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Southern Arizona ANNUAL REPORT


Leadership perspective Judy Rich, R.N. President and Chief Executive Officer

Tucson and Southern Arizona have witnessed significant changes in how health care is delivered in our community. But one thing has remained constant throughout; Tucson Medical Center remains a locally owned community hospital committed to delivering world-class health care. In fact, we remain the only locally owned community hospital in the Tucson area. While mergers have become the industry’s solution to the challenges of operating a hospital, consolidation is fraught with risks. Currently, Tucson is a relatively affordable health care market. According to Kaiser Health News, Tucson has the fourth-lowest commercial insurance premiums in the country. Medicare costs are 93 to 95 percent of national averages.


Low premiums are essential for our local economy given our challenges with relatively low wages, high poverty, and a large uninsured population. Unfortunately, other communities often find hospital consolidation has led to higher local insurance premiums or reduced health care benefits. We are committed to achieving our financial goals by achieving the Institute for Healthcare Improvement’s Triple Aim of improving patient experience, improving the health of populations and reducing the per capita cost of care. Why should the community care about who governs their hospital? Does it matter whether it is governed through fellow community members or corporate management structure elsewhere? There is no doubt that all hospitals - committed to healing the injured and sick while also promoting good health - seek to deliver quality health care. However, TMC, as a nonprofit, locally governed community hospital, has unique roles and responsibilities.

Even from the beginning, TMC has been driven first and foremost to meet the health care needs of the entire community. In 1943, local leaders established TMC to address a local need for more hospital beds. Our mission since then has focused on the health and well-being of the entire region.

Every day, people tell me that they appreciate our community focus, our commitment to remaining independent and our commitment to Southern Arizona. Some say we took a risk in choosing our direction, but it doesn’t feel that way.

As costs increase, those who are uninsured or lack adequate financial resources turn to nonprofit community hospitals such as TMC. The strategic direction for this hospital is set by TMC’s local Board of Trustees – not Wall Street investors or corporate leadership from other areas. We are connected to Tucson and Southern Arizona by virtue of the simple that fact we live and work here every day... and have for over 70 years.

We will not be led astray as long as we always frame our decisions in terms of how they will impact our patients and the community. We have chosen to affiliate instead of purchase, to partner instead of merge, and to align instead of buy. Through our partnerships and alignments, we are stronger and the community is better served.

TMC relies upon its dedicated and expert medical staff, who are equally committed to the value independence brings to health care. By working together with our physician colleagues, we can better serve our community and strengthen our position in the region.

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On the southeast corner of Tucson Medical Center, at the heart of the hospital’s women’s services area, there is a very special courtyard that is a place of reflection, healing, peace, beauty and learning.

Leadership perspective Louise Francesconi, TMC Chairwoman

When you walk the path, you see the names of women – wives, mothers, friends and daughters – who represent strength, love and giving. Words like Beginnings, Nurture, Growth, Explore and Wisdom guide you through the courtyard, much as the women honored used those same words to shape their families, their businesses, their community. It’s so fitting that a special place like this is at TMC, a place of caring and commitment to people. TMC is about community – we like to say, “We Are Tucson” – with roots as deep as the Texas ebony that grows in the center of the courtyard. But even as we honor our history, we are not rooted in the past. Instead, we are staring boldly into the future to visualize the needs of this community and to continue to invest in the wellness and health of all of us. TMC is more than a business. It’s even more than a hospital. It is part of the fabric of our community and that certainty is evident in how we approach our work – with authenticity, commitment, caring, compassion and love. How does a business do that? How does a business become more than a business? It’s through the legacy of individuals who strive every day to make a difference, combined with a vision for a future for our community that is a little brighter than it is today.

If you are reading this report, you have contributed to what TMC is now. And you will contribute to what we will be in the future. As we forge ahead in this time of innovation, we will have this space to reflect, learn and appreciate all of those who have led this community hospital with vision, leadership, strength and dedication. Just as the courtyard is cradled in the heart of our hospital, TMC is held in the hearts of so many families that we have touched. And, like the courtyard, TMC will continue to grow, change and evolve with the community we serve.


In my studies for a combined Masters of Healthcare Management/MBA program at the University of Texas, we spent one recent weekend analyzing the dynamic changes that have taken place in the health care landscape – many of which we’re seeing play out right here in Tucson.

Leadership perspective J. Manuel Arreguin, M.D. TMC Chief of Staff

Regardless of the profound evolution in the local health care market space, TMC’s strategy is to continue as the only nonprofit, independent hospital in Southern Arizona – and we’re doing it in partnership with our physicians and through collaboration with other like-minded health care organizations. Now in its second year of collaboration, the TMC/Phoenix Children’s Hospital relationship has expanded comprehensive services to our pediatric Tucson community. Pediatric specialists in infectious disease, endocrinology and gastroenterology allow our community pediatricians to keep patients local – which is better for patients and families, physicians, and the community as a whole.

A second affiliation is the consultation services that the Mayo Clinic Care Network affords to the physicians who care for our patients. When our capable local physicians are able to consult with the world-class professionals at Mayo and access carefully-vetted Mayo resources, TMC patients and families benefit without having to travel to Phoenix or Rochester. And these services are available with no additional cost to our patients. Finally, we continue to broaden affiliations with other highly respected, independent organizations, such as Arizona Community Physicians. And, we continue to grow the footprint of our own high-quality primary care services through TMC One, improving health care access and convenience for our community. TMC continues to put the patient in the center of our ongoing efforts to provide affordable, high-quality, value-based care. And we are pleased that these relationships strongly position us to navigate these everchanging health care waters.

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Wyatt Decker, M.D., CEO of Mayo Clinic in Arizona, announces TMC’s membership in the Mayo Clinic Care Network.

TMC taps expertise from Mayo Clinic, Phoenix Children’s

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TMC staff and supporters learn about the resources & benefits available through the collaboration.

As Tucson’s locally governed, nonprofit hospital, Tucson Medical Center works in collaboration with other providers to enhance services for patients and others in the community. TMC was proud to join the Mayo Clinic Care Network, a national network of organizations committed to better serving patients and their families through collaboration. TMC also developed a new relationship with Phoenix Children’s, which provides pediatric physician services for TMC’s inpatient and intensive care units. “Collaboration isn’t a buzzword or a nebulous goal in a planning document; it’s a critical element in strengthening patient care in a complex health care environment,” said Judy Rich, president and CEO of TMC. “We have seen it happen time and again in this hospital: When we work together, we’re better. Channeling our shared knowledge toward a common focus inevitably improves patient care, increases efficiency and helps us accomplish more than we can alone.”


Through the Mayo Clinic Care Network, physicians aligned with TMC can connect to more than 4,500 physicians and scientists at Mayo Clinic. Not only can providers ask for input on specific patient cases through electronic consulting, but they also have access to a repository of Mayo-vetted medical information and patient education materials. These tools, in addition to a Health Care Consulting program, help TMC provide the best care for its patients as well as improve its systems and the health of the community. “We are linking arms with TMC and other like-minded organizations around the country and across the world to do our absolute best in caring for patients,” said Wyatt Decker, CEO of Mayo Clinic in Arizona. “With that formula, the future of health care in the United States is very bright.” Rick Anderson, M.D., chief medical officer at Tucson Medical Center, said TMC’s membership in the network allows physicians to collaborate and access the expertise that is a hallmark of Mayo Clinic, even as patients continue receiving care as close to home as possible.

In addition, TMC was pleased to welcome Phoenix Children’s to provide long-term, consistent pediatric care under a shared treatment philosophy that emphasizes family-centered, multi-disciplinary approaches, daily rounds and strong connections with primary care providers. As one of the 10 largest children’s hospitals in the country, with a reputation for providing superior care, Phoenix Children’s is uniquely positioned to partner with TMC in developing comprehensive integrated pediatric services where service gaps exist in Southern Arizona. Not only does Phoenix Children’s medical team call TMC their hospital home, but the staff shares TMC’s commitment to work with community pediatricians and specialists to make sure patients are served closest to home to the degree possible. The two organizations also share a commitment to the education of Arizona’s future physicians.

“The foundation for this relationship is a shared treatment philosophy that is focused on best practices and evidencebased medical care,” Dr. Anderson said. “We look forward to the resources that this collaboration will bring to the high-value care we already provide our patients.” 6


TMC joins four other nonprofit hospitals in alliance to improve patient care, coordination

With hospital consolidation continuing at a strong pace nationally, Tucson Medical Center created a different kind of relationship with four other independent, nonprofit community hospitals to leverage resources and strengthen care to their respective communities. Each of the participating hospitals in the Southern Arizona Health Alliance will remain independent, and all believe patients deserve care close to home – whether that’s in Benson, Bisbee, Safford, Tucson or Willcox. When minutes matter, these hospitals are crucial parts of a network that ensures patients receive the care they need, when they need it, and where they need it. “This new relationship acknowledges that even though each hospital member has unique strengths to celebrate, we’re stronger together,” said Judy Rich, president and CEO of Tucson Medical Center. “And when we’re stronger, we’re better able to navigate the new health care frontiers that continue to unfold in this time of change and innovation.” The deeper connections allow for greater efficiencies in purchasing, insurance and electronic medical records. Importantly, it also allows members to better coordinate care for patients, to share best practices and to enhance access to a higher level of care when necessary. By working together, the hospitals also will be better positioned for changes in health care, including the shift to value-based medical services.

Roland Knox, CEO of Northern Cochise Community Hospital, meets with TMC Pharmacy director, Gilbert Romero, and Pharmacy business manager, Al Patterson,

TMC already had long-established relationships with partnering hospitals to provide for higher acuity patients when necessary and appropriate. Patients from outside the metropolitan Tucson area make up roughly a quarter of TMC’s annual census, and Alliance patients are always guaranteed a bed. Rich Polheber, CEO of Benson Hospital and board chairman for the Alliance said, “To be aligned with an exceptional health care delivery system provides Benson Hospital with assistance in advancing our quality initiatives and expanding our clinical and operational best practices.” Jim Dickson, CEO of Copper Queen Community Hospital in Bisbee, agreed. “Through this Alliance we hope to leverage best practices and resources while achieving economies of scale to improve patient care. We hope to keep health care under the control and ownership of each community.” Mark Marchetti, CEO of Mount Graham Regional Medical Center in Safford, said he is delighted that relationships will be enhanced among hospitals that share a commitment to improving patient care throughout the region. “In a larger sense, this Alliance provides strength in numbers, from reducing costs, to sharing resources and enhancing access to specialization.” The future direction of health care requires stronger connections and collaboration, said Roland Knox, CEO of Northern Cochise Community Hospital in Willcox. “Our membership in the Southern Arizona Hospital Alliance is important to Northern Cochise Community Hospital’s efforts to remain an independent community hospital. Through this alliance, we have access to resources that would otherwise be unavailable to us.“


In 2012, Tucson Medical Center joined what was then a new federal effort to infuse health care with higher quality while reducing costs.

Accountable care organizations & TMC partner with patients

Through that effort, Arizona Connected Care became the first accountable care organization in Southern Arizona to participate in the Medicare Shared Savings Program. TMC, the sole hospital member, partnered with primary care physicians and specialists who believed there was room for both more personalized care for patients and greater efficiencies in the delivery of that care. Fast forward to 2015 when using the knowledge gained in that process, TMC became the sole hospital member in a second accountable care organization, Abacus Health, founded by Arizona Community Physicians in partnership with TMC. Since the physician group’s inception in 1994, ACP’s 163 providers and 800 employees in the Tucson area have sought to remain a patient-centered, full-service, physician-owned medical group providing comprehensive outpatient services. It’s not an easy task to keep patients healthy and out of the hospital while making the Medicare trust fund more sustainable. By working closely as a team that often includes primary care providers, specialists, hospitalists, nurses, nurse practitioners, physician assistants and other providers with health care expertise, these networks have a better ability to more proactively manage patient health. There are now more than 430 Shared Savings Program accountable care organizations serving more than 7.7 million beneficiaries in the U.S. These organizations continue to show promising results on cost savings nationally, with a combined total net program savings in 2014 of $411 million. “Together with our partners in these two innovative organizations, we look forward to continuing our work to better coordinate and integrate patient care,” said Judy Rich, TMC’s president and CEO. “When patients receive coordinated care that keeps them healthier and out of the hospital, they’re happier. And providers can practice medicine the way they know it’s most effective.” Dr. Kenneth Adler, CEO of Abacus Health, agreed. “Delivering better care while spending health care dollars more efficiently will help sustain the future of health care and protect the health of our patients and communities over the long term.” Dr. Daniel McCabe, the CEO of Arizona Connected Care, said the lessons learned over the past three years have been crucial. “We believe we have demonstrated that the concept of investing in our patients’ good health is paying dividends – for our patients and for the health care system as a whole.” 8


Overall, Pima County residents practice some healthful behaviors when compared with much of the state, including high levels of physical activity, vaccines and cancer screenings. Nevertheless, a roadmap to Pima County’s overall health also shows there are some areas that could be strengthened if Pima County is to become a healthier place.

Local hospitals, health experts share data, focus to map community health

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Health and policy leaders – including local hospitals and the Pima County Health Department - joined forces to produce a 96-page assessment of community health. The Community Health Needs Assessment identified four primary areas of focus: • Anxiety and depression spectrum disorders, which have a higher prevalence in the Medicare population here than the rest of the state; • Substance abuse and dependency, which accounts for four of the top 20 leading causes of death in Pima County; • Injuries and accidents, which remain the third highest cause of death; • Diabetes, which has doubled in rates since 2003. The Needs Assessment, required every three years of nonprofit hospitals under the Affordable Care Act, relied on a variety of data from local, state and national sources, and gathered community input through interviews, focus groups, community forums and a web-based community health survey.

TMC CEO Judy Rich discusses community health findings with Northwest Medical Center CEO Kevin Stockton and Pima County Public Health Director Francisco Garcia

Judy Rich, president and CEO of Tucson Medical Center, said the hard work begins now. “These are large and complex issues – and solutions won’t come from any one hospital or any one organization alone,” Rich said. “But it’s exciting to know that we’ve been able to boil our needs down to these four priority areas and we are committed to getting results.” Dr. Francisco García, director of the Pima County Health Department, said the community has proven that collaboration works. After the 2012 assessment pinpointed low health insurance enrollment, health organizations and the business community banded together to connect consumers with new insurance options under the Affordable Care Act. The rate of the uninsured dropped from 14 percent in 2012 to about 10 percent in 2014. “This shows what can happen when we work from a common data source and have conversations about what’s important and what matters,” Dr. Garcia said. Those participating in the effort include Banner-University Medical Center, Carondelet, El Rio Community Health Center, Healthy Pima, Northwest Healthcare, the Pascua Yaqui Tribe, the Pima County Health Department, and Tucson Medical Center. To view the report in its entirety, please visit www.tmcaz.com/community-healthneeds-assessment


For many people, cycling is a key part of an active lifestyle, combining healthy activity with social networks.

Spinning new adventures in cycling

In 2015, Tucson Medical Center expanded its role in one of the premier cycling events in the United States, reaching beyond the hospital’s walls to educate and promote health, wellness and safety throughout Southern Arizona. Founded in 1983 with what was then a 198-person event, El Tour rounded out its 33rd year with more than 9,000 riders. “The mission and vision of TMC is a vibrant one and we are honored to be a part of it.” said Richard DeBernardis, founder and president of El Tour de Tucson.

Easter Seals Blake Foundation was El Tour’s primary beneficiary and the Tour was dedicated to former Congresswoman Gabrielle Giffords and Navy combat veteran and NASA astronaut Captain Mark Kelly. Perimeter Bicycling looks for individuals who serve as examples of achievement and who overcome life’s obstacles. TMC, meanwhile, also continued to serve as presenting sponsor of one of the largest roundthe-clock mountain bike racing events in the world, 24 Hours in the Old Pueblo, by Epic Rides. The race, in its 14th year, helped raise money to support those diagnosed with cancer.

Since the event’s inception, 12 title sponsors have been part of Perimeter Bicycling’s El Tour history. Assuming a larger role was a good fit for TMC, given the hospital’s support in the past, along with ongoing support for other cycling events such as Cyclovia and Epic Rides 24 Hours in the Old Pueblo. “As Tucson’s nonprofit community hospital, we are delighted that athletes from here and across the globe will once again have the opportunity to ride and race,” said Julia Strange, vice president of community benefit, Tucson Medical Center. “The energy around this event is contagious and we believe that it is foundational in making Tucson one of the healthiest cities in the nation. We are Tucson. And we are thrilled to sponsor El Tour.”

Tucson Medical Center El Tour de Tucson presented by Casino del Sol Resort


Sports can be an important part of youth development, but sports-related concussions are also increasingly becoming a public health concern. Even with protective equipment, concussions remain among the most common injuries and can not only result in emergency room visits, but can have longterm implications for still-developing brains.

TMC helps sponsor effort to reduce the risk of sports-related concussions

Tucson Medical Center was pleased to support efforts by The CACTIS Foundation (CACTIS), a nonprofit organization committed to sharing information with young athletes and their parents about the risks of concussion and how to reduce their harmful effects. Although most people are aware that concussion symptoms can include headache, nausea, sensitivity to light or noise and dizziness, some of the longer term impacts can include depression, sleep disturbances, and changes in concentration and memory. According to CACTIS, as many as 1 in 5 high school athletes will sustain a concussion during the season. And while football has garnered a great deal of attention, girls are not immune. Girls’ soccer represents the second highest percentage of contact sports athletes sustaining concussions. Not only have TMC and CACTIS joined forces to help raise awareness of the risks of concussion and how to reduce their numbers and impact, but through a grant from the TMC Foundation, were able to perform preseason baseline concussion testing of approximately 500 local soccer players. In case of injury, the baseline test results can be compared with postconcussion tests to identify the effects of the injury and help concussion-trained professionals make more informed decisions

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about when the athlete should return to play and school. “This is often the most difficult decision athletic trainers, physicians and coaches have to make, especially in the young athlete, whose brain matures and responds to trauma at its own highly individual rate,” said Hirsch Handmaker, M.D., chairman and CEO at CACTIS. Dr. Handmaker and his Conquering Concussions colleagues are co-founders of the Tucson Concussion Center. Julia Strange, vice president of community benefit for TMC, added, “Even as sports professionals consider player safety measures that can help mitigate the risk of concussion, it is our job to share the message that head injuries are always a serious concern.” Of course, concussions are not confined to sports and the Tucson Concussion Center opened in the Tucson Medical Park so that Southern Arizona patients have access to state-of-the-art concussion care “under one roof.” In addition to sports, concussions most commonly can occur among members of the military and first responders, as well as in workplace injuries, motor vehicle accidents and to victims of domestic violence. To learn more about the Tucson Concussion Center visit: tucsonconcussioncenter.com


Over the summer, Amber Bermudez signed up for a car seat education class to protect her toddler.

Mom passes vital car-seat test

One of her take-aways from the course was that while her son, Luis, was going on 3, it was best to keep him rear-facing until he exceeded the height and weight limit for the seat. That position better protects a child’s head, neck and spine in the case of a crash. Bermudez went home and installed her new car seat with education she obtained from the class, funded by the Governor’s Office of Highway Safety and administered through a partnership between Tucson Police and Tucson Medical Center. A few months later, a pickup truck ran a red light at 29th and Wilmot and T-boned her car. All three adults were seriously injured and had to go to the hospital. Luis was unscathed. “Everything happened so fast and was so surreal, but I do remember the medic asking, ‘Who put this car seat in?’ I was scared at first thinking, ‘Did I do something wrong?’ Then he told me that it was installed perfectly. He said that as first responders, they are too often called to car accidents where children were injured because the car seat was not installed properly. He told me that my son’s car seat took all the impact of the crash,” she recalled. “When he told me Luis was OK and that it was only because his car seat was installed properly, I broke down in tears. I was so relieved.”

Tucson Medical Center has provided a hospitalbased car seat program for community members in need for 32 years. Those programs have come with a pledge: We never give out a car seat without providing parent education. In 2015, TMC distributed 1,512 seats with the help of partnering organizations. In addition to a car seat loaner program, TMC also provides free booster seats as part of the Boost Your Booty program, in which 3,700 booster seats were distributed last year. “We couldn’t do the work we do without strong partnerships, from Tucson Police Department, to the Governor’s Office of Highway Safety, to Geico and our media partners,” said Hope Thomas, director of volunteer services and community programs. Although motor vehicle crashes remain one of the leading causes of death for children under the age of 10 in Arizona, those deaths decreased nearly 30 percent from 2013 to 2014. Half of those children had been improperly restrained or unrestrained, so while progress is being made, Thomas said there is more work to be done. TMC also has an active car seat recycling program. In 2015, 224 car seats were recycled or repurposed, with 60 going to Sonora, Mexico to make a difference for children who may otherwise ride unrestrained.

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Surely at some point, you’ve misplaced your keys or you’ve walked into a room, only to have no earthly idea what drew you there. On occasion, if you’ve shared in the normal human experience, you’ve also drawn a blank trying to recall someone’s name. Or maybe you’ve tried to retrieve the perfect word, only to have it stay planted on the tip of your tongue.

Classes launched to protect memory, boost brain health

Train Your 13

Brain

That process of retrieving information actually does decline to some degree as we get older. But just as lifting weights can help your biceps stay strong so you can complete everyday tasks like carrying grocery bags, and just as walking at a good clip keeps your heart healthy, exercising your brain can help protect against cognitive decline. Nearly 100 people have participated in TMC’s new Memory Training Program, which launched in May and is funded by the Raskob-Paulus Family Challenge Match. The coursework, designed to make new information “stickier” and shore up the memory bank, is designed and certified through the UCLA Longevity Center, drawing on 40 years of brain research demonstrating that focused training can help improve memory, attention and recall. Classes are held in small, interactive groups and share strategies over a four-week program to address the most common memory complaints, from forgetting names to misplacing objects or forgetting important appointments. Dr. Karen Miller, an associate professor at UCLA specializing in geriatric psychology, said only about a third of dementia risk is genetic, which means we can influence a number of other variables. Diet, physical activity, stress reduction and brain stimulation all work together to improve memory and language skills, she said.

In fact, she noted, research studies have drawn links between reduced risk of dementia and greater physical and cognitive activity levels. It has also become increasingly clear that the brain has the ability to rewire itself as we take in new information and learn new skills – revolutionizing how we think about our ability over time to retain and recall information. Maya Luria, director of TMC Senior Services, said the programs are in response to a community need. “We continue to see a demand for ways that memory can be improved as people age,” she said. “The Memory Training Program provides these skills by utilizing key components for development of our memory bank.” As one participant noted, “I had resigned myself to the fact that my memory would just continue to get worse as I age thinking there was nothing I could do about it. It was so refreshing to experience an improvement after practicing the techniques!”


TMC supports local farming community to improve community health

There’s no question that high-quality, healthy diets are connected to better health. So when Tucson Medical Center had a chance to support local food producers through a unique collaboration with the Tucson Community Food Bank, Food Services staff worked hard to make it happen. As the region’s largest hospital, TMC serves more than 2,000 meals every day in its cafeteria, as well as another 1,200 meals to patients. Leveraging that kind of buying power allows farmers within a 90-mile radius of the hospital to know they have a large, stable purchaser of their crops. Local producers, identified through the Food Bank, brought hundreds of pounds a week of summer crops such as cucumbers, slicing tomatoes and cherry tomatoes. Fall crops followed, including chard, broccolini, radishes and snap peas. Kara Jones, the farmer’s market manager for the Food Bank, said a grant from the U.S. Department of Agriculture served as a catalyst to address a gap in the market by harnessing the power of a collective. “These individual farms do not have the capacity to supply a big institution on their own,” she said. “And while there is power in selling directly to consumers at farmer’s markets, you do hit a ceiling in terms of growth if that’s your entire business model.”

The benefits accrue on the other side as well. The farm-to-table model allows produce to be picked and sold within two days, ensuring higher nutrient values and a lower carbon footprint by reducing transportation needs. Plus, the food is fresher tasting, said Beth Dorsey, TMC’s director of Food Services. “We share a similar mission with the Community Food Bank in that our goal is to help Southern Arizona,” she said. “By providing economic security for farmers, they have greater confidence to hire additional workers, which supports the region’s economic health as a whole and keeps resources within the local community.”


For Olivia Peters, The Core is a convenient one-stop shop: a place to strengthen muscle, stimulate the brain, build a social network, learn about the community – and then go grab lunch or a haircut afterward.

Wellness in store for thousands at The Core

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The ability to reach people like Olivia where they live and shop was one of the reasons TMC opened the wellness resource in a comfortable, convenient retail mall setting. By the time its first birthday rolled around on Thanksgiving weekend, it had touched about 14,000 people. “I thought it was too good to be true when I first learned about it,” said Peters, who retired from broadcast sales in Seattle and happened upon The Core while at the mall for another event.

With The Core offering fitness courses from circuit training to Let’s Get Lean, Zumba and tai chi, Peters was soon sampling a smörgåsbord of classes, including learning more about weight training and balance and trying a yoga class. Her husband, Paul, who retired from the construction industry, soon joined her, as did a few other friends. Olivia said she appreciates the small class sizes and knowledgeable, personable staff she can readily approach with questions. The Core is far more than a place of physical fitness. In 2015, The Core also featured roughly 125 free events and lectures that served to highlight TMC’s commitment to the community, giving Tucsonans the tools to take control of their health care or to learn more about community health. The Core also provides fitness and nutrition assessments as well as convenient access to health information.


TMC and the J: The Core of a strong partnership Tucson Medical Center is focused on making the community a healthier place. The Tucson Jewish Community Center shares that same interest. Combining efforts only made sense.

Tim Bentley, retail wellness outreach manager at The Core, said TMC’s mission is to protect the health of the community, whether that means treating them when they’re sick, or, as in the case of the Peters, providing them with information to better manage chronic conditions or avoid them altogether. “What we’ve found in the first year of operation is that The Core really does serve as a chance to connect the dots along the entire spectrum of care,” Bentley said.

When it comes to promoting healthy lifestyles, the two entities worked more closely than ever before to promote good health. Not only did TMC serve as the title sponsor for the J’s Family Wellness Festival in October – which provides education, activities and resources revolving around health and wellness for the entire family – but the two organizations worked together to provide a training program for El Tour de Tucson for new cyclists in the community. And while the J has excellent resources focused on physical activity, TMC helped accommodate many requests for nutrition education, providing nutrition classes and consultations. With the opening of The Core, the relationship deepened even further. The J provides a weekly fitness class at The Core, open to all members of the community. Meanwhile, the J promotes their fitness facilities and programs to users of The Core. “Sharing a common goal, even as we have our own respective missions, makes this relationship ideal,” said Tim Bentley, retail wellness outreach manager at The Core. 16


Wellness starts at home. Schools can reinforce messages of healthy diets and lifestyles, but with teachers already challenged to do too many things in a day, that’s where community partners can play a big role.

TMC works with schools to share healthy lifestyles with youth

Tucson Medical Center has had a longstanding relationship with local schools. Aside from promoting annual cycling and walking-toschool events, TMC helped develop a water safety curriculum, offers nutritional outreach and works with two dozen schools through Girls on the Run and Girls On Track running programs. These programs are funded in part by philanthropy and build confidence in elementary and middle school girls. But in 2015, TMC developed an even stronger relationship with two local schools. “By getting kids moving and engaged in healthy activities that are also fun, we’re hoping to build a foundation early to encourage good habits and help make a difference throughout their lifetimes,” said TMC Wellness Director Mary Atkinson. Whitmore Elementary, just north of the hospital campus, tapped TMC to share its wellness expertise with students through its 21st Century grant to expand after-school enrichment programming. TMC Wellness staff members worked twice a week with kindergarteners through third graders on nutrition and wellness concepts. The students adopted the MESS pledge – move, eat, sleep, smile – and even learned cheers to help them remember the acronym. They wrapped up the semester by showcasing what they learned for their parents and teachers.

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“Schools care deeply about their students’ academic achievements, but programs like these allow us to balance those intellectual efforts with other activities and information that will help our students build well-rounded lives,” said Whitmore Elementary Principal Lisa South. “Good health is an important piece of that.” TMC Wellness staff members also worked closely this year with students at Apollo Middle School in the Sunnyside Unified School District. Not only did they share healthful messages about exercise and nutrition, but social development issues as well, such as dealing with bullying and overcoming fear. Through grants and community partnerships, including with the Canyon Ranch Institute, the school has a fully equipped test kitchen, as well as a fitness center for families and a school garden to help families learn how to grow nutritious vegetables and herbs. “Apollo has been a strong partner and has made our job a lot easier because its families are already deeply engaged in healthy living,” Atkinson said. “The school’s families and students already understand the connection between physical and emotional well-being and scholastic success. As a community hospital that cares about the health of the community, we are thrilled to develop these deep connections with local schools.”


Local fire captain on the mend after catastrophic aneurysm

On March 26, Rural/Metro Fire Captain Eric Cline was celebrating his fourth wedding anniversary with his wife, Risa, when he complained about his head hurting and suddenly collapsed. Cline suffered a brain aneurysm that then caused a stroke. Although thousands of people suffer a ruptured aneurysm every year across the country, they don’t typically strike at the comparatively young age of 40. With a 50/50 chance of getting to the hospital alive, the father of three was rushed to Tucson Medical Center where Kurt Schroeder, M.D., a neurosurgeon from the Center for Neurosciences, helped save his life. Throughout his month-long hospital stay, his firefighter colleagues from Rural/Metro and across the region kept vigil at the hospital and supported his family by doing yard work and chores through his recovery. One surgery followed another to remove fluid from his brain. His rehabilitation is ongoing, but the family remains grateful that he will be around to raise his children. He continues to cope with after-effects of his brain trauma. And while his days of firefighting are likely over, Cline is hoping he’ll be able to secure a job in another aspect of public service. As a Neuroscience Center of Excellence, TMC is nationally recognized for its neurological and stroke care.


New multi-specialty medical complex to serve Southeast area Tucson Medical Center introduced a new medical campus to serve the Southeast region, providing new support and expertise in areas such as primary care, pediatrics and wound care. With increased demand for primary care as more people become invested in their everyday health, TMC is uniquely positioned to carry its commitment to the health and well-being of the community beyond the walls of the hospital.

News and Notes

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The 44,000-square-foot TMC Rincon Health Campus envisions a two-story medical office building. Expected to open in late fall 2016, it represents an $11 million investment on the southeast corner of Houghton and Drexel roads, which TMC has owned since 2005. “TMC has long been committed to the Civano area and we are thrilled that this project is coming to fruition after several years of planning,” said TMC President and CEO Judy Rich. “With continued growth in the southeast area, it is important to TMC that we are able to help meet the healthcare needs of our neighbors.”

TMC marked anniversary of streetcar with free rides Tucson Medical Center sponsored a day of free streetcar rides to kick off the holiday shopping season with Shop Local Saturday. “As Tucson’s nonprofit community hospital, Tucson Medical Center understands the importance of supporting local businesses,” said Julia Strange, TMC’s vice president of Community Benefit. “Shop Local Saturday connects Tucsonans with the products and services available in our own backyard and strengthens our economy by investing and circulating our money here.” The effort had the added benefit of supporting public health by raising awareness of public transportation’s role in reducing air pollution and encouraging walking and riding instead of driving.


White House in Tucson marks health expansion’s fifth anniversary In the five years since the Affordable Care Act was signed into law, 16.4 million previously uninsured Americans obtained health coverage. In Arizona, that translated to 205,000 people enrolled in Marketplace health insurance, and more than 306,000 Arizonans enrolled in the Medicaid program. That historic reduction in the uninsured – the largest shift of any period for more than four decades – was a cause for celebration in April that included not only the White House Office of Public Engagement, but the U.S. Department of Health and Human Services, health care executives, business leaders and public health activists. “I want to start by saying thank you to all of you. You are heroes to the people who finally have access to affordable, quality coverage,” said Bess Evans, Associate Director with the White House Office of Public Engagement, to the crowd gathered on the lawn in front of TMC, which was an early supporter of expanded coverage.

TMC program supports cord blood match Somewhere in the Tucson area, a baby who was born at Tucson Medical Center in the spring provided life-saving stem cells to a patient who had no other treatment options. And somewhere in Colorado, that patient – a child who was diagnosed with acute lymphoblastic leukemia – received the transfusion he or she so desperately needed. The match was made possible because of the Arizona Public Cord Blood Program, which TMC joined in October 2014. Donated cord blood is listed on the Be The Match national registry. Since the program’s inception in 2011, 30 life-saving matches have been made including this one – the first match for TMC.

Bring on the kindness! TMC joins with Ben’s Bells again Tucson Medical Center, one of 120 organizations that participated in the Ben’s Bells Kindness Challenge and the only local hospital, completed its Challenge with 1,240 acts of kindness. And it went so well, we signed up again in the fall. Even simple acts – such as helping someone carry a heavy load, unsolicited, or unexpectedly bringing them flowers – made a difference. “It gets very busy, but it says a lot when we stop to take the time to do something kind for someone else,” said Heather Bachman, director of patient experience at TMC.

TEP delivers holiday meals to hospice patients Tucson Electric Power volunteers have included hospice patients and their families in their holiday giving for 34 years. TMC was deeply grateful when three Santas, one Mrs. Claus, and several elves – mostly retired and current TEP employees who volunteer through the company’s Community Action Team – shared fully cooked Christmas meals with 18 families in the days leading up to Christmas. Krista Durocher, volunteer coordinator for TMC Hospice, said she was touched by the generosity, which included Thanksgiving meal distribution as well. “It is wonderful that our patients and families can experience firsthand the kindness of strangers, who are giving that extra support at what can be an emotional or challenging time.” 20


COMMUNITY BENEFIT OUTREACH AND EDUCATION

UNCOMPENSATED CARE

UNPAID COSTS

HOSPITAL ASSESSMENT

TOTAL

$4,951,023

$7,994,526

$31,816,000

$11,409,626

$56,171,175

9%

14%

57%

20%

100%

2015 Community Benefit TMC will report more than $56 million in community benefit and charity care for 2015, or about 11.8 percent of net revenues. In the previous year, TMC reported a community benefit of 12.7 percent of net revenues. TMC calculates community benefit using standards endorsed by the American Hospital Association.

(CHARITY CARE & BAD DEBT)

Total Community Benefit as percentage of net revenue: 11.8% (based on net revenue of $476,458,883)

COMMUNITY BENEFIT TRENDS 2011

2012

2013

2014

$38

$48

$53

$56

million

million

million

million

9.7%

11.4%

12.4%

12.7%

WHAT MAKES UP THIS NUMBER? Unpaid Costs: TMC provides services to patients covered by AHCCCS and other public programs for people with low incomes. This is the shortfall created when a facility receives payments that are less than the cost of caring for public-program beneficiaries. Uncompensated Cost of Care for Charity Care, Bad Debt & Discounts for the Uninsured: 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-assistance policy criteria.

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Bad debt consists of services for which the hospital anticipated but did not receive payment. Recognizing that self-pay patients who do not have health insurance are not in the same position as insurance companies to negotiate reduced rates, TMC discounts these patients’

bills by half; and, depending on a patient’s income, other discounts may apply as part of TMC’s Community Care program. For purposes of community benefit reporting, charity care, bad debt and uninsured discounts are reported in terms of costs, not charges. For more information about TMC’s charity care policy, visit www.tmcaz.com/community-care. Hospital Assessment: In 2014, hospitals in Arizona were assessed by the state to help fund the cost of expanding AHCCCS services to an additional 336,000 low-income residents. Outreach & Education: This figure includes community benefit programs and activities that 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.


Volunteering AT TMC With more than 90,000 hours logged, some 675 active volunteers donated their time in 2015 to support patients, staff and the community at large. Duties range from staffing information desks and checking people in for breast screenings to helping older adults navigate Medicare enrollment, making home visits to hospice patients and rounding with their pets. TMC volunteers are a critical component in reaching out to our patients and the community at large. Hours of Service for Active Volunteers

TMC for Seniors touched the lives of more than 7,000 people last year, providing a strong network of programs, from lectures and seminars to year-round wellness programs and volunteer opportunities to Medicare counseling and educational opportunities. These programs allow seniors to remain engaged in the community and have a better quality of life.

Licensed Beds

Pet Therapy teams visited more than 20,500 people in 2015 with some 48 two-legged and 51 tail-wagging volunteers. Those tail wagers were of both the canine and equine variety. TMC Auxiliary: Financial Support Joel M. Childers, M.D., Women’s Center Pledge Year 3 $50,000

Unit

Beds

Mom/Baby

60

NICU

42

Pediatric

44

PICU

12

Medical-Surgical

404

ICU

45

Geropsychiatric

16

Inpatient Hospice

16

Total

639

Breast Screening Services $30,000

2015 Volumes

Memory Care Program $10,000

Emergency Visits

95,028

TMC Auxiliary

480

78,392

TMC Hospice

100

9,480

TMC Healing Arts Museum Program $10,000

Adult

64,180

Senior Services

47

4,569

Cardiac Rehab Scholarships $7,500

Pediatric

30,848

Pet Therapy Program

48

1,409

Inpatient Admissions

31,291

675

93,850

Medical Massages for Open Heart Patients $7,500

Adult

30,243

Pediatric

1,048

Total

Hospice Family Assistance $6,000

Notable Achievements of Volunteer Areas:

Tómas the Turtle $5,000

TMC Auxiliary has volunteers in more than 40 areas throughout the hospital. From the Auto Shop to the Vascular Lab and just about everywhere in between Auxilians sport their teal vests and jackets in support of the TMC vision to enhance the quality of life and overall health for the people of Southern Arizona. Read more about the accomplishments of TMC Auxilary in the On Center portion of this report.

TMC Foundation $4,000

Babies delivered

5,534

Auxiliary Operations $171,000

Total Surgeries

22,931

Inpatient Surgeries

10,017

Adult

9,382

Pediatric

635

Outpatient Surgeries

12,914

Adult

10,508

Pediatric

2,406

In late 2015, TMC Hospice began piloting a new vigil program whereby volunteers provide comfort and companionship to a dying patient and the family, specifically in the last 24 to 48 hours of life. One of the goals of the program is to ensure that no TMC Hospice patient dies alone.

Total $301,000

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REPORT TO OUR COMMUNITY CREDITS Publisher: Judy Rich, R.N., President and Chief Executive Officer Executive Editor: Julia Strange, Vice President, Community Benefit Editor: Rhonda Bodfield Design: Hilton & Myers Advertising Contributing Writers: Rhonda Bodfield, Cheryl Kohout, Michael Letson, Alicia Moura, Julia Strange, Kimberly Romo Photography: Eric Suhm

ON CENTER CREDITS Publisher: Michael J. Duran, J.D., Vice President and Chief Development Officer Executive Editor: Julia Strange, Vice President, Community Benefit Editor: Kimberly Romo Design: Hilton & Myers Advertising Contributing Writers: Rhonda Bodfield, Cheryl Kohout, Michael Letson, Kimberly Romo Photography: Eric Suhm Published May 2016


on center

on center


The strategic vision TMC leadership has for today and the future is to remain an independent, notfor-profit, locally governed community hospital. To assist with that strategy, at TMC, we have what we call “True North” goals that drive excellence with each encounter with our patients. They are Safety & Quality, Patient Experience, People and Profitability. Like the needle on a compass pointing north, we never lose sight of the direction we’re going nor the focus it takes to achieve our goals. When we work together with our physicians and staff to realize our True Norths, we embrace the future by living and breathing these objectives each and every day.

From the Vice President & Chief Development Officer Michael J. Duran, J.D.

In 2015, the TMC Foundation Grant Awards Committee delivered on its promise to support TMC’s True Norths by making 58 grants worth more than $2 million. In this edition of On Center, you will read about a few of these grants that assist our physicians and staff to give our patients the best care in a supportive environment. At TMC, we take pride in the volunteers who dedicate their time, talent and treasure to Southern Arizona’s community hospital. When you read about the impact our volunteers and the Auxiliary make on an annual basis, like me, I think you will be astonished. From operating the retail gift shops to helping patients navigate the halls at TMC, our volunteers are an incredible asset that we are so fortunate to have. Last, we say goodbye to a valued friend and donor to TMC. Mannette Speas exemplifies the many donors who give annually through various direct mail programs and campaigns. A lifelong donor, Mannette supported children’s and women’s initiatives at TMC. Her contributions and commitment to TMC were significant and we will never forget the passion she held in her heart for the health of our community. In her passing, she exemplified her lifetime of service and leaves a legacy for future generations to come that will support innumerable programs and services. As the TMC Foundation continues to support the charitable mission of TMC, we are fortunate to have the support of the Southern Arizona community. It’s our pleasure to continue to meet the health care needs of you and your family.


From the TMC Foundation Chairwoman Christine Aronoff

As I reflect back on 2015, I am amazed at the impressive strides TMC has taken as part of its commitment to providing compassionate care to Southern Arizona in which the patient is truly at the center of everything. The staff and volunteers at TMC are an inspiration to maintaining this special hospital in Tucson. As the local health care landscape continues to evolve, one of the things I am perhaps most proud of is TMC’s resolve to staying locally owned, with incredible support from the community. TMC is fortunate to have a network of donors who are philanthropic to their core and choose to leave their legacy at TMC. These individuals and their families have our sincere gratitude as the impact of their gifts will be felt for generations. The Pozez family is a great example of Tucson residents who have chosen to leave their legacy of philanthropy at TMC. Shaol Pozez was a long-time trustee and board chair when Don Shropshire was chief executive officer. During his lifetime, Shaol worked to make TMC the strong, nonprofit, independent community hospital it is today. His daughter, Shelley, has chosen to carry on her father’s commitment and her family’s legacy by continuing to invest in TMC. The Pozez family has exemplified leaving a legacy of caring for the community and generational giving as we celebrated our 70th anniversary.

Speaking of making an impact, we are almost there! The opening of the Joel M. Childers, M.D. Women’s Surgery Center was a highlight of 2015. Women now have a gorgeous, comfortable facility that was completely designed with them in mind. As crews begin work on phase II, we thank those who have contributed to making this upgrade a reality while looking ahead to what’s needed to bring this campaign to a close. Once completed, this facility will provide generations of women state-of-the-art specialized women’s services and technology in a comfortable, secure environment. Excitement swirled about the TMC Mega Raffle, which netted more than $1 million to support many initiatives at TMC. You’ll read about some of them in On Center. We are so thankful to those who step up and participate in such a unique, fun opportunity that engages more of the community in supporting TMC. Thanks for dreaming big for our patients and families and congratulations to the winners! Recently, the TMC Foundation Board of Trustees developed a strategic plan for philanthropy. The main goal for the plan is to support the charitable mission of TMC by capitalizing on a changing health care market and engaging our physicians in philanthropy. You’ll also read about what inspired one physician to give back to TMC.

Thank you for your continued support and for your faith in TMC as Southern Arizona’s community hospital. I am proud to serve as the TMC Foundation chair and look forward to the continued contributions the hospital brings to the special community of Tucson.


Jawna Stickney and her son Finn. Photography by Jodi Lynn

“My experience at Tucson Medical Center has been one to remember.”

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ng our and and I, havi sb u h y m or F . er rough one to rememb to come and th n g ee in b s go a y h b r a b te ical Cen time? hen was this at Tucson Med the hospital on nd anxiety. W a to on it ti e a k p a ci My experience m ti e n a w eck on you e with a lot of labor? Would here nurses ch to w in t go en m lly n ra ro first child cam vi tu na ld, sterile en Was I going to nticipated a co a I e? what means? er th t ge s when we . The friendly. What happen ugh the doors e plain and un ro er w th t a ed p th ep lls st a hh my care the second I very rarely wit e involved with m re was relieved t ca ep y k m d g n a in s rd on re and y anxiety rega ll of my questi her into my ca ot m d n a d n a Fortunately, m and calm. They answered a ot the usb ng event and n rporated my h sant gi a co n le in a p , s a ch a ic ew ss lif ff Je a e, st nurse, ted - a positiv e process. My like I had wan ly ct a throughout th ex el fe is experience as to which sioned. really made th a “makeover” cess I had envi of ro p ss l a ce ic ro n p a e h ec th atients robotic, m y stay, was in rsthand how p m fi g g n n ri ci u n d ie d er p te a ex r,” it’s ed mpleted. After ves a “makeove , though a littl co lf er e se es se d it t to it n en d u m te e ci rt h T ex aff epa very eager and ring, selfless st st say if any d u ca ed m l, I em fu , se it er n d ff u a on y st w the Deliver e amazing, me, held my TMC’s Labor & behalf of all th me, cried with on h e it w on d ed e are treated in b gh ld u k them la ery and it shou that can than en and women n m io e ct es ru h T st n t. co Labor & Deliv ou ay t of paint and e day in and d e is no amoun er h T who work ther . rs a fe y me with. led all of m ho ce they blessed n ie er p hand and sett ex ture mothers w e iv fu it ll a os p d n te a , lu C so ab such ering at TM enough for the ft to us during aced with deliv gi gr r n ou ee y b r ve fo a h ou o our ky ll mothers wh ease anxiety. Y I want to than d , n C a M rs T a t fe a g On behalf of a lm in er l staff will ca l memories leasure of deliv ting a beautifu with wonderfu ec e fl will have the p m re ft it le n u ly l fu er my next on A beauti gerness to deliv y staff has not er ea iv d el n a D t a crucial time. & en or m b te sense of exci g with the La as given me a donation alon h t u b , y er iv el own d regarding my . child at TMC , this sweet gift my Thank you for teful, TMC mom a gr , ew n A – Jawna Stickney


Renovated, expanded Women’s Surgery area opens as Phase II begins The Joel M. Childers, M.D., Women’s Surgery Center opened with much excitement in April, 2015, offering women who are undergoing women’s surgery compassionate care in an aesthetically pleasing environment that was designed specifically for women. Phase I of the project helped centralize TMC’s Women’s Services, which have been spread throughout different areas of the hospital. Consolidating resources and creating a dedicated entry point for services will increase efficiency, enhance privacy and improve quality outcomes. The expanded operating suite features the latest technology and improved workflow. Patients and families now have dedicated waiting areas.

“We can’t thank our donors enough who have stepped forward with generous gifts to support the Joel M. Childers, M.D., Women’s Center Campaign,” said Michael J. Duran, TMC Foundation vice president and chief development officer. “Their philanthropic investment in a new and beautiful setting that is conducive to healing is thoughtful and exciting. The future of women’s care is secure because of their support.”

In December 2015, crews broke ground on Phase II of the project, a mix of new construction and renovation for the Labor & Delivery department. Two new Labor & Delivery rooms will be built to include laboring tubs for women who want the safety net of a hospital during delivery, but an experience that feels more like home. One of the surgical suites used for cesarean sections will be enlarged, and new construction will also take place in triage, which will be a dedicated area with actual rooms instead of one room separated by curtains.

The entire footprint of the campaign was designed to improve the flow and efficiency for patients, creating a better overall experience. The project was funded through the ongoing capital campaign, in which the TMC Foundation’s goal is $12.5 million.


Surgeon’s drive and personal commitment keeps TMC at the forefront of gynecologic surgery For gynecologic oncology surgeon Dr. Joseph Buscema, TMC isn’t just the place where he works. It’s where he and his wife receive care. It’s the place where his children come when they’re sick. It’s where his mother-in-law was cared for before passing away in Hospice.

“I take pride in TMC, what the hospital does for the community and the level of service it offers our patients. I believe it’s a mutual effort to elevate the level of care we are able to provide. We all need to contemplate giving back at some level. For me, giving back to TMC and the community is my way of reinforcing the mission of the hospital,” Dr. Buscema said.

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And since he arrived in Tucson 13 years ago, it’s the place he’s committed to improving and promoting advanced laparoscopy surgery in Tucson. Shortly after Dr. Buscema arrived in Tucson, TMC established a fully integrated laparoscopic surgical suite in Tucson. “This allowed us to care for women requiring more complicated laparoscopic procedures,” he said. “We were able to do this with the commitment of the late Dr. Joel Childers’ parents who supported the development of the first fully integrated, advanced laparoscopic surgical suite in Arizona. The sophistication of the operating room was significantly improved.” As technology advanced to the robotic laparoscopic surgery that’s performed today, Dr. Buscema has remained steadfast in his support of TMC so that the needs of women with reproductive tract cancers

and those with more complicated pelvic anatomy challenges can be more safely and effectively addressed. “I appreciate what’s been done to upgrade the women’s operating rooms and to develop the new women’s surgical suite. That’s one reason why I chose to make a personal financial commitment to support the hospital,” he said. Another reason? In the 30 years he’s been practicing, Dr. Buscema said he’s never had a connection with a hospital like he does with TMC. “This hospital creates a culture of community with physicians. It’s the only hospital to which I would bring my family, because I know they would receive outstanding care.”


Donor spotlight: The National Breast Cancer Foundation The TMC Breast Health Program participates in numerous outreach events sponsored by TMC and other community partners where breast health is taught and promoted. One-on-one education is provided to patients at the time of their visit, promoting early detection through screening to the public and physician offices. Thanks to a generous $50,000 grant from the National Breast Cancer Foundation, or NBCF, underinsured and uninsured women in Southern Arizona have access to mammography screening that may save precious lives. This funding allowed the TMC Foundation to provide more than 100 digital screening 3D mammograms, which creates multiple images of the entire breast. TMC Breast Health clinicians also have been able to see five patients who required diagnostic mammograms and breast ultrasounds. TMC’s program is frequently the last resort for these women who often do not qualify for any other programs but want a screening mammogram. TMC caters to Southern Arizona’s large Hispanic population in many ways, including staffing a Spanish interpreter at the breast health clinic on days these uninsured patients are scheduled to receive their screening. Additionally, patient education materials are printed in both English and Spanish.

Dr. Pal Evans receives Lifetime Achievement in Health Care Award 2015 was a big year for Palmer “Pal” Evans, M.D., who was recognized for Lifetime Achievement in Health Care by Tucson Local Media as part of the Influential Health and Medical Leaders awards. Dr. Evans, a former Ob/Gyn and senior vice president who serves on the board for the TMC Foundation, is board chairman of Arizona Connected Care, the first accountable care organization in Southern Arizona. “Dr. Evans had a simple goal that was profoundly difficult at the same time: doing the right thing for patients, every time,” said Michael Duran, vice president and chief development officer for TMC. “The trajectory of his career reflects deep community involvement, an unflagging compassion for patients and an insatiable curiosity about improvement processes and health care models.” Dr. Evans said he was shocked and humbled to receive the award. “I have been fortunate to have a wonderful career in which I had the privilege of taking care of many Tucson women including helping deliver many of their children. Even after many decades of doing it, participating in these births remained a magical experience for me. This award hasn’t changed my focus. I’ve always been driven by the belief that if we do the best for patients, we all win – especially the patients.”

TMC performs close to 4,000 screening mammograms each year. All clinical breast exams, mammograms and ultrasounds are read on site. All diagnostic mammograms and ultrasounds are read at the time of the appointment and patients are aware of their results before leaving the clinic. With this grant, the NBCF is living its mission of helping women now by providing help and inspiring hope to those affected by breast cancer through early detection, education and support services. Part of their outreach also includes messaging about other good women’s health practices such as a healthy diet and maintaining a healthy weight.

Pal Evans, M.D., left, receives Lifetime Achievement in Health Care award from Steve Pope, general manager, Arizona Local Media. Courtesy: Tucson Local Media

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TMC for Children creates real miracles with the help of Children’s Miracle Network TMC has been a part of CMN since 1984, raising more than $17.6 million to benefit local programs for infants and children. All the money raised in Southern Arizona stays here to support wellness programs, purchase life-saving medical equipment and provide health services for children at TMC.

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A’hyzia Johnson, 2015 CMN Champion Child “As a CMN Champion, A’hyzia has served as an ambassador, representing children treated at CMN hospitals in Arizona at the national level,” said Erika Grasse, CMN director at TMC. The Johnson family also traveled to Washington, D.C., to visit the White House. A’hyzia Johnson’s grandmother knew something was wrong when the 13-yearold was having trouble holding a pencil and writing. Eventually, the Tucson teen became unable to walk, speak or even recognize her family members. She spent time in TMC for Children and tests confirmed she had multiple sclerosis. Many sessions at TMC Pediatric Therapy, along with medications, helped A’hyzia regain her strength to walk and speak again. Today, A’hyzia has some weakness in her right hand and leg, but is lesion-free and doing well. She loves perfecting her baking skills by watching cooking shows, walking the mall and listening to music. A’hyzia dreams of becoming a nurse or doctor so she can share the hope and love her caregivers gave her. Three years into living with the disease, A’hyzia stays true to her self-proclaimed mantra: “I have MS; it does not have me.” Serving as Southern Arizona’s Children’s Miracle Network hospital, TMC provides occupational, speech and physical therapies for patients like A’hyzia, funded by CMN.


Jim Click answers phones with Bobby Rich, Greg Curtis and Mrs. Grant from 94.9 MIXfm

Annual Radiothon addresses pediatric needs The Children’s Miracle Network Radiothon raised more than $234,000 to benefit children in Southern Arizona. The two-day event featured stories from Southern Arizona families whose little ones had received care at TMC for Children. The money allowed the TMC Foundation to purchase 17 rocking chairs for families in TMC for Children’s pediatric and pediatric intensive care units as well as pediatric scales, which are more precise than putting a child on an adult scale. Also, they were able to replenish art supplies and bubbles for TMC’s Child Life Department. Child Life specialists go through an estimated 3,500 bottles of bubbles, 6,000 packs of crayons and 1,500 containers of Play-Doh every year.

Local Walmart store rocks CMN donations at the registers, earns additional grant for TMC for Children Walmart store #1291, located at Speedway and Kolb, is consistently the top, or one of the top, fundraising stores in the entire Walmart Corporation for Children’s Miracle Network. That store alone has raised more than $250,000. In 2015 they raised an impressive $63,200 which then made TMC for Children eligible to be awarded an incentive grant of $25,000. “We are so proud of the employees at this store and thank them for their dedication to TMC for Children through CMN,” said Erika Grasse, TMC director for CMN. “They are the ones who drive the success of their campaigns and, in the end, it’s local children who are on the receiving end of their efforts. Our hats are off also to the strong leadership who support fundraising year-round. They are committed to raising a significant amount of money for CMN, and we are honored to be able to count on them as one of our biggest partners.”

Jim Click’s star power Jim Click has been a continual supporter of the Children’s Miracle Network Radiothon for more than a decade. His big presence and boisterous personality always brings welcome energy to the 24-hour Radiothon. Over the years, Click has given significantly to CMN through the broadcast, often in the form of challenge grants, encouraging others to also open their checkbooks. In addition to his personal donations, Click has also helped raise thousands of dollars to support CMN by getting on the radio and asking the community for their support. “I think it’s fair to say that Jim Click is as well known in this community for his philanthropic contributions as he is for selling cars. We know there are many organizations that are deserving of his help and we are honored that he is so passionate about CMN and caring for Southern Arizona children,” said Erika Grasse, TMC director for CMN.

Bobby Rich, Solaine Carter, Greg Curtis, Brandon Smalling, Mrs. Grant and J.C. Boyd.

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Overwhelming gratitude for Peppi’s House staff inspires sculptor to donate gorgeous bronze angel in his mother’s memory

Jean Geckler

When Jean Geckler was in her late 80’s, she chose to celebrate her birthday year after year in Las Vegas. At 90 years old, she danced at a ‘Jersey Boys’ Las Vegas show. She was kind and compassionate - the type of woman who couldn’t be hurried. “She’d always stop and notice beautiful things like flowers and butterflies,” said her son, Karl. He described her as the type of person who was appreciative of everyone and everything around her. “When mom was being transported in the hospital and was in a great deal of pain, she looked at me and said, ‘Where did that nice man go? I wanted to thank him!’” Karl said. “She was constantly thinking of others.” Jean was now 93 and following a week-long stay in the hospital and a grim prognosis, her family decided it would be best to keep mom comfortable by introducing hospice care. “My mother, more than anything else in the world, loved being in the sun. As the transport crews pulled her out of the van at Peppi’s House, I had a feeling this would be the last time she could enjoy the sun on her face. We sat there for a few minutes and just let her soak it up one last time.”

As Karl and his family settled into Peppi’s House, he said he was overwhelmed by how compassionate the staff was at a time when his family was absolutely heartbroken. “The nurses and staff at Peppi’s House are angels. We were able to talk to them about the process of dying. We were able to understand that hospice would allow my mom to die with dignity and comfort, without fear and pain, and what a blessing that was. The nurses were there to hold our hands – to make mom and our family comfortable for however long the process took. I’m absolutely speechless at how these people help their patients and families. It’s awe-inspiring,” he said. Nine days after feeling the sun on her face one last time, Jean passed away peacefully. Karl sculpted a stunning bronze angel that weighs around 210 pounds with the base and in July 2015, he flew from Chicago to Tucson to personally install it inside Peppi’s House. “The staff at Peppi’s House works tirelessly to provide every single family with the care and compassion that made such an impact on Karl and his family,” said Michael Duran, vice president and chief development officer, TMC Foundation. “For a well-known sculptor to do something of this magnitude to say thanks provides such a boost to our staff. We are forever grateful for Karl’s creativity and generosity. His mother’s memory lives on, and staff, patients and families will admire his work for decades.”


His award-winning work is featured in museums across the country, including the Smithsonian Institution, Autry National Center of the American West and the Phoenix Art Museum.

World-famous painter donates prints to TMC Healing Art program

Howard and Marlies Terpning

It’s been on magazine covers and movie posters. And prints of his acclaimed pieces now dot one of the main corridors of TMC’s Orthopaedic and Surgical Tower as part of the hospital’s Healing Art program. Howard Terpning is a painter and illustrator best known for his paintings of American Indians. He’s lived in Tucson for nearly 40 years, but his first experience with TMC was before he and his wife Marlies called the Old Pueblo home. “We were in town for a show, and my wife needed care, so we went to TMC. The nurses and staff couldn’t have been nicer. We’ve always had positive experiences at TMC, which is why we are so supportive,” said Terpning. Terpning wholeheartedly believes in the power of art and the positive impact it makes in a hospital setting. “It gives people something to look at other than bare walls. It gives them a distraction from their medical concerns, even if it’s for a brief moment. It’s all very positive, and we’re glad to be a part of it.” “I think TMC is a great place to leave my legacy. Where better? I’m aware of the work I have that’s in museums, but it’s doubly rewarding to know that my work is also in a public place that does so much good for so many people. I’m very proud of that, and very pleased.” Terpning also gave the TMC Foundation more than a dozen prints that the foundation can sell as a way to provide additional income for TMC. And Marlies crochets blankets for babies who are born at TMC, including those who spend time in the newborn intensive care unit.

“Howard and Marlies are two of the most genuine, down-to-earth people you will ever meet,” said Michael Duran, TMC vice president and chief development officer. “We appreciate everything they do for TMC. It is a tremendous honor to have Howard’s work hanging in our hospital. By allowing us to showcase his art in this way, he touches the lives of thousands of patients, their families, visitors and staff who walk this hallway each year. We are humbled that Southern Arizona’s community hospital has strong support from such a world-renowned artist.” Terpning encourages other artists, especially younger artists who are trying to become recognized, to consider donating some of their work to the Healing Art Program. He notes that the program is beneficial for the artist and the public. “If your work can be a positive influence in other people’s lives, then you certainly should consider that,” he said.

For more information about getting involved with TMC’s Healing Art program, please call Michael Duran at (520) 324-3116.


With their hearts, hands and numerous hours, the TMC Auxiliary makes extraordinary contributions to patients, families and staff Every day, members of the TMC Auxiliary proudly put on their teal smocks, come to TMC and volunteer their precious time because this hospital is in their hearts, and they know they are making a difference.

By the numbers: Some of the TMC Auxiliary’s accomplishments in 2015: 35

visits by patient assistance team

16,286

“The Patient Assistance Team is a group of Auxiliary volunteers who visit with new patients. We make sure they’re comfortable and see if there’s anything we can get them during their hospital stay. We offer concierge-style services and make available at no cost items like reading materials, phone chargers, reading glasses, and games. We talk with them about some of the non-medical services TMC offers, like pastoral services, and share the hospital’s hand hygiene policy with them. I’ve been a patient at TMC before and I know how much it meant to me when the volunteers came in to talk to me. Most of the people you encounter in a hospital are addressing the clinical reason you’re there. It’s wonderful to have someone come in who just talks to you as a person and I love doing that.” - Dan Bailey, Patient Assistance, Auxiliary Service Chair

Increase of number of patients seen over prior year ..................................... 7%


average number of volunteers working each day

heart pillows sewn & delivered to patients

“I love everything about this hospital. I love how people are treated. I love what TMC does for the community, and I completely agree with its values. I currently volunteer at the Concierge Desk in the Orthopaedic and Surgical Tower. I love the interaction with patients and their families. It may be somebody’s bad day, but the most important thing to me in that moment is making sure they leave TMC happy. I express empathy for what these people are going through, and I feel for them. I do my best to solve their immediate problems when I’m able to, and their thanks is what makes it all worthwhile. I do everything I can to make sure their hospital experience is good.”

“2015 was a tremendous year for our group. Every heart pillow takes about 1.5 hours to make; each walker bag takes about 2.5 hours. I know we achieve a lot every time we meet at TMC on Tuesday mornings, but when you look at the numbers, it’s fun to see exactly how much we accomplished in a year. Our sewing group is like sisters. We’re a tight-knit group who is able to blend our passion and our talent for sewing, and use it to benefit others. It makes us feel good to do this work because we know patients appreciate it.”

2015 retail sales volume

$750,600

“In 2015, we were able to give more than $300,000 back to TMC to support special programs that directly touch patients who are in the hospital and members in our community. I’m amazed at the dollar amount we were able to sell, as most of our customers are employees. I regularly go on scavenger hunts to find items from vendors that are unique and different. We take a gamble on new merchandise and it’s great when it flies out the door! Patients and families expect that we will have candy and magazines, but I think they are surprised at the other items we sell including University of Arizona items that you can’t find in the bookstore, jewelry you can’t find anywhere else and clothes. Additionally, we’re really proud of the Desert Cradle breastfeeding support store that is available to provide convenient help to expectant and new mothers.” - Deanna Baumgardner, Auxiliary Gift Shop Retail Manager

Pieces of candy sold........................ 62,471 UA merchandise sold.................. $47,472 Children’s clothing sold............$42,086

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– Ginny Robbins, TMC Auxiliary Volunteer Since 1993

78,391.54 FTE Equivalent.............................................. 40.82 TMC Salary Savings............. $1,763,797 Auxiliary volunteers on-boarded .... 189 Students - Spring & Fall Semester........ 79 Total hours

.......................................

1,480

- Mary Ann Miller, TMC Auxiliary Volunteer Since 2003

Walker bags sewn & delivered to patients

600

...........................

Pediatric/NICU quilts made & delivered ........................................194 Dog beds made for Humane Society...................................................65

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TMC Mega Raffle funds patient care programs

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Tucson Medical Center’s Mega Raffle, and all the excitement that came with it, returned for a third year, raising money to benefit innovative patient care programs and services. When clinical departments at TMC identify a need that requires funding, they have the opportunity to apply for a grant from the TMC Foundation. The Foundation is then able to support projects that directly benefit patient care with Mega Raffle funds. Each ticket has a one in 20 chance of winning a prize. Every year, more than 2,000 prizes are raffled off, including two extravagant grand prize packages. “The Mega Raffle infuses excitement into this hospital and the Southern Arizona community every spring. When the winners are drawn, it’s so inspiring to learn about them and their connection to TMC. But after the buzz is over, we really get to see and experience how Mega Raffle funds support the hospital’s mission in the form of programs that directly help patients,” said Judy Rich, TMC president and CEO.

Here are a few examples of what the Mega Raffle helps fund: Continuing education for nurses on caring for stroke patients The TMC Mega Raffle funded a comprehensive educational series for nurses that focuses on caring for patients who have had a stroke. Nurses complete rigorous computer-based modules that focus specifically on caring for stroke patients and educating the family so that they can properly care for their loved one upon discharge. “I can tell you from firsthand experience how the Mega Raffle comes full circle,” said Clifford Daigler, assistant manager of the TMC Neurology Department. “The community buys raffle tickets that support TMC. Those same people may end up at TMC, and as a result of their own generosity, will be on the receiving end of programs that will improve their care.”


Kelly Nowak with baby Kailey

Lactation support for nursing mothers On May 22, 2015, little Kailey Nowak decided to enter the world, five weeks ahead of her due date. Her mom, Kelly, experienced difficulties with breastfeeding almost immediately. “She wouldn’t latch on, or if she did, it would only be for a few seconds,” she said. “It was awful. I cried every single day for six weeks as I pumped and fed my baby through a bottle.” The family lives in Sierra Vista and with few lactation support services available there, Nowak’s pediatrician suggested she seek expert advice from the lactation specialists at TMC, where she had previously rented her hospital-grade breast pump. “I didn’t know what to expect, but the lactation specialists solved my problems and had Kailey successfully breastfeeding just two minutes into my session. It was the most magical moment of being a mom.” The Mega Raffle provides funding for new moms to visit the outpatient breastfeeding clinic even if the service is not covered by their insurance or if they cannot otherwise afford it.

Equipment for pediatric therapy patients Proceeds from the TMC Mega Raffle funded much-needed supplies for TMC’s occupational therapists to use on pediatric inpatients. Tasks as simple as grabbing something off the floor, or tying a pair of shoes can spell a supersized challenge for a young patient fresh off spine surgery. Mega Raffle funds also helped purchase a pediatric Hoyer Lift, a special contraption that allows a patient to be lifted and transferred while requiring minimum physical effort. It can be used to get a patient who is not able to move out of bed and into a wheelchair, for example. “What used to require the strength of four or five people now requires only one or two,” said Hannah Burgess, Outpatient Therapies and Audiology supervisor. Therapists can consistently provide better, safer care and can also help train a patient’s family on how to use a Hoyer Lift at home. “As a hospital, and as a department, we feel so supported thanks to the Mega Raffle. It’s important for us and our patients to have these tools. It allows us to care for them in the safest way possible and to the best of our abilities. We feel so blessed to have the TMC Foundation provide this critical funding so that we can purchase what we need. Most importantly, our families are better off for it,” said Burgess.

iPads for adult therapy TMC’s Acute Therapy Department now has five iPads that therapists can use as they rehabilitate patients, thanks to the TMC Mega Raffle. The iPads are loaded with software and give patients an opportunity to work on cognitive tasks, fine motor skills, eye-hand coordination, balance exercises, attention deficits and visual perception skills while having fun. “These iPads help make a therapy session feel like a fun activity rather than a time they have to work,” said Amy Crumbaugh, TMC occupational therapy assistant. Plus, it helps us better educate them about their surgery and treatment.” Kathy Neff, TMC Acute Therapy manager, added, “Our therapists are very pleased to have these iPads. Patients are so excited and thankful when we bring out this technology. We instantly see them get engaged and stay motivated while doing an activity that’s appropriate for their needs. From a patient experience standpoint, it’s outstanding. We can’t thank Mega Raffle ticket buyers and the TMC Foundation enough.”

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News and Notes - Events Rock ‘N Rodeo wrangles up $137,800 for TMC Hospice

Dr. Donna Fulton with TMC President and CEO Judy Rich

The 18th annual Desert Toyota of Tucson Rock ‘N Rodeo benefited TMC Hospice, providing emergency funds to cover services to families in need. The money raised will also provide complementary therapies often not covered by insurance that improve the quality of life for those facing long-term medical needs. Proceeds also support the We Honor Veterans program at TMC Hospice to better care for, reach out and honor veterans needing end-of-life care. The event honored Dr. Donna Fulton for the incredible impact she has made on so many lives and her abundant contributions to TMC and the people of Southern Arizona.

TMC Foundation Gala: Manhattan Nights, City Lights A ballroom at the Westin La Paloma and Resort was transformed into Big Apple excitement for the TMC Foundation’s annual Gala, Manhattan Nights, City Lights. The gala raised more than $400,000 for TMC for Women, supporting the future of women’s health in our community. As the market leader for women’s care, TMC is committed to providing a lifetime of care For Women, About Women. “I feel the Gala represents a time to celebrate the power of a community and the difference that can be made when we work together,” said Karen Narum, certified women’s health nurse practitioner, TMC for Women.

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Erickson Legacy Society annual appreciation event The TMC Foundation and the TMC Planned Giving Council hosted a special evening of dinner and dancing at Tucson Country Club to celebrate a tradition of planned giving to TMC. Nearly 70 friends of TMC were in attendance, including many legacy donors and their families. Guests had the chance to learn more about Brain Health, Cardiac Health and the Healing Art Program. This event was made possible by the generous support of BMO Private Bank.


Grants Hospital-to-Home Empowerment Program aims to help patients, help themselves Elderly patients who may be on a low fixed income and therefore unable to afford the necessary tools to manage their chronic disease at home will benefit from TMC’s Hospital-to-Home Empowerment Program, thanks to a grant from the TMC Foundation. The program provides tools such as blood pressure cuffs, pulse oximetry devices and educational booklets so patients can keep their condition controlled at home, and hopefully not have to return to the hospital. “Seeing patients live well with chronic conditions because they choose to use the tools and resources the TMC Foundation provides for them makes our team smile!” said Brenda Carle, TMC Transitional Care coordinator, Hospital-to-Home Program. “When patients choose to be responsible and engage these ‘gifts for health,’ they experience more control over their well-being and confidence in managing their health. For our team, having the appropriate tools that promote this kind of patient engagement is priceless.”

Educational materials for cardiac patients With more than 1,500 catheterization lab procedures and 570 open heart surgeries taking place at TMC every year, it’s clear that the more patients and their families know about what to expect during a procedure, the better they tend to do. If they’re well prepared, they’re less anxious. They have fewer questions and generally this translates to a better overall patient experience. The TMC Foundation funded the overhaul of education materials that patients receive prior to having a procedure in the Catheterization Lab or open heart surgery. Everything is produced using simple language – at a fourth grade reading level – and is offered in both English and Spanish. Cath Lab patients receive an easy-to-read instruction book that also includes a DVD that helps them become familiar with TMC and the Cath Lab. In the six-minute video, a TMC Cath Lab patient shares his experience and perspective. “The feedback about our patient education materials has been very positive,” said Roxanne Lee, TMC Cath Lab manager. “Our combined efforts of a patient instruction book they can read and a DVD they can watch really helps calm their fears before they even set foot in our hospital. For our patients, the day of their procedure is often a huge day for them. We have found that when they know what to expect, many of their fears are quelled. Having our patients in the loop about ‘what’s next’ also helps our staff immensely.” Open heart patients now receive a three-ring binder that is organized into sections such as Pre-Anesthesia Testing, Before Surgery, Day of Surgery, Day of Discharge, After Surgery and

Miscellaneous. The style allows for patients to keep all important information and paperwork in one place and gives them the option to easily add to it. They also receive a video that walks them and their family through the experience from the time they arrive at our facility to the time they leave. It includes perspective and photos from a real patient who had open heart surgery at TMC the year prior. “TMC, The Most Caring of hospitals, is always working hard to educate patients and improve their satisfaction and outcome,” said Gulshan Sethi, M.D., TMC director, Cardiothoracic Surgery. “Any operation, especially open heart surgery, is stressful to both the patient and their family. The TMC Foundation’s generous support for the production of a video and education binder is sure to help calm open heart patients prior to surgery. It is our sincere hope that these materials help create a positive patient-hospital experience.”

Juvenile diabetes patient support The Charles and Gertrude Gordon Foundation generously invested in the TMC Foundation to enhance the care TMC clinicians provide to pediatric patients and families who are diagnosed with diabetes at TMC. Thanks to their support, every pediatric diabetes patient receives a gift bag, including fabric markers to decorate their bag, a stress ball, age appropriate books in English or Spanish, a cookbook, and a gift card for a medical ID bracelet.

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TMC Foundation sources corporation

40%

foundation

30%

individuals

26%

other

4%

Donor-designated funds women’s capital campaign

41%

children’s

26%

hospice

21%

general purpose

other

6%

5%

women’s care

1%

Grants awarded to TMC departments children’s

13%

hospice

22%

women’s

38%

total grants awarded in 2015 = 58 41

community benefit

13%

education

3%

patient care

2%

cardiac rehab

2%

total amount awarded in 2015 = $2,669,101.76


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

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

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

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

7%

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

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ANNUAL REPORT 2015 | Published May 2016 5301 E. Grant Road | Tucson, AZ 85712 | tmcaz.com | 520-327-5461


2015 Tucson Medical Center Report to Our Community