Walter Johnson President & CEO
“We’ve become sharp-focused on delivering the healthcare our unique community requires. And we deliver it in ways that other hospitals could not.”
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JRMC Uniquely Focused
Where Care Comes To Life
Uniquely Focused efferson Regional Medical Center is located on the western edge of the Arkansas Delta. It’s an area rich with tradition and filled with strong people who have weathered the societal and economic stor ms of life and succeeded. They persevere to make a better future for themselves and their families. Life in the Delta is sometimes filled with uncertainty, but it’s also filled with history, creativity, industrial development, rich far mland and even richer traditions. Yes, there are challenges, but with challenges come opportunities…and we at JRMC are in a unique position to see both every day. Here at home, poverty is widespread, and many in our community struggle daily to put food on the table with very little left over to pay for other needs, such as healthcare. Chronic diseases like diabetes, hypertension, and coronary artery disease have continued to grow at alarming rates. Over the course of more than 100 years, we’ve responded dynamically to many of these challenges, developing programs and services to meet these needs. There’s a term you may remember from your elementary biology class...symbiosis. It’s a great word to describe how JRMC has become intertwined with the community. As the term implies, we’ve formed a close, enduring relationship with Southeast Arkansas… one that provides mutual benefit. Without a doubt, our community has come to depend on JRMC…as we depend on them. We’ve become sharp-focused on delivering the healthcare our community demands. And we deliver it in ways that other hospitals could not. Looking across the years, you’ll see countless examples of how we’ve brought cutting-edge technology to the Delta to fulfill our mission. Beginning with traditional X-ray technology almost a century ago and evolving all the way through state-of-the-art computed tomography (CT) and magnetic resonance imaging (MRI), we’ve
made whatever investment was needed to keep our services current. And all the while we’ve continued to aggressively recruit physicians, who have brought the talent needed to utilize this technology. Now, after spending more than a century as the beating heart of healthcare in Southeast Arkansas, we find ourselves uniquely specialized to provide healthcare here at home. In recent years, the healthcare industry has undergone a dramatic transfor mation, and all the signs indicate there is more to come. These changes have required healthcare facilities to reassess and restructure many operational practices, especially for hospitals like JRMC, which operate in economically challenged areas. However, as we look ahead, we can say with confidence that the same expertise that sustained us over the last 100 years will keep us relevant in the future, regardless of what lies ahead. Recr uiting new physicians and nurses, improving access to care, tailoring ser vices to both the aging population and the newly insured…JRMC is focused on our community and we have both the skill and experience to be successful. With the same resilience and ing enuity that we use to answer the call ever y day, I believe we’ll succeed in the future. With this latest annual report, we’d like to bring “in focus” some of the unique qualities of Southeast Arkansas and paint a portrait of how we specialize in caring for this community…our friends, neighbors and family.
Over the course of 100 years, we’ve responded dynamically as Southeast Arkansas has changed, tailoring our services to the needs of the community.
Walter Johnson President & CEO
Focused On Care 06 Providing care that reflects the specific needs of our patients.
Photo Here
Technology 08 Living in the Delta doesn’t mean living without advanced medical care.
Definitive Needs 10 Meeting the unique healthcare needs of our population.
Medical Staff 12 Bridging the gap between JRMC and those in need across Southeast Arkansas.
Economic Benefit 14 JRMC’s investment in the community reaches far beyond the medical profession.
Quality 16 Keeping quality front and center.
Inclusiveness 18 Breaking down barriers to care.
Education 20 Providing opportunities in all levels of healthcare service.
Wellness 22 Creating an environment of good health.
Challenges Ahead 24 Preparing for the future of the healthcare industry.
Focused On Care hen you think of the word “care” in the context of healthcare, images immediately appear of physicians and nurses at the bedside, but the act of caring for patients can manifest itself in many different ways. Medical technology is obviously a key element of quality care, but education, support services and compassion are also important components. Many people would be surprised to know the breadth of JRMC’s technological and interpersonal abilities…except for those whose lives have been changed by them. We are proud to provide services, equipment and staff that reflect and meet the specific needs of our patients – people whose lives, lifestyle choices and medical conditions are the result of the unique challenges presented in Southeast Arkansas.
Our Patients, Ourselves Southeast Arkansas may present a unique set of challenges to its residents, but it also provides a multitude of benefits. This is our home, and we see a little of ourselves in every patient we treat. For many people, like Lee Walt of Dumas, deer hunting is a way of life from a very early age. Not just the thrill of the hunt, but the beauty and peacefulness of time in the solitary outdoors. Unfortunately, solitude sometimes comes with a cost. Lee is an avid hunter, so he didn’t think twice about making a quick trip into the woods by himself to hang a tree stand for his wife. “I usually wear a safety harness, but I thought it was going to be a simple, 15-minute deal. The last thing I remember is putting my foot on her stand.” The cable around the tree stand broke and Lee fell 20 feet to the ground, shattering his pelvis and making his legs completely useless. Lee was knocked unconscious and has only pieced together events from what family members later told him. He managed to drag himself to his truck, where he used a farm radio to reach his father. Lee was taken by ambulance directly to JRMC, where surgery was performed by Orthopedic Surgeon John Lytle, M.D. 06
JRMC Uniquely Focused
No other hospital in Arkansas could have provided the same unique combination of technology, skill, location and empathy that JRMC provided on that fateful day. Dr. Lytle is an avid sportsman himself, and he understands the connection to nature that keeps families in Southeast Arkansas returning to the deer woods. Having spent many hours in deer stands himself, he could picture exactly how the accident happened, and he also knew the level of mobility Lee would require to return to his daily routine of work, family and leisure time. Dr. Lytle is also one of only two physicians in Arkansas who utilize a unique procedure for injuries such as those sustained during Lee’s accident. “Dr. Lytle basically rebuilt my pelvis with a metal plate,” says Lee. “It’s held in place by 20 screws, and goes from one side of my body to the other.” After a week of post-surgical care, Lee simply moved to JRMC’s Rehab unit, where the Rehab team “did an incredible job” preparing Lee for his return home. Within just six weeks he was starting to stand again, and today, Lee is back to normal, thanks to the care he received at JRMC. “Dr. Lytle, all the nurses and the Rehab staff…they were just unbelievable,” says Lee. If he had not been transported to JRMC, his chances for a complete recovery might have been severely compromised. If he had not been treated by a physician who shared his passion for the Southeast Arkansas lifestyle, there would not have been the same level of understanding about what healing truly means, both inside and out. And he wouldn’t have had the benefit of the specialized procedure that put Lee’s pelvis back together. It has been quite a journey, but today, Lee Walt farms and hunts just like he always did. He even managed to get back in the deer woods for a little hunting before the season ended, but with a new appreciation for safety. “The first time I got back in a deer stand, I’ll bet I didn’t move an inch. And I always wear a safety harness, no matter what.”
Where Care Comes To Life
John Lytle, M.D. JRMC Orthopedic Surgeon
This is our home, and we see a little of ourselves in every patient we treat. Lee Walt Dumas, AR
Technology t’s almost beyond comprehension that an economically challenged community of this size could provide such highly advanced medical care and technology to its residents, but that’s exactly what we’ve done. With 371 beds and 125 physicians representing over 25 specialties, JRMC has the ability to provide virtually any healthcare service a patient could need. We have also proven that having the best tools can mean the difference between life and death. Right here in the Delta, healthcare providers can utilize positron emission tomography (PET), three-dimensional computerized tomography (CT) and magnetic resonance imaging (MRI) to diagnose diseases. They can perform advanced procedures such as extracorporeal shock wave lithotripsy, laparoscopic keyhole surgery, and coronary angioplasty. They can implant cardioverter defibrillators and temporary or permanent cardiac pacemakers. Surgeries that once took multiple months to recover from, now often have patients returning home the same day and back to work the next. Over the last two years, JRMC has spent $11.7 million on medical equipment, imaging, technology and information, building infrastructure and patient facility and monitoring upgrades.
FOCAL POINT: The community we serve is also the reason why we serve. It resides in the crosshairs of our focus.
Chris Harper JRMC Information Systems
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Advanced imaging equipment provides a clear picture of disease diagnosis and treatment…right here at home.
In July 2013, JRMC became the only hospital in Arkansas named to the list of Most Wired Hospitals and Health Systems by Hospitals and Health Networks magazine. One reason JRMC was selected is our use of barcode technology while administering medication, and another is our use of wireless documentation technology on patient floors. Technological advancements have resulted in more than 3,300 people signing up for JRMC’s Jchart program, creating a secure personalized electronic medical record that can be accessed from a computer, tablet or smartphone. And off-campus physicians can access their patient’s information electronically through Jconnect, a new program that saves time and eliminates the need for phone calls and faxes. There are currently a total of 30 clinics and hospitals participating in Jconnect, which includes 37 physicians and 12 nurse practitioners. Another way technology has allowed JRMC to reach out into the community is through social media. JRMC currently has 13,600 followers and contacts on Facebook, Twitter, Instagram, YouTube and Constant Contact. Over the past year, JRMC made more than 455 social media or Constant Contact posts/messages with 824,312 reaches.
Definitive Needs ome of the prevailing circumstances in our service area, such as the large number of rural residents, make the delivery of healthcare more difficult. At the same time, many chronic health conditions in Southeast Arkansas present their own challenges because they are caused, in part, by lifestyle choices: tobacco use, eating junk food, supersized portions, and not enough exercise. Most people know they need to make a change, but a large majority never do. So where and how we live has a big impact on our health. JRMC provides the counter balance and works hard to equal the scale. We’ve sought out ways to serve and encourage positive, healthy changes for our friends and families...and we’re making a difference. As the closest medical center for patients in this area, JRMC is often the primary resource for healthcare services, so our staff and our treatment options are tailor-made for the complications that arise from these chronic health issues. When you look at the prevalence of smoking and obesity in this area, it’s no surprise that many of our patients suffer from cardiovascular disease. JRMC’s cardiology department has three state-of-the-art Cath Labs, one Interventional Radiology room, 64-Slice CT technology with full support cardiology services, a 34-bed Progressive Cardiac Care Unit, an 8-bed Coronary Care Unit, and both inpatient and outpatient Cardiac Rehab services. As a result, a wide range of cardiology procedures are conducted at JRMC each year including diagnostic, interventional, pacemaker and implantable defibrillator procedures. Our cardiac team is made up of seven cardiologists, one cardiovascular surgeon, and a host of supporting staff. Cardiology is just one example of how JRMC has identified the risks facing our patients, anticipated their needs, and met those needs straight on. Another very specific need was met with the upgrade of our MRI equipment, allowing it to
accommodate individuals who are obese. We can now perform scans on patients up to 450 pounds at the I-530 Imaging Center, which has made a true difference for many patients. JRMC’s Nutritional Services department also plays an important role in meeting the unique needs of hospital patients, as well as members of the community. Nutrition counseling takes a different tone in communities like ours where diet is so closely tied to many of the persistent health issues such as heart disease, diabetes and stroke. Our dieticians understand the challenges of adapting the traditional Southern style of cooking, and are well-versed in teaching patients how to shop, prepare and enjoy different foods depending on their specific dietary needs. This information is not limited to hospital patients either. Members of the general public can also receive this assistance from our dieticians. Another unique need is being met by JRMC’s on-site retail pharmacy, something that is offered by very few medical centers. Our patients have often traveled many miles to get here, frequently depending on a friend, relative or public assistance transportation. They may not feel like making a trip to a second location, or may not have time, and as a result, may go home without prescriptions being filled. Having a pharmacy onsite can sometimes make the difference between successfully treating a patient or having them make a return visit to a clinic or the emergency department. Even our local patients benefit greatly from JRMC’s pharmacy and its close proximity to most of the physician offices in Pine Bluff. There are many other examples of JRMC’s response to the needs of Southeast Arkansas, including a Wound Care center featuring hyperbaric therapy, and the South Central Center on Aging, devoted exclusively to the needs of older Arkansans. We know this community, and we know how to care for the people who live here.
Many chronic health issues in our community are directly related to lifestyle, such as obesity and cardiovascular disease…our treatment options are tailor-made for the complications that arise from these chronic health concerns.
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CONVERGENCE: An on-site pharmacy is one more example of the convergence of community need and JRMC’s specific adaptation to serve the local population.
Cheryl Broughton, Pharm. D
Medical Staff hospital of JRMC’s size, with so many medical specialties, is an undeniable asset for a region such as Southeast Arkansas. Having a full range of services available is vital to ensuring patients can receive the care they need right here at home. From endocrinology to geriatrics to neurosurgery, we’ve got a specialist on staff ready to serve. And patients report regularly that we are meeting not only their medical requirements but their interpersonal needs, making their hospital experience as pleasant as possible. Lack of education, low income, poor access to healthcare, chronic illnesses, co-morbidities and more can create extremely complicated patient situations for our medical staff to navigate. Most of JRMC’s physicians have served in this community for more than a decade, and during that time, have developed a variety of unique abilities to better serve their patients. These men and women are not just experts in their field; they are well-versed in how to address the barriers that stand in the way of their patient’s good health. In some cases, it’s the knowledge that a home health nurse is the most reliable way to provide follow-up care in a specific community. In others, it’s knowing how to compensate for the fact that beans and cornbread will be on the menu several days a week, or showing low-income patients how to utilize prescription assistance plans to pay for their medication. In addition, members of our medical staff face their own obstacles in caring for the community. They have longer distances to reach across and a wide variety of local communities to become acquainted with. It’s a little like solving a puzzle, and our physicians have developed a unique set of skills in the process of putting the pieces together. A number of JRMC’s physicians also spend considerable time on the road, conducting clinics throughout Southeast Arkansas and providing specialized care that would not otherwise be available in surrounding communities. Clinics are held in hometown facilities featuring specialties such as
HIGH DEFINITION:
A highly defined cutting-edge vision is at the forefront of our care.
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Physicians clockwise from top left: Paolo Lim, M.D. Neuroradiology, Kenneth Lambert, M.D. Obstetrics/Gynecology, Amy Cahill, M.D. Obstetrics/Gynecology, Regan Gallaher, M.D. Neurosurgery.
cardiology, general surgery, neurology, pulmonary medicine and urology. Some JRMC physicians travel weekly to clinics in towns such as Camden, Dumas, Monticello, Star City, Stuttgart and Warren. Any of JRMC’s physicians could easily have chosen to practice in a larger, more metropolitan area, with shorter workdays and fewer barriers between them and their patients. But they have devoted themselves to learning and “Having JRMC specialists meeting the needs of our community. visit our practice is such a JRMC’s hospitalist welcoming benefit for our patients. program is another important tool for Many of them might never providing quality care to our patients, who come receive specialty care if they to us from across our 11 county service area. had to travel out of town.” Hospitalists are highlytrained physicians who do Darlene Savage, Manager not have a traditional office Monticello Medical Clinic practice and only treat patients who have been admitted to the hospital. They know the complete range of services offered at JRMC and are available 24-hours-a-day to utilize the latest diagnostic tools and best treatment modalities. JRMC recognized several years ago that hospitalists could provide an invaluable service to patients who either have no primary care physician, or live too far away to utilize their family doctor during a hospital stay. They also treat individuals who have a family physician, providing specialized hospital care and keeping the family doctor advised of all activities and progress. The hospitalist program is one arena in which JRMC’s electronic health records system really shines. As part of the Health Information Exchange (HIE), JRMC physicians and their partners in smaller communities can share health-related information with each other across the miles, exchanging information and reducing duplication of services. It plays a vital role in coordinating efforts between family physicians and hospitalists, and in keeping the lines of communication open between the two.
Focused On Economic Benefit lthough JRMC is a not-for-profit organization, it has been an anchor of the community and one of Southeast Arkansas’ largest investors for more than 100 years, both in terms of money and resources. That’s a powerful statement, but it’s just a snapshot of the bigger picture. “The presence of a large, technologically advanced hospital is an advantage for Pine Bluff on many levels,” said Lou Ann Nisbett, president and chief executive officer of the Economic Development Alliance for Jefferson County. “JRMC and its related clinics don’t just provide residents of Pine Bluff and the region with access to state-of-the-art medical care and jobs; they also make our community more attractive in any qualityof-life assessment by businesses looking to locate here.” The most obvious economic benefit of a healthcare facility can be traced back to employment. On a day-to-day basis, JRMC provides jobs for more than 1,500 people, and in fiscal year 2014, JRMC provided payroll and benefits totaling $87,556,000. For many years now, we have consistently been one of the largest employers in Jefferson County, and not just for medical professionals. Plumbers, housekeepers, cooks, construction workers and clerical staff are among the employees who keep JRMC running 365-days-a-year. The majority of those employees live, shop and pay taxes in Southeast Arkansas, contributing substantially to the local economy. Having a local hospital also positively affects the housing market, where the creation of jobs leads to greater home sales and new home construction, which also increases property values. Over the years, JRMC has been a strong supporter of other organizations that contribute to the growth and enhancement of our community. Our administrators and employees serve on local boards and committees, we forge working partnerships with other agencies, and we financially support other organizations that are vital to the economic health of our community. We know that working together is the only way to reach our goals, and we are pleased to share our vision of “JRMC makes our the future with other like-minded people. Within the next decade, JRMC community more attractive will be building a new facility to replace the current hospital. This will in any quality-of-life assessment further impact the economy through by businesses looking to construction jobs and the purchase of local services and materials. locate here.” Lou Ann Nisbett, All of these components benefit Southeast Arkansas greatly on their President & CEO, Economic own, but when put together, they demonstrate a commitment to the future Development Alliance for that makes us proud to be right where we Jefferson County. are. “JRMC is a valuable asset for those living here,” says Lou Ann Nisbett, “and for anyone considering a move to this community.” Today’s economy presents more challenges than we’ve seen in quite a while, but we know that working together benefits us all. Success breeds success.
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In a community such as Southeast Arkansas, collaboration is a necessity. Residents, business owners and community leaders must work together to make the economy stronger, the quality of life more fulfilling, and to set the stage for a future that holds the promise of growth and success. By extending our hands to each other, we are all stronger than we would be on our own.
Keeping Quality Front And Center he word “quality” carries a lot of weight in the healthcare industry. But just exactly how do you measure quality in a field that is constantly changing, where perfection can never be achieved, and where many aspects of success are intangible? In light of statistically significant health challenges and an ever-changing population base, our goal must be constant improvement. This requires that we employ specific scientific measurements to track our progress. Once again, we’ve called on our award-winning medical documentation system to assist us in tracking these measures. And in accordance with our desire for transparency, these measures are reported and made available publicly for all to see. The measures are all established and reported to organizations like the Centers for Disease Control
and Prevention, Centers for Medicare and Medicaid Services (CMS), Arkansas Medicaid, Hospital Engagement Network and other organizations with established quality indicators. One example of a 2014 quality measure that we scored higher on was “appropriate discharge instructions for heart failure patients.” Our patients frequently need extra help understanding the details of their discharge instructions. So JRMC has built in extra time with each person and has programmed reminders into our electronic medical records technology to make sure instructions are provided in a simple, timely fashion. As a result, JRMC scored 96 percent for this measure while the national average was 94 percent. Value-Based Purchasing (VBP) is a CMS initiative that rewards or penalizes acute-care hospitals based on performance rankings for a set of quality and
We’ve learned to not only take the extra time required, but we’ve hard-wired reminders into our electronic medical records technology to prompt the appropriate instruction at the appropriate time.
Left to right: Marva LaGrant, R.N., Nurse Manager Jenny Fischer, R.N.
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satisfaction measures. CMS also penalizes acutecare hospitals for excessive readmissions of patients within 30 days of a previous hospital stay. These two payment programs are part of an effort to hold hospitals accountable for the quality and value of the patient’s hospital stay. As the table below illustrates, JRMC scored better than a number of comparable Arkansas hospitals.
Most Recent Rankings From Centers for Medicare and Medicaid Services (CMS) Valued Based Purchasing Hospital
Composite Adjustment Score
Hospital
Composite Adjustment Score
100.02%
CHI St Vincent - Little Rock
99.01%
JRMC 99.60%
Conway Regional - Conway
98.92%
UAMS - Little Rock
99.60%
Saline Memorial - Benton
98.36%
Baptist - North Little Rock
99.31%
National Park - Hot Springs
98.04%
Baptist - Little Rock
99.02%
CHI St. Vincent - Hot Springs
JRMC was featured in an American Hospital Association promotional video because of our participation in the national Hospital Engagement Network (HEN). The network examines quality measures and outcomes that will reduce patient harm. More than 600 hospitals participated in the network, and of those 600, only 16 of the top performers were featured in individual videos for their progress in reducing harm across the board. Many of the hospitals featured were community hospitals like JRMC, which were faced with unique individual challenges specific to their location. As part of the HEN, JRMC became one of 34 Arkansas hospitals to earn “Century Club” membership through achievements aimed at improving care and reducing preventable readmissions. To become part of the Century Club, a facility must report outcome data in all 10 of the HEN’s areas of focus or all that apply to their hospital.
CLARITY: In the age of transparency, JRMC strives to present clear and unfiltered reporting of quality measures so the public can make informed healthcare decisions.
Inclusiveness t JRMC, our desire to serve is focused only on need: not race, religion, gender, or income. Every person in our community deserves access to quality, dependable healthcare services, and we take pride in providing comprehensive care all of our patients can count on. We are also proud to say that no one is ever turned away because of inability to pay. Economic uncertainty is nothing new to Southeast Arkansas, and JRMC has always been a haven for those who are lacking in resources…an unfaltering place of refuge in difficult times. In today’s rocky economic climate, more people find themselves needing help than ever before. The 11 counties that comprise our service area - Arkansas, Ashley, Bradley, Chicot, Cleveland, Dallas, Desha, Drew, Grant, Jefferson and Lincoln - represent some of the poorest areas of the state. According to the latest census, the average per capita personal income in our primary service area is $29,541. That is significantly below the state level of $32,315 and the national level of $39,635. In Arkansas, 18.4 percent of our residents live below the poverty level, as opposed to 14.3 percent nationwide. This has a substantial impact on their ability to pay for and their willingness to seek out healthcare services. In addition, according to the Arkansas Center for Health Statistics, most Southeast Arkansas counties have more residents with no health insurance than the state average. That’s why JRMC has pledged to always care for the
people who need us most, regardless of their economic situation. Whether it’s a family with insurance, a single parent with no job, or a retired person whose insurance coverage doesn’t go far enough, we will find a way to accommodate their needs. As you can see, JRMC remains committed to quality care for all, but it comes at a cost. While we are expected to remain fiscally responsible, those who need our attention are frequently unable to do the same. During fiscal years 2013 - 2014, the cost of charity and uncompensated care provided by JRMC was $31.6 million. We’re proud that JRMC is able to offer healthcare security to all segments of the population, even in uncertain times. We also reach outside the hospital to provide a number of services to ensure the health and well-being of our residents. Thanks to a grant from Komen for the Cure, JRMC’s Reach Every Woman mammography program provides free mammograms, biopsies and other follow-up care to women who don’t have insurance, those who don’t have enough insurance or just haven‘t met their deductibles. JRMC also partners with churches, industries and community service groups to participate in health fairs, where we offer free screenings and advice from medical professionals. We know there are many people who do not see a physician regularly, so we try to share healthcare information with them whenever possible. We’re all in this together, and we will continue caring for our neighbors in need regardless of their challenges.
Opening the Marketplace to Everyone The Affordable Care Act made health insurance available to every American in a new way, but presented a huge learning curve in the process. People who have not been able to afford medical insurance in the past were now shopping in the health insurance marketplace. However, many of those people had no idea how to look for and determine the right plan for themselves and their families. JRMC recognized that many members of our community would benefit from the health insurance marketplace and the Arkansas “private option.” We provided information on our website and in many locations throughout Southeast Arkansas. JRMC hosted several community education events and collaborated with numerous organizations that were guiding individuals through the enrollment process. JRMC saw the positive effects of the marketplace very quickly. For example, in the first six months of 2014, JRMC saw nearly 7,000 patients with insurance or “private option” coverage who had previously been uninsured. 18
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HIGH RESOLUTION: During fiscal years 2013 and 2014, the cost of charity and uncompensated care provided by JRMC was $31.6 million.
Education ne of the greatest economic investments that can be made in any community is education. It’s the key to success for both businesses and individuals, and nowhere is that demonstrated more clearly than in the medical field. JRMC has been focused on education for many years, and continues to devote substantial resources to this relationship. JRMC has been providing clinical training for physicians since 1973 through the Area Health Education Center (AHEC) Family Practice Residency Program. Students seeking other degrees in the medical field, such as radiology and respiratory care, also utilize JRMC for clinical experience. And JRMC’s School of Nursing, which has been offering a diploma program for registered nurses since 1981, will begin offering an Associates of Applied Science degree in 2015. The healthcare industry is heavily promoting higher education; in fact, there are currently only 47 diploma programs in the United States. Students who graduate with a degree feel a greater level of prestige because of their title, and it simplifies the process of pursuing even higher nursing degrees.
The Holcombs
Beneficiaries of JRMC’s Support for Education
Karen Holcomb always knew she would be a nurse, just like her mother and grandmother, and received her R.N. degree from the JRMC School of Nursing. However, she never imagined her daughter would follow the same path, or that one day she would be working at JRMC not only with her daughter, but also her husband and son. Karen’s training prepared her for many roles at JRMC, including her current position as Nurse Manager of JRMC’s Orthopedics Unit. She is also serving her second consecutive term on the Arkansas State Board of Nursing, (ASBN) and her second consecutive term as ASBN President – the first nurse to ever hold that distinction. Daughter Kathleen Holcomb Bottoms is studying at the School of Nursing, and is working in Same Day Surgery as a patient care tech. She says all the nurses in her family were a great inspiration, but she also remembers “everyone calling my mom when someone was sick, because she knew what to do. Now I want to be the one who knows what to do.” Daniel Holcomb is pursuing his Master’s degree in Math, but like many students, is also working. Daniel is a Tech in the JRMC pharmacy, where he has excelled because of his math skills. And Danny Holcomb, the patriarch of the family, is Manager of the JRMC Facilities Department, making sure everything is running as it should across the entire campus. “We’re hometown people,” he says. “We’re proud to live here, and proud to be part of one of the largest workforces in the area.” Karen agrees. “We all have a vested interest in this community and in JRMC. It’s given us all a lot of opportunities, and we’re committed to making it succeed.”
EXPOSURE:
We are continuously
seeking new ways to expose individuals to the education
and experience they need to
strengthen their own families as well as the future of Southeast Arkansas.
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J.D. Bridgforth
ER Tech/Pre-Med Student, University of Arkansas, Fayetteville
When he started college two years ago, J.D. Bridgforth of White Hall knew he wanted to be a doctor. So when his first summer break rolled around, he skipped vacation for some on-the-job training with JRMC Orthopedic Surgeon John Lytle, M.D. Dr. Lytle has been hiring aspiring physicians for about 15 years now, paying them a salary to work in his practice during the summer months, doing everything from cleaning rooms to learning how to bandage, cast and splint. “If we’re going to adequately train the next generation of physicians, we‘ve got to make sure they understand what medicine really is, and the best way to do that is to spend time in the hospital,” Lytle says. J.D. agrees. “It was such a great opportunity to be exposed to the medical field,” he says. “I felt like it would help me prepare for my future and even help me get into med school.” Two summers later, J.D. is working in the JRMC ER, and while he hasn’t settled on a medical specialty yet, he knows exactly where he wants to be. “My goal is to study at UAMS and come back to Pine Bluff to practice.”
Michelle Newton, MSN, RN Administrative Director, Nursing
Michelle Newton grew up in Star City, a community of 2,200 people just south of Pine Bluff. From an early age, Michelle knew she wanted to work in the healthcare industry, but she also wanted to raise her own family in the same small town atmosphere she enjoyed as a child. So she enrolled at the JRMC School of Nursing, graduated in 1986, and began working at JRMC. As the years went by, Michelle worked in many areas of the hospital, and in 2006, JRMC provided tuition assistance for Michelle to receive her BSN. In 2013, she received a Master’s degree in nursing administration, something she says would never have happened without the support of her family and her coworkers at JRMC. Today, Michelle is Administrative Director of multiple clinical areas. The training she received at the School of Nursing, along with the educational opportunities provided at JRMC, have allowed Michelle to continue growing in her profession while maintaining the lifestyle she loves and supporting her community. Now Michelle is serving as a role model to others, including her own two sons. Seth Newton completed his training at the JRMC School of Nursing in December of 2013 and is working in ICU; Stephen Newton will be entering the JRMC School of Nursing in January of 2015.
“I’ve had tremendous support from JRMC throughout my career. It has allowed me to meet some great people, and to be a student as well as a mentor.”
Focused On Wellness efferson County ranks 59th in health and wellness among the 75 counties in Arkansas. For JRMC, this provides both a challenge and an opportunity to change attitudes, behaviors and trends, while creating a new reality for the next generation. For example, diabetes is a significant threat in our community. The Arkansas Department of Health reports that 14 percent of the residents in Southeast Arkansas have been diagnosed with diabetes, while countless others have the disease and just don’t know it. On top of that, 41 percent of diagnosed adults do not participate in any type of physical activity, even though it has been proven that regular exercise goes a long way towards managing the symptoms of diabetes. In response, JRMC has developed a new outpatient diabetes program that offers new ways of dealing with the disease, which includes a special emphasis on exercise. This eight-week program is called LEAP, and JRMC Endocrinologist Maher Alesali, M.D. is the Medical Advisor. LEAP stands for Learning, Evaluation, Activity and Prepared. LEAP begins with information from a diabetes educator about diet, glucose monitoring and medication, and then introduces a fitness component, with exercise classes three times a week at one of JRMC’s Wellness Centers. The difference in JRMC’s LEAP program is that we’ve looked at the specific challenges facing diabetes patients in Southeast Arkansas, and molded this program to meet their needs. We know that many people fail to keep up with their glucose levels, so we’re training LEAP participants to sign up for JRMC’s Jchart personal health account. Jchart is a free service available online and accessible by computer or smartphone where participants have access to their own medical information. LEAP participants can quickly and easily log their results in their Jchart, where they and their physician can follow their progress. The same approach is used in the fitness component, where many people are intimidated by the prospect of starting an exercise program. Each participant is guided in movements that are specifically tailored to their personal level of mobility, so participation is easy and goals are realistic. We believe this one-on-one instruction and personal involvement in monitoring the program’s 22
JRMC Uniquely Focused
progress will make an impact on disease management in ways we have yet to see in Southeast Arkansas. While the Wellness Centers are a tremendous resource for programs such as LEAP, JRMC’s ultimate goal for the centers is to create a culture that embraces and celebrates physical fitness for everyone, regardless of age or health challenges. It’s a documented fact that overall eating and exercise habits in Southeast Arkansas are poor, and we know that changing behaviors can be hard. So the Wellness Centers were constructed to give residents of our community a welcome environment for adopting healthier lifestyles. Our first goal is making members comfortable, so they meet with a wellness specialist to discuss their personal goals and challenges, including nutrition and physical activity. We have two facilities – one in Pine Bluff and one in White Hall – so that access will be easy for residents all across Jefferson County. We offer a wide range of workout options, from the extremely popular Les Mills group classes to cardio, strength training, Zumba and racquetball (at the White Hall facility). Older members enjoy the Senior Strength and Stretching class, the PACE (People With Arthritis Can Exercise) group, and the Tai Chi class, which improves balance and helps
Where Care Comes To Life
prevent falls, an extremely important factor in older individuals. In addition, the walking track at the Pine Bluff facility is utilized by hundreds of members and nonmembers alike. By making wellness both fun and convenient, JRMC is changing attitudes about exercise and raising awareness about the need for healthy goals at every stage of life. We also recognize the importance of making an impression on our residents at an early age, by encouraging our youth to make positive lifestyle choices that will make the next generation of Arkansans healthier. However, we also know that youngsters don’t respond well to pamphlets or lectures. JRMC goes into the local school system for programs such as Healthy Lungs, which initiates
conversation with middle school and junior high students about the importance of not using tobacco products. We let them see and touch models of lungs, tongues, and mouths to demonstrate the drastic consequences of smoking, chewing and dipping tobacco. The same approach is used in education about breast cancer. A JRMC health educator visits area junior high schools and shows the girls plastic models that demonstrate abnormalities in the breast. A frank discussion is held and a dialogue begins that, hopefully, will carry over in the home and raise awareness of women’s health issues at an early age.
VISION:
JRMC strives to move beyond the day-to-day provision of care, and closer to the vision of encouraging a greater level of wellness throughout the community.
Reshonda Brown-Walker Pine Bluff, Arkansas
As a busy young mom, working out at the Wellness Center helps Reshonda “Shon” Brown-Walker ensure that her family’s future will be a healthy one. Volunteering at the Wellness Center allows her to help others do the same. Working out was mandatory during the five years Shon served in the U.S. Army, but after coming back home and starting a family with her husband, Lee, workouts became fewer and farther between. “I did get out of the habit,” Shon says. “I’m a stay at home mom, I volunteer at my daughter’s school and at my church, so I’m always on the go. But I missed the lifestyle benefits of regular exercise, so I started going to the White Hall Wellness Center.” Shon says she had gained weight during her first years of motherhood, and a knee injury kept her from running, so getting back in the swing of things was a little difficult. “I did the fad dieting, the yo-yo dieting, all of it. Around the first of the year though, something just clicked with me. I told myself I was going to eat healthy but not diet, and I was going to get moving.” Shon lost 24 pounds this year by working out four days a week, and she also spends one day each week volunteering at the Wellness Center. “I answer phones, give tours, and answer questions about working out. I try to encourage people to remember that we were all new to this at one time or another, so they shouldn’t be self-conscious. If you aren’t ready to take a class with a group of people, get on a treadmill, turn on the TV and just walk.”
Focused On The Challenges Ahead iven the current state of transformation in the healthcare industry, predicting the future is more difficult than ever before. Like numerous other hospitals, JRMC has been significantly affected by changes on the national, state and local level in terms of how people seek out and pay for healthcare services. We have been forced to make many adjustments in order to navigate the new healthcare environment,
and will continue to do so as that process unfolds. Although many uncertainties exist, we do know a few things for sure: • Federal healthcare legislation will continue to reduce our Medicare reimbursements by millions of dollars each year. • The shift from inpatient to outpatient procedures will continue, which will also reduce revenue. • A major emphasis must be placed on recruiting and retaining a sufficient number of physicians and
George Makris, Jr. Chairman, JRMC Board of Directors
24
JRMC Uniquely Focused
Where Care Comes To Life
nurses to care for the next generation of Southeast Arkansas residents. These are just a few of the primary issues JRMC will face in the near future, and any one of them alone would present compelling challenges in light of the current healthcare climate. Statistics and trends can help us prepare for the “new normal,” but regardless of the developments, we know that our unique location in Southeast Arkansas will require a different approach than anywhere else in the United States.
Luckily, that’s business as usual at JRMC. No one knows the healthcare needs of our community better than our staff, and no other facility is better prepared to deal with the medical, environmental and economic circumstances that are presented here. How we respond and what we do today has a direct and significant bearing on our future. Caring for this community has been our mission for more than 100 years, and we are committed to continuing to meet those needs for generations to come.
“JRMC is fortunate to have a Board of Directors made up of men and women who live in Jefferson County and have a vested interest in the future of our community.”
About JRMC Jefferson Hospital Association, Inc. is a 501(c)(3), not-for-profit organization, incorporated in the State of Arkansas. Jefferson Hospital Association’s primary purpose is to provide healthcare to the citizens of Southeast Arkansas. Jefferson Hospital Association, Inc., d/b/a Jefferson Regional Medical Center (JRMC), the only general acute care hospital in Jefferson County, is licensed for 471 acute care beds and currently operates 371 beds. JRMC serves residents of an 11 county area which includes Jefferson, Cleveland and Lincoln counties (primary service area) and Arkansas, Ashley, Bradley, Chicot, Dallas, Desha, Drew and Grant counties (secondary service area). It is estimated that approximately 65 percent of JRMC’s patients originate from its primary service area with 35 percent originating from the secondary service area.
Mission Jefferson Regional Medical Center is committed to providing measurable quality health services in a caring environment, which fulfill the needs of our patients, physicians, employers, employees and community.
Vision Jefferson Regional Medical Center will be widely recognized as the healthcare leader and referral center of choice for Southeast Arkansas by providing quality healthcare services in a cost effective manner.
Values Jefferson Regional Medical Center, as a community-owned, not-for-profit health care provider, is guided by a core set of values known as “STEER” which provides direction to the organization in achieving our mission. These values are as follows: Stewardship – We use our resources in an effective and efficient manner. Trust – We conduct ourselves with honesty, reliability and integrity. Excellence – We perform at a level that meets or exceeds expectations. Ethics – We hold ourselves to a high level of personal and corporate responsibility. Respect – We show consideration, fairness and dignity to others.
Reach JRMC’s stratigic plan for future growth is defined by the acronym “REACH.” Recruit, Retool & Rebuild – Medical Manpower & Modern Facilities Expand & Grow Services – Market Share, Referrals, Revenue & Services Affiliate & Align – Partnerships for Future Success Cultivate Loyalty – Improve Experience & Perception Help Improve Health – Prevention, Self-Management, Quality & Outcomes 26
JRMC Uniquely Focused
Where Care Comes To Life
Governance & Accountability Jefferson Hospital Association, Inc. is comprised of 30 members with the primary responsibility of electing the Board of Directors. A 15-member Board of Directors conducts the business of the Association. Thirteen members are elected for six-year terms by the membership of the Association following recommendations of a Nominating Committee. In addition to the elected Directors, the Chief Executive Officer of the Association and the Chief of the Medical Staff of Jefferson Regional Medical Center are members of the Board of Directors as long as they hold those positions. Each member of the Board of Directors must be a resident of Jefferson County. The Board of Directors has the authority to appoint standing or special committees as it sees fit to aid in the conduct of the Association’s business. The Board is expressly authorized to appoint an Executive Committee, which shall have power to transact all regular business of the hospital between meetings of the Board of Directors, provided any action taken by such Committee shall not conflict with the policies of the Board of Directors. The Board has formed the following standing committees: Affiliate Review Committee, Audit Committee, Building & Equipment Committee, Finance Committee, Focused Improvements Committee, Governance Committee, Investment/Retirement Committee, Patient Care/Quality Council Committee.
JHA Board of Directors Frank Anthony
Marty Casteel
John Lytle, M.D.
Scott Pittillo
Drew Atkinson
Michelle Eckert, M.D.
George Makris
Clifton Roaf, D.D.S.
David Brown
Walter Johnson
Joann Mays, M.D.
Ford Trotter, III
James A. Campbell, M.D.
Annette Kline
Chuck Morgan
JHA Association Membership David Beck
James A. Campbell, M.D.
Annette Kline
Bryan Robinson
Mac Bellingrath
Amy Cahill, M.D.
Albert Lowery
Ralph Siever
Carolyn Blakely
Walter Cash
Carla Martin, PhD.
Harvey Sizemore
Joy Blankenship
Marty Casteel
Joann Mays, M.D.
Terry Smith
Jerrel Boast
Marvin Caudle, D.D.S.
Wes McNulty
George Talbot
David Bridgforth
Jimmy Fisher
Kalebra Morehead
Diane Tatum
David Brown
Lee Forestiere, M.D.
Fred Reed
Earnest Brown
Marshall Kelley
Scott Pittillo
Jefferson County Hospital Board of Governors Glenn Bell
John Garrison
David Jacks, M.D.
James Bell, M.D.
Eugene Hunt
Ryland Robinson
Archie Sanders
Organization Jefferson Hospital Association, Inc. is comprised of the following divisions and companies. This entity owns and leases various real estate holdings including the following: Organization
Primary Business Activity
Tax Status
Jefferson Regional Medical Center Acute Care Medical Center Division of JHA a 501(c)(3) Organization Jefferson Management Services, Inc. Physician Practice Management
For-Profit Corporation
JRMC Development, Inc.
Practice Office Space Sold and Leased For-Profit Corporation to Physicians & Other Third Parties
Jefferson Surgery Center, PLLC Entity
Ambulatory Surgery Center (majority owned by JHA)
Professional Limited Liability Company
JRMC Development, Inc. is a for-profit, wholly owned subsidiary of Jefferson Hospital Association, Inc. This entity owns and leases various real estate holdings including the following: Locations Jefferson Professional Center I Jefferson Professional Center II I-530 Medical Mall White Hall Health Complex Jefferson Management Services, Inc. began as a collection agency (Bluff City Collections) and reorganized into a physician’s management company. JMS currently manages physician practices in JRMC’s secondary service locations. The following practices are managed by JMS: Monticello Medical Clinic: Jay Connelly, M.D., Sylvia Simon, M.D., Tim Simon, M.D., Michael Fakouri, M.D., Julia Nicholson, M.D., Reinhart Family Healthcare: Jeffrey Reinhart, M.D., Amanda Bickford, APN. During the year ending June 30, 2014, the Association had investments in the following unconsolidated subsidiaries. Arkansas Preferred Provider Organization, Inc. Premier Purchasing Partners, L.P. Jefferson Regional Home Care, L.L.C. 28
JRMC Uniquely Focused
Where Care Comes To Life
Hospital Based Clinics Cardiology
Ayman Alshami, M.D. Ricki Fram, M.D.
Endocrinology
Maher Alesali, M.D.
William Deneke, M.D. Nicholas Willis, M.D.
UrgentCare/ Lester Alexander, M.D. Occupational Medicine
Waseem Shah, M.D.
Internal Ahmed Ali, M.D. Medicine Goda Damera, M.D. Naznin Jamal, M.D. Tiffany Smith, M.D Pulmonology & Ali Al-Nashif, M.D. Critical Care J. Clyde Campbell, M.D.
Jesse Cooper, M.D. Sara Hanna, M.D. Jahan Riaz, M.D. Nauman Yunus, M.D. . Nutan Bhaskar, M.D. Khalid Mohammad, M.D.
Cardiovascular Surgery
John R. “Bo� Busby, M.D.
Neurosurgery
Regan Gallaher, M.D.
P.B. Simpson, Jr., M.D.
Orthopaedics
Roy Burrell, M.D. John Lytle, M.D.
Brent Lawrence, M.D. Alan Pollard, M.D.
Geriatrics
Dale Terrell, M.D.
General Surgery
Michelle Eckert, M.D. Heather LeBlanc, M.D.
Lee Forestiere, M.D. Charles Mabry, M.D.
Leadership Hastings Attwood
Barbara Gant
Marva LaGrant
Lelan Stice
Peter Austin
Thomas Harbuck
Lindsay Makris
Susan Sweat
Elijah Blackburn
Wayne Harris
Lisa Mayberry
Michael Swedenburg
Pam Blake
Charles Harrison
Morie Mehyou
Crystal Taylor
Barry Boast
Kenneth Hawk
Geraldine Moore
Renee Taylor
Julie Bridgforth
Louise Hickman
Patrick Neece
Brian Thomas
Anthony Brown
Danny Holcomb
Michelle Newton
Wesley Trussell
Peter Brown
Karen Holcomb
Dennis Olson
Jeff Turner
Jill Cabe-Hill
Gloria Holden
Kathy Pierce
Brian Vance
Deborah Caldwell
John Hopper
Rebecca Pittillo
Heather Walter
Jeff Carraway
Bryan Jackson
Mark Porter
Eric Wingard
Susanne Chambliss
Jeremy Jeffery
Kimara Randolph
Mike Wisely
Lance Cobb
Edie Jaggars
Misti Rodriguez
Brenna Woodruff
Patti Conley
Andy Jenkins
Jason Rogers
Lisa Woolley
Mary Daggett
Letetia Jenkins
Mike Roper
Leah Wright
Vicki Dardenne
Walter Johnson
Kenneth Rush
Mary Wynne
Carolyn Davis
Larry Kennedy
Amanda Scott
Deborah York
Jeff Ferris
Bundy Krakau
M. Daryl Scott
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Where Care Comes To Life
Employment Average Number of Employees 1,500
Employee Breakdown:
Number of Nurses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 525 Patient Care Techs/Nursing Aides . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104 Clerical Support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 58 Other Support/Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84 Pharmacists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Technicians/Clinical. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 Technologists/Clinical. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 03 Therapists/Clinical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 Clinical Leadership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Technical Support/Non Clinical. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 202 Professional Support/Non Clinical. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 Non-Clinical Leadership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Executive Staff. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Employees Living in Southeast Arkansas. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,395
Quality Fiscal Year 2014 Quality Measures Measure JRMC FY14 Score Patient Safety (lower number is better) Over-all Quality Composite Score (PSI-90) (rate per 1000 patients)
National Rate
0.581600
0.616248
0.374 0.188
1.112 0.545
Heart Attack Over-all Quality Composite Score
98.49%
92.66%
Heart Failure Over-all Quality Composite Score
99.46%
94.00%
Pneumonia Over-all Quality Composite Score
99.20%
96.64%
Surgical Care Improvement Over-all Quality Composite Score
99.61%
98.46%
Stroke Over-all Quality Composite Score
96.95%
98.64%
Infections and Hospital Acquired Conditions (lower number is better) Catheter Associated Urinary Tract Infections (rate per 1000 patients) Central Line Associated Blood Stream Infection (rate per 1000 patients)
Emergency Department
(lower number is better)
Median Time from Arrival to Departure Median Time from Decision to Admit to Admissions Median Time from Arrival to Departure
230 minutes 54 minutes 201 minutes
273 minutes 96 minutes 222 minutes
Summary Financial Information Assets Cash
June 30, 2014
June 30, 2013
$12,555,215 $11,688,914
Net patient accounts receivable
20,211,876
20,088,898
Other current assets
11,577,456
13,610,805
118,896,404
108,383,662
67,779,730
72,542,687
3,809,425
3,641,275
$234,830,106
$229,956,241
$23,631,795
$21,328,254
644,280
704,904
Bonds payable
22,838,767
24,181,006
Other non-current liabilities
15,668,644
18,086,131
$62,783,486
$64,300,295
$165,655,946
$165,144,213
Net patient revenue & other operating revenue
164,873,082
179,333,238
Salaries, wages & benefits
(87,556,268)
(94,780,800)
Supplies, utilities, services and other expenses
(73,029,486)
(77,589,969)
Depreciation, amortization and interest
(10,819,473)
(11,370,747)
Invested reserves Property, plant & equipment, net Other non-current assets Total assets
Liabilities Accounts payable & accrued expenses Other current liabilities
Total liabilities
Net Assets Beginning of year
Investment return Total net assets 32
JRMC Uniquely Focused
12,922,819
4,920,011
$172,046,620
$165,655,946
Where Care Comes To Life
Vital Statistics
FY14
Admissions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9,937 Patient Days . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52,922 Total Surgeries. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,751 Deliveries. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 818 Hospital Outpatient Visits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57,475 Emergency Visits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52,085 Hospital Based Clinics Visits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132,246 Cash. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $12,555,215 Invested Reserves. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $118,896,404 Debt Service Coverage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.5 Average Age of Plant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16.3 Annual Capital Expenditures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,981,330
Patient Payor Classification JRMC’s patient revenues are derived from the following third party payor classifications As a result of Arkansas’ private option insurance plan, JRMC has seen a decrease in uninsured patients.
FY13 FY14
Medicare patients. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52% 51% Medicaid patients. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12% 15% Blue Cross patients. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13% 16% Other insured patients. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13% 11% Uninsured patients. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10% 7%
JRMC Operates The Following Beds Medical/Surgical. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245 Critical Care. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 Rehabilitation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Transitional Care. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Psychiatry. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18 Short Stay/Observation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Labor & Delivery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 TOTAL. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 371
Community Benefit Although survival requires healthcare to operate as a business, we are a charitable organization first and foremost. Not-for-profit healthcare organizations, hospitals in particular, have a rich tradition of providing benefits to the community in which they operate and serve. JRMC was established not because of economic opportunity, but rather because there was a community need. This section is not intended to be an all inclusive or exhaustive list of all community benefits provided by JRMC. Rather, it is provided as a representation of the approximate cost (or value) of an array of community benefits provided throughout Southeast Arkansas. Utilizing established guidelines, we have attempted to describe and quantify the planned, organized, and managed approach to meeting the community’s healthcare needs for the fiscal year ending June 30, 2014.
Uncompensated Care This is the largest category and amount of charitable and community benefit provided by JRMC. There are several categories of uncompensated care for FY13/FY14. First, there are the charges and cost of patient care for those individuals who are without any form of third party insurance coverage and who qualify for charity care. 100% of this care was provided free. Charges. . . . . .$95,807,000 Cost. . . . . .$20,263,000 The second category and amount of charitable and community benefit provided is for those individuals who are underinsured. These are individuals who have some form of third party insurance, but do not have sufficient funds or resources to pay for the charges and cost, which exceed their insurance benefits. The following represents the amount provided free. Charges. . . . . .$10,731,000 Cost. . . . . . . .$2,443,000 The third category and amount of charitable and community benefit provided and reported is for those individuals who have some form of governmental coverage (typically Medicaid). The amounts reported under this category are the actual costs, which exceed the amount paid by Medicaid to the hospital. Patients were not billed for these amounts and such were written off. Charges. . . . . .$94,308,000 Cost. . . . . .$5,678,000. The fourth and final category and amount of uncompensated care is the cost of care for those individuals who either had third party coverage and/or either did not apply for or qualify for charity care and did not pay their hospital bill. The cost of providing this care is a cost to the hospital and a benefit to the community. By providing healthcare to all members of the community, regardless of the ability or willingness to pay, the community benefits. Charges. . . . . .$16,081,000 Cost. . . . . . .$3,199,000
Grand Total of Charity & Uncompensated Care Charges. . . . .$216,927,000 Cost . . . . .$31,583,000
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JRMC Uniquely Focused
Patient Encounters. . . . 130,888
Where Care Comes To Life
Charitable Socioeconomic Development There’s no denying that communities throughout Southeast Arkansas, like many rural areas in the Delta, face numerous socioeconomic challenges. Our focus has been to identify those factors, which are closely related to our mission, vision and values and support such development accordingly. While the benefit to the community is quite visible, the connection to the community’s economy may require a bit more thought. However, when the community’s socioeconomic challenges are improved, the community becomes stronger and thus healthier. FY13/FY14 Total Cost: $244,602 Lives Touched: 345,610
50 for the Future
American Cancer Society
Pine Bluff Downtown Development
Komen for the Cure
South Arkansas Chambers of Commerce
Arts & Science Center for Southeast Arkansas
Junior League of Pine Bluff University of Arkansas at Pine Bluff Neighbor to Neighbor
CASA
Pine Bluff Symphony Orchestra
Voices for Children
Jefferson Comprehensive Care
United Way
Special Olympics
South Arkansas Festivals
Partners in Progress
Habitat for Humanity
Outreach & Community Education Nothing connects people more than reaching out to one another, and when that happens in a healthcare setting, the benefits are almost limitless. Everyone benefits from becoming more aware of how to improve their own health. JRMC provides a vast array of educational classes, events and forums designed to raise awareness about health and wellness issues for every segment of our population. Ranging from our “Learn at Lunch” series to individual classes in specialized topics, we see health education outreach as a major part of our mission. FY13/FY14 Total Cost: $561,000
Lives Touched 58,312
Family Fright Night
CPR Training
Walk to Cure Diabetes
Kids Heart Program
Child Passenger Safety Program
Flu Shot Clinics
Art from the Heart
Reach Every Woman
LEAP Diabetes Program
Super Teen Sitter Squad
Colorectal Screening
Talk Health Radio
Good Health Hunting
Community Health Fairs
SEAlife Publication
Maternal Child Classes
March of Dimes Walk America
Relay for Life
Medical Staff Recruitment of physicians is vital to JRMC’s continued growth and success. In 2013 and 2014, JRMC recruited 16 new physicians to Southeast Arkansas, an investment in our community. ANESTHESIOLOGY
John T. Skowronski, M.D.
Atiya N. Waheed, M.D.
J. Scott Bryles, M.D.
Charles Smith, M.D.
Tim T. Wilkin, D.O.
Ferdinand K. Samuel, M.D.
Nancy Williams, M.D.
Charles J. Stearns, M.D.
ENDOCRINOLOGY
Fawad H. Walajahi, M.D.
Maher Alesali, M.D.
CARDIOLOGY
FAMILY PRACTICE
Ayman A. Alshami, M.D.
Lester Alexander, M.D.
W. A. Deneke, M.D.
Simmie Armstrong, Jr., M.D.
Shabbir A. Dharamsey, M.D.
H. Marks Attwood, M.D.
Abdul Ezeldin, M.D.
Keith Bennett, M.D.
Ricki Fram, M.D.
Jason Cobb, M.D
Sadeem Mahmood, M.D.
R. Douglas Coleman, M.D.
Nick Willis, M.D.
Paul W. Davis, M.D.
Heather LeBlanc, M.D.
Herbert F. Fendley, M.D.
Charles D. Mabry, M.D.
GASTROENTEROLOGY O.T. Gordon, Jr., M.D. Henry L. Rogers, M.D.
GENERAL SURGERY Lon G. Bitzer, M.D. Michelle Eckert, M.D. Lee A. Forestiere, M.D.
CARDIOVASCULAR SURGERY
Martha Ann Flowers, M.D.
John R. “Bo” Busby, M.D.
Kimberly Golden, M.D.
GERIATRICS
John E. Harris, M.D.
M. Dale Terrell, M.D.
DERMATOLOGY
Richard D. Justiss, M.D.
Jennifer Jacks, M.D.
Larisa Kachowski, M.D.
HOSPITALISTS
Don Lum, M.D.
Manuel R. Kelley, M.D.
Ahmed Ali, M.D.
Daniel F. Smith, M.D.
James A. Lindsey, M.D. Herschel C. Marcus, M.D.
Jesse Cooper, M.D. Goda Damera, M.D.
EMERGENCY MEDICINE
Toni Middleton, M.D.
Muazzum Aman, M.D.
Scott R. Nichols, M.D.
Carl H. Bell, Jr., M.D.
Darrell Over, M.D.
Janet Curry, M.D.
Michele A. Pashkevich, M.D.
Angelique T. Fontenette, M.D.
Tracy T. Phillips, D.O.
Marjorie Edwards, M.D.
Mark Ramiro, M.D.
Kristin Martin, M.D.
Anna Redman, M.D.
Tim McClure, M.D.
Timm Reece, M.D.
INFECTIOUS DISEASES
Currin M. Nichol, M.D.
Waseem Shah, M.D.
Estelita M. Quimosing, M.D.
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JRMC Uniquely Focused
Sara Hanna, M.D. Naznin Jamal, M.D. Jahan Zeb Riaz, M.D. Tiffany Smith, M.D. Nauman Yunus, M.D.
Where Care Comes To Life
INTERNAL MEDICINE
ORTHOPAEDICS
PULMONARY MEDICINE
James Steven Cash, M.D.
Roy Burrell, M.D.
Ali Al-Nashif, M.D.
John D. Dedman, M.D.
Brent Lawerence, M.D.
Nutan Bhaskar, M.D.
Olabode Olumufin, M.D.
John O. Lytle, M.D.
J. C. (Clyde) Campbell, M.D.
J. Alan Pollard, M.D.
Khalid Mohammad, M.D.
James A. Campbell, Jr., M.D.
OTOLARYNGOLOGY
RADIOLOGY
M. Ahmer Kashif, M.D.
Stephen D. Shorts, M.D.
Edward Angtuaco, M.D.
Steven H. Wright, M.D.
Jennings Boyette, M.D.
Henri Melvin Hegwood, M.D.
NEPHROLOGY
William N. Lim, M.D. NEUROLOGY
PATHOLOGY
Paolo Lim, M.D.
Jacquelyn Sue Frigon, M.D.
Julie Harris, M.D.
Rodolfo E. Lim, M.D.
Ghulam Khaleel, M.D.
Rebecca R. Wheeler, M.D.
James L. Workman, Jr., M.D.
NEUROSURGERY
PEDIATRICS
RADIATION ONCOLOGY
Regan Gallaher, M.D.
Lloyene Bruce-Reid, M.D.
Shahid Hameed, M.D.
P. B. Simpson, Jr., M.D.
Joyce Fletcher, M.D. Horace Green, M.D.
UROLOGY
OBSTETRICS/GYNECOLOGY
Vernora Hightower, M.D.
David C. Jacks, M.D.
Calvin M. Bracy, M.D.
Joann B. Mays, M.D.
Dennis W. Jacks, M.D.
Amy B. Cahill, M.D.
Paul L. Smith, M.D.
David A. Lupo, M.D.
Killeen DesLauriers, M.D. Kenneth J. Lambert, M.D.
PODIATRY
Ruston Pierce, M.D.
Scott K. Gray, D.P.M. John W. Robinette, D.P.M.
ONCOLOGY/HEMATOLOGY
John P. Thrash, D.P.M.
Omar T. Atiq, M.D. Ahmad Fora, M.D.
PSYCHIATRY
Jitesh Joshi, M.D.
Stephen A. Broughton, M.D.
M. Bilal Malik, M.D.
Shamim A. Malik, M.D.
Asif Masood, M.D.
Ronald J. Wauters, M.D. Abeer Washington, M.D.
OPHTHALMOLOGY David T. Nixon, M.D.
Focused On The Future Within the next decade, JRMC will build a new facility to replace the current hospital. This will impact the health, wellness and economy throughout Southeast Arkansas for generations to come, and will fulfill JRMC’s promise to provide quality health services to all members of our community.
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JRMC Uniquely Focused
Where Care Comes To Life