LMH 2013-2014 Mid-Year Report

2013-2014 MID-YEAR REPORT

EMBRACING CHANGE.

SHAPING TOMORROW.

LMH LEADERSHIP

BACK ROW: Dr. Eric Huerter, Jane Blocher, John Bullock, John Ross, Mike Wildgen, Dr. Lee Reussner FRONT ROW: Allen Belot, Cindy Yulich, Rob Chestnut, Gina Pacumbaba-Watson Board of Trustees Allen Belot, Chairperson Mike Wildgen,Vice Chairperson Rob Chestnut, Treasurer Gina Pacumbaba-Watson, Secretary Jane Blocher John Bullock Lee Reussner, MD John Ross Cindy Yulich Eric Huerter, MD (ex officio) LMH Administrative Council Gene Meyer, President & Chief Executive Officer Carolyn Bowmer,Vice President, Human Resources Kathy Clausing-Willis,Vice President & Chief Development Officer Sheryle D’Amico,Vice President, Physician Division Janice Early,Vice President, Marketing & Communications Jane A. Maskus,Vice President & Chief Information Officer Joe Pedley,Vice President & Chief Financial Officer Karen Shumate, Chief Operating Officer

LMH Auxiliary Board Proctor Crow, President Bob Bechtel,Vice President Karen Matthews, Secretary Shirley Anderson, Treasurer Sharon Stultz, Past President Bev Bartscher Suzie Craig Reaumur Donnally Judy Hollingshead Barbara Kurtz Jan Pollard Linda Troxel Medical Staff Officers & Department Chiefs Eric Huerter, MD, Chief of Staff John Keller, MD,Vice Chief of Staff Marc Scarbrough, Secretary Luke Huerter, MD, Internal Medicine Marshall Kelley, MD, Pediatrics James Mandigo, MD, Radiology Thomas Marcellino, MD, Family Practice Tiffinie Mercado, MD, Obsterics-Gynecology Stephen Myrick, MD, Surgery Sabrina Prewett, DO, Emergency Medicine Stephanie Schmidt, MD, Anesthesiology Michael Thompson, MD, Pathology Charles Yockey, MD (ex officio)

Lawrence Memorial Hospital Endowment Association Board of Directors Val Stella, President Ted Haggart,Vice President Teresa Kempf, Treasurer Bev Roelofs, Secretary Kurt von Achen, Past President Dale Denning, MD Becki Dick Marilyn Dobski Laverne Epp Jon Heeb, MD Kelli Henderson, DDS Matt Hoy Starla Jones Sarah Landers, MD Shade Little Sabrina Prewett, MD Doris Ricks Jean Shepherd Ex Officio: Gene Meyer, LMH President & CEO John Ross, LMH Board of Trustees Proctor Crow, LMH Auxiliary Board of Directors Kathy Clausing-Willis, LMH Vice President & Chief Development Officer

A MESSAGE FROM THE PRESIDENT & CEO

Dear Friends of Lawrence Memorial Hospital, It will probably come as no surprise to hear that health care is changing. The Affordable Care Act, combined with aging populations and rising chronic condition rates, means more people consume more health services every day. At the same time, payers are shifting to value-based reimbursements that align payments with outcomes achieved, not services rendered. In other words, the future of our hospital relies on keeping people healthy through high quality inpatient and outpatient care.

I take great pride in assuring you that LMH is well positioned for the health care transformation at hand. From our esteemed hospital leaders, physicians and associates to our generous volunteers and donors, we all agree on one thing: our ability to grow as a center of health care in the community depends on how well we care for our patients, not how often.

In a sea of changing policies, care delivery models, health technology and more, only institutions that respond strategically will thrive. At LMH, we celebrate and support greater access to medical care – but it’s no small challenge, especially since we are a standalone community hospital with limited cost-sharing opportunities. To meet community demand, we grow proactively and strategically. As a not-for-profit, self-funded hospital, we continuously reinvest operating revenues to expand and add service lines, recruit new expertise, and update technology in ways that address the specific needs of our patient population.

This 2013-2014 Mid-Year Report provides a glimpse into our accomplishments since last summer. From national awards to improved patient safety, added services, enhanced technology and more, at LMH, we are embracing change and shaping tomorrow…and we’re making great progress for this community every single day.

To your health,

LMH President and CEO

AWARDS & HONORS LMH Named Among Truven Health’s 100 Top Hospitals…Again

In March, LMH received the 2014 Truven Health 100 Top Hospitals® award, making it the only hospital in Kansas and western Missouri to earn this prestigious distinction.

The achievement marks the second year in a row for LMH, now the only hospital in both states to receive this recognition in 2013 and 2014 consecutively.

Truven Health Analytics recognizes the highest-performing hospitals in America through its 100 Top Hospitals study. Using independent public data and proprietary analytics, the program objectively identifies hospitals that demonstrate the vision to develop

long-term excellence in care, efficiency and community value.

“This year’s 100 Top Hospitals represent the highest national standards in hospital care and management today,” said Jean Chenoweth, Senior Vice President for Performance Improvement at Truven Health Analytics. “They set the benchmarks for peers around the country to follow – consistently delivering outstanding quality of care, satisfaction and community value at a reasonable cost.”

As a 100 Top Hospital for two years running, LMH has consistently delivered health care with higher

survival rates, fewer complications, better long-term outcomes, shorter hospital stays and superior overall hospital experiences. “At LMH we aim to bring higher value to our community while confronting the challenges of industry-wide reform,” said Gene Meyer, President and CEO, expressing his gratitude to everyone at LMH for their outstanding contributions in patient care, operational efficiency and financial stability.

“At LMH we aim to bring higher value to our community while confronting the challenges of industry-wide reform.”

– Gene Meyer, President and CEO

LMH Earns Top Performer Recognition for Second Consecutive Year The Joint Commission has again named LMH among the nation’s Top Performers on Key Quality Measures® for heart attack, pneumonia and surgical care in 2013. This was the second year in a row LMH has received the Top Performer award for exceptional strength in these three categories.

Receiving the award, which is based on performance data for calendar year 2012, means LMH is among the top one-third of more than 3,400 accredited hospitals that submitted accountability measure data in 2012.

Only nine other hospitals in the state of Kansas received this noteworthy distinction in 2013.

“Lawrence Memorial Hospital and all the Top Performer hospitals

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have demonstrated an exceptional commitment to quality improvement,” said Mark R. Chassin, MD, President and Chief Executive Officer of The Joint Commission. “They should be proud of their achievements.”

™

LMH Recognized as a Top 100 HealthStrong Hospital Just weeks before ringing in the new year, LMH received yet another esteemed award: the 2013 Top 100 HealthStrong™ Hospital award by iVantage Health Analytics. HealthStrong winners are determined by the Hospital Strength INDEX™, a national ratings and analytics program developed by iVantage. Hospital rankings are based on publicly available data across a range of performance indicators critical to success in today’s changing health care landscape. Together, these indicators encompass market position, hospital efficiency, clinical results, patient satisfaction and more.

To recognize the 100 top performing hospitals in 2013, the INDEX ranked all 4,430 general acute care hospitals in the U.S. on eight performance pillars. Those pillars comprised 56 different metrics in the categories of

Additional Recognition

In June, for the second year in a row, LMH was named among “100 Great Community Hospitals” by Becker’s Hospital Review. Again, LMH was the only Kansas hospital on Becker’s nationwide 2014 list, which is based on community hospitals’ accolades, quality and service to their communities. LMH was compared to other hospitals in the nation with fewer than 550 beds and minimal teaching programs. The Becker’s Hospital Review team selects hospitals based on rankings and recognition from a variety of industry sources. In announcing the 2014 list, the team

value-based strength (which is based on patient outcomes and affordability measures), competitive market strength and financial strength. Overall on the INDEX, LMH scored in the 99.93 percentile; for each of the three categories, LMH ranked as follows: • Market strength: 97.54 percentile • Value-based strength: 99.73 percentile • Financial strength: 92.08 percentile In early 2014, iVantage released its list of 2014 HealthStrong Hospitals, and again LMH was among them.

The 2014 study was expanded to evaluate 66 metrics and 10 performance pillars, and the number of hospitals eligible for the list is no longer limited to 100.

stated, “The hospitals [on the list] have continually worked to provide the quality of care and the experience patients deserve and expect.”

In May, LMH was named one of 24 Regional Business Excellence Award winners by the Kansas Department of Commerce as part of Business Appreciation Month. “The businesses honored during Business Appreciation Month have made outstanding contributions to our economy and their communities,” Kansas Commerce Secretary Pat George said.

2013-2014 Mid-Year Report

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WOMEN’S HEALTH Two New LMH Cardiologists Encourage Women to Take Heart

Elizabeth Guastello, MD Christina Salazar, MD

Heart disease claims the lives of approximately one woman every minute in the United States. According to the American Heart Association (AHA), 90 percent of women are at risk for heart disease, but only 20 percent see it as their biggest health threat. Fortunately, says the AHA, four out of five heart attacks and strokes “can be treated, prevented and even ended if women learn about what puts them at risk and take action toward fighting it.”

And that’s where LMH comes in.

Meet Elizabeth Guastello, MD and Christina Salazar, MD, the newest physicians at Cardiovascular Specialists of Lawrence, LMH’s affiliated cardiology practice. Drs. Guastello and Salazar are two of only about a dozen female cardiologists in Kansas, and together they’ve embarked on a mission to improve women’s heart health in and around Lawrence.

One way they’re succeeding is through Take Heart: Women’s Cardiac Care, which they helped develop after joining LMH last year. Through Take Heart, LMH is offering three fast and affordable heart risk assessment options, each tailored specifically for women.

Heart health is easier to manage when patients know their numbers, so Take Heart is designed to help women understand their individual risk factors and talk openly with their primary care providers about taking hearthealthy steps going forward. Through Take Heart and the patient education they provide in the exam room every day, Drs. Guastello and Salazar are working to improve awareness and promote healthy hearts for the mothers, sisters and daughters of the Lawrence community. More information is available at www.lmh.org/takeheart.

LMH Midwives Now Offer 24/7 On-Call Coverage

In 2014, LMH expanded the midwifery care team at its affiliated practice, Lawrence OB-GYN Specialists. Now with three full-time certified nurse midwives on board, patients can choose a midwife and still have access to round-the-clock coverage for their patient care needs.

Together, the midwives of LMH offer patients the peace of mind that comes from knowing their midwife is available for personalized guidance and support whenever they need it.

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Pamela Pray, CNM, APRN, MSN

Emily Fox, CNM, APRN, MSN

Karen Honn, CNM, APRN, MSN

LMH Becomes the First ‘High 5 for Mom & Baby’ Hospital in Kansas Last November, LMH became the first hospital to qualify for designation as a High 5 for Mom & Baby hospital.

The High 5 for Mom & Baby program encourages Kansas hospitals to approach postpartum care in ways that support breastfeeding. It comprises five hospital practices considered crucial for a successful breastfeeding experience: 1. Assuring immediate, sustained skin-to-skin contact between mother and baby after birth 2. Giving newborn infants no food or drink other than breast milk, unless medically indicated 3. Allowing “rooming in” so mothers and infants can remain together 24 hours a day 4. Not giving pacifiers or artificial nipples to breastfeeding infants 5. Providing mothers options for breastfeeding support in the community On average, 90 percent of new moms who deliver at LMH successfully initiate breastfeeding, compared to a statewide average of 73 percent and a national average of 76.5 percent (as reported by the Centers for Disease Control and Prevention in 2013).

In 2012, Traci Hoopingarner, Director of LMH’s Family Birthing Center, began coordinating the High 5 education process at LMH and led maternity staff in adopting the necessary changes to meet High 5 standards. Hoopingarner accepted an award from the High 5 program director at a November 2013 ceremony commemorating LMH’s achievement as the state’s first High 5 hospital.

Breastfeeding Health Benefits Babies who aren’t breastfed may be at higher risk for: • Obesity • Diarrhea • Pneumonia • Asthma • Ear infections • Sudden infant death syndrome

Mothers who breastfeed may be at lower risk for: • Breast cancer • Ovarian cancer

Source: The Surgeon General’s Call to Action to Support Breastfeeding, Fact Sheet

LMH OB Nursing Team Receives PROMPT Certification

In 2013, the OB care team at the LMH Family Birthing Center completed certification in PRactical Obstetric Multi-Professional Training, or PROMPT. This evidence-based training aims to improve outcomes for mothers and their babies during obstetric emergencies.

“It has been proven that leadership and multi-professional teamwork,

together with the appropriate knowledge and clinical skills, are essential to provide the best care for the mother and newborn,” said Traci Hoopingarner of LMH’s Family Birthing Center. “PROMPT provides this training, which helps the hospital achieve the goal of reducing maternal and child deaths in obstetric emergencies.”

2013-2014 Mid-Year Report

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BREAST CANCER CARE Megan’s Journal: A Personal Journey through Breast Cancer Treatment and Triumph In 2014, LMH launched a breast cancer campaign unlike any the hospital has unveiled before. Known as “Megan’s Journal,” the campaign includes print and digital ads, radio spots, billboards and more – but it’s not the media plan that makes it so unique. It’s the star of the campaign: a breast cancer survivor who waged and won her battle at LMH in late 2013 and early 2014.

From testing and diagnosis to surgery and chemotherapy, Megan Hill chose LMH for comprehensive, multi-disciplinary cancer care. Her personal journey is chronicled online at www.lmh.org/megansjournal.

Her story began in September 2013, when she felt a lump in her breast. After examining it, her provider at Lawrence OB-GYN Specialists, an LMH-affiliated practice, ordered a digital diagnostic mammogram at the LMH Breast Center.

For further evaluation, Megan visited a general surgeon at LMH for an ultrasound and breast biopsy, and soon after, a lumpectomy. After confirming it was breast cancer, her surgeon performed a single mastectomy, and over the months that followed, Megan’s breast was reconstructed by a plastic surgeon, also at LMH. Because her cancer was caught early, chemotherapy and radiation therapy were not necessary to destroy it – but chemo was an option to help prevent a cancer recurrence down the road. Additional diagnostic tests ordered by Megan’s oncologist at LMH Oncology Center showed a 15 percent chance of recurrence. The choice was ultimately Megan’s, and she decided to undergo four chemotherapy treatments over the course of 12 weeks from November to January.

Testing, diagnosis, surgery, chemotherapy – how she coped through it all and came out on top: Megan’s entire journey is told online in an open and honest fashion that accurately conveys her endearing personality and inspirational outlook.

Hers is the story of a devoted mother, a hard-working professional, a fun-loving friend, a cherished daughter…and now, a cancer survivor.

Pictured: Megan Hill at home with her son after beating breast cancer at LMH.

“It truly is a blessing to have this level of excellence right here in Lawrence. I feel so lucky to be able to fight this battle without having to leave the place I call home.”

– Megan Hill

Now at LMH Breast Center: Breast Risk Assessment Clinic “The idea is to be proactive in caring for your breasts, and this provides an opportunity to screen for breast cancer risks,” explained Roxy Johanning, Clinical Coordinator for the LMH Breast Center. That’s the driving force behind LMH’s new Breast Risk Assessment Clinic.

Knowing an individual’s risk for developing breast cancer can play a critical role in preventing the disease or identifying it early. For this reason, when a woman has a mammogram at any one of LMH’s three Breast Center locations, her screening now includes administration of a family health

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questionnaire. If her answers indicate a higher-than-average risk for developing cancer, experts at the Breast Risk Assessment Clinic provide comprehensive information, clinical services including clinical breast examinations and genetic testing, and supportive counseling. LMH Breast Center staff also can help her develop a personalized plan to continue watching her breast health closely.

LMH’s new Breast Risk Assessment Clinic is funded by proceeds from LMH Endowment Association’s Stepping Out Against Breast Cancer dance.

ENDOCRINOLOGY LMH Welcomes Endocrinologist to Fill Growing Need in Lawrence Diabetes, thyroid conditions, osteoporosis – these and many other endocrine disorders are on the rise in Douglas County. To meet this growing need for highly specialized care, LMH has added a full-time, fellowship-trained endocrinologist to its Medical Staff.

Amanjot Lehil, MD will begin seeing patients at Lawrence Endocrinology in the 4th Street Health Plaza on September 1.

Common conditions in the field of endocrinology include diabetes, overactive or underactive thyroid, thyroid nodules/cancer, osteoporosis, disorders of calcium balance, obesity, low testosterone, pituitary tumors, adrenal gland issues, and more.

Dr. Lehil will provide much-needed support for local primary and specialty care physicians in caring for patients with these types of health issues.

When asked about his philosophy of care, Dr. Lehil said he emphasizes patient education as a primary focus.

“Well-informed patients who take control over their diseases play an essential role in the overall treatment, which then helps reduce complications caused by diabetes and other endocrine diseases,” he explained.

These complications can be serious, such as heart attacks, strokes, kidney failure, blindness and amputations. The risk of complications is significantly lowered with optimal control of diabetes. Dr. Lehil says the focus on empowering patients with knowledge

about managing their conditions, and the consequences of non-compliance with prescribed medications and diet regimens, is one of the main reasons he chose endocrinology.

“Diseases such as diabetes are usually life-long issues, so establishing long-term, trusted relationships with patients is an integral part of my practice,” explained Dr. Lehil. “Building and maintaining those two-way dialogues is one of the things I value and enjoy most in my field.”

As a specialist in the highly sought-after field of endocrinology, Dr. Lehil chose LMH for several reasons: location, size, and the chance to build an endocrinology practice from the ground up. “It’s very exciting to have this opportunity, and I’m eager to address the high demand in this area for the specialized care I’m trained to provide,” he said.

For more information, visit www.lmh.org/endocrinology.

Amanjot Lehil, MD

“Diseases such as diabetes are usually life-long issues, so establishing long-term, trusted relationships with patients is an integral part of my practice.”

– Dr. Amanjot Lehil

2013-2014 Mid-Year Report

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PATIENT SAFETY LMH Reduces Hospital-Acquired Infections

LMH cares about the safety of everyone who walks through its doors. As a result, LMH has extremely low rates of health care-associated infections (HAIs) compared to national data collected by the Centers for Disease Control and Prevention. In fact, since 2011, not a single LMH intensive care patient has acquired a central-line infection (bloodstream), one of the most commonly cited ICU HAIs. To achieve its objectives in reducing HAIs, LMH follows stringent infection prevention guidelines and recommendations. For example, last year LMH began using portable disinfection devices to kill bacteria in patient rooms with ultraviolet radiation. Hand-sanitizing stations are abundant throughout the hospital to encourage visitors to practice hand hygiene. Undercover observers routinely monitor LMH employees to ensure everyone habitually engages in proper hand washing techniques. It is also standard procedure for LMH staff to apply passive alcohol disinfection caps to central lines.

In addition to preserving a patient’s physical health, preventing HAIs helps preserve the hospital’s financial health. Under federal regulations, certain Medicaid and Medicare reimbursements are reduced for hospitals when patients acquire infections in their facilities. Fewer HAIs, then, are good for the patient, good for the hospital, and great for the community.

LMH Leads the Way to Improved Patient Safety through the Kansas Health Information Network In November 2013, LMH signed a preliminary agreement to participate in the Kansas Health Information Network (KHIN). KHIN is a statewide exchange of electronic health records (EHRs) that enables health care providers to share information about their patients.

LMH physicians can already look up patient information entered by other providers on KHIN, and now, the hospital is preparing to contribute its own patient data to the secure online database. Regarding privacy issues, LMH assures the community it will refrain from sharing any data on KHIN until every technical detail, security feature, and patient notification protocol has been carefully assessed, properly implemented, and fully tested.

When LMH does begin sharing on the exchange, it will be a big step forward for health care delivery within the community. KHIN participation

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among Lawrence-area outpatient providers has been relatively low, but as KHIN Executive Director Laura McCrary pointed out, LMH’s involvement will likely turn that around. “[LMH is] a critical hospital because so many patients receive care there – it is sort of the center of health care in the community,” said McCrary. “When the hospital joins the exchange, then generally you’ll see most of the other health-related facilities in the communities join.”

By leading the charge in joining KHIN for safer, more coordinated and cost-effective care, LMH is helping to advance the availability of high quality health care that meets the area’s needs. KHIN offers an “opt out” option for patients in Kansas who do not want their health information on the exchange.

Benefits of KHIN Participation Increased Patient Safety Shared patient data reduces error risks with instant access to a patient’s list of medications, test results, pre-existing conditions, known drug allergies, and so on.

Lower Health Care Costs Shared patient data reduces health care costs by preventing errors and duplicative tests.

More Effective Care Time previously spent tracking down information can now be spent on direct, well-informed patient care.

CARE COORDINATION LMH Partners with Douglas County to Prevent Falls in Older Adults

Last year, LMH offered a community-based workshop for people living at home who have fallen or are fearful of falling. Known nationally and internationally as Stepping On, the program teaches balance and strength exercises aimed at preventing falls and injuries. It also includes a home safety check and medication review for each participant.

Stepping On is designed to help people gain more self-confidence when facing situations with a higher risk of falling, so they can safely maintain active, fulfilling lives. Experts

in physical therapy, pharmacology, community safety, and ophthalmology offer approaches involving safer footwear, proper eyewear, community mobility tools, and other techniques.

After receiving a grant from the Kansas Health Foundation to help support the workshop locally, Douglas County Senior Services partnered with LMH and the Lawrence-Douglas County Housing Authority to provide Stepping On for the local community.

The workshop met at LMH once a week for seven weeks in October and November 2013, and it will be offered again in the fall of 2014.

LMH Takes Action to Decrease Pneumonia Readmissions Through quality treatment, guidance and education, LMH reduced pneumonia readmission rates by more than 14 percent from 2012 to 2013 (from 20.8 to 6.6 percent).

To accomplish this objective, LMH developed a system that follows each pneumonia patient through recovery.

When a person with pneumonia is in the hospital, a respiratory therapist provides treatment and makes sure the patient understands the prescribed medications and how to manage the

disease at home. The therapist also arranges for the patient to see a primary care physician three to five days after discharge.

Once the patient is released, an LMH community care navigator calls within three days to review discharge and care instructions. The navigator checks in at least once a week for the next month, providing disease management coaching when needed.

To encourage this type of coordinated care, a provision of

the Affordable Care Act (known as the Hospital Readmissions Reduction Program) cuts Medicare reimbursements for hospitals when too many Medicare patients must be readmitted for the same condition too soon after discharge. Because LMH’s system of pneumonia care has been so effective, LMH will not face any penalties imposed by the federal program for pneumonia readmissions for the 2013 fiscal year.

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TECHNOLOGY New CT Scanners Deliver Greater Accuracy with Less Radiation

LMH is a Most Wired Hospital...Again Hospitals & Health Networks magazine has once again named LMH among its “Most Wired” hospitals. 2014 marks the fourth year in a row that LMH has received this national recognition for embracing change and shaping tomorrow through technological integration throughout the hospital and its affiliated practices.

In 2013, LMH Imaging Services became home to two state-of-the-art, dual source flash CT scanners. As one of very few community hospitals in the country to have such advanced imaging equipment, LMH leadership made the $2 million investment because the scanners offer superior image quality and test accuracy, while also reducing the amount of radiation patients receive from CT scans.

“We complete more than 20,000 scans per year at LMH, and many are oncology patients, so reduced radiation exposure is extremely important,” said Marc Schumacher, Lead CT Technologist at LMH, adding that the number of CT procedures performed in the U.S. continues to increase steadily each year. “With our new CT scanners, we’re performing exams with 40-60 percent less radiation than before. That’s very beneficial for our patients.”

The new equipment scans faster – so fast, in fact, that one scan now takes only one-fourth of a second. This

enhanced speed lessens the amount of time patients must spend in the enclosed machine, which in turn reduces their exposure to radiation.

It offers an additional benefit for cardiovascular patients as well: it’s no longer necessary to slow their hearts in order to capture images of coronary arteries between heartbeats.

Not only are the new flash scanners faster, image quality is significantly enhanced as well, enabling greater precision in diagnosis. The improved image quality makes it easier for physicians to visualize a stroke’s effects on the brain, determine types of kidney stones and so forth, which aids in determining the best course of treatment and prevention.

“We really have the best of both worlds,” said Schumacher on the scope of benefits the new scanners provide. “The accuracy of the study has gone up and the clarity has gone up, while the radiation dose has gone down.”

Online Portal Connects Patients with Health Records and Providers

For patients who want secure, online access to their health care providers and health information, LMH offers My Patient Portal. Robust functionality combines with data encryption and other security measures to put important personal health information safely at each patient’s fingertips.

“Providing access to health records allows patients to have more ownership of their data, and it gives them the ability to share or communicate as they wish,” said Jane Maskus,Vice President and Chief Information Officer for LMH. “My Patient Portal benefits care and treatment by engaging patients and encouraging patient-provider communication.”

Patients can sign up for the portal when visiting any participating LMH affiliate or through the Customer Service department at LMH’s main hospital campus. For more information, visit www.lmh.org/mypatientportal.

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My Patient Portal Offers Health Tools & Information

• See recent key measures for Patients (height, weight, cholesterol numbers and more) • Request appointments • Access vitals and selected lab/test results • Send and receive emails with providers for non-urgent needs • Send and receive medical records to and from other providers • Access wellness resources and search an online health library • View upcoming LMH educational classes and programs • Review EHR data to check accuracy; print copies on demand • Review a Medical Summary that includes current and past medications, allergies, immunizations, health issues and surgeries/procedures • View or print visit and discharge summaries

COMMUNITY BENEFITS 2013 Community Benefits Support LMH Mission Not-for-profit health care organizations like LMH have a rich tradition of providing community health and wellness benefits. In 2013, LMH community benefits totaled almost $9.2 million and impacted the lives of more than 58,000 people throughout Lawrence and the surrounding area.

“Community-focused programs and services enable LMH to achieve our mission and improve the health of our community,” said Janice Early,Vice President, Marketing and Communications.

Community benefits are defined as programs or activities that address identified community needs, are not provided for marketing purposes, and meet at least one of these objectives:

• Improve access to health services • Enhance community health • Advance medical knowledge • Demonstrate charitable purpose

“Community-focused programs and services enable LMH to achieve our mission and improve the health of our community.”

– Janice Early, Vice President, Marketing and Communications

Although not required to report community benefits to the IRS (as some hospitals are), LMH has joined hospitals across Kansas and the country in taking a more planned, managed and organized approach to documenting community benefits. “It’s important to tell our story about how LMH serves our community,” Early said.

For example, LMH provides a safety net for vulnerable populations who have no health insurance; the cost of providing charity care and unpaid costs of serving Medicaid patients are counted as community benefits. Last year that included serving 11,203 individuals with $3.8 million in charity care – an amount that represents the actual cost of providing that care, not the charges. In 2013, there were 19,595 Medicaid visits that cost LMH $4.3 million.

Summary of Community Benefit Activities

Estimated Cost of Charity Care Unpaid Cost of Medicaid Community Health Improvement Health Professions Education Subsidized Health Services Financial & In-Kind Contributions Community Building Activities Community Benefits Total

In addition, LMH offers free and low-cost educational programs, support groups, and health screenings each year. For example, in 2013 there were nearly 1,200 visits for the Breastfeeding and New Parent Support Group.

Community Education nurses had approximately 335 interactions with residents at Babcock Place during weekly wellness clinics. LMH also provides continuing education opportunities to physicians and health professionals throughout the region and supports training programs like the LMH Pharmacy Residency.

LMH actively supports organizations and endeavors that benefit the community, including the Sexual Assault Nurse Examiners, who were on-call more than 11,000 hours last year so they could serve 48 victims. The hospital expanded its baseline concussion testing for middle and high school student athletes to include Tonganoxie last year, and conducted 1,105 tests in Eudora, Lawrence and Tonganoxie at no cost to the students or schools. LMH associates serve on community boards and lend their expertise to community-building activities as well, and emergency planning efforts are ongoing to prepare the hospital in the event of a community disaster.

Excluding Unpaid Cost of Medicare and Bad Debt For Period from 1/1/2013 through 12/31/2013

Persons Total Offsetting Served Expenses Revenue

Net Benefit

11,203 $3,796,381 $0 $3,796,381 19,595 $12,034,747 $7,671,177 $4,363,570 23,783 $185,374 $30,257 $155,117 N/A $168,112 $0 $168,112 1,439 $557,581 $32,500 $525,081 1,545 $126,312 $0 $126,312 957 $19,978 $0 $19,978 58,522 $16,888,485 $7,733,934 $9,154,551

For 12 months ending 12/31/13

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2013-2014 Mid-Year Report

FINANCIAL STRENGTH

Highlights

2013

as restated

2012

Revenues Gross patient service revenues

$505,689,657

$462,777,492

Revenue deductions (Medicare, Medicaid and other discounts)

(302,623,694)

(261,596,797)

Charity care

(12,815,000)

(12,595,000)

Net patient service revenues

190,250,963

188,585,695

Provision for uncollectible accounts

(14,003,700)

(18,227,600)

176,247,263

170,358,095

3,231,576

4,712,189

$179,478,839

$175,070,284

Other operating revenue Net Operating Revenue

Expenses 72,126,637

69,793,488

Employee benefits

17,115,552

15,347,433

Medical professional fees

14,840,775

15,127,314

8,664,051

7,681,699

Supplies

30,238,995

28,942,103

Utilities

2,670,980

2,555,070

Miscellaneous expense Kansas provider tax assessment Repairs and maintenance Depreciation and amortization

Inpatient Discharges

37,678

Emergency Visits

160,733

Outpatient Visits

1,132 Births

9,378

Oncology Visits

4,586

Salaries

Purchased services

LMH by the Numbers 2013 7,795

1,162,128

1,251,238

973,218

663,204

8,465,801

7,664,090

10,786,238

10,748,998

Surgery Cases

25,231

Mammograms

20,966 CT Scans

571,435

Laboratory Tests

1,313,071 Pharmacy Orders

98,507

11,720

226,425

Physical Therapy Procedures

672,998

802,499

427,894

Other capital costs

2,665,089

2,663,516

Meals Prepared

Interest

3,195,830

3,541,998

$173,590,012

$167,009,075

357,068

$5,888,827

$8,061,209

Loss on sale or disposal of property Insurance

Total Expenses Operating Income Available for facility improvements, new equipment, and services to meet the health care needs of the community

Additions to Capital Assets Construction, equipment purchases and facility improvements

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Website Visits

234

Physicians on Medical Staff

1,124

$11,115,157

$11,282,976

Employees (FTEs)

927

Volunteers

NEW LMH MEDICAL/ALLIED STAFF (2013-2014)

Rob Beck, MD Neurology

Nathan Bloom, MD Family Practice

Holly Dunoon, APRN Obstetrics/Gynecology

Emily Fox, CNM Obstetrics/Gynecology

Shalina Gupta-Burt, MD Radiation Oncology

Karen Honn, CNM Obstetrics/Gynecology

Irfan Jawed, MD Oncology/Hematology

Chad Johanning, MD Family Practice

Amanjot Lehil, MD Endocrinology

Patricia Neis, APRN Family Practice

Rebecca Smith, DO Hospitalist

Leslie Underwood, MD Obstetrics/Gynecology

Not pictured: Thomas Alderson, II, MD (Nephrology); Roxy Johanning, APRN (Breast Center); Khylie McGee, MD (Emergency Medicine); Tanya Robb, APRN (Otolaryngology)

Takeshi Yoshida, MD Psychiatry

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2013-2014 Mid-Year Report

About Lawrence Memorial Hospital Lawrence Memorial Hospital (LMH) is a 173-bed, not-for-profit health care provider serving northeast Kansas. Supported by 1,300 associates and 250 physicians, LMH is dedicated to providing exceptional physician expertise, advanced technology and high standards of clinical excellence.

LMH receives numerous awards and honors for high quality and service, including several in recent years that put LMH among the nation’s top performing hospitals: • 100 Top Hospitals® award from Truven Health Analytics 2013, 2014 • Top 100 HealthStrong award from iVantage Health Analytics 2013 • Top Performer on Key Quality Measures™ from The Joint Commission 2013, 2012 • 100 Great Community Hospitals by Becker’s Hospital Review 2013, 2014 • Most Wired hospital award from Hospital & Health Networks 2011, 2012, 2013, 2014 LMH is self-funded from its operations, receives no tax support from the City of Lawrence or Douglas County, and serves the community’s health care needs regardless of individuals’ ability to pay. LMH does not discriminate on the basis of race, color, religion, national origin, age, disability, gender or sexual orientation in providing services to patients or the public, nor in relation to employment practices.

Inquiries about this annual report or requests for additional copies should be sent to the Marketing Department, Lawrence Memorial Hospital, 325 Maine, Lawrence, KS 66044, (785) 505-3130.

325 Maine Street • Lawrence, KS 66044 (785) 505-5000 • www.lmh.org