Who We Are 2019

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Randy Oostra, DM, FACHE President and CEO randy.oostra@promedica.org 567-585-3562 Main Offices 100 Madison Ave. Toledo, Ohio 43604

Web Site promedica.org Social Media Caring Bridge Facebook LinkedIn Pinterest Twitter YouTube

Pioneering who approaches we are to HEALTH and WELL-BEING Redefining Health Care to improve health and well-being

Š 2019 ProMedica

1.0391-A.R010719.LM

* Statistical information in this brochure is based on information as of January 1 through December 31, 2016

for generations


ProMedica is a not-for-profit, Mission-based organization working to create a stronger, more cohesive approach to delivering care at the right place, right time, and right cost.

A National Leader What does it mean to be well? Is it merely not feeling sick? Is it the food you eat, the neighborhood you live in? Yes. Driven by a Mission to improve health and well-being, ProMedica is at the forefront of developing innovative health and wellness solutions. While we seamlessly coordinate nationally recognized hospitals, healthcare providers, and skilled nursing and rehabilitation centers, we know clinical care represents only a portion of your overall health and well-being. To have a lasting impact on your health, we must do more.

ProMedica is a national leader in identifying and addressing these essential factors. We screen patients for 10 different social determinants, and connect them with local resources. We invest in neighborhoods. We opened a grocery store in a food desert. Combine our social determinant expertise with the acquisition of HCR ManorCare, and ProMedica is uniquely positioned to redefine the future for healthy aging. You need a holistic, fully integrated approach to reach your highest potential for health.

[ This is who we are. ]

How well you feel largely depends on your life circumstances – a good job, nutritious food to eat, a safe place to live. Collectively called the “social determinants of health,”

serving

communities SOCIAL DETERMINANTS OF HEALTH 2

Clinical and social CARE NATIONALLY RECOGNIZED for Unmatched Clinical Care

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National Leader in Managing SOCIAL DETERMINANTS OF HEALTH

ACUTE FACILITIES Nearly

EXPERTISE in Prevention, Diagnosis and Treatment of CHRONIC CONDITIONS

60,000 Employees

2,600

PHYSICIANS & PROVIDERS with Privileges

Health Insurance (Paramount) PRODUCTS:

Medicare/Medicaid

Commercial

Workers Comp/ Employer Solutions

Dental

Health Insurance Provider

MORE THAN 600,000 LIVES COVERED

Post-Acute Care (HCR ManorCAre) 400+

NATIONAL LEADER of Post-Acute Services

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Reliable Partner to HEALTH SYSTEMS in STATES

Senior Care facilities

Hospice Patients

AVERAGE 10,650/DAY

Home Care Patients

AVERAGE 3,300/DAY

Working with Strategic Partners • AARP • American Hospital Association • Acute Care Systems

• Academic Institutions • Health Insurance Companies

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Nationally Recognized Care • 2018 America’s 50 BEST U.S. HOSPITALS* (Top 1% in nation) ProMedica Toledo Hospital • 50 TOP CARDIOVASCULAR HOSPITALS Truven Health Analytics 2016 ProMedica Toledo Hospital • 100 GREAT COMMUNITY HOSPITALS Becker’s Hospital Review 2018 ProMedica Flower Hospital • 2018 DISTINGUISHED HOSPITAL FOR CLINICAL EXCELLENCE* (Top 5% in nation) ProMedica Flower Hospital • COMPREHENSIVE STROKE CENTER CERTIFIED (First hospital in Toledo) The Joint Commission and American Health Association/America Stroke Association ProMedica Toledo Hospital • LEVEL 1 TRAUMA CENTER Committee on Trauma of the American College of Surgeons ProMedica Toledo Hospital • 50-YEAR ACADEMIC AFFILIATION WITH THE UNIVERSITY OF TOLEDO College of Medicine and Life Sciences • 2016 PATIENT SAFETY EXCELLENCE AWARD* ProMedica Herrick Hospital • PLATINUM – GOVERNOR’S AWARD FOR EXCELLENCE The Partnership for Excellence ProMedica Memorial Hospital • 2016 DISTINGUISHED HOSPITAL AWARD FOR CLINICAL EXCELLENCE* (Top 5% in nation) ProMedica Monroe Regional Hospital

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• 2017 AMERICA’S 100 BEST HOSPITALS FOR JOINT REPLACEMENT* ProMedica Wildwood Orthopaedic and Spine Hospital (Division of ProMedica Toledo Hospital) • 2016 GOLD PLUS ACHIEVEMENT AND HONOR ROLL AWARDS FOR STROKE CARE American Heart Association/American Stroke Association ProMedica Bixby Hospital • 2017 STROKE CARE EXCELLENCE AWARD* ProMedica Bay Park Hospital • TOP 10% NATIONALLY FOR OVERALL QUALITY CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS (CAHPS) SCORES ProMedica Hospice • 50 HOSPITALS AND HEALTH SYSTEMS WITH INNOVATION PROGRAMS Becker’s Hospital Review 2016 ProMedica Innovations • 2016 GUARDIAN OF EXCELLENCE AWARD® Press Ganey ProMedica Defiance Regional and Wildwood Orthopaedic and Spine Hospitals • TOP 25 HOSPITALS IN OHIO (2016 – 2018) U.S. News & World Report ProMedica Toledo Hospital

Committed to Clinical Excellence

Excellence

* Healthgrades

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Focused Expertise Geography should not dictate health outcomes. ProMedica has created Institutes in key clinical areas to establish and share best practices so patients receive consistently high quality care throughout our system. Institutes include: • Cancer • Heart • Neurosciences • Orthopaedics

ProMedica and The University of Toledo College of Medicine and Life Sciences opened a state-of-the-art Neurosciences Center in 2018.

• Vascular Our centers offer specialties such as: • Behavioral health • Diabetes • Surgery • Urology • Vision • Women’s and children’s health

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best possible care

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Local Access A burgeoning academic medical center thanks to a 50-year academic affiliation with The University of Toledo College of Medicine and Life Sciences (page 24), ProMedica Toledo and Toledo Children’s Hospitals are the tertiary hub of ProMedica’s 13-hospital network in northwest Ohio and southeast Michigan. With access points throughout the region, this well-connected network shares an intense focus on safety to provide reliable, consistently high-quality care in every facility.

[ An unprecedented new campus ] In Lenawee County, Michigan, construction is underway on a remarkable healthcare campus symbolic of ProMedica’s vision. More than the new ProMedica Charles and Virginia Hickman Hospital, there will be an extraordinary emphasis on wellness, including a 3-acre farm offering locally grown produce, unique therapeutic opportunities and nutrition education.

[ The best keep getting better ]

Toledo Metro Region Hospitals: ProMedica Toledo Hospital ProMedica Toledo Children’s Hospital ProMedica Flower Hospital a division of ProMedica Toledo Hospital ProMedica Bay Park Hospital ProMedica Wildwood Orthopaedic and Spine Hospital a division of ProMedica Toledo Hospital

In 2018, Healthgrades® named ProMedica Toledo Hospital one of America’s 50 Best Hospitals™ — the top 1% of hospitals in the nation for overall clinical excellence. In 2019, Toledo Hospital’s landmark Generations Tower will open, designed to deliver an unprecedented patient experience and exceptional clinical collaboration.

Regional Community Hospitals: ProMedica Bixby Hospital – Adrian, MI ProMedica Monroe Regional Hospital – Monroe, MI ProMedica Coldwater Regional Hospital – Coldwater, MI ProMedica Memorial Hospital – Fremont, OH Critical Access Hospitals: ProMedica Herrick Hospital – Tecumseh, MI ProMedica Defiance Regional Hospital – Defiance, OH ProMedica Fostoria Community Hospital – Fostoria, OH

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Affiliated Hospital: Lima Memorial Health System – Lima, OH

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Seamless Transitions

400+ POST-ACUTE FACILITIES

After you’ve had a hospital stay (acute care), you may need more care before returning home, like rehabilitation or nursing care (post-acute care). Depending on the level of assistance you need, that care can be provided at home, in a skilled nursing and rehabilitation center or in one of our outpatient clinics. Skilled Nursing and Rehabilitation Centers Primarily known as Heartland Health Care Centers or ManorCare Health Services, our more than 170 skilled nursing and rehabilitation centers serve patients in 27 states. Post-acute or post-hospital skilled nursing care is a high level of medical care provided in an inpatient setting. These centers also offer long-term care for patients unable to transition home. Memory Care Communities With more than 55 locations in 11 states, Arden Courts Memory Care Communities cater to the special needs of individuals with memory loss, such as Alzheimer’s or related dementias. Staffed by specially trained caregivers, Arden Courts communities feature specialized programming, friendly common spaces,

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412,000 REHABILITATION THERAPY ENCOUNTERS

273,000 HOME CARE VISITS

inviting kitchen and family rooms and walking paths within secured courtyards, all designed for the safety and comfort of our residents.

Services include:

Outpatient Rehabilitation Clinics and Ambulatory Clinics

o Hospice Services

For the weekend warrior or as follow-up after a post-hospital stay, we have more than 60 outpatient clinics in seven states to serve patients with their physical, occupational and speech therapy needs.

o Advanced Disease Management

Home Health Care

o Durable Medical Equipment

Care at home may be appropriate after an illness, hospitalization or surgery, or if you have a new diagnosis that calls for a change in daily lifestyle. We offer home health care in 30 locations in 8 states.

o Laboratory

o Home Health Care

o Home Infusion IV Services o Pharmacy Services

o Skilled Nursing o Rehabilitation o Memory Care

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Care that Comes to You ProMedica’s continuum of service provides care for patients wherever they call home, and that can include their private residence, an assisted living center or a skilled nursing center. Palliative Care Managing a serious disease and relief from its symptoms can make all the difference in quality of life. ProMedica has an Advanced Disease Management program with more than 200 nurse practitioners in 24 communities across the country. End-of-Life Care Our Hospice program has 120 locations and cares for more than 10,000 patients across the country every day. Focused on supporting patients and their loved ones during an advanced illness, the emphasis is on comfort and quality of life, rather than finding a cure.

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right care time place 13


Trusted Providers Patients and their physicians are at the center of a thriving health system. ProMedica has an ever-expanding network of employed advanced practice providers and physicians board-certified in some 55 specialties. All primary care sites and physicians are recognized by NCQA as patient-centered medical homes.

More than

920

2,600

Physicians with privileges at our hospitals

1,400

Physicians participate in ProMedica Health Network

ProMedica Physicians’ providers

1.6 million ProMedica Physicians’ annual patient visits

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600,000+ Paramount insurance members

Paramount Health Care To best care for the whole person, ProMedica goes beyond physicians, hospitals and labs. We know affordability plays a large role in how well you can maintain your health and well-being.

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Established in 1988, Paramount Health Care is the largest health maintenance organization in northwest Ohio, earning Excellent member satisfaction ratings among all patient populations.

Products ° Commercial – 75,000+ members ° Ohio Workers’ Compensation – 5th largest MCO in Ohio ($128+ million) ° Medicare – 15,000+ members ° Medicaid – statewide; 237,000+ members and serving all 88 Ohio counties

° Insurance Marketplace – Commercial HMO – Gold, Silver, Bronze, and Catastrophic Plans – 5,000+ members ° Dental – 259,000+ members

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SYSTEM STRATEGIC PLAN | 2019 – 2021 OUR MISSION IS TO IMPROVE YOUR HEALTH AND WELL-BEING OUR VALUES: COMPASSION

| INNOVATION | TEAMWORK | EXCELLENCE | LEARNING

INTEGRATED HEALTH AND WELL-BEING ORGANIZATION

Assume role as leader in redesign of healthcare delivery nationally | Lead healthcare advocacy efforts nationally and in our communities Anchor Institution | Partner in community projects that promote the health and economic vitality of our communities

OPERATIONAL IMPERATIVES Operational Excellence

Stewardship

• Uphold and advance clinical excellence

• Grow enterprise, both organically and through disciplined M&A

• Ingrain a culture of safety

• Achieve margin growth, improve cash flow, and strengthen balance sheet

• Instill a consumer-driven mindset • Cultivate a workplace of choice • Advance efficiencies in work processes and ensure operational right sizing • Improve access to providers • Create a highly reliable patient/ customer/member experience

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STRATEGIC IMPERATIVES

• Optimize expense reduction opportunities

National Leader in Social Determinants of Health

National Leader in Healthy Aging

• Develop and promote telemedicine solutions between acute/post acute/home health • Expand research efforts to geriatric medicine • Increase healthcare industry advocacy and support for healthy aging • Implement innovative payment models between Paramount and HCR • Create new clinical models between providers/post acute

Research and Education

• Elevate focus on learning, education and research across the organization • Become a top quartile Academic Medical Center • Evaluate/implement new clinical programs and research opportunities to support the transformation to an academic healthcare delivery system • Foster relationships with education institutions to develop the next generation of healthcare workers

• Build strategic donor pathways • Bolster ProMedica Innovations • Accelerate HCR integration efforts • Reinforce community partnerships

• Develop SDOH Healthy Aging initiatives • Increase SDOH Screenings and interventions; connection of social and clinical care plans • Develop SDOH support for our employee groups • Increase healthcare industry advocacy and support for SDOH • Elevate focus on SDOH, learning, education and research across the organization

HOSPITALS | PHYSICIANS | AMBULATORY SERVICES | SKILLED NURSING FACILITIES | ASSISTED LIVING FACILITIES HOSPICE | HOME CARE | HEALTH/MEDICAL/DENTAL INSURANCE | ACADEMIC MEDICAL CENTER | INTERNATIONAL

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{

lives changing

A National Leader in Addressing Social Determinants of Health Clinical and medical care only accounts for 20% of a person’s health and well-being. The other 80% includes the social determinants of health (SDOH) – the physical environment, social/economic factors and health behaviors that impact health. For more than 10 years, ProMedica has been a national pioneer and leader in SDOH thought, innovation and action. We see an unprecedented opportunity to improve health outcomes and reduce healthcare costs. That’s why we’re committed to an all-in strategy that encompasses efforts within our clinical, academic and research enterprises as well as community outreach, interventions and investments.

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Our work in SDOH continues to evolve and expand through the ProMedica National Social Determinants of Health Institute. Grounded in three core functions – Care, Community and Research/Analytics – the Institute collaborates with ProMedica operational teams and community partners to develop and implement SDOH initiatives throughout the regions we serve.

1,729,172

FOOD INSECURITY SCREENINGS (since 2014)

53,533 PEOPLE

served in our FOOD CLINICS

The ProMedica Ebeid Institute for Population Health has brought a healthy food market to UpTown Toledo, a neighborhood that is currently classified as a “food desert” because it lacks ready access to fresh, healthy and affordable food. A floor above the market you’ll find a teaching kitchen, education workstations for nutrition classes and community space for programs. It’s also home to a job training program and Financial Opportunity Center, offering free financial coaching.

15%

REDUCTION IN HEALTHCARE COSTS for individuals who received a prescription to a ProMedica Food Clinic

(Source: 2015-2017 Paramount Food Screening Data)

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53,200+ Urgent Care visits

Connected for Your Convenience

The easier it is to access healthcare services, the more likely you are get the care you need. This is why we have opened ProMedica Urgent Care centers throughout the Toledo metro area, and have introduced virtual visits with ProMedica OnDemand, enabling you to see a provider on your smartphone or computer.

Checkups to ER visits. Primary care providers to specialists. Diagnostic testing to rehab. Throughout your life, or the course of a particular illness or injury, there will be many stages in your healthcare journey.

Add the hundreds of ProMedica physicians and our hospital emergency rooms, and an appropriate level of care is always nearby. Best of all, our providers seamlessly share information to maximize safety and efficiency using the latest electronic health record technology.

This is why ProMedica is Well Connected. 22

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ProMedica isn’t the region’s only anchor institution committed to building a healthier future for our community. We have formed an Academic Affiliation with The University of Toledo College of Medicine and Life Sciences to transform health care and medical education in northwest Ohio.

The Next Generation of Medicine Spanning 50 years and encompassing a financial investment of more than $2.5 billion, the Academic Affiliation is building a legacy model of health care that will benefit residents of our region for generations to come by: • Creating a premier academic medical center for patients, faculty, students, residents and fellows at ProMedica Toledo and Toledo Children’s Hospitals • Recruiting nationally prominent faculty and researchers to Toledo and surrounding communities • Attracting top students in the health sciences • Generating new jobs and economic development opportunities in the health science and medical industries

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ProMedica Innovations Academics are only part of ProMedica’s forward thinking. ProMedica Innovations started out in late 2012 with the goal of helping local inventors, employees and community members develop and commercialize intellectual property around health care, with the intent to improve patient care and change people’s lives.

In 2015, we opened the doors to our world-class facility to serve as a landing point and launch pad for some of the technologies we are creating. And it’s taking off!

250

EXPECTED

JOBS IN TOLEDO 26

• 250 new jobs over next three years • Four companies invested in to date • More than five companies evaluating investment • Three companies in incubator • Economic development support

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INTERNATIONAL ProMedica is establishing itself as one of the premier healthcare solution providers in China, assisting and strengthening our Chinese partners and clients to succeed in their evolving healthcare industry. ProMedica expertise is also contributing to the Healthy China 2030 strategic national plan through the principles of health as a priority, reform and innovation, fair and just, and scientific development.

2018 Advancements: Domestic Training Programs ProMedica welcomed two contingents from Beijing to provide them a two-week training seminar on the American healthcare system. Sister Hospital Affiliation Bao’an Women’s and Children’s Hospital and ProMedica Toledo Children’s Hospital entered into an agreement to establish sister hospital status. ProMedica Delegation in China A ProMedica delegation of clinical and operational experts spent a week in Bao’an Hospital to assess the current operations of the hospital using our exclusive 100 Point Assessment tool. ProMedica Improvement Programs The ProMedica International team is installing improvement programs and projects into Bao’an Hospital. Systemizing Care Delivery in Bao’an ProMedica will be engaging the Shenzhen government in conversations regarding using ProMedica as the preferred partner in systemizing the entire care delivery structure of the Bao’an District.

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Philanthropy

23,000 PATIENTS received state-of-the-art TOMO MAMMOGRAMS

The communities that ProMedica serves have tremendous needs. As a not-for-profit healthcare provider, philanthropy allows us to focus on those needs through projects and initiatives we could not otherwise do. Over the years, millions of dollars from ProMedica‘s 11 foundations have been used to support programs, expand care and build facilities that touch the lives of millions of patients, their families and the communities we serve. The philanthropy team at ProMedica is dedicated to finding the intersection of donor passions, community needs and our vision. Our unprecedented “Generations of Care” initiative includes major fundraising campaigns in a number of our communities and facilities – initiatives and projects that will make catalytic gains in providing health and well-being services today and for generations to come.

49,600

TOTAL CUSTOMERS shopping at Ebeid Institute’s Market on the Green

$65 MILLION

RAISED Thanks to generous donations, philanthropy makes a critical impact.

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By the Numbers ProMedica has more than 60,000 employees, 13 hospitals, 2,600 physicians and advanced practice providers with privileges, 900+ healthcare providers employed by ProMedica Physicians, as well as 400+ senior care facilities.

600,000+ Paramount insurance members 10,000/day Hospice patients 3,300/day Home Care patients

2,100+ licensed inpatient beds 76,000+ inpatient discharges 62,000/yr surgeries 7,800/yr births

1,500 ProMedica Health Network members

345,000+/yr ER visits

Four ambulatory surgery centers

Nearly $65 million raised through philanthropy

40+ boards, committees/councils, foundations

More than $192 million in community benefit (2017)

450 volunteer board members

well

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connected mission-based

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KEY Skilled Nursing Memory Care Assisted/Independent Living Home Health Hospice Outpatient Rehab Hospital Urgent Care

Where You’ll Find Us Established in 1986, ProMedica is a locally owned, nationally recognized, not-for-profit healthcare system headquartered in Toledo, Ohio. We operate in 30 states as well as provide healthcare consultative services in China (see page 28).

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care close to

home

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