SCL Health 2020 Annual Report

2020 REPORT TO THE COMMUNIT Y

From Our Board Chair and Our President and CEO

Lydia Jumonville and Steven Huebner

It was a true honor to spend another year guiding SCL Health, which served more patients than ever in our hospitals and clinics across Colorado, Montana and Kansas in 2019. As we reflect on our collective accomplishments from the year, we remain both humbled and energized by a healing ministry that calls us to improve the health of the people and communities we serve, especially those who are poor and vulnerable.

We have positioned our ministry to stay nimble in our approach to the vast changes that continue to unfold across the healthcare industry, all the while honoring our heritage and remaining rooted in our mission. As we look to the future, in 2019 we launched a multiyear strategic plan to ensure that we are focusing our resources on the most important ways we can expand the reach of our healing mission to better serve our patients – no matter what challenges we may face.

In the spirit of always looking ahead, we named our strategic plan Mission Forward 2025. To focus our resources on the most important ways we can grow the reach of our mission and better serve our patients, our strategic plan reflects four strategic imperatives we relentlessly pursue. We may adjust the initiatives within 2 | SCL Health

each focus area slightly each year, like the sails of a boat, but ultimately these four imperatives guide every aspect of our work across our ministry. Our new strategic plan will continue to propel us forward, while our updated strategic imperatives will guide our work across our ministry.

Our foundresses, The Sisters of Charity of Leavenworth, emphasized caring for those who are poor and vulnerable as the main tenet of their ministry, and their legacy continues on through our work today.

One example of this legacy can be found in our community benefit work, where we invest back into our communities. In 2019, we provided $255.3 million in charity care and community benefit.

Through multiple outreach programs, we were honored to: help those from young to old who needed shelter; identify and assist pregnant mothers struggling with hardships; provide the youngest survivors of abuse and trauma with a creative, healing outlet; and increase access to medical care for more individuals than ever before.

As always, none of this work would have been possible without the tireless support of our Board of Directors, our Leaven Ministry sponsors, our associates, our providers, and our communities.

There is much more to be done, and we are excited to continue this journey with a strong plan to guide us.

Steven D. Huebner, CPA SCL Health Board Chair

CONTENTS SECTION 1: OUR STRATEGIC IMPERATIVES Aligned & Empowered Organization. . . . . . . . . . 5 Growth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Aligned Clinician Network . . . . . . . . . . . . . . . . . 19 Clinical & Operational Transformation . . . . . . . . 25 SECTION 2: HOW WE GIVE BACK TO OUR COMMUNITIES Community Benefit . . . . . . . . . . . . . . . . . . . . . . . 31 Addressing Social Determinants of Health . . . . 35 Impact of Philanthropy . . . . . . . . . . . . . . . . . . . . 41 Ensuring a Safety Net for the Most Vulnerable 49 International Ministries . . . . . . . . . . . . . . . . . . . . 54 SECTION 3: ABOUT SCL HEALTH Our Mission, Vision and Values . . . . . . . . . . . . . 57 Leadership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 Where We Serve. . . . . . . . . . . . . . . . . . . . . . . . . 61 Financial Summary. . . . . . . . . . . . . . . . . . . . . . . . 62

Lydia Jumonville SCL Health President and CEO

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SEC TION 1

Our Strategic Imperatives

To focus our resources on the most important ways we can grow the reach of our mission and better serve our patients, we have created a multi-year strategic plan reflecting four strategic imperatives we relentlessly pursue.

We may adjust the initiatives within each focus area slightly each year, like the sails of a boat, but ultimately our strategic imperatives guide every aspect of our work across our ministry.

STRATEGIC IMPERATIVES

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Section 1 | Our Strategic Imperatives

Aligned & owered p m E an i z a tio g r n O

G r ow t h

A li d C l i ng n ea n ici Netw ork

A deep connection and commitment to the SCL Health mission and values is the thread that binds every one of our associates and caregivers around a common purpose. Our mission and values also lay the foundation for us to advance our strategic imperatives and expand our health ministry.

Focusing on investments and initiatives to ensure that we foster an aligned and empowered organization, we can create a unified ministry identity that SCL Health associates, patients and providers can all understand, connect to and engage with more deeply.

Cl inical & l O Tr p e r a atio n io n an sfor m at

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Aligned & Empowered Organization

Renewing connection, meaning and purpose through Ministry Formation We know that when our physicians, nurses and associates are aligned and engaged, our patients reap the benefits.

In 2019, SCL Health expanded a program called Ministry Formation as a top strategic objective, which was designed to renew associates’ sense of connection, meaning and purpose in their work and extend learnings and compassion to the care they provide to our patients. The Ministry Formation initiatives are framed by our rich history and tradition as a Catholic health system, originating from our founding Sisters of Charity of Leavenworth. One of the many ways SCL Health continues to uphold the sisters’ passion for caring for the whole person – body, mind and spirit – is through Ministry Formation.

In 2019, Ministry Formation was incorporated at every level of the organization: • Leaders, including those in the Medical Group, participated in the “Foundations for a Community of Care” program, which included four sections exploring the human experience, values-driven leadership, Catholic social teaching, and ethicsand values-based decision-making – all of which influence the care we provide to our communities.

• Associates and their work groups or units participated in the “L.O.V.E. (Living Our Values Everyday) Associate Formation” program, which included seven interactive sessions. The sessions were designed to engage associates in reflection, storytelling, and conversation to increase

engagement and promote a personal connection with SCL Health’s mission and core values related to an individual’s area of work. Mission Leaders, Spiritual Care Champions, and other department leaders were trained to facilitate work group discussions across SCL Health.

• SCL Health’s Board of Directors, as part of its annual retreat, participated in a 60-minute formative experience that explored the role of board members in ensuring the Catholic identity of SCL Health into the future and maintaining the quality and sustainability of SCL Health as a Catholic healthcare ministry.

By enriching the experience associates and providers have with their work and connecting them with their purpose, we enhance engagement and retention, and foster a sense of satisfaction for those providing care, which is reflected in the experience patients have when they come to our hospitals and clinics.

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“ What we’re finding is that our leaders and associates are using common language – talking about justice and honoring diversity – and speaking to our mission of caring for those who are poor and vulnerable. They’re integrating deep themes and, when speaking about the patient experience, everyone is using the same language.”

Deborah Simmen, System Vice President of Ministry Formation

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Aligned & Empowered Organization

Looking within: surfacing innovation from the front lines When describing how SCL Health approaches innovation, Peter Kung, Vice President and Chief Innovation Officer, says it best: “Innovation isn’t something situated on the edges of our organization; it’s become embedded so deeply throughout SCL Health that it’s part of our DNA. We know the best ideas come from the teams at the forefront of delivering patient care. We encourage every associate to actively participate in advancing innovation by surfacing their ideas – and there’s been no shortage of them.”

Over the past few years, SCL Health has implemented 15 enterprise initiatives, dozens of pilot programs and has launched several organization-wide innovation challenges. The annual Innovation Challenge identifies, initiates and deploys high-value ventures from associates to improve the access and experience of the patients and communities we serve. In 2019, contestants focused their creative efforts on improving the care for our Medicaid and Medicare patients. Out of 57 submissions, 20 finalists emerged, and five teams competed in a “Shark Tank”-style pitch for the chance to win up to $250,000 to fund their ideas.

“ The best ideas come from the front lines, and we are committed to creating room and space for our associates to do that. That’s exactly the purpose of the Innovation Challenge.”

Peter Kung, Vice President and Chief Innovation Officer

Three teams were selected as winners of the 2019 Innovation Challenge: Team: Open.Oncology – Brad Schuller, PhD, DABR Idea: A project that creates videos to communicate and educate patients about the care process and appointment time with providers to help patients navigate the complexity of their care.

Team: Project 4th Trimester – Courtney Evans, MOT, OTR/L; Katie Halverstadt, RN, BSN, IBCLC; Sarah Kuenne, BSN, RNC-OB, CPLC Idea: A project focusing on providing resources dedicated to the physical and mental wellness of mothers after they deliver a newborn at one of our facilities.

Team: MedSherpa – Claire Overturf, Doug Malcolm, PharmD, Julie Lindsay Idea: A project focused on providing patients with an understanding of what medications have been prescribed to them and assisting them with ensuring that they take the right medications at the right time, through the support of resources such as a pharmacy advisor and digital toolkit.

A common theme of care navigation emerged from the winning teams’ projects, and these teams continue to partner to support care navigation across SCL Health.

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2020 Awards When seeking where to go for medical care, awards and recognition can help determine which hospitals and healthcare systems are known for safe, quality care and clinical excellence – and what sets them apart. SCL Health is steadily gaining a national reputation for an ongoing commitment to safety, excellence and innovation. This includes national recognition for having some of the best hospitals in the country, among other honors for high scores in quality and patient safety.

Leapfrog Hospital Safety Grades:

Newsweek:

Lutheran Medical Center, Saint Joseph Hospital, St. Vincent Healthcare, St. Mary’s Medical Center and St. James Healthcare all received “A” grades, and Good Samaritan Medical Center earned a “B” grade from Leapfrog Hospital Group in spring 2020.

Newsweek’s 2020 World’s Best Hospitals list included Good Samaritan Medical Center and St. Vincent Healthcare, for the second year in a row.

Healthgrades: Lutheran Medical Center and Good Samaritan Medical Center were each named one of America’s 50 Best Hospitals™ by Healthgrades in 2020, placing them in the top 1 percent of hospitals in the nation for the second year in a row.

U.S. News & World Report: U.S. News Best Hospitals 2019-2020 list ranked St. Vincent Healthcare the #2 hospital in Montana. Saint Joseph Hospital was recognized as the #5 hospital in Colorado and the #4 hospital in Denver.

St. Mary’s Medical Center was named the #6 hospital in Colorado.

Saint Joseph Hospital was named one of America’s 250 Best Hospitals™ by Healthgrades in 2020.

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Aligned & Empowered Organization

Going above and beyond to live the brand promise we make to our patients What does it mean to “live” a brand? Our mission, vision and values are the compass guiding our healing ministry through the delivery of excellent patient care. We see the person (and their loved ones) behind the patient during each and every interaction.

From practicing small acts of kindness to going well beyond what is expected, SCL Health associates bring our mission and our brand to life every day in their interactions with patients and their families. SCL Health asked associates to nominate their peers who truly live our brand by going above and beyond. The three stories below are just a few examples of the incredible experiences our caregivers provide to our patients every day.

See the video “Living Our Brand.”

Visit: sclhealthreport.org

Empowering new moms with compassionate guidance Having a baby is a joyous – and exhausting – event. In those early hours and days, new mothers face a quick learning curve when figuring out how to care for their newborn.

It can feel overwhelming if things don’t go as planned, especially when trying to breastfeed.

Jenna Merlin, who gave birth at Lutheran Medical Center, leaned on the caring support and expert guidance of Katie Halverstadt, Registered Nurse Lactation Specialist, when she struggled to breastfeed.

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“By being who she is, she makes you feel comfortable to ask the questions you didn’t necessarily know how to ask, and she holds a space for you that is very informative and calming and makes you feel like, wherever you are on your journey, she’s going be right there with you,” Merlin says.

Halverstadt is passionate about creating a comfortable environment where mothers can take whatever time they need to learn breastfeeding techniques without the fear of judgment.

“The best part of my job is watching moms grow: when I see them going from step A to step B, from week one to week two, and really finding that sense of empowerment and sense of self. When I see them trusting their instincts and learning how to take care of their babies,” Halverstadt says.

Creating deep connections from small acts of kindness Hospitalization can be an isolating time. Patients find themselves distanced from the comforts of home and may not have any loved ones to visit them. Small acts of kindness from caregivers can open the door to deep and meaningful patient connections.

When Star Morris, Registered Nurse at St. Vincent Healthcare, learned that drawing was important to one of her nonverbal patients, she made sure to get him the materials he needed to express himself.

“Star always goes out of her way to make a difference for patients. She loves to find little personal things that she can do for people, just to make them feel happier or make them have a better experience,” says Kelly Kaufman, Nursing Operations Manager.

Morris’s patient showed her a picture of his daughter, whom he had not seen in decades; so she tracked her down and was even able to reconnect the family.

“The daughter was just overcome; I mean she just cried and said thank you and just that she couldn’t thank Star enough for what she had done,” Kaufman says.

Morris says the meeting left a lasting impact on her, as well.

Offering more than a helping hand Hospitalizations are difficult for families. And when your loved one is receiving care far from home, it’s stressful – even more so if you don’t have reliable transportation to and from the hospital.

When Ernie Angwin, Respiratory Therapist at St. Mary’s Medical Center, learned that the wife of a patient in his critical care unit was stuck at the hospital, 100 miles from home, because her car broke down, he knew he had to do something.

“Ernie came out on his day off, got her car keys and took the car to the mechanic to get it fixed and paid for it out of his pocket,” says Connor Hardy, Respiratory Manager. “That was incredibly generous in and of itself, but the gift that his efforts gave this family I think is more incredible.”

For Angwin, his selfless act was just the right thing to do.

“I just love to help people and she was in need,” he says. “There was really no other way for her to be able to go back and forth to take care of her husband. There wasn’t a question; it was just something that needed to be done, so I did it.”

“It’s a story I will never forget,” she says. “I’m very honored that I was recognized, but I also want to recognize that we all work together as a team.”

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Section 1 | Our Strategic Imperatives

Cl inical & l O Tr p e r a atio n io n an sfor m at

G r ow t h

Expanding the reach of our healing mission based on the unique needs of each community we serve remains at the heart of SCL Health’s focus on growth. We continue to seek out new and creative opportunities to ensure that more individuals – especially those who are poor and vulnerable – experience safe, compassionate, high-quality care. We do this in many ways, including forming strategic partnerships with organizations that share SCL Health’s vision and values, expanding services, improving technology, and by providing more opportunities for care closer to home.

A li g e d C lin n a n ici Netw ork

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Growth

“ It is a beautiful facility, all fully equipped to care for individuals with a wide spectrum of neurologic and orthopedic conditions.”

Steve Loveless, President of St. Vincent Healthcare and SCL Health Montana

New inpatient rehab hospital opens as part of St. Vincent Healthcare’s unique partnership The Rehabilitation Hospital of Montana, located in Billings, Montana, opened its doors in August as part of a unique partnership between St. Vincent Healthcare, Kindred Healthcare and Billings Clinic. While it may seem unusual for competitors to pursue a joint venture, the three organizations were united by a shared desire and commitment to address the growing needs of a region that had previously been underserved.

“The Rehabilitation Hospital is a great example of pursuing growth by way of partnerships and perhaps partnering with an organization you may not have normally thought of in that process,” says Steve Loveless, President of St. Vincent Healthcare and SCL Health Montana.

The new 34-bed freestanding inpatient rehabilitation hospital, the first of its kind in the state, treats patients who are recovering from conditions such as stroke, traumatic brain injury and spinal cord injury so they are best prepared to return home.

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St. Vincent Healthcare partnership helps keep pediatric surgery patients close to home St. Vincent Healthcare in Billings, Montana, began offering pediatric surgery services in 2019 as part of an expanded partnership with the Intermountain Primary Children’s Hospital and the University of Utah’s School of Medicine.

The agreement further builds on St. Vincent Healthcare’s long history of providing pediatric care to children of Montana and surrounding areas for more than a century. By pairing with prominent pediatric surgeons, St. Vincent Healthcare’s youngest patients benefit from access to advanced surgical care close to home.

“ We are thrilled to join forces with the Intermountain Primary Children’s Hospital and the University of Utah’s School of Medicine.

In an effort to exceed expectations for quality healthcare for our patients and communities, we believe that offering pediatric surgery to some of our most vulnerable patients is one way we fulfill our mission.”

Michael Skehan, Chief Operating Officer of St. Vincent Healthcare

At St. Vincent Healthcare, the surgical services team performs surgery on newborns and youth to address a host of pediatric conditions, including birth defects, gallbladder disease, tumors and gastrointestinal issues.

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Growth

St. Mary’s Medical Center offers “new dimension” of heart and vascular care to Western Colorado The opening of the new Heart & Vascular Institute at St. Mary’s Medical Center in Grand Junction, Colorado, brought neverbefore-available technology and specialists to the region, including advanced imaging equipment and innovative, minimally invasive procedures.

The 46,000-square-foot facility serves an area roughly 150 miles in radius and represents a significant step forward for patients challenged with cardiac and vascular issues.

“This facility cannot be compared to anything we have here, in terms of its capabilities. It’s not just a new surgical suite, it’s a whole new dimension of care for the people of Western Colorado and Eastern Utah,” says Grant Wicklund, President of Western Colorado and Lutheran Medical Center.

The Heart & Vascular Institute provides superior diagnostic, interventional, medical and surgical services closer to home.

New capabilities include heart valve implants that can reduce patient discomfort, shorten recovery time – and can even be an alternative to open heart surgery in some cases.

It is equipped with a hybrid operating room, three heart catheterization labs, one electrophysiology lab, 10 cardiac short stay medical suites, seven cardiac testing rooms, nuclear medicine, a radial lounge and even a 1,500-square-foot cardiac rehab gym.

Thanks to the new specialized heart and vascular care options available at the Institute, individuals in need across Western Colorado will benefit from lifesaving care and a better quality of life.

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Lutheran Medical Center’s enhanced neurology services improve stroke, trauma care Lutheran Medical Center has been working for several years to expand its neurosciences services and capabilities, including stroke care and neurosurgery.

These efforts have led to the growth of this priority service line and additional recognition for the specialized neurology care Lutheran Medical Center provides along the Front Range.

In 2019, Lutheran Medical Center was designated a Comprehensive Stroke Center by DNV GL-Healthcare. The certification means Lutheran Medical Center’s caregivers achieved the highest level of skill to treat serious stroke events and are able to provide 24/7 advanced stroke care for the most complex cases across the full spectrum – from diagnosis and treatment to rehabilitation and education.

Lutheran Medical Center has invested significant resources to advance stroke care in the community, leading to national recognition for positive patient outcomes.

Lutheran Medical Center offers some of the fastest treatment times in metro Denver, as well as several advanced programs and technologies to care for those experiencing strokes. In addition, these programs and technologies allow for improved diagnosis and treatment for various neurological disorders.

“As a Primary Stroke Center for more than 10 years, Lutheran Medical Center has gradually increased its capabilities to care for serious stroke cases,” says

Grant Wicklund, President of Lutheran Medical Center.

“Comprehensive Stroke Certification reflects a team effort of our neurosciences service line, the entire hospital and our community partners to ensure the health and safety of our patients.”

The certification from DNV GL-Healthcare, a Centers for Medicare and Medicaid Services-accredited certification organization, is based on standards set forth by the Brain Attack Coalition and the American Stroke Association.

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Section 1 | Our Strategic Imperatives

Aligned C l i n i c i an Network

Cl in l & T r O p e r i c ao n a l n ati a n sf o r m atio

At SCL Health, providers play a critical role in the success of our ministry, and ensuring that we have a strong, aligned network of caregivers is imperative. We remain focused on delivering the best experience for our physicians and advanced practice providers, growing our network of primary care and priority specialists, implementing systems, and enhancing our continuity and coordination of care. We’re doing this by giving our care providers tools to increase resiliency, reduce burnout, build their leadership skills, make stronger connections to our culture and mission, and improve their workflow.

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Aligned Clinician Network

Inspiring connection, collaboration and leadership We know that when our providers are connected to their purpose, they perform at their best. In turn, their patients are healthier and happier. We want providers to see our clinics as their home for their careers, as a place where they can realize their professional goals and feel the satisfaction of dedicating their lives to caring for others.

SCL Health is devoted to the growth of providers as clinicians and leaders, and we value their satisfaction and experience. Last year, SCL Health Medical Group introduced three new programs dedicated to helping our providers grow in all areas of their practice:

“ We know that happy providers equal happy patients, and that’s been shown over and over and over again.”

Scott Sears, MD, Medical Director, Primary Care, SCL Health Medical Group in Billings, Montana

Clinician Experience Project The Clinician Experience Project is an app-based, interactive, multimedia learning platform that was made available to providers across SCL Health. The app promotes clinician education, resiliency and connection to joy and purpose.

“SCL Health is invested in providers. We recognize that the patient is really the reason we all go into healthcare, because we want to help people. However, those who are delivering that healthcare also need to be cared for,” says Scott Sears, MD, Medical Director, Primary Care, SCL Health Medical Group in Billings, Montana.

“The Clinician Experience Project helps reconnect you with purpose, and the little things that you do every single day can bring you joy in that day’s work.”

The app offers coaching on skills that include: • Clinical leadership development to bring out the best in others and facilitate impactful change.

• Connecting with patients to improve their experiences.

• Team collaboration with the goal of improving patient outcomes.

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Leadership Development for Physicians/Clinicians SCL Health clinical leaders play a key role in influencing the engagement of staff, colleagues and team members, and actively help define our culture.

To support the continued growth of their leadership skills, the Leadership Development for Physicians/Clinicians Program was introduced in 2019.

Across the system, 48 providers were nominated to participate in the eight-session program, with 29 providers beginning in 2019. The course work helps develop additional skills needed to lead compassionately and effectively. Simply put, there are benefits for everyone involved: Patients are more satisfied because they receive better care from happier doctors who find greater meaning in their work.

Conscious Physician Leadership Program for Providers The Conscious Physician Leadership Program was created as the next step to build on the learnings shared in the Leadership Development for Physicians/ Clinicians Program, with the ultimate goal of helping providers gain skills in four key areas: • Leading self • Leading others • Leading change • Leading the organization At the end of the six-month program, participants will have tools to help them navigate the demands of healthcare and foster better self-care and resiliency. Most important, these tools will help providers continue to deliver exceptional patient care.

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Aligned Clinician Network

Innovative clinic design benefits providers and patients In 2019, we opened three new primary care clinics and a sports medicine clinic along the Front Range, all featuring a new, standardized design that is centered on the patient and provider experience.

In designing the new clinics, clinic space was rebuilt and optimized to produce the highest-quality patient experience and promote teamwork and efficiency across the care teams. How patients enter the clinics and how the clinical teams interact with patients – and each other – within the care environment was also redesigned. The clinics feature flat-screen monitors in all exam rooms, exam room recliners and a more modern look that still feels comfortable and welcoming.

“The new design brings the patient and the clinical team together, and we all know that really great communication allows for better care,” says Marcela Serrano, MD, family medicine provider at SCL Health Medical Group – Superior. “I enjoy how quickly I have access to my staff, because it really makes it a more cohesive group and it’s easy to find each other. Patients have responded extremely favorably.”

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New clinics and expanded services As we continue to increase capacity at SCL Health to better serve communities, several new primary care and family medicine clinics opened in 2019 in Colorado and Montana, while some clinics in the Denver area relocated and expanded their services:

New clinics • SCL Health Medical Group – Superior (Family Medicine & OB-Gyn)

Relocated, expanded clinics • SCL Health Medical Group – Cherry Creek • SCL Health Medical Group – Denver West • SCL Health Medical Group – Denver Sports Medicine

When convenience and choice is just a click away: Technology helps expand our reach To better serve our patients, we consider each new project with one question in mind: “Will this innovation benefit our patients and providers?” From this perspective, we thoughtfully adopt innovations designed to expand access to care, deliver safe and effective outcomes, foster a positive experience and make care more affordable.

MyChart SCL Health’s MyChart online patient portal helps patients take an active role in their healthcare by providing a range of patient resources, including access to personal medical records and the ability to email and communicate with a provider straight from the tool.

Online Scheduling and eCheck-in Offered through MyChart, online scheduling and eCheck in tools provide a convenient time-saving way for patients to schedule appointments and check in for their appointments – anywhere, anytime.

This also cuts down on paperwork and waiting room lines.

Electronic Reminders SCL Health sends email or text reminders to patients three days before appointments to decrease missed visits.

Virtual Visits Virtual visits allow a patient to receive non-emergency medical care with an SCL Health doctor through video chat – even after hours. Patients who use this service will receive a quick

diagnosis, care instructions, and even a prescription when appropriate.

Epic SCL Health utilizes the Epic electronic medical records platform to streamline recordkeeping system-wide and ensure that vital medical history records follow patients to all appointments.

OpenNotes As part of an international movement to make healthcare more open and transparent, OpenNotes enables doctors to share progress notes with their patients, empowering patients to take control of their health and ensuring that both are in agreement with the plan of care.

Innovative Pharmacy Programs & Tools SCL Health Medical Group has redefined where and how we offer our pharmacy services. In moving beyond the traditional dispensing pharmacy, our pharmacists and advanced practice technicians now offer personalized services and advocacy directly within our clinics.

Pharmacists and Technician Integration Pharmacists and technicians are embedded into primary and specialty clinics, allowing them to offer onsite consultations and medication monitoring to expand patient education and improve medication compliance.

MyChart Electronic Prescription Refills Patient portal allows patients to send a secure prescription renewal request to their provider from a variety of online devices anytime, anywhere.

Pill Planner Home Delivery Medications are sorted by dose, prepackaged for each day and delivered every month directly to patients’ homes in convenient packaging to help patients who have transportation challenges and those needing extra assistance.

Pill Planner, Colorado’s first health-system-based compliance packaging program, ships dailydose medication packs to Colorado patients’ homes.

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Section 1 | Our Strategic Imperatives

Clinical & ratio Opeformanal tio an s r n T

A li g e d C lin n a n ici Netw ork

Healthcare continues to undergo rapid changes, with hospitals and healthcare systems everywhere feeling a number of very real pressures. This is also a time of great opportunity to take new approaches to operations and delivery of care to patients. The next version of the SCL Health strategic plan was designed to do just that.

It will help guide the way we advance and change patient care, operations and cost structures to make healthcare better and more affordable.

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Clinical & Operational Transformation

Last year, Jennifer Alderfer, President of Good Samaritan Medical Center, was selected to lead this effort and build a diverse and experienced Clinical and Operational Transformation Team across the system. Fortunately, there is no shortage of creative ideas, expertise and energy to advance this work. Several new care delivery and operations approaches have already been identified and put into place to help eliminate waste, reduce costs and create better ways to do things across our ministry – all to benefit care teams and patients.

Breaking down silos to enhance surgical care and recovery Across SCL Health, more than 47,386 surgeries were performed in 2019. And for every surgery performed, patients typically interact with 80 caregivers during their medical experience. To ensure surgical patients receive the best outcomes from their procedures and have the best chance to return back to their normal lives, we must continue to evolve our delivery of care and focus on the whole team and process, not just the surgeons and the surgery. This work begins before surgical patients come into the hospital and will not end until they fully recover.

This model of care is called Enhanced Recovery After Surgery (ERAS) and focuses on using patient-centered, evidence-based approaches across multidisciplinary teams to address every phase of the surgical process for the benefit of the patient’s recovery.

“We need all of those 80 people to understand what the patient 26 | SCL Health

“ Traditionally, we have looked at each phase of care in isolation. This initiative allows us to look at the whole continuity of care and think long-term about the patients’ experience so that they will have a better experience in each phase of care.”

Ben Jagodzinski, MD, an anesthesiologist at St. Vincent Healthcare

Watch an online video of this story.

Visit: sclhealthreport.org

is going through from start to finish,” says John Eisenach, MD, Anesthesiology, Good Samaritan Medical Center. “When we each know what the other is doing, then we can understand and develop true empathy for what these patients are going through so that we can then standardize, streamline and optimize our care, which will then drive outcomes.”

Empiric Health partnership taps into big data to increase surgical efficiency, quality The Clinical and Operational Transformation Team embarked on an additional initiative: They partnered with analytics leader Empiric Health in 2019 to help SCL Health surgical teams improve their surgical outcomes and lower patient costs. Teams now have access to thousands of data points, expanded through the use of technology, like machine learning and artificial intelligence. This helps surgeons identify ways to improve efficiency and quality for all phases of surgical procedures by using the data to help make decisions.

“The data made available through Empiric Health assists our providers in overcoming the traditional problem of surgical-data variation due to individual patient differences,” says Simon Payne, MD, Chief Medical

Officer, Clinical and Operational Transformation, for SCL Health. “Openly sharing data that our providers and surgeons trust affords us a tremendous opportunity to evaluate variability, to continue our commitment to enhancing our quality excellence – including improvements in surgical quality and perioperative efficiency – and to ultimately reduce surgical cost.”

Good Samaritan Medical Center and St. Mary’s Medical Center were the first two hospitals to begin using Empiric Health’s data, with plans for additional SCL Health hospitals to go live with the technology over the next two years. The collaboration with Empiric Health is just one of the many ways SCL Health continues to find new solutions to transform how we bring high-quality and affordable care to our patients.

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Clinical & Operational Transformation

When timing is everything: Length of stay optimization improves patient outcomes, experience It may seem counterintuitive to think shorter hospital stays could lead to better patient outcomes and reduced costs, but that’s exactly the case. Efficient care translates to high-quality care because it reduces risks for hospitalacquired conditions (a medical condition or complication a patient develops during a hospital stay), returning to the hospital – and even death. In addition to health risks, the longer a patient stays hospitalized, the greater the overall cost of care.

Optimizing length of stay requires careful planning and a team-based approach focused on continuity of care (the quality of a patient’s care over time). Across SCL Health, length of stay optimization has been set as a top initiative to provide the best possible experience for patients and to support the best use of our resources.

“When we align our initiatives around length of stay, we’re closely looking at readmissions and to the things that might not equate to a safe discharge,” says Kathy Crabtree, MD, at Lutheran Medical Center. “I think our care sites are doing a great job of pulling that all in.”

Improving the hospital discharge process Patient surveys have regularly pointed to hospital discharge as an area where we could do better – and SCL Health is working hard to do just that. One of the ways we’re doing this is through better care coordination among people and processes when we discharge each patient, ensuring collaborative communication and a safe and timely departure when patients are ready to leave the hospital.

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Lutheran Medical Center created a Discharge Navigator Program for each of their clinical units, which includes multidisciplinary huddles each morning and afternoon.

Following their lead, five other SCL Health hospitals developed their very own program in 2019. Discharge Navigators help patients get home – or to the next point of medical care – comfortably, safely and without unnecessary delay. And that makes for healthier, happier patients.

SCL Health delivers cutting-edge cancer care with precision We’ll never stop searching for new ways to advance person-centered care and transform the experience for our oncology patients. Precision oncology, which uses information from a person’s genetic profile to help drive treatment decisions, is just one way we do this.

Through a partnership with Strata Precision Oncology Network, we now offer our patients treatments specifically designed to target their unique form of cancer. Eligible patients benefit from the comprehensive treatment program for personalized cancer care at no additional cost. This includes routine testing, rapid interpretation of test results and the ability for patients to participate in clinical trials.

“As our understanding of cancer becomes more complex, the advent of targeted therapies and immune-based therapies allows us to look at the genes that drive cancer. This has led to a whole new class of medications that enable us to treat cancer in a more precise way with potentially fewer side effects,” says Alan Miller, MD, Chief Medical Director of Oncology and Associate Chief Medical Director of Clinical Research for SCL Health.

SCL Health is one of only two health systems in Colorado and the only health system in Montana to be part of Strata Precision Oncology Network.

“ As our understanding of cancer becomes more complex, the advent of targeted therapies and immunebased therapies allows us to look at the genes that drive cancer. This has led to a whole new class of medications that enable us to treat cancer in a more precise way with potentially fewer side effects.”

Alan Miller, MD, Chief Medical Director of Oncology and Associate Chief Medical Director of Clinical Research for SCL Health

2020 Report to the Community | 29

SEC TION 2

How We Give Back to Our Communities

30 | SCL Health

Section 2 | How We Give Back to Our Communities

I NVES TM E NT BAC K I NTO OU R CO M M U N ITI ES – COM M U N IT Y B E N E FIT SCL Health remains faithful to the charitable spirit of our Founders, the Sisters of Charity of Leavenworth, by addressing the most important health-related needs of the communities we serve, especially for those who are poor and vulnerable. In keeping with our mission, nine cents of every dollar SCL Health earns is reinvested back into our communities. Our community benefit programs and partnerships are driven by a Community Health Needs Assessment conducted in each community. These assessments help identify the most pressing health challenges facing communities to ensure support is deployed in the most effective way possible. Our programs include free and discounted healthcare services, partnerships with other nonprofits to address social determinants of health like food security and housing, and mental health resources, among many others. By dedicating resources to address these needs, we believe meaningful and lasting change can be created in communities and bring the SCL Health mission to life through action.

2020 Report to the Community | 31

Communit y B e nef it

Helping older adults age well Coloradans are living longer than ever, and the aging population is rapidly growing. It is projected that residents age 65 and older will top 1.2 million by 2030, a jaw-dropping 125 percent increase since 2010. With these shifting demographics in mind, older adults (and their caregivers) need skills and resources that support their overall wellness and quality of life – especially those in underserved populations.

“Through our community health needs assessment, we identified several priority areas and opportunities to address the complex health issues related to aging,” says Gaye Woods, SCL Health System Director of Community Benefit.

In a grant partnership with the National Council on Aging (NCOA), SCL Health brought the Aging Mastery Program to Colorado’s Front Range. NCOA’s evidencebased program is penned as a “playbook for aging

well,” and includes 10 weeks of classroom or self-guided curriculum. Topics covered in the program include exercise, sleep, healthy eating, financial fitness, advance planning, healthy relationships, medication management, community engagement and fall prevention.

“Last year, falls were the second most common reason Colorado seniors visited a number of SCL Health emergency departments,” Woods says. “We want to support decreasing health risks that are preventable by helping people change their behaviors.”

Community partners Metro Caring, Meals on Wheels, Brighton Senior Center, and the Alzheimer’s Association, along with several other organizations, served as host sites for classes.

Woods says the program was “collaborative and very well-received by our participants,” and is already expanding to more locations for 2020.

2019 STATS | AGING MASTERY

514 80% 98% 32 | SCL Health

participants (234 in core class, 262 self-guided, 18 in caregiver class) completed all weeks of the class would recommend class to a friend

93% 79% 12%

rated that it helped them to better manage their health rated that it helped to strengthen financial decisions (e.g., advanced-care planning) of SCL Health patients are age 65 or older

Community Heart Print opens new doors for associate volunteerism There is no doubt that SCL Health associates have heart. And many live the mission outside their everyday service at work by doing good in their communities on their own time.

“We were receiving so many requests from associates for volunteer service opportunities that it was becoming hard to respond to all of them,” says Gaye Woods, SCL Health System Director of Community Benefit.

“To answer their call and illuminate the caring spirit and collective impact our associates have in our communities, we created a program to help associates identify, participate in and even track their volunteer service.”

The program, named Community Heart Print, launched in 2019 and is powered by the online platform KyndHub

by Project Helping, a nonprofit working to impact community members living with mental-wellness challenges.

The online platform allows users to view and select volunteer opportunities with multiple nonprofits and 2019 STATS | COMMUNITY HEART PRINT

5,362

associate volunteer service hours

Top causes supported: social services, youth programs, food security, and nonprofit board service

$20,000

1,500

donations to charities Kynd Kits created for members of the community

causes; and SCL Health can create organizational service opportunities, challenges, and team service activities as well.

One of the first events held as a part of the Community Heart Print program was a service activity focused on honoring Mental Health Month. Approximately 250 associates gathered at the Broomfield system office to create gratitude kits for veterans, called Kynd Kits, and activity and educational kits for kids in need.

“Our goal is to use KyndHub to impact individuals and the community at large. Last year was a soft launch, but we’ve already seen a lot of excitement and impressive momentum,” Woods says. “This program really intersects with our focus on mental health, because it returns so much to the individual who is giving. It’s true when they say the giver gets as much as the receiver.”

2020 Report to the Community | 33

34 | SCL Health

Section 2 | How We Give Back to Our Communities

AD D R ESS I N G SOC IAL D E TE R M I NANTS O F H E ALTH – PROG R A M M ATI C S U PP O R T The environments in which we live, work, learn and play impact our health risks and outcomes. This includes factors such as economic stability, education, social and community environment, food security, housing and transportation. SCL Health addresses these factors, or social determinants of health, by continually evolving approaches to community benefit and health improvement investments. Now more than ever, it is important to work with stakeholders across multiple business segments to solve pressing issues. This involves working with public health, community-based organizations and social support agencies so together we can make a bigger impact on the health of the people we serve. Last year, the SCL Health ministry made gains in addressing the root causes of poor health by focusing on social determinants of health, specifically food and housing security, as part of our effort to build a culture of health and overall well-being.

2020 Report to the Community | 35

Pro gr ammatic Supp or t

A Big Green impact on Mount Saint Vincent

Cultivating connection and community access to fresh food Fresh food nourishes the body, and the act of gardening can actually feed the soul. Through a collaboration with the Colorado chapter of Big Green, SCL Health is helping a vulnerable population grow their own food – and what’s being returned goes beyond fruits and vegetables. Big Green, a national nonprofit organization, builds learning gardens in schools across the country. Learning gardens serve as outdoor classrooms to connect kids to real food, leading to increased academic achievement, all while driving community engagement. A portion of SCL Health community benefit investments supported these projects to improve access to fresh fruits and vegetables, nutrition education and obesity prevention.

Last April, our investment helped Big Green build a learning garden at Brady Exploratory High School, an alternative school in Lakewood, Colorado, for students who have been unsuccessful in traditional school.

36 | SCL Health

Mount Saint Vincent’s school, which provides academic programming to students from pre-K through middle school, received a learning garden in 2019. The garden was built thanks to investments from Big Green, Leprino Foods Company and Mount Saint Vincent’s Board of Directors. The garden serves children in the residential program, where they receive intensive services after surviving extreme trauma, abuse and neglect.

With help from SCL Health, Brady High School Learning Garden was built in April 2019. Brady High School is in Jefferson County with 400 students, 68 percent of whom receive Free and Reduced lunch.

Once the learning garden was constructed, Big Green’s team implemented their food literacy and nutrition programming for Brady’s students. They organized planting and harvest days, provided teacher workshop training and helped educators integrate the garden into their teaching. Brady uses learning gardens to focus on overall health, including an emphasis on mental health and wellness programs.

The garden not only serves Brady’s students, where 72 percent of students receive free and reduced lunch services, but also serves their families and the general community.

“With such a transient population, families are rarely able to have their own gardens or grow fresh produce.

Because of these challenges, the young generation in this neighborhood does not have access to any sort of enrichment or education around healthy eating and nutritional well-being. The garden is a long-term education opportunity, and I suspect it will have an amazing impact on our students,” says Angelina Valvona-Herndon, Lead Teacher at Brady High School.

The garden was maintained throughout the summer and fall of 2019 by students, parents, teachers and community members. During the summer, volunteers harvested a variety of fruits and vegetables – including corn, pole beans, squash, and salad and salsa vegetables – providing healthy food to the community. When school started back in the fall, more than 30 pounds of produce were harvested for the school. Big Green will ensure Brady’s learning garden can be harvested for at least two full growing seasons each year.

Tapping into creativity and collaboration to address housing security Across SCL Health, work is underway to create collaborative solutions to provide housing security to the most vulnerable members of the communities we serve.

Breathing new life into an old building to house senior citizens The Saint Joseph Hospital campus in central Denver is now home to Tammen Hall Apartments. The former nurse dormitory was built in 1932 and sat vacant on the campus for more than a decade. After an extensive renovation of the building, 49 units opened in September 2019 and now houses low-income seniors. The units are situated close to our medical facilities and offer nearby access to grocery stores and transportation.

“This project is a triple win. We preserve a historic building, create affordable housing for seniors and enhance our

community,” says Jamie Smith, President of Saint Joseph Hospital.

In addition to SCL Health’s financial investments in this project, a combination of federal and state tax credits for historic preservation and low-income housing, contributions from the Neenan Company and a loan from the Denver Office of Economic Development, helped make these apartments a reality.

2020 Report to the Community | 37

Pro gr ammatic Supp or t

New approach to affordable housing helps the elderly stay at home Good Samaritan Medical Center in Lafayette, Colorado, collaborated with Flatirons Habitat for Humanity and the Community Housing Development Organization to address the affordable housing crisis for the elderly who want to stay at home as they age. The investment helped make possible the purchase of land in an area formerly known as the Glory Community in Broomfield and the development of Cottonwood Cooperative Independent Living Home, which opened in 2019. The independent living home features eight single rooms (four of which are handicap accessible) for individuals 55 or older whose income is at or below 80 percent of the area median income. Residents have their own private space and share a common area that includes a kitchen, living/dining room, library and community

garden. This unique living arrangement helps residents be part of something beyond simply renting an apartment: They belong to a community.

Sheltering homeless college students Lutheran Medical Center is actively involved in a groundbreaking collaboration with The Action Center, STRIDE and Red Rocks Community College to address student housing insecurity. At Red Rocks Community College alone, 46 of the students enrolled in 2019 were homeless.

This number only accounts for students age 24 and younger. Thanks to investments from the collaboration, The Action Center’s homeless shelter in Lakewood, Colorado, which closed in 2017 due to lack of funding, reopened in 2019.

38 | SCL Health

When it reopened, it was transformed into temporary housing for Red Rocks students. The center can house up to 12 students each semester, which in addition to bedrooms features a kitchen, laundry and study area, and includes internet access. As part of the program, students who qualify also have access to educational scholarships, a mobile health van and mentoring/ shadowing opportunities. Now these students are able to focus on their education and preparing for their future without worrying about not having a place to live.

Housing and mental health support for Butte’s chronically homeless takes strain off community-based services People experiencing chronic homelessness in Butte, Montana, often turn to St. James Healthcare’s Emergency Department or commit petty crimes to land themselves in jail – just to have someplace warm and safe to lay their heads. These acts of desperation add up: In one year, 19 individuals cost the hospital, local corrections and the overall Butte community around $1 million in expenses.

A collaborative approach was desperately needed to improve health outcomes and reduce the community-wide shared cost of providing emergency housing to this population. The Montana Healthcare Foundation awarded St. James Healthcare a $100,000 implementation grant in 2019 Margie Seccomb, Chief Executive Officer of Action Inc., and Kevin Dennehy, Vice President to bolster the Butte-Silver Bow Supportive of Strategy and Business Development at St. James Healthcare Housing Development Project. This project is a coalition of community organizations in Butte working to through various support systems, whether through create housing solutions and provide case management bridge housing or housing voucher programs. assistance for the homeless community frequently using public services.

“What we hope to see is that we have permanent housing for a number of these people, so they are in a The grant builds on $80,000 in initial funding St. James stable permanent house where they are getting services Healthcare received from the Montana Healthcare they need to live happy and healthy lives,” says Vice Foundation in 2018. Those funds were used to identify President of Strategy and Business Development for St. regular users of public services in Butte, study their James Healthcare, Kevin Dennehy. economic impact and estimate the potential savings to the community if those individuals had access to The 2019 funds went toward training existing community permanent housing. agency staff to develop initial supportive housing services and provide permanent mental health case management Since the completion of the first phase of the and comprehensive health and mental health services for collaborative project, six of the 19 people identified to the individuals who rely on this program. be in need of these types of services have been housed 2020 Report to the Community | 39

40 | SCL Health

Section 2 | How We Give Back to Our Communities

I M PAC T O F PH I L ANTH RO PY Philanthropy is at the heart of all we do at SCL Health. As a faith-based nonprofit healthcare system, we are called to give of ourselves, our time and our possessions to those in our community who are in need.

Our foundations engage and connect donors to our programs and initiatives, which are aimed at saving lives and improving the health of the communities we serve. Gifts to SCL Health Foundations, which serve as an extension of our mission, equip us with essential resources needed to provide compassionate care and support to as many individuals as possible. Across our foundations, we see the amplified power of our communities’ generosity to build or renovate facilities, to improve patient care, to buy lifesaving medical equipment, and to implement programs that improve patient health and change lives.

$

more than

more than

17.3 12.3 940 9,900 million million thousand $

$

donors

Raised in contributions and Planned Giving commitments in 2019

Transferred to our hospitals

Secured in Caring Spirit Associate Giving Campaign commitments

Made a gift in 2019

2020 Report to the Community | 41

Imp ac t of Philanthropy

Creating healing spaces for children It can be scary for children to go to the hospital, especially if they are being treated in an environment that feels cold and sterile. In fact, research shows that child-friendly spaces within medical settings help address emotional needs, stimulate learning and comprehension, and reduce stress. Focusing on emotional needs ultimately and positively influences healing; it can even decrease the need for additional sedation or pain medication and could even decrease a young patient’s length of stay.

Children who receive care in the pediatric unit at St. Mary’s Medical Center in Grand Junction, Colorado, can now enjoy special spaces created just for them – and they have another young person to thank for it.

Micah Montag, a former patient of St. Mary’s Medical Center, was only 10 when he succumbed to an aggressive brain tumor in 2014. His family and friends created a pediatric endowment in his name to honor his memory and make sure all children who come to the hospital receive excellent care in a space designed with the whole child in mind.

The endowment has raised $1.3 million since it was founded in 2014, with $500,000 allotted for remodeling the pediatric unit, including its waiting area, playroom, and nursing station. The playroom, which was converted from a family waiting area, now contains a television, movies, books and plenty of toys to keep little ones entertained.

42 | SCL Health

“This makes it a less clinical and more comfortable place where they can still be kids,” says Karin VanMeter, pediatrics nurse manager at St. Mary’s Medical Center.

“One of the big things is creating spaces where children are comfortable and feel they belong.”

This is only the beginning; the unit renovation was the first phase of a three-phase project. Work has already begun to construct a new outdoor play space and additional child-friendly spaces, including an ER waiting area and two emergency rooms.

Funds from the endowment have also supported additional equipment needs, pediatric education and training for hospital staff, and community education surrounding the identification and treatment of child abuse.

Platte Valley Medical Center Ambulance boosted by grant Platte Valley Medical Center Ambulance Services is improving access to emergency medical response services with the addition of two new ambulances, thanks in part to a grant from the Adams County Foundation and support from the community.

A two-year campaign raised more than $309,000 to fund the purchase and build-out of the ambulances, which will help meet emergency needs of residents in the rapidly growing Adams County area.

“ We are proud to serve.

We are ready. We’ll be here for you when you need us.”

Carl Craigle, Director of Ambulance Services for Platte Valley Medical Center

“We are exceedingly grateful to the Platte Valley Medical Center Foundation Board and to all those who donated in order to provide another safe, well-designed ambulance to our growing fleet of state-of-the-art emergency vehicles,” says Carl Craigle, Director of Ambulance Services for Platte Valley Medical Center.

“Platte Valley Ambulance Services has provided prehospital patient care to our communities for the last 48 years,” he continues. “The support of our hospital foundation and our citizens has served to assure that our service can continue well into the future.”

The new ambulances are equipped with portable ventilators, ultrasounds, and IV pumps that can help EMTs provide life-saving prehospital intervention for true medical emergencies, such as heart attacks, strokes and traumas. This equipment is especially important for patients who live in more isolated parts of the region and face longer travel times to get to the hospital.

Platte Valley Medical Center Ambulance Services averages more than 6,000 medical emergency and trauma calls each year and serves a 1,000-squaremile region that also includes Brighton, Great Rock, Henderson, Lochbuie, Todd Creek, Wattenburg and Weld County.

2020 Report to the Community | 43

Imp ac t of Philanthropy

1,000 days to shape a life: St. James Healthcare pregnancy screenings surface risks, enable interventions When Lacey Salminen found out she was 11 weeks pregnant, she knew in that moment she needed to turn her life around. As an expectant mother with a methamphetamine addiction who had never held a steady job or had a permanent place to stay, she had a tough road ahead.

Women like Lacey are why Joslin Hubbard, Obstetrical Social Work Case Manager, and George MulcaireJones, MD, started the “First 1,000 Days of Life” program at St. James Healthcare in Butte, Montana.

What happens to a child during the first 1,000 days sets in motion their lifelong physical, emotional and relational health. Armed with the proper support, resources and education, women and families can Lacey Salminen is photographed with her baby, ensure that Raiden, and her boyfriend, Jimmy Starcevich, their babies will at their home in Butte. (Courtesy The Montana Standard, Meagan Thompson) be less likely to endure the same challenges they faced in their own childhoods.

“This is absolutely the most critical time in human development,” Dr. Mulcaire-Jones says. “It’s when the foundation of lifelong health is set in place.”

44 | SCL Health

Watch an online video of this story.

Visit: sclhealthreport.org The “First 1,000 Days of Life” program was made possible by a grant from the Montana Healthcare Foundation’s Meadowlark Initiative, which provides pregnant women and new mothers and their families with effective, supportive care for mental illness and substance use “ Pregnancy helps women disorders. The relook at life because initiative was created there is a life inside of in response to an you. But people still need increasing number of newborns testing a lot of support. We are positive for drugs hopeful that support at birth.

will help families get in a better place to parent and Beginning last year, end cycles of sadness and all pregnant patients who walked through trauma.”

the doors of St. James Healthcare Work Case Manager received a packet with information on the “First 1,000 Days of Life” and a 34-question healthy pregnancy screening survey. The pregnancy screening includes questions about physical, emotional, and relationship health, along with questions about alcohol and substance use and abuse.

Joslin Hubbard, Obstetrical Social

If any responses raise a concern, a social worker will make sure patients receive outreach and information on the services that could help them address the program’s three priorities: Make the womb safe, make the birth safe, and make parental-child attachments secure.

The screenings identified pregnant mothers who struggle with substance abuse, with the most common substances being methamphetamine, opioids and marijuana.

Patients addicted to opioids may be prescribed buprenorphine-based medications like Subutex and Suboxone by certified addiction treatment providers within the clinic. Mothers abusing methamphetamines or marijuana receive education about how the drugs are harmful, since approved treatments that address abuse of these chemicals do not exist.

Joslin Hubbard, OB and Pediatric Care Coordinator, stands with Danelle Petritz, RN, and Dr. George Mulcaire-Jones. (Courtesy: The Montana Standard, Meagan Thompson)

While drug addiction was a key driver in starting the program, patients with mental health conditions also receive treatment and support in the office. Integrating physical and behavioral health during IN 2019 | “FIRST 1,000 DAYS OF LIFE” PROGRAM

244 70

pregnancy screenings pregnant women identified at risk for substance use

SINCE PROGRAM BEGAN IN 2018

94%

of pregnant women in area now receive adequate care before they give birth, up from 83% in 2018

50%

decrease in babies testing positive for substances since program was founded

pregnancy and right after birth makes access to care easier for patients and helps combat the stigma against mental health services.

“Increasing communication between disciplines and the coordination of services is bridging the gap for women who suffer from addiction and mental illness.

We have seen trust replace fear, and more women are engaging in prenatal care because of the supportive, nonjudgmental environment,” says Vicki Birkeland, St. Vincent Healthcare Nursing Director, Women’s Services. “We have a better understanding of addiction during pregnancy and know that these mothers are more motivated to seek help. We are making a difference one woman at a time.”

2020 Report to the Community | 45

The power of giving: how one family’s history of philanthropy shaped healthcare in Billings Although philanthropists Philip and Mary Alice Fortin have long since passed away, the couple’s strong legacy of giving to St. Vincent Healthcare lives on today. The Fortin Foundation is based in Florida, but Philip, who died in 1982, had strong ties to Montana. The foundation has continued to invest in charitable causes benefiting the state and SCL Health spanning almost four decades.

The Fortin Foundation’s generous support, directed

by Mary Alice until her passing in 2007, has paved the way for new facilities and technology at St. Vincent Healthcare, leading to better care for thousands of patients in the region. The foundation contributed capital funds for the Fortin Lobby, New Hope Rehabilitation Center and the west wing of the hospital,

known as the Fortin Tower, as well as sponsorship of the annual Fortin Memorial Golf Tournament over the span of three decades.

The trustees of the foundation have a strong passion for children and share in the belief that the best care for children should be delivered close to home.

Multiple gifts have benefited the youngest St. Vincent Healthcare patients over the years, with the foundation’s benevolence changing the world of pediatric healthcare in Billings by creating a “one-stop” place of healing, specifically for children.

Contributions include annual Christmas gifts to children in the pediatric ward, funding for state-of-the-art equipment for the Newborn Intensive Care Unit, a $1 million donation to create the Fortin Regional Pediatric Specialty Clinic, and support for the general pediatric and pediatric intensive care units, each with a wing named in the foundation’s honor.

46 | SCL Health

The foundation’s most recent gift to St. Vincent came in 2019, in the form of a $500,000 donation to lay the framework for a partnership with Children’s Hospital of Utah so St. Vincent Healthcare could begin offering pediatric surgery. The pediatric surgery program opened in September of 2019, and approximately 60 surgeries were performed there by the end of the year.

“ We are blessed with a wonderful relationship with the heirs of the Fortin Foundation. The trustees value the importance of bringing quality and accessible healthcare to rural areas, especially to children. They are impressed with the strides we have made in pediatric care and are pleased with our commitment to help kids and families close to home.”

Nichole Miles, Senior Director of Development, St. Vincent Healthcare Foundation

“We’re now the only pediatric surgical program in eastern Montana. In addition to stress, families face financial burdens when they must travel out of state for their child to undergo surgery.

The ability to do pediatric surgeries here provides such a relief for families and is really a godsend,” says Nichole Miles, Senior Director of Development of St. Vincent Healthcare Foundation. “The Fortins have made a tremendous impact on the health of the people in our region, and we couldn’t be more grateful to them and the continued generosity of the foundation’s trustees.”

2020 Report to the Community | 47

48 | SCL Health

Section 2 | How We Give Back to Our Communities

E NSU R I N G A SAFE T Y N E T FO R TH E MOS T VU LN E R AB LE It is shortsighted to think the successful delivery of healthcare is based solely on results from within the walls of SCL Health hospitals and clinics. We look beyond internal patient care to include coordination and access to external social services for improved health management. Some patients are in vulnerable situations, such as financial insecurity, homelessness, unemployment or exposure to violence. The mission of SCL Health guides us to make sure the most vulnerable are treated with compassion and cared for in ways that meet their individual needs.

2020 Report to the Community | 49

A S af et y N et f or the Mos t Vulne r able

“ They’ve come to my rescue over and over again. To know that they are there, helping…they are just angels in disguise.”

Caritas Clinic patient Monique

Caritas Clinics readies to accept value-based payment models When Caritas Clinics first opened its doors more than three decades ago to serve the very low-income, uninsured residents of Leavenworth and Wyandotte Counties in Kansas, most patients needed treatment for their immediate medical needs. Since then, healthcare has changed dramatically; now, 80 percent of patients who visit the St. Vincent Clinic or Duchesne Clinic struggle with at least one chronic disease – meaning a disease that lasts more than a year and that requires ongoing medical treatment – and lack of consistent care prior to coming to one of the clinics.

Caritas Clinic patients come from poor, vulnerable populations and have placed tremendous trust in SCL Health clinics and providers as their medical home, the place where they receive comprehensive and coordinated primary care. Historically, when clinic 50 | SCL Health

patients became Medicare/Medicaid eligible, they were forced to move to other providers. In 2019, Caritas Clinics prepared to accept patients insured by Medicare or Medicaid starting in 2020. This is one of the most important ways the clinics can assure continuity of care and well-being for patients.

“We believe our mission, to improve the health of our communities by caring for the poor and vulnerable, and our vision, to exceed our patients’ expectations for health, will be best met by accepting patients covered

by Medicare and Medicaid. We want to remain a trusted medical home for all of our patients,” says George M. Noonan, Executive Director of Caritas Clinics.

To prepare, Caritas Clinics partnered with Kansas Healthcare Collaborative, a member of the Practice Transformation Network, to set goals and use data from

2019 STATS | CARITAS CLINICS

1,741 13,108 1,099 60% > 500 161

individual patients served patient encounters patient screenings for social determinants of health and adverse childhood experiences of patients who required Spanish bilingual interpretation clinic patients have diabetes bilingual diabetes education sessions held

electronic health records and national benchmarks to further improve quality of care and be ready to accept value-based payment models. The groundwork completed in 2019 will help ensure the success of the program in coming years.

It is a challenge for clinics like Caritas Clinics to afford to operate only based on philanthropy. Accepting Medicaid and Medicare patients will help the clinics build a new revenue stream that is needed to stay open for the long term, while making sure patients continue to receive the excellent medical care they need – and deserve.

Getting life saving medications to patients who need them the most In 2019, the Caritas Pharmacy Assistance Program provided $3.2 million in medications to patients, often with chronic diseases, who could not otherwise afford them. As the most robust program of all safety net clinics serving the Kansas City area, the amount of no-cost medications dispensed represented a 30 percent increase over the previous year.

“We feel that one of the reasons our patients have better than average health outcomes for chronic diseases is because of this program,” Noonan says. “These monthly medications are the backbone of most chronic disease management plans. Now more than ever, we must seek ways of providing these life saving medications, given the rising costs of prescription drugs.”

2019 STATS | PHARMACY ASSISTANCE PROGRAM

617 2,872

patients assisted medications distributed

Watch an online video about Caritas Clinics.

Visit: sclhealthreport.org 2020 Report to the Community | 51

Nursing collaboration aims to improve oral health outcomes Dentistry and medicine, often seen as separate points of care, work best in partnership. Through effective and efficient use of resources and medical expertise, both patients and providers benefit. When oral health and nursing colleagues collaborate, health outcomes improve by having a team of professionals from diverse fields dedicated to care for the whole person.

In 2019, the SCL Health Marian Dental Clinic in Topeka, Kansas, built a relationship with the nursing profession to enhance the quality of patient care. They did so by incorporating a registered nurse and nursing students from Baker University into the dental clinic as an important part of the care team. The nonprofit safety net clinic offers comprehensive, quality dental care to the community.

The clinic is one of only a few in the area providing dental services to 2019 STATS | MARIAN DENTAL CLINIC patients with low income. nursing students in program

137 360 54 7

“Dentistry is no longer health or social services referrals just about by nursing students the mouth. pre-diabetic referrals by nursing It’s about students the whole person. The mouth is the gateway to our entire body and can tell a story about health conditions,” says Barbara Sollner, RN, MSN, assistant professor at Baker University. ”Nurses are an integral part of the dental team, and this model of care incorporates nurses’ insights and expertise with regard to the health of the patients.” total nursing hours

Baker nursing students participate in eight-week sessions where they volunteer in the clinic twice a 52 | SCL Health

week and perform basic physical assessments.

The partnership allows students to gain valuable clinical experience while being supervised by Baker nursing faculty. If students discover a possible health issue in a patient, such as high blood pressure or high blood sugar that requires medical follow-up, their findings are shared with clinic staff to assist with the patient’s plan of care.

The nurse clinical care manager in the dental clinic also provides nursing services, care management and care coordination in an effort to improve overall health outcomes. This includes performing patient assessments to identify any economic or social conditions that might lead to health challenges.

Referrals to primary care, specialty care and social services are made when needed. The unique collaboration has allowed the clinic to provide expanded services, with the opportunity for additional future growth.

When words aren’t enough: using art therapy as a gateway to healing Mount Saint Vincent provides mental health treatment, foster care services, preschool through eighth grade education, and trauma-informed training – all focused on children and their families.

Mount Saint Vincent, helped the mostly nonverbal Kaylee work through her feelings.

At the same time the lengthy court process to terminate parental rights was occurring, Kaylee created a complex painting that appeared to be a metaphor of what was happening with her family. In the painting, she depicted objects smashing into one another, careening wildly and breaking apart.

Providing psychological treatment in the form of cognitive behavioral therapy for children can often look different than talking to a therapist about thoughts and feelings. If you are a young girl whose ongoing physical abuse began when you “ It’s as if she’s a different child.” were an infant, you may not even “It was a terribly sad but beautiful Mount Saint Vincent Art Therapist Lindsay Ritscher have the words or capability to metaphor of what she felt,” describe your experiences. That Ritscher recalls.

“She processed the loss and pain of is why Mount Saint Vincent’s highly trained therapists use losing her parents using art as a symbolic means of many alternative methods, including art therapy, to treat communication.” the youngest survivors of trauma.

Gradually, Kaylee began to connect with Ritscher as well as Kaylee, age 10, arrived at Mount Saint Vincent after three with her classroom teacher. Strong bonds began to form, years of numerous foster care placements. With a long signifying a turning point. Today, she is a star student and history of physical abuse and chronic neglect, she was eager participant in class. The violent behavior is gone, disconnected from life and rarely engaged with others, and she is happy, smiling and preferring to isolate herself in 2019 STATS | MOUNT SAINT VINCENT joking with students and staff. her imaginary world. trauma-informed caregiving training During her stay, the parental rights of Kaylee’s parents were terminated. She became severely depressed, would have violent outbursts and suffered from uncontrollable bouts of crying. Lindsay Ritscher, Art Therapist at

44

16 93% 95% 100%

sessions led by staff and presented throughout Colorado, resulting in 142 total hours training for 708 individuals Front Range school districts served by the K-8 school

satisfaction rate for Residential Program satisfaction rate by referral sources for educational services their clients received discharge rate to less-restrictive setting for clients in short-term Stabilization Unit

In large part, Ritscher credits Kaylee’s treatment at Mount Saint Vincent for her transformation.

“No matter what Kaylee did, no matter what behaviors she exhibited, she was always received with kindness, love and compassion.”

2020 Report to the Community | 53

A S af et y N et f or the Mos t Vulne r able

Section 2 | How We Give Back to Our Communities

I NTE R NATIO NAL M I N IS TR I ES – ARUS HA E XC HAN G E An impactful exchange program helps advance emergency care in Tanzania Since 2004, SCL Health has partnered with Arusha Lutheran Medical Center (ALMC) in Tanzania to help advance and modernize the hospital’s medical care and to improve its infrastructure. This has included associates volunteering to travel to ALMC to train physicians and nurses to help with filling any gaps in skills; identifying and donating needed equipment, supplies and medications; performing surgeries and 54 | SCL Health

other procedures as part of medical missions; and even helping to establish a nursing school.

For the very first time in the 15-year relationship, SCL Health hosted two healthcare providers from ALMC to provide a firsthand look at American healthcare. Peter Mabula, MD, ALMC Emergency Medicine Chief, and Bahati Ng’obo, Emergency Department Nurse Director, spent October 2019 traveling from Arusha to the United

States to visit multiple hospitals within the SCL Health system.

During their monthlong visit, Dr. Mabula and Director Ng’obo learned new ways to improve care back home and gained ideas on how to create a more efficient and dynamic emergency department.

the practices identified during the externship into place. The missions team also spent time training staff at ALMC, Selian Hospital, and the ALMC School of Nursing, and worked on implementing nursing education and mentoring programs.

“It was a privilege to have Dr. Mabula and Bahati in our organization. We The practice of shared information emergency medicine and rounded up is still a new specialty equipment, supplies and in East Africa. ALMC’s educational resources emergency department that are so needed in first opened in 2017 and Tanzania. We were also sees about 200 patients able to provide them a day. Dr. Mabula is the exposure and insight only trained emergency into how EMS works in physician at ALMC, our community,” says BJ where he oversees the Gilmore, Chief Nursing rest of the emergency Officer/VP Patient Care staff, who are all general Services at St. Vincent practitioners.

Healthcare. “One of the most important “ W e are well prepared to challenge our team and During visits to SCL aspects of the visit was colleagues in Tanzania to elevate the professional Health care sites in Colorado and Montana, emergency and critical care to our esteemed patients. the impact it had on our leaders and associates, the pair discussed how Thank you for giving us this opportunity.” who were very humbled caregivers approach Peter Mabula, MD, Emergency Medicine Chief at Arusha Lutheran by the work Dr. Mabula emergency and criticalMedical Center and Bahati did with so care medicine and little available to them in interacted with several community partners, including their country.

It was certainly a lesson in gratitude.” local fire departments and paramedics.

Before Dr. Mabula and Ng’obo returned home, they met 19 SCL Health physicians and nurses who were scheduled to soon travel to ALMC for a two-week medical mission. In November 2019, the two teams worked together at ALMC to begin putting some of

In addition to medical missions and the externship program, SCL Health donated approximately $500,000 in medical equipment to ALMC in 2019 and has provided several leaders to teach practices to medical professionals in Arusha.

2020 Report to the Community | 55

SEC TION 3

About SCL Health

56 | SCL Health

MISSION

We reveal and foster God’s healing love by improving the health of the people and communities we serve, especially those who are poor and vulnerable.

VISION VALUES

Inspired by our faith, we will partner with our patients and communities to exceed their expectations for health.

Caring Spirit — We honor the sacred dignity of each person.

Excellence — We set and surpass high standards.

Good Humor — We create joyful and welcoming environments.

Integrity — We do the right thing with openness and pride.

Safety — We deliver care that seeks to eliminate all harm for patients and associates.

Stewardship — We are accountable for the resources entrusted to us.

2020 Report to the Community | 57

SCL Health Board of Directors

From our sponsor to our board of directors and our senior executives, SCL Health leaders are dedicated to fulfilling our mission and vision and to living our shared values.

Standing, left to right:

Seated, left to right:

Douglas E. Aden Retired Regional President, U.S. Bancorp

Michael Salem, MD President & CEO, National Jewish Health

Nguyen-Vu Pham, JD, MHA Owner/Consultant, Endgame Solutions, LLC

Steven D. Huebner, CPA, Chair Retired Audit Partner, KPMG

Kathryn A. Paul Vice Chair Retired President & CEO, Delta Dental Plan of Colorado

Maureen Hall, SCL Former Community Director, Sisters of Charity of Leavenworth

Alan R. Yordy, MBA, FACHE President & CEO, The Infinity Group Mario M. Carrera Retired Chief Revenue Officer Entravision Communications Robert E. Wilson Retired SVP/Chief Finance Officer, Phoenix House, Brooklyn Mary Beth Mikols Managing Director Technology Strategy, Healthcare and Life Sciences, Deloitte Consulting LLP

58 | SCL Health

Michael L. Fordyce Retired President & CEO, Craig Hospital

Gordon Howie, MBA Retired Managing Director, Bank of America Securities

Pamela S. Federbusch Consultant, Healthcare Finance and Credit Consulting

Beth P. Beckman, RN, DNSc, FNP, NEA-BC System Chief Nurse Executive, Yale New Haven Health System

Lydia Jumonville President & CEO, SCL Health

D. Lynn Casey, SCL Retired Chancellor, Diocese of Great Falls – Billings Constance Phelps, SCL Community Director, Sisters of Charity of Leavenworth

System Services Executive Team

Standing, left to right: Janie Wade EVP, Chief Financial Officer Lydia Jumonville President & CEO Craig Richardville SVP, Chief Information Officer Rosland Fisher McLeod SVP, Chief Legal Officer James P. (JP) Valin, MD EVP, Chief Clinical Officer Mark Korth EVP, Chief Operating Officer, Hospital Operations Shawn Dufford, MD SVP, Chief Medical Officer, Acute Care Operations

Leaven Ministries

Megan Mahncke President of SCL Health Foundations & SVP, Communications and Marketing

Left to right:

Tajquah Hudson EVP, Chief Strategy & Growth Officer

Rita Turley, RN, Vice Chair

Seated, left to right:

Maureen Hall, SCL, Chair

David Pringle SVP, Mission Integration

Brian D’Arcy, MD Bruce Waring, MD Constance Phelps, SCL

Tamara Saunaitis SVP, Chief Human Resources Officer Lori Wightman, RN SVP, Chief Nursing Officer Steven Chyung SVP, Supply Chain & Real Estate

2020 Report to the Community | 59

C AR E S ITE & R EG I O NAL PR ES I D E NTS

Karen Costello

Jennifer Alderfer

John Hicks

St. James Healthcare

Bryan Johnson

Platte Valley Medical Center

St. Mary’s Medical Center

Jamie Smith

Saint Joseph Hospital 60 | SCL Health

Jay Doyle

Holy Rosary Healthcare

Good Samaritan Medical Center

Grant Wicklund

Steve Loveless

St. Vincent Healthcare Montana Region

Lutheran Medical Center Western Colorado

WH E R E WE S E RVE The heart of our ministry is to provide compassionate, safe, person-centered care for every patient, every time. We focus on taking care of those who need it most.

MONTANA REGION

COLORADO – WESTERN COLORADO REGION

3 Hospitals Holy Rosary Healthcare – Miles City St. James Healthcare – Butte St. Vincent Healthcare – Billings

1 Hospital St. Mary’s Medical Center – Grand Junction 1 Outpatient Imaging Center

1 Long-Term Care Facility

1 Outpatient Procedure Center 1 Clinically Integrated Network

MONT

1 Inpatient Rehabilitation Hospital

ANA

1 Outpatient Imaging Center1

25+ Clinic Locations

3 Outpatient Procedure Centers 55+ Clinic Locations

COLORADO – FRONT RANGE REGION

COLORA

DO

KA NS AS

4 Hospitals Good Samaritan Medical Center – Lafayette Lutheran Medical Center – Wheat Ridge Platte Valley Medical Center – Brighton Saint Joseph Hospital2 – Denver

KANSAS REGION 3 Safety-Net Clinics

3 Community Clinic Emergency Centers

Aurora, Littleton, Northglenn

1 Home Health Agency 1 Hospice Center 2 Mental Health Centers 12 Outpatient Imaging Centers1 5 Outpatient Procedure Centers 70+ Clinic Locations

Includes joint venture with Touchstone Imaging for 11 Front Range locations and 1 Montana location Joint operating agreement with National Jewish Health

1

2

Where we serve communities as of 6/30/20

© 6.30.20 Sisters of Charity of Leavenworth Health System, Inc. All rights reserved.

2020 Report to the Community | 61

FI NAN C IAL S U M M ARY SCL Health added to its multi-year trend of strong operating and financial performance in 2019.

We maintained a vital operating cash flow and a healthy operating margin – putting us well above rating-agency and Catholic health system benchmarks.

We also maintained our firm commitment to investing in the communities we serve. In 2019, we invested $255.3 million – or 9 cents of every dollar we earn – to support health improvements through Community Benefit efforts.

Hospital Utilization*

Clinic and Outpatient Facilities

Hospital Locations . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Clinic Locations . . . . . . . . . . . . . . . . . . . . . . . . . . 160

Acute Admissions. . . . . . . . . . . . . . . . . . . . . . 73,735

Outpatient Visits (Including Observation).1,145,406

Births. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11,986 Emergency Visits. . . . . . . . . . . . . . . . . . . . . 300,640

Affiliates and Other Ministries

Inpatient Surgeries . . . . . . . . . . . . . . . . . . . . . 21,386

Adult Mental Health Treatment. . . . . . . . . . . . . . . . . 1

Outpatient Surgeries . . . . . . . . . . . . . . . . . . . 45,604

Children’s Mental Health Treatment. . . . . . . . . . . . . 1

Net Operating Revenue* . . . . . . . . . . . . . . $2.8 Billion Total Operating Expenses* . . . . . . . . . . . . $2.7 Billion Capital Expenditures* . . . . . . . . . . . . . $201.0 Million

*2019 figures

62 | SCL Health

2020 Report to the Community | 63

500 Eldorado Boulevard | Suite 4300 | Broomfield, CO 80021 303-813-5190 | SCLHealth.org

in Š2020 Sisters of Charity of Leavenworth Health System Inc. All rights reserved.