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the development continues Rochester and Elmore District Health Service - Annual Report 2007


Our Vision Rochester & Elmore District Health Service (REDHS) is widely recognised for its service excellence, through the provision of high quality, sustainable health services.

Contents

Our Mission Year In Brief – 2006-2007

1

REDHS provides quality and compassionate services in the areas of comprehensive acute hospital, residential aged and community based care.

Report From President & CEO 2 Corporate Governance

4

Staff 7 Key Performance Indicators Performance Against Strategic Goals

Our Objectives To organise for and provide health care services in Rochester and Elmore districts, in particular acute hospital, residential aged care, community based services, and services provided jointly with other agencies in accordance with the Health Services Act and all existing or future relevant Acts and Regulations.

8 To utilise appropriate physical and personnel resources, knowledge and technologies available to promote health, independence and to prevent disability, injury and suffering. 10

Redevelopment 12

To set and achieve standards consistent with best practice principles of quality patient and residential care and promote and provide access to community health.

Clinical Care Report

14

To foster continuing quality improvement in best practice standards through education and training.

Acute Services

15

Who We Are

Aged Care

16

Rochester & Elmore District Health Service was established on 1st. November, 1993 following the amalgamation of the Rochester and District War Memorial Hospital and the Elmore District Hospital.

Primary Care Report

19

Primary Care Services

20

REDHS is an incorporated body under Section 31 of the Health Services Act 1988 providing a broad range of services including residential aged care, acute care and primary care including home nursing to our catchment population of 8,697 and has:

Campaspe Primary Care Partnership 22

•• 102 Staff (EFT)

Support Services

•• 30 low care residential aged care beds (including 1 respite and 10 dementia-specific beds)

23

•• 30 high care residential aged care beds

•• 4,648 community health occasions of service Facilities & Risk Management

25

Community Involvement & Support

27

Volunteers 28 Statutory Information Quality Of Care Report

•• 12 inpatient beds, including one palliative care bed •• 1 accident & emergency bed The responsible Minister is the Victorian Minister for Health the Hon Bronwyn Pike MLA

Location Mu rra yR

29

Mur ray

31

41

Financial Report

42

Vall ey H wy

Go ulb um

Moama

Echuca

Mur ray

Valle y

Lockington

Hwy

Bamawm Strathallan Nanneella

Ballendella

Moama

Rochester

C am

pasp e

Rive r

Dingee

Elmore

Greens Lake

VICTORIA

Echuca Elmore

Corop

wy

Melbourne Northern Hwy

nd H Mid la

Goornong

redhs annual report 2007

Riv er

Kotta

Sustainability 39 Financial & Operational Performance Summary

ive r

Colbinabbin

Rochester


Overview

Year In Brief – 2006-2007 Highlights

2006-2007

•• Key Plan development and approval

Acute Ward

• Strategic Plan – A Vision for the Future

Total Acute Ward Separations

• Primary Care Development Plan

Acute Bed Days

• Human Resources Plan

570 2,436

Average Length of Stay (Days)

4.27

•• Successful reaccreditation of our aged care facilities for a further three years. (August 2006)

Total NHT (Days)

211

•• Key Appointments:

Total Non-admitted Occasions of Service

• Staff Education and Training Plan

• Director of Primary Care Development (September 2006), • Health Promotion Officer (October 2006),

Emergency Physiotherapy (IP)

• Chief Executive Officer (January 2007),

641 70

• Facilities & Risk Manager (January 2007),

Radiology

1,192

• 2 x Social Workers (January 2007),

District Nursing

5,643

• Clinical and Ambulatory Care Manager (April 2007),

Planned Activity Group

1,655

•• Commonwealth Community Water Grant – Rainwater Harvesting Project (July 2006) •• Successful funding submission to the Geoffrey Gardiner Dairy Foundation Ltd (November 2006)

Meals on Wheels

10,954

•• Introduction of “Go for Gold” Quality Improvement Program (December 2006)

Community Health Occasions of Service

•• Stage 1 redevelopment commences (December 2006)

Physiotherapy (OP)

377

•• Creation and implementation of new corporate logo (February 2007)

Podiatry

562

•• Reformation of the Staff Social Club (March 2007)

Social Workers

701

•• Formation of the Waste Management Committee (April 2007) •• Hi-lo beds now throughout all of our facilities •• Increased uptake of Influenza and Hepatitis B vaccinations by REDHS staff

•• Information and Communication Technology advances including additional hardware and software platforms for

Challenges

The Future

•• Ageing workforce / attracting and retaining staff in a rural area

•• Complete Service Plans for Acute and Aged Care

•• Unexpected increase in staff sick leave •• Increased administration requirements to meet new/updated legislation, regulations and codes of practice for health professionals •• Management of continuation of high quality services during redevelopment.

Hostel Bed Days Hostel Separations

policy management and aged care resident information

•• Four staff members injured in car accidents and off work for extended periods.

Nursing Home Bed Days Nursing Home Separations

•• Collaboration with Rochester Community House

•• Computer server failure

Aged Care

•• Continued expansion of partnerships and Memorandums of Understanding with other health and community based services •• Completion of communication and community engagement strategy •• Redevelopment - Stages 2 & 3 •• Continued community forums and consultation •• Planning and meeting the changing health needs of the community and industry trends

redhs annual report 2007 page 1

10,898 10 10,450 7


Report From President and CEO “It is not the strongest of the species that survives, nor the most intelligent, but the one most responsive to change…” Charles Darwin was not only talking about nature in his above quote. In the past twelve months Rochester & Elmore District Health Service (REDHS) has undergone some significant change in order to respond to its environment and the needs of providing high quality, excellent and sustainable health services.

Building a Sustainable Future The Board of Management in its governance role has been focused on the development of a strategically planned, sustainable health service that will meet future needs and improve health for all people within the district. In so doing, our focus has been on the implementation of the recommendations of the 2005 Service Plan and Strategic Plan - A Vision for the Future which focuses on seven key strategic goals: •• Our People (Attract & Retain people of the highest calibre) •• Our Community (Actively & Positively engage with the community) •• Our Service (Service delivery responsive to changing needs) Mary Magennis Board President

•• Our Partnerships (Integrated, client focused care) •• Our Resources (Responsible & Sustainable use of our financial resources) •• Our Culture (Continuous improvement is embedded in the work culture) •• Our Leadership (United, focussed & proactive leadership at all levels)

Services offered by REDHS •• Acute Services •• Cardiac Rehabilitation •• District Nursing •• Health promotion •• Men’s health/drought counselling •• Pathology collection •• Physiotherapy •• Planned Activity Group (PAG) •• Podiatry •• Psychologist •• Radiology •• Residential Aged Care •• Social Work and Counselling •• Visiting drug/alcohol counselling; diabetes education; Centre Against Sexual Assault (CASA) •• Women’s Health/Community Nurse

A strong management team over the past three to four years has enabled REDHS to perform at a high level and seek the recognition it deserves as a leading, innovative small rural health service within the state. Duane Attree was appointed as the CEO in January and is already serving REDHS with great energy. On behalf of the Board, we wish to acknowledge the strong leadership and dedicated work of former CEO, Robyn Whyte, who led the change process through a very difficult planning time. The Board of Management has a commitment to working closely with the community for all major planning activities through its Community Engagement Strategy. Planning for acute care with emergency services and the operating theatre will commence in the coming months. Aged care, with its wide range of activities and increasing demands, will also be reviewed in order to keep us informed in an ever-changing, regulatory environment. These planning processes demand a financially secure and sustainable base for development.

Our Achievements The major development over the last twelve months has been the commencement of our $21.7M building program. This has been an outstanding achievement for all concerned with REDHS. It is a result of the hard work and dedicated service of countless people who have contributed over many years. In implementing recommendations from the organisation’s Service Plan, priority has been given to the development of facilities that support new models of care and focus on a “one-stop shop” for health services. This will mean some significant change in the way we deliver and offer services in the future. The Board and Management are dedicated to keeping the community informed of these significant and exciting changes. With attention in the health care industry focusing on Primary Care services, REDHS responded to the changing environment with the recruitment of Shirley Rutherford to the new position of Director of Primary Care Development. Sustainable primary health care relies on a broad range of professions, including General Practitioners, working as a team to improve health for all people within the district. In order to develop this approach, a Primary Care Development Plan was endorsed in principle by the Board as a key document for the delivery of innovative health services. In its development the Primary Care Development Plan included public consultation and will be used as the reference for the growth of existing services and to define and establish new services in the future.

redhs annual report 2007 page 2


Report from President and CEO

Financially, the organisation continued to improve its cash position with an increase of $182,994 from Operating Activities compared to the previous year. This is due mainly to the review of aged care entry contributions and admission processes as well as the generous grants provided by various philanthropic and corporate trusts. The endorsement and implementation of an investment strategy by the Board also contributed to improved cash performance and will continue in the coming years. The organisation posted a loss, prior to Capital and Depreciation of $27,710. This result was driven mainly by the loss of assets due to our building program and high Employee Entitlements payments due to high sick leave during the year. Some other achievements for 2006-07 include: •• The announcement and public release of our new image including a change to our logo. Our new logo was designed to symbolically demonstrate four key features of our future. They are: • An organisation having a transformation and re-birth • A recognition that we serve three main districts (Rochester, Elmore, Lockington) and encompass the smaller townships and villages in the area Duane Attree Chief Executive Officer

• A focus on holistic care in partnership and collaboration • Vibrant, fresh and distinctive •• Completion of an organisational structure review with a renewed management focus on the organisations strategic priorities, building teamwork and clear formal communication forums for all staff •• Establishment of a new Social Club, who have hosted many social gatherings •• Development of a Staff Training and Education Plan •• Review of emergency procedures It is pleasing to note that whilst we are in a significant period of development and change, Director of Nursing Ruth White and volunteer archivist Eve Salter are currently constructing the history of health services in the district. With a small seeding grant received recently, it is anticipated that this very important work will be completed in time for the opening of our new buildings in late 2009.

Our Thanks On behalf of the Board of Management and staff, we wish to thank the former Minister for Health, Bronwyn Pike, and the Department of Human Services for their commitment to the future of health services in the local area. We look forward to welcoming new Minister Hon. Daniel Andrews to REDHS in the near future. We thank the Board for their continued contribution and we also wish to acknowledge the contribution to our service of outgoing President, Heather Acocks. Her leadership was instrumental in the organisation realising its potential. We also acknowledge and thank the extremely dedicated and caring staff, volunteers and Auxiliary members of our organisation. It is a pleasure to know that we have such a committed team to provide excellent service to the community. In particular we acknowledge the support given by our Executive and Management team to assist us in implementing our future plans. Darwin’s challenge to remain responsive is well served by the team at REDHS, whose talents and dedication will see a thriving organisation in the future.

Mary Magennis Board President

Duane Attree Chief Executive Officer redhs annual report 2007 page 3


Corporate Governance President

REDHS Board of Management The Rochester & Elmore District Health Service (REDHS) is an incorporated body listed under Schedule 1 of the Health Services Act 1988. Board members are recommended by the Minister and appointed by the Governor-InCouncil for a term of 3 years. The activities of REDHS are directed by the Board of Management, which meets regularly with the CEO and Executive staff to determine policy and strategic direction. The Board is supported in its decision-making by a number of sub-committees. See page 11.

Mary Magennis, RN B.App.Sc, MA (Sc) Consultant Term of Appointment: 1.11.2004 to 30.6.2008

Vice-President

Stuart McDonald M.Sc(Melb) AO Farm Management Retired Term of Appointment: 1.11.2006 to 30.6.2009

Subject to the requirements of government and the Health Service By-laws the Board exercises decisions including the control of funds, determining of the range of services to be provided, and the appointment of visiting medical officers and other senior staff.

Members Heather Acocks

Astrid Jensen

Farm Management Term of Appointment: 1.11.2005 to 30.6.2009

B.Bus(Pub Rel) Term of Appointment: 1.11.2006 to 30.6.2009

Graeme Nelson

Dot Moon, RN

Retailer Term of Appointment: 1.11.2004 to 31.10.2007

Dip AOD AOD Withdrawal Nurse Term of Appointment: 1.11.2004 to 31.10.2007

Sonia Martin, RN

Allison Shotton, RN

BNSci(Hons), DipASci, Registered Nurse Agribusiness owner Term of Appointment: 1.11.2005 to 30.6.2009

Grad Dip Midwifery, Registered Nurse, Midwife Term of Appointment: 1.10.2004 to 30.6.2008

Treasurer

Meeuwis Boelen BSc(Neth), MSc(Neth), PhD(Neurophysiology) Assoc Prof Neuroscience & Pharmacology Academic Head, Higher Education Programmes 1.11.2006 to 30.6.2009

redhs annual report 2007 page 4

Retiring Members Peter Lawford

Greg Walkley

Retailer Term of Appointment: 1.11.2003 to 31.10.2006

Electrical Contractor Term of Appointment: 1.11.2003 to 31.10.2006


Corporate Governance

Meeting Attendance

Board Meetings 2006 Sep Oct

2007 Mar Apr

Total Other meetings meetings attended

Jul

Aug

Nov

Dec

Jan

Feb

May

Jun

Mary Magennis

NA

11/11

18

Stuart McDonald

NA

10/11

7

Meeuwis Boelen

NA

8/11

6

Heather Acocks

NA

11/11

10

NA

���

4/7

4

Peter Lawford (to 31.10.06)

Sonia Martin

NA

Astrid Jensen (from 1.11.06)

3/4

3

9/11

12

Dot Moon

NA

9/11

9

Graeme Nelson

NA

11/11

8

Allison Shotton

NA

8/11

6

Greg Walkley (to 31.10.06)

2/4

2

Committee Membership

Physical Financial Resources & Resources and Planning Audit (to 31.10.06) • (2/2)

Mary Magennis

Risk Management Audit and Planning (from 1.11.06) • (4/4)

• (3/3)

Credentials and Medical Appointment Advisory Committee

Medical Consultative Committee

Quality of Care

• (3/4)

Stuart McDonald • (2/4)

Meeuwis Boelen • (2/2)

Heather Acocks

• (3/3)

• (4/4)

• (3/4)

Peter Lawford (to 31.10.06) Sonia Martin

• (4/4)

Dot Moon • (2/2)

Graeme Nelson

• • (3/3)

Astrid Jensen (from 1.11.06)

• (4/4)

• (1/3) • (3/4)

Allison Shotton

• •

Greg Walkley (to 31.10.06)

Executive Officers Chief Executive Officer

Director of Medical Services

Duane Attree

Prof Ian Brand

B.App.Sc(HIM), Grad Cert (PH), CHE

AM, MB, BS, FCPA, FRACMA, FCHSE, FSHP

Director of Nursing

Director of Primary Care Development

Ruth White

Shirley Rutherford

RN, RM, Dip N.Ed, B.App. Sc, FRCNA, FNSWCN, FACNM, AFCHSE

Dip. Teach, B.Ed, M. Bus.Lead, Dip Qual. Aud, MBIT Accred.

redhs annual report 2007 page 5


Organisational Chart

Board of Management Responsibility • Corporate & Clinical Governance • Strategic Plan Implementation • Organisational Development & Leadership • Community Education/ Engagement

Chief Executive Officer

Executive Support Office Service Responsibility • Corporate communication • Board Secretariat • PA Services

Administration & HR Manager

Facility - Risk Manager

Support Services Manager

Service Responsibility • Reception • Payroll • HR Coordination • Administration • Aged Care Finance Support • Accountancy Contract

Service Responsibility • IT Support Contract • Redevelopment Project • OHS Coordination • Maintenance/Grounds • Risk Management

Service Responsibility • Catering • Cleaning • Stores/Supply • Fleet • Business Development • Security • Accounts Coordination

Reporting Structure

Credentials & Medical Appointments Committee

Risk Management & Planning Committee

Medical Consultative Committee

OHS Committee

All Medical Staff

Director of Nursing & CLinical Services

Visiting Director of Medical Services

Director Primary Care Development

Service Responsibility • Act as CEO during absences • Acute Care • Emergency • Ambulatory Care • Residential Aged Care • Quality Improvement • Infection Control • Staff Development • H.I.M. • Professional Support

Service Responsibility • VMO’s

Service Responsibility • Health Promotion • Allied Health Services • District Nursing Services • Chronic Disease Mnagement • HACC Services • Volunteers • Intake Coordination • Primary Care Development

Professional support/supervision

Board of Management

Audit Committee

Quality of Care Committee

Board Executive Group

REDHS Executive

Infection Control Committee

Working Groups

Cultural Diversity Committee

Volunteers and Auxiliaries

Various Working Groups as required

Residents Consultative Committee Community Focus/ Consultative

All Departments

All Staff

redhs annual report 2007 page 6

REDHS Management Group

REDHS Department Managers


Our People

Staff Executive Chief Executive Officer Mr D Attree – (Appointed CEO January 2007) (Acting CEO September 2006 – January 2007) B.App.SC (HIM), Grad.Cert (PH), CHE, AIMM Ms R Whyte, - (Resigned September 2007) B Pharm, MBA, MAICD, ACHSE Director of Corporate Services Mr D Attree – (Appointed CEO January 2007) B.App.SC (HIM), Grad.Cert (PH), CHE, AIMM Director of Medical Services Prof Ian Brand AM, MB, BS, FCPA, FRACMA, FCHSE, FSHP Director of Nursing and Clinical Services Ms R White RN, RM, Dip N Ed, Bch App Sc, FRCNA, FNSWCN, FACNM, AFCHSE Director of Primary Care Development Ms S Rutherford Dip. Teach, B.Ed, M. Bus.Lead, Dip Qual. Aud, MBIT Accred.

Department Heads Clinical & Ambulatory Care Manager Ms H Thomson (Appointed April 2007) RN, BNursing, ICU Cert, MHA Ms W Fimmel (Resigned December 2006) RN, RM, BN, Crit Care Cert, MRCNA District Nurse Manager Mrs K Eddy RN, B Hlth Sc Mr C Jones (Acting from February 2007) RN, BNursing Facilities and Risk Manager Mr M Dennis (appointed January 2007) A Grade Electrical Mechanic Garden/OH&S Co-ordinator Mr A Gibson – (Resigned July 2006) Hostel Supervisor Ms J Ellis RN, RM, B Hlth Sc, Post Grad Dip in Dementia

Infection Control Practitioner / Redevelopment Project Officer Mrs G Kerlin RN, Sterilization, Infection Control Cert. Maintenance Officer Mr DJ Dinsdale – (Resigned July 2006) Nursing Home Unit Manager Mrs A Chirnside RN, Cert Onc Cert. Gerontology Planned Activity Group Coordinator Mrs G Howard RN Div 2

Staff Awards 15 Years •• Susan Barkla, Nursing Services •• Tracey Boyack, Nursing Services •• Sherrill Carr, Support Services •• Jenny Ellis, Nursing Services •• Mary Parker, Nursing Services •• Ruth Wood, Nursing Services

20 Years •• Barbara Cail, Nursing Services

Quality Coordinator Ms L Wolfe Adv Dip Bus Man, Adv. Dip Bus Man (HR Bridging) Dip App Sci (Hort) Staff Development Officer/Clinical Support Nurse Ms Di Kenyon, RN, Grad Dip FET, Cert IV TAA, Cert IV Workplace Assessment and Training, Cert in Stomaltherapy Supply Manager Mrs G McConnell

•• Patricia Costello, Administration •• Lynette Godden, Support Services •• Gwenda Howard, Nursing Services •• Valerie Naughton, Support Services

30 Years •• Maree Johnson, Nursing Services

Support Services Manager Mr R Beddell Chef, Qualif in Catering Man. Adv Dip. Bus Man. Dip Support Services Management

Visiting Medical Officers General Practitioners Dr AS Asaid, MBBS (Egypt), AMC, FRACGP, FACRRM Dr ED Ekeanyanwu, MBBS (Nigeria) Dr N Fang, MBBS, DRANZCOG, FRACGP Dr P Radrekusa, MBBH Dr OT Shaw, MBBS Dr K Thompson, MBBS

Radiologist Bendigo Radiology (from January 2007) Dr WM Benson, MBBS, FRACR (Benson Imaging) (Until January 2007) redhs annual report 2007 page 7


Key Performance Indicators Income

Expenditure

$M

$M

10 –

10 –

9–

9–

8–

8–

7–

7–

6–

6–

5–

5–

4–

4–

3–

2006/07 2005/06 2004/05 2003/04 2002/03 2001/02

3–

2006/07 2005/06 2004/05 2003/04 2002/03 2001/02

Income- 2006-07 reduced from previous years due to changes in recognition of DHS Capital Revenue.

Expenditure- 2006-07 increased due to loss on disposal of assets (building program) and high level of staff sick leave.

Acute Separations

Acute Ward: Average Length of Stay (days)

1400 –

1271

1200 –

5–

1126

1000 –

570

3.13

3–

621

1–

200 – 2006-07

2005-06

2004-05

2003-04

2002-03

0–

2006-07

2005-06

2004-05

2003-04

2002-03

In late 2004 day procedures ceased. Separations have continued to decline since the closure of theatre and the associated bed number reduction from 16 to 12. Current separations are meeting the community’s needs.

There has been a reduction in the Average Length of Stay in the Acute Ward. The current average is now more in line with state averages.

Acute Bed Days: Nursing Home Type

Emergency Department

750 –

682

750 – 641

604

500 –

500 –

454

418

377 250 –

0–

319 250 –

211

2006-07

141

151

2005-06

2004-05

2003-04

2002-03

A patient is defined as being Nursing Home Type once they exceed a length of stay of 35 days. These figures reflect the increased availability of aged care beds and a greater availability of community based care packages.

redhs annual report 2007 page 8

3.32

2–

400 –

0–

3.78

4–

934

800 – 600 –

4.71 4.27

0–

2006-07

2005-06

2004-05

2003-04

2002-03

Increased number of presentations is reflective of community need for after hours access to medical care. Most attendances are Triage Categories 4 or 5 (non-urgent type).


Overview

Aged Care Bed Days

Occupancy (%) 100 –

12000 –

75 –

8000 –

50 – 4000 –

0–

25 – 2006-07

2005-06

Nursing Home

2004-05

2003-04

2002-03

0–

2006-07 Acute

Hostel (inc. Respite)

2005-06

2004-05

2003-04

2002-03

Hostel

Nursing Home

There are no major changes in total Aged Care bed days as bed numbers have remained unchanged. Nursing Home had ten separations and Hostel had seven.

Aged Care occupancy is consistently high with almost 100% occupancy at all times. Hostel occupancy was slightly down this year due to temporary bed closures during the redevelopment.

Hostel Bed Days per Care Level

Nursing Home Bed Days per Care Level

4500 –

7000 –

4000 –

6000 –

3500 –

5000 –

3000 – 2500 –

4000 –

2000 –

3000 –

1500 –

2000 –

1000 –

1000 –

500 – 0–

S2

2006/2007

S3

S4

S5

2005/2006

S6

S7

2004/2005

0–

Respite

2003/2004

S1

2006/2007

S2

S3

2005/2006

S4

2004/2005

2003/2004

Residents who are entering the hostel are increasingly frail on admission and their conditions are often subject to decline. (S2 is a higher level of care than S7)

These results reflect the expected levels of care provision required in the Nursing Home.

Meals on Wheels

Social Workers : Occasions of Service

12000 –

800 –

10954 9576

789 701

10397

650 –

9323 9038

8000 –

400 – 276 200 –

4000 –

0–

0–

2006-07

2005-06

2004-05

2003-04

182

2007-08

2006-07

2005-06

2004-05

0 2003-04

2002-03

The increase recorded this year is mainly due to the provision of meals to the Lockington community.

The increase in occasions of service is due to the appointment of two social workers in response to ongoing drought conditions in the region.

redhs annual report 2007 page 9


Performance Against Strategic Goals Strategic Goals

Strategies

Achievements in 2006-07

Attract and retain skilled people of the highest calibre

Professional Development Opportunities

Staff Education and Training Plan developed and approved

Innovative HR Practices

Establishment of HR Working Group to review Best Practice and identify gaps

Staff Consultation

Extensive staff consultation during development of HR Plan and review of organisational communication. Participation in public sector People Matter Survey 2007.

Actively and positively engage with the community

Establish positive working relationships with community groups

•• Attendance by CEO at over 20 local forums •• Membership of Rochester Community House Committee •• Production and distribution of Community Newsletter

Increased opportunities for community input to Public consultation invitation re Primary Care Development Plan REDHS planning Marketing the health service

Development of a new logo and professional image for REDHS

Professional Management of Volunteers

•• Development of Volunteer Orientation Package •• Documented volunteer coordination and value through organisational restructure

Service Delivery that is responsive to changing needs

Recruitment of Key Personnel for Primary Care development

Successful recruitment of Director of Primary Care Development, two social workers and a Health Promotion Officer

Build flexibility into new facilities

Incorporated multi-purpose rooms in plans. Provision throughout new facilities for wireless internet access and multi-purpose communication devices

Integrated clientfocused care and client satisfaction

Develop service linkages and collaborative arrangements with other providers

Developed MOU with Echuca Regional Health and Kyabram District Health Services Health Promotion programs

Monitor client satisfaction with service access / quality of care

Consistently high levels of satisfaction recorded in Victorian Patient Satisfaction Monitor. Excellent feedback from Aged Care and District Nursing Service Satisfaction Surveys

Ongoing participation with Campaspe PCP

Review of PCP arrangements - involvement in programs such as "Kids Go for your Life' , "Healthy Community" and Integrated Chronic Disease Management.

Develop a culture of financial accountability

•• Use of cost centre based budgets developed from the bottom up •• REDHS representative on DHS Financial Management Information System Implementation Committee •• Benchmarking of finances with other similar sized organisations

Provision of skills, tools and processes for managers to manage budgets

Skills audit of management level staff undertaken and identification of training providers for management development program

Develop effective financial reporting systems

Regular payroll reports to Department Managers for key expense areas

Demonstrate efficient use of resources

Benchmarking of finances with other similar sized organisations and development of trended data demonstrating SRHS allocation and growth.

Organisation-wide approach to OHS

•• Review of Board sub-committee structure and establishment of Risk Management Committee and organisation-wide Risk Management Plan developed and endorsed. •• Review of emergency procedures – desktop audits conducted •• Establishment of two OHS committee working groups - Legislation and Compliance and Management Systems

Publish our successes

Regular press releases and monthly page in local newspaper, reintroduction of Staff Newsletter, Quality Times newsletter, additional information in REDHS Annual Report

Compliance with all statutory requirements

Accreditation status maintained. Aged Care facilities compliant with all outcomes.

Electronic improvement management and incident reporting system

Introduction of "Go For Gold" Program to encourage staff initiation of improvement projects.Use of additional reporting features of Incident Reporting database

Participation in benchmarking

Benchmarking of Human Resources information and , Aged Care Performance Indicators and People Matter Survey

Organisational structure and reporting review

New organisational framework and provision of clear reporting structure

Succession Planning

Internal appointments of CEO, Quality Coordinator, Redevelopment Project Officer.

Board Education Program and Performance Review

Attendance at DHS Board Governance training and implementation of Board Education program. Completion of Board Performance survey and establishment of Board Effectiveness working group

Responsible and sustainable use of financial resources

Continuous Improvement is embedded in the work culture

United, focussed and proactive leadership at all levels

redhs annual report 2007 page 10


Overview

Status

Plans for the Coming Year

Full implementation of Plan and continued support of educational opportunities for staff.

Review, develop and implement Code of Conduct in consultation with staff

  Ongoing

Continuing staff consultation with strategic reviews, service plan development and policy/procedure review and development

  Ongoing   Ongoing   Ongoing

•• Continuing involvement in the community by Board members and staff. •• Review of newsletter content and distribution including readers’ survey

•• Public involvement in the development of Acute and Aged Care services •• Development of community involvement in strategic planning and policies.

Roll out of corporate image to all areas of the organisation

 

•• Development of “volunteer-specific’ organisation orientation sessions •• Continuing recognition of the time and worth of volunteer contributors

Further recruitment in line with budget process and Primary Care Development Plan

Complete redevelopment project

Further establish and enhance primary care services in line with PCDP

  Ongoing

Continuing evaluation of client satisfaction and involvement. Improved access, variety and quality of information sources

  Ongoing

Continuing involvement with PCP initiatives

 

REDHS Management Group is responsible for putting the Strategic Plan into action and consists of REDHS Executive and the following management staff:

Richard Beddell

Dianne Kenyon

Anne Chirnside

Gayle Kerlin

Mathew Dennis

Gayle McConnell

Jenny Ellis

Helen Thomson

Colin Jones

Lynn Wolfe

•• Continuing development of management reporting systems •• Implementation of FMIS in 2008-09 •• Increasing use of benchmarking of financial indicators with similar sized organisations

 

Source and allocate adequate resources for management development program

  Ongoing

Continue provision of reports and clarification for managers as required

  Ongoing

Continue benchmarking and identify further benchmarking opportunities

  Ongoing

•• Review of Risk Management Plan •• Develop OHS Plan to further improve health and safety and reduce risk •• Introduce new quick reference flipcharts for emergency codes. Continue reviewing procedures as redevelopment alters access and egress points. •• Complete evaluation of OHS working groups.

  Ongoing

Evaluation of communication methods. Continue effective dissemination of information to maximise staff and community knowledge regarding REDHS operations and development

Complete ACHS accreditation and continue quality activities

  Ongoing

•• Encourage ongoing participation in quality activities •• Continue to explore software capabilities to further enhance reporting and analysis

  Ongoing

Ongoing participation in benchmarking projects

Review reporting structure to measure effectiveness

  Ongoing

Identify and document opportunities for Nursing and Allied Health career development. Continuing work with Rochester Secondary College re partnership arrangements. Identify and actively recruit and retain board members during next nomination cycle.

  Ongoing

Evaluation of Education and Training programs. Evaluation of survey and working group findings.

redhs annual report 2007 page 11


Redevelopment The Honourable Bronwyn Pike, Minister for Health, officially launched the $21.7 million project with the turning of the first sod on 24th October 2006. Stage 1

The Minister for Health, Bronwyn Pike turns the first sod with local member Noel Maughan and Board President Heather Acocks.

New Nursing Home and Support Services building. New road and car park in Village Drive

Stage 2 New administration wing, theatre and emergency department. Refurbishment of existing nursing home for new acute area

Stage 3 New Community Health wing and Medical Practice Consulting rooms

To assist with the day to day management issues relating to the redevelopment and to ensure an information flow to staff and the public, two part-time Redevelopment Project Officers were appointed – Gayle Kerlin in July 2006 and Mathew Dennis in January 2007. Three information sessions were held in August and September 2006 for aged care residents, their families and members of the Planned Activity Group, to explain the stages of the redevelopment and the effect on them. A total of eighty-one consumers attended these meetings. To date, apart from some “noisy” days due to demolition work and heavy vehicle movement, there has been minimal impact on residents’ daily lives. However, the staff have had to implement some changes to their work practices, especially with regard to delivery and collection of goods to and from the Hostel.

Jenny Major delivering lunch to the Hostel with the new canopy overhead.

In September 2006, the first edition of our “Community Newsletter” was distributed throughout the region via the Health Service, Medical Practices and local businesses. Further editions have been distributed in December 2006, March 2007 and June 2007. The purpose of the newsletter is to inform interested members of the community about progress of the redevelopment and changes to access. Articles are also included in the Campaspe Valley News (CVN) on a regular basis. In November 2006 a questionnaire was distributed to assess the effectiveness of our communication to the community. We received 58 responses; unfortunately 69% of respondents were unaware that a newsletter was available despite 68% indicating that they regularly read the CVN articles where the newsletter was mentioned. Valuable suggestions were made with many already in use. These include a mail out to service clubs and community groups when each new newsletter is released, a display at the local supermarket and additional distribution points. REDHS has been fortunate to have access to a shopfront in Gillies Street Rochester for most of 2007. A display of posters, photographs and the timeline of the redevelopment have been maintained for interested community members.

Community newsletters are valuable sources of information.

redhs annual report 2007 page 12

Staff have been kept informed about developments via the fortnightly “Staff Newsletter” and since February 2007 the annual staff Orientation/Training day has included a “Walk about” to explain the redevelopment project.


Redevelopment September 2006 Planned Activity Group relocated to Salvation Army Hall.

October 2006 Kane Constructions site sheds/offices and security fences erected and utilities connected.

December 2006 Hostel Canopy construction commenced. Demolition of Day Care building and adjoining residence to allow site preparation for the new Nursing Home.

February 2007 Clean up of Nursing Home site and foundation works commenced

March 2007 Hostel - canopy and “Gopher� parking area completed , pergola extended and nurse call system installed. Kane Construction took possession of southwest corner of existing Nursing Home to allow for new building to be joined on.

April 2007 Foundations and services to east/west wing (A) of new Nursing Home completed. Site levelling and preparation for north/south wing (B) and Support Services building commenced.

May 2007 Concreted foundations of north/south wing (B) of new Nursing Home completed. Foundations for Support Services building commenced, and utilities installed.

June 2007 Wall framing in Wing A completed and roof trusses set in place. Wing B wall framing and roof truss installation underway. Concreting of Support Services building foundations commenced. First section complete.

Completion of the first stage of the redevelopment is expected in early 2008.

redhs annual report 2007 page 13


Clinical Care Report Director of Medical Services The health of Victorians living in rural areas is significantly worse than those living in urban areas. Lower incomes and sole parent status are higher in rural and regional areas and are closely linked to poor health. Another important reason for the poor health status of rural Victorians is the limited access to health care. However, after nearly two years as Director of Medical Services, I am happy to report that the care provided to patients of REDHS and to the local community is of a commendable standard, due to the high quality of our medical, nursing, administrative and support services staff. As well as looking after many of our inpatients, Drs Onn Shaw and Nigel Fang provide an excellent on call service to the hospital. Drs Adel Asaid, Eji Ekeanyanwu, Poate Radrekusa, and Karen Thompson from the Elmore Medical Practice are also credentialled at the hospital. We are very fortunate to have such dedicated practitioners to look after the community, as there is a serious shortage of GPs in rural Victoria, with many doctors having long waiting lists for new patients. We thank all of the doctors who work here and who help to make this the excellent health care facility that it is. Professor Ian Brand Director of Medical Services

We are looking forward to the new hospital that will have a modern operating theatre and much better facilities for patients and staff and will further enhance the fine service already provided. I want to record my thanks to all the medical staff for their cordial reception of me, and their willingness to discuss matters at any time, as well as their readiness to cooperate in the provision of the very good services they give. I wish to especially thank Drs Onn Shaw and Adel Asaid for their assistance. Finally I thank Duane Attree and Ruth White for their many kindnesses and encouragement, which have made my role a very rewarding one. Professor Ian Brand Director of Medical Services

Director of Nursing The year 2006/07 has been one of changes and challenges for all staff, especially in those areas that have experienced disruption during the new and exciting redevelopment program. Staff have been diligent and thoughtful in how the care of patients/ residents or clients can be minimally affected by this disruption. In August 2006, ACSAA accreditation was awarded to our aged care facilities for a further three years. ACHS accreditation is to be undertaken in September 2007 and all staff have participated in maintaining standards of continuous improvement in order to be successful in this important phase of the accreditation cycle. Following the resignation of Wendy Fimmel after many years of service, we were pleased to welcome Helen Thomson into a new redefined role as Ambulatory and Clinical Care Manager in April 2007. The role will be a major catalyst in preparation for the new Acute and Theatre services, due for completion in late 2008. Helen has senior management experience in acute and ambulatory care settings. Ruth White Director of Nursing

With the installation of new beds in the Hostel this year, all clinical areas now have electronic hi-lo beds. This enables us to further meet the changing needs of consumers in accordance with OHS requirements. All staff have continued to remain committed to our changing organisation in a positive and professional manner and I thank them all for their continued support. Ruth White Director of Nursing

redhs annual report 2007 page 14


Department Reports

Acute Services The Acute Ward provides acute medical and palliative care services to the local community with twelve acute beds and one emergency trolley. During 2006/2007 the Acute Ward has concentrated on Occupational Health and Safety issues, improving quality of care, and preparing for the new facility. The ward clerk reception area was reconfigured to provide a safer work environment and a toilet and shower area was renovated. Quality of Care improvements include evidence based review of many of our protocols and the implementation of new processes to improve activities such as medication management and safety for patients undergoing blood transfusions. Equipment in the Acute Ward is kept up to date with regular purchases, often provided through generous donations. This financial year purchases include a defibrillator, a vital signs monitor and paediatric cot.

Acute Ward Clerk Wendy Dey has found that the extra space and height of her new workstation is much more functional and comfortable.

The Acute Ward is fortunate to have a dedicated team of staff who care about their patients and one another. This is reflected in the positive feedback received from patients. The Victorian Patient Satisfaction Monitor is a survey conducted throughout Victorian hospitals. When compared with other “like” hospitals REDHS performed extremely well. We also attempt to contact all of our patients at home after discharge via telephone. For the month of May, sixty-seven percent of our patients discharged home were contacted and asked several questions about their stay in hospital, achievement of goals of admission, symptom management, information provided to assist the transition home, and services provided at home. In all audited cases, patients were satisfied that their admission goals were achieved, and that discharge information and arranged services were both adequate. The survey has recently been refined to allow a more detailed review of post discharge services. The Acute Ward has been preparing for accreditation in September 2007 with all staff actively participating in the quality activities that occur routinely all year round. More specifically, they have been preparing documentation for the accreditation survey, both in hard copy and electronically for the first time.

RN Division 1 Acute nurses Cheryl Petrini and Robyn Kelly check blood before administering it to a patient.

The ward is preparing for the new facility and much work has been done to incorporate better workflow practices across the acute ward, emergency department and new theatre into the new model of care. Ongoing work includes continuous review of latest practices and staffing models, detail such as policies and procedures, and fit out specifications. The ward is also looking at better integration with community-based services and streamlining care for patients as they are admitted and then discharged back to the community. One of the key strategies for the ward in 2007-08 will be involvement in the implementation of an Integrated Chronic Disease Management program. Preliminary education for staff has begun.

Ambulatory and Clinical Care Manager, Helen Thomson with RN Div1 Maree Johnson who has just reached the thirty year milestone at REDHS

Bed Days: Acute Ward 5000 – 4224 4000 – 3000 –

3531

3520

2004-05

2003-04

2926 2436

2000 – 1000 – 0–

2006-07

2005-06

redhs annual report 2007 page 15

2002-03


Aged Care Rochester Nursing Home (High Care) and Rochester & District Hostel (Low Care) continue to provide high quality and compassionate care to older people in our community. The maintenance of independence, privacy and dignity is of paramount importance and is reflected in the philosophies of both facilities. We have seen many changes to our resident mix, with people receiving a lot more community based services enabling them to stay at home longer. This has led to residents entering the hostel with an increased need for care and nursing support, and entering the nursing home with increased frailty and more complex care requirements. To ensure that all residents’ needs are met and quality of life maintained at the highest possible level, individual care plans are developed and reviewed monthly by care staff (in consultation with the resident or representative where appropriate) or more frequently if required. Quarterly reviews of resident medications are undertaken by an external pharmacist to ensure that all medication continues to be appropriate. Nursing Home resident Bill Ellis enjoyed meeting one of the competitors at the Echuca Sheep Dog Trials.

Residents are encouraged to participate in our Activities and Lifestyle program which aims to maintain resident contact with community groups and activities, e.g. church, senior citizens, library, CWA, Great Northern Show (Rochester), farm and family visits, shopping, concerts and many outings. Clergy from the local churches conduct weekly services on a rotational basis and visit with residents who are unable to leave their beds on the day. In remembrance of residents who had passed away in the past twelve months, the annual memorial service was conducted in the presence of family, friends and staff in February. This year’s Activities program has been very varied and interesting. Outings were very popular and took in a variety of destinations including: horse studs, jersey farm (including an opportunity to feed the cows), the Murray River at Echuca, the RSL Club (Moama) for lunch, the Elmore Field Days in October, the International Scout Jamboree in January (also at Elmore), the Corop Winery and the Echuca Sheep Dog Trials. On site activities continue to be popular – especially Bingo, Scrabble and cards. Other enjoyable pastimes indulged in were newspaper reading, cooking, Knitting Club, exercise sessions, quizzes and crosswords (designed for residents with visual impairment) and the ever-popular Happy Hour. Male residents are invited to attend the Men’s Shed at Rochester Community House with two residents in regular attendance. Special meals, barbeques, morning and afternoon teas provide opportunities for family and friends to join with residents to mark occasions such as birthdays, wedding anniversaries and culturally significant days. We are most grateful to our volunteers for their continuing dedication and interaction with our residents and staff.

Hostel ladies Barbara Lees, Verdun Price and Cathy Brown admire a 1937 Buick when the local Vintage Car Club paid a visit.

redhs annual report 2007 page 16

Resident and former farmer, Ross Bubb, looks over some sheep on a local, drought affected farm.


Department Reports

Easter Bunny (aka Madeline Holt) paid a visit to our aged care facilities where she caught up with Monica Kerlin and Nellie Bickley

Stan Murdin enjoys catching up with some of the “local blokes” in the Men’s Shed at the Rochester Community House.

The RCS Management Advantage database has been adopted with extensive training and ongoing support in place. The database allows the centralised recording of resident details, care plans, financial considerations such as fees, bonds and payments. The nutritional needs of residents are monitored on an individual basis by chef, Darlene Weeks. In consultation with the residents and staff, Darlene devises menus to meet the residents’ nutritional and hydration needs and to assist in chronic disease management such as diabetes. In August 2006, both facilities underwent a two-day accreditation assessment with ACSAA. The assessors deemed that our facilities were fully compliant with all 44 outcomes. Information regarding accreditation outcomes can be found at http://www.accreditation.org.au/AccreditationStandards

HRH Queen Elizabeth II, the Australian Governor General and letters from the Prime Minister and Victorian Governor General were just some of the many messages of congratulations received by Nursing Home resident Len Cunnington when he celebrated his 100th birthday with family and friends in February.

In July 2006, quarterly reporting of Aged Care Clinical Key Performance Indicators to DHS was introduced in the areas of: •• Weight management (monitoring unplanned weight loss), •• Residents taking more than nine medications •• Falls (and any associated fractures) (See below) •• Pressure ulcers (see below) •• Restraint These indicators have ensured an individualised, resident-focused approach to determining strategies to address clinical care areas and form the basis for further improvements. Staff training was undertaken to ensure that the indicators are recorded consistently and in accordance with DHS guidelines. This year there have been many celebrations with our residents and families. Two very special milestones were reached: resident Len Cunnington’s 100th Birthday and Lucy and Keith Weeks’ 65th wedding anniversary. Both occasions were marked with celebrations involving family, friends, residents and staff.

A rescued joey was a very cute and cuddly Nursing Home visitor as resident Aaltje Kuiper discovered.

redhs annual report 2007 page 17


Hostel 15th Birthday Celebrations The Hostel celebrated fifteen years of operation in June. Many changes have taken place over the years, making it the first class facility it is today. Of the original staff, four remain today, Sue Barkla, Sherrill Carr, Jenny Ellis and Mary Parker. Representatives from the Rochester and District War Memorial Hospital Board of Management, Shire of Rochester, RSL and the community formed a group to seek financial commitment from the Commonwealth Government.

Our Hostel’s Significant Dates February 1989 •• Sum of $479,850 granted (conditional on local fundraising contributions being in hand at the time the grant was payable).

May 1990 •• The Fundraising Appeal was launched by Sir Edward Dunlop. $533,000 was raised over the next two years.

March 1992 Original staff members Sherrill Carr, Jenny Ellis and Mary Parker cut the 15th birthday cake with assistance from Mary’s grandson, Alex.

•• Jenny Ellis (Hostel Supervisor) commences employment to coordinate progress towards opening the facility for nineteen frail elderly residents.

May 1992 •• Construction of Bacchaus House (twenty beds) completed

1st June 1992 •• Staff commenced work. Five care staff - Sue Barkla, Sylvia Flack, Norma Hoogenboom, Mary Parker and Jane Shotton and four Hotel Services staff - Sherrill Carr, Wendy Foote, Pauline Marrone and Lois Foster.

30th August 1992 •• Official opening of the hostel by Senator Olive Zakharov.

6th April 1997 Hostel staff (both past and present) and residents gathered to celebrate the Hostel’s 15th birthday in June 2007.

REDHS kitchen staff made and decorated a beautiful cake for the Hostel’s 15th birthday celebrations.

redhs annual report 2007 page 18

•• Official opening of Deravin House - the ten bed specialised dementia unit by Federal Member the Honourable Dr Sharman Stone

December 2006 •• Construction of canopy over main entrance


Department Reports

Primary Care Report Health is defined as “a complete state of physical, mental and social wellbeing and is a resource for life.” (Ottawa Charter 1986) Primary Care Development has occurred in line with the principles of the Ottawa Charter for Health Promotion which is “the process of enabling people to increase control over, and to improve, their health.” Since September 2006, a key strategic task was the development of the Primary Care Development Plan (PCDP) in consultation with staff, Board of Management, Community Service providers, members of the local community and relevant government departments. The plan was adopted in principle by the Board of Management in April 2007. The PCDP identifies a range of services that include treatment, primary prevention, early intervention and health maintenance, health promotion and chronic disease management. Building relationships is a key strategy of primary care development in order to promote health-supporting environments. We have established collaborative working relationships including: •• Partnership with Echuca Regional Health and Kyabram & Districts Health Service for integrated Health Promotion services

Shirley Rutherford Director of Primary Care Development.

•• Expanded participation in the Campaspe Primary Care Partnership •• Secretariat services for the Central Murray Health Forum •• Established links with Rochester Community House via representation on the Management Committee. There has been a doubling of participation in physical activity sessions, provision of new group activities since this increased involvement. •• Collaboration with Elmore Primary Care, Bendigo Community Health Services to conduct health promotion activities at Elmore Field Days. These relationships have resulted in the successful implementation of a wider range of community health promotion activities. See also Health Promotion section in Quality of Care Report. There have been changes to services and the way they are delivered due to a better understanding of the best way to provide care, changes in legislation and/or available funding and its sources and to the development of new treatments. Two years ago, Day Care was renamed Planned Activity Group which placed the focus on providing older adults with a range of health promotion activities in a group setting and maintaining connections with the local community. The ongoing, crippling drought has resulted in REDHS’ decision to support drought affected members of our community through the development of the “Farm Gate” program and the employment of two additional social workers. This program is partly supported by grants from the Geoffrey Gardiner Dairy Foundation Ltd and DHS. Over the coming months, Primary Care will continue to develop new community support activities and services in accordance with the PCDP and identified community needs. Established services continue to be provided to the community through both individual and group programs such as Fitness for Older Adults, Cardiac Rehabilitation and Diabetes Support Group. Some programs are run offsite in partnership with other agencies such as Rochester Community House and the Campaspe PCP. Group physical activity programs also operate for Planned Activity Group and Hostel and for community groups such as Mums and Prams and Women on the Move. The Diabetes Educator from ERH visits REDHS once a week to provide advice to the local community. Diabetes will be a focus of Integrated Chronic Disease Management initiatives in 2007-08.

Shirley Rutherford Director of Primary Care Development.

redhs annual report 2007 page 19


Primary Care Services District Nursing Service (DNS)

District Nursing: Occasions of Service 7851

8000 – 6000 –

6250

6337

5643

5783

Two key staff members have been on long service leave this year with their positions being competently filled by Acting Unit Manager, Colin Jones and Division 1 nurse, Joel Lind.

4000 – 2000 – 0–

2006-07

2005-06

2004-05

2003-04

During 2006-2007, our District Nurses have made 5649 visits to local clients over a wide area from Rochester to Elmore, Goornong and Nanneella and many stops in between, travelling an incredible 23,364 kilometres!

2002-03

The range of nursing care provided predominantly consists of care of the frail aged in their homes, wound care, medication administration, catheter care, pathology collection, monitoring, diabetes care, palliative care and domiciliary midwifery. This year all our targets for nursing hours have been met. A satisfaction survey of clients conducted in December indicated that clients were extremely satisfied with the care and services provided. Many clients complimented the staff on their friendly, professional approach and looked forward to their “chats”. See District Nursing Survey on page ??? Some improvements that have been made within DNS include: the use of a high clearance vehicle and the introduction of a trolley (see photo), updating of the “Failure to Gain Access” card to alert clients who were not home, to the fact that DNS has visited as scheduled, and a review of the “Security off-site” policy to promote the continued safety of our staff.

District Nurse Leanne Rankin demonstrates the ease with which equipment is now moved to and from the high-based vehicle with a minimum of lifting involved.

Congratulations to District Nurse Andrea Howarth (and Wendy Kneebone from the Hostel) on graduating from LaTrobe University - Bendigo with a Certificate of Gerontology. Director of Nursing Ruth White was in attendance at the ceremony to support the staff in their achievement. The DNS continues to provide mentoring of medical, nursing and pharmacy students. As most of the students are from the city or from overseas, they appreciate the opportunity to get out and about in our community, meet people in their homes and learn about life in rural Victoria.

Planned Activity Group Planned Activity Group Attendances 4000 –

3696

3404

3311

2004-05

2003-04

3000 – 2000 –

1943 1655

1000 – 0–

2006-07

2005-06

2002-03

In late 2004-05, Elmore Planned Activity Group transferred to Bendigo Community Health.

Since the commencement of Stage 1 redevelopment PAG has operated from the Rochester Salvation Army Hall. The Salvation Army community were most helpful during the settling in period and made us feel welcome. Midday meals are delivered to us from the main kitchen by Support Services staff. Management and Executive staff are also regular visitors and provide good support for this off-campus program.

One of the final gatherings of the Planned Activity Group before the demolition of the Day Care building.

Although now happily settled into their new surroundings, they have missed the large, sunny space that they once occupied. The new Community Health building (to be built in Stage 3) will be facing the north and be even bigger and better. Entertainment groups from the community have faithfully continued to provide music and entertainment – the many sing-a-long sessions have been thoroughly enjoyed by all. Each month a group of lower Primary School children come to sing and dance, read stories and play card games. It is always a lively and entertaining session. There have been a wide range of craft activities, a daily exercise program, footy tipping, a Pamper Day for the ladies, a fishing trip for the men, making exhibits and winning prizes at the Great Northern Show (Rochester) and lunch and shopping trips to Echuca and Bendigo. We would like to thank our wonderful volunteers who drive the bus and assist us with our many activities and outings. Your support enables us to provide an even higher quality of care than would otherwise be possible.

redhs annual report 2007 page 20


Department Reports

Physiotherapy The demand for this service is constant and physiotherapist Sarah Attree is kept very busy with inpatients, aged care residents and outpatients. In 2004-05 there were more occasions of service because we had two physiotherapists providing treatment services. As a result of fewer admissions, demand for inpatient physiotherapy in the acute ward has declined with a corresponding increase in the number of outpatients seeking treatment.

Physiotherapy: Occasions of Service 1400 – 1200 – 1000 – 800 –

Podiatry This is a HACC funded service for older adults and people with disabilities. With an ageing community and the increase in the rate of diabetes, foot care is a high priority and in demand. Podiatrists under contract to REDHS from Bendigo Community Health Services attend Rochester weekly and we also provide regular outreach podiatry services to Stanhope and Rushworth. Private podiatry through Shepparton Foot Clinic is available at our facility for non-HACC clients.

Radiography This service is provided twice a week and as you can see in the graph, the demand is remaining constant from year to year. State of the art digital imaging will be available in the new facility (to be in use in 2009), however there will be major disruption to this service during the redevelopment program.

600 – 400 – 200 – 0–

2006-07

2005-06

Outpatients

2004-05

2003-04

2002-03

Inpatients

Podiatry: Occasions of Service 600 –

577

562

375

400 –

200 –

Social Work

0–

2006-07

2005-06

2004-05

Consultation services to the local community were provided by Community Counsellor Carmel Williams until her resignation in December 2006 and by social worker Kate McLindon. During the Christmas/New Year period, two newly appointed social workers, Pat Andruchow and Kevin Holmes, provided on-call telephone support before taking up their permanent positions at the end of January. In addition to individual consultations, they are also involved in developing a range of community programs (See Health Promotion section page?????). As Senior Social Worker, Pat provides specialist support for aged inpatients and residents and their families.

Radiography: Occasions of Service 1200 –

1192

1128

1131

1038

1173

2006-07

2005-06

2004-05

2003-04

2002-03

1000 – 800 – 600 – 400 – 200 – 0–

redhs annual report 2007 page 21


Campaspe Primary Care Partnership Campaspe PCP covers the local government area of Campaspe with Emma Brentnall in the Executive Officer role and Sarah Parry as Administrative Assistant. Paul McKenzie (Executive Manager, Community & Culture, Shire of Campaspe) was re-elected as Chair for a further twelve-month period. Mary Magennis and Stacy Williams are the two community representatives on the PCP Management Group this year. The Shire of Campaspe is the PCP’s lead agency/fund holder and REDHS are the employing organisation for PCP staff. The State Government, as part of the Primary Care Partnership Strategy, funds 31 Primary Care Partnerships across Victoria. Each Primary Care Partnership represents a specific region within Victoria and has formed voluntary alliances with a range of service providers. Primary Care Partnership Members include Divisions of General Practice, hospitals, community health centres, health services and other government and non-government organisations. The Primary Care Partnership Strategy aims to improve the overall health and wellbeing of Victorians by: •• Improving the experience and outcomes for people who use primary care services. •• Reducing the preventable use of hospital, medical and residential services through a greater emphasis on health promotion programs and by responding to the early signs of disease and/or people’s need for support. Key areas for PCP member organisations continue to be electronic referral and e-communication between service providers; service coordination; chronic disease management; care planning; falls prevention; mental health promotion; physically active communities and promoting accessible and nutritious foods. PCP work has extended this year with additional funding for drought support; diabetes self-management; electronic referral and a Go for your Life Walk Together grant. Additionally, Campaspe PCP have been selected as a “Be Active, Eat Well” demonstration site (one of five in Victoria) with the support of $614,000 over the next three years to enhance our work in physical activity and nutrition. From October to December 2007, Campaspe PCP members will be undertaking a Health Promotion Strategic Planning process Emma Brentnall Executive Officer Campaspe PCP

Member Agencies •• Bendigo Health Care Group

•• Lockington Bush Nursing Centre

•• Bendigo Regional Breastscreen

•• Loddon Mallee Housing

•• Centre Against Sexual Assault – Loddon Campaspe region

•• Njernda Aboriginal Corporation

•• Community Living and Respite Services

•• Murray Human Services

•• Community Representatives

•• Murray Plains Division of General Practice

•• Echuca Regional Health

•• Murray Shire Council (NSW)

•• Greater Southern Area Health Service (NSW)

•• Rochester and Elmore District Health Service

•• Goulburn Valley Health – Waranga (including Waranga Aged Care)

•• Shire of Campaspe

•• Interchange •• Kyabram Community and Learning Centre •• Kyabram and District Health Services

redhs annual report 2007 page 22

•• Sports Focus •• St Luke’s Anglicare •• Women’s Health Loddon Mallee •• YMCA – Greater Murray


Department Reports

Support Services The Support Services team have been working hard to ensure that services are maintained to all of our facilities and the community during the redevelopment. Work routines have had to be altered a number of times with changes being necessary on an ongoing basis for the next couple of years. While continuing to provide services, the team has been working on finalising all the details for the new Support Services building that will house the kitchen, laundry and stores departments. Acting Support Services Manager, Richard Beddell and Supply Manager Gayle McConnell, have been finalising all of the required new Kitchen and Laundry Equipment. A lot of time has been spent on investigating new equipment for the kitchen and the new production systems that will meet all Infection Control, OHS and Food Safety Standards.

Catering Department Our Catering Department continues to produce a remarkable number of high quality meals for our aged care residents, patients and clients – on average just over 200 per day as well as Meals on Wheels for Rochester, Elmore and Lockington and the Rochester Senior Citizens Club. 2007

2006

2005

Rochester PAG

2280

2880

2655

Elmore PAG

1500

1482

1432

Rochester Meals on Wheels

8128

8188

8218

Elmore Meals on Wheels

1468

1388

1358

Lockington Meals on Wheels

1358

0

0

Rochester Senior Citizens’ Club

1176

864

790

Bec Moroney (Apprentice Chef), Darlene Weeks (Chef) and Karen Tognolini (Diversional Therapist) were on hand to serve a Christmas meal to Hostel residents.

This department also caters for many functions/meetings, often three to four per day, both on and off site. The Catering Department undergoes an annual external Food Safety Audit that includes checks on: cleanliness, cooking temperatures, fridge temperatures, reporting mechanisms, food delivery and dispatch. REDHS received a 100% result with only one recommendation to reformat the fridge temperature forms to include signatures when temperatures are checked. The redevelopment has necessitated significant changes to the work routines surrounding meal deliveries to both the Hostel and PAG. Food Handling standards are monitored and maintained at all times. The design of the new kitchen will have the capability to produce up to 2000 meals a day (the current kitchen could comfortably produce approximately 350 per day), offer four different menus a day and cater for the outside market.

redhs annual report 2007 page 23


Housekeeping and Laundry Departments The Housekeeping and Laundry departments have had a busy year working around the redevelopment, with part of the Nursing Home closed off and the Hostel temporary isolated. The Nursing Home laundry closed in January 2007 and a temporary laundry was established in the main Hospital to maintain residents’ laundry service. The method of delivery of linen supplies to the Hostel was also altered and is now delivered on a trolley. In the past twelve months, all Housekeeping staff have attended a Cleaning Standards Workshop and learnt how to conduct Cleaning Audits. Results of cleaning audits continue to improve annually. Facilities must achieve a minimum of 85% to pass. This year’s result was an outstanding 94% and is a credit to the Support Services staff. The audits check all components within the “four walls” including paintwork, curtains, floor coverings, furnishings, door jambs, equipment etc.

Cleaning Audits result for 2005-2007 Month

Audit

Result

April 2007

External

94%

September 2006

Internal

93.3%

April 2006

External

91%

May 2005

External

82%

Supply The Supply Department works hard to ensure that all departments have the necessary consumables and equipment on hand so that quality service and care is maintained at all times. In the past twelve months, this has included 4094 toilet rolls and 880kg self-raising flour!! Items

2007

2006

2005

2004

Toilet Paper (rolls)

4094

3682

4560

3648

Comfeel Dressings (10cm x 10cm)

145

181

290

250

Self Raising Flour (kg)

880

795

975

875

The Supply Department has had a busy year helping all departments with their future equipment requirements for the redevelopment and has continued to our work with the Finance Department on the new finance and supply systems. Supply Manager, Gayle McConnell, is a member of the statewide Financial & Supply Management Information System (FMIS) Alliance Implementation Committee and has been attending workshops in Melbourne over the past few months. The on-line ordering system is to be introduced throughout all government health services in 2008-09 and will allow statewide monitoring of health service supplies and expenditure. Gayle’s involvement ensures that the interests of small rural health services are represented during the development and implementation of the system.

redhs annual report 2007 page 24


Department Reports

Facilities and Risk Management Maintenance It has been a busy year for the Maintenance Department with requests for 895 repair jobs, 827 of which have been completed to date. Many of those not completed require further investigation or capital works with most to be addressed in the redevelopment. The most common requests have been in the area of the nurse call system, lighting and toilet repairs. Building and Equipment Integrated Management System (BEIMS) continues to be the method used for maintenance requests and seems to be an ideal way to prioritise tasks. Early in the year, a new utility was purchased to accommodate the larger maintenance jobs as needed, and to allow more reliability in areas needing prompt attention. Trainee Nathan Shaw is continuing with studies for his Certificate III Health Support Services – Grounds Maintenance, as well as assisting with maintenance support. Due to staff changes, for several months some services were contracted to Echuca Regional Health. The resignations of both Darren Dinsdale and Andrew Gibson resulted in the development of a new role, Facility and Risk Manager, filled by Mathew Dennis.

Mathew Dennis Facilities and Risk Manager

Occupational Health & Safety The Occupational Health and Safety Committee and its two working groups (Legislation & Compliance and Management Systems) had a very productive year with the review of many systems and policies. Some new initiatives were also introduced to promote a safe working environment one of which is a buddy system when lifting eskies full of meals. An education session on minimising the risk of shoulder and neck injuries was conducted by the physiotherapist and was followed up by a training session for Support Services staff around safe trolley handling techniques to minimise injury. In preparation for the introduction of the Smoke Free Workplace Policy on 1st July 2007, the Committee conducted staff surveys, developed an implementation action plan and reviewed the current Smoke Free Policy. Each committee/working group meets at least quarterly which means that there is a meeting of at least some representatives on a monthly basis. During 2006-07, it became apparent that REDHS needed to address the issue of driver fatigue after shift work following several staff being involved in car accidents.Information posters were on display in all departments and significant education discussions were undertaken by Department Managers. A chemical audit of the facility has been completed, chemical registers updated and the Chemical Selection Policy reviewed. This is an ongoing process as we work to minimise the number of hazardous chemicals used on site. Over the past six months, a full revision of emergency procedures was undertaken, with a view to ensuring procedures are as clear and simple as possible. A Quick Reference Flip Chart has been developed and is to be distributed to all departments. Some results from the annual public sector People Matter Survey 2006 indicated that 36% of staff who responded had observed bullying and harassment in the workplace and 20% had personally experienced it. In response, Workplace Behaviour Training was conducted in August 2006 and repeated in December to give all staff the opportunity to attend and gain a better understanding of Bullying and Harassment issues in the workplace. Attendance was just over 80% (128 staff). Results from the 2007 survey will be available later in the year and will be one method for ascertaining the effectiveness of the information session.

redhs annual report 2007 page 25


No Lift During the past twelve months the “No-Lift” Committee and staff at REDHS have made a concerted effort to trial new equipment throughout the facility, from the Acute area to the Nursing Home and Hostel in preparation for our redeveloped facility. It is indeed an exciting time and new and innovative ideas are being encouraged in every direction. Much discussion has taken place regarding the types of floor coverings needed for a safe, yet workable, environment for consumers and staff alike. The CEO has discussed the floor coverings with architects on behalf of the staff and all are working together to obtain a satisfactory outcome Currently there is an ongoing audit of the Nursing Home’s No-Lift resident handling assessment sheets being conducted. Staff and resident safety is a top priority when manual handling of residents is required. The type of equipment and number of staff required is noted on admission and reviewed monthly. No Lift principles strive to protect staff from injury while allowing maximum independence for the resident based on their current mobility. Manual Handling education is a component of the ATD for all staff. On this day, the mandatory, annual competency for clinical staff is conducted to ensure continued safe practice for both staff and residents / patients / clients.

Risk Management This is an area that encompasses all departments and includes many types of risks including: finances, human resources, loss of utilities and communications, staff shortages and outbreaks of infection, to name but a few. The Risk Management and Planning Committee (a sub-committee of the Board) was formed in November 2006. A Risk Management Plan was developed and approved in July 2006 and reviewed in April 2007 to ensure that the Board of Management were able to monitor all risks effectively. Our risk management procedures have been updated in line with quality systems. The new Risk ID form has been implemented in our ImproveIT® format to make tracking and reporting, easier and more effective. Nine risks have been identified and reported since the introduction of the new system. One of the risks that has been identified includes floor coverings, as outlined above. Staff, volunteers, residents, patients and visitors are encouraged to report any risk to management. The person making the original report is provided with feedback regarding action taken or reasons for inaction. Risk Management has been included as a standing agenda item at departmental meetings to encourage staff consideration and identification of risks to health, safety and wellbeing.

Information Technology Policies and procedures became available through the REDHS intranet in October 2006. The new electronic system has significantly streamlined policy development, review and approval procedures and allows all staff to have access to current policies as they are approved. One of our computer servers failed in June 2007 and a significant amount of data was lost from the network drive. Our IT support company worked around the clock to repair the damaged server and recover most of the lost data. However, some data had to be completely recreated. As a result we have obtained a contract for a complete backup solution to protect us from a similar event in future. Throughout the year a lot of planning has been done to achieve a solution for the redevelopment that will make for a very efficient workplace. We are hoping to have a complete communications system that allows us to interact between phones, pagers, and computers. Building management systems will allow for early diagnosis of system failures. This is a very exciting time in the IT sector and we are looking forward to having leading edge technology in our new facilities. redhs annual report 2007 page 26


Community Involvement

Community Involvement and Support REDHS continues to enjoy the support of the local community whose fundraising efforts assist us to maintain and improve the quality of the care provided to residents, patients and clients. The Health Service gratefully acknowledges their ongoing support and commitment.

Rochester and District Hospital Auxiliary This year, the auxiliary presented REDHS with a cheque for $7,000 for the purchase of two large-screen televisions and three chairs for the Hostel. The money was raised from functions such as: a Ploughman’s Lunch, Melbourne Cup Day, an Open Garden Day, morning and afternoon teas, Christmas Cake stall, raffles, and a number of catering events. The Auxiliary entered exhibits in the Great Northern Show (Rochester), St John’s Presbyterian Church Fair and the Anglican Church Christmas display in the Shire Hall. A quality improvement initiative this year was the introduction of a banner to display for fundraising ventures, as well as badges for President, Secretary and Treasurer. The Auxiliary would like to express their sincere appreciation for the wonderful support they receive from the local community in their fundraising endeavours.

Diggora and Ballendella Hospital Auxiliary This small, dedicated group continues to collect annually for the Health Service, covering many kilometres in the process as they call on rural residents. In spite of the prolonged drought, donors continue to be generous. President J. Lees and Secretary/Treasurer, Mrs G. Haines, sincerely thank donors and collectors for their continuing support. The total amount raised this year has yet to be finalised and will be available later this year.

Auxiliary officebearers Faye Latter, Kath Bubb and Yvonne Andrews proudly display their new poster for use at fundraising officebearers

School Scholarship Our annual Rochester Secondary College Scholarship is awarded each year to a student who is working towards future study in a health related field. This year’s winner is Kate Parry who is undertaking a VET course through CCAE in Echuca, and wishes to pursue a career in the community service industry.

Murray to Moyne REDHS again fielded a team in the annual Murray to Moyne cycle relay on 24th - 25th March 2007. The team consisted of nine riders and three support personnel

Riders Marion Carter, Holly Fowler, Gary Hedington, Jeanie Holmberg, Peter Hyden, Mark Langford, Nicole Petschel, Les Sands and Heather Wickham.

Support Crew •• Georgina Alexandrova – support driver (3rd vehicle) •• Barry Carter – Mini bus drive •• Graeme Nelson - and his 4 wheel drive and big trailer for all the bikes

Heather Wickham, RN Division 1 nurse and Murray to Moyne team member, checks her pedals before the team lines up at the start in Echuca

A strong head wind on the first day made conditions a little trying but our team rose to the challenge. Hostel RN1 Wendy Kneebone and Don and Margaret Hedington met the team at the overnight stop in Hamilton in their caravan and had a very welcome and much appreciated hot dinner prepared for the riders and their support team. The weather the next day was much more rider-friendly for the final push to the finishing line in Port Fairy. The total amount raised was $1,990 and is being held in trust for the redevelopment. Well done, team!!

redhs annual report 2007 page 27


Volunteers REDHS could not offer the range of activities that it does without the continued support of its many dedicated volunteers. Our volunteers work across our facilities and in the community providing valuable assistance. For example, the Meals on Wheels volunteers were responsible for the delivery of 10954 meals over the past twelve months.

Rochester Secondary College students entertained volunteers and staff with music and singing at the 2006 Volunteers Day in December.

Donations and Bequests (over $100)

As a way of showing the Health Service’s appreciation to its volunteers, Volunteer Day was celebrated in December in a marquee in the Health Service grounds. Over forty volunteers were present and received a small gift from REDHS as a token of appreciation. Rochester Secondary College students entertained the crowd with music and song. A delicious lunch prepared by REDHS kitchen staff was thoroughly enjoyed by all.

Scout Jamboree Volunteers REDHS was fortunate to be offered an opportunity to participate in community catering for the Australian Scout Jamboree held in January, and consequently receive a share of the profit. A total of $7,467 was received as a result of the efforts of thirty REDHS volunteers (made up of Board members, staff and community members) who worked countless shifts over the twelve days of the Jamboree amongst the12000 scouts and leaders on site. Some of our aged care residents were able to go on a tour of the camp. They were amazed at the enormous amount of organisation that had gone into the event and the fact that it was virtually a self-contained town.

The Jack Brockhoff Foundation

25,000.00

Tattersalls George Adams Foundation

20,000.00

Annie Danks Trust

8,000.00

Elmore Field Days Special Events Catering

7,467.00

Rochester Hospital Auxiliary

This year REDHS is awarding three Life Governorships in appreciation of the services that the following have so generously provided to the Health Service:

7,000.00

Majors IGA

2,266.50

•• Peter Lawford – Peter has served as a dedicated Board member for nine years ( 1/11/97 to 31/10/06) including three years as President (2001-02, 2002-03, 2003-04) and as Treasurer for two years (2004-05, 2005-06).

Coliban Water

2,000.00

Pierce Armstrong Trust

2,000.00

Life Governors REDHS awards the title ‘Life Governor’ to individuals who have made an outstanding personal contribution to the Health Service. Those awarded the title of Life Governor are recorded in a register and include those who have served for many years either as an Auxiliary or Board Member, a volunteer, or those who have made significant financial contributions to the Health Service.

•• Eileen Palmer – Eileen has been a committee member of the Rochester Hospital Auxiliary since 1991. She is a willing and tireless worker in her efforts to assist the Auxiliary in raising money for the Health Service. •• Greg Walkley – Greg has served as a dedicated Board member for nine years from 1/11/97 to 31/10/06.

Kane Constructions

520.00

Tectura Pty Ltd

520.00

Certificates of Appreciation

Elmore & District Machinery Field Days

500.00

Best Jackel & Co

250.00

•• Bob Andrews – Bob has assisted the Rochester Hospital Auxiliary for over twenty years and also worked with the Rochester Lions Club at the Hospital Garden Fair for many years. Among other tasks, Bob helps deliver food to catering jobs and assists with the annual street stall.

Rojay

100.00

Moroneys Plumbing

100.00

Shire of Campaspe

100.00

Rochester Card Club

100.00

Total Donations for 2006/ 07

$ 73,592.74

redhs annual report 2007 page 28

•• Brian Love – Brian has helped the Rochester Hospital Auxiliary for over twenty years, working behind the scenes, setting up tables and chairs and other requirements for Auxiliary functions.


Statutory Information

Statutory Information The Rochester and Elmore District Health Service Annual Report has been prepared in compliance with the requirements of the Financial Management Act 1994 and the Standing Directions of the Minister for Finance and the Financial Reporting Directions.

Building Compliance The Rochester & Elmore District Health Service ensures that all buildings, plant and equipment in its control are maintained and operated according to the statutory requirements of the building Act 1993 and the Minister for Finance Guideline Building Act 1993/Standards for Publicly Owned Buildings November 1994.

Competitive Neutrality The Rochester and Elmore District Health Service is committed to the principles of the Victorian Government Competitive Neutrality Policy, as set out in the Guide to Implementing Better Work Practices and is continually reviewing market changes and conducting benchmarking against applicable tenders.

Compliments, Suggestions & Complaints We welcome your comments in regard to the quality of our service. Your suggestions are important to us as we develop our strategies for continuous improvement. Compliments, suggestions and complaints should be directed to: Chief Executive Officer, REDHS, PO Box 202, Rochester, Victoria 3561 or by telephoning (03) 5484 4451

Consultants There were eighteen consultancies during the year, none of which exceeded $100,000. The combined total of the consultancies was $34,907.

Equal Opportunity Employer The Rochester and Elmore District Health Service is an equal opportunity employer and is committed to a policy of equal opportunity based on the merit principle in employment in accordance with the Public Sector Management Act 1992, including the submission of an Annual Report to the Commissioner of Public Employment. The Health Service employs a workforce of permanent, part time and casual staff throughout the year. At 30th June 2007 the Health Service employed 102 EFT.

Freedom of Information The Freedom of Information Act 1982 provides the public with a means to obtain information held by the Health Service. During the 2006/07 financial year, three requests for information were received. These requests were granted in full to the applicants. Freedom of Information Requests can be made by contacting the Health Service Freedom of Information Officer on (03) 5484 4400.

Financial Management Compliance Framework (FMCF) This was introduced from 1 July 2003 and applies to all Victorian Public Sector (VPS) entities. The Framework has been established to ensure that all VPS entities have implemented appropriate systems to ensure that public resources are used in an efficient, effective and responsible manner. REDHS was largely compliant with the framework when it was released and this opinion was endorsed via the Internal Audit Program. Work is continuing to ensure that full compliance is achieved within the specified timeframe. REDHS will continue to review its performance, policies and procedures to ensure that the Service is operating in an effective and responsible manner.

redhs annual report 2007 page 29


Police Checks The Rochester & District Health Service, in accordance with the Australian Government’s Aged Care Act 1997 and amendments to the Accountability Principles 1998 and Records Principle 1997, effective from 1 March 2007, will require all staff and volunteers to undergo a Police Check and assessment for suitability to work in Aged Care. As all staff have the potential to be involved, this process will include all Board Members, new and existing staff members, VMOs, volunteers and students.

Staff Analysis Occupational Category

2006/07 Total EFT

2005/06 Total EFT

2004/05 Total EFT

2003/04 Total EFT

Administration & Clerical Services

13.65

11.98

9.36

9.55

Support & Allied Services

24.36

37.2

24.14

18.07

Health Professional Services

2.89

2.62

0.77

0.32

Nursing Services

61.01

50.56

64.4

57.15

Medical Services TOTAL

0

0

0

0

101.91

102.36

98.67

85.09

Whistleblowers Protection The Whistleblowers Protection Act 2001 is designed to protect people who disclose information about serious wrongdoing within the Victorian public sector and to provide a framework for the investigation of these matters. The Act’s key objectives are to promote a culture in which people feel safe to make disclosures; protect these people from discrimination; provide a clear process for investigating allegations, and ensure that investigated matters are dealt with in an appropriate manner. The Rochester & Elmore District Health Service has a prescribed procedure in place for dealing with disclosures made under the Act. A copy of the procedures is available from the Health Service’s Privacy Officer to whom all enquiries on this matter should be directed. In the year ended 30th June 2007 there were no disclosures made to the Rochester & Elmore District Health Service, under the Whistleblowers Protection Act 2001.

redhs annual report 2007 page 30


Quality of Care Report

Quality Of Care Report REDHS’ mission is to provide compassionate care services of the highest possible quality to all of its consumers. Successful provision relies on the commitment to quality improvement by the Board of Management, Executive members and staff from all departments. In order for REDHS to meet the needs of its consumers it must: •• continually monitor its surroundings and services, •• undertake evaluations of programs, treatments, and work routines, •• ensure that an appropriately qualified and skilled workforce is in place, •• communicate effectively with the community that it serves, •• maintain its accreditation status. Feedback received through a variety of avenues, both formal and informal, provide a guide to the type of information that community members would like to receive, so that they can be assured that REDHS is providing a safe environment and quality care and is continually seeking to improve. This report provides a description of our performance over the past twelve months, comparing it to previous years. It also gives an insight into the methods we use to monitor safety and improve quality. The information is derived from data that is received and monitored by the Quality of Care Committee on a regular basis in accordance with its reporting schedule. When a member of the Committee queries the information or statistics provided or identifies a variance in the results, the issue is discussed as required. Further reports may be requested and recommendations made where appropriate.

Quality of Care Committee

improvement regarding documentation and additional computer training. All suggestions have been considered and action taken where appropriate.

Encouraging Quality Improvement The introduction of the “Go for Gold” quality improvement initiative in December 2006 has made it easier for staff to record their quality improvement ideas, projects and progress. The utilisation of more features in the ImproveIT® database has enabled staff to receive quality improvement reports and feedback at departmental meetings on a regular basis. Since its introduction, there have been eighty-six improvements logged in the past seven months, twentyone of which have been closed out. This compares to forty-seven improvements logged for the same period the previous year. A number of improvements revolved around Hand Hygiene and Infection Control activities as well as Health Promotion activities and Aged Care menu development by the Chef in consultation with aged care residents.

Knowing Our Consumers And Working With Them Our catchment area has approximately 8,700 people, with patients/residents/clients drawn from Rochester, Elmore, Lockington, Dingee, Prairie, Corop, Colbinabbin and Goornong. It is interesting to note that the REDHS catchment has 17% of its population aged 65 years and over. The Victorian state average is 13.7% while the Australian average is 13.3%. (Source: Australian Bureau of Statistics Census 2006).

Our Consumers Country of Birth

%

Age Group (yrs)

%

Australia (incl. Indigenous)*

91

0 - 14

22

The Committee consists of a broad representation of clinical and non-clinical staff and Board of Management (Community) representatives and is chaired by the Chief Executive Officer.

UK / Ireland

2

15 – 29

14

Europe

1.1

30 – 44

19

Oceania

0.7

45 – 59

21

Accreditation

Asia

0.2

60 – 74

16

Other (or not stated)

5.5

75 & over

8

The Committee also works to maintain the accreditation status of our facilities. The Acute facility is accredited until January 2008 (the next organisation-wide ACHS survey is due in September 2007). Our aged care facilities achieved accreditation for a further three years in August 2006 and were compliant with all forty-four outcomes. All residential aged care facilities will have at least one unannounced site visit carried out by ACSAA every twelve months. One such visit was conducted in our facilities in November. The assessor was satisfied that REDHS continued to be compliant with accreditation standards but made some suggestions for

*Indigenous population: 80 people (0.1%)

Indigenous Admissions 2006-07 - 0 2005-06 – 1 2004-05 - 5 In accordance with DHS guidelines, REDHS has a Cultural Diversity Committee that reports to the Quality of Care Committee. Its responsibilities are: •• to recommend that the Health Service cater appropriately to culturally and linguistically diverse communities. redhs annual report 2007 page 31


Quality of Care Report

•• to implement the Culturally and Linguistically Diverse (CALD) Plan, review it on a regular basis, and ensure that the Plan is signed off by the Board •• to ensure that all Departments are aware of and participate in the CALD Plan •• to ensure that the CALD services provided by REDHS are assessed and evaluated on a regular basis. •• to develop and implement CALD policies and procedures

VPSM Results: September 2006 – February 2007 100 – 95 – 90 – 85 – 80 – 75 –

The most significant contributions the initiative has made is to ensure that:

70 –

•• the CALD Plan is appropriate for our organisation

65 –

•• our staff are able to access relevant information and translation services should a CALD consumer present at the Health Service for assistance or care. (Translation services were not required during 2006-2007).

60 –

The Patient Handbook (Acute Ward), Resident Information Handbooks for aged care residents and other fact sheets contain important information that is very reader friendly, contains up to date, relevant information in plain English and is in an appropriate font size to suit readers who may be visually impaired. The Njernda Aboriginal Corporation is based in Echuca and REDHS’ relationship with them is expressed through joint membership of the Campaspe PCP and participation in PCP health promotion activities, training and consultation. At the invitation of the Njernda Aboriginal Corporation and the Campaspe PCP, twelve REDHS staff members attended an Aboriginal Cross Cultural Training Day. It involved the sharing of information regarding the cultural, social and economic needs, issues and experiences of Aboriginal people nationally.

“Doing it with us not for us” – a Victorian government initiative In keeping with the initiative and the REDHS Strategic Plan, consumer involvement is essential to the ongoing effectiveness of the Health Service. Individual care plans for all of our patients / clients / residents are in place and reviewed on a regular basis with them in conjunction with staff, family members/carers, medical practitioners and allied health professionals. Input and feedback was sought on the Primary Care Development Plan through distribution of the draft plan to community groups for comment. Formal presentations were also made to staff and community groups. Feedback obtained, including requests for clarification, was incorporated in the final document. The most common method we use to gain consumer feedback is through evaluations and surveys.

Victorian Patient Satisfaction Monitor (VPSM) Acute Ward patients are invited to participate in the VPSM which is conducted after discharge by an independent agency engaged by DHS. Results are provided to REDHS in Waves (one Wave = six months). redhs annual report 2007 page 32

Discharge and Follow-up

Physical Complaints Environment Management

All Hospitals

Treatment and Related Information

General Patient Information

Access and Admission

Overall Care

Category D Hospitals

Rochester & Elmore District Health Service

A Consumer Participation Index (CPI) is calculated in the VPSM and allows REDHS to report on consumer involvement in health care delivery, planning, development, and improving quality and safety. The CPI is calculated using the following three VPSM survey items: Satisfaction Item – Wave 12 REDHS Category D* State-wide (Sept 06 – Feb 07) % satisfied 1. Opportunity to ask questions about treatment 2. Way staff involved patient in decisions 3. Willingness of staff to listen

98

96

93

98

95

91

98

96

93

* REDHS is rated by DHS as a Category D hospital (Area hospitals with 500-1000 overnight patients per year)

Consumer Participation Indicator: 2005 – 2007 100 – 95 – 90 – 85 – 80 – 75 – 70 – 65 – 60 –

Wave 9

Wave 10

Wave 11

Wave 12

Rochester & Elmore District Health Service

86

82

90

88

Hospital Category D Mean

85

85

86

85

State-wide mean

81

80

80

80

Communication Questionnaire This was distributed in the local community in November 2006. Suggestions from the community have resulted in the Health Service increasing information flow through a variety of methods. A major market research initiative with a distribution to approximately 3000 households is scheduled for October 2007. The


Quality of Care Report

results will give REDHS an indication of the health and information needs of the community and the current effectiveness of our communication strategies.

Acute Ward Post-Discharge Phone Call This has proven to be an effective method of obtaining feedback from patients. It is also a method of checking on the progress of the patient following discharge. To improve the rate of contacting former patients, they are now asked the preferred time of day for the phone call.

Aged Care Resident Satisfaction Surveys Until this year, Nursing Home and Hostel surveys were conducted annually but at different times and with some differences in content. To enhance efficiency and to gain an improved overview of resident/representative responses across both facilities it was decided that one integrated survey would be conducted simultaneously. The results from the Nursing Home survey conducted in 2006 indicated that residents are very satisfied with the way that staff care for them and the equipment provided to assist in their care. Satisfaction with the meals was also high (taste, choice and portion size). There was provision on the survey for residents/representatives to list their food likes and dislikes. Some suggested that the provision of additional information regarding visiting services such as podiatry and physiotherapy would be useful. This suggestion was taken up and there is now more information available and passed on at Resident Committee Meetings. Of our Nursing Home, one family wrote: “ We are extremely satisfied in the way our loved one is being looked after and find the staff to be very caring towards her and other residents. Thank you all so much.” All residents have the opportunity to discuss any issues at Resident Committee meetings, or at any time with staff.

REDHS currently holds the required ACHS accreditation rating of MA (Moderate Achievement) for Care Planning - in partnership with the consumer/patient and when relevant, the carer, to achieve the best possible results (ACHS EQuIP3 Criterion 1.3.1). It is also compliant with ACSAA Outcome 3.9 – Choice and Decision Making – Each resident participates in decisions about the services that the resident receives and is able to exercise choice and control over his or her lifestyle while not infringing on the rights of other people.

Compliments, Suggestions & Complaints Management All REDHS patients/residents/clients are advised of their right to comment about the services provided. During 2006-07 REDHS logged 106 written compliments with many more verbal ones received by staff. This year we reviewed the Compliments/Complaints form to include the internal Complaint Resolution Process and updated the external avenues of redress. From February 2007, the opportunity to provide suggestions was also incorporated on the form to further encourage people to assist us in improving our care. Two suggestions were received regarding ward cleaning procedures and restricting light through a glass door. Actions taken as a result have allowed us to improve our service to Acute patients.

Complaints 15

15 – 12 –

12

12 10

9–

7

6– 3– 0–

2006-07

2005-06

2004-05

2003-04

2002-03

District Nursing Survey In December 2006, seventy-nine surveys were distributed to clients who were attended by DNS between 1/10/06 and 8/12/06 with fifty-eight replies received (73%). The professional manner and knowledge of staff was highly praised as was the care and the information provided to clients. Overall the service was rated Excellent 79%, Good 17% and Fair 2%.

During 2006-07 we received twelve complaints, the same number as last year. All complaints, except one, were resolved within our stipulated time frames of fourteen days for minor complaints and twenty eight days for major complaints. All complaints were resolved to the satisfaction of the consumer.

In response to the question regarding a quick response to needs, one client said “even to the point of being there before I realised I needed them. Thanking the service very much.”

One of the complaints received was regarding the poor state of our Australian flag at the front entrance to the hospital. The flag was replaced and entries made to our preventative maintenance system to ensure that flagpoles and flags will be checked regularly so that significant days can be commemorated appropriately.

Some other comments included: •• “Your staff listen courteously, attend to any problem to understand patient worries, always arrived when they said they would and they are friendly.”

Other improvements as a result of complaints this year have been:

•• “Never too busy to answer any questions I asked them.”

•• Review of the process of delivering toasted sandwiches to Nursing Home residents

•• “They explained simply as to why and what medication I am taking.”

•• Menu brochure that highlights foods suitable for diabetics and that are low in fat

•• “I feel I can ask questions if I am not sure of anything.” redhs annual report 2007 page 33


Quality of Care Report

Our People REDHS is committed to ensuring that its staff and visiting medical officers are suitably qualified, well trained and can respond to the needs of the Health Service and the wider community. With the dual challenges of an ageing workforce and the successful attraction and retention of high calibre staff in a rural health service, REDHS developed a Human Resources (HR) Action Plan to outline strategies to meet these challenges. Position descriptions (including key selection criteria) are reviewed at least annually during the Performance Appraisal process or more often if required. To ensure a successful appointment, new staff must meet specific selection criteria as set down in the position description and clinical credentials must be current. For example: all Support Services Staff must have successfully completed the appropriate competencies before handling food and/or chemicals. All Clinical (Nursing) staff must have current registration and competencies in Blood and Blood Products – Handling, Storage and Transfusions, and Medication Administration before the commencement of duties. Visiting Medical Officers (VMO) must be fully credentialed every three years. Current VMOs are credentialed until 2009, however they are required to present their registration and public liability insurance to REDHS annually.

GOTAFE and LaTrobe University (Bendigo). Medical and Pharmacy students have also gained valuable experience in our facilities. In 2006/07 a Training and Education Plan was developed in response to the individual needs of staff (as indicated in the Education Needs Analysis survey) and to meet organisational needs in accordance with the Strategic Plan. The Training and Education Plan outlines the strategies for ensuring that staff are well trained and can respond to the needs of the Health Service and the wider community. Performance indicators set down in this training plan will be reviewed on an annual basis. In order to attract and retain staff, Management encourage and support staff in their pursuit of education and professional development opportunities. REDHS is also linked with Continuing Nurse Education (CNE) that provides educational opportunities to nurses. Over seventy staff have accessed external training sessions/ courses in the past year with many achieving outstanding results. Congratulations to the following staff on the completion of training: •• Sarah Attree - Masters of Physiotherapy •• Richard Beddell - Diploma of Bus Man •• Mathew Dennis - OHS Training, Project Officer Training

All new staff must attend an Orientation Day that is conducted in conjunction with the mandatory Annual Training Day for existing staff. These days are held monthly so that all staff have the opportunity to attend within a twelve month period. In 20062007, a total of 149 staff and volunteers attended. Topics covered include: Privacy, Basic Life Support, Occupational Health and Safety, Risk Management, Emergency Procedures/ Fire Response Training, Quality, Infection Control/ Waste Management and Manual Handling/No Lift (both clinical and non-clinical sessions).

•• Jeannie Holmberg, Andrea Howarth, Wendy Kneebone – Certificate of Gerontology

Conducting the Orientation/ Annual Training Day (ATD) on a monthly basis requires a significant allocation of resources. To ensure that the sessions are relevant and informative, all participants are encouraged to provide evaluations of each session throughout the day and the results are monitored, allowing adjustments to programs as required. The walking tour around the facilities was reintroduced following requests from staff.

•• Traineeships – Amy Price (Business Administration) and Nathan Shaw (Cert III Health Support Services – Grounds Maint.)

Volunteers have also been attending the ATD but feedback has indicated that they find that not all information is relevant to them and a full day commitment is not always possible or desirable. In response to this, during 2007-08 we will be conducting halfday “volunteer –specific” sessions to provide volunteers with an abridged version of the ATD, be taken on a guided tour of all facilities and the redevelopment projects and finish with a catered lunch in appreciation of their attendance. Evaluations will be conducted to monitor the effectiveness of this initiative. Students from all levels are encouraged to carry out work placements / work experience in our facilities to gain a wide range of experience. Secondary school students have participated in our work experience programs, as have nursing students from BRIT,

redhs annual report 2007 page 34

•• Beverley Hunt, Lynda Kellow, Elizabeth Moulden - Medication Endorsement for Division 2 Nurses •• Dianne Kenyon - Graduate Diploma – Further Education & Training •• Lynn Wolfe - Adv. Diploma of Bus Man (HR Bridging) Staff currently undertaking further training:

•• Certificate IV – Training and Assessment • RN Div 1 - Tarnya Hamilton, Robyn Kelly, Cheryl Petrini, and Jan Prigg • RN Div 2 - Lynda Kellow • Social Worker - Kevin Holmes External sessions/courses have included: •• Advanced Cardiac Life Support Practical •• Avian Influenza •• Better Quality Better Health Care •• Business Performance Improvement •• Certificate IV in Mental Health Nursing •• Child Sexual Assault •• Continence Management •• Dementia Essentials •• Diabetes Information


Quality of Care Report

•• Falls Prevention and Risk Screening

Health Promotion

•• Financial Aspects of Resident Admission

One of our aims is to promote self-management of our community’s health, allowing people to:

•• General Practice & Community Health •• HARP - ICDM •• Management of Adult Diabetes •• Managing Risks in Community Nursing •• Managing Your Patients with Cancer •• Medication Mix in Aged Care Pt 1 •• Men’s Health

•• prevent or minimise health episodes that result in a stay in a hospital and •• allow people to stay in their own homes as long as possible. REDHS Primary Care has developed and implemented many initiatives to support this aim. Some of the many activities have included:

•• Diversional Therapy Assoc.

Mums and Prams Walking Group

•• No Lift workshop

Our Health Promotion Officer developed a program that encouraged new mothers to exercise with their baby and friends. Each Friday, the walk along the river track concluded with a cup of coffee at the Rochester Community House (RCH) Toy Library. The group became self-supporting and continued to operate after the REDHS Health Promotion Officer moved on to establish other new activities.

•• Nutrition in the Elderly •• Palliative Care: The Essentials •• Patient Assessment across the lifespan •• Community Sustainability in Victoria •• Return to Work Coordinator training •• Safe Smoking Cessation & Mental Illness Training •• Suicide First Aid Workshop •• Wound Management REDHS is committed to maintaining a healthy Work / Life Balance for its staff. Health promotion activities and an Employee Assistance Program are available. Self-rostering is used in clinical areas. The Management Group uses various indicators to monitor human resources trends, one of which is the percentage of family/sick leave versus total wages. It was identified earlier in the year that REDHS was experiencing higher costs surrounding sick leave compared to previous years. Subsequent benchmarking analysis indicated that the Health Service percentage of sick leave/wages was the highest of the nineteen participating organisations. Department Managers monitored the trend and reported that other than the fact that many of them had staff on long-term sick leave, there seemed to be no one reason for the upward trend. It is anticipated that the trend will reverse in the coming financial year.

REDHS staff and volunteers participated in a decorated bra competition for to raise awareness of breast cancer on Pink Ribbon Day. PAG volunteers Betty Gusak and Audrey Hunt with their entry.

Yoga Pilates Classes at RCH and Relaxation sessions at REDHS and Kyabram Learning Centre were commenced.

De-identified Benchmark of Sick Leave to Total Salaries & Wages 2005/06 - 2006/07 5.0% – 4.5% – 4.0% – 3.5% – 3.0% – 2.5% – 2.0% – 1.5% – 1.0% – 0.5% – 0% –

Sick Leave to Total Salaries & Wages 2005/2006 Other

2005/2006 REDHS

2006/2007 Other

2006/2007 REDHS

As part of the “Kids Go for Your Life” program, Health Promotion Officer Jo Webb worked with teachers and parents from Rochester Primary School to put on a display of healthy eating alternatives for lunchboxes.

redhs annual report 2007 page 35


Quality of Care Report

Farmgate The Farmgate program has attracted state-wide attention due to its innovative and effective approach to working with droughtaffected farming families. The program involves a social worker and a drought officer “cold-calling” on all families with information regarding support services and resources, providing a direct referral service and follow-up support where required. Maintaining social connections is also an integral part of the program with large community get-togethers such as “Block Barbeques.” This very important and worthwhile initiative was made possible through the generosity of the Geoffrey Gardiner Dairy Foundation Ltd. In May, a very well attended and successful Biggest Morning Tea was held at Dingee to raise money for breast cancer research and support.

Workplace Healthy Eating and Pedometer Challenge (REDHS staff) Following a successful program in 2006, a further six week challenge was undertaken by over thirty staff. Seventy-five percent of the participants found it to be a valuable motivator in order to increase their daily walking and healthy eating program. Almost all of the staff felt good about achieving the goals they set. Several thought their goals may have been unrealistic and will reassess for the next challenge. All but one staff member felt confident that the changes would be maintained. REDHS will continue to keep fruit/ healthy alternatives available for morning teas.

“Women on the Move” A six week program with a weekly three hour session at RCH exposed women to activities and provided information with which they may not come in contact in their everyday lives. Activities included: Nails/hand massage/facials, podiatrist, spiritual healing, pharmacist, chiropractor, psychologist, solicitor, river trail walk and quilting. Attendances were on target with ten to thirteen participants per week. Positive feedback was received on all of the evaluation forms completed. Owing to the positive response, another six- week program commenced after a four-week break with different speakers.

Health Promotion Officer Jo Webb organised a Women’s Health forum to promote the range of services available around women’s wellbeing at Community Health.

Motorised Mobility Aids A forum was held at the Rochester Senior Citizens Clubrooms with REDHS Aged Care staff and Victoria Police members present to provide advice on the safe and lawful use of motorised mobility aids in the home and community. redhs annual report 2007 page 36

Health Promotion Participants: 2006 - 2007 2500 – 2000 – 1500 – 1000 – 500 – 0–

April-June

Jauary-March

October-December

Infection Control REDHS continues to maintain a high standard in Infection Prevention and Control throughout its facilities and continues to employ a qualified Infection Control Practitioner. The increased provision of information to the local community has been very important in light of potential and actual infectious outbreaks in the wider community. The three main areas of focus for Infection Control throughout the past year have been: gastroenteritis, influenza and hand hygiene. •• Gastroenteritis - REDHS updated this policy following an episode of gastroenteritis that was closely monitored. All residents and their families were informed by mail and signage was posted at entrances. We also distributed a brochure “Food Poisoning and How to Prevent It” to them as well as at Planned Activity Group where an education session was given. •• Influenza - REDHS has been involved in planning for a possible pandemic by attendance at a workshop to brainstorm issues that may arise and actions that may be required. Attendees included other health workers and local government members from this region. A policy is in place but will be updated as further information is available. Fifty-five of our sixty residents have received the influenza vaccine this year and staff uptake has increased from sixty four in 2006 to eighty nine this year. We have also promoted “Cough Etiquette” via education at Planned Activity Group and with posters throughout our facilities. •• Hand Hygiene -The Victorian Quality Council’s Hand Hygiene Project has been completed and the challenge now is for health care facilities to maintain the emphasis on hand hygiene. In the past twelve months, 161 staff have received education on this topic and completed a competency test. Use of alcohol hand gel has been promoted at Planned Activity Group and to visitors to the Health Service through education, signage and increased access to the gel.


Quality of Care Report

Infection Control performance is monitored by benchmarking, both internally and externally. External benchmarks audits are: •• Victorian Nosocomial Surveillance System (VICNISS) for Occupational Exposure (OE), Blood Stream Infection (BSI), Multi-Resistant Organisms (MRO) and Surgical Site Infections (SSI). Our rates have been zero with the exception of one MRO; this compares very favourably with like sized hospitals throughout Victoria. •• Compliance with Clinical Standards. In December 2006, these twelve audits were undertaken throughout the whole of regional Victoria for benchmarking for the first time. However REDHS has conducted internal benchmarking between the three clinical areas. REDHS has continued to achieve well above the 85% required level to reach the standard. •• Point Prevalence - Infection Audit & Device Use Audit. Point Prevalence measures the proportion of cases of existing infectious disease within a defined population at a specified point in time. The prevalence rate is calculated by dividing the number of active infections in residents surveyed by the total population surveyed. The annual audit in the Nursing Home was conducted in July 2006 and compared with twenty-six other care providers. The 2006 report indicates our infection and device use rate well down in comparison with the overall totals. Rochester Nursing Home July 2006

Loddon Mallee Region July 2006

Overall Infection Rate

3.3%

6.12%

Conjunctivitis

3.3%

12.72%

0%

5.23%

Device Use

•• Clinical Waste Audit - this audit is used to monitor whether clinical waste is being disposed of in the appropriate way.

Pressure Ulcer Prevention Pressure Ulcer Prevention remains a priority for clinical staff. The Victorian Quality Council have so far conducted two Point Prevalence Surveys (PUPPS) but have yet to conduct a follow up survey in the past year. Clinical staff continue to complete a selfeducation and competency test program annually. All patients and residents admitted to REDHS have an initial assessment for evidence of pressure ulcers and risk factors and appropriate interventions are adopted for the individual. The effectiveness of the interventions is monitored by care staff, doctors and the Quality of Care Committee. Our Aged Care facilities are required to report all pressure ulcers and their current stages to DHS on a quarterly basis and all clinical departments report monthly to the Quality of Care Committee. Ulcers are rated from Stages 1 – 4 according to severity (Stage 4 being the most severe). The Acute Ward was the first department to adopt this rating method three years ago with the Nursing Home and Hostel following in consecutive years. Of the fourteen pressure ulcers reported in the Acute Ward this year, two were acquired after admission. They were assessed as Stage 1 and strategies were put in place to ensure that they did not progress. All appropriate management strategies are in place in our ages care facilities.

Pressure Ulcers 2004 – 2007 16 – 14 – 12 – 10 – 8– 6–

Staff Immunisation Program

4–

In order to protect our staff, and the consumers for whom they care, REDHS conducts an immunisation program for staff. Vaccinations for influenza and Hepatitis B are offered. As you can see from the graph, take up rates have increased each year.

2– 0–

2006-07 Acute

2005-06 Nursing Home

2004-05 Hostel

REDHS intend to further promote staff uptake next year.

Staff Immunisation (%) 100% –

75% –

75 58

50% –

67 53 44 28

25% –

0% –

15

2007 Hepatitis B

2006 Fluvax

2005

2004

Leading from the front - CEO Duane Attree was one of the first staff members to be vaccinated against influenza this season by Immunisation Nurse Leanne Rankin.

redhs annual report 2007 page 37


Quality of Care Report

Incident Reporting

Falls by Department

An effective incident reporting system is essential in helping to identify and manage clinical and safety risks. Over the past three years, the number of incidents being reported has risen in all areas. This is due, in part, to the introduction of the current electronic system and associated user-friendly forms. There has also been a culture shift that promotes a no blame reporting environment that provides greater opportunities to improve quality of care for the consumer.

140 –

129

120 – 96

100 – 80 – 56

60 – 40 –

43

41 25

Provision for Near Miss reporting has also been made this year to enable REDHS to be proactive and reduce risks. During 2006-07, fifteen near misses were reported compared to two in 2005-06.

Falls Prevention REDHS is committed to Falls Prevention and Minimisation and employs a number of strategies to prevent falls. This includes: •• Falls Assessment on all admissions •• Regular medication assessment •• Footwear and room clutter assessments •• Infra-red bed sensors (Nursing Home) REDHS was a contributor to the PCP / Shire of Campaspe Falls Assessment Pathway Initiative. Regional health services came together to develop a consistent method of assessment and associated actions for care and referral. The pathway was already largely consistent with REDHS practice, so no major changes to our assessment methods and actions were required. Falls brochures have been developed for use in the Acute and Aged Care facilities to assist patients and residents in recognising the potential causes of falls and provides some strategies for falls prevention when in our facilities. Although the brochures were developed for consumers when in our care, the information contained therein is equally useful in the home. All reported falls are investigated and the patient/client/resident checked by their doctor as appropriate. Any new strategies are introduced or existing strategies reviewed and reinforced. As a significant number of our Aged Care residents are cognitively impaired, the staff are required to remind each individual resident of the strategies and their importance on a regular basis. As you can see in the Falls graph, the number of falls reported has risen in the past two years due to a number of factors: •• Increased frailty in resident/patient mix •• Change in the definition of a fall •• Improved reporting mechanisms

redhs annual report 2007 page 38

26

20 – 0–

Acute 2006-07

All incidents and near misses are addressed by the appropriate people and referred to either the Quality of Care Committee for those involving consumers, or to the OHS Committee for those involving staff. Feedback to staff is provided at departmental meetings.

42

42

Hostel 2005-06

Nursing Home 2004-05

Medication Safety The safe and effective administration of medication is a high priority of REDHS staff. All medications that come into any of our facilities are checked in by Division One nurses or qualified pharmacists. Staff who are qualified to administer medication are Division One nurses in the Acute Ward and Nursing Home. In the Hostel, trained Personal Care Attendants administer medication that has been prepacked by the pharmacy. Any additional medication required by Hostel residents, that is not prepacked, is administered by a Division One nurse. A contracted, external pharmacist conducts a quarterly review of Aged Care resident medications and makes recommendations to the visiting medical officers and nursing staff as required. Residents/carers can then discuss them with their doctor. On admission, all patients in the Acute Ward have their medication charts checked by the ERH pharmacist. An ERH pharmacist visits Rochester twice a week. They check pharmacy stock , ensure that none is out of date and are available to speak with staff or inpatients about medications. During 2007-08, they will commence conducting staff education sessions. Medication Incident reporting has steadily increased over the past few years because of the aforementioned improved reporting mechanisms and no blame culture.

Medication Incidents 50 –

40 32 21

25 –

0–

2006-07

2005-06

2004-05

We are pleased to report that no adverse or sentinel events have occurred at REDHS in relation to a medication incident. In response to incidents/near misses, further staff education is provided and any improvements put in place as required.


Quality of Care Report

Continuity of Care A person needing treatment requires the correct assistance at the correct time from the most appropriate health professional. REDHS uses a number of processes to ensure that this happens. Adherence to the Acute Ward Admission Criteria in the Admission and Discharge Policy ensures that the only patients admitted are those whose care needs the organisation can safely meet. Those who do not meet the criteria are referred to the most appropriate facility. Newly developed Clinical Deterioration Pathways ensure that if an admitted patient’s condition deteriorates, appropriate action will be taken to address their changing needs and a transfer to another facility is arranged when necessary. When a consumer becomes a client of any REDHS department, they are issued with a unique identification number that is used universally across the organisation. This allows for a smoother transition between departments and allows client information to be tracked more efficiently. Aged Care resident care plans are reviewed on a monthly basis and Acute patients’ care plans are reviewed daily. Both are reviewed more frequently if required. Continuity of care for patients who require access to multiple services provided either by REDHS or other health care providers is facilitated by a Post Acute Care program. This program is coordinated by the District Nursing Service in consultation with the Acute Ward nursing staff who have assessed the discharge needs of patients for their return home.This process also assists with reducing length of stay within the Acute facility but also allows the patient to go home with appropriate services in place.

Sustainability REDHS is committed to excellence, quality and leadership in all of its activities, and strives to lead though an innovative approach to education and commitment to a sustainable environment. Effective and responsible management of consumer care, human resources, waste and utilities is essential from social, environmental and financial perspectives. The first two areas have already been discussed in this report.

Waste Management Like all health services, REDHS generates a significant amount of waste, both clinical and non-clinical. Our goal is to introduce a Waste Management Program that provides improved environmental outcomes by increasing recycling. Staff have been working very hard to decrease the amount of waste deposited in landfill. Regular audits are conducted to measure the amount of waste generated. A waste survey was conducted in the Acute Ward in September 2006 and compared throughout the Loddon Mallee Region (LMR). REDHS Appropriate Clinical waste was only at 29%. An action plan which included education, new signage and bin location brought that up to 100% within a week and in January 2007 was at 82%. Monitoring is ongoing and staff education provided as required.

Acute Ward Waste Survey Results 100% – 75% –

A typical example would be an elderly patient with one or more chronic diseases who has recently been admitted to hospital. Community-based services required on discharge would be flagged as would any likely need for future respite or residential care. At the weekly REDHS Co-ordinated Care meeting, the actual and potential need for further services for elderly people in the community or hospital and for residents in the Nursing Home or Hostel are flagged. The meeting is attended by managers from the Acute Ward, Primary Care, District Nursing, Hostel and Nursing Home and also a representative from the Aged Care Assessment Team.

50% – 25% – 0% –

11.7.2007

31.1.2007

Appropriate Clinical Waste

13.9.2006

6.9.2006

Appropriate General Waste

Recycling and Waste Management The average cost for Landfill rubbish for REDHS was $941.10 per month and this decreased to $569.80 per month following the introduction of the recycling initiatives introduced in the past year.

Printer and Laser Cartridge Recycling In the past twelve months, REDHS has achieved a threefold increase in the amount of printer and laser cartridges prevented from going to landfill though the introduction of cartridge recycling boxes in strategic areas of the organisation, This year 100kg of cartridge and toners have been sent to Planet Ark for recycling. The redevelopment has given us the opportunity to restructure Support Services, which will include Laundry operations, Waste Management, Catering, Housekeeping and also the Maintenance department. redhs annual report 2007 page 39


Quality of Care Report

Utilities

Laundry with Ozone typically provides the following reduction in utilities:

Project: Installation of Rainwater Tanks for Garden Maintenance REDHS is one of the biggest users of water in Rochester with an average annual use of 20.25Ml; Rochester is in a drought-declared region of Australia. By saving and collecting rainwater, REDHS hopes to contribute to the sustainable allocation of water to local residents and farmers in the future. With a roof area of 300m2 and average rainfall, approximately 12,000lt can be captured and used on a garden area of approximately 370m2 with potential expansion throughout the site. The installation of tanks and storm water drains is scheduled for August 2007 as part of the redevelopment program.

Utility

% Saved

Water In

40%

Sewer

40%

Hot Water (gas)

99%

Internal washer heating (steam)

95%

Operating energy (electricity)

30%

Gas for dryers

49%

Source: Redhead Gardens Hostel These two projects fit within the scope of the DHS Environmental Policy for reducing water consumption by 20% by 2010.

Grow Me the Money Project: Installation Ozone Laundry Support Systems Business/Industry Sector Environmental Management Trends In May 2006 Redhead Gardens Hostel in New South Wales was the first aged care facility to install the Ozone Laundry Support System. This resulted in a reduction in water use and a dramatic saving on utility costs. Based on these results, REDHS made the decision to change to cold water ozone laundering. The washers now operate on 100% cold water and the cost of upgrading the main hot water system was reduced. Significantly, there has since been a trend in Aged Care Facilities to upgrade to Ozone Laundry systems due to the dramatic savings that have been achieved.

Restructure of Laundry Department On completion of the Support Services building in 2008, REDHS will combine existing laundries to gain efficiencies and reduce costs. The cost of chemicals is predicted to be approximately $3600 per year, a saving of $5400. The restructure will also give us the opportunity to introduce Ozone Laundry support systems and water recycling throughout the laundry Water Savings (per five day period) Name

Current Laundry (Litres)

New Laundry w/out ozone (Litres)

New Laundry w/ozone (Litres)

Full / Washer

23,800

12,650

6,615

3,795

1,985

8,855

4,630

Recycling rinse water Trade water

23,800

Recycling trade water

Source: Internal audit and relevant equipment suppliers

redhs annual report 2007 page 40

4,630

REDHS is currently becoming involved in the Environmental Protection Agency / Victorian Employers’ Chamber of Commerce & Industry joint initiative, “Grow Me The Money”. This is a free program that provides Victorian organisations with the help they need to reduce their impact on the environment and save money in the process.

“Our Environment, Our Future” This State Government framework and associated environment policy seeks to minimise environmental impacts. Tools are provided to assist us making reductions. One such tool is enabling the Health Service to benchmark its annual energy consumption against other like organisations. REDHS’ energy consumption (measured in Gj/ m2) was one of the lowest recorded. Further reductions will be able to be made through in-built efficiencies in the new facilities currently under construction.


Financial Report

Financial & Operational Performance Summary Important note. The following factors had a significant impact on the 2006-07 Operating deficit/surplus result of $(27,710): •• The loss on Disposal of Non- Current Assets $(279,320) •• The increase in Salaries and Wages paid to staff due to high sick leave during the year •• Reduction in Supplies and Consumables of $4,353 •• Reduction in Other expenses of $43, 702

Financials in Brief

2006-07 $000’s

2005-06 $000’s

2004-05 $000’s

2003-04 $000’s

2002-03 $000’s

2001-02 $000’s

Total Revenue

7,937

8,493

8,250

7,592

6,884

7,124

Total Expenses

8,531

8,268

9,071

7,428

6,738

6,552

Operating Surplus (Deficit)

(27)

225

(821)

164

146

572

Net Cash Result

846

14

(130)

690

708

576

Total Assets

14,606

11,563

11,154

11,122

10,044

8,071

Total Liabilities

5,105

4,372

4,188

3,578

2,962

2,814

Net Assets

9,501

7,191

6,966

7,544

7,082

5,256

Total Equity

9,501

7,191

6,966

7,544

7,082

5,256

Future Financial Plans: •• Review and redefine long term Financial Strategy in line with various service and capital plans •• Continue the implementation and monitor results of Investment Strategy •• Implement contemporary financial management systems in line with DHS HealthSmart Strategy •• Continue to improve the capacity and skills of Accountable Persons and management level staff to ensure greater understanding of financial management and audit requirements.

Revenue Indicators Revenue Indicators

2007 Private

Debtors Outstanding as at 30 June, 2007

Average Collection Days

Under 31-60 61-90 Over Total Total 30 days days days 90 days 30/6/07 30/6/06

2006

29

91

Private

9456

1253

1723

4026

16458

13,305

TAC

-

-

TAC

VWA

-

-

VWA

-

Other Compensable

-

-

Other Compensable

Psychiatric

-

-

Psychiatric

Nursing Home

44

45

-

-

Nursing Home

29462

1947

44

10425

41878

54,450

TOTAL

38918

3200

1767

14451

58336

67,755

* ABBREVIATIONS: TAC: Transport Accident Commission VWA: Victorian WorkCover Authority

redhs annual report 2007 page 41


Financial Report

Financial Report

redhs annual report 2007 page 42


Financial Report

redhs annual report 2007 page 43


Financial Report Operating Statement For the year ended 30 June 2007 Note

Statement of Changes in Equity For the year ended 30 June 2007

2007

2006

$

$

Revenue from Operating Activities

2

7,716,537

7,573,421

Revenue from Non-operating Activities

2

318,921

327,537

Employee Benefits

2b

(6,229,930)

(5,927,581)

Non Salary Labour Costs

2b

(234,967)

(259,826)

Supplies and Consumables

2b

(430,383)

(434,736)

Other Expenses from Continuing Operations

2b

(1,167,888)

(1,211,590)

(27,710)

67,225

Net Result Before Capital & Specific Items Capital Purpose Income

2

(97,864)

592,522

Depreciation and Amortisation

3

(397,477)

(414,186)

Finance Costs

4

(17,471)

(17,297)

Expenditure Using Capital Purpose Income

2b

(53,829)

(3,306)

(594,351)

224,958

NET RESULT FOR THE YEAR

Note

Total Equity at beginning of financial year Gain/(loss) on Asset Revaluation

2007

2006

$

$

7,191,145

6,966,187

0

0

14

NET INCOME RECOGNISED DIRECTLY IN EQUITY

0

0

Net result for the year

(594,351)

224,958

TOTAL RECOGNISED INCOME AND EXPENSES FOR THE YEAR

(594,351)

224,958

Transactions with the State in its capacity as owner

14b

CLOSING BALANCE

2,903,931

0

9,500,725

7,191,145

This statement should be read in conjunction with the accompanying notes.

This statement should be read in conjunction with the accompanying notes.

Cash Flow Statement For the year ended 30 June 2007

Balance Sheet as at 30 June 2007 Note

2007

2006

$

$

ASSETS

Note

CASH FLOWS FROM OPERATING ACTIVITIES

Current Assets Cash and Cash Equivalents

5

3,996,824

1,608,392

Receivables

6

158,342

187,467

Other Financial Assets

7

0

885,121

Inventories

8

47,313

48,676

28,943

55,872

4,231,422

2,785,528

Prepayments Total Current Assets

2007

2006

$

$

Inflows/ Outflows

Inflows/ Outflows

Operating Grants from Government

6,291,627

6,852,249

Patient and Resident Fees Received

1,161,538

1,152,945

Interest Received

155,106

128,197

Other Receipts

292,653

283,506

Employee Benefits Paid

(6,208,261)

(5,983,040)

Non Salary Labour Costs

(234,967)

(263,132)

Payments for Supplies and Consumables

(430,383)

(507,446)

Finance Costs

(17,297)

75,260

(393,846)

(979,201)

(1,198,030)

GST Received from / (Paid to) ATO

Non-Current Assets Receivables

6

20,256

61,050

Property, Plant & Equipment

9

10,354,075

8,716,155

10,374,331

8,777,205

Total Non-Current Assets TOTAL ASSETS

14,605,753

11,562,733

Other payments Cash Generated from Operations Capital Grants from Government Capital Grants from Non-Government

NET CASH INFLOW/(OUTFLOW) FROM OPERATING ACTIVITIES

Current Liabilities Payables

10

Interest Bearing Liabilities

11

97,094

85,546

Provisions

12

1,329,440

1,348,124

Other Liabilities

13

3,093,354

2,376,207

4,894,190

4,205,830

Total Current Liabilities

374,302

395,953

Interest Bearing Liabilities

11

34,341

29,614

Provisions

12

176,497

136,144

210,838

165,758

TOTAL LIABILITIES

5,105,028

4,371,588

NET ASSETS

9,500,725

7,191,145

Total Non-Current Liabilities

EQUITY Asset Revaluation Reserve

14a

2,554,074

Restricted Specific Purpose Reserve

14a

181,933

2,554,074 181,933

Contributed Capital

14b

7,264,650

4,360,719

Accumulated Surplus/(Deficits)

14c

(499,932)

94,419

9,500,725

7,191,145

redhs annual report 2007 page 44

319,074

0

0 206,939

182,994

580,119

(1,352,035)

(671,586)

15

Purchase of Property, Plant & Equipment Proceeds from Sale of Property, Plant & Equipment

126,449

121,270

58,245

(58,245)

(1,167,341)

(608,561)

Purchase of Investments

CASH FLOWS FROM FINANCING ACTIVITIES Proceeds from Borrowings

16,275

101,359

Repayment of Borrowings

0

(58,469)

Contributed Capital from Government

1,814,800

0

NET CASH INFLOW/(OUTFLOW) FROM FINANCING ACTIVITIES

1,831,075

42,890

NET INCREASE/(DECREASE) IN CASH HELD

846,728

14,448

CASH AND CASH EQUIVALENTS AT BEGINNING OF PERIOD

714,519

700,071

1,561,247

714,519

CASH AND CASH EQUIVALENTS AT END OF PERIOD

5

Non-Cash Financing and Investing Activities

16

This statement should be read in conjunction with the accompanying notes. This statement should be read in conjunction with the accompanying notes.

54,106

3,500

CASH FLOWS FROM INVESTING ACTIVITIES

NET CASH INFLOW/(OUTFLOW) FROM INVESTING ACTIVITIES

Non-Current Liabilities

105,901

73,593

Capital Donations and Bequests Received

LIABILITIES

TOTAL EQUITY

(17,471)


Financial Report Notes to and forming part of the Financial Statements for the year ended 30 June 2007 Note 1 : Statement Of Significant Accounting Policies This general-purpose financial report has been prepared on an accrual basis in accordance with the Financial Management Act 1994, Accounting Standards issued by the Australian Accounting Standards Board and Urgent Issues Group Interpretations. Accounting standards include Australian equivalents to International Financial Reporting Standards (A-IFRS). The financial statements were authorised for issue by Mr Duane Attree, Chief Executive Officer on 11/09/2007.

(f) Other Financial Assets Other financial assets are recognised and derecognised on trade date where purchase or sale of an investment is under a contract whose terms require delivery of the investment within the timeframe established by the market concerned, and are initially measured at fair value, net of transaction costs. Other financial assets are classified between current and non current assets based on the Rochester and Elmore District Health Service Board of Management’s intention at balance date with respect to the timing of disposal of each asset.

The Rochester and Elmore District Health Service classifies its other investments as available for sale. This classification depends on the purpose for which the investments were acquired. Management determines the classification of its investments at initial recognition.

Other investments held by the Rochester and Elmore District Health Service are classified as being available-for-sale and are stated at fair value. Gains and losses arising from changes in fair value are recognised directly in equity, until the investment is disposed of or is determined to be impaired, at which time to the extent appropriate, the cumulative gain or loss previously recognised in equity is included in the operating statement for the period.

other factors that are believed to be reasonable under the circumstance, the results of which form the basis of making the judgements. Actual results may differ from these estimates.

Dividend revenue is recognised on a receivable basis. Interest revenue is recognised on a time proportionate basis that takes into account the effective yield on the financial asset.

The estimates and underlying assumptions are reviewed on an ongoing basis. Revisions to accounting estimates are recognised in the period in which the estimate is revised if the revision affects only that period, or in the period of the revision and future periods if the revision affects both current and future periods.

(g) Property, Plant and Equipment Freehold and Crown Land is measured at fair value with regard to the property’s highest and best use after due consideration is made for any legal or constructive restrictions imposed on the land, public announcements or commitments made in relation to the intended use of the land. Theoretical opportunities that may be available in relation to the asset(s) are not taken into account until it is virtually certain that any restrictions will no longer apply.

Basis of preparation The financial report is prepared in accordance with the historical cost convention, except for the revaluation of certain non-current assets and financial instruments, as noted. Cost is based on the fair values of the consideration given in exchange for assets. In the application of A-IFRS management is required to make judgements, estimates and assumptions about carrying values of assets and liabilities that are not readily apparent from other sources. The estimates and associated assumptions are based on historical experience and various

Accounting polices are selected and applied in a manner which ensures that the resulting financial information satisfies the concepts of relevance and reliability, thereby ensuring that the substance of the underlying transactions or other events is reported. The accounting policies set out below have been applied in preparing the financial statements for the year ended 30 June 2007, and the comparative information presented in these financial statements for the year ended 30 June 2006. (a) Reporting Entity The financial statements include all the controlled activities of the Rochester and Elmore District Health Service. The Health Service is a not-for profit entity and therefore applies the additional Aus paragraphs applicable to “not-for-profit” entities under the A-IFRS. (b) Rounding Of Amounts All amounts shown in the financial statements are expressed to the nearest $1. (c) Cash and Cash Equivalents Cash and cash equivalents comprise cash on hand and in banks and investments in money market instruments, net of outstanding bank overdrafts. Bank overdrafts are shown within borrowings in current liabilities in the Balance Sheet. (d) Receivables Trade debtors are carried at nominal amounts due and are due for settlement within 30 days from the date of recognition. Collectability of debts is reviewed on an ongoing basis, and debts which are known to be uncollectible are written off. A provision for doubtful debts is raised where doubt as to collection exists. Bad debts are written off when identified. (e) Inventories Inventories include goods and other property held either for sale or distribution at no or nominal cost in the ordinary course of business operations. It includes land held for sale and excludes depreciable assets

Inventories held for distribution are measured at the lower of cost and current replacement cost. All other inventories, including land held for sale, are measured at the lower of cost and net realisable value.

Cost is assigned to land for sale (undeveloped, under developed and developed) and high value, low volume inventory items on a specific identification of cost basis.

Cost for all other inventory is measured on the basis of weighted average cost.

Buildings are measured at fair value less accumulated depreciation and impairment.

Plant, Equipment and Vehicles are measured at cost less accumulated depreciation and impairment.

(h) Revaluation of Property, Plant and Equipment Financial Reporting Direction (FRD) 103B Non-current Physical Assets, prescribes that non current physical assets measured at fair value are revalued with sufficient regularity to ensure that the carrying amount of each asset does not differ materially from its fair value. This revaluation process normally occurs every five years as dictated by timelines in FRD103B which sets the next revaluation for the Health, Welfare and Community Purpose Group to occur on 30 June 2009, or earlier should there be an indication that fair values are materially different from the carrying value. Revaluation increments or decrements arise from differences between an asset’s carrying value and fair value.

Revaluation increments are credited directly to the asset revaluation reserve, except that, to the extent that an increment reverses a revaluation decrement in respect of that class of asset previously recognised as an expense in net result, the increment is recognised as revenue in the net result.

Revaluation decrements are recognised immediately as expenses in the net result, except that, to the extent that a credit balance exists in the asset revaluation reserve in respect of the same class of assets, they are debited directly to the asset revaluation reserve.

Revaluation increases and revaluation decreases relating to individual assets within an asset class are offset against one another within that class but are not offset in respect of assets in different classes. Revaluation reserves are not transferred to accumulated funds on derecognition of the relevant asset.

(i) Non-Current Assets Classified as Held for Sale Non-current assets (and disposal groups) classified as held for sale are measured at the lower of carrying amount and fair value less costs to sell.

Non-current assets and disposal groups are classified as held for sale if their carrying amount will be recovered through a sale transaction rather than through continuing use. This condition is regarded as met only when the sale is highly probable and the asset (or disposal group) is expected to be completed within one year from the date of classification.

(j) Depreciation Assets with a cost in excess of $1,000 (2005-6 and 2006-7) are capitalised and depreciation has been provided on depreciable assets so as to allocate their cost - or valuation - over their estimated useful lives using the straight-line method. Estimates of the remaining useful lives and depreciation method for all assets are reviewed at least annually. This depreciation charge is not funded by the Department of Human Services.

redhs annual report 2007 page 45


Financial Report Notes to and forming part of the Financial Statements for the year ended 30 June 2007 Note 1 : Statement Of Significant Accounting Policies (j)

Depreciation (continued)

The following table indicates the expected useful lives of non current assets on which the depreciation charges are based. 2007

2006

Buildings

30 to 40 Years

30 to 40 Years

Plant & Equipment

8 to 10 Years

8 to 10 Years

Medical Equipment

4 to 5 Years

4 to 5 Years

Computers & Communications

3 to 5 Years

3 to 5 Years

Furniture & Fittings

3 to 5 Years

3 to 5 Years

Motor Vehicles

2 to 3 Years

2 to 3 Years

Other

3 to 5 Years

3 to 5 Years

(k) Impairment of Assets Intangible assets with indefinite useful lives are tested annually as to whether their carrying value exceeds their recoverable amount. All other assets are assessed annually for indications of impairment, except for:

(q) Goods and Services Tax Income, expenses and assets are recognised net of the amount of associated GST, unless the GST incurred is not recoverable from the taxation authority. In this case it is recognised as part of the cost of acquisition of the asset or as part of the expense.

Receivables and payables are stated inclusive of the amount of GST receivable or payable. The net amount of GST recoverable from, or payable to, the taxation authority is included with other receivables or payables in the Balance Sheet.

Cash flows are presented on a gross basis. The GST components of cash flows arising from investing or financing activities which are recoverable from, or payable to the taxation authority, are presented as operating cash flow.

(r) Employee Benefits Wages and Salaries, Annual Leave, Sick Leave and Accrued Days Off Liabilities for wages and salaries, including non-monetary benefits, annual leave, accumulating sick leave and accrued days off expected to be settled within 12 months of the reporting date are recognised in the provision for employee benefits in respect if employee’s services up to the reporting date, classified as current liabilities and measured at nominal values.

Those liabilities that the health service does not expect to settle within 12 months are recognised in the provision for employee benefits as current liabilities, measured at present value of the amounts expected to be paid when the liabilities are settled using the remuneration rate expected to apply at the time of settlement.

Long Service Leave Current Liability - unconditional LSL (representing 10 or more years of continuous service) is disclosed as a current liability regardless of whether the Rochester and Elmore District Health Service does not expect to settle the liability within 12 months as it does not have the unconditional right to defer the settlement of the entitlement should an employee take leave.

The components of this current LSL liability are measured at:

present value - component that the Rochester and Elmore District Health Service does not expect to settle within 12 months; and

nominal value - component that the Rochester and Elmore District Health Service expects to settle within 12 months.

Non-Current Liability - conditional LSL (representing less than 10 years of continuous service) is disclosed as a non-current liability. There is an unconditional right to defer the settlement of the entitlement until 10 years of service has been completed by an employee. Conditional LSL is required to be measured at present value.

Consideration is given to expected future wage and salary levels, experience of employee departures and periods of service. Expected future payments are discounted using interest rates of national Government guaranteed securities in Australia.

Superannuation Defined contribution plans Contributions to defined contribution superannuation plans are expensed when incurred.

(n) Resources Provided and Received Free of Charge or for Nominal Consideration Resources provided or received free of charge or for nominal consideration are recognised at their fair value. Contributions in the form of services are only recognised when a fair value can be reliably determined and the services would have been purchased if not donated.

Defined benefit plans The amount charged to the Operating Statement in respect of defined benefit superannuation plans represents the contributions made by the Rochester and Elmore District Health Service to the superannuation plan in respect of the services of current Rochester and Elmore District Health Service staff. Superannuation contributions are made to the plans based on the relevant rules of each plan.

(o) Interest Bearing Liabilities Interest bearing liabilities in the Balance Sheet are recognised at fair value upon initial recognition. Subsequent to initial recognition, all financial liabilities are recognised at amortised cost using the effective interest method.

Employees of the Rochester and Elmore District Health Service are entitled to receive superannuation benefits and the Rochester and Elmore District Health Service contributes to both the defined benefit and defined contribution plans. The defined benefit plan(s) provide benefits based on years of service and final average salary.

The Rochester and Elmore District Health Service made contributions to the following major superannuation plans during the year:

Defined benefit plans: Health Super

Defined Contribution Plans: Health Super HESTA

• inventories; • assets arising from employee benefits; • financial instrument assets; • investment property that is measured at fair value; • non-current assets held for sale.

If there is an indication of impairment, the assets concerned are tested as to whether their carrying value exceeds their recoverable amount. Where an asset’s carrying value exceeds its recoverable amount, the difference is written-off by a charge to the Operating Statement except to the extent that the write-down can be debited to an asset revaluation reserve amount applicable to that class of asset. The recoverable amount for most assets is measured at the higher of depreciated replacement cost and fair value less costs to sell. Recoverable amount for assets held primarily to generate net cash inflows is measured at the higher of the present value of future cash flows expected to be obtained from the asset and fair value less costs to sell. It is deemed that, in the event of a loss of an asset, the future economic benefits arising from the use of the asset will be replaced unless a specific decision to the contrary has been made.

(l) Payables These amounts represent liabilities for goods and services provided prior to the end of the financial year and which are unpaid. The normal credit terms are usually Net 30 Days. (m) Provisions Provisions are recognised when the Rochester and Elmore District Health Service has a present obligation, the future sacrifice of economic benefits is probable, and the amount of the provision can be measured reliably.

The amount recognised as a provision is the best estimate of the consideration required to settle the present obligation at reporting date, taking into account the risks and uncertainties surrounding the obligation. Where a provision is measured using the cash flows estimated to settle the present obligation, its carrying amount is the present value of those cash flows.

(p) Functional and Presentation Currency The presentation currency of the Rochester and Elmore District Health Service is the Australian dollar, which has also been identified as the functional currency of the Rochester and Elmore District Health Service.

redhs annual report 2007 page 46


Financial Report Notes to and forming part of the Financial Statements for the year ended 30 June 2007 Note 1 : Statement Of Significant Accounting Policies (r) Employee Benefits (Continued) The Rochester and Elmore District Health Service does not recognise any defined benefit liability in respect of the superannuation plans because the Rochester and Elmore District Health Service has no legal or constructive obligation to pay future benefits relating to its employees; its only obligation is to pay superannuation contributions as they fall due.

The Department of Treasury and Finance administers and discloses the State’s defined benefit liabilities in its financial report.

Termination Benefits Liabilities for termination benefits are recognised when a detailed plan for the termination has been developed and a valid expectation has been raised with those employees affected that the terminations will be carried out. The liabilities for termination benefits are recognised in other creditors unless the amount or timing of the payments is uncertain, in which case they are recognised as a provision.

On-Costs Employee benefit on-costs are recognised and included in employee benefit liabilities and costs

(w) Revenue Recognition (continued) Government Grants Grants are recognised as income when the Rochester and Elmore District Health Service gains control of the underlying assets in accordance with AASB 1004 Contributions. Where grants are reciprocal, revenue is recognised as performance occurs under the grant. Non-reciprocal grants are recognised as income when the grant is received or receivable. Conditional grants may be reciprocal or non-reciprocal depending on the terms of the grant.

• Long Service Leave (LSL) - Revenue is recognised upon finalisation of movements in LSL liability in line with the arrangements set out in the Acute Health Division Hospital Circular 16/2004

Patient and Resident Fees Patient fees are recognised as revenue at the time invoices are raised.

Private Practice Fees

when the employee benefits to which they relate are recognised as liabilities. (s) Finance Costs Finance costs are recognised as expenses in the period in which they are incurred.

Private Practice fees are recognised as revenue at the time invoices are raised.

Finance costs include: • interest on bank overdrafts and short-term and long-term borrowings; • amortisation of discounts or premiums relating to borrowings; • amortisation of ancillary costs incurred in connection with the arrangement of borrowings; and • finance charges in respect of finance leases recognised in accordance with AASB 117 Leases.

(t) Residential Aged Care Service The Residential Aged Care Service operations are an integral part of the Rochester and Elmore District Health Service and shares its resources. An apportionment of land and buildings has been made based on floor space. The results of the two operations have been segregated based on actual revenue earned and expenditure incurred by each operation. (u) Intersegment Transactions Transactions between segments within the Rochester and Elmore District Health Service have been eliminated to reflect the extent of the Rochester and Elmore District Health Service’s operations as a group. (v) Leases Leases of property, plant and equipment are classified as finance leases whenever the terms of the lease transfer substantially all the risks and rewards of ownership to the lessee. All other leases are classified as operating leases.

Indirect Contributions • Insurance is recognised as revenue following advice from the Department of Human Services

Donations and Other Bequests Donations and bequests are recognised as revenue when received. If donations are for a special purpose, they may be appropriated to a reserve, such as specific restricted purpose reserve.

(x) Fund Accounting The Rochester and Elmore District Health Service operates on a fund accounting basis and maintains three funds: Operating, Specific Purpose and Capital Funds. The Rochester and Elmore District Health Service’s Capital and Specific Purpose Funds include unspent capital donations and receipts from fundraising activities conducted solely in respect of these funds. (y) Services Supported by Health Services Agreement and Services Supported by Hospital and Community Initiatives. Activities classified as Services Supported by Health Services Agreement (HSA) are substantially funded by the Department of Human Services and include Residential Aged Care Services (RACS) and are also funded from other sources such as the Commonwealth, patients and residents, while Services Supported by Hospital and Community Initiatives (Non HSA) are funded by the Health Service’s own activities or local initiatives and/or the Commonwealth. (z) Comparative Information There have been no changes to previous year’s figures other than detailed below.

Revenues and Expenses by category in notes 2a and 2b(i) have been reclassified to accord with the government’s requirements for reporting under the Australian Health Care Agreement with the Commonwealth government. This reclassification has had no impact on the comparative financial information other than a change in name from Acute Services to Admitted Patients.

(aa) Asset Revaluation Reserve The asset revaluation reserve is used to record increments and decrements on the revaluation of non-current assets.

Assets held under a finance lease are recognised as non current assets at their fair value or, if lower, at the present value of the minimum lease payments, each determined at the inception of the lease.

The minimum lease payments are discounted at the interest rate implicit in the lease. A corresponding liability is established and each lease payment is allocated between the principal component and the interest expense.

Finance leased assets are amortised on a straight line basis over the shorter of the estimated useful life of the asset or the term of the lease.

(ab) Available-for-Sale Revaluation Reserve The available-for-sale revaluation reserve arises on the revaluation of available-for-sale financial assets. Where a revalued financial asset is sold that portion of the reserve which relates to that financial asset, and is effectively realised, is recognised in the Operating Statement. Where a revalued financial asset is impaired that portion of the reserve which relates to that financial asset is recognised in the Operating Statement.

Contingent rentals associated with finance leases are recognised as an expense in the period in which they incurred.

(ac) General Reserves No General Reserves are in existence at the date of this report.

Operating lease payments, including any contingent rentals, are recognised as an expense in the Operating Statement on a straight line basis over the lease term, except where another systematic basis is more representative of the time pattern of benefits derived from the use of the leased asset.

(ad) Specific Restricted Purpose Reserve A specific restricted purpose reserve is established where the Health Service has possession or title to the funds but has no discretion to amend or vary the restriction and/or condition underlying the funds received.

(w) Revenue Recognition Revenue is recognised in accordance with AASB 118 Revenue and is recognised as to the extent it is earned. Unearned income at reporting date is reported as income received in advance.

Amounts disclosed as revenue are, where applicable, net of returns, allowances and duties and taxes.

(ae) Contributed Capital Consistent with UIG Interpretation 1038 Contributions by Owners Made to Wholly-Owned Public Sector Entities and FRD 2A Contributions by Owners, appropriations for additions to the net asset base have been designated as contributed capital. Other transfers that are in the nature of contributions or distributions, that have been designated as contributed capital are also treated as contributed capital.

redhs annual report 2007 page 47


Financial Report Notes to and forming part of the Financial Statements for the year ended 30 June 2007 Note 1 : Statement Of Significant Accounting Policies (af) Net Result Before Capital & Specific Items The subtotal entitled ‘Net Result Before Capital & Specific Items’ is included in the Operating Statement to enhance the understanding of the financial performance of Rochester and Elmore District Health Service. This subtotal reports the result excluding items such as capital grants, assets received or provided free of charge, depreciation, and items of unusual nature and amount such as specific revenues and expenses.

The exclusion of these items are made to enhance matching of income and expenses so as to facilitate the comparability and consistency of results between years and Victorian Public Health Services. The Net result Before Capital & Specific Items is used by the management of Rochester and Elmore District Health Service, the Department of Human Services and the Victorian Government to measure the ongoing result of the Health Services in operating hospital services. Capital and specific items, which are excluded from this sub-total comprise:

(af) Net Result Before Capital & Specific Items (continued) • Depreciation and amortisation, as described in note 1 (g) and (j) • Assets provided or received free of charge, as described in note 1 (n) • Expenditure using capital purpose income, comprises expenditure which either falls below the asset capitalisation threshold (note 1 (g)), or doesn’t meet asset recognition criteria and therefore does not result in the recognition of an asset in the Balance Sheet, where funding for that expenditure is from capital purpose income. (ag) Category Groups The Rochester and Elmore District Health Service has used the following category groups for reporting purposes for the current and previous financial years.

• Capital purpose income, which comprises all tied grants, donations and bequests received for the purpose of acquiring non-current assets, such as capital works, plant and equipment or intangible assets. It also includes donations of plant and equipment (refer note 1 (n)). Consequently the recognition of revenue as capital purpose income is based on the intention of the provider of the revenue at the time the revenue is provided. • Specific income/expense, comprises the following items, where material: • Voluntary departure packages • Write-down of inventories • Non-current asset revaluation increments/decrements

ophthalmic aids.

Aged Care comprises revenue/expenditure from Home and Community Care (HACC) programs, allied Health, Aged Care Assessment and support services.

Primary Health comprises revenue/expenditure for Community Health Services including health promotion and counselling, physiotherapy, speech therapy, podiatry and occupational therapy.

Other Services excluded from Australian Health Care Agreement (AHCA) (Other) comprises revenue/expenditure for services not separately classified above, including: Public health services including Laboratory testing, Blood Borne Viruses/ Sexually Transmitted Infections clinical services, Kooris liaison officers, immunisation and screening services, Drugs services including drug withdrawal, counselling and the needle and syringe program, Dental Health services, including general and specialist dental care, school dental services and clinical education. Disability services including aids and equipment and flexible support packages to people with a disability, Community Care programs including sexual assault support, early parenting services, parenting assessment and skills development, and various support services. Health and Community Initiatives also falls in this category group.

• Diminution of investments • Restructuring of operations (disaggregation/aggregation of health services) • Litigation settlements • Non-current assets lost or found • Forgiveness of loans • Reversals of provisions • Voluntary changes in accounting policies (which are not required by an accounting standard or other authoritative pronouncement of the Australian Accounting Standards Board) • Impairment of non current assets, includes all impairment losses (and reversal of previous impairment losses), related to non current assets only which have been recognised in accordance with note 1 (k)

Admitted Patient Services (Admitted Patients) comprises all recurrent health revenue/ expenditure on admitted patient services, where services are delivered in public hospitals, or free standing day hospital facilities, or palliative care facilities, or rehabilitation facilities, or alcohol and drug treatment units or hospitals specialising in dental services, hearing and

(ah) New Accounting Standards and Interpretations Certain new accounting standards and interpretations have been published that are not mandatory for 30 June 2007 reporting period. As at 30 June 2007, the following standards and interpretations had been issued but were not mandatory for financial years ending 30 June 2007. Rochester and Elmore District Health Service has not and does not intend to adopt these standards early.

(ah) New Accounting Standards and Interpretations (continued) Standard / Interpretation

Summary

Applicable for reporting periods beginning on or ending on

Impact on Health Service’s Annual Statements

AASB 7 Financial Instruments: Disclosures

New standard replacing disclosure requirements of AASB 132

Beginning 1 Jan 2007

AASB 7 is a disclosure standard so will have no direct impact on the amounts included in the Rochester & Elmore District Health’s financial statements. However the amendments will result in changes to the financial instrument disclosures included in the Rochester & Elmore District Health’s annual report.

AASB 2005-10, Amendments to Australian Accounting Standards (AASB’s 132, 101, 114, 117, 133, 139, 1, 4, 1023 & 1038

Amendments arising from the release in Aug 05 of AASB 7 Financial Instruments: Disclosures

Beginning 1 Jan 2007

Amendments may result in changes to the financial statements.

AASB 101 Presentation of Financial Statements (revised)

Removes Australian specific requirements from AASB 101, including the Australian illustrative formats of the income statement, balance sheet, and the statement of changes in equity which Health Services were previously encouraged’ to adopt in preparing their financial statements.

Beginning 1 Jan 2007

Amendments may result in changes to the financial statements

AASB 2007-1 Amendments to Australian Accounting Standards arising from AASB Interpretation 22 (AASB 2)

Additional paragraphs added underneath transitional payments

1 March 2007

Amendments may result in changes to the financial statements

redhs annual report 2007 page 48


Financial Report Notes to and forming part of the Financial Statements for the year ended 30 June 2007 Note 2: Revenue HSA 2007

HSA 2006

Non HSA 2007

Non HSA 2006

TOTAL 2007

TOTAL 2006

$

$

$

$

$

$

4,359,406

4,358,356

4,359,406

4,358,356

1,937,880

1,951,155

1,937,880

1,951,155

0

Revenue from Operating Activities Government Grants - Department of Human Services

0

0

0

0

0

0

0

258,405

250,018

0

0

258,405

250,018

- Commonwealth Government • Residential Aged Care Subsidy - Other State Government Indirect Contributions by Department of Human Services Patient and Resident Fees (refer Note 2c)

1,054,491

954,804

0

0

1,054,491

954,804

Interest and Dividends

57,325

38,413

0

0

57,325

38,413

Other Revenue

49,030

20,675

0

0

49,030

20,675

7,716,537

7,573,421

0

0

7,716,537

7,573,421

Interest and Dividends

0

0

93,666

93,899

93,666

93,899

Catering

0

0

82,700

80,390

82,700

80,390

Property Income

0

0

19,330

24,845

19,330

24,845

Other Revenue from Non-Operating Activities

0

0

123,225

128,403

123,225

128,403

Sub-Total Revenue from Non-Operating Activities

0

0

318,921

327,537

318,921

327,537

312,174

Sub-Total Revenue from Operating Activities Revenue from Non-Operating Activities

Revenue from Capital Purpose Income State Government Capital Grants - Targeted Capital Works and Equipment

0

312,174

0

0

0

3,500

6,900

0

0

3,500

6,900

104,363

110,935

0

0

104,363

110,935

Net Gain/(Loss) on Disposal of Non-Current Assets (refer note 2d)

0

0

(279,320)

(44,426)

(279,320)

(44,426)

Donations and Bequests

0

0

73,593

206,939

73,593

206,939

107,863

430,009

(205,727)

162,513

(97,864)

592,522

7,824,400

8,003,430

113,194

490,050

7,937,594

8,493,480

- Other Residential Accommodation Payments

Sub-Total Revenue from Capital Purpose Income Total Revenue from Continuing Operations (refer note 2a)

Indirect Contributions by Human Services Department of Human Services makes certain payments on behalf of the Hospital These amounts have been brought to account in determining the operating result for the year by recording them as revenue and expenses.

redhs annual report 2007 page 49


Financial Report Notes to and forming part of the Financial Statements for the year ended 30 June 2007 Note 2a: Analysis Of Revenue By Source Admitted Patients 2007

Residential Aged Care 2007

Aged Care 2007

Primary Health 2007

Other 2007

TOTAL 2007

$

$

$

$

$

$

Revenue from Services Supported by Health Services Agreement Government Grants - Department of Human Services

3,206,375

674,765

463,434

14,832

0

4,359,406 1,937,880

- Commonwealth Government 0

1,937,880

0

0

0

- Insurance

- Residential Aged Care Subsidy

274,950

0

0

0

0

274,950

- Long Service Leave

(16,545)

0

0

0

0

(16,545)

3,500

104,363

0

0

0

107,863

252,315

749,550

52,626

0

0

1,054,491 57,325

Capital Purpose Income (refer note 2) Patient and Resident Fees (refer note 2c) Interest and Dividends

57,325

0

0

0

0

9,742

11,886

5,364

22,038

0

49,030

3,787,662

3,478,444

521,424

36,870

0

7,824,400

Bank & Investment Income

0

0

0

0

93,666

93,666

Catering

0

0

0

0

82,700

82,700

Property Income

0

0

0

0

19,330

19,330

Capital Purpose Income (refer note 2)

0

0

0

0

(205,727)

(205,727)

Other

0

0

0

0

123,225

123,225

Sub-Total Revenue from Services Supported by Hospital and Community Initiatives

0

0

0

0

113,194

113,194

3,787,662

3,478,444

521,424

36,870

113,194

7,937,594

Other Sub-Total Revenue from Services Supported by Health Services Agreement Revenue from Services Supported by Hospital and Community Initiatives

Other Activities

TOTAL REVENUE FROM ALL SOURCES

Indirect Contributions by Human Services Department of Human Services makes certain payments on behalf of the Hospital These amounts have been brought to account in determining the operating result for the year by recording them as revenue and expenses.

Note 2a: Analysis Of Revenue By Source Admitted Patients 2006

Residential Aged Care 2006

Aged Care 2006

Primary Health 2006

Other 2006

TOTAL 2006

$

$

$

$

$

$

Revenue from Services Supported by Health Services Agreement Government Grants - Department of Human Services

3,230,142

657,023

421,537

49,654

0

0

0

0

0

0

0

0

1,951,155

0

0

0

1,951,155

234,276

0

0

0

0

234,276

15,742

0

0

0

0

15,742

Capital Purpose Income (refer note 2)

319,074

110,935

0

0

0

430,009

Patient and Resident Fees (refer note 2c)

207,862

700,587

46,278

77

0

954,804

38,413

0

0

0

0

38,413

4,034

4,488

1,510

10,643

0

20,675

4,049,543

3,424,188

469,325

60,374

0

8,003,430

Bank & Investment Income

0

0

0

0

93,899

93,899

Catering

0

0

0

0

80,390

80,390

Property Income

0

0

0

0

24,845

24,845

Capital Purpose Income (refer note 2)

0

0

0

0

162,513

162,513

Other

0

0

0

0

128,403

128,403

Sub-Total Revenue from Services Supported by Hospital and Community Initiatives

0

0

0

0

490,050

490,050

4,049,543

3,424,188

469,325

60,374

490,050

8,493,480

- Commonwealth Government - Residential Aged Care Subsidy - Insurance - Long Service Leave

Interest and Dividends Other Sub-Total Revenue from Services Supported by Health Services Agreement

4,358,356

Revenue from Services Supported by Hospital and Community Initiatives

Other Activities

TOTAL REVENUE FROM ALL SOURCES

redhs annual report 2007 page 50


Financial Report Notes to and forming part of the Financial Statements for the year ended 30 June 2007 Note 2b: Expenses HSA 2007

HSA 2006

Non HSA 2007

Non HSA 2006

TOTAL 2007

TOTAL 2006

$

$

$

$

$

$

Employee Benefits Salaries & Wages WorkCover Long Service Leave Superannuation (refer note 20) Total Employee Benefits

5,248,735

5,004,159

250,587

180,112

5,499,322

85,152

84,462

2,879

2,965

88,031

5,184,271 87,427

112,505

157,213

6,095

7,825

118,600

165,038

504,267

475,391

19,710

15,454

523,977

490,845

5,950,659

5,721,225

279,271

206,356

6,229,930

5,927,581

151,678

168,745

0

0

151,678

168,745

80,972

91,081

2,317

0

83,289

91,081

232,650

259,826

2,317

0

234,967

259,826

Non Salary Labour Costs Fee for Service Medical Officers Purchased Services Total Non Salary Labour Costs Supplies and Consumables Drug Supplies

42,633

42,693

0

0

42,633

42,693

120,653

117,640

906

46

121,559

117,686

9,328

35,530

0

0

9,328

35,530

0

0

2,605

3,219

2,605

3,219

Food Supplies

216,085

199,351

38,173

36,257

254,258

235,608

Total Supplies and Consumables

388,699

395,214

41,684

39,522

430,383

434,736

Medical, Surgical Supplies and Prothesis Pathology Supplies Special Services

Expenditure Using Capital Purpose Income Employee Benefits

0

0

0

0

0

0

Non Salary Labour Costs

0

0

0

3,306

0

3,306

Other Expenses

0

0

53,829

53,829

0

Total Expenditure using Capital Purpose Income

0

0

53,829

3,306

53,829

3,306

Domestic Services & Supplies

123,718

123,165

5,837

5,342

129,555

128,507

Fuel, Light, Power and Water

106,732

108,916

0

0

106,732

108,916

Insurance costs funded by DHS

274,950

234,276

0

0

274,950

234,276

Motor Vehicle Expenses

36,439

42,566

686

704

37,125

43,270

Repairs & Maintenance

65,256

145,127

0

5,309

65,256

150,436

Maintenance Contracts

45,008

38,810

3,312

1,973

48,320

40,783

Patient Transport

31,556

80,130

0

0

31,556

80,130

3,636

15,798

0

0

3,636

15,798

461,358

397,552

0

3,747

461,358

401,299

Other Expenses from Continuing Operations

Bad & Doubtful Debts Administrative Expenses Audit Fees Total Other Expenses from Continuing Operations Depreciation and Amortisation

9,400

8,175

0

0

9,400

8,175

1,158,053

1,194,515

9,835

17,075

1,167,888

1,211,590 414,186

0

0

397,477

414,186

397,477

Finance Costs

17,471

17,297

0

0

17,471

17,297

Total

17,471

17,297

397,477

414,186

414,948

431,483

7,747,532

7,588,077

784,413

680,445

8,531,945

8,268,522

Total Expenses

redhs annual report 2007 page 51


Financial Report Notes to and forming part of the Financial Statements for the year ended 30 June 2007 Note 2b(I): Analysis Of Expense By Source Admitted Patients 2007

Residential Aged Care 2007

Aged Care 2007

Primary Health 2007

Other 2007

TOTAL 2007

$

$

$

$

$

$

Services Supported by Health Service Agreement Employee Benefits Salaries & Wages

1,522,800

2,842,945

424,326

458,664

0

WorkCover

24,907

46,126

6,620

7,499

0

85,152

Long Service Leave

25,452

60,819

18,475

7,759

0

112,505

157,820

262,265

41,050

43,132

0

504,267

126,581

21,262

2,382

1,453

0

151,678

43,483

2,948

17

34,524

0

80,972

Superannuation (refer note 20)

5,248,735

Non Salary Labour Costs Fee for Service Medical Officers Purchased Services Supplies and Consumables Drug Supplies

30,479

9,305

1,617

1,232

0

42,633

Medical, Surgical Supplies and Prothesis

41,752

68,466

5,444

4,991

0

120,653

Pathology Supplies

9,328

0

0

0

0

9,328

26,646

175,463

9,813

4,163

0

216,085

Domestic Services & Supplies

29,052

83,370

3,068

8,228

0

123,718

Fuel, Light, Power and Water

29,640

66,503

6,578

4,011

0

106,732

Insurance costs funded by DHS

74,594

169,738

19,020

11,598

0

274,950

Motor Vehicle Expenses

7,168

10,143

11,337

7,791

0

36,439

Repairs & Maintenance

17,890

34,931

3,033

9,402

0

65,256

Maintenance Contracts

18,340

18,747

928

6,993

0

45,008

Patient Transport

31,556

0

0

0

0

31,556

3,636

0

0

0

0

3,636

119,983

258,881

37,254

45,240

0

461,358

2,341,107

4,131,912

590,962

656,680

0

7,720,661

Salaries and Wages

0

0

0

0

250,587

250,587

WorkCover

0

0

0

0

2,879

2,879

Long Service Leave

0

0

0

0

6,095

6,095

Superannuation (refer note 20)

0

0

0

0

19,710

19,710

0

0

0

0

2,317

2,317

Medical, Surgical Supplies & Prosthesis

0

0

0

0

906

906

Special Services

0

0

0

0

2,605

2,605

Food Supplies

0

0

0

0

38,173

38,173

Domestic Services & Supplies

0

0

0

0

5,837

5,837

Motor Vehicle Expenses

0

0

0

0

686

686

Repairs & Maintenance

0

0

0

0

25,070

25,070

Maintenance Contracts

0

0

0

0

3,312

3,312

Other Administrative Expenses

0

0

0

0

28,759

28,759

Sub-Total Expense from Services Supported by Hospital and Community Initiatives

0

0

0

0

386,936

386,936

Depreciation and Amortisation (refer Note 3)

0

0

0

0

397,477

397,477

Audit Fees - Auditor General’s (refer note 23)

9,400

0

0

0

0

9,400

Finance Costs

3,881

6,802

4,610

2,178

0

17,471

2,354,388

4,138,714

595,572

658,858

784,413

8,531,945

Food Supplies Other Expenses

Bad & Doubtful Debts Administrative Expenses Sub-Total Expenses from Services Supported by Health Services Agreement Services Supported by Hospital and Community Initiatives Employee Benefits

Non Salary Labour Costs Purchased Services Supplies and Consumables

Other Expenses

TOTAL EXPENSES FROM CONTINUING OPERATIONS

redhs annual report 2007 page 52


Financial Report Notes to and forming part of the Financial Statements for the year ended 30 June 2007 Note 2b(I): Analysis Of Expense By Source Admitted Patients 2006

Residential Aged Care 2006

Aged Care 2006

Primary Health 2006

Other 2006

TOTAL 2006

$

$

$

$

$

$

Services Supported by Health Service Agreement Employee Benefits Salaries & Wages

1,472,380

2,778,961

392,118

360,700

0

WorkCover

24,931

46,818

6,619

6,094

0

84,462

Long Service Leave

57,220

74,255

15,640

10,098

0

157,213

166,314

237,940

35,259

35,878

0

475,391

161,097

6,536

678

434

0

168,745

62,122

4,703

19

24,237

0

91,081

Superannuation (refer note 20)

5,004,159

Non Salary Labour Costs Fee for Service Medical Officers Purchased Services Supplies and Consumables Drug Supplies

32,622

9,147

924

0

0

42,693

Medical, Surgical Supplies and Prothesis

52,272

55,181

5,798

4,389

0

117,640

Pathology Supplies

35,388

142

0

0

0

35,530

Food Supplies

24,969

163,683

8,454

2,245

0

199,351

Domestic Services & Supplies

34,804

83,118

2,684

2,559

0

123,165

Fuel, Light, Power and Water

24,630

74,177

6,280

3,829

0

108,916

Insurance costs funded by DHS

63,559

144,629

16,206

9,882

0

234,276

Motor Vehicle Expenses

9,793

14,935

12,714

5,124

0

42,566

Repairs & Maintenance

44,570

78,095

6,614

15,848

0

145,127

Maintenance Contracts

17,756

13,365

1,110

6,579

0

38,810

Patient Transport

79,721

409

0

0

0

80,130

Bad & Doubtful Debts

15,798

0

0

0

0

15,798

109,475

220,932

29,908

37,237

0

397,552

2,489,421

4,007,026

541,025

525,133

0

7,562,605

Salaries and Wages

0

0

0

0

180,112

180,112

WorkCover

0

0

0

0

2,965

2,965

Long Service Leave

0

0

0

0

7,825

7,825

Superannuation (refer note 20)

0

0

0

0

15,454

15,454

0

0

0

0

3,306

3,306

Medical, Surgical Supplies & Prosthesis

0

0

0

0

46

46

Special Services

0

0

0

0

3,219

3,219

Food Supplies

0

0

0

0

36,257

36,257

Domestic Services & Supplies

0

0

0

0

5,342

5,342

Motor Vehicle Expenses

0

0

0

0

704

704

Repairs & Maintenance

0

0

0

0

5,309

5,309

Maintenance Contracts

0

0

0

0

1,973

1,973

Other Administrative Expenses

0

0

0

0

3,747

3,747

Sub-Total Expense from Services Supported by Hospital and Community Initiatives

0

0

0

0

266,259

266,259

Other Expenses

Administrative Expenses Sub-Total Expenses from Services Supported by Health Services Agreement Services Supported by Hospital and Community Initiatives Employee Benefits

Non Salary Labour Costs Purchased Services Supplies and Consumables

Other Expenses

Depreciation and Amortisation (refer note 3)

0

0

0

0

414,186

414,186

Audit Fees - Auditor General’s (refer note 23)

2,136

4,862

545

332

0

7,875

81

185

21

13

0

300

2,690

5,790

2,527

6,290

0

17,297

2,494,328

4,017,863

544,118

531,768

680,445

8,268,522

- Other Finance Costs (refer note 4) TOTAL EXPENSES FROM CONTINUING OPERATIONS

redhs annual report 2007 page 53


Financial Report Notes to and forming part of the Financial Statements for the year ended 30 June 2007 Note 2c: Patient And Resident Fees

Note 5: Cash And Cash Equivalents

2007

2006

$

$

252,315

207,862

For the purposes of the Cash Flow Statement, cash assets includes cash on hand and in banks, and short-term deposits which are readily convertible to cash on hand, and are subject to an insignificant risk of change in value, net of outstanding bank overdrafts.

Patient and Resident Fees Raised Recurrent: Acute - Inpatients

2007

2006

$

$

Residential Aged Care - Nursing Home

393,763

357,970

- Hostel

355,787

342,617

52,626

46,278

0

77

1,054,491

954,804

Aged Care - District Nursing Primary Health Total Recurrent

Cash at Bank

Residential Accommodation Payments (*)

104,363

110,935

Total Capital

104,363

110,935

(*) This includes accommodation charges, interest earned on accommodation bonds and retention amount.

2007

2006

$

$

6,699

6,374 1,608,392

1,561,247

714,519

- Cash at Bank

2,435,577

893,873

TOTAL

3,996,824

1,608,392

Represented by:

2007

2006

$

$

Trade Debtors Patient Fees

30,193

20,000

96,256

101,270

126,449

121,270

- Motor Vehicles

Cash for Monies Held in Trust

CURRENT

Proceeds from Disposal of Non Current Assets - Plant & Equipment

650 1,601,368

3,996,824

TOTAL

Note 6: Receivables

Note 2d: Net Gain/(Loss) On Disposal Of Non-Current Assets

650 3,989,475

Deposits at Call

Cash for Health Service Operations (as per Cash Flow Statement)

Capital Purpose:

Total Proceeds from Disposal of Non-Current Assets

Cash on Hand

21,266

31,484

115,820

118,504

Accrued Investment Income

0

4,115

35,256

47,364

172,342

201,467

Accrued Revenue - Other TOTAL Less Provision for Doubtful Debts

Less: Written Down Value of Non Current Assets Sold - Plant & Equipment

38,409

21,034

- Motor Vehicles

114,430

144,662

- Buildings

Patient Fees TOTAL CURRENT RECEIVABLES

14,000

14,000

158,342

187,467

242,226

0

NON CURRENT

- Furniture & Fittings

1,632

0

Bond Debtors

6,277

0

- Leasehold Equipment

9,072

0

DHS - Long Service Leave

13,979

61,050

405,769

165,696

TOTAL NON-CURRENT RECEIVABLES

20,256

61,050

(279,320)

(44,426)

TOTAL RECEIVABLES

178,598

248,517

3,636

15,798

Total Written Down Value of Non-Current Assets Sold Net Gains/(Losses) On Disposal Of Non Current Assets

BAD AND DOUBTFUL DEBTS

Note 2e: Analysis Of Expenses By Internal And Restricted Specific Purpose Funds For Services Supported By Hospital And Community Initiatives 2007

2006

$

$

Note 7: Other Financial Assets

Radiology

32,204

31,774

Property Maintenance

13,688

5,097

139,926

142,001

0

5,394

96,423

0

Primary Care Partnership

104,695

81,996

TOTAL

386,936

266,262

Meals on Wheels Medical Clinic Redevelopment Expenditure

Patient Related Debtors

Specific Purpose Fund

Capital Fund

Total

2007

2006

2007

2006

2007

2006

$

$

$

$

$

$

CURRENT Australian Dollar Term Deposits

0

58,245

0

826,876

0

885,121

TOTAL

0

58,245

0

826,876

0

885,121

58,245

0

0

0

58,245

Represented by:

Note 3: Depreciation And Amortisation

2007

2006

Health Service Investments

0

$

$

Monies Held in Trust - Accommodation Bonds (Refundable Entrance Fees)

0

0

0

826,876

0

826,876

TOTAL

0

58,245

0

826,876

0

885,121

Depreciation Buildings

208,015

216,037

4,050

3,949

Land Improvements Plant & Equipment - Plant

119,605

132,124

- Motor Vehicles

34,123

27,658

Furniture and Fittings

31,684

34,418

TOTAL DEPRECIATION

397,477

414,186

Note 4: Finance Costs

2007

2006

$

$

Note 8: Inventories

2006

$

$

CURRENT Pharmaceuticals - at cost

13,708

11,736

Catering Supplies - at cost

7,375

7,763

Housekeeping Supplies - at cost

7,069

3,985

13,257

18,045

5,904

7,147

47,313

48,676

Medical and Surgical Lines - at cost

Interest on Short Term Borrowings

17,471

17,297

Administration Stores - at cost

TOTAL

17,471

17,297

TOTAL INVENTORIES

redhs annual report 2007 page 54

2007


Financial Report Notes to and forming part of the Financial Statements for the year ended 30 June 2007 Note 9: Property, Plant & Equipment

2007

2006

$

$

Note 10:Payables

- Land Improvements at Cost Less Depreciation - Land Improvements at Valuation Less Impairment

Total Land

430,000

430,000

430,000

430,000

3,000

3,000

Trade Creditors

107,953

Other Payables

1,270

0

91,301

92,468

154,708

79,448

Accrued Expenses GST Payable

499

199

2,501

2,801

75,000

75,000

DHS - Accrued Grant Recall

15,500

11,750

59,500

63,250

TOTAL

492,001

496,051

Accrued Audit Fees

- Buildings at Cost Less Accumulated Depreciation and Impairment - Buildings at Valuation Less Accumulated Depreciation and Impairment

Total Buildings

Note 11: Interest Bearing Liabilities

2,553,928

314,674

CURRENT

883,666

883,667

Bank Overdraft

104,825

69,479

778,841

814,188

Less Accumulated Depreciation and Impairment Total Plant and Equipment

11,094,046

11,986,366

5,385,415

5,862,841

5,708,631

6,123,525

Total Furniture and Fittings

9,041,400

7,252,387

Less Accumulated Depreciation and Impairment Total Motor Vehicles TOTAL

374,302

395,953

2007

2006

$

$

- Hire Purchase Liability

97,094

85,546

97,094

85,546

- Hire Purchase Liability

34,341

29,614

Total Non Current Australian Dollars Borrowings

34,341

29,614

131,435

115,160

97,093

85,546

34,341

29,614

Australian Dollar Borrowings

1,283,669

2,229,674

755,787

1,590,805

527,882

638,869

Secured

467,101

652,211

NON CURRENT

360,130

513,556

Secured

106,971

138,655

261,923

261,602

76,102

71,409

185,821

190,193

10,354,075

8,716,155

TOTAL INTEREST BEARING LIABILITIES CURRENT

- Hire Purchase Liability

Borrowings are secured by motor vehicles to which the agreements relate. Seven hire purchase agreements exist with terms of up to 24 monthly payments followed by a balloon payment. Interest rates vary between 9.200% and 13.500%.

Motor Vehicles at Cost - Motor Vehicles

64,400

Total Current Australian Dollars Borrowings

- Hire Purchase Liability

Less Accumulated Depreciation and Impairment

7,875

11,670

NON CURRENT

Furniture and Fittings at Cost - Furniture and Fittings

7,400

Australian Dollar Borrowings

Plant & Equipment at Cost - Plant and Equipment

151,762

Buildings - Buildings Under Construction

2006 $

CURRENT

Land - Land at Valuation

2007 $

The approved Bank Overdraft limit is $150,000 Finance costs of the Health Service incurred during the year are accounted for as follows: Amount of Finance Costs recognised as expenses

$17,471

$6,846

Note 9: Property, Plant & Equipment (continued) Reconciliations of the carrying amounts of each class of asset at the beginning and end of the previous and current financial year is set out below.

Balance at 1 July 2005

Land

Buildings & Land Improv.

Plant & Equipment

Furniture & Fittings

Motor Vehicles

Total

$

$

$

$

$

$

430,000

7,200,664

666,806

128,858

198,123

Additions

0

337,760

125,220

44,215

164,391

671,586

Disposals

0

0

(21,033)

0

(144,663)

(165,696)

Revaluation increments/(decrements)

0

0

0

0

0

0

Net transfers free of charge

0

0

0

0

0

0

Depreciation and Amortisation

0

(219,986)

(132,124)

(34,418)

(27,658)

(414,186)

430,000

7,318,438

638,869

138,655

190,193

8,716,155

Additions

0

2,239,253

57,731

0

144,179

2,441,163

Disposals

0

(242,225)

(49,113)

0

(114,428)

(405,766)

Depreciation and Amortisation

0

(212,065)

(119,605)

(31,684)

(34,123)

(397,477)

430,000

9,103,401

527,882

106,971

185,821

10,354,075

Balance at 1 July 2006

Balance at 30 June 2007

8,624,451

Land and buildings carried at valuation An independent valuation of the Health Service’s land and buildings was performed by Mr S.F. Eishold to determine the fair value of the land and buildings. The valuation, which conforms to Australian Valuation Standards, was determined by reference to the amounts for which assets could be exchanged between knowledgeable willing parties in an arm’s length transaction. The valuation was based on independent assessments. The effective date of the valuation is 30 June 2005.

redhs annual report 2007 page 55


Financial Report Notes to and forming part of the Financial Statements for the year ended 30 June 2007 Note 12: Provisions

2007

2006

$

$

Note 14: Equity & Reserves

CURRENT 1,329,440

1,348,124

TOTAL

1,329,440

1,348,124

Employee Benefits (refer note 12a)

176,497

136,144

TOTAL

176,497

136,144

Balance at beginning of the reporting period - Buildings

2007

2006

$

$

- Land

244,325

2,554,074

2,554,074

Balance at the beginning of the reporting period

181,933

181,933

Balance at the end of the reporting period

181,933

181,933

2,736,007

2,736,007

Balance at the beginning of the reporting period

4,360,719

4,360,719

Capital Contribution Received from Victorian Government

2,903,931

0

7,264,650

4,360,719

545,529 604,601

Accrued Salaries and Wages

204,785

187,710

9,993

10,284

1,329,440

1,348,124

Expected to be utilised within 12 months (nominal value)

821,817

788,537

Expected to be utilised after 12 months (present value)

507,623

559,587

1,329,440

1,348,124

Conditional Long Service Leave Entitlements (present value)

176,497

136,144

Balance at the end of the reporting period

TOTAL

176,497

136,144

(c) Accumulated Surpluses/(Deficits)

Balance at start of year

681,673

665,931

Provision made during the year

118,600

165,035

(135,140)

(149,296)

665,133

681,673

Restricted Specific Purpose Reserve

Total Reserves

*Current Employee benefits that:

NON-CURRENT

(b) Contributed Capital

Balance at the beginning of the reporting period

Movement in Long Service Leave:

* The following assumptions were adopted in measuring present value: - Wage inflation rate of 4.75% - Bond rates applied to future values are as advised by the Department of Treasury and Finance and range from 5.675% to 5.743%

2007 $

94,419

(130,539)

Net Result for the Year

(594,351)

224,958

Balance at the end of the reporting period

(499,932)

94,419

(d) Total Equity at end of financial year

9,500,725

7,191,145

Note 15: Reconciliation Of Net Result For The Year To Net Cash Inflow/(Outflow) From Operating Activities

NET RESULT FOR THE YEAR

2006 $

CURRENT Monies Held in Trust*

2007

2006

$

$

(594,351)

224,958

Depreciation & Amortisation

397,477

414,186

Provision for Doubtful Debts

0

(16,000)

Net (Gain)/Loss from Sale of Plant and Equipment

279,320

44,426

Increase/(Decrease) in Payables

(25,609)

(107,303)

25,271

21,322

3,068,083

2,350,927

Increase/(Decrease) in Employee Benefits

3,093,354

2,372,249

Increase/(Decrease) in Other Liabilities

0

3,958

Total Current

3,093,354

2,376,207

* Total Monies Held in Trust

3,093,354

2,372,249

Cash Assets (refer to Note 5)

2,435,577

893,873

Receivables (refer to Note 6)

6,277

0

0

826,876

651,500

651,500

3,093,354

2,372,249

Rental Income Received in Advance

2,554,074

2,309,749

626,026

- Accommodation Bonds (Refundable Entrance Fees)

2,554,074

244,325

488,636

- Patient Monies Held in Trust

0

2,309,749

- Buildings

Annual Leave Entitlements

Note 13: Other Liabilities

0

- Buildings

Unconditional Long Service Leave Entitlements

Balance at end of year

244,325 2,309,749

Represented by:

CURRENT

Settlement made during the year

244,325 2,309,749

Revaluation Increment/Decrement

Balance at the end of the reporting period

TOTAL

$

Asset Revaluation Reserve - Land

NON-CURRENT

Accrued Days Off

2006

$ (a) Reserves

Employee Benefits (refer note 12a)

Note 12a: Employee Benefits

2007

21,669

85,523

0

(171,306)

(Increase)/Decrease in Prepayments

26,929

(52,122)

(Increase)/Decrease in Receivables

76,196

154,787

(Increase)/Decrease in Stores NET CASH INFLOW/(OUTFLOW) FROM OPERATING ACTIVITIES

1,363

2,970

182,994

580,119

Represented by the following assets:

Other Financial Assets (refer to Note 7) Land and Buildings TOTAL

redhs annual report 2007 page 56

Note 16: Non-Cash Financing And Investing Activities

2007

2006

$

$

Acquisition of Plant and equipment by means of Hire Purchase Agreements

144,179

101,359

Total

144,179

101,359


Financial Report Notes to and forming part of the Financial Statements for the year ended 30 June 2007 Note 17: Financial Instruments

Note 17: Financial Instruments (continued)

(a) Risk Management policies A finance and audit committee meet on a regular basis to receive and discuss reports from both internal and external auditors. An effective framework is in place to adequately assess, monitor, manage and report, the significant financial risks to which the Health Service is exposed to as a result of, and in the course of its activities and responsibilities. (b) Significant accounting policies Details of the significant accounting policies and methods adopted, including the criteria for recognition, the basis of measurement and the basis on which income and expenses are recognised, in respect of each class of financial asset, financial liability and equity instrument are disclosed in note 1 to the financial statements. (c) Significant terms and conditions The Health Service’s financial instruments consist mainly of deposits with banks, short term investments, accounts receivable and payable, and loans from banking institutions.

Interest Rate Exposure as at 30/06/2006

The Health Service does not have any derivative instruments at 30 June 2007.

Trade Creditors & Accruals

0

(d) Credit risk exposures The maximum exposure to credit risk, excluding the value of any collateral or other security, at balance date to recognised financial assets, is the carrying amount, net of any provisions for impairment of those assets, as disclosed in the balance sheet and notes to the financial statements.

Interest Bearing Liabilities Other Liabilities Total Financial Liabilities

The Health Service does not have any material credit risk exposure to any single receivable or group of receivables under financial instruments entered into by the Health Service. (e) Interest Rate Risk Exposure The Health Service’s exposure to interest rate risk and effective weighted average interest rate by maturity periods is set out in the following table. For interest rates applicable to each class of asset or liability refer to individual notes to the financial statements. Exposure arises predominantly from assets and liabilities bearing variable interest rates.

Fixed interest rate maturing Floating Interest Rate

1 Year or less

1 to 5 Years

Non Interest Bearing

Total 2007

Weighted Average Interest Rates

$

$

$

$

$

%

Financial Assets Cash Assets

1,607,742

0

0

Trade Debtors

0

0

0

135,988

650 1,608,392 135,988

5.65% 0.00%

Other Receivables

0

0

0

112,529

112,529

0.00%

Other Financial Assets

0 885,121

0

0

885,121

5.71%

Total Financial Assets 1,607,742 885,121

0

249,167 2,742,030

0

0

395,953

395,953

0.00%

0

85,546

29,614

0

115,160

11.21%

0

0

0

2,376,207 2,376,207

0.00%

0

85,546

29,614

2,772,160 2,887,320

1,607,742 799,575 (29,614)

(2,522,993) (145,290)

Financial Liabilities

Net Financial Assets/Liabilities

(f) Credit Risk Exposure Credit risk represents the loss that would be recognised if counterparties fail to meet their obligations under the respective contracts at maturity. The credit risk on financial assets of the entity have been recognised on the Balance Sheet, as the carrying amount, net any provisions for doubtful debts. The Health Service is not materially exposed to any individual debtor.

Interest Rate Exposure as at 30/06/2007 Fixed interest rate maturing Floating Interest Rate

1 Year or less

1 to 5 Years

Non Interest Bearing

Total 2007

Weighted Average Interest Rates

$

$

$

$

$

%

(g) Fair Value of Financial Assets and Liabilities The carrying amount of financial assets and liabilities contained within these financial statements is representative of the fair value of each financial asset or liability. The following table details the fair value of financial assets and financial liabilities.

Financial Assets Cash Assets

3,996,174

0

0

650 3,996,824

Trade Debtors

0

0

0

123,086

123,086

0.00%

Other Receivables

0

0

0

55,512

55,512

0.00%

Other Financial Assets

0

0

0

0

0

0.00%

Total Financial Assets 3,996,174

0

0

2007

5.90%

Fair Value

Book Value

Net Fair Value

$

$

$

$

Financial Assets Cash Assets Trade Debtors

179,248 4,175,422

2006

Book Value

Other Receivables

3,996,824

3,996,824

1,608,392

1,608,392

123,086

123,086

135,988

135,988

55,512

55,512

112,529

112,529

0

0

885,121

885,121

4,175,422

4,175,422

2,742,030

2,742,030

395,953

Financial Liabilities

Other Financial Assets

Trade Creditors & Accruals

Total Financial Assets 0

0

0

374,302

374,302

0.00%

Interest Bearing Liabilities

0

97,094

34,341

0

131,435

11.21%

Trade Creditors & Accruals

374,302

374,302

395,953

Other Liabilities

0

0

0

3,093,354 3,093,354

0.00%

Interest Bearing Liabilities

131,435

131,435

115,160

115,160

Other Liabilities

3,093,354

3,093,354

2,376,207

2,376,207

Total Financial Liabilities

3,599,091

3,599,091

2,887,320

2,887,320

Total Financial Liabilities Net Financial Assets/Liabilities

Financial Liabilities

0

97,094

34,341

3,996,174 (97,094) (34,341)

3,467,656 3,599,091

(3,288,408)

576,331

Fair values are capital amounts. Fair values of financial instruments are determined on the following basis: (i) Cash, deposit investments, cash equivalents and non-interest bearing financial assets and liabilities (trade debtors, other receivables, trade creditors and advances) are valued at cost which approximates to fair value. (ii) Interest bearing liability amounts are based on the present value of expected future cash flows discounted at current market interest rates quoted for trade (Treasury Corporation of Victoria) Service as at the date of this report.

redhs annual report 2007 page 57


Financial Report Notes to and forming part of the Financial Statements for the year ended 30 June 2007 Note 18: Commitments

Note 20: Superannuation (continued)

2007

2006

$

$

Land & Buildings

19,000,000

21,700,000

Total Capital Commitments

19,000,000

21,700,000

Not Later than one year

10,000,000

5,425,000

9,000,000

16,275,000

19,000,000

21,700,000

The name and details of the major employee superannuation funds and contributions made by the Health Service are as follows:

Capital Commitments

Later than one year and not later than 5 years Total

2007

2006

$

$

Contribution for the Year FUND Health Super Fund

Total capital commitments for the hospital redevelopment will be met by the Department of Human Services.

519,450

488,893

HESTA

4,527

1,952

TOTAL

523,977

490,845

The bases for contributions are determined by the various schemes.

Note 19: Contingent Liabilities And Contingent Assets

The unfunded superannuation liability in respect to members of State Superannuation Schemes and Health Super Scheme is not recognised in the Balance Sheet. Rochester & Elmore District Health’s total unfunded superannuation liability in relation to these funds has been assumed by and is reflected in the financial statements of the Department of Treasury and Finance.

There are no known contingent liabilities or contingent assets for Rochester & Elmore District Health Service as at the date of this report.

Note 20: Superannuation

The above amounts were measured as at 30 June of each year, or in the case of employer contributions they relate to the years ended 30 June.

Superannuation contributions for the reporting period are included as part of employee benefits and on-costs in the Operating Statement of the Health Service.

All employees of the Health Service are entitled to benefits on retirement, disability or death from the Government Employees Super Fund. The defined benefit fund provides defined lump sum benefits based on years of service and annual average salary.

Note 21: Segment Reporting

HEALTH SERVICES

RACS

Other

CONSOLIDATED

2007

2006

2007

2006

2007

2006

2007

2006

$

$

$

$

$

$

$

$

REVENUE External Segment Revenue

4,401,825

5,030,879

3,384,778

3,330,289

0

0

7,786,603

0

0

0

0

0

0

0

0

4,401,825

5,030,879

3,384,778

3,330,289

0

0

7,786,603

8,361,168

(4,382,562)

(4,239,152)

(4,131,912)

(4,012,073)

0

0

(8,514,474)

(8,251,225)

0

0

0

0

0

0

0

0

Segment Result

19,263

791,727

(747,134)

(681,784)

0

0

(727,871)

109,943

Net Result from ordinary activities

19,263

791,727

(747,134)

(681,784)

0

0

(727,871)

109,943

(10,669)

(11,507)

(6,802)

(5,790)

0

0

(17,471)

(17,297)

57,325

38,413

93,666

93,899

0

0

150,991

132,312

Intersegment Revenue Total Revenue External Segment Expenses Unallocated Expense

Interest Expense Interest Income

8,361,168

Share of Net Result of Associates & Joint Ventures using Equity Model

0

0

0

0

0

0

0

0

65,919

818,633

(660,270)

(593,675)

0

0

(594,351)

224,958

3,525,878

3,891,372

6,894,721

6,283,354

0

10,420,599

10,174,726

0

0

0

0

2,630,184

1,388,009

2,630,184

1,388,009

Total Assets

3,525,878

3,891,372

6,894,721

6,283,354

2,630,184

1,388,009

13,050,783

11,562,735

Segment Liabilities

1,083,318

886,096

3,647,408

2,897,871

0

0

4,730,726

3,783,967

0

0

0

0

374,302

587,621

374,302

587,621

1,083,318

886,096

3,647,408

2,897,871

374,302

587,621

5,105,028

4,371,588

Net Result for Year OTHER INFORMATION Segment Assets Unallocated Assets

Unallocated Liabilities Total Liabilities Investments in associates and joint venture partnership

0

0

0

0

0

0

0

0

Acquisition of property, plant and equipment and intangible assets

184,609

284,917

17,301

71,995

2,239,254

314,674

2,441,164

671,586

Depreciation & amortisation expense

397,477

264,824

145,399

141,765

7,827

7,597

550,703

414,186

Non cash expenses other than depreciation

0

0

0

0

0

0

0

0

Impairment of inventories

0

0

0

0

0

0

0

0

The major products/services from which the above segments derive revenue are: Business Segments Services Health Services Acute Hospital services Aged Care services Primary Health services Residential Aged Care Nursing Home facilities Hostel facilities Geographical Segment Rochester & Elmore District Health Service operates predominantly in Rochester, Victoria. More than 90% of revenue, net surplus from ordinary activities and segment assets relate to operations in Rochester, Victoria.

redhs annual report 2007 page 58


Financial Report Notes to and forming part of the Financial Statements for the year ended 30 June 2007 Note 22: Responsible Person Related Disclosures (a) Responsible Persons Responsible Minister: The Honourable Bronwyn Pike, MLA Minister for Health Board of Management Members throughout the year included: Mrs H. Acocks Mrs S. Martin Mr G. Nelson Assoc Prof M. Boelen Mrs M. Magennis Mr P. Lawford (to 31/10/2006) Mrs D.H. Moon Mr G. Walkley (to 31/10/2006) Mr S. McDonald Ms A. Jensen (from 01/11/2006) Mrs A. Shotton

Chief Executive Officer (Accountable Officer):

Mr Duane Attree (from 09/02/2007) Ms Robin Whyte (resigned 08/02/2007)

(b) Remuneration of Responsible Persons The number of Responsible Persons are shown in their relevant income bands; Total Remuneration

Base Remuneration

2007

2006

2007

2006

No.

No.

No.

No.

$40,000 - $49,000

1

-

1

-

$110,000 - $120,000

1

-

1

-

$140,000 - $149,000

-

1

-

1

Total Numbers

2

1

2

1

Income Band

(c) Retirement Benefits of Responsible Persons No retirement benefits have been paid by the reporting entity in connection with the retirement of Responsible Persons. (d) Other Transactions of Responsible Persons and their Related Parties No responsible person or their related parties received any remuneration or retirement benefits during the year. 2007

2006

$

$

(e) Other Receivables from and Payments to Responsible Persons and their Related Parties.

Aggregate amounts payable at balance date:

0

0

0

1,009

0

236

(f) Amounts Attributable to Other Transactions With Responsible Persons and their Related Parties.

The result of the period includes aggregate amounts attributable to transactions with Responsible Persons and Responsible Persons Related Parties in respect of:

Mr P. Lawford, proprietor of Lawford Rural Supplies, supplies hardware products to the Health Service on normal terms and conditions.

Aggregate amounts paid for Hardware Supplies

Mr G. Nelson, proprietor of Graeme Nelson Motors supplies vehicles and other automotive services on normal terms and conditions

Aggregate amounts paid for supplies & services

(g) Executive Officer Remuneration

No executive officers received greater than $100,000 during the financial year.

Note 23: Remuneration Of Auditors

2007

2006

$

$

Audit fees paid or payable to the Victorian Auditor-General’s Office for audit of the Health Service’s financial report. Paid as at 30 June

2,000

0

Payable as at 30 June

7,400

7,875

Total Paid and Payable

9,400

7,875

redhs annual report 2007 page 59


Glossary A & E ACAS ACCV ACHS ACSAA ALOS AOD ATD BEIMS

Accident & Emergency Department Aged Care Assessment Service Aged and Community Care Victoria Australian Council of Healthcare Standards Aged Care Standards and Accreditation Agency Average Length of Stay Alcohol and Other Drugs Annual Training Day Building & Equipment Integrated Management System BRIT Bendigo Regional Institute of TAFE CALD Culturally & Linguistically Diverse CVN Campaspe Valley News DHA Department of Health and Ageing (Federal) DHS Department of Human Services (State) DVA Department of Veterans’ Affairs EEO Equal Employment Opportunity EFT Equivalent Full Time - Staff EQuIP Evaluation and Quality Improvement Program ERH Echuca Regional Health FOI Freedom of Information FRAT Falls Risk Assessment Tool GOTAFE Goulburn Ovens Institute of TAFE HACC Home & Community Care HARP Hospital Admission Risk Program IC Infection Control ICDM Integrated Chronic Disease Management IP Inpatient LAOS Limited Adverse Occurrence Screening NHT Nursing Home Types (Acute) (stay greater than 35 days) Occupancy Percentage of Beds filled per nominated period OP Outpatient PAC Post Acute Care PAG Planned Activity Group PCP Primary Care Partnership Pandemic A worldwide outbreak of a new strain of virus to which humans have no immunity and that is spread easily between them PUPPS Pressure Ulcer Prevalence Program (DHS) QOC Quality of Care SCTT Services Coordination Tool Templates TAFE Technical and Further Education REDHS Rochester & Elmore District Health Service Separation/ The completion of an episode of care and the Discharge patient/client leaves the organisation VET Vocational Education Training VMO Visiting Medical Officer VPS Victorian Public Sector VPSM Victorian Patient Satisfaction Monitor VQC Victorian Quality Council

redhs annual report 2007 page 60

Your Community – Your Health Service You Can Help In Many Ways Donations and Bequests are a vital part in the provision of services to Residents in our community. Our service relies on the generosity of individuals and organisations within our community. You can help by: •• Making a Donation towards a specific item •• By defraying the cost of much needed equipment •• By remembering the Health Service in your Will •• By joining one of the Health Service Auxiliaries Donations in memory of loved one or in lieu of flowers is also appreciated. Envelopes are available for this purpose from the Health Service. Receipts are issued, acknowledgement letters are written, and when known, summary letters are mailed to the deceased next of kin.

Your Help Is Needed - And Will Be Appreciated


TECTURA Architects are pleased to be undertaking the design and renewal of the Rochester and Elmore District Health Service, to be completed in 2009 for the local community.

Tectura Pty. Ltd. Level 6, 55 Exhibition St. Melbourne, VIC 3000 Australia ABN: 13 053 962 413 T: +61 3 9654 5444 F: +61 3 9654 5155 E: design@tectura.com.au W: www.tectura.com.au


Rochester and Elmore District Health Service

PO Box 202, Rochester Vic 3561. phone: (03) 5484 4400 fax: (03) 5484 2291 This report is also available on our website: www.redhs.com.au

Design by Rojay.com.au


Redhs Annual Report