Community Benefit Report 2016–2017
Message from the President Jeffrey M. Fried, FACHE, President and CEO We are pleased to share our annual report for our most recent fiscal year. As you look through the report and read about our people, our programs, and our services, please know we deeply appreciate your support of Beebe Healthcare. Our patients are at the center of our healthcare system, and our doctors and staff work every day to improve the thousands of processes in our organization that enable us to ensure your safety, provide an outstanding patient experience, and hopefully sustain your confidence in the care that we provide. The innovative programs that you will read about in this issue, as well as the numerous awards that our physicians and team members have earned, demonstrate our commitment to the idea of continuous performance improvement—always trying to get better.
In addition to continually improving our operations, I am proud to share with you that Beebe Healthcare is also focused on evaluating what we need to do to better serve our community, not just today but for the next generation. We are expanding our facilities and services and changing the care delivery model so we can provide better care at lower costs, while at the same time always working to help our patients get healthy again. As we prepare to spend $180 million to support the Next Generation of Care, we are excited about our initiatives in the south coastal region to build a free-standing Emergency Department and a
second Tunnell Cancer Center, the development of a surgical hospital at our Route 24 campus, and the plans to grow and support our main hospital on Savannah Road. Our expansion plans will not only transform the way we deliver care but also make medical services so much more accessible in our community.
To do a better job of serving our community, we will continue to develop plans, programs, and facilities that care for people where they live, so they do not have to travel to Lewes. We’ve heard your voices and are designing the Next Generation of Care with you in mind. We recognize with the growth in our community, no matter how hard we work, no matter how successful we’re going to be at keeping people out of the hospital, we’re still going to need to provide more inpatient beds (and private ones) to people who are continuing to move into our community. We’re serving the fastest-growing population in the state, certainly in southern Delaware. At the same time we all recognize that not only are we growing as a community—we are also getting older. Recent data shows that 26 percent of our population is 65 and older, which is almost twice the national average of 14 percent. That is also a critical factor in our plans for the future. One of the biggest moments in 2017 came when we announced the transformational $10 million gift from the Ma-Ran Foundation to help propel us toward our fundraising goal for this expansion campaign. Beebe has been so fortunate over the years to be able to count on our community’s support of our important initiatives. We are extremely grateful for that support, and we hope you will be very pleased and proud of what Beebe is able to do to better care for your health and your healthcare needs.
As we acquire the latest technology and equipment, recruit more physicians, and improve our systems, patient and physician demand for Beebe services has increased. We think our plan is an innovative response to growth of the population, to expectations for excellent service provided in convenient locations, and to the insurance companies’ requirements that we be as efficient and costeffective as possible. While much of the focus on our expansion is related to bricks and mortar, we all know that Beebe Healthcare is much more than buildings. Most importantly, it is our people serving behind the four walls that make Beebe Healthcare what it is today, and what it will be going forward.
We have over 2,500 team members, more than 400 doctors and practitioners, and 700 volunteers who care for you and your families when you need them. Each of us takes pride in what we do at Beebe Healthcare and in being able to make a difference in the lives of those we touch. James and Richard Beebe probably wouldn’t recognize much of what we do in the hospital (especially outside the hospital) they founded more than 100 years ago. But they would recognize the care, the compassion, and the desire to treat everyone like they were family. Those values continue to live and breathe today, and they serve as a compass to guide our decisions as we work to keep Sussex County healthy. We are here for you and your families in partnership on your health journey, and we are so very grateful for your support and belief in Beebe Healthcare as your local not-for-profit community hospital. While it is very gratifying to reflect on our accomplishments over the past year and the lessons learned, it is even more exciting to look to the future as we create the Next Generation of Care.
Where the Next Generation of Care Meets our Communities 1 Lewes Improving Inpatient Care • Plans include a new four-story patient wing, to be called the Margaret H. Rollins Pavilion, made possible by a generous $10 million donation from the Ma-Ran Foundation— the largest gift ever received by Beebe. It will front on Savannah Road and will allow for improved ease-of-access to the Medical Center. • The creation of a Heart and Vascular Center of Excellence.
• The new Pavilion will include a new Women’s Health wing on the second floor to provide advanced care for labor and delivery patients. • Additionally, semi-private rooms already existing in the Medical Center will be converted to private rooms to improve patient experience.
2 Rehoboth Beach Specialty Surgical Hospital • A new hub for specialty surgical services off of Route 24, will accommodate both shorter-term inpatients and outpatients.
• Future home of Beebe’s newly created, stateof-the-art Minimally Invasive Surgical Center of Excellence with surgical robotics.
3Millville New Health Campus for South Coastal Area • Free-standing Emergency Department to serve the community year-round with 22 emergency bays and 24/7 support from physicians, care providers, and on-site imaging technology. • Expands upon existing diagnostic imaging, physical rehabilitation, laboratory, and walk-in care services already offered in the area.
• Creation of a second cancer center to provide advanced oncology services in the Millville area, including medical oncology, hematology, chemotherapy, and radiation oncology, so patients can receive treatment closer to home.
2017 Quality & Safety Awards
Each year, we are thrilled to see the innovative and thoughtful ideas that our Beebe Healthcare’s Quality and Safety committee started its awards program in 2009. In its team members come up with to improve our first year, just three teams entered; it has since grown. In the past two years, there have been internal processes and systems for the benefit 26 projects submitted. For 2017, three of the 26 teams were presented with awards for their of our patients. We also are thrilled to see how outstanding projects, solving quality or safety problems identified in a hospital setting. the number of teams has increased. We look QUALITY & SAFETY AWARD–WINNING TEAMS FOR 2017 INCLUDE: for teams that identify problems on their NEONATAL ABSTINENCE SAFE PATIENT HANDLING FALLS PREVENTION TEAM own and look at quality and data to drive SYNDROME (NAS) TEAM WITH THE LIFT TEAM Presented by Holly M. Heilner, RN, CPHQ, performance improvement. It is these efforts Presented by Bridget Buckaloo, MSN, Presented by Tara Cooper, MSN, RN, CSSGB, and Margaret Porter, MSN, RN-BC, RNC-OB, Executive Director of Women’s and Jamie Dickerson, MSN, MBA, RN Nurse Manager for the Medical-Surgical Unit that are driving us toward our vision of and Children’s Health Services The Lift Team—a designated The Falls Prevention Team put becoming a High Reliability Organization. The NAS Team put a strucgroup of team members who many action plans in place to reThe three teams that received awards ture in place to work with the received special training on duce patient falls throughout the demonstrated the ability to go above addicted moms of NAS babies helping patients up—sends out hospital. It is one of Beebe’s top to educate, connect them a post-implementation survey priorities to prevent patient falls and beyond. with resources, and help keep the family together. The team noted that in 2013, each NAS baby cost the healthcare system about $38,000. In 2017, that cost has been reduced through the team’s protocols to about $21,000 per baby.
after 30 days. Results found that job satisfaction went up by 40 percent and lift injuries decreased by 52 percent.
by focusing on a team concept that includes “everyone, every patient, every time.”
—Jeffrey M. Fried, FACHE, President and CEO of Beebe Healthcare
Awards | Recognitions | Certifications American Heart Association/ American Stroke Association– Get With The GuidelinesStroke Gold Plus Quality Achievement Award American Heart Association/ American College of Cardiology Foundation–Get With The Guidelines®–Heart Failure Gold Plus Quality Achievement Award American Heart Association– Mission: Lifeline® NSTEMI Bronze Quality Achievement Award The Joint Commission’s Gold Seal of Approval—Heart Failure, Joint Replacement– Hip, Joint Replacement–Knee, Spine Surgery, and Stroke Center of Excellence in Women’s Health Surgery by the American Institute of Minimally Invasive Surgery (AIMiS) Quality Respiratory Care Institution by the American Association for Respiratory Care (AARC)
The only accredited Breast Center by the National Accreditation Program for Breast Centers (NAPBC) in the State of Delaware
Quality Cancer Care: Recognizing Excellence
Beebe’s Tunnell Cancer Center–Quality Oncology Practice Initiative (QOPI®) Certification Program, an affiliate of the American Society of Clinical Oncology (ASCO)
Healthgrades® Recognizes Beebe as One of America’s 100 Best Hospitals for Coronary Intervention™ in 2017 & 2018. The only hospital on DELMARVA! Eight Healthgrades Five-Star Ratings in Clinical Areas & Three Excellence Awards
American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) NICHE (Nurses Improving Care for Healthsystem Elders)
To find out more about how Beebe has been recognized for providing quality care, go to www.beebehealthcare.org/ about-beebe/awards.
The Gift of Time
provided 73,000 hours of their time to Beebe.
BEEBE HEALTHCARE | COMMUNITY BENEFIT REPORT 2016–2017
Celebrating Excellent Care PETER & DIANE ISSEL
If you want to celebrate the excellent care you received at Beebe, contact the Beebe Medical Foundation at (302) 644-2900 or go to www.beebehealthcare.org/celebrate-beebe-team-member.
GIVING IN SUPPORT OF BEEBE’S HEART AND VASCULAR CENTER OF EXCELLENCE
EXCEPTIONAL EMERGENCY AND SURGICAL CARE John Kennedy, of Ocean View, has been seen in Beebe’s Emergency Department in Lewes numerous times over the years for heart issues, including atrial fibrillation, or AFib. In addition, he has had several surgeries at Beebe, including orthopaedic surgery on his knee.
Peter Issel was taken to Beebe’s Emergency Department by paramedics with tightness in his chest. He was very sick and developed pneumonia before the Cardiac Surgery Team could perform the open-heart surgery needed to save his life. “It was extraordinary to watch them taking care of you,” Diane said to Peter, tears welling up in her eyes. “Your room, in less than five minutes, was totally transformed with new equipment to treat your pneumonia. They were all so wonderful and kind to me.” Peter sums it up: “This was a very powerful thing—our experience at Beebe. The relationships we built were incredible. It was like family.”
“Whether in the Emergency Department or when I was going to have my surgeries, every person who was involved with my care was just wonderful,” John says. Beebe is creating the Next Generation of Care and plans to expand services in the south coastal area. Plans include a free-standing Emergency Department and a second cancer center to be located on Route 17 near Millville. These services will join the full diagnostic imaging, physical rehabilitation services, lab, and walk-in care already offered on Route 26 in Millville.
NICK AND TERRY DIMINNO
IN MEMORY OF
When Nick and Terry DiMinno retired, they decided to start a new chapter in their lives by moving closer to relatives in Delaware. The excitement of their new home near the beach was dampened quickly when only days after moving into their new home, Nick suddenly became extremely ill.
When Catherine “Jeanne” Brownlee was diagnosed with a second and incurable form of stomach cancer. Jeanne and her husband, Don, worked with Tunnell Cancer Center medical oncologist Dr. Nataliya Melnyk, who volunteered to help them explore all options.
Nick’s wife, Terry, recalls, “Nick was trying to communicate, but he wasn’t making any sense, and being an LPN, I was extremely concerned."
Jeanne’s last infusion took place on June 20, 2017, the couple’s 52nd wedding anniversary. Soon after this, she was admitted to the hospital and then entered a hospice care program before her passing on July 11, surrounded by her husband and two daughters.
CATHERINE “JEANNE” BROWNLEE
HE WASN’T MAKING ANY SENSE
“I had always been healthy—I was never really sick. It was at this point, and out of frustration, that I turned my life over to God,” Nick shares. After spending six weeks in the hospital, three weeks in physical rehab, home care, and outpatient physical therapy, Nick finally came home—to his new home in Milton and a fresh start at life. Nick says: “They ALL saved my life. We were new in the area. We didn’t know doctors; we didn’t know hospitals; and Beebe, our local hospital, was able to take such amazing care of me! If I had to get sick like this, I was in the right place—I was at Beebe Healthcare!”
For the Brownlees, the human connection at Tunnell Cancer Center made all the difference. Don remarks: “Each time we arrived at Tunnell, everyone there recognized us and knew what we were going through. It’s just not the same at the larger institutions. I am convinced that the medical care and personal dedication we received at Tunnell Cancer Center rivals any of the larger cancer institutions anywhere.”
Supporting a Healthy Community
HEALTH FAIRS AND EVENTS
FREE FLU SHOTS
E HEALTH SCREENINGS
We are grateful for your support of Beebe Healthcare, our not-for-profit healthcare system, and for giving where you live! If you are a regular donor to Beebe, thank you! If you have never given a gift to Beebe, please consider donating! Our needs are growing as fast as Sussex County, and we hope all who live, vacation, or work here will contribute to help us grow and expand. To learn more about how you can give, contact the Beebe Medical Foundation at (302) 644-2900 or online at BeebeMedicalFoundation.org.
Impact of Beebe Nationally
Beebe Emergency Department Patients’ Hometowns Across the United States
37 6 321
Ontario 2 Puerto Rico 1 Unknown 424
Our Financials Community Benefit Cost (Fiscal Year Ended June 30, 2017)
Cost of Charity Care and Bad Debt . . . . . . . . . . . $7,098,519 Expenses from Medicare and Medicaid Not Reimbursed. . . . . . . . . . . . . . . . 42,757,570 COMMUNITY BENEFIT PROGRAM (NET LOSS) Health Fairs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $36,000 Health Promotion and Wellness Programs. . . . . . . 1,025,012 School-based Wellness Programs. . . . . . . . . . . . . . . . . 116,525 Motivate the First State . . . . . . . . . . . . . . . . . . . . . . . . . . 8,271 Behavioral Health Services . . . . . . . . . . . . . . . . . . . . . 230,405 Sexual Assault Nurse Examiner Programs. . . . . . . . . . 154,172 Oncology Research Program . . . . . . . . . . . . . . . . . . . 307,980 Interpreter Services. . . . . . . . . . . . . . . . . . . . . . . . . . . . 115,497 Physician Services Recruitment. . . . . . . . . . . . . . . . . 854,318 Physician Practice Guarantees for New Doctors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,614,731 Workforce Development with Educational Institutions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,180,632 Sponsorships. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171,800 Gull House Adult Day Care . . . . . . . . . . . . . . . . . . . . 529,829 Subtotal Community Benefits. . . . . . . . . . . . . . . . 7,345,172 Beebe Medical Group . . . . . . . . . . . . . . . . . . . . . . . 23,596,041 Total Cost of Community Benefits. . . . . . . . . . 30,941,213
Community Benefit Programs
Cost of Charity Care and Bad Debt
53% Expenses from Medicare
TOTAL COMMUNITY BENEFIT
and Medicaid Not Reimbursed
4,826 Cardiac Procedures
(Inpatient and Outpatient)
Comparative Consolidated Audited Statements of Operations for the twelve months ending June 30, 2017 FISCAL YEAR
Total Beebe Emergency Patients with hometowns across 47 states, Ontario, and Puerto Rico
PATIENT REVENUE Net Patient Revenue . . . . . $405,476,340 $381,106,324 Other Operating Revenue . . . . . . 4,626,371 5,740,248 Total Operating Revenue. . . . . . . . . . . . . . $410,102,711 $386,846,572 OPERATING EXPENSES Salaries . . . . . . . . . . . . . . . . . . $159,177,362 $149,782,261 Contract Labor. . . . . . . . . . . . . . . 7,248,254 7,100,100 Employee Benefits . . . . . . . . . . 51,700,649 50,267,295 Physician Fees. . . . . . . . . . . . . . . 10,263,632 9,847,026 Patient-related Supplies and Services. . . . . . . . . . . . . . 82,615,285 76,465,552 Non-patient-related Supplies. . 4,506,387 4,611,351 Utilities . . . . . . . . . . . . . . . . . . . . . 5,788,471 5,739,741 Insurance. . . . . . . . . . . . . . . . . . . 4,070,646 4,708,838 Depreciation and Amortization . . . . . . . . . . . . . 19,752,556 19,620,572 Interest . . . . . . . . . . . . . . . . . . . . . 1,200,790 1,204,518 Repairs and Maintenance. . . . . . 9,458,682 8,438,116 Other Expenses . . . . . . . . . . . . . 34,296,567 32,779,475 Total Operating Expenses. . . . . . . . . . . . $390,079,281 $370,564,845 Income from Operations. . . . . . . . . . . $20,023,430
59,452 Home Care Visits 48,965 Inpatient Days of Care 751,934 Laboratory Tests (Outpatient) 11,903 Radiation Oncology Procedures (Outpatient) 134,260 Radiology Procedures (Outpatient) 98,650 Physical Rehab Visits (Outpatient) 15,624 Surgical Procedures (Inpatient and Outpatient) 214,223 Beebe Medical Group Visits (Office Visits plus Outpatient Visits)
Beebe Leadership Beebe Boards
Effective as of July 1, 2016– June 30, 2017 BEEBE HEALTHCARE BOARD OF DIRECTORS The Honorable William Swain Lee, Chair David A. Herbert, Vice Chair Jeffrey M. Fried, FACHE, Secretary Paul T. Cowan, Jr., DO, Treasurer Gregory A. Bahtiarian, DO James W. Bartle Wilson C. Choy, MD R. Michael Clemmer Thomas J. Cooper Frank Czerwinski Stephen M. Fanto, MD James P. Marvel, Jr., MD Janet B. McCarty Terry A. Megee Michael A. Meoli Paul H. Mylander Paul C. Peet, MD Wesley E. Perkins Anis K. Saliba, MD Eric C. Sugrue Christopher J. Weeks Michael L. Wilgus Jacquelyn O. Wilson, EdD EMERITUS MEMBERS Joseph R. Hudson, Chair Halsey G. Knapp BEEBE MEDICAL FOUNDATION, INC. BOARD OF DIRECTORS Thomas J. Cooper, Chair Charles L. Burton, Vice Chair Cindy L. Szabo, Esq., Secretary Paul J. Pernice, CPA, Treasurer Jack N. Berberian William L. Berry, CPA Jennifer Carroll Benedette Cooper Christopher Dagesse Mouhanad Freih, MD Jeffrey M. Fried, FACHE The Honorable Gerald W. Hocker Christian Hudson Lynn Kokjohn The Honorable William Swain Lee Janet B. McCarty Keith Parsell Paul G. Townsend Mindi M. Tunnell EMERITUS MEMBER The Honorable Theodore W. Becker Joseph R. Hudson Robert H. Moore Paul H. Mylander
BEEBE MEDICAL GROUP BOARD OF DIRECTORS Daniel Cuozzo, DO, Chair Frank Czerwinski, Vice Chair Paul J. Pernice, CPA, Treasurer Ercilia E. Arias, MD Paul T. Cowan, Jr., DO Jeffrey M. Fried, FACHE Maria V. Haldar, MD David A. Herbert George Kluchnik, MD Delbert Kwan, MD Anis K. Saliba, MD MEDICAL EXECUTIVE COMMITTEE Paul C. Peet, MD, Chair and President, Medical Staff Vikas Batra, MD, Vice President, Medical Staff Ehtasham Qureshi, MD, Secretary, Medical Staff Alberto R. Rosa, MD, Treasurer, Medical Staff Jeffrey M. Fried, FACHE, President/CEO, Beebe Healthcare Jeffrey E. Hawtof, MD, FAAFP, Vice President, Medical Operations & Informatics David A. Herbert, Board of Directors EXECUTIVE STAFF Jeffrey M. Fried, FACHE, President/CEO, Beebe Healthcare Judy Aliquo, President/CEO, Beebe Medical Foundation Catherine C. Halen, Vice President, Human Resources Jeffrey E. Hawtof, MD, FAAFP, Vice President, Medical Operations & Informatics Marcy Jack, Esq., BSN, CPHRM, Vice President, Quality, Safety and Risk Management Bruce Leshine, Esq., General Counsel Michael J. Maksymow, CPHIMS, FHIMSS, Vice President, Information Systems & CIO Paul J. Pernice, CPA, Vice President, Finance & CFO Steven D. Rhone, RN, MS, NE-BC, FABC, Vice President, Patient Care Services Richard A. Schaffner, Jr., RN, Executive Vice President/Chief Operating Officer Alex A. Sydnor, Vice President, External Affairs BEEBE AUXILIARY BOARD OF DIRECTORS Nancy Tartaglione, President Lesley Nance, First Vice President Nancy Almacy, Second Vice President Patricia Sandy, Treasurer Lester Levin, Assistant Treasurer Rosey Vanderhoogt, Recording Secretary Eileen Thompson, Corresponding Secretary Patricia Barry, Member-at-Large
Average Length of Hospital Stay COMMUNITY BENEFIT REPORT 2016–2017
This is an annual publication sharing information from fiscal year 2017.