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2011 Report to Our Community ISSUE DATE: JULY 2012 PUBLISHED ANNUALLY BY TUCSON MEDICAL CENTER 5301 EAST GRANT ROAD TUCSON AZ 85712-2805

Our mission TUCSON MEDICAL CENTER DELIVERS CARING, PERSONALIZED, QUALITY HEALTH CARE TO PATIENTS AND THEIR FAMILIES IN AN ENVIRONMENT THAT IS SUPPORTIVE AND COMPASSIONATE.

Report to Our Community credits Publisher: Judy Rich, President and Chief Excutive Officer Executive Editor: Julia Strange, Vice President, Community Benefit Editor: Cheryl Kohout Design: Hilton & Myers Advertising Contributing Writers: Rhonda Bodfield, Cheryl Kohout, Michael Letson, Julia Strange Photography: Eric Suhm, John Litteer

On Center credits Publisher: Michael J. Duran, Vice President & Chief Development Officer Executive Editor: Julia Strange, Vice President, Community Benefit Editor: Cheryl Kohout Design: Hilton & Myers Advertising Contributing Writers: Rhonda Bodfield, Cheryl Kohout, Michael Letson, M. Scot Skinner, Julia Strange Photography: Eric Suhm, Jim Wood

These pages have been put together to inform you about our financial performance, our programs and how we benefited the community in 2011. And, interestingly, like everything else in health care, that story is changing.

Leadership perspectives From the president & chief executive officer Judy Rich

How we define our sphere of influence has changed and what it means to “benefit” the community has evolved. Today we know that our responsibility is to the broader population of Tucson, to lower cost, improve quality and drive real change to the health of our population. How we define the role of the individual in that change is evolving as well. To this end, TMC has joined with physicians and local, federallyqualified community health centers to create an accountable care organization. Ours is named Arizona Connected Care. We are fortunate that Southern Arizona is not the highest cost region of the country nor is our population the sickest. But even being in the middle of the pack, we have tremendous opportunities to control cost through better management of diabetes, heart disease and other chronic conditions. Our goal is to reduce the cost of care by actually increasing medical services. We can do that by providing the right medical service at the right place and the right time. It’s a new way of thinking for a hospital like TMC, looking beyond the walls of the hospital and into the continuum – into physician’s offices, support groups, health coaching sessions and more. The answer is complicated, but we believe we can influence the cost of health care in our community if we work with physicians to provide the best care instead of the most care. We are convinced that by improving access and increasing touch-points, we can lower the cost of health care for the whole community. Of course, a hospital or physician group or insurance company can’t do this alone. It requires individuals making healthy choices every day. Eat this, not that. Exercise. Don’t smoke. See your physician for routine visits, not just when acutely ill. By viewing your physician’s office as part of your personal healthy living team we can do something that has been elusive in this country for years: Reduce the cost of health care, one person at a time. And at TMC, we walk the talk. We have increased opportunities for our employees to make healthy food choices in our cafeterias. We no longer hire smokers. We support and encourage employees participating in runs, walks, bike races and other fitness activities all over Tucson. Additionally, we sponsor programs with the YMCA to help employees with diabetes and pre-diabetes mitigate their risks. As we re-envision health care, we will take risks because our community deserves the best health care in the world. We know we can do better. We have to do better. For ourselves, our children, our future.

From the chairwoman Louise Francesconi

FIVE YEARS AGO, WE INTRODUCED THIS ANNUAL PUBLICATION SO WE COULD REPORT WHAT TUCSON’S COMMUNITY HOSPITAL WAS DOING TO BENEFIT THE COMMUNITY. AS CHAIR OF THE TMC BOARD OF TRUSTEES, I AM PLEASED TO REPORT TO YOU THE THE HEALTH OF YOUR HOSPITAL IS STRONG, RETURNING A POSITIVE OPERATING MARGIN OF $10.7 MILLION OR 2.6% IN 2011.

+$10.7million, or 2.6% TMC wrote off $28.6 million in charity care and bad debt charges in 2010. With unprecedented cuts to AHCCCS (Arizona’s Medicaid program), that number climbed to $40 million in 2011, with estimates indicating that number is expected to be close to $60 million in 2012. While these numbers certainly challenge us, we understand and celebrate our role as a nonprofit community hospital to care for the most vulnerable in our community. As a nonprofit hospital, it is our mission to care for those regardless of their ability to pay and so we continue to focus on improving quality, expanding services while reducing costs. The pages of this report are filled with stories of how the staff, physicians and volunteers of TMC benefited the community in 2011, from helping us move beyond the tragedy of Jan. 8, to providing care and thanks to our veterans facing the end of life, to helping our families and patients navigate the hospital. But, one project that gained momentum in 2011 doesn’t need to be told on the pages of a report. It’s clearly evident when you drive down Grant Road near Craycroft. In fact, it’s impossible to miss the four-story structure rising from the ground on TMC’s west campus.

Throughout TMC’s history, plans have been put forward to build “up” only to step back for one reason or another. In 2011, despite unprecedented challenges from State of Arizona budget reductions, we collectively agreed to continue moving on a redevelopment plan that we broke ground on in late 2009, building for the future, investing in Southern Arizona. Through this $110 million project, we are investing in Tucson by creating jobs, engaging with local subcontractors, and creating a world-class orthopaedic and surgical center for the people of Southern Arizona. Even with all the challenges facing hospitals in this economic environment, Tucson Medical Center continues investing to create the highest quality facilities and services for our community.

Helping our community heal and moving Beyond Counseling, running shoes and drums helped the community take steps toward healing following the January 8 shooting in northwest Tucson that killed six and wounded 13, including U.S. Representitive Gabrielle Giffords. In the immediate aftermath of the 2011 weekend rampage, Tucson Medical Center teamed up with the YWCA to offer community stress debriefings. TMC’s partners, United Healthcare and OptumHealth, also assisted in helping the community recover not only from the initial shock, but from other feelings of loss that were triggered by the trauma. Julia Strange, TMC’s vice president of community benefit, said the hospital and its partners wanted to do what they could to help. “January 8 was a full community event in so many ways,” she said. “It affected us all, as Tucsonans and as a family, and for TMC there was a real sense that we needed do something to help, especially as a community hospital.”

Triple Crown Series

600 Participants

Proceeds benefitting Child & Family Resources

6000

$

Raised

After the initial response, the hospital wanted to remain engaged, Strange said. Over the summer and fall, TMC helped organize the Gabe Zimmerman Triple Crown – a trio of runs and walks that commemorated Giffords’ 30-year-old outreach director, who was killed in the shooting. Zimmerman, who enjoyed being active and outdoors, was born at TMC but also had close ties to the hospital through his family. His father, Ross, worked at TMC as a network expert for six years until 2000. Gabe’s stepmother, Pam Golden, delivered many babies here. His fiancée, Kelly O’Brien, a nurse, cares for TMC’s patients. Gabe himself toured TMC to learn about its transition to electronic medical records, given the health care reform debates raging at the federal level.

The Triple Crown series drew roughly 600 participants and raised $6,000 for its designated charity, Child & Family Resources. “Tucson had been in a deep, citywide mourning. In some ways, we’ll always be in mourning, but the wonderful thing about running and walking is it literally moves us forward and gets our hearts pumping and celebrates being alive and looking forward,” said Randy Accetta, the race organizer and a member of the Southern Arizona Roadrunners. “I think the city needed that.” As the first anniversary of the shooting neared, TMC hosted the opening ceremony for January’s Beyond events, designed to help the community move beyond grief and embrace positive choices. Drummers and dancers welcomed the first rays of sunlight at dawn, rejoicing in movement and kinship and closing with a procession that led participants to a health and wellness fair. Visitors tapped into services such as diabetes screening, expressive art projects, blood pressure checks and even Zumba and Jazzercise classes. Ross Zimmerman said his son, as a social worker, would have enthusiastically approved. ZIMMERMAN SAID HE WAS GRATEFUL FOR THE COMMUNITY RESPONSE, AND SAID THE TRIPLE CROWN EVENTS WERE A COMFORT, AS HE RAN PAST PARTS OF THE COURSES THAT HELD MEMORIES OF GABE – WHO TWICE RAN THE GRAND CANYON RIM-TO-RIM AND COMPLETED HIS FIRST MARATHON IN 2010. “I GOT A BIG KICK OUT OF IT,” SAID ZIMMERMAN, AN EXPERIENCED TRAIL RUNNER SINCE BEFORE GABE’S BIRTH.

Strange said both the Triple Crown and Beyond events not only meshed with the hospital’s overall mission, but dovetailed with the launch of its accountable care organization, designed to better manage health care costs by helping patients stay healthier longer and avoid acute care episodes. “As a community hospital with a focus on wellness, it just made sense for us to be involved,” Strange said, adding the hospital remains committed to continuing that work.

Never too late to say thank you to our veterans

Chuck Amedia recalls a recent visit to a TMC Hospice patient in Oro Valley. Amedia, an Air Force retiree and TMC Hospice veteran volunteer, met with the family of a former Marine, who had served during the Korean War. The man was unresponsive and his death was imminent. After visiting with the man’s wife, Amedia leaned down to speak to the veteran. He asked him if by chance, he had served under the then-Col. Lewis Burwell “Chesty” Puller. Puller, a Marine’s Marine, had commanded the 1st Marine Division. “HERE IS THIS MAN, HE’S DYING, HE’S UNCONSCIOUS, BUT WHEN I ASKED HIM IF HE SERVED UNDER COL. CHESTY PULLER, HE OPENED HIS EYES, RAISED UP, SMILED AND SAID, ‘YOU BET!’”

Each veteran is also presented with a flag, pin and plaque to recognize and honor their military service. In addition, if the veteran is able, Amedia will complete a biography as part of the Veterans History Project and send the information to the Library of Congress so that future generations will be able to go back and read first-hand accounts from those who served. “It’s overwhelming, sometimes, the appreciation from the veterans we reach out to,” said Lewis Jones, who served in the Army during the Vietnam War and is the other veteran volunteer at Hospice. Veterans will willingly swap stories with other veterans, but maybe not so much with civilians, including spouses and children.

The man went back down on the bed, never opened his eyes again and died the next day.

“It helps connecting with family, too, especially spouses,” said Jones, explaining that oftentimes family members have never heard about their loved one’s time in the service.

Each month between 25 and 30 veterans enter TMC Hospice. With the number only expected to grow, TMC Hospice joined with national partners We Honor Veterans and the Hospice Veterans Partnership to better reach out to, care for, and honor veterans needing end-of-life care.

Amedia is surprised sometimes with the reception he receives. “When we walk into their rooms, they just light up,” he said. “They have very little time left, yet they want me to sit down and compare notes ... what did you fly, where were you ... It’s just such an honor.”

The TMC Hospice Veteran’s Program offers a veteran-toveteran volunteer program, veteran-specific community outreach, staff and volunteer training, regular reviews of veteran-specific best practices for hospices, and various collaborations with area nonprofits and agencies for the benefit of veterans at the end of life.

Most of our veterans were young adults when they were in the military and their experiences become a defining point in their lives. At the end of their lives, sometimes issues they faced during their service “come home to roost,” said Amedia, whose background includes a master’s degree in counseling, specializing in bereavement. “They are asking themselves if they had value and worth in their lives. And our goal is to comfort them and let them know they are valued.”

When patients are identified as veterans, TMC Hospice wants to be sure they know the services available to them, including the non-medical ones. That’s where Chuck Amedia comes in. For those patients who allow it (most do), Amedia will discuss available options such as burial and death benefits, help arrange an honor guard for a funeral, and help with other non-medical, palliative needs.

“WE PAY SPECIAL TRIBUTE TO YOU FOR YOUR MILITARY SERVICE TO AMERICA AND FOR ADVANCING THE UNIVERSAL HOPE OF FREEDOM AND LIBERTY FOR ALL.”

James Wilson Dec. 7, 2011 marked the 70th anniversary of the bombing of Pearl Harbor, propelling the United States to enter World War II. On this auspicious anniversary, a number of airmen from Davis-Monthan Air Force Base joined with Chuck Amedia, a veteran volunteer, at TMC Hospice to honor the service of James R. Wilson, who served in the U.S. Navy from 1940-46 as a pharmacist’s mate on the battleship U.S.S. Tennessee. Wilson delighted the members of the 355th Fighter Wing, explaining how battleships were named after states, cruisers after cities and aircraft carriers after people. In appreciation of his service, the airmen presented Wilson with a flag and a plaque that read: “We pay special tribute to you for your military service to America and for advancing the universal hope of freedom and liberty for all.”

Mary Anne Burr Mary Anne Burr was proud of her service as a flight nurse during World War II. Burr, a patient at Peppi’s House in May, cared for many wounded servicemen and cradled more than one in their final moments. In this photo, TMC Hospice staff gratefully acknowledges Mary Anne’s service.

100 MILLION DOLLARS

INVESTED INTO

OUR FUTURE

93

%

STAYED IN OUR LOCAL ECONOMY

RICHARD PREVALLET, TMC VICE PRESIDENT OF FACILITIES; LINDA WOJTOWICZ, TMC SENIOR VICE PRESIDENT AND CHIEF OPERATIONS OFFICER; AND SCOTT SLAGIS, M.D., MEDICAL DIRECTOR OF THE TMC ORTHOPAEDIC CENTER AND A PHYSICIAN WITH TUCSON ORTHOPAEDIC INSTITUTE, REVIEW PLANS FOR THE NEW ORTHOPAEDIC AND SURGICAL TOWER.

Building for the future: Orthopaedic and Surgical Tower The skeletal frame of a new world-class orthopaedic specialty center has risen on the west side of the TMC campus as part of a $100 million investment in the future. Two floors in the new wing will be dedicated to surgery, with one floor devoted to orthopaedics and another floor for other procedures, including cardiothoracic, vascular, urologic, pediatric, neurological, general and ambulatory surgeries. The building will house 24 operating rooms, plus an option for two more rooms to be completed later. Tucson Orthopaedic Institute will relocate into the four-story pavilion, which is set to open by mid-2013. TOI will lease the first floor to serve its patients with outpatient clinics and office space. The proximity and alignment of the Tucson Orthopaedic Institute with the inpatient and orthopaedic surgical unit will create the TMC Orthopaedic Center, bringing together state-of-the-art technology, nationally recognized physician specialists and expert nursing, physical therapy and other clinical staff. The operating rooms will have state-of-the-art video technology and innovative video imaging systems, with links to hospital information networks. The virtual communication system will have customizable displays and monitoring, with wide-screen high-definition technology to gain the best resolution, clarity and color. The video system’s capabilities will allow surgeons to access live and stored files via their laptops, smartphones, iPads and hospital computers, and will facilitate teleconferencing and education opportunities. In addition, a 600-space parking deck to support the new wing and other clinical services opened in April 2012.

Surviving sexual assault

TMC TEAMS UP WITH SOUTHERN ARIZONA CENTER AGAINST SEXUAL ASSAULT TO CREATE A BETTER RESOURCE AND SUPPORT CENTER FOR RECENT SURVIVORS OF SEXUAL ASSAULT. In September, TMC and Southern Arizona Against Sexual Assault launched a support facility in the TMC Emergency Department that includes a dedicated medical forensic examination room, a quiet space for family and friends, and a separate entrance for additional privacy. TMC donated the facility, which is the first step of medical support for recent survivors, and SACASA staff provides emotional support services and conducts medical forensic exams. Both agencies understand how important it is to respond immediately and professionally to the needs of a survivor of sexual assault, while also providing as much comfort as possible in such situations. “This center is a huge step forward in our community’s ability to provide the full spectrum of care that is so urgently needed in a crisis situation following an assault,” said Montserrat Caballero, program director of SACASA. “Sexual assault is a reality in Southern Arizona and it is our responsibility as a community to provide support. This facility helps meet the needs of survivors. This partnership is incredibly unique and highlights the level of compassion and care that Tucson Medical Center has for all survivors.” The mission of SACASA, a member of Arizona’s Children Association family of agencies, is to reduce the trauma and incidence of sexual assault by providing treatment and promoting prevention of sexual abuse, incest, molestation and rape.

Joining forces with the ‘Y’ so workers can get the skinny on their health In the interest of promoting workplace wellness, Tucson Medical Center joined forces with the YMCA to give more than 500 local workers the skinny about their health. The partnership started as a result of the Communities Putting Prevention to Work grant, funded by the Centers for Disease Control. The YMCA’s Worksite Wellness program assisted businesses with creating or enhancing worksite wellness through programs that supported increased awareness of good nutrition and encouragement to increase physical activity throughout the work day. Mary Atkinson, TMC’s director of Food & Nutrition Services, said the TMC/YMCA partnership got its start at a community wellness meeting funded by the Prevention to Work grant, when some small business owners indicated they’d like to offer health screenings to employees. Some didn’t have health insurance plans that allowed it, she recalled, or had high health care premiums or were so small they didn’t offer health plans at all. “We thought it only made sense, as a community hospital, to try to help, since we have the resources here,” she said. VOLUNTEERS, INCLUDING TMC CLINICAL STAFF AND HEALTH EDUCATORS, PROVIDED FREE HEALTH SCREENINGS TO NEARLY A DOZEN SMALL BUSINESSES INVOLVED IN THE WORKSITE WELLNESS PROGRAM. SINCE THE INCEPTION OF THE PARTNERSHIP, TMC STAFF HAS PROVIDED EMPLOYEES WITH THEIR BLOOD SUGAR AND CHOLESTEROL LEVELS, BLOOD PRESSURE READINGS AND WEIGHT-TO-HEIGHT RATIOS.

Laura Rosebaugh, a human resources generalist with the Providence Service Corp., said she was pondering how to respond to results from a recent employee survey, in which workers expressed interest in free or reduced-cost health screenings. She reached out to the YMCA when she heard about the program, noting it also meshed with her company’s goals of raising awareness of health and safety among its roughly 200 employees.

“The employees who had [participated] commented on how helpful it was,” Rosebaugh said, noting that some workers were told to get in to see their doctors based on risk findings, such as high blood sugar or high blood pressure readings. Vivian Cullen, the Community Outreach Director for the YMCA, said the program is the result of an effective partnership. “The statistics around the country show if both employees and management understand the importance of better nutrition and increased activity during the workday, it results in a real win-win. Employees win through improved personal health,” she said, “and employers win by having healthier employees whose insurance claims often are lower, sick days are fewer, and productivity is increased.”

A

Adult supervision

B

Barriers around water

C

CPR & swim classes

Water safety classes save lives With the help of Stewie the duck, nearly 700 first-graders in eight area schools learned the ABC’s of water safety: Adult supervision, Barriers between children and water, and Classes - CPR for adults, swimming for children. Safe Kids Tucson, with Tucson Medical Center as its proud lead agency, distributed curriculum materials to elementary school teachers in Tucson Unified and Sunnyside school districts. The series, which meets state standards, is designed to help youngsters master skills such as reading comprehension and writing, while reducing Arizona’s grim statistics on child drowning. Tucson has an average of five drowning and near-drowning cases a year. It can take just a matter of minutes. Risk is heightened when adults aren’t present, effective pool barriers aren’t installed, and children don’t know how to swim. IN THE FIVE YEARS OF THE PROGRAM’S OPERATION, THERE HASN’T BEEN A SINGLE WATER INCIDENT IN ANY OF THE FIRST-GRADE COHORTS THAT TOOK THE CLASSES, SAID HOPE THOMAS, DIRECTOR OF VOLUNTEER SERVICES & COMMUNITY PROGRAMS. ARIZONA RANKS SECOND IN THE NATION ON CHILD DROWNING – AND THAT’S NOT A RANKING TO BOAST ABOUT. “IT’S CRITICAL TO INTRODUCE THE CONCEPTS EARLY,” THOMAS SAID.

After learning about water safety, it was time for students to put their knowledge into practice. TMC and the YMCA partnered to offer “Second Grade Swim” to provide swimming lessons for more than 250 students over the summer. If only all homework assignments came with the potential for splashing.

Learn the ABC’s of water safety

700

First graders from eight schools “Second grade swim” swimming lessons

250

Students over the summer

Getting a head start on safety

On average in the state of Arizona, the equivalent of an entire kindergarten class dies every year because of improperly installed car seats. Under a grant through Safe Kids Worldwide, TMC trained Head Start teachers to provide training to parents about the proper use of car seats. THE TEACHERS FIRST WENT THROUGH A 90-MINUTE TRAINING SESSION WITH A CERTIFIED CAR SEAT INSTRUCTOR, BEFORE SHARING WHAT THEY LEARNED IN SUBSEQUENT MEETINGS WITH PARENTS WHOSE PRESCHOOLERS WERE PARTICIPATING IN THE PROGRAM. FOLLOWING THE CLASSROOM PORTION, 85 FAMILIES WERE OFFERED FREE CAR SEATS, WHICH WERE INSTALLED BY CERTIFIED TECHNICIANS.

Amanda Valenzuela, the center director for the Mission Manor Head Start program, said parents learned information that surprised them. Even though there is a presumption that kids only need child restraints until they’re 5 years old, children should be in booster seats until they are 4 feet 9 inches tall. “We have a number of high-needs families who really needed the seats, so we’re grateful that the program was able to help.”

Giving safety a boost Littles don’t fit well in grown-up seat belts. So while Arizona was among three states in 2011 that did not have a booster seat law, TMC for Children, the TMC Foundation and Kohl’s Cares for Kids teamed up to provide 3,460 booster seats to Southern Arizona families. State law in 2012 was changed to require a booster seat for children ages 5-8, while children younger than that must be in a car seat. There are good reasons to boost little booties. Since cars are designed for adults, seat belts typically won’t rest on children at the hard contact points along the hip bones and shoulders, explained community outreach specialist Yomaira Diaz, who is an instructor level child passenger safety seat technician. To make the seat belts more comfortable, kids might slouch down into the seat, or they might put the seat belt under their arm, instead of over the shoulder.“If they’re in an accident, they’ll fold over like a taco,” Diaz said, noting that can cause whiplash or internal injuries. While the visual might sound jarring, she wants the parents to have a picture that will prompt action. “FOR ME, IT’S ALL ABOUT KEEPING KIDS SAFE,” DIAZ SAID. “A LOT OF THESE INJURIES ARE PREVENTABLE. IN MANY CASES, WHEN YOU ARM FAMILIES WITH INFORMATION, YOU CAN SEE THE LIGHT BULB GO OFF. JUST THAT LITTLE BOOSTER, BELIEVE IT OR NOT, WILL SAVE LIVES.”

TMC first hospital in state to achieve Stage 7 EMR LAST JUNE, CHICAGO-BASED HIMSS ANALYTICS ANNOUNCED THAT TUCSON MEDICAL CENTER ACHIEVED STAGE 7 ON THE ELECTRONIC MEDICAL RECORD ADOPTION MODEL (EMRAM), ITS HIGHEST LEVEL TO DATE. THIS LEVEL IS THE “PINNACLE OF AN ENVIRONMENT WHERE PAPER CHARTS ARE NO LONGER USED TO DELIVER PATIENT CARE,” ACCORDING TO HIMSS. As of the end of 2011, TMC was one of just 66, or 1.2 percent, of the more than 5,000 U.S. hospitals tracked by HIMSS Analytics that had reached Stage 7. Tracking their progress in completing eight stages (0-7), hospitals can review the implementation and utilization of information technology applications with the intent of reaching Stage 7, which represents an advanced electronic patient record environment.

2011 Recognition ®

TMC’s Electronic Medical Record (EMR) system is one of the few to reach Stage 7 on the HIMSS Analytics Database, which tracks hospital EMRs from Stages 0-7 TMC earned designation as a Bariatric Surgery Center of Excellence by the American Society for Metabolic and Bariatric Surgery TMC was selected among the nation’s 50 Top CardioVascular Hospitals for 2011 by Thomson Reuters TMC earned the American Heart Association/ American Stroke Association’s Get With The Guidelines®-Stroke Gold Plus Quality Achievement Award for 2011

TMC is recognized as a top-ranked Community Value Provider, the only Tucson hospital among the Community Value 100 listed by Cleverley + Associates

TMC is a pilot hospital for the national Accountable Care Organization project run by Dartmouth University and the Brookings Institution

TMC earned an Ascent Healthy Hospital Award for reducing environmental impact through medical device remanufacturing and reprocessing

TMC is certified as a Primary Stroke Center by the Healthcare Facilities Accreditation Program (HFAP)

TMC was listed as one of the top-ranked hospitals in Tucson for 2011 by U.S. News & World Report in its Best Hospitals Metro Area Rankings TMC is recognized for its support of breastfeeding with the IBCLC Care Award from the International Lactation Consultant Association

TMC has been endorsed as an Accredited Chest Pain Center by the Society of Chest Pain Centers TMC for Children is an associate member of the National Association of Children’s Hospital and Related Institutions TMC Neurosciences holds designation by NeuStrategy as a Neuroscience Center of Excellence

Community Benefit for 2011

10%

Outreach & Education

$3,886,313

58%

32%

Unpaid Costs

Uncompensated Care (Charity Care & Bad Debt)

$22,101,622

$12,075,105

TOTAL OF $38,063,040 TMC WILL REPORT MORE THAN $38 MILLION IN COMMUNITY BENEFIT AND CHARITY CARE FOR 2011, OR ABOUT 9.7 PERCENT OF NET REVENUES. LAST YEAR, TMC REPORTED A COMMUNITY BENEFIT OF 7.2 PERCENT OF NET REVENUES. TMC CALCULATES COMMUNITY BENEFIT USING STANDARDS ENDORSED BY THE AMERICAN HOSPITAL ASSOCIATION.

WHAT MAKES UP THIS NUMBER?

DISCOUNTS FOR UNINSURED PATIENTS Self-pay patients who do not have health insurance are not in the same position as insurance companies to negotiate reduced rates. In an effort to address this disparity, TMC reduces a patient’s bill by half if the patient is without any insurance coverage. The Board of Trustees approved this uninsured-patient discount at the end of 2011. Depending on a patient’s income, other discounts may apply as part of the TMC Community Care program.

Unpaid costs of Medicare, ACCCHS and other public programs for low-income people: 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 and bad debt: Charity care is free or discounted health services provided to people who can demonstrate that they do not have the means to pay the full cost of care and who meet the organization’s financial-assistance policy criteria. Bad debt consists of services for which the hospital anticipated but did not receive payment. For purposes of community benefit reporting, charity care and bad debt are reported in terms of costs, not charges. For more information about TMC’s charity care policy, visit www.tmcaz.com. 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.

Tucson Medical Center at a glance Licensed Beds: 615

Including: Pediatric: 44 in TMC for Children PICU: 12 Inpatient Hospice (Peppi’s House): 16 ED beds (not included in above) Peds Emergency Department:15 Main Emergency Department: 60 2011 Emergency Department visits:

80,845 2011 Payroll

$168,470,000 2011 Full-Time-Equivalent Employees:

TMC Auxiliary 717 active volunteers contributed

80,595 hours, or 38.75 full-time employees Average number of volunteers working each day: 76

Total Contribution: $117,000 $50,000 TMC for Children pediatric construction project $30,000 Breast Screening patient scholarships $10,000 Hospice Family Fund $7,500

Happy heart pillows & busy bags

$5,000 Shropshire Endowment, supporting health care education

2,904 (as of Dec. 31)

$5,000

Child Life Family Fund

Registered nurses: more than 1,000 Physicians, nurse practitioners, residents and other TMC-credentialed health care providers: more than 1,400

$5,000

Cardiac Rehab Services scholarship funds

$4,500

Courtesy Car to move families and visitors throughout the hospital

2011 total admissions:

Healthy Living Connections

Inpatient surgeries: 10,181 Outpatient surgeries: 11,073 Total surgery cases: 21,254

75 volunteers,

Baby Deliveries:

Interventions:

32,303 adults, pediatrics and psychiatric

3,002 attendees in 2011 Classes/Events

6,397 volunteer hours

5,212

123

Medicare Counseling

1464

Alzheimer’s

Audit count of doors at TMC: 3,157 (not counting the new building)

284

Health Coach

New TMC Orthopaedic and Surgical Tower

166

Health Resource Center

709

Seniors Helping Seniors in-hospital contacts

• More than 600 spaces in new parking garage • Ground floor: lobby, clinic exam rooms, support services and physician offices • 24 operating rooms: 10 for orthopaedics on zthird floor, 14 for all others on second floor • 40 private patient rooms, designated for family-centered post-surgical care • Total size of building: more than 200,000 square feet

1,043 Seniors Helping Seniors community support (includes phone, in-person visits) Other notables: provided space to American Parkinson Disease Association and Eastside Congregate Meals Program

Tucson children make us smile! Hundreds of watts of smile power from Tucson kids lit up billboards around town last year. When TMC for Children issued a call for photos of the community’s smiling children, we had a tremendous response. We created two special collages in the shape of the TMC for Children logo. The collages went up in December on billboards around town to the delight of many.

ON CENTER

On Center

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From the vice president & chief development officer Michael J. Duran

At Tucson Medical Center, we are committed to providing extraordinary care to our patients and their families. Every day, we strive to make a difference in the lives of those entrusted in our care. Exemplifying the best of Tucson’s past, present and potential, Tucson Medical Center stands as a leader in what community health care can and should be. Today, TMC is Southern Arizona’s leading provider for emergency care and pediatric care with top-notch intensive care units for adults, children and newborns. Other specialty areas include women’s, maternity, cardiovascular, orthopaedic, neuroscience, hospice, imaging and senior services.

We extend heartfelt thanks to our physicians, nurses, care staff, volunteers and all members of the TMC family for their many contributions during this past year of growth and success. TMC is the community’s hospital, and our donors are its backbone. Supporters like you allow us to continue to be an asset for the community and a regional leader in health care. Generations of donors have helped to ensure the delivery of the highest quality care in Tucson and Southern Arizona.

The TMC Foundation has been proud to provide the financial resources needed to advance this care. These resources have enabled the hospital to build on its excellence year by year through improving the facilities, purchasing lifesaving equipment, expanding opportunities for training and education, and collaborating with other community partners to benefit patients and the broader community. This past year was no exception.

YOUR BELIEF IN OUR MISSION AND YOUR GENEROSITY LITERALLY SUSTAINS US, ESPECIALLY IN DIFFICULT ECONOMIC TIMES. PLEASE KNOW HOW MUCH YOUR SUPPORT MEANS TO US AND TO THE THOUSANDS OF PEOPLE WHOSE LIVES YOU HAVE HELPED TO IMPROVE. THANK YOU!

Our pediatric expansion campaign is closer to the goal line thanks to our donors; we supported the Hospital to Home program to ensure continuity of care for patients with chronic conditions; and our local Children’s Miracle Network sponsors have raised more funds for TMC for Children than ever before. Whether people give their time, money or expertise, the support for the TMC Foundation has been nothing short of inspirational. We would be remiss if we did not mention the incredible efforts and resources put forth by our donors, board members and volunteers.

Giving back: grateful for a ‘community in our community’ From the chairwoman Anne Fulton-Cavett

My mom started medical school when I was 5 years old. I quietly read at her side; she studied her medical texts. In the late 1970’s and early 1980’s, she completed her internship and residency at TMC. I am sure she was learning a lot about how to be a doctor, but I was focused on the new frozen yogurt machine in the Cafeteria and being able to sleep in the doctor’s on-call room. She developed in her profession as I developed as a person and, later, as a professional. In her early years of practice and hospital work, I, as a teenager, carefully watched my mom and her colleagues practice the art of healing in medicine and nursing. Their dedication and compassion shaped the person I am today in ways I cannot fully articulate. Virtually growing up in a hospital, watching my mother in her white coat gently caring for patients and their families inspired my passion for supporting such extraordinary work. Tucson Medical Center was the community of my childhood and is a place of sweet memories for me. As an adult, the nurses, midwives and neonatologists were my community when I delivered my babies at TMC. Throughout my father’s fight with cancer, the nursing staff, oncologist, pulmonologists and surgeons were our supportive community. As a Tucsonan, I am proud of and grateful for this “community in our community.”

GRATITUDE CAN CREATE THE URGE TO GIVE BACK. I WANT TO GIVE BACK, AND, IN FACT, I AM PASSIONATE ABOUT IT. I HOPE YOU ARE TOO. THERE ARE SO MANY WAYS, BIG AND SMALL. GIVE OF YOUR TIME, GIVE OF YOUR TREASURE, GIVE OF YOUR HEART. IN THE END, WHAT MATTERS MORE THAN WHAT WE “DID” EVERY DAY THROUGHOUT OUR LIFE, IS WHAT WE WERE ABLE TO GIVE BACK.

Pediatric expansion humming along; push on to raise final funds

TMC for Children, fully operational since last June, is like a brand-new car in your garage. It’s sleek, clean and jammed with advanced technology and life-saving features. But it’s not really yours until you make the last payment. The colorful pediatric unit is humming along nicely, tending to the needs of infants, toddlers, teens and their families. But Tucson Medical Center won’t have a clear title until it raises another million dollars. THE CAPITAL CAMPAIGN, WHICH KICKED OFF TWO AND A HALF YEARS AGO WITH A $12.5 MILLION GOAL, HAS ALREADY RAISED MORE THAN $11.7 MILLION.

The remaining balance will be somewhat easier to raise than the first million, said Kim Bourn, who chairs the pediatric campaign, dubbed Block by Block, Miracles Happen! “Now that people can actually see and touch what we’ve established for the community, I think it’s a little more tangible,” she said. “They get it. It’s like when you take out a bank loan. The foundation has to pay that money back.” It’s been an intense, all-consuming effort, said Michael J. Duran, chief development officer for the TMC Foundation.“Raising money for this pediatric expansion has been a singular focus of the foundation since 2010,” said Duran. “We started with new construction — about 16,000 square feet — and then we went back and renovated the existing unit.” The result is a cheerful, welcoming place, he said. And TMC for Children is not just for children, of course. Great attention has been paid to the needs of parents and siblings of the young patients, not to mention the needs of all those adults who work in pediatric care.

Although some of us see children as short, adorable versions of adults, pediatric medical care is not akin to grown-up care downsized. Are the needs of a 60-pound child really that much different than a 120-pound adult? Cut the medical recipe in half and you’re good to go, right? Dr. Moira Richards, TMC’s medical director for children’s services, is too polite to laugh at such nonsense. Instead, she takes her time explaining just how specialized the practice of pediatric medicine has become, and why pediatrics “frankly deserves its own unit.” Medically speaking, a child is not just a small adult and treatment options can be entirely different for kids than adults, she said. “Children, for example, respond differently to chemotherapy. The way the liver reacts to medication is different. And there’s the fact that the patient is a changing person. What are we going to do that might change the growth and development of an infant or child?” THE PEDIATRIC TEAM MEMBERS ARE ALWAYS MINDFUL THAT THEY ARE TREATING A FUTURE ADULT, SAID RICHARDS, WHO SPECIALIZES IN PREMATURE AND SICK NEWBORNS. THE NEW FACILITIES ALLOW TMC STAFF TO ADDRESS WHAT RICHARDS CALLS “THE PSYCHOSOCIAL NEEDS OF GROWING BEINGS.”

“In young children, play is so important,” she said, “so our specialists work with medical play, which helps explain

In the words of our lead donors OUR FAMILY HAS ALWAYS APPRECIATED THE NATURE OF OUR SONORA DESERT. WHEN MY HUSBAND, BILL, WAS ILL, HE PARTICULARLY FOUND IT PLEASING TO BE OUTSIDE AROUND NATURE. WE SAW HOW IMPORTANT THE GARDENS AND PATIOS WERE IN THE HEALING PROCESS, AND THAT MADE US HAPPY TO SUPPORT A PATIO FOR FAMILIES AT TMC.

– SHIRLEY ESTES

WE’VE HAD AN ONGOING CONNECTION TO TUCSON MEDICAL CENTER SINCE OUR DAUGHTER WAS BORN THERE 53 YEARS AGO, A CONNECTION THAT’S INCLUDED SEVERAL INSTANCES OF LIFE-SAVING HEALTH CARE PROVIDED TO FAMILY MEMBERS. SO IT SEEMED TO BE A NATURAL PROGRESSION OF OUR PHILANTHROPY, AS OUR OWN FAMILY GENERATIONS EXPAND, TO FULLY SUPPORT TMC’S ADDITION OF A PEDIATRIC CENTER. WE ARE PLEASED TO MAKE TMC A BENEFICIARY OF THE ZUCKERMAN FAMILY FOUNDATION FOR THIS PURPOSE.

– ENID & MEL ZUCKERMAN, FOUNDERS OF CANYON RANCH

OUR CHILDREN ARE THE FUTURE OF OUR GREAT COUNTRY AND AS PARENTS AND GRANDPARENTS WE MUST DO EVERYTHING IN OUR POWER TO SEE THAT THEY ARE WELL CARED FOR AS CHILDREN SO THAT THEY MAY GROW UP TO BE PRODUCTIVE ADULTS.

– HOWARD & MARLIES TERPNING

IN THEIR WILLS, TWO OF OUR DONORS, THE ABSOLONS AND THE GREENS, MENTIONED THE DESIRE TO SUPPORT BOTH HOSPITALS AND CHILDREN. TMC FOR CHILDREN WAS A PERFECT FIT FOR FUNDS FROM BOTH OF THESE FOUNDATIONS. WE WERE THRILLED THAT WE NOT ONLY HAD AN OPPORTUNITY TO HONOR OUR DONORS, BUT TO HELP PROVIDE AN EXCELLENT FACILITY FOR THE CHILDREN OF SOUTHERN ARIZONA.

-- LINDA LOHSE, TUCSON FOUNDATIONS

what it means to have a tube in your stomach. The new facilities give us more room for this sort of thing.” Because siblings face their own kind of stress, including fears that they might get really sick, too, TMC for Children makes sure that there are games to play, movies to watch and books to read. The playground, naturally, is state of the art. “There’s a library with a big reading tree, and the tree is a big hit,” said Bourn. “TMC for Children is a happy place for the families. It’s clean, it’s fun.” All of the 44 patient rooms are private, and that’s no small thing. “Health care is a very personal matter,” Bourn said, “and you don’t want people to hear all about your diagnoses and treatments through a curtain and then know that they can tell whoever they want.” Bourn said she got involved in TMC’s fundraising because her family is passionate about community health care. “It was a no-brainer.” “Michael Duran recruited me to help lead this effort specifically because all three of our children were born at TMC. Our first we had difficulty with because he was premature.” The successful campaign was a team effort from the outset, Bourn said. “Duran’s leadership and his team at the Foundation are just stellar, and we have our volunteer leadership committee as well. It’s not like there were just one or two people. It took a village.” And Southern Arizonans stepped up to the plate in a big way, said Duran. “We have been so impressed and humbled by the community’s response,” he said. “We received donations large and small from a really diverse cross-section of the community.” The TMC family came through, as well. “The commitment of the TMC staff was just phenomenal,” said Bourn. “You had nurses, anesthesiologists, doctors and other staff holding fundraisers of their own. It illustrates how much these folks who work with children wanted to have something new, that was state-of-the-art, that would serve not only the needs of families and children, but also the needs of the staff.” If you’d like to help put the last block in the Block by Block campaign, make a donation by calling us, (520) 324-5982 or going online to www.tmcfoundation.org.

Commitment to their community, re-rooting in Tucson DIANA AND BILL BERGEN MOVED TO TUCSON IN 2001 AFTER MANY YEARS VISITING FROM THEIR HOME IN MINNESOTA. DIANA, ORIGINALLY FROM TORONTO, HAS ASTHMA AND NEEDED A WARMER CLIMATE, AND THE COUPLE HAD SPENT TIME OUT HERE THROUGHOUT THE 1990s.

Picking up and moving away didn’t mean giving up roots, though. The couple has fostered new community here, contributing of their time and treasure to give back and grow new roots. Diana recalled going for a test at the hospital, and the gratitude she felt after getting the good news of a negative diagnosis. “I was so thrilled that I was OK and appreciative of the way I was treated, I really wanted to do something in return, to give back,” she said, and soon became a member of the TMC Auxiliary, serving as president in 2005. Last summer, she was tapped by then director of TMC Volunteer Services Marian Rogerson to finish out the term of the prior president, who had recently resigned after getting married and moving out of town. Then Diana agreed to stay on for a full term, to serve in 2012, much to the delight of Hope Thomas, current Volunteer Services director. “She has incredible leadership skills, and she can work with everyone in the organization,” said Thomas, who assumed her role in July. The role for the Auxiliary is more important than ever, Thomas noted. “The Auxilians are integral to the patient experience. Part of my goal is to more fully integrate a customer-service focus throughout the hospital.” Many people’s first encounter with the hospital is with a volunteer, Thomas said. “The goal is to partner together between staff and volunteers to bring that positive experience to our patients and families.” Financially, the Auxiliary has been the hospital’s biggest philanthropic supporter over the years. In 2011, the volunteer-driven organization donated $150,000 to the hospital and TMC Foundation from money raised in the Gift Shop, various jewelry and clothing sales, and other fund-raising efforts. But Bergen is not about to take full credit. While the president may run the ship, she can’t do it alone. “The Auxiliary board is well thought out, with expertise where we need it,” she said. “I’m very pleased to be working with them; it’s a good group.”

IN ADDITION TO HER ROLE AT THE HELM OF THE AUXILIARY, SHE VOLUNTEERS 15-PLUS HOURS A WEEK, INCLUDING SHIFTS AT THE NORTHEAST DESK AND THE DESERT CRADLE BOUTIQUE. IT’S SURPRISING, SHE SAID, “YOU DON’T EXPECT TO GET SO INVOLVED ESPECIALLY SINCE YOU’RE RETIRED.” AS FOR WHAT DRIVES THE COUPLE’S COMMITMENT TO

Making a planned gift The life of Tucson Medical Center is connected to the community it serves. You can secure your family’s financial future and ensure the continuation of Tucson Medical Center’s work by making a planned gift with the Foundation. A planned gift is a simple and flexible way to combine charitable giving with sound financial planning. A charitable gift annuity with the Tucson Medical Center Foundation is one of our most popular planned gifts. It is easy to establish and can provide you, another beneficiary or both with fixed, dependable payments for life. You will receive a tax deduction the year you make the gift and a portion of your payments are tax-free. TO FIND OUT MORE REGARDING MAKING A PLANNED GIFT, PLEASE CONTACT MICHAEL DURAN Vice President & Chief Development Officer (520) 324-2501 or michael.duran@tmcaz.com

TMC, PART OF IT IS ABOUT ROOTS: “IT MAKES US FEEL PART OF THE COMMUNITY,” BILL SAID. “I FIND AS I NURTURE A COMMUNITY, I GET VALUE OUT OF NURTURING, VALUE OUT OF THOSE FRIENDS I MAKE. IT’S NOT FOR THEM I DO IT, IT’S FOR ME.”

Diana and her husband are also financial supporters of the hospital. As part of their estate planning, the couple created a charitable trust to provide them income while they’re alive, but to benefit the TMC Foundation after their death. Bill, too, speaks of his gratitude from his experience of three surgeries at TMC. “My treatment couldn’t have been better,” he said of his three surgeries, noting that he had “nothing but positive experiences.” And he knows a good investment when he sees one. “I like the community involvement, the hospital being nonprofit,” he said. He also appreciates the breadth of the services, “TMC takes care of elder as well as infant. That kind of focus is very important to me and those around me, especially at this stage in my life.”

A partnership of caring In November, Tucson Medical Center joined with Handmaker Jewish Services for the Aging to accept a $3 million challenge grant to launch a much-needed facility for dementia care. The Paul and Lydia Kalmanovitz Foundation of San Francisco awarded the $3 million challenge grant to add a two-story, 40-bed health-care facility on the Handmaker Campus, 2221 N. Rosemont Blvd. Handmaker is spearheading the effort to raise $1.5 million to match the grant, and TMC Foundation is managing the funds. TMC will manage a 20-bed unit dedicated to shortterm geriatric psychiatric care for people experiencing severe breaks in behavior or other psychiatric symptoms. This unit better serves a patient’s psychiatric needs than can be achieved in a traditional hospital setting. Handmaker will manage the other 20 beds, providing skilled nursing care for Alzheimer’s and dementia patients. These new beds add to Handmaker’s current long-term memory care program.

The Paul and Lydia Kalmanovitz Foundation of San Francisco awarded a:

The entire project fills a significant gap in adult care services presently unavailable in Southern Arizona. “This facility will help fill a hole in the continuum of care and give hope to not only patients but their families and caregivers, too,” said Art Martin, Handmaker chief executive officer.

Handmaker will add:

AS MANY AS 16 MILLION OLDER ADULTS WILL SUFFER FROM DEMENTIA BY THE YEAR 2050, COSTING THE HEALTH CARE SYSTEM MORE THAN $172 BILLION ANNUALLY IN MEDICAL AND NURSING-HOME BILLS.

“This is clearly an issue that needs to be addressed,” said Judy Rich, TMC president and CEO, “It’s a critical community need that cannot be met by one organization. Instead, it takes a community of professionals, volunteers, and donors to create a truly unique and compassionate approach to caring for those suffering from dementia.”

$3million challenge grant

2-story /40-bed health care facility

Handmaker is spearheading the effort to raise:

$1.5million to match the grant

Navigating past barriers, fast-food joints to make it safely from hospital to home

One patient was so exhausted after being discharged for heart failure that she only had the energy to hit the fast food drive-through for her hunger, or to stop by the drug store to get her prescriptions filled. Taco Bell won out, but she was back in the hospital the next day.

HOSPITAL TO HOME SERVES AS A BRIDGE WITH CARE TO OTHER MEDICAL PROVIDERS, SUCH AS PRIMARY CARE PHYSICIANS AND SPECIALISTS. IT ALSO LINKS PATIENTS TO RESOURCES THAT CAN ADDRESS OTHER HEALTH CONCERNS, SUCH AS SMOKING CESSATION, WEIGHT

Having a chronic condition can leave a person tired, short of breath, in pain and just not feeling well. This, in turn, makes it difficult to navigate a multitude of decisions needed to maintain health and quality of life, as well as stay out of the hospital. Brenda Carle, RN, BSN, PCCN, is ready to make a difference in patients’ lives. As chronic-disease coordinator for Tucson Medical Center, she helps ensure that patients are able to safely transition from hospital to home. “Imagine the struggle of being chronically sick,” she said. “People want to do the right thing, but might not understand fully how their actions impact their well being. We want to help empower and motivate them to achieve their goals.” TMC started Hospital to Home in 2010 to help patients with chronic, incurable conditions make healthy lifestyle choices in order to maximize their overall joy and wellbeing. The program is part of a national initiative led by the American College of Cardiology and the Institute for Healthcare Improvement. Carle, along with her chronic-disease managers Louisa Liguori, RN, MBA, and Sherrie Sheets, RN, MSN, have worked with more than 1,000 patients and their caregivers to assess a patient’s medical and health status, quality-oflife issues and individual goals, and then help to develop a course of action. The efforts are paying off. TMC is seeing a reduction in 30-day readmission rates for heart failure, heart attacks and pneumonia, where rates are well below national benchmarks.

MANAGEMENT AND PALLIATIVE CARE. CARLE AND HER TEAM HELP COORDINATE CARE WITH MULTIPLE TMC RESOURCES, INCLUDING DIETARY, PHARMACY, CASE MANAGEMENT, THERAPIES AND CARDIAC REHAB.

“We’re bridging a lot of gaps,” Carle said, including the knowledge gap, which is where a TMC Foundation grant last year has really helped. Carle was able to purchase scales, educational DVDs, self-care notebooks and logs to help empower patients with the resources and skills to better manage their health. Since the hospital environment is not the most conducive to learning, Carle and her team members call patients within 24-72 hours from discharge to make sure they haven’t run into any roadblocks with medications, follow-up appointments, or other medical or health needs. Patients especially benefit from having someone with the knowledge, skill and compassion helping them navigate their incurable conditions. “It’s not that you can never have fast food again,” Carle said. “But it helps to fully understand the ramifications, so you can make a more informed decision and achieve your own goals.”

It all started at TMC… Being on the leading-edge of technology is certainly not new for TMC, especially in the area of oncology. In the early 1990’s, Tucson became the epicenter for laparoscopic cancer surgery. Led by Dr. Joel M. Childers, M.D., the predominant driving force behind the technology’s use in gynecological cancer, over 50 percent of practicing gynecological oncologists came to TMC to learn about the advances between 1993 and 1995. After Dr. Childers’ untimely death in 2002, his colleagues committed themselves to continuing his advancements in women’s gynecological health by establishing a lecture series that occurs every spring. TMC just marked its 10th conference with robotics as a strong emphasis in the series.

Technology, training keep TMC at leading edge AS WITH SO MUCH OF WHAT TMC HAS BEEN DOING OVER THE LAST SEVERAL YEARS, THE DA VINCI ROBOTICS PROGRAM WAS INTRODUCED WITH AN EYE TOWARD THE FUTURE. ADVANCED ROBOTIC SURGERY IS A NATURAL CHOICE FOR A HOSPITAL STRIVING TO PROVIDE THE SURROUNDING COMMUNITY WITH THE MOST ADVANCED CARE AND BEST PATIENT EXPERIENCE POSSIBLE.

TMC purchased its first da Vinci robot last July, building an exceptional robotics program that emphasizes physician collaboration, cross-specialty training and a rigorous training program that ensures highly skilled doctors and successful outcomes.

“TMC HAS THE HISTORY OF BEING A LEADER IN WORLDCLASS LAPAROSCOPIC SURGERY,” SAID DR. HANK HALLUM, WHO PRACTICED WITH DR. CHILDERS AT TMC DURING THE PEAK OF CHILDERS’ CAREER. “I REALLY WAS INTERESTED IN PROMOTING TMC AS INVESTING IN THEIR REPUTATION AS A CENTER PURSUING EXCELLENCE. NOW THAT WE HAVE A DA VINCI PROGRAM, WE CAN REALLY BRING THIS BACK TO THE KIND OF INNOVATION THAT I WAS A PART OF BACK THEN. THAT WAS ONE OF THE REASONS WHY I WAS SUCH A BIG PROPONENT. I WANTED TO BRING THE HISTORY OF TMC BACK.”

With the help of Dr. Michael Probstfeld, as well as participating physicians such as Dr. Manuel Arreguin, Dr. Hank Hallum and others, TMC developed a teaching program that set specific, rigorous guidelines and paid for the proctorship of participating physicians. Inherent in this process was that once a physician became a qualified da Vinci surgeon, that doctor, in turn, became an experienced proctor for other doctors. Early in the program, TMC began by enlisting physicians who were already experienced in laparoscopic surgery. “We wanted to take experienced laparoscopic surgeons and give them the latest technology, believing that it would be learned more quickly, with fewer complications,” explained Dr. Arreguin.

Collaboration helps detect, treat breast cancers of unisured Quilting for women’s lives Members of Quilt for a Cause Inc. are busy at work to benefit women’s health. Quilt for a Cause auctions and sells handmade quilts to support breast and gynecological cancer research. The organization auctioned off more than 1,000 quilts in 2003, 2006 and 2009, and donated part of the proceeds to benefit a number of TMC programs related to women’s health: SCREEN UNINSURED WOMEN FOR BREAST CANCER BREAST RECONSTRUCTION FOR WOMEN UNDER 40 WHO HAVE HAD A MASTECTOMY DIGITAL SPECIMEN RADIOGRAPHY SYSTEM PHYSICIAN TRAINING AT THE ANNUAL JOEL M. CHILDERS, M.D., LECTURE SERIES

Quilt for a Cause is preparing for 2013, already collecting quilts for the February hanging in the halls of Tucson Medical Center. The auction is March 2. For more information, go online to www.quiltforacause.org.

A large collaboration among providers and local and national foundations supports a program at TMC that has for more than a decade provided services for uninsured women needing breast cancer screening. Started in 1998 by TMC with support from the TMC Foundation, the Avon Foundation Breast Care Fund and the Susan G. Komen Breast Cancer Foundation of Southern Arizona, this program has drawn support from within TMC and from outside agencies. Since its inception, more than 5,500 mammograms have been performed at TMC and read by Radiology Ltd. Both TMC and Radiology Ltd. provide these services at reduced rates. Funding from Avon supports outreach and education and administrative time. The Komen Foundation funds screening, diagnostics and some of the treatment costs. In addition, Quilt for a Cause donated $10,000 for three years from proceeds of its last auction in 2009. To date, 27 cancers have been detected and treated. Five women have died from the disease, but the other 22 are doing well, according to Karen Narum, NP. Follow-up work based on results from the screening mammograms has included 652 additional mammographic views, 563 ultrasounds, seven MRIs and 183 biopsies. TMC is collaborating with the Komen Foundation, the Arizona Department of Health Services, St. Elizabeth’s Health Center, Tucson Hospitals Medical Education Program’s surgical residency program and Pima County Well Woman Health Check to provide services for those who are diagnosed with breast cancer and have no resource for treatment. For patients who undergo surgery, TMC offers a program funded by the Komen Foundation that can help prevent or reduce the effects of lymphedema, which can cause swelling in the lymph system that is disfiguring and disabling. Women from throughout Southern Arizona utilize this service.

Donald G. and Mary Ruth Shropshire Endowment offers flexibility for the hospital while creating lasting legacy A 45-YEAR-AND-COUNTING HISTORY WITH TUCSON MEDICAL CENTER MADE THE DECISION EASY. MARY RUTH AND DONALD SHROPSHIRE WOULD ESTABLISH AN ENDOWMENT FOR THE HOSPITAL HE ONCE LED. THE DONALD G. AND MARY RUTH SHROPSHIRE ENDOWMENT FUND ENSURES THAT THE COUPLE WILL CONTINUE HELPING THE HOSPITAL LONG AFTER THEY BOTH ARE GONE.

“We must look beyond where we are today and plan for the future,” said Shropshire, who continues to serve as president emeritus.

Having a planned giving expert can help you evaluate how best to maximize assets and understand any shortand long-term tax impact.

The Shropshires wanted to provide a mechanism that offers the organization flexibility and found that through an endowment. “They’ll have the funds set aside for when the opportunity presents itself, what ever that may be,” he said, “so that the hospital can move on a dime.”

For the Shropshires, the endowment was seeded upon his retirement in 1993, and continues to grow through not only donations they add, but through gifts of others who wish to honor them, including the regular contributions of the TMC Auxiliary. And the couple has a portion of their estate earmarked for TMC Foundation.

Michael Duran, TMC Foundation vice president and chief development officer, said creating a planned gift can be a powerful way to help you accomplish your philanthropic and personal goals. “As a donor it’s important that you know what you want your gift to accomplish and how to empower your assets,” he said, adding that establishing a donation through real estate, a bequest, a lifeinsurance policy or an individual retirement account-beneficiary designation can work.

“OF ALL THE WAYS MARY RUTH AND I CAN CONTINUE TO DO GOOD WORK, WE SETTLED ON THIS ENDOWMENT,” HE SAID. “WE CAN’T LIVE OUR LIFE THINKING ONLY ABOUT TODAY. PART OF OUR PLANNING PROCESS IS TO CREATE A WAY TO MAKE THESE EFFORTS LAST BEYOND OUR LIFETIME TO HELP THE GENERATIONS AHEAD.”

TMC alumnus in action: Jerry Freund Forward-thinking but grounded in the past

Tucson Medical Center has greatly benefited from Jerry Freund’s passions for history and education. Originally from Dodge City, Kansas, Freund grew up around Western history and reveled in the stories of his grandfather, whose life spanned more than a century before his passing in 1978. Freund graduated from the University of Kansas and spent 18 months at the Sorbonne before joining the U.S. Air Force. “The military put me into missiles and sent me to Tucson,” he said, “where I just fell in love with the place.” After his discharge, he and his wife, Sally, decided to strike out in this new place he now calls home. His wife got wind of a new education department opening at Tucson Medical Center. Freund was one of two finalists for the job, but he lacked a degree in education. TMC saw his potential and hired him for the No. 2 spot, with the understanding that he would attend ASU’s new master’s program in adult education. “Don (Shropshire) waived the prerequisites for that job and I’ve really appreciated him for that,” he said of TMC’s then president. That was in 1970, the beginning of a long career with Tucson Medical Center that still continues to this day, long past Freund’s 2001 retirement. DURING HIS TENURE IN THE EDUCATION DEPARTMENT, FREUND CREATED MANY NEW PROGRAMS. IN THE EARLY DAYS, HE SET UP TMC’S FIRST TUITION-REIMBURSEMENT PROGRAM, WORKED TO INTEGRATE OSTEOPATHIC PHYSICIANS INTO THE PROFESSIONAL STAFF, AND SURMOUNTED OBJECTIONS TO TRAINING NON-PHYSICIANS IN CARDIOPULMONARY RESUSCITATION, OR CPR.

With the support and leadership of Shropshire, Freund advanced training and education in numerous ways, including creating a stand-alone program for teaching cardiac staff how to read EKGs; implementing a recruitment and training program to employ people who were blind in the darkroom of Radiology; and continuously finding ways to upgrade technology to keep the hospital current.

Even as he was looking toward the future, Freund didn’t want to lose sight of the past. Shropshire had suggested that the hospital needed to preserve its history, and Education had a writer, Reba Grubb, who would take on the task. With Freund’s help and supervision, Grubb would pen two volumes of Portrait of Progress, the definitive history of the Desert Sanitorium and TMC through the 1990s. During this time, too, Freund thought about the need to preserve artifacts from the organization’s history. He never intended a museum, per se, but always envisioned the history would be put back into the hospital for the community to appreciate. Many displays, in places such as the West Entrance and in front of the Gift Shop, have helped tell the TMC story. Freund still spends time in the unofficial TMC Museum in the Catalina Building, where history – in articles, photographs, newspaper clippings, medical equipment and more is collected, stored and cataloged. During the Old Fort Lowell Neighborhood Association’s annual Fort Lowell Days in February, Freund showed a slide presentation (using a computer instead of a carousel) on the history of TMC and its historical buildings. He continues volunteering and researching the history of the medical center, and wants to see it shared with others. “I want to honor all the effort over the years that we’ve put into preserving our history and to make sure we’re able to keep and share that in some way.”

A golden celebration When the Findysz family opened its first store at Kolb and 22nd Street 50 years ago, it was the first Ace Hardware to open west of the Mississippi. To celebrate their golden anniversary, the family’s five Ace Hardware stores held a drawing to benefit Children’s Miracle Network and TMC for Children.

MORE THAN $6,500 WAS RAISED AND PRESENTED TO THE TMC FOUNDATION EARLIER THIS YEAR. IT’S NOT LIKELY TO BE THE LAST HEARD OF THEM, THOUGH. LAST YEAR, THE LOCAL ACE HARDWARES DOUBLED THEIR GIVING TO CMN AND RAISED MORE THAN $12,000.

Surgeons vs. chefs at pumpkin carving contest benefiting TMC for Children Ghosts and goblins gathered once again to see surgeons from Tucson Orthopaedic Institute take on chefs from local restaurants for the second annual Surgeons vs. Chefs-Pumpkin Carving Contest at the Embassy Suites Tucson-Paloma Village. Proceeds from the frightfully fun event benefited TMC for Children and Children’s Miracle Network. Surgeons from Tucson Orthopaedic Institute put their well-honed skills to the test as they sliced, cut and trimmed pumpkins at Embassy Suites Tucson-Paloma Village. Carving the orange orbs on the culinary side included chefs from Embassy Suites Tucson-Paloma Village, BRIO Tuscan Grille, Fleming’s Prime Steakhouse, Hilton El Conquistador, Loews Ventana Canyon and Sholomo & Vito’s.

2011 event round up 2011 DESERT TOYOTA OF TUCSON ROCK ‘N RODEO

On Saturday, March 5, more than 600 people were wrangled up at the JW Marriott Starr Pass Resort for a good time and a great cause. More than $198,000 was raised to support TMC Hospice; branding the event the most profitable rodeo ever! Through the community’s generosity, TMC Hospice can continue to offer much needed services to patients and their loved ones, with proceeds from Rock’N Rodeo providing emergency funds to cover services for families in need and complimentary therapies often not covered by insurance that improve the quality of life for those facing long-term medical needs. Rock ‘N Rodeo committee members Marilyn Wolfarth (Chair), Kristin Ashdown and Cindy Morrissey A TRADITION OF CARING: A CELEBRATION OF LEGACY GIVING TO TMC

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 75 friends of TMC were in attendance, including many legacy donors and their families. The evening included a video presentation with a donor testimony from the well known Dr. Palmer Evans, and Linda Wojtowicz, senior vice president and chief operations officer shared a “State of TMC” address. Friends of TMC, Dr. & Mrs. Nancy Willingham alongside TMC Planned Giving Council member Larry Adamson and wife Florence 2011 TMC FOUNDATION GALA

More than 650 friends of TMC came together on Saturday, November 19, for an evening of “Happily Ever After” at The Westin La Paloma. Complete with fairies and footmen, royal symphonic sounds, the appearance of a fairy godmother and the unforgettable tunes of Rockola, this fairy tale fête was an expression of our appreciation to the gracious donors, physicians and staff who have helped make our wishes come true. With your support, the Gala proceeds of more than $171,000 benefited the Block by Block, Miracles Happen Pediatric Capital Campaign.

A few of the evening’s princesses: Donna Morton, Patsy Sable, Maureen Batik and Susan Rogers

TMC community affairs recipients As corporate citizens in the Southern Arizona community, Tucson Medical Center provides support to other nonprofit organizations serving the region. Last year, TMC provided more than $275,000 to these important community partners. Below is a list of some of the organizations receiving financial support from TMC.

Alzheimer’s Association

Juvenile Diabetes Research Foundation

American Cancer Society

La Frontera

American Diabetes Association

Leukemia and Lymphoma Society

American Heart Association

Marana Healthcare

American Liver Foundation

March of Dimes

American Lung Association

Mobile Meals of Tucson

Ara Parseghian Medical Research Foundation

Mothers Against Drunk Driving, Southern Arizona

Arizona Blind & Deaf Children’s Foundation

National Alliance on Mental Illness

Arizona Chapter American Parkinson Disease

National Fallen Firefighter Benefit

Arizona’s Children Association

New Parents Network

Arthritis Foundation

Pima Council on Aging

Aurora Foundation

Reid Park Zoological Society

Big Brothers Big Sisters of Tucson

Ronald McDonald House

Boys & Girls Club

Southern Arizona AIDS Foundation

Caregiver Consortium

Southern Arizona Center Against Sexual Assault

Casa de los Niños

Southern Arizona Network for Down Syndrome

Child & Family Resources

Susan G. Komen for the Cure, Southern Arizona

Community Food Bank

Tucson Children’s Museum

Copper Queen Community Hospital

Tucson Festival of Books

Cyclovia Tucson

Tucson Hispanic Chamber of Commerce

DM-50

Tucson Jewish Community Center

Educational Enrichment Foundation

Tucson Meet Yourself

El Rio Health Center Foundation

Tucson Metropolitan Chamber of Commerce

Emerge! Center Against Domestic Abuse

Tucson Nurses Week Foundation

Epilepsy Foundation Arizona

Tucson Police Foundation

Fox Tucson Theatre Foundation

Tucson Urban League

Girl Scouts of Southern Arizona

Tucson Values Teachers

Green Valley Assistance Services

UA Center for Integrative Medicine

Handi-Dogs Inc.

UA Zuckerman College of Public Health

Handmaker Foundation

United Way

Humane Society of Southern Arizona

Women’s Foundation of Southern Arizona

Jewish Family & Children’s Service of Southern Arizona

YMCA

TMC HealthCare Board of Trustees

TMC Medical Executive Committee

Louise L. Francesconi, Chairwoman J. Manuel Arreguin, MD Henry K. Boice Michael W. Bracht, MD Mary E. Cochran, MD David J. Cohen Susan L. Ernsky Manuel M. Ferris Eduardo A. Leon Michael R. Probstfeld, MD Judy Rich Beckie Torrey Jon R. Young

Michael R. Probstfeld, MD, Chief of Staff J. Manuel Arreguin, MD, Chief of Staff Elect Abraham Bressler, DO Brian Cammarata, MD Cecilia Colmer, MD Amram Dahukey, DPM Gayle Dean, MD Lionel Faitelson, MD Carlos Flores, MD Thomas Harmon, MD Barton Hodes, MD Steven Ketchel, MD David Killion, MD Luis Leon, MD Douglas Lowell, MD Anthony Manson, MD Clifford Martin, MD Brandon Massey, MD Eva McCullars, MD Abhilash Nair, MD William Odette, MD Michael Parseghian, MD Douglas Peterson, MD Ronald Quintia, MD, DDS Abhay Sanan, MD Gulshan Sethi, MD Steven Siwik, MD Keith Soderberg, MD Shawn Stafford, MD David Teeple, MD Paul Walshaw, MD George Wilcox, MD J. Paul Yurkanin, MD

TMC Foundation Board of Trustees Anne Fulton-Cavett, Chairwoman Christine Aronoff Jodi Bain Diana Bergen Henry K. Boice Kim Bourn Jeffrey J. Cesare David J. Cohen Palmer C. Evans, MD, Life Trustee Dorothy Finley, Life Trustee Louise L. Francesconi Fran Katz Sidney Mendelsohn David F. Peachin Judy Rich Cody Ritchie Alan K. Rogers, MD Keri Lazarus Silvyn Steven Siwik, MD David Smallhouse Arlene Webster Jim Zarling

5301 East Grant Road • Tucson, Arizona 85712 • 520.327.5461 • www.tmcaz.com


Tucson Medical Center Report To Our Community