Expenses 174,810 168,060 Loss on bond financing (508) __0 Income from Operations (4,685) 266 Investment income and other, net 1,520 2,800 Unrestricted Revenue (Less than) in Excess of Expenses (3,165) 3,066
Condensed Balance Sheet December 31, 2012 & 2011 (In thousands)
2013
2012
Assets Cash 9,515 13,747 Assets for required Current Liabilities 4,495 4,009 Net Patients Accounts Receivable 25,228 21,489 Inventories 4,184 4,454 Other Current Assets _5,717 _4,041 Total Current Assets 49,139 47,740 Board Designated Funded Depreciation 65,133 73,031 Bond Indenture Funds 4,649 16,019 Less amount required for current liabilities (4,495) (4,009) Total Assets Limited To Use 65,287 85,041 Net Property, Plant, Equipment 115,798 106,008 Other Assets _10,967 _10,702 Total Assets 214,191 249,491 Liabilities and Net Assets Current Liabilities 26,237 24,809 Long Term Debt 97,752 102,878 Unrestricted Net Assets 113,333 118,245 Temporarily Restricted Net Assets __3,869 ___3,559 Total Liabilities and Net Assets 241,191 249,491
Changing The Caring Experience...
2013 Financial Highlights In 2013, Longmont United Hospital continued to maintain and advance the level of services, while sustaining its value as a contributing community resource, by providing over $43 million of benefits to the community. This result is $8.54 of benefit for each dollar of tax relief granted from being a tax-exempt nonprofit 501(c)3 hospital. Longmont United Hospital provided $5.4 million in charity care, $8.8 million in subsidized healthcare services, and over $26 million in unreimbursed costs of healthcare services received by low income and/ or aging members of the communities we serve. As you may know, the communities we serve endured a 1000 year flood in September 2013. We are very proud of the way our organization responded to this disaster and supported the community during the recovery. Unfortunately, the months immediately following the flood were difficult financially as our patient volumes declined and our uncompensated care increased. As a result, Longmont United Hospital recorded a net loss for the year.
For the year ended December 31, 2013, Longmont United Hospital had a net loss of $3.2 million or 1.9%. Inpatient days and outpatient visits were 32,127 and 131,345 respectively. Our Milestone Medical Group saw 37,605 patient visits for primary care, internal medicine, cardiology, obstetrics, and gynecology services. Total expenses increased by 4.3% as a result of higher salaries, supplies, and purchased services. As a non-profit community hospital, we are continually challenged to manage rising healthcare costs and declining reimbursement. We actively strive to achieve and maintain a strong margin so we can reinvest into services, equipment, and facilities while meeting the needs of the communities we serve. We are very proud of the Hospital’s caring staff and physicians who continually meet these challenges while providing extraordinary care and optimum patient satisfaction. Neil W. Bertrand Chief Financial Officer
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Helping People in the Communities We Serve Each year we help provide services to communities in need of food, healthcare, wellness, and education.
AIMS Community College American Cancer Society Arapahoe Community College Berthoud Chamber of Commerce Boulder College of Massage Boulder County Business Hall of Fame Boulder County Civic Forum Boulder County Fair Boulder Valley Care Network Boulder Valley Women's Health Center Carbon Valley Chamber of Commerce Center for Personalized Education for Physicians Colorado AHEC Colorado Cancer Research Program Colorado Physician Health Program Colorado State University Community College of Denver Community Food Share Community Health Resource Library Denver School of Nursing Education Foundation for the St. Vrain Valley El Comite Erie Chamber of Commerce Front Range Community College Hospice Care of Boulder &Broomfield Counties Idaho State University Institute of Medical & Business Careers John Hopkins Bloomberg School of Public Health Justin Parker Neurological Institute Lactation Consulting and Community Outreach Latino Task Force Livewell Colorado Livewell Longmont
Longmont Area Chamber of Commerce Longmont Area Economic Council Longmont Community Foundation Longmont Council for the Arts Longmont Entrepreneurial Network Longmont Surgical Mission Longmont United Hospital Foundation Lyons Chamber of Commerce Mead Chamber of Commerce Mental Health Partners Metro State College Mt. States Children’s Home Niwot Business Association OUR Center Phlebotomy Learning Center PIMA Community College PrestigePLUS Senior Wellness Regis University Rhythm on the River Rotary Club - Longmont Salud Family Health St. Vrain Valley School District Sunrise Lions Club Teen Childbirth Education Class Tiny Tim Center University of Colorado University of Northern Colorado VHA Disaster Fund Via Walk to Remember Women's Work YMCA
Changing The Caring Experience...
Facts About Longmont United Hospital
Planetree Designated Hospital Hospital Services 2013 Board of Directors, Leadership Council Medical Staff Officers 2013 Statistics
Accreditations & Certifications
98,882 outpatient visits
>A ccredited by The Joint Commission
32,463 emergency room visits
7,576 admissions
>B reast Diagnostic Center accredited by American College of Radiology
1,057 births
Average length of stay: 4.24 days
Over 1,285 employees
Over 300 physicians
Over 650 volunteers
> Laboratory accredited by College of American Pathologists >D iabetes Education Program recognized by American Diabetes Association > Accredited by the American College of Surgeons Commission on Cancer
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