University Hospital Community Report 2012

2012 COMMUNITY REPORt

CHANGE Embracing

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LETTER from the CEO 2012 Was Challenging, Yet Exciting It’s a good thing that University is known as the region’s “heart hospital,” because health care in 2012 was certainly not for the faint of heart.

On the heels of the Affordable Care Act University is among hospitals across the country affected by a string of reimbursement cuts from the federal government as they try to balance the federal budget on the backs of the country’s health system.

As the CSRA’s only locally owned not-for-profit hospital, University Hospital provides access to care 24 hours a day, seven days a week for all who need and seek emergency care regardless of their ability to pay. Every dollar we are able to make above the expenses required to care for our patients is retained right here in Augusta to support our organization and the community’s future.

These funds allow us to ensure we have the most advanced technology, progressive facilities and most highly skilled staff and physicians to care for patients.

In a year in which a record number of hospitals closed and most others were on shaky financial ground, University had its bond ratings reaffirmed

by S&P and Moody’s with “stable outlooks.” We have a reputation of being financially solid because we plan well and keep our focus on providing quality care to our patients and families.

At University, the impact of health care reform was estimated to be $27 million per year by 2019, assuming that the subsequent Medicaid expansion would occur in Georgia. Gov. Nathan Deal has taken the position that Georgia will not expand Medicaid.

That means in Georgia, hospitals will have to take their share of the $155 billion in cuts to the nation’s hospitals with no upside revenue from expanding Medicaid to provide insurance to the uninsured.

During the fiscal cliff negotiations, the federal government took more money from the nation’s hospitals to solve a problem they created relative to payment rates for physicians. Essentially, they took $28 billion from hospitals to avoid a 28 percent reduction in physician payment rates that was supposed to take effect at the beginning of 2013. The impact of this reduction on University Hospital is approximately $2 million per year over the next four years. All told, in 2013 we anticipate reimbursement from federal programs to decrease by $12.1 million as compared to reimbursement for the same amount of business in 2012.

Sequestration will only add to this stripping of revenue from our hospital. We will see our Medicare reimbursement cut by 2 percent for our hospital, home care services, nursing homes, physicians and hospice. Conservatively, that will amount to approximately $5 million on top of the $12.1 million already in place.

While our budget for providing care is stretched razor-thin, our commitments will not change. We continue to remain in the top five employers in Augusta-Richmond County, and our annual economic impact is in excess of $1 billion. We’re expanding and introducing innovations comparable to those of the leading health systems in the country.

University is dedicated to setting and maintaining the standard for health care in the region.

We promise to always keep what is best for our patients and their families at the forefront.

James Davis President and Chief Executive Officer University Health Care System

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GOVERNING BOARDS University Health Care System’s corporations are governed by volunteer boards of directors who spend a gracious amount of time to help ensure University continues to provide progressive, accessible and compassionate care.

Board members for University Health Inc., University Health Services Inc., University Extended Care Inc. and University Health Resources Inc. Randy Smith, M.D., Chairman Terry Elam Richard Fairey Jeffrey Foreman Hugh Hamilton Levi W. Hill IV Sanford Lloyd Brian Marks Eugene McManus John Rhodes Natalie Schweers Ellen Shaver, M.D. Ernie Sizemore Steven Vaughn, M.D. James R. Davis (ex officio)

University Health Care Foundation Officers Jed W. Howington, M.D., Chair Catherine D. Knox, Immediate Past Chair Richard A. Fairey, Chair-elect Natalie Schweers, Vice Chair

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LEADERSHIP TEAM Executive Team

Medical Staff Officers

James R. Davis President/CEO University Health Care System

James Sherman, M.D., President Daniel Boone, M.D., President-elect

David Belkoski Vice President Financial Services/Chief Financial Officer Marilyn Bowcutt President University Hospital

Barry Jenkins, M.D., Secretary/Treasurer Benjamin Kay, M.D., Vice President Matthew Mondi, M.D., Member-at-large

Laurie Ott Vice President Community Services/President University Health Care Foundation Edward Burr Vice President Legal Affairs Les Clonch Vice President Information Systems William Farr Jr., M.D., Vice President Medical Affairs/Chief Medical Officer Stephen Gooden, M.D. Vice President Care Transformation Kyle Howell Vice President Support and Ancillary Services Richard Kisner President University Extended Care Sandra McVicker President University Hospital McDuffie Lynda Watts Vice President Patient Care Services/Chief Nursing Officer Doug Wilson President University Health Link

Mallory Lawrence, M.D., Member-at-large

Medical Directors Mac Bowman, M.D. Cardiovascular Services Thomas Hunter, M.D. Cardiothoracic Surgery Tara Kattine, M.D. Palliative Care and Hospice Chris Carlson, M.D. Bariatric Surgery

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QUALITY & PATIENT SAFETY Ensuring our patients receive the highest level of care is our goal with every patient and family member, every time. Our Board challenges us to remain in the top 10 percent of hospitals in the country in composite quality scores, and they meet monthly with physicians and clinical staff to analyze the data and develop a plan to better serve our patients.

n Five-star rating for Excellence in Orthopedic Surgery on healthgrades.com n The Joint Commission specialty certification in stroke and heart failure n Number one ranking in Augusta in ENT, GI, Nephrology and Orthopedics by US News & World Report n Women’s Certified Top 100 Hospital for Patient Experience for the second consecutive year

n Blue Distinction status for Cardiac Care, Spine and Joints n Quality Respiratory Care Recognition by the American Association for Respiratory Care (AARC) n The Pinnacle Award from McKesson Corp. for its effective use of McKesson technology in the care of patients with congestive heart failure n Georgia Hospital Association’s (GHA) Partnership for Health and Accountability (PHA) Core Measures Honor Roll Trustee Category for exceeding in clinical quality

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GROWTH In 2012, it became clear that the Affordable Care Act had forever changed the health care landscape. With our feet firmly grounded in providing the highest level of care, University set its sights on the horizon and planned for the future of health care delivery. n Elected officials and community leaders gathered in July to celebrate a new beginning for University Hospital McDuffie and quality care into the future for McDuffie County and surrounding areas. University has stabilized and improved care at the former McDuffie Regional Medical Center, while construction begins on a modernized hospital set to be completed September 2014 on Washington Road in McDuffie County near Interstate 20. n We neared the end of construction for Brandon Wilde’s Windsor House, Georgia’s first “small house” concept for Alzheimer’s and dementia care. n We celebrated the inaugural year of our Heart Attack & Stroke Prevention (HASP) Center, a progressive program in which specially trained medical personnel offer advanced individualized testing and move beyond the standard of care to determine your true risk for cardiovascular disease. n The HASP “Heart Cart,” the mobile version of the Heart Attack & Stroke Prevention Center, continued taking this advanced diagnosis to business and industry, churches and community centers, and found multiple cases of advanced heart or vascular disease in people who had no idea they would soon likely suffer a massive heart attack or debilitating stroke. n We increased our number of employed physicians to 68, eliminating variation in care and improving quality. n We strengthened our academic affiliation with Georgia Regents University Augusta by welcoming medical residents for clinical rotations at University Hospital. n To help patients with chronic conditions improve their quality of life and decrease avoidable hospital admissions, University opened a new and expanded Disease Management Clinic on D’Antignac Street.

AWARDS AND RECOGNITION Our dedication to excellence results in numerous awards and recognitions each year. Here are a few highlights in 2012: n CSRA’s Consumer’s Choice Award for Overall Quality and Image from the National Research Corporation for the 14th consecutive year n Top hospital in all three categories of giving by the United Way of the CSRA for the third consecutive year n Seven ADDY® Awards from the Augusta Advertising Federation, including Gold ADDY®s and Specials Judges’ Awards for the Breast Health Center’s Portraits of Life calendar and print ads; Silver ADDY®s for Women’s Center print ads and Bronze ADDY®s for Healthy U Magazine and Healthy U Calendar. n Kim Beavers of Eating Well with Kim received the “Distinguished Service to the Media” award and Sunitha Zechariah, Clinical Nutrition Manager at University, was recognized for “Distinguished Service to the Augusta Area Dietetics Association” by the Georgia Dietetic Association. n Heart & Vascular nurse Larry Lassiter was named the “Rising Star” at the third annual March of Dimes Nurse of the Year Awards in Atlanta.

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INNOVATION Structural Heart/Transcatheter Aortic Valve Replacement (TAVR) Program There’s a reason why the community calls University the “heart hospital.” In 2012, international heart and vascular visionaries confirmed what we have known to be true – no other hospital in the Augusta-Aiken region compares to University’s heart and vascular facilities, technology, physician expertise and vision necessary to thrive as a regional referral center – not even close.

It was this realization that led to the successful implementation of University’s Structural Heart Program, the foundation for future Cardiac Centers of Excellence, where patients receive a second chance at life.

TAVR is a new option for inoperable and high-risk patients suffering from severe symptomatic aortic valve blockages, known as stenosis. In 2012, University joined only five other hospitals in Georgia and South Carolina as a nationally recognized Valve Center. The others are Emory, Piedmont Medical College of Central Georgia in Macon, Wellstar in Marietta and Medical University of South Carolina. TAVR was the next step after University performed the CSRA’s first mini mitral valve surgery earlier in the year.

Aortic stenosis is a progressive and life-threatening disease and aortic valve replacement greatly improves survival rates. Traditional open-chest valve replacement surgery has been the only treatment for symptomatic patients with severe stenosis and remains extremely successful. However, more than 30 percent of patients with severe aortic stenosis are not candidates for the traditional replacement because of their age, prior open heart surgery or other conditions. Without TAVR, they live with increasing angina, shortness of breath, light headedness and lack of energy until their death.

TAVR patients experience an almost immediate increase in energy after surgery. They generally leave the hospital with an adhesive bandage covering a two-inch incision within a week of surgery, and return to normal activity almost right away.

A multidisciplinary team including physicians, surgeons, nurses and other specially trained clinical staff is necessary to evaluate and screen patients, perform the procedure and follow their post-procedure gains in clinic. Fewer than one in every 200 heart hospitals in North America that apply to be a procedure site are approved. University is proud to be among those elite institutions giving second chances to heart and vascular patients every day.

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INNOVATION

An EPIC Go-Live At about 4:30 a.m. on Dec. 1, 2012, we flipped the proverbial switch on our new Epic Electronic Health Record (EHR) system throughout the hospital after more than two years of intense planning and training. In our opinion and that of others throughout the health care industry, Epic is the best EHR system, hands down. We chose Epic because it was the most complete, easy-touse system that can be effectively shared by physicians and throughout our entire health care community.

Epic was built from the ground up as a fully integrated system. It has won numerous industry awards, regularly tops the list of EHR systems in surveys and is used by the Cleveland Clinic, Kaiser Permanente, the Mayo Clin-

ic and other health care leaders. EHR systems enable hospitals and physicians to store and retrieve detailed patient information to be used by health care providers, and sometimes patients, during a patient’s hospitalization, over time and across care settings. Embedded clinical decision support and other tools help clinicians provide safer, more effective care than is possible by relying on memory and paper-based systems. In addition, Epic is helping us monitor, improve and report data on health care quality and safety. The Centers for Medicare and Medicaid Services (CMS) calls EHRs, “the next step in continued progress of health care.” We are extremely pleased in our choice of Epic, our successful launch and our continued efforts to maximize its capabilities to better serve patients and their families.

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INNOVATION Not All ‘Chest Pain Centers’ Are the Same In 2012, University received full Cycle IV accreditation with PCI (percutaneous coronary intervention) from the Society of Chest Pain Centers (SCPC). University is the only hospital in the region to have the PCI designation and only the fourth in the nation to attain Cycle IV accreditation.

You may hear other hospitals promoting their chest pain centers, but you should arm yourself with the knowledge to make the best decision regarding your heart health. With the increase in chest pain centers came the need to establish standards designed to improve the consistency and quality of care provided to patients. SCPC’s accreditation process ensures that centers meet or exceed quality-of-care measures in acute cardiac medicine.

The staff at University provides timely care for chest pain patients through systematic protocols that quickly move patients from early diagnosis through

emergency treatment and ultimately to any necessary procedures in our catheterization lab.

The Accredited Chest Pain Center’s protocol-driven and systematic approach to patient management allows physicians to reduce time to treatment during the critical early stages of a heart attack, when treatments are most effective, and to better monitor patients when it is not clear whether or not they are having a coronary event.

Such observation helps ensure that patients are neither sent home too early nor needlessly admitted.

Unlike other centers, the Accredited Chest Pain Center at University Hospital has demonstrated its expertise and commitment to quality patient care by meeting or exceeding a wide set of stringent criteria and undergoing an onsite review by a team of SPCP’s accreditation review specialists.

Why would you trust your heart with anyone else?

MyChart Enables Patients to Connect with Their Health With the installation of Epic came MyChart, giving patients direct online access to portions of their electronic health record where their physicians store their health information. Whether at work, on the road or at home, patients can view lab results, appointment information, medication, immunizations and more all securely stored and available for quick retrieval. MyChart also provides new, convenient methods of communication with your physician’s office. Renew prescriptions, send messages and schedule appointments – all online. Patients can even access their family’s records and schedule appointments online. MyChart is also a free app available for smart phones. More than 10,000 patients had signed up at the end of 2012, and are enjoying easier, better coordinated management of their health information.

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Indigent AND Charity Care In 2012, University Health Care System provided $29,001,872 in indigent and charity care. These costs include the following:

$19,723,862 for inpatient and outpatient ser-

vices for indigent patients. This includes Project Access, which University helped develop in 2002 with the Richmond County Medical Society to care for Richmond and Columbia County indigent patients. University continues to be Augusta’s largest hospital contributor of funds and services to this organization.

$1,966,867

to help support community clinics such as the Lamar Medical Center, Belle Terrace Health and Wellness Center, Christ Community Clinic, St. Vincent dePaul and the Harrisburg Family Healthcare Clinic.

$7,110,251

for uncompensated physician services for indigent and charity patients.

$200,893

for disease management programs coordinated and staffed by University to help people with chronic diseases like congestive heart failure, asthma and congestive obstructive pulmonary disease (COPD) better manage their conditions so they live longer, healthier lives.

Not included in the community benefit amount, but a significant contribution by University Hospital is the loss sustained by “bad debt,” or the amount of care provided for which payment was expected but not received and “Medicare and Medicaid shortfalls,” or the difference between the cost of care provided to those patients and the payment received from the state and federal government for that care.

COMMUNITY OUTREACH University reached more than 200,000 people in 2012 and invested nearly $1.4 million on free screenings, community education classes, publications and more to educate the community on the importance of prevention and early detection of disease. n Heart Attack & Stroke Prevention screenings n Community-wide heart attack drill, teaming with Gold Cross EMS, Columbia County Fire and Rescue and Walmart n Community health fairs n Skin cancer screenings n Diabetes Expo n Breast Health Center patient contacts n Mobile Mammography free mammograms n Monthly physician-led community education classes n Bi-annual Healthy U Magazine n Monthly Healthy U Calendar n Breast Cancer Survivor Dinner n Online health library and website n Women’s Wellness Expo with The Augusta Chronicle n Support groups for diabetes, cancer, heart disease and childbirth preparedness n Community-wide enrollment event for the American Cancer Society’s new research project, Cancer Prevention Study-3 (CPS-3), to help researchers better understand the genetic, environmental and lifestyle factors that cause or prevent cancer.

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GIVING BACK Unlike the philanthropic arms of many hospitals that focus their energy on building opulent structures, University Health Care Foundation concentrates on raising money that directly benefits the lives of patients and their families in a significant, meaningful way. They help people cover life’s necessities when there often isn’t another source.

In 2012, University Health Care Foundation: n Disbursed $2,867,640.20 in funds to care for patients in our community n Provided 3,359 instances of direct patient assistance n Funded 1,639 free mammograms, of which eight cancers were discovered n Provided 48 scholarships to ensure we maintain the highest quality employees and best trained clinical staff in the region n Provided 199 University employees with continuing education opportunities n Renovated the Jernigan Cancer Center Family Room n Gave $5,000 to help educate staff at Christ Community Health Services

n Held the most successful Miracle Mile Walk in history with 9,550–plus walkers raising $364,455.22

n Held the 20th Annual Patchin-Weston Celebration event raising $68,277.99 for the special needs of patients

n Featured the 27th Jernigan Golf Tournament raising $170,261.68 to benefit the Harry W. Jernigan Jr. Endowment for cancer patients

Health Professions Education At University we know that a skilled and educated workforce is an important part of providing advanced health. In 2012, University invested $643,690 in three University-based programs — Harry T. Harper Jr., M.D., School of Cardiac and Vascular Technology; Augusta Area Dietetic Internship; and Stephen W. Brown School of Radiography — to train excellent allied health professionals

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GIVING BACK

For nearly 60 years, the men and women who serve on the Volunteer Board of University Health have contributed more than $6 million to University Hospital and its patients, raised in the Board’s businesses. The time they give and the wisdom they impart is priceless. In 2012 Volunteer Services: n Completed 38,208 hours of service in 37 departments throughout the hospital

n $10,000 for Breast Health Center for patient camisoles n $9,800 for Cardiopulmonary Rehab patient treadmills

n Donated $251,725 back to the hospital and patient care services, including:

n $9,000 for Patient Care management fund

n $50,000 for 3-D Tomosynthesis Mammography

n $8,800 for Born to Read program for newborns

n $50,000 for Jernigan Cancer Center Family Room renovation

n $7,508 for Shumsky pillows for heart surgery patients n $7,500 for Tree of Love for children’s programs

n $25,000 for Pastoral Care Intern n $6,100 for Diabetes Services testing equipment n $12,500 for Orthopedic/Spine patient recliners n $2,719 for Heart and vascular education booklets n $10,000 for Miracle Mile Walk

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University Health Care System Dedicates Its 2012 Community Report to University Health Services Board Chairman R. Lee Smith Jr. RESOLUTION Whereas, R. Lee Smith Jr., volunteer trustee, successful businessman and community leader, having given selflessly of his time and talent and without expecting any rewards, and Whereas, having served as a University Health Services Trustee since 1985 and as its Chairman since 2000; as a University Extended Care Trustee since 1985 and as its Chairman from 1992-1999; as a University Health Trustee since 1999; as a University Health Resources Trustee from 1985-1991 and on the Richmond County Hospital Authority as a member from 1984-1991, as its Chairman in 1990; and Whereas, having been awarded the Distinguished Service Award by the Georgia Hospital Association and Whereas, having been awarded the Lester S. Moody Award of Excellence by the Augusta Metro Chamber of Commerce, and Whereas, due to his vision and leadership, University and other not-for-profit community hospitals in Georgia have moved forward in making health care more accessible through satellite centers in neighboring communities, and Whereas, due to his leadership efforts and focus on quality, University became one of the first hospitals to publicly report its quality measurements, and Whereas, due to his keen insight, pragmatic leadership, insight, courage, stewardship, integrity, and unwavering dedication and commitment, R. Lee Smith Jr. has left an indelible mark on the University Health Care System and its community.

Therefore, Be It Resolved on this 23rd day of February 2012, University Health Care System bestows upon R. Lee Smith Jr. the title of Chairman Emeritus of University Health Care System.

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