Annual Report - Winthrop University Hospital

Winthrop-University Hospital 2011 Annual ReportA Message from the President & CEO and Chairman of the Board“Our promise is never to accept the status quo.”Charles M. Strain, Chairman of the BoardFor Winthrop-University Hospital, 2011 was another year ofgrowth and financial stability, an impressive accomplishmentduring these economically challenging times.We closed the year with an operating margin of 2.83%, demonstratingthe efficiency of our operation, which is driven toa great extent by our foresight in technology investment andthe efforts of our dedicated staff to provide superior care thatresults in reduced lengths of stay for patients. Our occupancyrates remained steady at 91.7%, slightly higher than the 91.1%reported for 2010.Our clinical achievements last year were impressive. For example,in 2011 our surgeons achieved a breakthrough in minimallyinvasive surgery techniques when they successfully performedesophageal surgery by inserting an endoscope through thepatient’s mouth, thereby avoiding an incision. Natural OrificeTransluminal Endoscopic Surgery (N.O.T.E.S.) holds great promise,and the accomplishment of our surgeons in using the techniqueto treat a condition of the esophagus, known as Achalasia,paves the way for further innovation.We remain among the top 5% of hospitals nationwideIt is not surprising then that HealthGrades, the nation’s mosttrusted source of healthcare provider information, has namedus a Distinguished Hospital for Clinical Excellence for thefourth consecutive year. This prestigious distinction placesWinthrop-University Hospital among the Top 5% of hospitalsnationwide for clinical performance.Our long-standing academic mission was strengthened in 2011when Winthrop became a Clinical Campus of the Stony BrookUniversity School of Medicine. As a teaching affiliate prior tothis new designation, Winthrop hosted medical student rotationsthrough various clinical departments. As a Clinical Campus,80 third- and fourth-year medical students will live and trainat Winthrop each year, making Winthrop the only Long Islandhospital training students under this model.To ensure our continued success, Winthrop’s board and administrativeteam this year adopted a long-term strategy that focuseson enhancing our research capabilities and on continuing toidentify operational efficiencies.Strengthening researchResearch is the cornerstone of progress in medicine, andWinthrop historically has had robust programs in basic, clinicaland health outcomes research. At present, these activities arespread throughout our campus. In 2011, the administrationand the board of directors, in collaboration with our clinicaland research faculty, adopted a plan to consolidate all ourresearch efforts into one new location to be known as TheResearch Institute.The Institute will reside in a new, four-floor, 95,000-squarefootbuilding that will include core laboratories, a clinical trialcenter and classrooms for medical students. To enhance ourbench-to-bedside research, the facility will include an in-patientarea for adult and pediatric endocrine patients. This will increaseJohn F. Collins, President and Chief Executive Officer, (left), Charles M. Strain, Chairman of the Board (right)2

in 1896 we were Long Island’sfirst voluntary communityhospital with 48 beds.

ResearchEducationHealthcareHealthcare at WinthropCancer CareDigestive CareFamily CareWinthrop-University HospitalWinthrop is certified withFrom acid reflux to pancreaticFrom unborn babies andoffers the most sophisticatedcommendation by thecancer, Winthrop providespremature infants to childrendiagnostic and therapeuticAmerican College ofcomprehensive preventive,of all ages and young adultscare in virtually every spe-Surgeons’ Commission ondiagnostic, and interventionalthrough geriatric patients,cialty and subspecialty ofCancer. The Hospital pro-care for all aspects of gastro-Winthrop provides the fullmedicine and surgery. Evervides a full spectrum of careintestinal (GI) health. Withrange of healthcare serviceschanging and growing withfrom advanced diagnosticspecialized programs forfor the entire family. Winthropthe diverse community ittechnology through surgery,Crohn’s and Colitis, women’soffers comprehensive pro-serves, Winthrop is a uniquechemotherapy, and radiationGI issues, and Hepatitis C,grams in women’s health,institution that successfullytherapy—including the break-and an advanced endoscopyincluding a high-risk preg-blends the progressive philos-through treatment CyberKnife ®program that is paving thenancy program; men’s health,ophy and sophistication of—for all types of cancer withway in natural orifice translu-featuring the widest range ofa teaching and research insti-outcomes on par with otherminal endoscopic surgeryoptions for prostate care; andtution with a very personalmajor cancer centers.(N.O.T.E.S.), Winthrop is aa full complement of pediatricapproach to patient care.leader in GI care.generalists and subspecialists.6

ONE of the Best RegionalHospitals for Cancer Care inthe New York Metro RegionU.S. News & World ReportHeart CareLung CareNeurosciencesSpecialty CareWinthrop’s Heart andSleep apnea and other sleepWinthrop’s Department ofWinthrop also offers a wideVascular Institute offers thedisorders are diagnosed andNeurosciences providesrange of Specialty Care serv-most advanced diagnostic,corrected at Winthrop’s hotel-comprehensive neurologicalices including a Bariatriclifestyle and disease preven-style Sleep Disorders Centerand neurosurgical services.Surgery Center of Excellence,tion programs, as well as—the first sleep center on L.I.Resources at Winthrop includean Orthopaedic programsophisticated medical treat-to achieve national accredita-a sophisticated 14-bed Neuro-that includes experts in jointment and cardiac rehabilita-tion more than 20 years ago.sciences Special Care Unit, areplacement and sports medi-tion, the latest proceduresBoard-certified pulmonarydedicated Epilepsy Programcine, the Winthrop Diabetesin interventional cardiology,specialists provide the mostand a comprehensive MSEducation Center, an unparal-and superior cardiac surgery.advanced care for the fullCare Center. Winthrop’sleled Wound Healing andWinthrop is known acrossrange of pulmonary conditionsadvanced facilities and expertRegenerative Medicine pro-New York State for its excel-from asthma and chronicStroke Team contributed togram, and the largest hospital-lent outcomes in cardiac careobstructive pulmonary dis-Winthrop being named abased renal dialysis programfor men, women and children.ease (COPD) to pulmonaryNew York State Departmenton the Island.hypertension.of Health designated StrokeCenter.7

Winthrop-University Hospital 2011 Annual ReportAt Winthrop, we treat the most complex casesAs a major regional healthcare resource with a long-standingcommitment to medical education and research, Winthrop-University Hospital offers patients facing complex health issueshighly sophisticated care, some of which is not available anywhereelse in our region.From unborn babies to elderly patients struggling with chronicillnesses, patients find help—and hope—at Winthrop.Fetal surgery saves babies’ livesWhile news of a baby on the way is joyous, pregnancy isnot without risk. Thanks to Winthrop’s Fetal Surgery Program,which is the only one on Long Island that allows in-uterosurgical treatment options, conditions that once may havethreatened a fetus are being treated successfully during earlypregnancy.Our team of fetal medicine specialists uses state-of-the-art fetaltreatments including fetoscopic laser coagulation procedures tocorrect twin-to-twin transfusion syndrome, intrauterine bloodtransfusions to treat conditions such as fetal anemia and fetalthrombocytopenia, and intrauterine shunt catheters to treatpleural effusions or fluid build-up in the space around thelungs, among other conditions. Our experts also perform fetalshunting drainage procedures to correct, for example, lowerurinary tract obstructions that may harm the fetus’ kidneys.These and other fetal surgeries are available exclusively throughWinthrop’s prestigious Maternal Fetal Medicine program. AtWinthrop, not only do we ensure the optimal health of momsto-beand ensure the safest possible delivery of babies, but alsowe save the lives of at-risk mothers and babies…nothing couldbe more important.Robotic surgery use expandsThe sophistication of minimally invasive surgical techniquescontinues to grow, and Winthrop-University Hospital remains aleader in the use of these procedures. The hospital was the firston Long Island to acquire the daVinci Si HD Surgical System,the most current equipment of this type.Seated at a console a few feet away from the patient, surgeons,with their fingers attached to robotic controls, view a highdefinitionscreen displaying a three-dimensional magnified8

Winthrop’sFetal SurgeryProgram... is the only onein our region that allowsin-utero treatment options.

FIRST hospital onLong Island to acquire thedaVinci Si HD Dual ConsoleRobotic Surgical System

Winthrop-University Hospital 2011 Annual Reportimage of the surgical field of interest. Fine surgical instrumentsthen are placed inside the patient through tiny incisions andthe surgeon is ready to work.Surgeries performed with robotic tools not only are replacingtraditional open surgeries, but also are providing outstandingpatient outcomes. Among the fastest growing specialty proceduresbeing performed at Winthrop with the daVinci surgicalrobot are hysterectomies, gynecological oncology surgeries,colon resections, gastric bypass surgeries, partial nephrectomies,and prostatectomies. In 2011, Long Island’s first roboticassistedlung surgery was performed at Winthrop, and theHospital acquired a second daVinci robot, equipped with themost sophisticated fluorescent imaging capabilities.Winthrop excels in women’s healthcareWinthrop-University Hospital has become a nationally recognized,regional leader in women’s health services.Long Island has a higher-than-average incidence of breastcancer. The experts at the Winthrop Breast Health Center providecomprehensive risk assessment, diagnosis, treatment andfollow-up care to patients. The team specializes in the evaluationand treatment of all types of breast conditions, includingbenign and malignant breast tumors, breast pain, suspiciousand abnormal mammograms, previous breast cancer diagnosisor positive biopsy, and BRCA1 or BRCA2 genetic mutations.In 2011, our Breast Health Center earned a three-year fullaccreditation by the National Accreditation Program for BreastCenters (NAPBC), a program administered by the AmericanCollege of Surgeons. Winthrop’s Center is only one of 12 suchcenters in New York State and the only center in NassauCounty to achieve this prestigious accreditation.HealthGrades, the nation’s leading independent source ofphysician information and hospital quality ratings, in 2011 honoredWinthrop with both the Gynecologic Surgery ExcellenceAn avid runner and skydiver, Connie Murphy appeared to bein good health when she discovered a small lump in her groin.The 49-year-old Huntington resident and sales professional wasshocked to learn of her diagnosis of stage 3 ovarian cancer.After several unsatisfactory consultations, Ms. Murphy sought out Dr. EvaChalas, Chief of Gynecologic Oncology and Director of Clinical Cancer Care atWinthrop, and reports that Dr. Chalas was the only specialist who gave her hope.“Here at Winthrop, we offer state-of-the-art radical and ultra-radical surgeriesfor gynecological cancers,” says Chalas. “And, because of our active researchprograms, we also can provide patients with access to innovative therapies,such as new types of chemotherapy.”Ms. Murphy underwent a complete hysterectomy and removal of metastasizedcancer lesions on surrounding organs, a procedure that took more thanfive hours. “The incision ran from my pelvis to the top of my diaphragm,”Ms. Murphy recalls.With surgery followed by chemotherapy, Ms. Murphy stayed as physicallyactive as possible and with Dr. Chalas’ blessing, she was back on her exercisebicycle two weeks after surgery.Today, she has returned to her accomplished running routine and skydivingactivity, and is preparing to become a certified skydiving instructor, an outcomeMurphy credits to the care and support she received at Winthrop. “Stayingfit was an important part of my lifestyle, treatment plan and recovery,” saysMs. Murphy, “and Dr. Chalas supported me in that every step of the way.”11

Winthrop-University Hospital 2011 Annual ReportWhen 49-year-old music industry marketing professional TyroneKelsie went for his routine physical exam, he was feeling just fine.“I didn’t feel like anything was wrong,” says the Westbury resident.A month later he was trying to decide the best treatment optionfor prostate cancer.When Tyrone’s father was diagnosed with prostate cancer several years ago,his prostate was removed, a path that Tyrone was not keen to follow. With thehelp of family and a close friend, Tyrone researched prostate cancer treatmentsand learned about CyberKnife. Despite its name, CyberKnife is not surgery,but rather a technology that provides highly precise radiation therapy to treattumors while minimizing damage to surrounding tissue.Tyrone’s urologist concurred that CyberKnife was an excellent treatmentoption and referred him to Winthrop, which was the first CyberKnife Center of LIand NYC, and is the second largest site in the world for treating prostate cancerwith CyberKnife technology.“In addition to being highly effective in treating tumors, Cyberknife’s treatmentplan calls for 30–40 minutes of radiotherapy a day for an average offive days,” explains Dr. Jonathan Haas, Chief, Division of Radiation Oncology.“This is a great benefit to patients, who can continue on with their lives.”Cancer-free for more than a year, Tyrone, who enjoyed fame in the 1990sas co-host of the MTV music program, “Yo! MTV Raps,” has become anadvocate for screening and CyberKnife treatment when necessary. “Guys don’treally want to hear it, but I tell them what happened to me,” he says, adding,“I’m living a normal, healthy life now, and I thank CyberKnife.”Award and the HealthGrades Maternity Care Excellence Award.Our hospital has a long-standing tradition of excellence in treatinggynecological conditions, including cancer, with the mostsophisticated non- and minimally-invasive surgical procedures.Further underscoring its outstanding clinical outcomes in women’shealth, Winthrop was also recognized by HealthGrades asa recipient of the 2011 Women’s Health Excellence Award andranked among the top five percent in the nation for Women’sHealth for the second year in a row.Winthrop is the only hospital in New York State to simultaneouslyreceive the HealthGrades Maternity Care ExcellenceAward, the HealthGrades Gynecologic Surgery Excellence Award,and the HealthGrades Women’s Health Excellence Award in2011, reflecting the unmatched standard of care that womenreceive at Winthrop.Innovative prostate cancer treatmentOther than skin cancer, prostate cancer is the most commoncancer in American men, according to the American CancerSociety. Roughly 1 man in 6 will be diagnosed with prostatecancer during his lifetime.At Winthrop, prostate cancer patients are offered a full array oftreatment options, permitting patients and their physicians toselect the most appropriate for the stage of the cancer and thehealth of the patient.Minimally invasive surgery using the daVinci Surgical RobotSystem is available, as well as intensity-modulated radiationtherapy (IMRT), a radiotherapy that uses a linear accelerator todeliver precise radiation doses to a malignant tumor or specificareas within the tumor. Winthrop also offers cryotherapy, atechnique that freezes the tumor, for those patients whosecancer cannot be treated with surgery.12

$27,845,238in Charity CareDelivered in 2011

More than 37,000inpatients, over 68,000emergency visits, 802,000Outpatient Encountersat Winthrop faculty &associated practices14

Winthrop-University Hospital 2011 Annual ReportPerhaps the most exciting advancement in prostate cancertreatment is use of CyberKnife technology. Despite its name,CyberKnife is not surgery. Rather, it is a technology that takesradiotherapy to new levels, and it has proven highly successfulfor treating prostate cancer. As a matter of fact, Winthrop isthe second largest site in the world for treating prostate cancerwith CyberKnife technology. Our hospital also is a designatedCyberKnife training site, attracting surgeons from around theworld interested in learning to use this state-of-the-art technology.CyberKnife uses a combination of advanced imaging equipmentand a robotic arm to deliver high doses of radiation therapywith higher precision than previously possible. Extraordinarilyaccurate, the radiation beams can be sculpted to reach small,deeply imbedded, complex masses, thereby minimizing damageto healthy tissue and providing access to previously unreachableand untreatable tumors throughout the body when radiationtherapy is indicated. Treatments generally take 20 to 30minutes each day for five days or less, adding to the technique’smany advantages over previous treatments.Winthrop currently is one of the few sites in the world usingCyberKnife to treat breast cancer tumors, and our hope is thatthis foundational work will lead to advances in breast cancertreatment.Life-saving cardiac careHeart disease is the leading cause of death in the United States.About every 25 seconds an American will have a coronaryevent and approximately one person will die each minute asa result, according to an American Heart Association study.Winthrop’s Heart and Vascular Institute offers advanced diagnosticsand disease prevention programs, as well as a superiorcardiac surgery program and sophisticated medical treatmentand cardiac rehabilitation services that save the lives of thousandsof patients each year.At 39 weeks pregnant, Hempstead resident Tracey Mallory hadalready suffered through a host of complications. A busy professional,Mrs. Mallory was getting prenatal care close to herworkplace in New York City and was planning to deliver at ahospital there.But Mrs. Mallory’s plans changed suddenly when she began bleeding andhaving contractions while at home on Long Island. Concerned that she did nothave time to make the trip into New York City to see her doctor, her husbanddrove her to Winthrop, only minutes away from their home.“Mrs. Mallory was in active labor and although her plan was for the baby tobe turned so she could deliver naturally, there was just no time,” said Dr. ArinBuresch, Acting Chief Resident in Ob/Gyn. With her consent, she was broughtinto the Operating Room for an emergency C-section.Dr. Joseph Cioffi, Director, Division of Ob/Gyn Hospitalists at Winthrop,discovered that uterine fibroids were posing a significant threat to both her andher baby and that Mrs. Mallory had had a placental abruption, a complicationin which the placental lining separates from the uterus, causing blood to fill upinside of the amniotic sac.Dr. Cioffi and his team worked diligently to deliver the baby safely while alsotreating Mrs. Mallory’s conditions. Three days later, both Evan and Mrs. Mallorywere discharged from the Hospital in good health.“Had Mrs. Mallory attempted the trip to the City, her baby would have diedfrom complications, and she might have died as well from loss of blood. Herstory demonstrates how important it is for women to immediately seek medicalattention from the right institution when complications arise,” Dr. Cioffi said.15

Winthrop-University Hospital 2011 Annual ReportWinthrop’s Cardiac Surgery Program has long been a benchmarkfor open-heart surgery in New York State and continues togrow in importance. From open-heart coronary artery bypasssurgery and heart valve repair and replacement to specializedtreatment of aortic disease at the Center for Aortic Diseases,cardiac patients have access to the most innovative procedures.For example, cardiologists at Winthrop perform transcutaneousaortic valve replacement (TAVR), one of the newest techniquesthat allows a heart valve to be replaced without open-heartsurgery. Surgeons insert a catheter into an artery in the groin,pass through the catheter a thin wire with the new valveattached and install the new valve from the inside. Percutaneousvalve replacement has proven especially helpful for elderlypatients who are not candidates for open-heart surgery, providingimproved quality of life for these patients and their families.Advances in neuroscienceAs modern science has begun to reveal the mysteries of howthe brain and central nervous system function, great strides havebeen achieved in neuroscience. At Winthrop’s Department ofNeuroscience, physicians, surgeons, physician assistants, nursepractitioners and nurses are members of an interdisciplinaryteam of healthcare professionals that is pioneering the use ofadvanced approaches for diagnosis and treatment, includingcomputerized imaging systems, state-of-the-art surgical interventionssuch as deep brain stimulation and the latest generationof medication therapies.In addition to a 14-bed Neurosciences Special Care Unit, theDepartment of Neuroscience boasts comprehensive resourcesfor diagnosis and treatment of a wide range of conditions,including aneurysms, blood clots and tumors and special programsfor conditions including Multiple Sclerosis, MovementDisorders, and Epilepsy.Addressing the diabetes epidemic andits implicationsModern conveniences have made our daily lives easier thanthose of our grandparents, but we’ve paid a price. Most of usno longer have physically demanding jobs. We’re not likely towalk to work or school or to prepare healthy home-cookedmeals on a regular basis.The result has been increased obesity among Americans,which has precipitated an unprecedented high rate of Type 2diabetes. The Centers for Disease Control and Preventionforecast that by 2050 one in three Americans may have thisdisease. Left untreated or poorly managed, the serious sideeffects may include heart disease, blindness, kidney failureand nerve damage.Education and management are keyIn an effort to help stem the rising tide of obesity and diabetes,and to provide the best possible care to patients with theseconditions, Winthrop-University Hospital has created theWinthrop Diabetes and Obesity Institute to coordinate patientcare, medical research and education so as to maximize theeffectiveness of the hospital’s efforts in each area.Prevention and treatment of diabetes is a primary focus. TheDiabetes Education Center at Winthrop-University Hospital,the first diabetes education program in New York State to beaccredited by the American Diabetes Association, has beenserving as a resource for members of the community since 1979.Here adults and children with diabetes or pre-diabetes—andtheir families—can attend education programs, including classeson use of insulin pumps and similar technologies now availablefor diabetes management, as well as support groups. The Centeralso hosts an extensive variety of programs of interest to overweightand at-risk children and their parents and caregivers.Improving healthcare professionals’ understandingPrimary care physicians are the front line of defense in managingthe care of patients with diabetes. In 2011, 41 Winthropclinicians from six hospital-affiliated primary care practices andfrom the endocrinology faculty practice achieved recognitionby The National Committee for Quality Assurance’s (NCQA’s)Diabetes Recognition Program (DRP). This designation identifiesphysicians who are well educated in diabetes managementand consistently treat patients according to the best availablescientific evidence. Several New York State grants will continue16

ONE of the BestRegional Hospitals,with 11 high performingspecialtiesU.S. News & World Report

FIRST and onlyhospital on L.I. tosuccessfully attest forStage 1 MeaningfulUse of HealthInformation Technologyin 2011

Winthrop-University Hospital 2011 Annual Reportto fund Winthrop’s efforts to help its affiliated primary carephysicians achieve this level of diabetes care expertise.Because diabetes is so prevalent, we see many patients withthe condition in our inpatient population. As a result, theDiabetes and Obesity Institute coordinates a hospital-wideprofessional education program aimed at giving physicians,physician assistants, nurse practitioners, nurses, pharmacists,home care workers and medical students the informationnecessary to understand the complexities of this disease andhow best to coordinate the care of patients with diabetes. TheInstitute also incorporates the various clinical research projectsinvolving diabetes and will be a premier component of ourplanned Research Institute.Obesity and diabetes are epidemic in our nation today, whichlimits the quality of life for many of our citizens and increasesgeneral healthcare costs. At Winthrop, we are assuming aleadership role in our region to improve the health of all wholive here.Every patient is a special patientA hospital, particularly a large, tertiary-care institution likeWinthrop-University Hospital, can be a daunting place. But,it does not have to be, and all of us at Winthrop do our bestevery day to make sure that each person who enters our doorsfeels safe and respected.Caring for childrenChildren, in particular, need special attention. The Children’sMedical Center at Winthrop brings together an impressivearray of pediatric services, as well as pediatric specialists, someof whom are internationally renowned. In 2011, our Children’sMedical Center was named to U.S. News and World Report’sBest Children’s Hospitals ranking for providing high-qualitycare in the specialty of pediatric diabetes and endocrinology.Prior to gastric bypass surgery in April 2011, Bob Evans weighed340 lbs. and was taking 16 medications. He also was using aninsulin pump to control his Type 2 diabetes and a continuous positiveairway pressure (CPAP) machine to cope with his obstructivesleep apnea. Today, Mr. Evans is down to 207 lbs., five medications,no insulin pump and no CPAP machine.Improving his health has been a long journey for Mr. Evans, a retired schooladministrator and former music educator. Despite medical advice fol lowing asextuple coronary by-pass in March 2003, he did not lose weight. The wakeupcall came two years ago when a national weight loss program declined hisparticipation because of his health issues.“That really got me thinking,” Mr. Evans recalls. “My doctor had suggestedgastric bypass surgery a few years before, but I didn’t do it.” Mr. Evans wasreferred to Winthrop-University Hospital, which has pioneered the use of thedaVinci Si HD Robotic Surgical System for gastric bypass.But gastric bypass is not a quick fix; major lifestyle changes in support ofimproved health must follow. “It took me a while to adjust my attitude abouteating, but the post-op support I’ve received has been great,” says Mr. Evans,who regularly attends support group meetings led by a dietician and a nurseat Winthrop.His greatest reward since taking charge of his health has been enjoying histhree-year-old grandson. “The thought of not being able to horseplay with himis unthinkable,” Mr. Evans says.19

Winthrop-University Hospital 2011 Annual ReportDay after day, Eric Davidson was continually exhausted, strugglingthrough his busy day as a commercial and luxury real estateappraiser. Then came the trouble speaking, the “heavy tongue,”and finally the hand tremors. He knew he needed medical help.After Winthrop’s sleep medicine specialists diagnosed him with sleep apnea,and neurological tests proved inconclusive, he was referred to Nancy Langdon,RNC, BSN, MPH, patient navigator and clinical coordinator at Winthrop’s Centerfor Advanced Care of Chronic Conditions.“Nurse navigators are not diagnosis or department specific. They try to helppatients who have been frustrated in their attempts to obtain a clear diagnosisand treatment plan,” says Dr. Michael Niederman, Chairman of the Departmentof Medicine and Medical Director of the Center.Langdon reviewed Mr. Davidson’s medical tests and consulted with hisphysicians. She recommended a cardiology workup as a next step, butMr. Davidson was skeptical. After all, he did not have classic symptoms of acardiac condition. But over time, as symptoms persisted and a clear diagnosisremained elusive, Mr. Davidson finally agreed to a cardiology work-up. Thetests revealed a 90% blockage of the left artery and he underwent successfulopen-heart surgery at Winthrop.“Nancy saved my life,” says the Levittown resident who, since his surgery,walks and jogs about eight miles a week. Mr. Davidson continues to work withLangdon and relies on her to help coordinate his medical care. “Nancy givesme good information and helps me get the appointments I need,” he says.“She forces me to keep my health up front.”Among the special pediatric programs here are the CancerCenter for Kids, Nassau County’s largest facility for childrenwith cancer and blood disorders; pediatric emergency andintensive care units; a New York State Regional PerinatalCenter, which features a Neonatal Intensive Care Unit withoutcomes among the world’s best, and the Child Life Program,which aims to reduce the stress of a hospital stay for childrenand their families.Coping with cancerThere are few things more frightening than receiving a cancerdiagnosis. To make the journey from diagnosis through treatmenteasier for patients and their families, Winthrop createdthe unique Cancer Navigators Program. These registered nursesand physician assistants become a patient’s “go-to” personfor the coordination of appointments, for tests and follow-upcare. They offer educational resources; referrals to specialists,support groups and community services; serve as the liaisonbetween the medical team and the patient; and, perhaps mostimportant, reaffirm for cancer patients and their families thesense that they do not have to face the challenges alone.No place like homeRecuperation from or management of an illness is most effectivein a patient’s familiar surroundings. Winthrop’s award-winningcertified home healthcare agency offers nursing, as well asphysical, speech and occupational therapies in conjunctionwith medical social work and home health aide services toNassau County residents.In 2011, our home health agency was named for the fifthconsecutive year to the HomeCare Elite—a compilationof the top-performing home health agencies in the UnitedStates, attesting to the impressive care provided by our homecare professionals.20

$71,744,000*Invested in MedicalEducation in 2011*estimated

FIRST andonly RegenerativeMedicine Programfor wound healingin the Northeast

Winthrop-University Hospital 2011 Annual ReportRespecting traditionWinthrop’s Pastoral Care and Education Program serves thespiritual needs of patients and families by offering healingministry, spiritual support and pastoral care. Our chaplains mayhelp by contacting clergy of a patient’s faith or by ministeringdirectly through discussion, prayer, rituals and sacraments.Chaplains assist patients and their loved ones as they copewith illness, and provide support during times of grief andbereavement 24 hours a day, seven days a week.To accommodate the needs of families of observant Jewishpatients, Winthrop offers a variety of services, including aSabbath House. This facility may house up to five families andoffers a kitchen equipped for kosher food handling and lightsthat turn on automatically in the afternoon and shut off at nighton the Sabbath.Within the Hospital setting, there are numerous resources forJewish patients and visitors. These include a Sabbath elevator,which stops at each floor on the Sabbath and Yom Tov, andalso Glatt Kosher patient meals.Quality of life and end-of-life careRespect, comfort and dignity are essential for those nearing theend of life. Winthrop has on staff three board-certified palliativecare physicians, something not generally found at other institutions.As a result, our patients and their families can be assuredthat every effort will be made to alleviate the stresses of thisdifficult time.Our surgeons are developing tomorrow’s proceduresPhysicians at Winthrop-University Hospital have made a significantbreakthrough in minimally invasive surgery, treating aserious condition of the esophagus by passing an endoscopethrough a patient’s mouth, thereby avoiding an incision.When a child is diagnosed with diabetes, management of thecondition becomes a family affair. Taylor Rosenking enteredWinthrop’s Pediatric Diabetes Program at age four when shewas diagnosed with Type 1 diabetes, a chronic condition inwhich the body produces little or no insulin.“Discovering that my daughter had diabetes was scary,” says Taylor’smother, Carol, “but by the time we left Winthrop, I wasn’t scared anymore.” Themulti-disciplinary team in Winthrop’s Pediatric Diabetes Program, which servesmore than 1,000 children in the tri-state area, monitors and treats patients,and, equally as important, works to educate their families and communitymembers such as school nurses about effective management of the condition.“The simplest things, like going on a field trip, aren’t simple for children withdiabetes,” explains Jean Corrigan, RN, MA, Program Director. “They have tomake sure that they have all of their equipment with them, that they will be ableto eat if they need to, and, if they eat, that they will be able to see nutritioninformation and count carbs in order to manage their blood glucose levels andinsulin therapy.”Today, Taylor is an active teenager who loves to dance and who uses aninsulin pump to continuously deliver insulin subcutaneously. The pump eliminatesthe need for insulin injections, gives Taylor greater flexibility with hermeal plan and allows her to live and enjoy a full life.“I remember how I felt when I first was diagnosed with diabetes and howmany challenges I faced,” she says. “I want kids to know that they are notalone, and that they can’t let diabetes stop them from anything.”23

Winthrop-University Hospital 2011 Annual ReportAlan M. Jacobson, MD, Chief Research OfficerUnder a March of Dimes grant, Winthrop researchers currentlyare studying the potential for using low levels of carbon monoxideas a preventive treatment for pregnant women at risk ofdelivering pre-term babies.The aging processWhether or not you believe that 60 is the new 40, the truth isthat life expectancy in the United States is getting longer. And,on Long Island in particular, the percentage of older residentsis increasing.Among the Winthrop research initiatives aimed at improvingthe health of older adults is an investigation of the link betweenCOX-2 inhibitors, popular drugs used to treat pain and inflammationin conditions such as rheumatoid arthritis, and increasedrisk for stroke and heart attack. Our team is developing waysin which to make these drugs less toxic to the cardiovascularsystem, which would benefit patients in need of pain reliefbut who are currently avoiding these drugs because of safetyconcerns.Osteoporosis is a major concern for the elderly, particularlywomen. A current study at Winthrop is looking at the effectivenessof vitamin D and calcium in preventing osteoporosis inAfrican-American women.Neuroscience research related to the elderly also is a focus.Among the work under way is a study of neurodegeneration,the cause of diseases such as Amyotrophic Lateral Sclerosis(ALS) and Parkinson’s disease. Parkinson’s affects approximately1 million U.S. citizens, and ALS has no current availabletreatment.CancerAs an academic institution, Winthrop is the site of some of themost current clinical trials and research into cancer, ensuringthat patients have access to the latest therapies.The Hospital’s cancer specialists and researchers are involvedin rigorous basic and clinical studies of a wide variety of cancers,including lung cancer, childhood cancers, blood cancers,27

Winthrop-University Hospital 2011 Annual ReportJohn F. Aloia, MD, Chief Academic Officer, announces the creation of the Winthrop-University Hospital Clinical Campus of Stony Brook University School of Medicine.colorectal cancer and gynecological cancers. In fact, in 2011,Winthrop was named as one of only three sites nationwide tooffer a clinical trial for an ovarian cancer vaccine.Winthrop researchers are also analyzing predictors of longtermsurvival in breast and other cancers. Another study isaimed at developing an approach to using multiple methodssimultaneously to treat cancers of the bile ducts, gallbladderand liver.Research has helped us make great strides in the prevention,diagnosis and treatment of cancer. But, much remains to belearned, and at Winthrop our researchers continue the quest.Taking research to the next levelPatient care, academics and research are the three componentsof Winthrop’s mission. Because research is so essential, Winthrophas initiated creation of a dedicated Research Institute.The four-story, 95,000-square-foot facility to be built on ourcampus will house basic science research, clinical/translationalresearch, outcomes research, medical education classroomsand support services.In addition to coordinating the research currently under wayat Winthrop’s various Institutes and Centers of Excellence, thenew building will allow greater interaction between researchersand clinicians. For example, one floor will house outpatientservices for adult and pediatric endocrine patients, which willincrease collaboration among those studying diseases suchas diabetes and those caring for such patients. The benefit tocurrent and future patients from such a partnership will besubstantial.AcademicsFor more than half a century, Winthrop-University Hospitalhas been a leading center for medical education, and in 2011 itexpanded its role by becoming a full-fledged Clinical Campusof the Stony Brook University School of Medicine.28

Winthrop-University Hospital 2011 Annual ReportAmong the topics and conditions studied in this academicresearch program are obesity and diabetes, end-stage renaldisease, causes of premature labor, vascular disease, gastrointestinaltreatment and ovarian cancer. This enrichment programsupports clinical investigators as they test new ideas and obtaindata in order to be in a better position to apply for and obtainexternal funding.TechnologyThe desire to maintain the highest level of patient safety hasalways been the impetus for Winthrop’s Health InformationTechnology (HIT) initiatives, and it’s the reason we are a leaderin adopting technology.In 2006, Winthrop-University Hospital began implementingan electronic health record (EHR) system, which now operateshospital-wide. Last year, we became the first and only LongIsland hospital to demonstrate meaningful use of EHR technologyduring the 2011 federal fiscal year.As a result, the hospital qualified for the financial incentiveprogram established by the American Recovery and ReinvestmentAct of 2009 and received $3.2 million from the U.S.Department of Health and Human Services to continue implementingits HIT program. At the close of 2011, Winthrop wasone of only four hospitals in New York State to qualify for theincentive. Fewer than 4 percent of hospitals in the United Stateshave reached this milestone of technology implementation.Effective technology improves patient safetyThe EHR system provides for Computerized Provider OrderEntry through which physicians and other healthcare providersinput medication and other orders into a computer system.This eliminates handwriting errors, expedites the sharing ofinformation and facilitates quality patient care.For example, when a medication order is entered into the system,the system checks for possible contraindications based onthe patient’s medical record. And by scanning and matchingthe barcode on the drug to the barcode on the patient’s IDJohn McNelis, MD, FACS, Vice Chairman of the Department of Surgery, uses “Winnie” the robot to see patients when he is not in the Hospital.30

Winthrop-University Hospital 2011 Annual ReportMaureen Gaffney, MHS, RPAC, RN, Winthrop’s Senior Vice President for Patient Care Services and Chief Medical Information Officer, combines her clinicalexperience and technological savvy to foster the best possible environment for healing.bracelet at the bedside, nurses have a reliable mechanismby which they confirm correct patient, correct medication,correct dose and correct time. If there is any contraindicationor discrepancy, the system alerts the provider, thereby avertingpotential medication errors.Winthrop last year installed a cloud-based picture archivalsystem in the Imaging Services department. Radiology imagesare stored remotely but can be accessed easily throughout theWinthrop system. Not only does this facilitate sharing of crucialinformation among the health professionals treating a patient,but also it safeguards the ability to access images should therebe an unexpected system interruption on site.Last year, we also began a patient consent initiative to ensurethat patients can control access to their electronic health record.The portability of health records will result in better patientcare and reduced costs because health professionals treating apatient outside of his or her physician practice or hospital willhave access to the patient’s critical health information.Health IT trailblazers—on Long Island and beyondAs an early adopter of health IT, Winthrop has been able tocapitalize on its relationships and experiences to help developthe next generation of these tools. We collaborate with industryand academia and currently we are piloting a scheduling systemthat will reduce patient wait times for certain tests andprocedures. We are also helping to develop a touch screendevice-based bedside system to facilitate communicationbetween patients and nurses.Winthrop-University Hospital is a founding member of theE-Health Network of Long Island, the regional health informationorganization working toward interconnectivity withhealthcare providers in other parts of the state—and ultimatelynationwide—through compatible health information exchangesystems.31

Winthrop-University Hospital 2011 Annual ReportMichael Ammazzalorso, MD, MACP, Chief Medical Officer & Associate Chairman of the Department of Medicine, leads the world-class medical staff at Winthrop.Distinguished MedicalStaffWinthrop’s medical staff—which includes more than 1,300full-time and voluntary attending physicians—cared for morethan 37,000 inpatients, handled more than 68,000 emergencyvisits, and conducted more than 800,000 outpatient appointmentsin 2011. And that’s just their clinical work. They arealso esteemed professors, respected researchers, and prolificpublishers of original medical literature.In 2011, 86 Winthrop physicians were named to Castle Connolly’sTop Doctors: NY Metro Area edition. Winthrop doctors holdleadership positions with national organizations and many haveearned prestigious NIH and other federal grants. Physicians atWinthrop participate in Clinical Research Trials to offer thelatest available treatment options, and maintain a steadfastcommitment to quality, efficient resource utilization, preventingunnecessary admissions and appropriate transitional care. Inrecognition of their commitment to superior quality in all thatthey do, Winthrop doctors are recognized regularly with awardsfor clinical, academic and research excellence. And all thewhile, they provide the highly personalized and compassionatecare that has made Winthrop the hospital of choice for so manypatients and their families.Many Winthrop medical staff hold academic appointments atStony Brook University School of Medicine and are activelyengaged in teaching medical students. This activity ranges fromteaching in the classroom to mentoring students in physicianpractice offices and at the hospital.PartnershipsWinthrop is…a partner in the Winthrop South Nassau University Health Systema member of the New York-Presbyterian Healthcare Systema member of the Nassau-Suffolk Hospital Councila member of the Long Island Health Networka founding member of the e-Health Network of Long Island32

Winthrop University Hospital 2011 Annual ReportWinthrop’s Chief Operating Officer, Garry J. Schwall, MBA, RPA, drives growth and advancement of Hospital programs, services and facilities.

Winthrop-University Hospital 2011 Annual ReportWinthrop-University Hospital CampusWinthrop-University Hospital owns 50 buildings,including the main hospital and parking garage andothers at the 259 First Street address in Mineola, andmore than 30 nearby houses and two apartmentbuildings, which provide housing for the residentswho serve the hospital and its patients 24/7, as wellas other key medical staff and the medical studentswho study and practice at the hospital full time aspart of Winthrop’s Clinical Campus of the StonyBrook University School of Medicine. In addition,Winthrop has a major long-term lease presencein dozens more properties from Garden City toBethpage and beyond.The hospital has 27 faculty medical practices and 13Article 28 facilities—medical practices that are offsiteextensions of the main hospital. Among these arethe Cancer Center for Kids in Mineola, the region’slargest outpatient facility for children with cancer andhematologic conditions, a pediatric practice and aWomen’s Wellness Ob/Gyn practice, both located inHempstead. In addition, Winthrop is affiliated withmore than 111 physician practices from New YorkCity to the East End of Long Island.This extensive list of locations represents the breadthand depth of services offered by Winthrop, extraordinaryaccess to the best possible healthcare forcommunities across the region, and a tremendouseconomic contribution to Long Island’s economy(see chart pg. 36).Major Properties—Key (owned and leased)1—Winthrop-University Hospital2—Biomedical Services3—Parking Garage4—Loading Dock & Support Services5—Professional Offices6—Academic & Research Offices, Labs7—Community Outreach Center8—Diabetes Education Center9—Medical Offices10—Medical Offices11—Medical & Professional Offices12—Radiation Oncology13—Employee Parking14—Administrative Offices15–20—Residential21–31—Residential32–46—Residential47—Residential48—Wedgewood Apartments, Residential49—Nassau Towers, Residential50—Heart & Vascular Institute51—Wellness Pavilion52—Medical, Professional Offices34

Winthrop-University Hospital 2011 Annual ReportArchitect’s rendering of the soon-to-be-built Winthrop Research Institute, to be located at the corner of Mineola Blvd. and 2nd Street in MineolaFinancial Highlights2011 2010 ChangeOperating Revenue $918,227,315 $841,503,693 9.12%Operating Income $ 20,480,894 $ 18,010,432 13.72%Operating Margin 2.23% 2.14% 4.22%Economic Impact 2011Winthrop is also vital to the health of the local economy.Number of Employees Salaries, WagesSupplies Capital Spending Leases and Rentals& Benefits6,600Employees$513.9Million$226.3Million$50Million$15.3MillionSource: Winthrop36

Winthrop-University Hospital 2011 Annual ReportRevenue(in millions)2000Inpatient Revenues Payer Mix(in millions) (Percent)$1,639A balanced payer mix helps ensure financial stability. Revenues remain strong, and margins aresolid, even with a significant commitment to research, academics, and employee benefits.1500$842 $833$506 $487$3761000PPO/Commercial 46.3%500Self Pay/Other 3.1%Work Comp/No Fault 1.6%0WinthropSouth NassauNUMCNSUH ManhassetSt. FrancisStony BrookWinthropSouth NassauNUMCNSUH ManhassetSt. FrancisStonybrookSource: Healthcare Association of New York State (HANYS)Institutional Cost Report (ICR), 2010Margins(Percent)14.67%15Margins(Percent)127.03%7.54%9Medicaid/Medicaid HMO 13.6%6Medicare/Medicare HMO 35.4%2.14%3Source: Winthrop0.32%0WinthropSouth NassauNUMCNSUH ManhassetSt. Francis(0.83%)Stony Brook-3Source: HANYS Institutional Cost Report, 201037

Winthrop-University Hospital 2011 Annual ReportGrowth in overall employment, and for the medical staff as well, reflects avibrant clinical environment. Our people enjoy working at Winthrop.One of the busiest hospitals on LI, Winthrop has been able to consistently lowerlength of stay for our patients, especially compared to other teaching hospitals.Length of Stay(average per day)Number of Winthrop Employees5,3025,665 5,993 6,217 6,619Number of Winthrop 5.89 5.97 Medical Staff5.69 Length of Stay(average number of days)5.166.33 6.246.21,6001,5501,5001,4001,3005.85.8PMS 431 PMS 618 PMS 7419 PMS 5635.45.45.05.0ployees6,619’07 ’08 ’09 ’10 ’11Source: WinthropSt. FrancisNumber of Winthrop Medical Staff1,6001,5501,5001,4001,3004.610,0009,0008,000’09Q1North Shore’09Q2’07 ’08 ’09 ’10 ’11Winthrop75th Percentile Teaching HospitalMedian Teaching Hospital 25th Percentile Teaching HospitalSource: Winthrop’09Q3’09Q4’10Q1’10Q2’10Q3’10Q4Discharges 2011(average (less newborns) per month)’11Q1’11Q2’11Q3Source: AAMC Council of Teaching Hospitals (COTH), Quarterly Survey of Hospital Operations, 2011 Q449,038WinthropStonybrook33,85231,673South NassauBrookhavenSt. Francis’11Q44.64.2120001100010000900080005000040000300007,0006,00022,75120,83917,96970006000200005,0004,000’08Q4NSUH Manhasset’09Q1’09Q2Winthrop’09Q3Stony Brook’09Q4’10Q1South Nassau’10Q2NUMC’10Q3’10Q4St. Francis’11Q1’11Q2’11Q35000400010000’11’07 ’08 ’09 ’10 ’11Source: WinthropWinthrop Source: Nassau-Suffolk Hospital Council75th Percentile Teaching HospitalMedian Teaching Hospital 25th Percentile Teaching Hospital038Source: Nassau Suffolk Hospital Council, Hospital Statistics and Service Utilization Report, Dec. 2011

Winthrop-University Hospital 2011 Annual ReportBed CapacityType of BedNSUHManhasset Winthrop Stony Brook South Nassau NUMC St. FrancisAlcohol 0 0 0 0 20 0Burn 0 0 6 0 10 0Chem Dep Reh 0 0 0 0 30 0Med/Surg 635 471 402 355 222 364Neonatal 51 27 40 6 28 0Ob/Gyn 73 63 36 26 30 0Pediatric 27 30 50 12 32 0Psych 26 0 40 36 133 0Rehab 0 0 0 0 25 0Certified Bed Capacity 812 591 574 435 530 364PMS 5405PMS 5405PMS 542 PMS 542PMS 431 PMS 431PMS 618 PMS 618PMS 7419PMS 7419 PMS 563 PMS 563Winthrop is the second largest standalonehospital on LI.Source: NYS Department of Health websiteWUH Percentage WUH Percentage of Occupancy of Occupancy(based on (based available on beds) available beds)WUH DischargesWUH Discharges(less newborns) (less newborns)94.3% 94.3% 95.9% 95.9% 92.1% 92.1% 93.6% 93.6% 90.1% 90.1% 91.5%33,581 33,581 33,658 33,658 33,852 33,85291.5% 31,923 31,923 31,238 31,238 31,527 31,527’06 ’06 ’07 ’07 ’08 ’08 ’09 ’09 ’10 ’10 ’11Source: Winthrop Source: Utilization Winthrop Report Utilization Report’11 ’06 ’06 ’07 ’07 ’08 ’08 ’09 ’09 ’10 ’10 ’11 ’11Source: Winthrop Source: Utilization Winthrop Report Utilization ReportOccupancy rate remains high, as does the number of discharges. Winthrop continues to meet the needs of our growing community.39

Palmira M. Cataliotti, CPA, Senior Vice President and Chief Financial Officer“Fiscal stability isthe cornerstone of asuccessful hospital.At Winthrop, we considerthat fundamental truthin all we do. Ourfinancial strengthenables our caregiversand healers to deliver theextraordinary care forwhich Winthrop is sowell known.”

Winthrop-University Hospital 2011 Annual ReportLeadershipBoard of DirectorsChairman of the BoardCharles M. StrainPresident &Chief Executive OfficerJohn F. CollinsVice Chairmenof the BoardJoan CoxKevin T. CurranJohn H. TreiberSecretaryJames J. DalyTreasurerPalmira M. CataliottiDirectorsJohn F. Aloia, MDPeter C. BreitstoneJames F. CampbellChristopher J. CavallaroMaureen E. ClancyMark S. DavisSoraya GageMary Ellen GilganPaul E. Harnick, MDTheodora W. HootonHarry KasselKenneth Kaushansky, MDEric KrasnoffJohn T. LanePatrick K. LongJoseph L. MancinoJames F. McCannRonald H. McGlynnJohn D. MillerYvonne M. MowattDaniel L. Murphy*Nancy NammackRichard A. Newhouse, Jr.George PappasJeanne S. PidotShepard T. PooleHenry R. PupkeVeronica RenkenNicholas J. Rosato, Jr.Charles L. RuoffStephen RushmoreThomas E. SullivanHarriette P. ThayerEdward Travaglianti*deceasedHonorary DirectorsO. John Betz, Jr.George J. Farrell, Jr., Esq.John H. KrumpeJohn M. McCarthyJane Ann SmithAdministrationJohn F. CollinsPresident and Chief ExecutiveOfficerGarry J. SchwallChief Operating OfficerPalmira M. Cataliotti, CPA,FHFMASenior Vice President andChief Financial OfficerJohn F. Aloia, MDChief Academic OfficerMichael Ammazzalorso, MDChief Medical OfficerAlan M. Jacobson, MDChief Research OfficerGeorge P. RainerSenior Vice President, HumanResourcesMaureen Gaffney, RPAC, RNSenior Vice President, PatientCare ServicesBarbara L. Kohart-KleineSenior Vice President,AdministrationJames S. FlahertyVice President, AdministrationRichard Rivera, MPH, MT,LCLT, CHEVice President, AdministrationDennis W. Sheridan, MBA,FACHEVice President, AdministrationSolomon A. Torres, FACHEVice President, AdministrationJohn P. BroderVice President, External Affairsand DevelopmentJoseph BurkeVice President, Engineeringand FacilitiesJ. Edmund KeatingVice President, Marketing,Advertising and PublicRelationsStacey PfefferVice President,Human ResourcesValerie Terzano, BSN, MSN,CAN, NEA-BCVice President, NursingEd ChewensAssistant Vice President,Women’s and Children’sServicesBruce M. Cohn, JD, MPHVice President, RiskManagement and Legal AffairsAnn HanfordAssistant Vice President, CaseManagement and QualityMetricsJohn H. PfeiferAssistant Vice President,Materials ManagementRita Roberts, RN, CNORAssistant Vice President,Perioperative ServicesAmy WolinAssistant Vice President,Patient Financial ServicesCathy J. FordAssistant Vice President,Clinical Practice BillingSystemsTimothy C. ReillyAssistant Vice President,Financial Planning andReimbursementAnnette Marinaccio, CPAAssistant Vice President,Physician PracticeManagementMonica Santoro, RN,CPHRM, CPHQ, FASHRMAssistant Vice President,Patient Safety, Quality andInnovation and Chief QualityOfficerNicholas A. CasabonaChief Information OfficerMedical StaffLeadershipChief Medical OfficerMichael Ammazzalorso, MDChairmen and ChiefsAnesthesiologyJoseph Greco, MDChairman, Department ofAnesthesiologyArthur Cooperman, MDChief, Division of CardiacAnesthesiologyWalter Wiess, MDChief, Division of PediatricAnesthesiologyPaul Steinberg, MDChief, Obstetric Division ofAnesthesiologyBariatric and MinimallyInvasive SurgeryCollin Brathwaite, MDChief, Division of MinimallyInvasive and Bariatric SurgeryCardiologyKevin P. Marzo, MDChief, Division of CardiologyCarlos Montoya-Iraheta, MDChief, Division of PediatricCardiologyDental MedicineAndrei Barasch, DMD, MDSCChairman, Dental MedicineDermatologyPeter E. O’Neill, MDChief, Division ofDermatologyEmergency CareBarry Rosenthal, MDChairman, EmergencyMedicineEndocrinologyLawrence E. Shapiro, MDChief, Division ofEndocrinologyMariano Castro-Magana, MDChief, Division of PediatricEndocrinologyFamily PracticeFrancis L. Faustino, MDActing Chairman, FamilyMedicineGastroenterologyJames H. Grendell, MDChief, Division ofGastroenterology, Hepatologyand NutritionGeneticsMoris Angulo, MDChief, Division of PediatricGeneticsGeriatric MedicineIrving Gomolin, MDChief, Division of GeriatricMedicineGynecologyAnthony M. Vintzileos, MDChairman, Department ofObstetrics & GynecologyGeorge Lazarou, MDChief, Division of GynecologyChief, Division ofUrogynecologyEva Chalas, MDChief, Division ofGynecologic OncologyGabriel San Roman, MDChief, Division ofReproductive Endocrinologyand FertilityFarr Nezhat, MDDirector, Minimally InvasiveGynecologic SurgeryImmunologySteven Carsons, MDChief, Division ofRheumatology, Allergy &ImmunologyLuz Fonacier, MDHead of the Allergy Section,Division of Rheumatology &ImmunologyInfectious DiseaseBurke A. Cunha, MDChief, Division of InfectiousDiseaseLeonard Krilov, MDChief, Division of PediatricInfectious DiseasesDirector, InternationalAdoption ProgramInternal MedicineMark J. Corapi, MDChief, Division of GeneralInternal MedicineMedicineMichael S. Niederman, MDChairman, Department ofMedicine41

iver Care Ophthalmology Hepatitis C Kidney Center Hypertrophic Cardiomyopathy Dialysis Genetics Brain Cancer EndoscopEar, Nose & Throat Dental Medicine Cardiac Rehab Anesthesiology daVinci Robot Behavioral Health Imaging ServiceBreast Imaging CT Scan MRI Neuroradiology Nuclear Medicine PET Scan Maternity Radiation Oncology Radiology StrokUltrasonography Endocrinology & Metabolism Hepatology Weight Loss Chronic Pain Asthma Orthopaedics Nutrition GeriatricInfectious Disease ALS Nephrology Hypertension Neurology Arthritis Oncology Hematology Neuropathy Bariatric SurgerPhysical Therapy Children’s Health Angioplasty Critical Care Medicine CyberKnife Rheumatology Allergy Education Breast CanceSpinal Tumors Immunology Maternal-Fetal Medicine Cancer Care Ambulatory Surgery Cardiac Rehab Home Health CarReproductive Health Endocrinology Infertility Care COPD Urogynecology Research Neurosciences Pathology Alzheimer’s DiseasPulmonary Hypertension Surgery Diabetes Herniated Discs Oral & Maxillofacial Surgery Plastic & Reconstructive SurgerDigestive Care Urology Neuromuscular Disease Parkinson’s Disease Bed Wetting Hyperbarics Trauma Bereavement BlooWound Healing Disorders Neurosurgery Breast Feeding Pediatrics Atrial Fibrillation Breast Health Chronic Fatigue SyndromColitis & Crohn’s Disease Colon Cancer Pulmonary Emphysema Epilepsy Gallbladder/Disease Heart Care Pancreatic canceFamily Care Impotence Incontinence Inflammatory Bowel Disease Dystonia Lupus Lyme Disease Tourette Syndrome MelanomMemory Problems OB/GYN Menopause Spasticity Gastroenterology Men’s Health Parkinson’s Disease Sleep DisorderJoint Replacement Emergency Medicine Tremors Poisoning Pregnancy Prostate Cancer Heart Failure Kidney Disease Seizure DisorderSexually Transmitted Diseases Headaches Movement Disorders Open Heart Surgery Prostate Care Nuclear Cardiology Lung CanceSinusitis Dermatology Multiple Sclerosis (MS) Swallowing Disorders Neonatology Memory Disorders Cardiology Travel MedicinSports medicine Pain Management Vascular Surgery Osteoporosis Clinical Trials Childhood Cancer Liver Care OphthalmologHepatitis C Kidney Center Hypertrophic Cardiomyopathy Dialysis Genetics Brain Cancer Endoscopy Ear, Nose & Throaental Medicine Cardiac Rehab Anesthesiology daVinci Robot Behavioral Health Imaging Services Breast Imaging CT Scan Meuroradiology Nuclear Medicine PET Scan Maternity Radiation Oncology Radiology Stroke UltrasonographEndocrinology & Metabolism Hepatology Weight Loss Chronic Pain Asthma Orthopaedics Nutrition Geriatrics Infectious DiseasLS Nephrology Hypertension Neurology Arthritis Oncology Hematology Neuropathy Bariatric Surgery Physical TherapChildren’s Health Angioplasty Critical Care Medicine CyberKnife Rheumatology Allergy Education Breast Cancer Spinal TumorImmunology Maternal-Fetal Medicine Cancer Care Ambulatory Surgery Cardiac Rehab Home Health Care Reproductive HealtPulmonary Hypertension Surgery Diabetes Herniated Discs Oral & Maxillofacial Surgery Plastic & Reconstructive SurgerDigestive Care Urology Neuromuscular Disease Parkinson’s Disease Bed Wetting Hyperbarics Trauma Bereavement BlooWound Healing Disorders Neurosurgery Breast Feeding Pediatrics Atrial Fibrillation Breast Health Chronic Fatigue SyndromColitis & Crohn’s Disease Colon Cancer Pulmonary Emphysema Epilepsy Gallbladder/Disease Heart Care Pancreatic canceFamily Care Impotence Incontinence Inflammatory Bowel Disease Dystonia Lupus Lyme Disease Tourette Syndrome MelanomMemory Problems OB/GYN Menopause Spasticity Gastroenterology Men’s Health Parkinson’s Disease Sleep DisorderJoint Replacement Emergency Medicine Tremors Poisoning Pregnancy Prostate Cancer Heart Failure Kidney Disease Seizure DisorderSexually Transmitted Diseases Headaches Movement Disorders Open Heart Surgery Prostate Care Nuclear Cardiology Lung CanceSinusitis Dermatology Multiple Sclerosis (MS) Swallowing Disorders Neonatology Memory Disorders Cardiology Travel MedicinSports medicine Pain Management Vascular Surgery Osteoporosis Clinical Trials Childhood Cancer Liver Care OphthalmologHepatitis C Kidney Center Hypertrophic Cardiomyopathy Dialysis Genetics Brain Cancer Endoscopy Ear, Nose & Throaental Medicine Cardiac Rehab Anesthesiology daVinci Robot Behavioral Health Imaging Services Breast Imaging CT Scan Meuroradiology Nuclear Medicine PET Scan Maternity Radiation Oncology Radiology Stroke UltrasonographEndocrinology & Metabolism Hepatology Weight Loss Chronic Pain Asthma Orthopaedics Nutrition Geriatrics Infectious DiseasLS Nephrology Hypertension Neurology Arthritis Oncology Hematology Neuropathy Bariatric Surgery Physical TherapChildren’s Health Angioplasty Critical Care Medicine CyberKnife Rheumatology Allergy Education Breast Cancer Spinal TumorImmunology Maternal-Fetal Medicine Cancer Care Ambulatory Surgery Cardiac Rehab Home Health Care Reproductive HealtPulmonary Hypertension Surgery Diabetes Herniated Discs Oral & Maxillofacial Surgery Plastic & Reconstructive SurgerDigestive Care Urology Neuromuscular Disease Parkinson’s Disease Bed Wetting Hyperbarics Trauma Bereavement BlooWound Healing Disorders Neurosurgery Breast Feeding Pediatrics Atrial Fibrillation Breast Health Chronic Fatigue SyndromColitis & Crohn’s Disease Colon Cancer Pulmonary Emphysema Epilepsy Gallbladder/Disease Heart Care Pancreatic canceFamily Care Impotence Incontinence Inflammatory Bowel Disease Dystonia Lupus Lyme Disease Tourette Syndrome MelanomMemory Problems OB/GYN Menopause Spasticity Gastroenterology Men’s Health Parkinson’s Disease Sleep DisorderEndocrinology Infertility Care COPD Urogynecology Research Neurosciences Pathology Alzheimer’s DiseasEndocrinology Infertility Care COPD Urogynecology Research Neurosciences Pathology Alzheimer’s Diseas

WHITEYour Health Means Everything 259 First Street, Mineola, NY 11501516-663-0333 www.winthrop.orgPMS431