2009 Report to Our Community

rejuvenation

roots

TMC’s Report to Our Community

growth service

Our Mission: Tucson Medical Center delivers caring, personalized, quality health care to patients and their families in an environment that is supportive and compassionate.

Report to our Community Credits Publisher: Judy Rich, President and Chief Executive Officer Executive Editor: Julia Strange, Vice President, Community Benefit Editor: Cheryl Kohout Graphic Design: Nancy Serensky Contributing Writers: Jane Erikson, Tara Kirkpatrick, Marni Dittmar, Bruce Chandler, Michael Letson, L’Don Sawyer Photography: Eric Suhm, Bruce Chandler, Erik Hinote, Dr. Donnie Sanson, Dr. Luis Esparza Creative Strategy Team: Cheryl Kohout, Michael Letson, Christel Pettengill, Hope Thomas, Hilton & Myers Advertising, Raim & Associates LLC, Strategic Issues Management Group With special thanks to the TMC Community Benefit Task Force, TMC Financial Services, TMC Foundation, the TMC HealthCare Board of Trustees and the thousands of helping hands who make a positive difference every day.

TMC HealthCare, 5301 E. Grant Road, Tucson, Arizona (520) 327-5461 www.tmcaz.com

integrity

dedication

We tell the truth We are responsible in how we use our resources We have the courage to uphold our values

We work hard for our patients and each other We are committed to professionalism and excellence We listen, we learn, we grow

compassion

compassion

In 2009 we articulated the values that had been previously evident but unstated. I hope you will see reflections of the heart and soul of thousands of caregivers who have defined our community hospital for 65 years.

We have heart We respect diversity and individuality We honor body, mind and spirit

integrity

community

We are welcoming and friendly We practice kindness in all our relationships We We reach out as teachers and as leaders

report to our community We listen, we learn, we grow I

n the pages of this community report, you

Tucson Medical Center is a tax-exempt hospi-

Strange, vice president, Community Benefit,

will see that some of our best work takes

tal. That means that instead of paying taxes, we

(520) 324-2017, or any member of our leader-

place outside the walls of the hospital at Grant

provide services and care to benefit the com-

ship team.

and Craycroft. You will see your community

munity. In this report, we will endeavor to ar-

hospital at work in schools, at civic events, in

ticulate the tangible and intangible value we

Because of our solid financial performance, we

support groups. We are an economic driver,

provide to people of Southern Arizona. In the

are able to invest in bricks and mortar, we are

obtaining goods and services from hundreds of

end, our accountability is to you, our friends,

able to invest in the latest technology, we are

Tucson and Arizona businesses large and small.

neighbors and families. And, in the spirit of our

able to step into an elite group of hospitals na-

We are exploring ways to make incremental

values: we listen, we learn, we grow. If you see

tionally in terms of our use of electronic medi-

wellness changes and healthy choices close to

opportunities for improvement, if you see plac-

cal records. And, importantly, we are able to in-

home as we begin to reform the health of our

es we can make a difference in the community,

vest in programs and services that improve the

community one step at a time.

we want to hear from you. Please contact Julia

health and well-being of you, our community.

Judy F. Rich President and Chief Executive OfďŹ cer

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confidence & community T “I believe the value of being a stand-alone community hospital is that we are not, in fact, standing alone.”

Louise Francesconi Chairwoman, TMC Board of Trustees

ucson Medical Center has the widest reach of any hospital in Southern Arizona. From head to toe, and birth to the end of life, TMC provides comprehensive and compassionate care, in recognized centers of excellence, to our friends, families and neighbors.

The most wonderful part of serving on the TMC HealthCare Board of Trustees for the region’s largest nonprofit hospital is knowing that we touched the lives of more than 113,000 individuals last year. To echo one of the organization’s value statements, we do it with heart.

TMC is an organization based on a foundation of caring, and a focus on quality, that is a constant inspiration to me.

transform the hospital and health care we provide. Based on the Epic Enterprise platform, OneChart, a $28 million investment, places TMC in an elite class of hospitals nationally. I am very proud of our commitment and focus on deploying a world-class electronic medical record – it was a bold decision, and a challenging process. Our OneChart system will be successful not just because of the care and attention being paid to the technological details. Perhaps more importantly, it will succeed because of the active and passionate participation and advocacy of our physician partners, working alongside our hospital employees to make it happen

But, a hospital like TMC can’t focus on caring alone. It is caring plus state-of-the-art equipment and technology employed by the region’s most experienced nurses and physicians that define a patient’s experience. CEO Judy Rich and her leadership team have articulated values and forged partnerships to create a truly remarkable hospital for our community. Physicians, staff, community leaders, patients and their families have come together to start changing health care from the ground up.

I believe the value of being a stand-alone community hospital is that we are not, in fact, standing alone. We have seen time and time again that the community stands behind TMC. Our doctors stand with us, and our staff is on the front line every day taking care of people from throughout our region. We give back through our commitment to aim high; through campus redevelopment, technology and innovation; and through our commitment to invest in our community. Through our physician partners, our staff and my Board colleagues, TMC is seamlessly integrated into the community.

The electronic medical record – we call ours OneChart – is one major step we are taking to

The Board’s confidence in the leadership of the hospital is validated by the fact that we continue 2

to be profitable in tough economic times. Being profitable allows us to invest in the future; to realize a new vision for the campus; to support centers of excellence in neurosciences, cardiac care, maternity and pediatrics, and on and on.

The community doesn’t need to see an advertisement to know that the very best care is at TMC. The volunteer community Board is made up of people of different professions, backgrounds, life experiences and perspectives. This allows for a rich vision of the kind of care Southern Arizona needs. We all benefit because there are lots of hearts and minds that understand what happens at a community hospital – and lots of hearts and minds that understand what happens in our community.

My vision? I see a hospital modernized through the electronic medical record and focused technology investments. I see an organization highly partnered with the physician community in clinical areas of excellence. And I see world-class delivery of quality care that will positively impact generations to come.

the changing face of charity care D

rive around Tucson and it’s hard to miss signs of the economic climate we have been living in the last few years. And, as a community hospital, we have been impacted in many ways, but most dramatically in the changing face of charity care.

“Fiscal discipline and careful stewardship of resources have allowed us to grow, thrive and expand...”

Jon Young Chairman, TMC Finance Committee

As people have lost their jobs and become uninsured or underinsured, more and more are finding they need the safety net they never thought they would need: charity care services for necessary hospital and medical services.

TMC is one of the largest hospital providers to patients on AHCCCS, Arizona’s Medicaid program. In fact, from a gross charge standpoint, our mix of AHCCCS payers increased from 25.5 percent in 2008 to 27.1 percent in 2009. In real terms, that shift of 1.6 percentage points away from health maintenance programs and commercial plans resulted in about $1.5 million less reimbursement for TMC, as AHCCCS payments are significantly less than other payers. In addition, as people struggle financially, more are finding themselves uninsured or in health plans with large deductibles.

From 2008 to 2009, TMC saw a 25 percent increase in bad debt and charity care.

As a nonprofit community hospital, we recognize and celebrate our role as a safety net for the people of our community. TMC’s mission calls for us to develop and support programs that improve the overall health and well-being of our community. Our doors are open and we will continue to operate in a manner that provides health and medical services to a population that would not otherwise have access to care. With that said, we must maintain a level of fiscal responsibility that will allow us to continue to operate as a nonprofit community hospital.

Being nonprofit does not mean we can be “unprofitable.” In fact, we are compelled to achieve a positive operating margin so we can reinvest in the services our community needs.

We need to support ourselves to further our mission.

As chairman of the Finance Committee and member of the TMC Board of Trustees, I must work to balance our stewardship of resources and our mission to meet community need. I am pleased to inform you that TMC is in a solid financial position, which allows reinvestment in facilities, capital and programming.

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And the successes of the last several years have allowed us to invest in the following projects: $120 million in campus redevelopment $28 million in electronic medical record $25 million in other facilities improvements Fiscal discipline and careful stewardship of resources have allowed us to grow, thrive and expand while continuing to serve patients regardless of their ability to pay. It’s important to note that your neighbors are investing their time as volunteer board and committee members to ensure the mission is upheld. A patient in need may not think about mission – they just want to know our nurses and doctors are here to provide expert care for them.

Behind all of this is a group of volunteers whose job is to advocate for the community and challenge management to operate efficiently and effectively. I care that members of our community can get the medical help they need, when they need it – and we hold the safety net for the uninsured and underinsured in nonprofit hospitals like TMC.

highest quality state-of-the-art care with a personal touch

state-of-the-art state-of-the-art “Excellent medical care doesn’t happen by accident”

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have been a surgeon on staff at Tucson Medical Center for more than 10 years and have observed quantum changes in the physical plant, technology and personnel. As Tucson’s only nonprofit community hospital, TMC provides comprehensive care to our entire community without regard to ability to pay. This is done in a caring and high-quality environment.

Providing this level of care is not without challenges. From the TMC HealthCare Board of Trustees, to CEO and President Judy Rich and upper-level administration, one senses a palpable commitment to quality and excellence.

Partnering with physicians in order to deliver the best possible care in a fiscally responsible and viable manner is the order of the day at TMC. Excellent medical care doesn’t happen by accident. At TMC we are working hard every day to meet the challenges of 21st century medicine.

Michael R. Probstfeld, M.D. Chief of Staff elect

Take for example the OneChart electronic medical record currently being implemented at TMC. This state-of-

the-art system promises to help us achieve our goal of “the right treatment for the right patient every time.” TMC is the community leader, the first in Tucson to implement a totally functional EMR system.

Another accomplishment we are proud of at TMC is the Professional Practice Committee, or PPC, which has been operational for over a year now. This robust committee of dedicated hardworking professionals has changed the face of “peer review” from a punitive, fault-finding body to one whose goal is physician education and continual process improvement.

America’s healthcare delivery system is presently undergoing a revolutionary transformation. The future relationship that will develop among physicians, hospitals, insurers and government programs is unknown. However, Tucson Medical Center remains committed to providing quality and compassionate health care to all residents of Southern Arizona.

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OneChart:

TMC at the forefront with its EMR implementation Less than 1 percent of the country’s 5,000-plus hospitals currently have the comprehensive electronic medical record that Tucson Medical Center will have June 1.

stages of adopting an EMR. Stage 0 is where a hospital might have some clinical automation in place, but is lacking lab, pharmacy and radiology systems

TMC’s $20 million project – known as OneChart: One Patient One Record — uses Epic EMR technology. The system will streamline care processes and, ultimately, redefine how hospital care is delivered at TMC.

Stage 7 represents a healthcare system that has achieved a paperless EMR environment, and clinical information is readily shared through continuityof-care electronic transactions.

Most Stage 7 organizations, including Kaiser Permanente in California, are multi-facility systems.

Fewer than 50 hospitals are at Stage 6, out of 5,170 nationwide. Only 17 hospitals have reached Stage 7.

The EMR adoption model, developed by Healthcare Information and Management Systems Society, scores hospitals on the progress in completing eight

TMC is targeting Stage 6 — a complete EMR, including physician documentation, computerized physician order entry, full clinical protocols, and picture archiving and communications systems.

TMC breaks ground on $120M campus development Capital campaign funds Pediatric renovations The first phase of TMC’s $120 million renovation involves expansion of the current Pediatric unit by adding 16,000 square feet of new space and renovation of more than 15,000 square feet of existing space. The $12.5 million project will: • Add new private pediatrics beds • Remodel existing rooms to private • Provide more space for families, in community rooms and at patient bedside • Enhance play areas for children • Create a central entrance for pediatric services at TMC • Ease coordination of pediatric services • Expand pediatrics outpatient services and capacity The resulting new general pediatric floor – designed by Hobbs+Black Architects with

the help of staff, physicians and patients – features private rooms throughout.

“Children throughout the region will be well-served by the extra capacity for pediatric beds and the much-needed enhancements that create a children’s medical center within the hospital,” said Michael J. Duran, TMC Foundation vice president and chief development officer.

“This is a community effort,” Duran said, adding that the TMC Foundation is seeking funds for the pediatric expansion and has raised more than half of the needed funds through the Block by Block, Miracles Happen capital campaign.

T

ucson Medical Center broke ground Nov. 12 on a $120 million five-year plan to expand its ability to serve the community.

“The project will be completed in phases and is to be financed with a blend of fundraising, savings and borrowing,” said Michael J. Duran, TMC Foundation vice president and chief development officer.

An ambitious campus redevelopment plan has been approved by the TMC HealthCare Board of Trustees, with a phased timeline for several major projects. The redevelopment will include: • Expanded Pediatric and Maternity units • New operating rooms • New entrances • New parking garages • New four-story bed tower • New medical offices for physicians

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Additionally, TMC is investing in sidewalks, trails and other amenities on its campus as part of its 2008 rezoning. Included is application for four of its historic structures – the Water Tower, Erickson House, Arizona Building and Patio Building – to be listed on the National Register of Historic Places, Duran said.

Neighbors continue to have input on the future look of TMC through the Architectural Review Board, which includes representatives from area neighborhoods and TMC. The ARB reviews and approves design aspects of the renovation and expansion as part of the permitting process.

“Solid financial performance has allowed TMC to invest in its facilities and equipment for the future, while honoring its history,” Duran said, adding that as the projects proceed, patient care services will continue without interruption.

community GARDEN

community GARDEN

community GARDEN tmc’s

B

ack in the fall of 2009, a small seed of an idea was planted. The Green Team had just been created to help Tucson Medical Center look at better ways to use resources, and to encourage efforts to reduce, reuse and recycle all kinds of materials. A chance remark about a garden during an early meeting was greeted with great enthusiasm from the team, and the Garden Club was formed.

The group started with a great space – an unused children’s playground and playset in TMC’s LifeGain Park. A new home was found for the equipment, at the New Life United Pentecostal Church, and the rest of the playground space was cleared.

Brad Wedding, supervisor of facility trades and TMC’s longtime landscaping chief, took an innovative approach to creating new planting

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beds. For three of the beds, he used the plastic rails that had framed the playground equipment. For another, he collected the concrete ashtrays that are no longer needed on the tobacco-free campus and turned them upside down in two rows. Filled with soil, they make a fine raised bed.

Winter planting produced cauliflower, broccoli, Swiss chard, onions, lettuce and carrots.

A little herb bed has rosemary, thyme, chives, basil, dill and oregano. The Garden Club crew has put in several fruit trees, including apricot, apple, peach, plum, grapefruit, orange and lemon, and a beautiful grape vine. Warmer weather will see plantings of tomatoes, chili peppers, tomatillos, okra, eggplant and decorative gourds. The TMC Community Garden, like the community, is healthy and growing!

non-judgmental health coaching keeps seniors on track T

eresa Crocco had been hoping for the past few years to get back to a fitness level that would make her feel and look her best. But with lung disease and foot pain, she faced a difficult challenge.

Then she met Bill Cook. He was a Senior Services Health Coach volunteer trained to offer one-on-one support to help older adults reach personal health goals.

Crocco recalls their first encounter at TMC Senior Services. “We met in the Health Resource Center, and Bill

asked what I hoped to attain from the program.”

Together they came up with a plan for appropriate exercises. Stretching was important, as her muscles had stiffened. They also discussed relaxation, breathing and meditation to help her reduce stress.

Over the next two years, they met to review weekly goals. If Crocco did not meet her goal, Cook would ask, “What activity can you do next week?” He helped motivate her to stay on course, in a non-judgmental fash-

ion. She began taking daily walks and slowly increased the distance. With Cook’s help, she soon was able to walk to the bank, the store and even the mall.

“If it weren’t for the Health Coach program, I would not be exercising every day,” she said. “The program helped me get back to where I was years ago, and has changed my life.

I am no longer depressed, and I even wake up before the alarm clock goes off, ready to start my day!”

“The program helped me get back to where I was years ago, and has changed my life” —Teresa Crocco

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Office s s e n i Bus

!

S K C RO

communityOutreach tmc’s

Alex the Ambulance

Safe Kids Tucson, a public safety coalition spearheaded by TMC, gets a boost whenever “Alex the Ambulance” rolls by. Southwest Ambulance, one of many community partners that make up Safe Kids, has decorated Alex with vital water-safety messages designed to save children’s lives.

Business Office The community-minded financial experts in the TMC Business Office continue their tradition of supporting worthy causes. The money is raised a few dollars at a time, with employee donations to events such as drawings for gift baskets to fund their projects.

Gifts included blankets and non-slip socks in a special

NICU at School NICU nurses have shared their time and their school supply donations with students at

Helping Hands

Fort Lowell Elementary School. It’s a chance

An enthusiastic TMC crew helped the

for the nurses to connect with children who

Community Food Bank process food do-

are a bit larger than the tiny babies in the

nations as part of a “100 Helping Hands”

Newborn Intensive Care Unit.

project. During their first three-hour shift at the Food Bank, the handy helpers filled

holiday delivery to the seniors at St. Luke’s Assisted

2,282 family food boxes, representing

Living.

63,564 pounds of food.

Employees created a special presentation to accompany their contribution to the Marks Fund, which pro-

Be Safe Saturday

Everyone Runs!

vides emergency assistance for TMC employees in

Families from throughout the

TMC partners with Everyone Runs! to pro-

crisis.

community flock to TMC’s an-

mote healthier lifestyles and to raise funds

nual Be Safe Saturday, with

in an all-inclusive atmosphere. Runners,

Food and gifts from the Business Office keep the

more than 100 interactive in-

walkers and onlookers are welcome to

shelves stocked at Youth on their Own, a dropout-pre-

formation booths, safety les-

participate in events that range from short

vention program that aids homeless young people.

sons, exercise sessions, car

jaunts for kids, to longer treks for hard-

seat inspections, and TMC’s

core runners.

Primavera Foundation clients are transitioning from

safety mascot, Tomas the Tur-

TMC Senior Services

homelessness and poverty, with help from donated

tle. The event showcases the

Older members of the community can find a

items delivered by the Business Office.

Children’s Miracle Network,

“Healthy Living Connection” at TMC Senior Ser-

TMC’s Desert Kids Safety Pro-

vices. In addition to support for patients during

The four-legged clients at Hope Animal Shelter, a no-

gram, and dozens of commu-

and after hospitalization, Senior Services offers a

kill adoption haven for cats and dogs, get gifts of food,

nity organizations that share

full program of educational and wellness oppor-

treats and toys from the Business Office’s special pet

an interest in family safety.

tunities in the community and in their dedicated

collection.

facility at the El Dorado Health Campus.

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plant services holiday fund The crew at TMC Plant Services is used to fixing things – and that’s their goal as they raise money throughout the year to help meet special needs that certain families face during the holiday season.

The concept started with eight workers who felt inspired to make a difference in a direct way, and it has grown every year to about 20 employees today. The group expects to accomplish even bigger things as they look to the future.

The workers donate a little cash each payday and hold fund-raising golf tournaments to support their dedicated Holiday Fund. It can add up to a couple of thousand dollars, all of which goes to make the holidays special for several local families. In 2009, the program added an Air Force family in need, as part of the Davis-Monthan AFB family assistance program.

“Our guys do all the shopping, based on the list of what these families need,” said Derrell Blair, manager, Plant Services. “One change we’ve made through the years: we’ve decided not to do the gift

the ABC’s of water safety

the key to drowning prevention

L

ast summer provided painful lessons over and over again about the dangers of leaving children unattended around water – whether it’s a swimming pool, a bathtub or even a cooler with water just a few inches deep. In 2009, there were 23 water-related incidents involving Southern Arizona children.

Six were fatal.

Tucson Medical Center’s staff becomes involved with many of these tragedies at the point where first responders are desperately trying to save a life.

“At TMC, we have the best doctors and nurses specializing in caring for children,” said Melissa Moreno, Emergency Department manager. “From the minute a child is brought through our doors by paramedics, the doctors and nurses do everything we can to save the child’s life. We put in tubes to help them breathe, continue CPR, start medication IVs to get the heart to beat, but often it just isn’t enough.

“These children may have been underwater for minutes, depleting their brains of oxygen and filling their lungs with water, and their chances of survival are slim,” Moreno said.

wrapping ourselves. Not our strong point.”

For the next holiday season, the team has set a goal of $3,000 to enable the program to expand.

They’d like to connect with a nursing home, to provide gifts for seniors in need.

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“Often, all we can do is hope for a miracle, and we prepare for the next step – which is comforting the family as we tell them we couldn’t save their child’s life.”

Recognizing the critical need in the community, TMC and Safe Kids Tucson enhanced their drowning prevention messaging and partnered with others in the community to spread the word. The key message for the community coalition is for anyone with children to follow the ABCs of Water Safety: Adult supervision, Barriers and Classes.

“Even in cases where we are able to save the child, months of hospitalization and therapy are often ahead,” said Moreno, noting that education, vigilance and preparation are key.

“If you have children, I urge you to be vigilant around water and to become certified in CPR. Early CPR has often been the difference between life and death in these children.”

Dr. Pal Evans a career of service P

al Evans was probably a freshman in high school when he figured out what he wanted to do with his life.

He grew up in Coaldale, Pa. – coal-mining country – where his father worked as a rock contractor. One day his dad gave him a tour of the mine where he worked.

“I got to deliver babies and I got to help with surgeries and I thought, ‘Boy, this is really cool. I really love doing this.’ That’s how I got down that path. I never regretted it at all.

“He said to me, ‘Well, do you think you want to do this for the rest of your life?’ and I said, ‘Heck, no,’” Evans recalled.

“I never thought it was a bother to get up in the middle of the night to deliver a baby. I always thought I was participating in a miraculous event, each time.”

Evans’ uncle was a general practitioner, and the stories he told were fascinating to young Evans. The mine tour settled it.

In 1972, as Evans was finishing his residency at the University of Pennsylvania, he took the advice of Dr. Edward Wallach, who would become a renowned fertility expert and chairman of OB/GYN at the Johns Hopkins University School of Medicine.

A doctor was born

And now, after more than 40 years as a doctor and hospital administrator – well-loved and respected in both of those roles – Dr. Palmer Evans has decided to retire. July 9 will be his last day at Tucson Medical Center, one week before his 69th birthday.

“Everything I’ve done, I’ve really enjoyed and loved,” Evans said. “The relationships I’ve had and the people I’ve come across along the way – it’s been wonderful.”

In recent weeks, Evans has found time to reflect on his career.

Two factors drove his decision to become an obstetrician-gynecologist. His mother and his aunt were two of the most important people in his life, “guardian angels through tough times.” And his first clinical rotation at Temple University medical school was in OB/GYN. 10

“He had worked in Tuba City (on the Navajo Reservation) and he said, ‘If you really want a wonderful experience, go to a hospital there, where you’re the only OB,’” Evans recalls.

Lessons learned

During his two years at the Fort Defiance Indian Hospital, from 1972 to 1974, Evans learned two of the most important lessons of his life.

“It was the only time in my career when I was ever really needed,” he said. “Here in Tucson there’s always someone to fill in for you. But not there. I was it. And there I was seeing things like bubonic plague and typhoid fever and a huge amount of toxemias of pregnancy – I really learned a lot.”

Lesson Two: The Navajo view of life and death

“I was taking care of a Navajo woman who had a very malignant tumor of her uterus.

I was sending her back and forth to the Indian Health Service Hospital in Phoenix.

One day the Fort Defiance ER called me and said ‘Dr. Evans, Catherine’s here and it doesn’t look like she’s doing very well.’ So I rushed down and I said ‘OK, Catherine, we’re going to start an IV...’

“And she looked at me and said, ‘Dr. Evans, I’ve gone to all the medicine men, and I’ve gone through all the healing ceremonies, and I’ve gotten all the treatment you’ve sent me for, and now it’s my time to go. And I’m ready.’”

For Evans, it was hard to face. “But I learned then and there that there’s a time to go, and this was her time. And that I wasn’t going to cure everybody.”

Evans came to Tucson at the suggestion of a friend he had made while in training at Philadelphia General Hospital: Dr. James Lohman, who served at the former DavisMonthan Air Force Base Hospital before completing his residency in Philadelphia.

Evans wound up at the former Tucson Clinic, for decades one of Tucson’s two leading multi-specialty group practices.

He took classes through the American College of Physician Executives and became a local officer of the American College of Obstetricians and Gynecologists. He became a member of the TMC Foundation Board of Trustees in 1992, and played a key role in TMC’s creation of a statewide managed-

care system, and subsequent exploration of merging with what was then the Samaritan Health System in Phoenix. The merger idea was dropped in October 1996.

It was also that year that Evans gave up the obstetrics part of his clinical practice. He gave up gynecology three years later.

Important Lessons Three and Four

In 1984, Sally Evans was working with her husband as an OB/GYN nurse practitioner when she became seriously ill. The diagnosis was lupus, a chronic auto-immune disease that has required her to be hospitalized numerous times, and eventually forced her retirement.

me keep my priorities straight. You have to take care of yourself and your family, and everything else comes after that.”

think there’s hope. And what I like about TMC is the attitude and the commitment that we want to do things better.”

Evans will retire as Senior Vice President and Chief Medical Officer of TMC. He also has led the hospital’s quality improvement efforts, and has overseen TMC’s participation in a national pilot study of a new health care model, called the Accountable Care Organization, or ACO. It brings together hospitals and physician groups who agree on ways to reduce costs while improving the quality of patient care. TMC is heading one of three ACO pilot projects nationwide.

After he retires, Evans expects to continue his role with the TMC Foundation, and with the hospital’s Senior Services program. He is medical director of cardiac rehab, and would like to continue that, as well as his role with the Arizona Healthcare Leadership Academy, and teaching with The University of Arizona Eller College of Management.

Critical to how an ACO will operate is what Evans calls “one of the transformational things that’s really going to make a difference in health care” – electronic medical records. Instead of paper charts, all patient data will be kept in a secure computer system that can be accessed by hospitals and doctors involved in a patient’s care.

“I was bound and determined that as a physician, I was going to find the answer, so Sally wouldn’t have to tolerate this,” Evans recalled. “And I think the most important lesson I have ever learned in this life was that I couldn’t solve her problems, and that she didn’t need me to do that.

“The electronic medical record allows for the integration of information,” Evans said.

“It allows us to align everything so we can really do the right thing for our patients.

Medical errors will go down. Patient safety issues will be addressed. It’s going to make a huge difference.”

“She didn’t need me to be her physician.

She needed me to be there for her. It really helped me in my dealings with my patients. I could listen to them and empathize with them, better than before Sally became ill. And I was able to tell my patients’ husbands what their role was, what they needed to do.

Will there be bugs to work out? Of course, Evans said.

In March 1999, it was Pal who was hospitalized – for a triple coronary bypass surgery.

“You have to realize, I’m an eternal optimist,” he said. “I don’t think there’s any function for pessimism except to make you feel bad. Health care has been in a state of transition for the last 20 years. I

“Looking back on it, that was a very positive experience for me,” Evans said. “Number one, I’m doing well, but it also helped 11

This actually is not the first time Evans has retired. He did so four years ago, but was asked to come back to TMC in 2007. But it sounds like this time is for real.

“Sally and I want to enjoy our time together. We love to load the dogs into the RV and take off,” he said. “And I want to spend a lot of time with my grandkids.

They all live around here and it’s always fun to spend time with them. I’ve missed that, so I’m looking forward to it again.”

lighting it UP! S

taff, physicians, families, friends and neighbors celebrated Tucson Medical Center’s 65th anniversary by lighting up the landmark Water Tower for the holiday season.

Hundreds of people enjoyed the cool early December evening for an old-fashioned birthday celebration complete with live music, corn dogs, lemonade, eggplants and cucumbers.

That’s right – eggplants and cucumbers. In recognition of the initial planting of the TMC Community Garden, the 17th Street Farmers Market set up an area to sell fresh winter fruits and vegetables. The stand was nearly bare as dark settled in.

Mr. & Mrs. Claus, the Grinch, Frosty the Snowman and Santa’s helpers were on hand for photo ops and play; one lucky girl won a new bicycle for her winning coloring contest entry.

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President Emeritus Donald Shropshire joined President Judy Rich at dusk to flip the switch to a roaring crowd as “65” lit up in red and green on the historic Water Tower, the first structure built on the campus in 1926.

The lights on the Water Tower were visible north to Sunrise Drive and beyond, and remained lit until the end of the year. When TMC first opened its doors in 1944, it was far outside of town with no streetlights, let alone a blazing Water Tower or a green Grinch.

Over the years, TMC has grown as the city has grown, and will continue to be run by and for the people of Southern Arizona.

leukemia

Lighting the Night for a Friend

light the NIGHT

tmc

Jessica Grubb, a patient relations representa-

cause. Collectively they donated 327 hours to help

tive in the TMC Emergency Department, want-

a friend and co-worker in need.

ed to do something – anything – to support her colleague, Becky Willis, RN, who was fighting

When all was said and done, TMC Emergency Ser-

leukemia.

vices was awarded the Gold Corporate Award for the fund-raising success of $6,125; Becky Willis

the HEART of the community Recognizing that heart disease is the No.

cluded a carotid Doppler test, blood glucose

1 killer of Americans, Tucson Medical

test, an EKG, education and more.

Center is dedicated to improving heart

Grubb decided to rally friends and colleagues

received a Shining Star award for raising more than

from throughout the hospital to “Light the Night” in

$1,000; and Jessica Grubb received two awards

health. In 2009, TMC celebrated Heart

More than 60 TMC staff members volun-

honor of Willis by participating in the Leukemia &

for her efforts. But, those awards were secondary

Week in October.

teered, including physicians, physician as-

Lymphoma Society’s evening walk and fund-rais-

to supporting a friend.

sistants and nurse practitioners. Look for The week included a physician symposium,

ing event held in late September. It is the nation’s night to pay tribute and bring hope to thousands of

The Leukemia & Lymphoma Society funds life-sav-

free on-site screenings at TMC’s first Heart

people battling blood cancers.

ing research that has contributed to major advanc-

Check and educational events for staff.

es in the treatment of blood cancers and treatments The planning team, headed by Grubb and her

for other types of cancer, such as chemotherapy

colleagues in the Emergency Department and

and stem cell transplants. These treatments have

Children’s Emergency Center, held bake sales,

helped patients live better, longer lives.

The Heart Check was a great success with 316 people showing up on a Saturday morning to receive the free screenings, which in-

donated money, raised money and walked for the

Becky Willis & Jessica Grubb

13

Heart Week, again, in October.

bulk of $400M in TMC spending stays in region ‘Being community-based and nonprofit leaves millions of dollars here in Southern Arizona each year’

A

s Southern Arizona’s largest hospital, Tucson Medical Center is both a top employer and a major economic driver in the region. Of TMC’s $400 million in annual expenditures, more than 70 percent stays within the community and directly impacts the local and state economies.

The largest piece of the hospital’s annual expenditures is $200 million in salaries and benefits paid to more than 3,500 full- and parttime employees. And, of the $90 million in annual supply costs, more than 38 percent, or $35 million, is spent with Tucson and

townsend traffic SAFETY

Arizona vendors and suppliers.

Of the remaining $110 million in non-wage expenditures, 45 percent, or $50 million, benefitted the state and local economies.

(Expenditures in this category include physician and other professional contracted services, new equipment and refurbishing, leasing, repair and maintenance, and community health expenses.) The result is more than $285 million directly impacting state and local economies.

And, as a nonprofit communityowned hospital, TMC is able to

reinvest both in the hospital and in the community. Nonprofit status ensures that there are no stockholders with whom to share any earnings. And as a community-owned hospital, TMC does not send jobs or dollars back to a parent company’s headquarters.

“Being community-based and nonprofit leaves millions of dollars here in Southern Arizona each year,” said Steve Bush, TMC senior vice president and chief financial officer.

And in 2009 the TMC HealthCare Board of Trustees approved

$120 million in refurbishment projects over the next five years, or an average of $24 million annually. Much of this money is spent with local contractors and professional firms.

“These construction dollars come at an opportune time,” Bush said.

“I’m sure the folks working on our pediatric build-out are not only proud to be building something important for the community, but also happy to have the work. And we’re glad we have the financial wherewithal to give them the work.”

When parents send their child to school,

students as they received treatment from

A “walk about” around the school property

safety issues may not be foremost in

paramedics. Both students recovered and

identified areas of concern, and quick fixes

their minds. October 2009 was differ-

returned to school, but the impact of their

were made. Action plans are in the works,

ent for the families of two students at

accidents was life-changing for all involved.

including traffic sign and signal upgrades, sidewalk improvements and classroom pe-

Townsend Middle School.

A community team dedicated to improving

destrian-safety instruction.

On separate occasions, just days apart,

student pedestrian safety around Townsend

two students were stuck by vehicles while

Middle School went into action. Brain-

TMC’s commitment to improving the health

crossing Grant Road to meet friends. Both

storming sessions involved partners from

and safety of the community extends in very

accidents were just minutes from Townsend

the school, Tucson Unified School District,

real ways to the streets and sidewalks sur-

and seconds from Tucson Medical Center.

Pima County Bike & Pedestrian Safety, Tuc-

rounding the hospital campus.

son Police Department, the Governor’s OfTownsend principal Barbara Kohl and TMC

fice of Highway Safety, City of Tucson and

Security director Bill Fleming stayed with the

TMC’s Community Outreach team.

14

tmc

community CARE a bad case A

sudden illness, a serious car accident or other medical crisis can happen to anyone, at any time. And for many people – even those with health insurance – being faced with a hospital bill only adds to the crisis.

TMC’s Community Care policy provides financial assistance to families and individuals who are unable to pay their share of the cost of their hospital care. As a nonprofit community hospital, it is TMC’s mission to deliver quality care to all patients, regardless of their ability to pay.

Community Care helped 2,941 patients in 2009, reducing the amount they owed by a combined total of more than $6 million.

Here’s how the policy helped two families last year:

A Healthy Couple for 26 Years

Kevin and Cheryl Konow will celebrate their 32nd anniversary May 13. For the first 26

of the flu

years of their marriage, they enjoyed good health and the financial security that came from running their own cotton-harvesting business near Yuma.

Then in 2004, Kevin suddenly became critically ill with a disease called Guillain-Barré syndrome, which left him temporarily paralyzed from the neck down. The couple had no insurance to cover the $200,000 cost of Kevin’s month-long stay at TMC, most of it in intensive care. Their assets made them ineligible for AHCCCS, the state’s Medicaid program.

The Konows wanted to pay their bill, and worked out a plan with TMC in which they agreed to pay $10,000 at the end of each harvest season.

They continued with their harvesting business until last year, when Kevin suffered a relapse of Guillain-Barré, which left him with

Jennifer and Trent Humphries know

tion. She was able to go home two days

how fortunate they are to have three

later.

healthy children – especially since last August, when their youngest had to be

Rebekah’s hospital bill amounted to

hospitalized with a common stomach

about $4,200 – charges the family’s high-

virus.

deductible insurance plan would not pay.

Jennifer and Trent, who have their own

The “stomach flu” made its rounds

computer-repair business, arranged to

through the Humphries household, and

make monthly payments. They hoped to

21-month-old Rebekah was the last to

pay off the bill by the end of the year.

become ill.

But after they made two payments, the

“Community Care helped 2,941 patients in 2009,

“I took her to the doctor after a couple

rest of their bill was paid by the Commu-

reducing the amount they

of days, because she just wasn’t getting

nity Care program, which is funded in part

owed by a combined total

better,” Jennifer said. “The doctor told us

by donations to the TMC Foundation.

of more than $6 million.”

what to do at home, but it still wasn’t getting better, and by about the fifth day, she

“Rebekah was really, really, really sick, and

woke up too weak to lift her head up.”

she received wonderful care,” Jennifer said. “Of course, we wanted to pay the

continued on Page 20...

15

The family’s pediatrician arranged for

bill. But these are tough financial times,

Rebekah to be seen immediately in the

and we really appreciated the help. It was

Children’s Emergency Center at TMC.

a very scary experience, but it turned out

From there the toddler was admitted and

to be a wonderful experience, and TMC

treated with IV fluids and other medica-

was great.”

TMC’s ‘NEURO RED’ Process Calls Attention to Stroke “Stroke is the third leading cause of death in the United States.

TMC’s acute stroke response team responds to strokes 24 hours a day, seven days a week. A neurologist is also on call 24 hours a day.”

Marcie Paradise, TMC nurse

T

MC nurse Marcie Paradise was working her shift in the hospital’s progressive critical care unit when her leg went numb.

“I thought, oh my gosh...I’m having a stroke,” she recalled. “Then, I said, ‘No, no, that’s impossible. It probably just fell asleep.’”

But then, her arm went numb. Looking for an aspirin to chew, she could only find an Excedrin in her purse. She tried to eat some yogurt, but kept missing her mouth.

Stroke is the third leading cause of death in the United States. TMC’s acute stroke response team responds to strokes 24 hours a day, seven days a week. A neurologist is also on call 24 hours a day.

whether the stroke is the result of a blood clot (ischemic) or a burst blood vessel (hemorrhagic). There are over 700,000 strokes per year, 85 percent of which are ischemic. The only FDA-approved treatment for ischemic stroke is tPA, or tissue plasminogen activator, a powerful clotbusting drug. However, it’s only effective if given within 4.5 hours of the onset of symptoms. If the stroke is hemorrhagic, blood thinners must be avoided.

Like a Code Blue, a Neuro Red demands immediate attention as doctors must evaluate the patient and determine

Neuro Red is successful at TMC because it brings together physicians from Neurology, Neuroradiology, Emergency

the project last year and has since personally trained emergency room staff, rapid response nurses and critical care nurses to recognize possible stroke symptoms of incoming patients.

“I’m having a stroke!” Paradise cried out in the nurses’ lounge. “I just burst into tears. It was so terrifying. This all happened within five minutes.” Another nurse quickly helped her into a wheelchair and pushed her quickly to Neurology.

It was there that TMC Stroke Director David Teeple, M.D. and the new Neuro Red protocol saved Marcie’s life.

“Neuro Red is a process we put in place to identify stroke patients quickly so we can provide effective therapy in an efficient manner,” said Teeple, who championed 16

child life specialists ease and Neurosurgery, in addition to other disciplines including Nursing, Pharmacy, Radiology, Laboratory, and physical, occupational and speech therapy to provide collaborative care. They also meet monthly to review the effectiveness of the process and look for ways to improve it.

Paradise’s stroke was caused by a blockage in one of the brain’s blood-carrying arteries. She was given tPA and recovered over the next few days in the intensive care unit. Her symptoms ultimately resolved and, one year later, she has no residual problems.

“You hear about people waiting in the ER for 12 hours, sometimes more,” said Teeple. “Most stroke victims are not fortunate enough to have a stroke in the hospital. My hope is to give any patient who comes into TMC with ischemic stroke the same chance that Marcie had.”

“NEURO RED is a process we put in place to identify stroke patients quickly so we can provide effective therapy in an

young patients’ hospital visits

T

ruth be told, children don’t really want to go to the hospital.

That’s why Tucson Medical Center launched its Child Life program – to meet the social, emotional and psychological needs of their youngest patients. With funding from the Children’s Miracle Network, the child life specialists have the necessary tools to help children feel as comfortable as possible in the hospital and even find some fun and happiness while they are there.

“Child life specialists are trained professionals whose expertise is helping children and their families through difficult life events,” said Child Life manager Jolene Eggert. “Children process information much differently than adults, so it is our job to understand and ensure that we help them through these challenging events to ensure they do not have lasting negative effects.”

Whether it’s showing a movie while the child undergoes a fluoroscopy test or facilitating a medical play session, child life specialists provide age-appropriate distractions for children and help prepare them for medical procedures using anatomically correct dolls and other tools that can reach children at their individual developmental level.

They also help parents adjust to the difficulty of having an ill child by providing resources and education about what to expect for the family.

efficient manner” Dr. David Teeple, TMC Stroke Director

17

“Children who have access to child life specialists have a much easier time being in the hospital because, no matter how ill they are, the specialists can bring some joy into their hospital stay,” said Dr. Mary Cochran, a Tucson pediatrician who serves on the TMC Board of Trustees.

Individuals who are interested in becoming child life specialists receive their college education, training and certification to work with hospitalized/ill children.

They work throughout the hospital, including the pediatric units, fluoroscopy area, surgery and emergency departments.

“TMC is committed to caring for children, but it would not be possible to have as many child life specialists as there are currently in several areas of the hospital without the support of Children’s Miracle Network,” said Cochran.

tmc team tends to rural Hond S

ula is an agricultural community of about 3,000 people in western Honduras, one of the poorest countries in Central America. But Sula grows great coffee beans and pineapples, and has its own 26-bed hospital. And, thanks in part to a crew of compassionate doctors, nurses and others from Tucson Medical Center, the residents of Sula receive excellent health care.

A TMC team of about 25 has traveled to Hospital Centro Socorro de lo Alto for a week to 10 days every January for the last four years. They deliver babies, replace farm workers’ worn-out hips and knees with state-of-the-art artificial joints, treat children with chronic ear infections, fit older residents with hearing aids – the list goes on.

Patients pay what they can. Some pay nothing. All are grateful.

“We all like to do this, and we get a lot out of it,” said Dr. Donnie Sansom of Old Pueblo Anesthesia, a member of the TMC volunteer team.

“Every time you give to the people of Sula, you get a lot more, emotionally and spiritually,” Sansom said.

18

“The Honduran people are very kind and loving and they say ‘thank you.’ They wait for 12 hours to see a doctor and they don’t complain. You’re not buried in paperwork. It keeps you refreshed and focused on what medicine is all about.”

Since 2003, the hospital has been a part of Evangelistic International Ministries based in Arkansas, with no affiliation to TMC. A Honduran obstetrician-gynecologist serves as director of the hospital, which has its own support staff. But it depends almost entirely on doctors and other health professionals from across the United States who volunteer their time and skills.

The hospital also relies on donations of cash, medications, equipment and supplies – everything from Band-Aids and pencils to ventilators, laboratory equipment and surgical tables.

“This January we worked on a gentleman who had been waiting for an artificial hip since last year,” Sansom said. “His artificial hip was donated, as was his doctors’ time. Now he can walk without pain.”

ndurans

“The power will go out. The water will go out.

The equipment will break down. That’s how it is.

You stretch yourself. You’re outside the box.”

Dr. Gulshan Sethi, TMC’s medical director of cardiothoracic surgery

Chronic ear problems are common in children in Honduras, and doctors from Tucson Ear Nose and Throat have joined the TMC group, providing medical and surgical care to save children’s health and hearing.

“Our presence grows each year,” Sansom said. “Next year our plan is to teach CPR to the Honduran nurses who have never had CPR training. I’m a CPR instructor and my Spanish is limited, but one of the techs here is bilingual and she’s going to go down and work with me on it. The nurses there are very hardworking and very bright, and willing to learn.”

laugh your way to a healthier life While walking through the TMC

Laughter in the workplace is conta-

hallways, you may detect laugh-

gious and does not require any spe-

Hospital Centro Socorro de lo Alto has its share of challenges, Sansom said.

ter therapy in action.

cial equipment or space. It is one of

“The power will go out. The water will go out. The equipment will break down. That’s how it is. You stretch yourself. You’re outside the box.”

ho” are signs of simple stress-reliev-

the most economical and easy-toSounds of “Ha, ha, ha” and “ho, ho, ing techniques taught to hospital

Children laugh out loud more than

staff by Dr. Gulshan Sethi, TMC’s

300 times each day. It’s time to join

medical director of cardiothoracic

in the fun! Take time daily to breathe,

surgery. As a richly accomplished

stretch and laugh and enjoy the

surgeon, Sethi’s recent interest in

long-term benefits of better health.

integrative medicine has everyone laughing for joy.

Laughter therapy consists of three components, including a series of breathing exercises and stretching and a period of unconditional laughter exercises, followed by guided relaxation. Sethi reminds us that “people who fail to smile or laugh in stressful or uncomfortable situations may be more prone to heart problems.”

19

practice anti-stress measures.

children at TMC community benefit from 25 years of CARE CMN support ...continued from Page 15

In 2009, TMC Foundation celebrated a quarter-century

no muscle strength from the waist down. He was hospitalized again at TMC, this time at a cost of about $8,000. By the end of last year, the Konows had paid $44,500 to the hospital. And after reviewing their situation, TMC chose to write off the rest of their balance.

The hospital also helped Kevin find discount plans to help cover the cost of his medications.

relationship with Children’s Miracle Network, benefiting children’s services at Tucson Medical Center.

TMC’s affiliation began the year after CMN was founded in 1983 – with the commitment that funds raised through the nonprofit organization remain in the local community. The first CMN telethon in Tucson was held on KVOA-TV Ch. 4 in May

Kevin gets around by wheelchair and is too weak to operate his harvesting equipment, so he now teaches others how to repair and maintain farm equipment.

Cheryl’s full-time job, she said, is helping Kevin get around.

1986.

Since then, various telethons, radiothons and corporate fundraising events in Tucson have generated more than $10 million – and every penny raised here has stayed here to support TMC for Children.

“We just deal with this as best we can,” Cheryl said.

“TMC was great with us. It’s possible we could never have paid off that bill. They were just a blessing. They gave us a second chance at life.”

Planning is underway for Aug. 25-27, when TMC will again take to the airways with Clear Channel Radio and 92.9 The Mountain’s morning show for a radiothon to share TMC’s story

Jean Newton, manager of TMC’s patient financial services office, said she and her staff gladly “took the Konows under our wing. They are wonderful, diligent, hard-working people who made every effort to pay their bill.”

about taking care of the children of Southern Arizona.

Jean Newton

20

A boy is all smiles on his father’s lap after getting his arm treated by Tucson physicians.

The three orthopedic surgeons and one anesthesiologist traveled to Haiti to provide medical assistance to earthquake victims.

Help in Haiti

With support from their practices, the community, and TMC, four physicians with strong TMC ties traveled to Haiti in January to help with earthquake relief efforts.

Drs. Russell Cohen, Joel Goode and Eric Anctil of Tucson Orthopaedic Institute were joined by Dr. Luis Esparza of Old Pueblo Anesthesia.

TMC employees and community members stuffed two shuttle buses with goods to aid Haiti’s earthquake victims. The goods were delivered to Haiti by World Care, an international relief organization based in Tucson.

From left to right: Eric Anctil, Russ Cohen, Joel Goode, and Luis Esparza take a break during their week-long humanitarian mission to Haiti.

21

tmc services Cardiac Care The cardiac care services at TMC combine leading medical and surgical specialists with expert staff and state-ofthe art equipment to treat patients in all stages of cardiac disease.

Our cardiac catheterization suites are equipped to provide diagnostic and treatment procedures performed by cardiologists, nurses and technologists.

Two operating rooms are dedicated to cardiothoracic and cardiovascular surgery. And our cardiac diagnostics program includes exercise stress testing, echocardiography, heart monitoring and other services.

Children’s Care TMC is an associate member of the National Association of Children’s Hospitals and Related Institutions – the only NACHRI member hospital in Southern Arizona. Being an associate member reflects TMC’s commitment to children’s health care.

TMC for Children includes the region’s first dedicated Children’s Emergency Center, the only pediatric hospice and the only pediatric gastrointestinal laboratory.

and seniors, and 24-hour crisis and evaluation services.

Our diverse team of behavioral health professionals works in an atmosphere of collaboration, providing care to our community since 1960.

Emergency Care TMC’s Emergency Department is the largest in Southern Arizona, caring for close to 100,000 patients each year.

About a third of those patients are children, who receive specialized care in Tucson’s first Children’s Emergency Center. TMC has dedicated a separate area with child-focused equipment and staff to serve the families of Southern Arizona.

Neurosciences TMC and the Center for Neurosciences provide non-stop neuroscience care, staffed 24 hours a day with neurosurgeons and neurologists. The TMC Neuroscience Center offers the region’s most comprehensive diagnostic and treatment services for patients with neuromuscular and neurological disorders, including treatment for Parkinson’s disease, brain tumors, epilepsy, multiple sclerosis, cancer, strokes, seizures and other brain, nerve and sleep deprivation disorders.

TMC for Children offers inpatient and ambulatory surgery programs with dedicated pediatric anesthesiologists and child-life specialists, and also includes the hospital’s acclaimed Newborn Intensive Care Unit, Pediatric Intensive Care and Pediatric Therapies.

The facilities include two neurosciences operating rooms, a neurointensive observation unit, a neuronursing unit, epilepsy monitoring units for both adults and children, a Sleep Diagnostics Lab, a Neurophysiology Lab, and a neuroradiology biplane, the gold-standard for state-ofthe-art multi-dimensional brain scanning.

Behavioral Health Palo Verde Hospital provides behavioral health services based in a community hospital setting. We have 48 adult inpatient beds, intensive outpatient programs for adults

Imaging and Diagnostic Services TMC provides a full range of imaging and diagnostic services including X-ray, mammography, CT scan, ultrasound, MRI, EEG, EMG, diagnostic radiology and

nuclear medicine imaging. TMC offers imaging services in a family-friendly environment, with an emphasis on low-dose pediatric imaging and designated kid-friendly waiting areas. Since 2008 TMC provides all-digital imaging services, eliminating the need for film and allowing doctors to look at results and images from their office computers.

Intensive Care Units TMC has adult, cardiac, pediatric and newborn Intensive Care Units, all with state-of-the-art equipment and specialized nursing staffs specially trained to care for the complex needs of critically ill patients.

Maternity TMC continues to deliver the most babies in Southern Arizona, with the family-oriented, specialized obstetrical and newborn expertise to support expectant mothers and families throughout the pregnancy and birthing experience. Experienced anesthesiologists, perinatologists and neonatologists are available at all hours.

continued on Page 24...

22

benefi t 2009 community benefit as reported in 2009

community benefit as reported in Uncompensated Care (Charity Care and Bad Debt) ..... $14,908,079 Unpaid Costs ............................................................. $ 9,997,656 Outreach & Education ................................................. $ 8,554,493 Total .......................................................................... $33,460,228* *unaudited figure

giving backgiving

more

outreach & education

25.6% charity care unpaid costs

17.2%

29.9% 27.3% bad debt

TMC will report more than $33.4 million in community benefit and charity care for 2009. This is a $5 million increase over 2008 reporting. TMC utilizes the community benefit standards endorsed by the American Hospital Association.

What makes up this number?

Uncompensated care includes both charity care and bad debt. Charity care is free or discounted health services provided to people who can demonstrate that they do not have the means to pay the full cost of care and who meet the organization’s financial-asistance policy criteria. Bad debt consists of services for which the hospital anticipated but did not receive payment. Charity care and bad debt are reported in terms of costs, not charges.

23

For more information about TMC’s charity care policy, visit www.tmcaz.com.

Nonprofit hospitals also report unpaid costs of public programs for low-income people – the shortfall created when a facility receives payments that are less than the cost of caring for public-program beneficiaries.

Community benefit programs and activities provide treatment or promote health and healing as a response to identified community needs. These programs and activities help improve access to health care services, enhance the health of the community and advance medical knowledge.

...continued from Page 22

tmc services

Senior Services TMC Senior Services offers a variety of programs and support, including services during the hospital stay and after patients go home, plus year-round wellness programming and volunteer opportunities. This unique program is headquartered on the El Dorado Health Campus.

Therapy Services TMC Therapy Services is committed to providing the highest quality of care with specialized staffing and innovative programming. Multidisciplinary teams of dedicated health care professionals make it possible for patients of all ages to access the appropriate intervention and treatment at each point in the therapy continuum.

We offer services for inpatient acute therapy, assistive technology, audiology, cardiac rehabilitation, hearing aids, pediatric therapy and stuttering therapy. Working in a team approach, experienced and specialized staff provides multiple levels of care. Our therapy staff includes physical therapists, occupational therapists, speech-language pathologists, audiologists, exercise physiologists and registered nurses.

Respiratory Care TMC Respiratory Care helps patients achieve the optimum level of daily functioning through goal setting, assessment and monitoring. The team provides diagnostics and therapeutic services, disease management, health promotion, and patient and caregiver education.

Respiratory therapists assess and treat respiratory ailments, including chronic lung conditions such as asthma, bronchitis and emphysema, as well as more acute multi-systemic problems stemming from other conditions such as heart disease, stroke or trauma. Specialty services include bronchoscopy, hyperbaric oxygen therapy, pulmonary function testing and sweat chloride testing.

Recognizing the staff’s commitment to their patients, the Arizona Society of Respiratory Care honored TMC Respiratory Care last August as Arizona’s Department of the Year.

Other Services TMC offers many more programs serving Southern Arizonans from birth to the end of life. More information about programs such as therapies, gastrointestinal, vascular and much more is available at www.tmcaz.com.

Saguaro Physicians Saguaro Physicians LLC offers the community a healthy variety of medical services. Primary care providers and specialists deliver care in internal medicine, family practice and rheumatology with quality and convenience as their cornerstones.

Saguaro Physicians offices are in growing neighborhoods throughout the north, east and southeastern sections of town.

In 2009, TMC HealthCare’s employed physician group went live with its electronic medical record. Once TMC goes live in June with its system, both the physician and the hospital will have access to a patient’s medical records.

TMC Foundation TMC began with a single act of philanthropy when Mrs. Anna E. Erickson donated land to the community for the development of a much needed-hospital. A legacy of community support continues today through the TMC Foundation.

As Tucson Medical Center’s charitable arm, the TMC Foundation is able to touch the lives of people throughout Southern Arizona. Gifts to the foundation go toward funding the latest in life-saving medical equipment, improving facilities, providing educational programs for TMC patients and staff, and promoting community well-being and safety.

24

TMC Community Affairs recipients As corporate citizens in the Southern Arizona community, Tucson Medical Center provides support to other nonprofit organizations serving the region. Last year, TMC provided $239,535 to these important community partners. Below is a list of some of the organizations receiving financial support from TMC.

American Cancer Society American Diabetes Association American Heart Association American Lung Association American Red Cross Ara Parseghian Medical Research Foundation Arizona Chapter American Parkinson Disease Arizona Blind & Deaf Children’s Foundation Arthritis Foundation Big Brothers Big Sisters of Tucson Boys & Girls Club Caregiver Consortium Casa de los Niños Children’s Action Alliance CODAC Behavioral Health Services Community Food Bank Diaper Bank of Southern Arizona Educational Enrichment Foundation El Rio Community Health Center Foundation Epilepsy Foundation of Arizona Hispanic Scholarship Program for Southern Arizona Juvenile Diabetes Research Foundation Susan G. Komen, Southern Arizona Leukemia and Lymphoma Society Lupus Foundation March of Dimes National Alliance of Mental Illness National Multiple Sclerosis Society New Beginnings for Women & Children Pima Community College Pima Council on Aging Ronald McDonald House Southern Arizona AIDS Foundation Southern Arizona Center Against Sexual Assault Southern Arizona Red Cross St. Luke’s Home Tucson Interfaith HIV/AIDS Network Tucson Children’s Museum Tucson Clean and Beautiful Tucson Jewish Community Center Tucson Nurses Week Foundation University of Arizona University of Arizona Hispanic Scholarship Endowment Volunteer Center of Southern Arizona Women’s Foundation of Southern Arizona YWCA

TMC HealthCare Board of Trustees Louise L. Francesconi, Chairwoman Matthew Atlas, M.D. Henry K. Boice Michael W. Bracht, M.D. Mary E. Cochran, M.D. David J. Cohen Susan L. Ernsky Manuel M. Ferris Lou Lancero, M.D. Eduardo A. Leon Michael R. Probstfeld, M.D. Richard M. Moreno Judith F. Rich David F. Peachin Joel D. Valdez Jon R. Young TMC Medical Executive Committee Matthew Atlas, M.D., Chief of Staff Michael Probstfeld, M.D., Chief of Staff Elect Department Chairs J. Manuel Arreguin, M.D. Brian Cammarata, M.D. Christopher Florence, M.D. Thomas Harmon, M.D. Steven Ketchel, M.D. Eva McCullars, M.D. Moira L. Richards, M.D. Steven Siwik, M.D. George Wilcox, M.D. Section Chiefs Robert Aaronson, M.D. Michael Badruddoja, M.D. Susan Bazzell, M.D. Richard Callihan, M.D. Amram Dahukey, D.P.M.

Charles Daniel, M.D. Joel R. Goode, M.D. Michael Hamant, M.D. Barton Hodes, M.D. David Killion, M.D. Michael Lavor, M.D. Douglas Lowell, M.D. Marco Marsella, M.D. Brandon Massey, M.D. Ann O’Connor, M.D. Doug Peterson, M.D. Ronald Quintia, M.D. Gulshan Sethi, M.D. Mohammed Sikder, M.D. Keith Soderberg, M.D. Paul Yurkanin, M.D. TMC Foundation Board of Trustees David J. Cohen, Chairman Ann M. Aros Henry K. Boice Joni S. Condit Palmer C. Evans, M.D., Life Trustee Dorothy Finley, Life Trustee Louise L. Francesconi Anne M. Fulton-Cavett Christine Kocsis Christopher Maloney, M.D. Sidney N. Mendelsohn, Jr. Kevin Morrow David F. Peachin Rory “R.J.” Riley Alan K. Rogers, M.D. Keri Lazarus Silvyn Alan Stein Karen Thurman Arlene Webster, R.N. Jim Zarling

65

years