2018 Report to Our Community/On Center

Created to

CARE REPORT TO OUR COMMUNITY

Leadership perspective When Tucson Medical Center rewrote our mission statement in 2017, we pledged to provide exceptional health care with compassion. Exceptional doesn’t happen unless the care is safe, consistent and high quality. I am very pleased to report the outstanding work that occurred in 2018 around our commitment to continue reducing patient harm. We’ll share more information in the report, but just as an example, we saw more than a 60 percent reduction in central-line infections. C. diff infections dropped by 40 percent.

We know that what we’re doing works. We’ve been standardizing more of our processes and working with our medical staff to have more systematic protocols in place. It’s affirmation that when we all do our work the same way every day, we get stronger outcomes for our patients.

The lean work we have undertaken over the last several years, to reduce waste and errors in our process, has been an important building block in the progress we’re now seeing. We have a common language around tools we can use, a common focus on our True North goals, and a common understanding that we have to harvest the ideas and engagement from those closest to the work. 2018 was notable in other ways as well.

Those of us in health care know there are barriers that keep patients from being their healthiest selves.

Even if we give thorough discharge information and recommend the best medicine for their care, that doesn’t work if they struggle to read, if they don’t have transportation to get to the pharmacy or if they can’t put a healthy meal on the table.

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Every three years we join other health systems in drafting a Community Health Needs Assessment.

Typically, that tells us which diseases have the most profound impacts on our community.

This time, we expanded that scope to look at these social determinants of health to see what factors are most closely associated with poor outcomes. Read on for more details, but it is clear that health providers have to reach outside the walls of the hospital to have an impact on building a healthier community.

In that light, we took an unorthodox step for a community hospital last year. We partnered with CODAC Health, Recovery & Wellness and the Connie Hillman Foundation to launch a transitional home for mothers in recovery from substance abuse disorders.

We had a choice: Help manage patients through emergency care or take steps to stop that cycle of addiction so families can stay together and have a brighter future. We can’t wait to see what better looks like for these families – and for all of us – in 2019.

Judy Rich, R.N.

Louise Francesconi

President and Chief Executive Officer

TMC HealthCare Chairwoman

Leadership perspective I take great pride in being a long-term Tucsonan.

I was born in Sierra Vista, but my relationship with Tucson Medical Center began 17 months later, when my sister was born here in 1972.

Four decades later, my son was born within these same walls. Shortly after his birth, my godfather, who lived with me and my family for the last few years of his life, was cared for by the physicians and nurses of TMC Hospice.

Along the way, my father had two inpatient surgeries here and was taken care of by several of the physicians, surgeons, nurses, physical therapists and case managers at TMC. As a graduate of the University of Arizona College of Medicine, I spent part of my residency and fellowship training at TMC, spending the night in the call rooms between the Emergency Department and the ICU, admitting patients in the middle of the night and caring for them at all hours of the day.

I have a feeling that my experience is not so different than most Tucsonans. For those of us with roots in this community, TMC has very likely touched our lives in some way. Whether we have worked here, been a patient here, visited a loved one who has been hospitalized here, visited the Emergency Department or, more recently, made appointments at one our growing outpatient clinics, our lives have been touched by the 75-year tradition of excellent medical care that TMC brings to Tucson.

I am therefore very proud to report that 2018 was a year of great success at TMC with regards to quality and safety. We are living proof that a

community-based hospital, committed to a tradition of providing excellent care, can grow and adapt in today’s emerging health care environment. In 2019, TMC HealthCare is committed to further strengthening the framework in which our community-based doctors and hospital-based health care providers can continue to offer our patients quality care and choice in their health care decisions. I see real value in the communities of Southern Arizona being able to choose a community hospital and health care system with a commitment to tradition, excellence, quality, safety.

At Tucson Medical Center and TMC HealthCare, our vision is to serve our community by being the best health system, as measured by the quality of care we deliver, the experiences we create and the value we bring. I am incredibly proud to be affiliated with an institution that is committed to the highest quality of patient care with compassion in Southern Arizona.

TMC HealthCare Board of Trustees Dr. Eric Anctil Arnie Aros David Cohen Dr. Gayle Dean Stephen G. Eggen Louise L. Francesconi Dr. Jay A. Katz Dr. Clifford Martin Judy Rich Dr. Alan K. Rogers Ira H. Rosenberg Dr. Steven Siwik Beckie Torrey Gay Tosch Jon R. Young

Clifford P. Martin, M.D. TMC Chief of Staff

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TMC celebrates diamond anniversary On Nov. 2, 1943, articles of incorporation were filed for Tucson Medical Center, which would kick off a community campaign to raise money to support a nonprofit community hospital. That was 75 years ago.

More than 5,000 people attended our open house.

Since our first baby, Peter Erickson Godfrey, was born in February 1945, thousands upon thousands of babies have been welcomed into the world.

Countless patients have been treated with emergencies, including Paul Newman, who caused a stir when he showed up in 1971 to get stitches for a forehead wound while filming “Pocket Money� in town.

Over the years, TMC has reached into the community to help keep children safer, to provide social connections for maturing adults and to empower others to take charge of their health.

In that time, TMC has honored the legacy of our founders and has grown from a hospital to a system that offers primary and specialty care as we find more ways to serve the community in meaningful ways.

In the years to come, we will undoubtedly challenge ourselves to continue evolving as we strive to provide exceptional health care with compassion.

Thank you for trusting us with your care.

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TMC reinforces commitment to make patients safer The quality of patient care continued to be a focus across TMC HealthCare on its march to zero harm. Significant improvements are being driven by focused conversations, visual management and reinforced hand-hygiene campaigns.

Hospital-acquired clostridium difficile infections, more commonly known as C. diff, dropped more than 40 percent from 2016 to 2017 – and dropped another 47 percent in 2018.

“We know that what we’re doing works,” said Judy Rich, president and chief executive of TMC HealthCare. “We’ve been standardizing more of our processes and working with our medical staff to have more systematic protocols in place. It’s affirmation that when everyone does their work the same way every day, we see stronger outcomes.”

A focus on patient data served as a foundation for improvement, but visual cues also were incorporated to extend the learning. Floor stickers were placed at the exit of patient rooms as a reminder to adhere to safety protocols, for example. And because C. diff is more likely to be eradicated with soap and water, covers were placed on hand-sanitizing dispensers in those rooms to remind staff that hand-sanitizers are ineffective in controlling its spread.

Other great news on the quality front • TMC ended 2018 with a six-month streak of attaining zero central-line infections for adult inpatient care.

CareChex 2019 Medical Excellence Awards

• TMC saw a 22 percent reduction in pressure injuries.

For overall medical excellence in hospital, medical and surgical care, TMC is:

Weekly meetings with nursing staff to identify trends in real time also made a difference, Mazzola said.

When an incident was identified on a unit, hospital executives joined other leaders in responding to that unit as a group within 24-48 hours. Those meetings were designed to open the conversation about what barriers existed and how those could be overcome.

“By approaching these meetings with an attitude of ‘What can we do to support you?’ it’s incredible the difference we saw in engagement, accountability and collaboration,” Mazzola said.

· Top 10 percent of all hospitals in the nation · #1 for medical excellence in Arizona TMC is in the top 10 percent as well for medical excellence in heart attack treatment, joint replacement, major neurosurgery, orthopaedic care, spinal fusion and stroke care. TMC also placed in the top 10 percent in the nation for patient safety in bariatrics, joint replacement, major neurosurgery, orthopaedics, spinal surgery, vascular surgery and women’s health.

“We not only implemented interventions to improve care to our patients, but we sustained those improvements and continue to better our processes along the way,” said Nina Mazzola, the director of Infection Prevention at Tucson Medical Center. “This was a huge success story.”

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Assessment identifies Pima County’s most pressing health needs Heart disease surpassed cancer as the leading cause of death over the past three years locally.

Suicide is now the 10th leading cause of death in Pima County. Pima County performs better than the state in adult obesity rates but has higher rates of diabetes diagnosis.

These facts surfaced when health leaders pored through data and interviewed scores of residents to identify the critical gaps in health care facing Pima County – as well as to identify what conditions exist that are preventing residents from attaining optimal health.

Every three years, nonprofit hospitals study the needs of the community to align priorities and help focus their health investments. The top three health priorities facing Pima County include: • Behavioral health, including mental illness and substance abuse • Obesity and related chronic diseases, such as diabetes and childhood obesity • Access to services, including how services are provided and their overall availability For the first time, the health systems also worked to understand not just which disease states to tackle, but wanted to learn more about what’s

known as “social determinants of health” – those social factors that are most correlated with poor health outcomes.

The report, which may be accessed in pdf form at tmcaz.com/chna2018, highlights three social determinants that are most closely related to leading causes of death and disease – poverty, education and health insurance.

“We can look at statistics and know generally which diseases impact the lives of our neighbors here at home, but the next step is trying to determine what kinds of factors in our community are preventing us from being as healthy as we can be,” said Judy Rich, president and chief executive of TMC HealthCare.

“When we figure out how – and why – disease plays out in our community the way it does, we can determine the interventions that can keep people healthier and reduce the total cost of health care. As a community hospital, we have a clear recognition that we will succeed when the overall health of the community succeeds.”

Community partnership establishes housing program to break addiction cycle Mothers who are recovering from addiction often struggle with sustainable recovery and keeping their family together.

Tucson Medical Center partnered with CODAC Health Recovery & Wellness and the Connie Hillman Family Foundation to create a transitional-housing program for women who may otherwise face hardships such as poverty, unstable housing, a lack of support services and risk of relapse.

As established in the Pima County Community Health Needs Assessment, substance-use disorder continues to be a top health challenge in our community, leading TMC and CODAC to take proactive steps to stop the cycle of addiction. In addition to a safe and stable housing environment, mothers have access to: • after-care treatment • life-skill training • pediatric care • other evidence-based services that facilitate recovery and independence Each patient receives a behavioral-health evaluation and treatment plan. An on-site CODAC recovery coach facilitates these services, which also include life skills such as budgeting and parenting. A childlife social worker from TMC coordinates medical and developmental needs for kids, from physical therapy and child safety to wellness and cognitive play activities.

“Together, we are providing comprehensive support services to create a stable foundation for recovery and long-term health of the whole family,” said Dennis Regnier, president and chief executive of CODAC. Judy Rich, president and chief executive of TMC HealthCare, acknowledged that this is a unique endeavor for a community hospital.

“We have seen how addiction and the opioid crises has gripped our community, and we believe that TMC has a critical role to play in addressing these community health needs.”

The Connie Hillman Family Foundation provided a grant to renovate and outfit the 16-unit apartment complex at East Monte Vista Drive and North Alvernon Way. The location can serve up to 19 women and their children.

From laundry to hospice, TMC increases support to rural hospitals Rural hospitals across the country have responded to economic pressures by building stronger affiliations with other health facilities and exploring increased access to care through telehealth services.

In 2015, an alliance of like-minded, nonprofit community hospitals formed the Southern Arizona Hospital Alliance, including independent hospitals in Benson, Bisbee, Safford, Tucson and Willcox.

Through stronger alignment, smaller hospitals are better able to achieve economies of scale that support improved operating margins and can enhance care delivered to their communities.

The collaboration between Benson Hospital and TMC HealthCare enhances services in the San Pedro Valley, said Julia Strange, chief executive for Benson Hospital. “By leveraging the expertise of both of our hospitals, we’ve been able to streamline operations and provide the level of care our community deserves.�

Consider Benson Hospital. Through the power of shared purchasing, the 22-bed critical access hospital saved significant resources in purchasing and material costs. TMC HealthCare also provided additional savings by assuming laundry services and improving efficiency for pathology reports, while also exploring new channels for telemedicine.

Hospice inpatient services opened at Benson as well, made possible by a grant from the TMC Foundation. The location and amenities reflect the spirit of donor Rick Schoen, who wanted his estate to support high-quality hospice services in rural Arizona.

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Donors Greg Schoen and Barb Anthem join Benson Hospital and TMC Foundation staff in celebrating new hospital amenities with a ribbon cutting.

TMC first Southern Arizona hospital to deliver virtual care as part of growing effort around accessibility Jason Zibart knows one thing is inevitable: When earaches happen in his household, it’s never at a convenient time.

“It’s always on a Friday night after 9 p.m. or something – never on a weekday – so we’re scrambling to get into an urgent care, or even emergency care,” Zibart said. This time, he was ready. When his 3-year-old son ended up with the telltale symptoms, Zibart jumped onto a visit through TMC HealthCare’s new virtual visit platform, TMC Now. For a flat fee of $49, patients can talk to a board-certified doctor within minutes - 24 hours a day, 365 days a year.

“It was great. I waited about 15 minutes for a visit, shared the photos I had taken and the doctor sent in a prescription to my preferred pharmacy,” explained Zibart, a patient care coordinator at TMCOne. “It saved me from having to make a trip after hours.”

TMC Now is designed for anyone who is experiencing an illness or injury that doesn’t require an emergency room visit, but is urgent enough to need immediate care. “It’s about providing care whenever and wherever patients

need it,” said Judy Rich, president and chief executive at TMC HealthCare. “We’re meeting patients where they are, helping them get quality treatment faster and get back to their lives.”

TMC also offers online scheduling for emergency room visitors, allowing them to wait in the comfort of their home until a designated time of arrival.

Add in TMC’s new digital wayfinding to help patients better navigate the campus and it adds up to TMC’s ongoing investment in technology.

TMC has consistently been the first in our state and area to implement digital advancements, including an electronic medical record and an online patient portal.

“We know that today’s patients are increasingly comfortable in a digital environment, so it’s critical to provide mobile tools to increase convenience, access and engagements,” said TMC HealthCare’s Chief Information Officer Frank Marini. “It’s not about just having technology in place – it’s about using it effectively to support clinical excellence.”

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TMC expanding lifesaving care for children TMC for Children continued to expand pediatric specialty care in 2018, making lifesaving treatment more accessible to children in our community, like Aaron Marten.

DON’T STOP ANYWHERE

blood-glucose level in the body,” Dr. Patel said.

“It is a chronic condition. However, the good news is a healthy life is possible with proper ongoing treatment and management.”

“Go directly to the emergency department and don’t stop anywhere,” said Aaron’s mother, Jami Marten. “That’s what our pediatrician told me after testing Aaron’s bloodsugar.” At just 11 years old, Aaron had been acting a little differently in the fall of 2018. “All of a sudden he was incredibly thirsty – drinking five and six bottles of water a day,” Marten said. The sudden symptoms began a few days before a routine visit to Aaron’s pediatrician.

Marten said having a pediatric specialist made a difference in care for the patient and created peace of mind for the parents. “Within 24 hours, Dr. Patel was able to get Aaron’s blood-sugar back into a normal range,” Marten said. “We had many questions and he answered each one completely – we knew what to expect and felt more confident setting up Aaron’s care.”

“We explained the changes and the doctor decided to do a blood-sugar test to be sure everything was alright,” Marten said. A normal blood-sugar range is between 80 and 120 mg/dL – Aaron’s level was 679 mg/dL.

In addition to pediatric endocrinology, TMC for Children has also added pediatric pulmonologists, pediatric gastroenterologists and pediatric infectious disease specialists. The specially trained physicians are available 24/7 to ensure superior care is available to children and families throughout Southern Arizona.

RUSHED TO THE ED “Without treatment, high blood-glucose levels like this can lead to diabetic ketoacidosis, a life-threatening condition,” said Dr. Chetanbabu Patel, a pediatric endocrinologist and one of the pediatric specialists providing care at TMC for Children.

Aaron was rushed to the TMC Pediatric Emergency Department, where Dr. Patel oversaw Aaron’s testing and treatment. “Everybody in my family started crying after my test,” said Aaron. “I didn’t know if I was going to be OK.” The family was worried that high blood-sugar levels indicated diabetes – and what that meant for Aaron’s health in the short and long term.

WITHIN 24 HOURS “Aaron’s symptoms and test results were congruent with Type 1 diabetes, caused when the pancreas is not producing enough insulin to regulate the

EXPANDING PEDIATRIC SPECIALTIES

The specialists have also created an opportunity to provide more comprehensive residency training for medical students, enhancing care at TMC for Children and building a stronger clinical experience and greater knowledge for new doctors.

DIABETES DOESN’T HAVE ME Aaron now wears an insulin pump and a continuous glucose monitor. “Things are different, but the quick and complete care he received at TMC for Children gave him the right start and frame of mind,” said Marten.

“I don’t drink soda anymore and I have to count carbohydrates every time I eat. I’m healthier and I like my new life,” Aaron said. “I might have diabetes, but diabetes doesn’t have me.”

TMC celebrates 300 TAVR, 200 WATCHMAN and 100 MitraClip procedures The structural heart program at TMC celebrated a milestone year – making complex cardiac procedures more accessible and changing lives of those who receive them. The “3-2-1” celebration represented 300 TAVR, 200 WATCHMAN and 100 MitraClip procedures – all of which provide patients with more options, faster recovery and less pain than traditional open-heart surgeries.

•

TAVR, or transcatheter aortic valve replacement, can place a new valve in the heart through a catheter inserted in the upper thigh. The procedure offers less scarring, pain and recovery time than traditional open-chest surgery.

• MitraClip can be life-changing for patients unable to undergo traditional open heart surgery, improving their overall health, energy and emotional well-being.

• WATCHMAN is designed to prevent stroke in patients who have atrial fibrillation who are unable to take long-term blood thinners.

Each of these sophisticated procedures require experienced clinical staff and advanced technology to ensure safety and promote strong outcomes. Additionally, TMC has invested in three state-of-the-art biplane rooms that house the latest imaging equipment.

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Voices of our patients One of the amazing things about working for a community hospital is hearing the stories of others that kindle our admiration and nurture our inspiration.

Here are a few incredible people we met this year:

Federal pharmacy discount program essential to care Thousands of patients were able to receive lifesaving care and medical treatment at Tucson Medical Center last year as a result of a program that provides discounted drugs to hospitals that care for high numbers of financially vulnerable patients. Through the 340B program, TMC saved approximately $5 million in 2018.

“TMC serves some of the sickest and poorest members of our community. Because of the savings we get by replenishing necessary but high-cost drugs on 340B, we are able to invest those resources into the hospital and into the community so we can continue to extend services to underserved and vulnerable populations,” said Claudia Koreny, director of Pharmacy.

Through 340B, TMC has expanded coverage to patients with diabetes who have no prescription-benefit coverage, making it very challenging to afford expensive insulin, lancets, test strips and other needs.

Along with expanding services for patients who need infusion medications, TMC expanded its discharge medication program for patients at high risk of readmission. This is essential to the care for an aging population, many of whom experience challenges related to mobility and transportation.

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From bariatric surgery to instructor of intense workout When Marni Gould topped out at 248 pounds, it became evident she needed to make a change. Although she was active, and dance and exercise had long been a passion, her health was getting worse. At 35, the middle school math teacher was grappling with sky-high blood pressure and a resting heart rate of more than 100 beats per minute. Her knees hurt. Her ankle rolled too often. Diets didn’t seem to work.

Four months after weight-loss surgery, she happened upon a high-intensity endurance workout called Insanity Live. It was hard but she stuck with it and within 18 months, she had lost her 100-pound goal.

When her instructor moved, Gould couldn’t imagine a Saturday without the class. She decided to teach it. “At the training, they said, ‘You don’t have to be the best at the moves. You just have to be the most motivating,’ ” she recalled. “That stuck with me.”

TMC patient Mayo Clinic’s Arizona WomenHeart Champion

TMC patient finds new freedom with 3D knee replacement

Susan Smith’s heart attack was a wake-up call. Smith, who can be seen dancing on TMC’s commercials celebrating recovery, proudly represented TMC at the 2018 WomenHeart Science & Leadership Symposium at the Mayo Clinic.

Barbara Wagner was informed 10 years ago that she needed to have both knees replaced. She had the left knee replaced soon after the recommendation, but decided to try to stave off surgery on the right by getting cortisone injections.

The four-day symposium, which selected 50 women from 18 states, was designed to prepare the participants to be advocates for women’s heart health in their communities – providing support and education about heart disease, the No. 1 killer of women.

Over time, the shots were less and less effective, and she soon found herself with a limp and a cane. In seeking new options, she found technology had changed over the past decade. One such advancement involves producing a custom-made, knee-replacement implant to fit a patient’s unique anatomy by using 3D CT scanning technology.

Smith said she has now realized her busy lifestyle was stressing her system. “I was so intent on taking care of everyone else, I put my own self-care at the bottom of the list,” she said. After four days in the hospital, she left not just with two new stents, but a new attitude, she said. “People see a ‘new me’ practicing self-care and moving through the day at a stroll instead of a sprint.”

Tucson youngster collects books to share with pediatric unit Addison Braswell surprised her parents as a kindergartener when she decided to donate the contents of her piggy bank – collected from gifts and holidays – to pediatric patients.

She has done the same thing every year since, explaining that she feels badly for children who are sick and wished she lived in a world where sickness didn’t exist.

Recently, Wagner walked down the hall of Tucson Orthopaedic Institute with a smile, without pain and without a limp.

“The custom knee replacement has given me the freedom to be more comfortable in everything I do.”

So when she celebrated her first Holy Communion, it was completely within character that the 9 year old asked her friends and family to purchase children’s books to donate to children recovering in the hospital.

“Sometimes, when I don’t feel well, stories help me imagine that I’m somewhere else,” explained Addison, who donated more than 20 books to TMC for Children.

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News and Notes

Patient and Family Advisory Council pampers TMC patients Parents of children recovering in the hospital enjoyed a day of massage, skin care, pastries and gift baskets, compliments of the Patient and Family Advisory Council for Women’s and Children’s Services at Tucson Medical Center.

Each visitor also received a bag filled with small gifts, discount coupons and fresh flowers.

The event was only possible with the generous support of a dozen different vendors who gave their time to help patients feel better.

New patio dedicated to organ donation Tucson Medical Center dedicated a new Garden of Life Memorial Patio in honor of those who made the choice to share the gift of life.

The soothing patio area features a garden of flowers and a tree hand painted by TMC Facilities as a symbol of strength and hope.

The first plaque to be placed on the tree honors Jared Koltnow, whose gift saved three others after he passed away in 2016.

Over the last decade, 33 organ donors at TMC have saved the lives of 83 others.

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“It is important that each patient’s support unit take care of their own well-being because the patient will need them to be strong and healthy for the journey ahead,” said member Edmundo Zevallos. “We want them to know we understand and support them.”

1,000th work of art sparks celebration About 100 guests celebrated the unveiling of the 1,000th work of art added to the TMC Healing Art Program collection: “Abstract Aspens, Grand Canyon North Rim,” a series of three digital photographs

by Dr. Larry Haas, a founding surgeon of the Tucson Orthopaedic Institute.

“The donated paintings, drawings, photographs and sculptures really go a long way in promoting healing and enhancing the patient experience,” said Lauren Rabb, program curator.

The ceremony was a time to thank the donors and musicians who contribute to the program, as well as to thank other artists for their gifts in 2018, including Lauri Kaye, Wes Jernigan, Fred Wackerle and Shirley Wagner.

Stroke program receives national recognitions When minutes matter, patients can be reassured that Tucson Medical Center routinely achieves critical treatment timelines for patients that give them the best outcomes after a stroke.

TMC earned the Get with the Guidelines® Stroke Gold Plus Quality Achievement Award from American Heart Association/ American Stroke Association for meeting specific quality metrics for the diagnosis and treatment of stroke within a designated period that is scientifically proven to reduce death and disability for stroke patients.

Additionally, the association awarded the hospital the designation of Target: Stroke Elite Honor Roll, for reducing the time between when a patient suffering from a specific kind of stroke arrives at the hospital and when treatment starts with a clot-busting drug. TMC is the only hospital in Southern Arizona with this top-level designation.

Senior volunteers paint uplifting rocks for patients Small acts of kindness can lift spirits in a big way. A social group at TMC for Seniors provides a creative and artistic way to send big-hearted messages to patients at Tucson Medical Center – a therapy benefiting both artist and patient.

While rock painting isn’t new, TMC for Seniors put a new twist on the longtime hobby – painting fun designs and positive messages on rocks that are placed in the patios and common areas at the hospital to be found by patients and their family members.

“The painting is as uplifting for the painters as it is for the patients,” said Anne Morrison, services coordinator at TMC for Seniors. “They really enjoy the social element of it.”

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2018 Community Benefit

Community Benefit 2018

TMC reports almost $62.7 million in community benefit and charity care for 2018, or about 10.7 percent of net revenues. In the previous year, TMC reported a community benefit of 11.9 percent of net revenues.

51%

Unpaid Costs for AHCCCS/Medicaid Patients $31,829,000

20%

Cost of Uncompensated Care (Charity Care & Bad Debt) $12,381,000

19%

Hospital Assessment $12,157,967

10%

Outreach & Education $6,353,378

What Makes Up This number?

UNPAID COSTS FOR AHCCCS/MEDICAID PATIENTS: 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

Total

$62,721,345 Percentage of net revenue: 10.7%

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.

Bad debt consists of services for which the hospital anticipated but did

Community Benefit Trends

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 69 percent; and, depending on a patient’s income, other discounts may apply as part of TMC’s Community Care program.

$56

MILLION

$56

MILLION

$64

$63

$59

MILLION

MILLION

2016 11.6%

2017 11.9%

2018 10.7%

MILLION

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: tmcaz.com/community-care.

HOSPITAL ASSESSMENT: In 2018, hospitals in Arizona were assessed by the state to help fund the cost of expanding AHCCCS services to an additional 398,000 low-income residents. TMC’s portion of the hospital assessment was $12.2 million.

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.

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2014 12.7%

2015 11.8%

(% of net revenue)

2018 HOSPITAL DATA

TMC Community Events

Licensed Beds

5.9% 2.8% 62.7%

TMC for Children

General*

28.6%

Unit

Total Number Served

TMC for Seniors

The Core

Mom/Baby

60

NICU

42

Pediatric

44

PICU Medical-Surgical

70,405

12 404

ICU

45

Geropsychiatric

16

Inpatient Hospice

16

Total * Includes Wellness, Girls on the Run and TMC for Women

Beds

639

2018 VOLUMES Emergency Visits Adult

70,340

Pediatric

28,233

Total

98,573

Inpatient Admissions 32,413

Pediatric

2,099

Total

Total Events: 1,076

34,512

Babies Delivered 5,485 Safety and Wellness items provided to community

Surgeries Inpatient

• Bike Helmets

3,585

Adult

• Car Seats

1,908

Pediatric

• Booster Seats

1,979

Outpatient

• Pack ’n Plays Community Organizations Supported: 83

Adult

• School Supplies • Swim Lessons

44 16,800 250

10,376 9,904 472 14,246

Adult

11,543

Pediatric

2,703

Total

24,622

On

CENTER

The TMC Foundation continues to be humbled and motivated by the extraordinary support of our donors. Their gifts demonstrate the confidence our community has in TMC and the hardworking men and women who provide care each and every day.

As we take the next steps to provide exceptional health care with compassion, we will continue our dedication to services within the hospital but also recognize that our work must extend beyond the walls of the hospital. At the TMC Foundation, we are committed to working with local governments, the nonprofit sector and our donors to engage in critical and complex issues experienced in our community.

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

The Centurions and other generous donors are providing funds to remodel the current NICU area, creating a more soothing, private environment that fosters parent-newborn bonding, an aspect research has proven to enhance a child’s cognitive and social development.

This year’s accomplishments are another great step forward for care in our community, and it has been difficult for me to make the decision to retire in 2019.

Hospitals and health care organizations are learning more about social determinants of health. In its broadest terms, social determinants are the conditions in which people are born, live, work and age.

As I reflect on the distinct honor to serve TMC HealthCare for the last 16 years, I am proud of the connections we have made to link generous donors to critical projects and programs that help TMC deliver exceptional health care with compassion.

A person’s education level, access to economic opportunities and environmental living conditions have direct impacts on health and well-being. By leveraging our knowledge about social determinants and collaborating with community partners, we aspire to improve the health of the community we serve.

To see the faces of our grateful patients, staff and providers as a result of investments we have been able to achieve through philanthropy – that’s what has made this work so much more than a job.

In 2018, we began the effort to create the Connie Hillman Family Foundation House – a transitional housing collaborative between TMC, CODAC Health, Recovery and Wellness and the Connie Hillman Family Foundation.

The program is designed to help break the cycle of addiction by providing safe and stable housing for mothers in recovery, while providing aftercare treatment, life-skill training, pediatric care and other evidence-based services that facilitate lasting recovery and independence.

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In this issue of On Center, you will read about additional TMC efforts to address social determinants of health in our community, such as the Small Baby Unit in the TMC Newborn Intensive Care Unit.

The strides we have made put the TMC Foundation in a strong position to continue its vital work of expanding access to quality care and programs that make a difference in people’s lives and our community.

I have been fortunate to work with many volunteers, community stakeholders and coworkers throughout the years. The talent and commitment are stronger than ever, and I am looking forward to the accomplishments yet to come.

TMC Foundation experienced a productive and exciting year in 2018, growing philanthropic opportunities and strengthening our community’s access to high-quality health care.

“Record-setting” is the best way to summarize the 2018 TMC Foundation Gala. Focused on raising funds to support crucial enhancements to the TMC NICU, I am happy to report the event drew a larger attendance than ever before and broke fundraising records, far exceeding goals and expectations.

Health education is an important part of preventive medicine, and TMC Foundation has spearheaded an effort called We Are Champions to empower the community with health care knowledge. Members meet quarterly to attend lectures provided by leading physicians, and then share the newly acquired knowledge throughout the community.

From the TMC Foundation Chairman Steven Siwick, M.D.

Thanks to support of TMC Mega Raffle donors, the TMC Emergency Department continues to have the only advanced equipment in Southern Arizona to provide comprehensive forensic exams for victims of sexual assault.

This year we continued to receive generous gifts through the Grateful Patient program. Marlies Terpning and Zippy Gross were two of many patients who made gifts that will touch the lives of future patients.

Although we are excited for new opportunities and successes in the coming year, we are saddened TMC Vice President and Chief Development Officer Michael Duran is retiring after 16 years of leading the TMC Foundation.

Duran has been innovative in his approach to fundraising, recognizing the value of donors of all

levels. Under his leadership, Children’s Miracle Network has grown from $300,000 to $2 million annually; the TMC Mega Raffle was introduced and now raises more than $1.5 million annually; and the TMC Foundation Gala has become the event of the season, bringing our community together to raise money for essential health services.

Significant projects supported by the TMC Foundation under Duran’s leadership include: • TMC for Children: A $12.5 million capital campaign funded the construction of our pediatric hospital- within-a-hospital.

• TMC for Women: A $12.5 million capital campaign funded the development of a women’s center on the southeast corner of the main hospital.

• Peppi’s House: A $4.5 million capital campaign funded a new facility for TMC Hospice administration and inpatient services.

• The Healing Arts Program: This innovative program filled TMC’s long halls with gallery-quality art and brings music and other cultural benefits to our patients, staff and visitors.

• The Connie Hillman Family House: This collaboration between TMC HealthCare and CODAC created a safe transitional housing program for women and their children.

Tens of thousands have benefited from Duran’s commitment to make Tucson and Southern Arizona a better place to call home, and we are grateful for his service, passion and dedication. A sincere thank you and best wishes to Michael Duran, who has been an integral part of the TMC Foundation and its mission.

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Contributing to a culture of caring Inspired by the memory of a beloved family member and their experiences at Tucson Medical Center, Tommilee Phillips and her husband, Dick Keiler, established the Frances Philips Bond Scholarship Fund to assist TMC employees in need.

The scholarship was named in honor of Phillips’ sister, Frances “Tootie” Phillips Bond, “a lifelong nurse and a wonderful, caring human being,” Phillips said. The scholarship celebrates Tootie’s life each year by helping a member of the TMC family. That help has come in the form of a reliable automobile, furniture, elimination of student loans and more.

“We wanted to find ways to give deserving staff members a much-needed hand up or peace of mind or just a break from life’s flat tires, leaky pipes and other unwelcome surprises,” said Phillips. The scholarship is changing lives, and there were specific reasons they chose to give back to TMC. “Tommilee and I have been patients there and caregivers for friends there. We have always been impressed with the culture of kindness throughout TMC,” said Keiler.

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“From the time you arrive until the time you leave, everyone seems determined to make sure you are cared for, fully and thoughtfully.

It is really quite remarkable.”

Charitable giving can be very rewarding, and that experience was no different for this philanthropic couple. “There is nothing quite like the realization that you have made a real difference in someone’s life,” Phillips said.

“The incredible satisfaction more than pays back all the effort - way more.”

Employees are family, and the TMC Foundation endeavors to provide support in meaningful ways that better lives of the TMC family.

“The Frances Phillips Bond Scholarship has provided TMC with another important way of supporting the men and women who accomplish our mission of providing exceptional health care with compassion,” said Michael Duran, TMC vice president and chief development officer.

“We are inspired, encouraged and grateful for donors like Dick Keiler and Tommilee Phillips.”

If you are interested in donating to the Frances Philips Bond Scholarship, contact the TMC Foundation, (520) 324-3116 or foundation@tmcaz.com.

Clark’s Corner – new dog park honors memory of hospice patient Pets are family – and that’s why Peppi’s House welcomes pets. Thanks to the generosity of one patient’s family and friends, dogs visiting our inpatient hospice facility now have their very own dog park – Clark’s Corner.

The idea originated from the park’s eponymous Clark, a loveable Samoyed. Clark’s fluffy white coat, frequent smiles (yes, this dog smiles) and happy-go-lucky demeanor are enough to persuade anyone to build a dog park. But Clark’s influence goes much deeper.

“Patients and their families are happily surprised when they learn pets are welcome,” said Kim Fore, R.N., the director of patient care services at TMC Hospice. “Pets really are family, and it means a lot to patients that they can spend this important time with them.”

When Clark’s owner, Martha, was a patient at Peppi’s House, he never left her side. “Martha was so grateful Clark could be with her,” said Donna Morton, TMC Foundation director of

development. “It meant so much that after Martha passed, her friends and family asked us how they could help make Peppi’s House even more pet-friendly.”

It wasn’t long before the idea was hatched to build a dog park in one of the many outdoor areas around Peppi’s House. Adorned with decorative patina fencing, Clark’s Corner sits west of the main and administrative entries.

It has many of the amenities one would expect from a dog park – space for running and playing, an automatic water bowl, a lush patch of grass, and a comical, fake fire hydrant.

As pets and their people enter Clark’s Corner, though, they find something truly unique. The Clark’s Corner sign is a mural-like mosaic made with custom tiles. The artistic piece includes many details that have strong significances to Martha, her friends and her longtime partner, Molly.

“It really means a lot,” Molly said. “A part of Martha will live on through Clark’s Corner.”

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The Centurions enhance NICU care, Block by Block “The NICU enhancements are a thoughtful step forward in addressing the unique needs of these tiny babies,” said Moira Richards, M.D., neonatologist and medical director at TMC for Children.

HOW PATIENTS AND THE COMMUNITY ARE HELPING In 2018, Hilary Lace and her husband, Aaron Skoczen, spent 19 days in the TMC NICU with their premature twins, Evan and Ella. Lace has been outspoken about her positive experience at TMC, helping to raise funds to support the much-needed NICU expansion. “I was so impressed with the NICU staff and how eager they were to show my husband and me how to care for NICU infants – private NICU rooms will further enhance the privacy and individualized care,” she said.

The Centurions are continuing their efforts to support TMC for Children, helping fund vital enhancements to the Newborn Intensive Care Unit that will provide families with additional space, greater privacy and promote long-term development for TMC’s tiniest patients.

BLOCK BY BLOCK Block by Block, Small Miracles Happen is a recent campaign of the TMC Foundation to further improve the care and environment in the NICU and meet the community’s need for additional services for these infants. Upon completion, the rooms will provide: • Private nurseries with state-of-the-art medical technology • A place for parents to stay overnight and to bond with their babies • Rooms with low lighting and minimal noise disruption • A place where parents can remain and bond with their child around their own schedules • A space where babies can grow strong and prepare for their departure home with their families 5

Aaron Skoczen, Lace’s husband, is a member of The Centurions and was part of the TMC partnership to benefit TMC for Children.

His efforts are coming full circle.

IMPROVING LONG-TERM DEVELOPMENT Infants born at 28 weeks or earlier who receive care in a private room transitioned faster to independent feeding, had stronger respiratory function, improved growth and spent fewer days in the hospital, according to research published in the Journal of Developmental and Behavioral Pediatrics.

Once home, the infants showed improved attention and motor function, as well as better cognitive and social skills.

“This effort is about much more than enhancing the surroundings,” said Michael Duran, TMC vice president and chief development officer. “We are raising the bar, strengthening care through evidence-based best practices that go beyond immediate care needs and support the long-term development of children in our community.”

Supporting children’s care translates into any language Spanish-speaking radio stations La Caliente 92.1/95.7 FM and La Buena 94.3 FM/990 AM are valued CMN partners. The Tucson stations invested more than 36 hours of live broadcast, raising more than $36,000 to change the lives of children in our community.

“Arizona Lotus Corp. is proud to be a part of raising funds to support CMN, which does so much to help the families and kids in Tucson and Southern Arizona,” said General Manager Ken Kwilosz, Jr., general manager of Arizona Lotus Corp., the parent company of La Caliente and La Buena. “We are committed to helping CMN reach more Southern Arizona families with their messages and to helping raise funds for their efforts.”

Panda Express – asking every customer, every time Sometimes a little can mean a lot – and that’s why Panda Express asks each customer to contribute a few cents toward stronger care for children in their community.

The Panda Express strategy is simple: ask every customer every time for the change from rounding up a purchase to the next dollar. So, if a customer purchases a meal for $9.27, the server will ask if the customer would like to round up 73 cents for TMC. The change really ads up. In 2018, Panda Express raised more than $220,000 to support TMC for Children.

Panda Restaurant Group has been a proud fundraising partner since 2007, supporting Children’s Medical Network hospitals such as Tucson Medical Center. Every donation made at Panda Express restaurants in Southern Arizona supports TMC programs for infants and children, purchases lifesaving equipment and provides vital health services for kids at TMC.

Arizona Lotus Corp. has been a sponsor for several years, stepping up commitment year after year and reaching new fundraising goals. “A heartfelt thank you for creating this opportunity for CMN and the Spanish-speaking community to come together,” Grasse said.

“A most sincere thank you to Panda Express,” said Erika Grasse, TMC director for CMN, “for their long-time partnership and determination to support care for children in Southern Arizona.”

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Chair donation brings comfort to patient families donated countless prints to the TMC Healing Art Program.

His artwork adorns several hallways, providing a more soothing and healing environment for patients and staff.

Amongst many efforts, Marlies has crocheted more than 500 plush and soft blankets for babies staying in the Newborn Intensive Care Unit. Considering each blanket takes four days to complete, the time investment is both considerable and greatly appreciated by TMC and families.

In the past, Howard was hospitalized with serious health concerns and Marlies never left his side. “Sitting in one place for a while can be uncomfortable and distracting, especially if you have back or joint problems.”

As Howard recovered, Marlies reflected on her challenges and thought of a way to help TMC patients and their families.

Chairs designed for hospital use must meet specific safety and durability standards – which creates a greater expense.

Undaunted, Marlies was determined to contribute.

“I wanted to make sure the chairs were safe and would last,” Marlies said. “But I also wanted the fabric to be comfortable, and I wanted the chair to recline so a family member could sleep there if they had to.”

No matter how long – family will be there every second when a loved one is staying in the hospital. After sitting by her husband’s side for extended periods, philanthropist Marlies Terpning recognized an opportunity to help families rest easier while supporting their loved one.

From sculptures and courtyards to medical equipment and handcrafts, Marlies and Howard Terpning are longtime, generous donors to TMC Foundation. A famed artist known the world over for his Southwest and Native American paintings, Howard has 7

True to her word, Marlies chose comfortable materials, made sure the chairs fully recline and even chose the color of the fabric. And for her efforts and investment, Marlies said she feels great. “It makes me smile knowing that families can rest and focus on their loved one getting better.”

Grateful patient champions health care education Chris and Stan Turney are helping lead the charge to provide stronger health care education through We Are Champions – an effort established by the TMC Foundation to build a healthier Southern Arizona by bringing together the community and health care knowledge.

We Are Champions is a group of community volunteers, or champions, who organize in-depth health care presentations presented by leading physicians and covering important information regarding health and the health care system.

GREATER KNOWLEDGE MEANS GREATER CONFIDENCE Stan was always in strong health. He exercised regularly, ate a wholesome diet and kept a healthy weight. His wife, Chris, a former intensive-care nurse, knew his family history and made sure Stan got his cardiac stress tests.

In February 2018, several cardiac tests determined Stan had coronary-artery disease and that bypass surgery was needed.

The couple felt better prepared and more at ease thanks to We Are Champions lectures.

“As a registered nurse, even though I had extensive experience working in cardiac and surgical units, the We Are Champions information still helped,” Chris said. “We joined, in part, because we thought the information would be helpful if we faced a medical challenge someday – and we did.”

We Are Champions provided the knowledge and familiarity that built their confidence. “We had seen TMC-affiliated physicians present and we felt confident in their skill and commitment to patients,” said Stan. “Through We Are Champions, we got a better understanding of medical problems and how surgeries were done, and we definitely went into this more comfortable because of it.”

STRONG OUTCOME AND TRUST Stan had a very strong outcome, and took his first steps back onto the golf course a few days later - though he didn’t play for a few more weeks.

“In addition to the knowledge from We Are Champions, our experience solidified our trust in TMC,” Chris said. “The preparation, hospital stay and aftercare were stellar – and we want to be a part of empowering people with health care knowledge they can share with their family, friends and neighbors throughout the community.”

From heart and bone health to healthy skin and veins, We Are Champions hosts a lecture each quarter. “The doctors answer a good number of questions,” said Chris. “They are passionate, and really take the time with the group.”

Contact the TMC Foundation to join We Are Champions, reserve seats at the next lecture or for more information at (520) 324-3116 or foundation@tmcaz.com.

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Planned giving offers a win-win-win for a TMC patient The support and knowledge of the TMC Foundation made planned giving an easy choice for Tucson native Suzanne “Zippy” Gross. Zippy’s family moved to Tucson in the 1930s and 1940s. A love for the community, culture and desert landscapes kept her feet firmly in the Old Pueblo. When medical needs arose, the Gross family trusted Tucson Medical Center.

“My mother, my aunts and many family members have been treated at TMC, including me,” she said. “We have received great care across the decades – from my tonsillectomy to a recent knee replacement.”

Planned giving allows a donor to maximize a gift and the community impact, by using asset, estate and tax-planning techniques. Gifts can be made outright, delayed to a future period, or made over time in a manner that provides financial benefits to the donor.

“TMC is nonprofit and locally run, and they are sincerely dedicated to making Tucson healthier,” Zippy said. “I am a member of We Are Champions and heard TMC Foundation was holding a planned giving seminar. I really wanted to learn how I could give and what incentives were possible.”

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The Planned Giving Council at TMC Foundation hosts free, planned giving seminars, presented by licensed financial professionals who explain and answer questions about planned giving options. “I was so impressed with their detailed knowledge,” Zippy said. “It made me feel confident and safe making a gift.”

The extensive information revealed an opportunity, but that was just part of Zippy’s interest. “I found out that I could make a significant gift and receive a tax incentive,” she said. “I was just as thrilled that I could decide how my gift would benefit TMC – I’m passionate about supporting health care services for the elderly, women and newborns.”

Zippy explained that planned giving provided new philanthropic avenues that allowed her to accomplish several goals, satisfying her heart and her checkbook. “A tax incentive, supporting the causes I care deeply about, and giving to the hospital that has cared for my family for 75 years – it was a win-win-win!”

Sexual assault survivors receiving comprehensive care The TMC Mega Raffle is funding sophisticated technology to best diagnose, treat and complete a comprehensive forensic exam for victims of sexual assault – the only program of its kind in Southern Arizona.

“It is our priority to provide the most advanced and compassionate care for sexual assault victims during the worst time in their lives,” said Cynthia Carsten, R.N., MSN, director of patient care services at the TMC Emergency Department. “The highly specialized colposcope enhances the ability to diagnose sexual trauma, allowing for the most accurate care for the victim and providing expert forensic documentation to support law enforcement investigations.”

The colposcope allows for clear, magnified examination, and is the centerpiece of a comprehensive approach to caring for sexual assault victims.

At the TMC Emergency Department, there is a dedicated private space for sexual assault evaluation and treatment. The Southern Arizona Center Against Sexual Assault partners with TMC, deploying certified sexual-assault nurse examiners and crisis advocates who work with physicians and law enforcement to treat, document and provide additional support and resources.

“For survivors, this can be the first step toward healing and justice,” said Katlyn Monje, who administers the SACASA program. “There is a relief for survivors knowing the colposcope can help the nurse examiners identify injuries, and pictures recorded by the colposcope can support prosecution against perpetrators.”

The collaboration has been in operation for more than 10 years, and the initial equipment is reaching the end of its service life. “Every community deserves to have this service available to them,” said Julie Wolfe Beadle, TMC Foundation director of major gifts. “We are fortunate to have the support of Mega Raffle donors whose support allows us to extend better care to patients and assist law enforcement.”

The new equipment means more than continuing care, but also enhancing care.

“We began this program in 2005 and the updated instrumentation provides greater clarity and modern compatibility,” Carsten said. “With this equipment we are able to continue to partner with SACASA and provide the highest standard of care available for women, men and children who have experienced rape, abuse or assault.”

Working together to reduce domestic violence and sexual assault TMC joined a community coalition to reduce the incidence and lethality of domestic violence and sexual assault. Comprised of public agencies and private nonprofits, the collaborative effort also works to increase accessibility to victim services.

The coalition has adopted the Arizona Intimate Partner Risk Assessment Instrument System, an evidence-based protocol used to identify the potential risk of severe re-assault, and lethal or near-lethal intimate-partner violence.

Pooling resources and knowledge, the coalition aims to increase the community’s ability to identify high-risk victims.

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VOLUNTEERING AT TMC TMC experienced another outstanding year of volunteer participation in 2018. Throughout the year, 542 volunteers logged 88,591 hours, donating their time to support patients, staff and the community.

Volunteer duties range from staffing information desks, transporting patients and visitors across the hospital, helping older adults navigate Medicare enrollment, making home visits to hospice patients and rounding with their pets. Volunteers have an important role here at TMC and are committed to improving the patient experience one smile at a time.

Active volunteers hours of service AREA

# ACTIVE

HOURS

TMC Auxiliary Pet Therapy Program TMC Hospice TMC for Seniors

376 39 92 92

76,593 2,047 7,500 2,451

TOTAL

599

88,591

TMC Auxiliary – delivering compassion and a memorable experience Auxiliary volunteers continued providing their support to TMC in a variety of areas, including information desks, in clinical units, and transporting patients and guests throughout the hospital. The college student program grew tremendously, providing more support to clinical staff in areas such as the Emergency Department, surgical units, critical care and more. The Auxiliary volunteers proudly wear their teal smocks in support of TMC while demonstrating our values and providing exceptional health care with compassion.

TMC Auxiliary financial support to TMC Joel M. Childers, M.D., Women’s Center Initial Pledge for 2018 NICU Services Breast Screening Services TMC Hospice Family Support Services TMC Foundation Events Auxiliary Operations

$50,000 $25,000 $20,000 $10,000 $5,000 $171,000

TOTAL $281,500

TMC Auxiliary totals:

Fiber Arts donations:

Volunteer Areas Auxiliary Volunteers Total Volunteer Hours Full-Time Equivalent TMC Salary Savings

Heart Pillows Walker Bags Bolsters Bereavement Blankets Veteran Pillowcases Pediatric Quilts

46 415 78,640 38 $1.8M

TOTAL

1,130 491 120 25 48 26 1,840

TMC Hospice volunteers TMC Hospice volunteers are an integral part of the hospice care team. They provide helping hands, listening ears, companionship and support to hospice patients, families and staff.

Our hope is to improve the quality of life of our patients and families with the help of our volunteers. They are a valued part of our interdisciplinary team.

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TMC Foundation Gala sets new fundraising and attendance records The 2018 TMC Foundation Gala raised a record amount to support a vital enhancement of the TMC Newborn Intensive Care Unit. The TMC Foundation galas have a strong reputation for extraordinary entertainment, elegant formal wear and exhilarating live music. The 2018 “World of Wonder” featured Arabian-themed decorations, performances and entertainment.

The evening was filled with excitement as the record-number of attendees danced, mingled and celebrated. And the more than 800 guests endeavored to break another Gala record: donations from sponsors and attendees exceeded a half-million dollars, setting an all-time fundraising high for the TMC Foundation.

Proceeds benefit the NICU’s Small Baby Unit, a crucial enhancement that will provide private, quiet areas for parents to bond with their babies. Research has shown this bonding period is critical to an infant’s growth and development.

The volunteer chair for the 2018 gala committee, Rose Steele, used her leadership and creativity to bring the vision of the World of Wonder to life.

“I was amazed by the energy of the gala and by the generosity of our sponsors and guests,” Steele said. “A very special ‘thank you’ goes out to the members of this year’s committee, who worked tirelessly to surpass our goals. Together we are making the Small Baby Unit possible and improving the lives of children and families.”

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Corporation 33%

Individual 41%

Foundation 26%

TMC Foundation sources 2018 Corporation

Individual

26%

41%

5%

General Purpose

Foundation

Breast Oncology

33%

26

Breast Oncology Donor-designated funds

Children’s

26%

5%

General Purpose

15%

Social Determinants of Health

46%

Children’s

Corporation

Individual

Foundation

8%

Other

26%

Breast Oncology General Purpose

5% 46%

Children’s

Grants awarded to TMC

15%

Social Determinants of Health

Children’s

Children’s

37%

37%

General

26%

Other

13%

Other Hospice

18%

General

26%

Hospice

18%

Social Determinants of Health

6%

Other

13%

Social Determinants of Health

6%

Children’s

37%

General

26%

Hospice

18%

Social

Other awarded in 2018 = 70 Total amount awarded in Determinants Total grants 2018 = $3,486,246

13%

13

8%

Other 15%

Social Determinants of Health

of Health

6%

8%

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 Contributing Writers: Rhonda Bodfield Angie Bush Cheryl Kohout Jim Marten Julia Strange Design: Hilton & Myers Advertising Photography: Eric Suhm Rick Peterson

ON CENTER CREDITS Publisher: Michael J. Duran, J.D., Vice President and Chief Development Officer Executive Editor: Julia Strange, Vice President, Community Benefit Editor and Writer: Jim Marten Design: Hilton & Myers Advertising Photography: Eric Suhm Rick Peterson

Honoring the memory of Marks Fund co-founder, Selma Marks TMC marked the end of an era in 2018 with the passing of Tucson-native Selma Marks. Marks and her husband, Pima County Superior Court Judge Jack Marks, established the Marks Fund following his treatment at TMC in the early 1980s.

The couple had gotten to know staff members well and were impressed by their passion and dedication, but saddened to see the financial struggles of some due to common life challenges – a broken-down vehicle, a washing machine on the fritz or a plumbing leak.

The Marks Fund provides a financial hand up for TMC personnel going through tough times. The fund has helped hundreds of TMC employees and continues going strong today. Marks Fund requests are reviewed by a committee of fellow TMC employees. Although each recipient receives a grant, a vast majority of recipients choose to repay the grant – intending to make the fund accessible to more employees in need.

While both the Marks have now passed away, their legacy of providing financial assistance for TMC employees endures.

Many donations were made to the Marks Fund in her honor.

“Words cannot express the depth of our gratitude,” said Michael Duran, TMC vice president and chief development officer. “Selma Marks’ generosity and intrepid efforts made positive enduring changes in our community – she will always be remembered as one of Tucson’s best.”

Published May 2019 14