Delnor Community Benefits Report for 2010 - Delnor Hospital

Delnor Community BenefitsPlan and Report for 2010Delnor Hospital300 N. Randall RoadGeneva, IL 60134

2Delnor is an Illinois not-for-profit corporation along with its affiliates:• Delnor Hospital, a 159-bed acute-care hospital• Delnor Foundation• Delnor Glen Senior Living• Living Well Cancer Resource Center• Delnor Health & Wellness Center• DelCom Medical Practice ManagementDelnor also owns or operates medical office buildings on the hospital campus in Geneva, and in St.Charles, Batavia, Elburn and Sycamore.Mission and ValuesMission Statement:To provide excellence in health care and to promote lifelong wellness in the communities we serve.Values:Compassion, Respect, Integrity, Service and ExcellenceIdentifying Community NeedsThe programs and services provided by Delnor are based on the medical and health and wellness needsof the communities served. The hospital determines those needs and develops plans and strategies toaddress them through its strategic planning process, operational plans developed by all hospitaldepartments, and as a result of a community health needs assessment that was conducted and reviewedby a committee formed specifically for that purpose.Populations and Communities Served by the HospitalDelnor primarily serves the residents living in the following Illinois communities: Geneva, St.Charles, Batavia, Elburn, Wasco, LaFox, Kaneville, South Elgin, Elgin, North Aurora, Aurora, SugarGrove, West Chicago, Wayne, Maple Park, Sycamore and DeKalb.Residents who live in Delnor’s service area have the following demographic characteristics:• The median age is 35 in the primary service area and 33 in the secondary service area,compared to a national median age of 36.• The median household income is $88,337 in the primary service area and $70,433 in thesecondary service area, compared to a national median of $54,719.• The percentage of the population 25 years and older who have attained a bachelor’s degreeor higher in Delnor’s primary and secondary service areas is 42% and 33% respectively,compared to a national average of 27%.• The racial distribution of the Kane County population is:o White: 392, 672o African-American: 31,638o Asian: 12,058o American Indian: 1706o Multiple Race: 14,307o Pacific Islander: 216o Other: 70,641

3Health Indicators for the Population ServedLeading Causes of Death in Illinois• Diseases of the Heart• Malignant Neoplasm• Cerebrovascular DiseaseTop Reasons for Hospitalization in Delnor’s Service Area• Pregnancy/Newborn• Psychoses• Major Joint Replacement• Esophagitis, gastroenteritis and other digestive disorders• PneumoniaTop Reasons for Patient Visits to Delnor• Children and Adolescents: injury, asthma, infectious disease, anemia• Adults: pregnancy, chest pain, cardiac related diagnoses, asthma, diabetes• Elderly: diabetes, cardiac related diagnoses, pneumoniaCommunity Needs AssessmentIn 2007, Delnor conducted a comprehensive health needs assessment for its service area. In orderto complete this assessment, Delnor engaged Professional Research Consultants to surveycommunity members, conduct secondary research on the incidence of disease in the service area,and facilitate focus groups to elicit further community health needs. The compiled study resultswere compared to Healthy People 2010 goals, and health priorities in the service area that needattention were identified. A Community Benefits Task Force was created, comprised of HospitalLeadership, Physicians and Board Members to review the survey data and existing services andresources within the community and make recommendations on Community Benefits Tactics.Based on the needs assessment and an ongoing review of the health indicators of the populationwe serve, the Community Benefits Plan for the current and upcoming years has been developed.An updated comprehensive health needs assessment will be completed during Fiscal Year 2011.This assessment will be conducted by Northern Illinois University, and will be a coordinated effortwith the Kane County Health Department and the other hospitals within the county. The results ofthe needs assessment will be evaluated by the Community Benefits Task Force and theCommunity Benefits Plan will be revised as needed to address the health needs of our community.Community Benefits Report for 2010Community Benefits Plan Objectives Provide access to care for the uninsured, the underinsured, and those in financial need Improve the health status of area residents by providing education, screenings and other resources Continue to provide needed clinical services and facilities to meet the medical/health care needs ofthe service area

4Strategies to Achieve Community Benefits Plan ObjectivesProvide access for the uninsured, the underinsured, and those in financial needCharity CareDelnor Hospital recognizes that community members have varying abilities to pay for thehealthcare services they receive. Delnor has developed a progressive charity care policy thatmeets or exceeds various recommended guidelines in the industry (such as those put forth by theAmerican Hospital Association, Metropolitan Chicago Healthcare Council and the AttorneyGeneral’s Office of Illinois). The goal of Delnor’s Financial Assistance Program is to identify alleligible patients who may qualify for assistance. Delnor employs three full-time financialcounselors who assist patients in determining their eligibility for charity care and guide themthrough the process. For those who qualify, financial assistance is provided for up to 100% of thepatient’s bill. Eligibility is determined based on the poverty guidelines established by the U.S.Department of Health and Human Services and adjusted by the Medicare regional wage index.Delnor also has a catastrophic illness policy that protects patients from having to pay medical billsthat exceed 30% of their annual income.Government Sponsored Indigent CareDelnor accepts and treats Medicaid patients and all patients requiring emergent care regardlessof their ability to pay. Financial counselors proactively identify patients that may be eligible forcoverage in a government sponsored indigent care program. Once identified, the counselorsassist eligible patients in completing the necessary forms to apply for coverage. Delnor alsoemploys an outside company that assists patients with this process.In addition, the hospital has four specially-trained community volunteers (through the SeniorHealth Insurance Program) who provide Medicare counseling to individuals in our community. Allof these services are provided free to patients.Additionally, the hospital refers appropriate patients in financial need to Tri-City HealthPartnership, a free medical clinic supported by Delnor that provides primary care services. Delnornurses and physicians on the hospital’s medical staff volunteer their time at the clinic. Tri-CityHealth Partnership refers patients to Delnor for diagnostic testing and other outpatient services atno charge to the patient, and coordinates with Delnor to provide on-site reference lab testing forpatients.Hospital Patient Advocate ProgramDelnor employs patient advocates to provide a wide range of free assistance to hospital patientsand their families during and after their stay. This support ranges from answering questions aboutthe hospital to addressing the family member’s concerns about the care that their loved onesreceive. In FY2010, Delnor served more than 2400 patients and family members through thisprogram, at a cost of $70,558.Access to TransportationDelnor helps homebound individuals and others who lack transportation with access to a freeHealthRide service which transports eligible patients with round-trip transportation to and from thehospital for outpatient services. Requests for transportation increased steadily throughout theyear, and in 2010, the hospital provided 8943 rides at a cost of more than $199,072, which was a30% increase from 2009. Delnor was able to meet the challenge of increased requests whilemaintaining costs through a process improvement initiative that allowed for improved schedulingof routes and pick-ups.

5Vaccines for ChildrenDelnor works closely with several service agencies, including the Kane County HealthDepartment (KCHD). One of KCHD’s largest programs was the Bee-Wise Immunize program,which provided Vaccines for Children (VFC) immunizations. VFC is a federally funded programsponsored by the Centers for Disease Control and the Illinois Department of Public Health. Itprovides free vaccines for children 18 years of age and younger. Eligibility for benefits under theVFC program are: 1) Medicaid coverage, 2) no health insurance or 3) underinsured. In 2009,KCHD announced their immunization program was in grave danger of being cut due to hugebudget deficits, and they issued a plea for help to Kane County healthcare providers, includingthe 5 hospitals located within the County. Delnor embraced the opportunity meet this criticalneed in our community, despite our lack of experience in running a VFC Clinic. After meetingwith KCHD personnel and IDPH, Delnor put the procedures in place to offer a vaccine clinic onsiteat the hospital. This was a significant undertaking and required the development of policiesand procedures, training of staff, and the implementation of the clinic logistics prior to holding thefirst vaccine clinic in November, 2009 to 13 eligible children. In less than 1 year, the cliniccapacity has increased to 55 children per clinic. In FY2010, 1094 vaccinations were provided tochildren in need.Improve the health status of area residents by providing free or low cost healtheducation programs, screenings and other resourcesCommunity Health and OutreachDelnor provides extensive programs and services to members of the community through amultidisciplinary team of health care professionals. Delnor continues to provide a dedicatedCommunity Health and Outreach Department at a cost of more than $574,000 annually.The department offers access to a comprehensive array of free or low-cost medical, health andwellness lectures, classes, special events and exercise sessions available. The programs andservices offered through the department are provided by nurses, certified teachers, personaltrainers and physicians. Exercise programs are offered that have been specifically designed forseniors, individuals with multiple sclerosis, arthritis, fibromyalgia, and children with neurologicaland orthopedic conditions. Free or low-cost group education classes are available as well forweight loss, smoking cessation and babysitting instruction. In addition, a full line of maternal/childeducation programs are offered, including classes that will support patients in getting the bestprenatal care.Delnor offers free screenings to the community for heart disease, osteoporosis, blood pressure,colorectal cancer, skin cancer, prostate cancer and hearing loss.In addition, hospital professionals and physicians frequently conduct free presentations andprograms for local residents through the Hospital’s Speaker’s Bureau Program and otheroutreach programs. Programs are based in local agencies and schools throughout the servicearea.Community Health Fairs and Support of Community OrganizationsDelnor participates in a number of health fairs and community festivals each year to makehospital and health information and resources as convenient and accessible as possible formembers of the communities served. The hospital also generously supports a wide range ofcommunity groups and civic organizations. In 2010, the hospital participated in 10 communityhealth fairs and festivals and supported many groups and organizations, at a cost of $18,000.

6Living Well Cancer Resource CenterLiving Well’s purpose is to inspire and empower people living with cancer and their loved ones.They are currently providing more than 30 programs and services that focus on three initiatives:education, emotional support and mind/body fitness activities. All programs and services areprovided free of charge. In 2010, these services were provided at a cost of $886,498.Continue to provide needed clinical services and facilities to meet themedical/health care needs of the service areaA Strong Investment in Meeting Current and Future Needs:The most significant demographic factor impacting the medical and health care needs within ourservice area is the rapid growth in population, coupled with the aging of the “baby boom”generation. The 65+ age cohort grew 20% from 2005-2010, and the 45-64 age group grew 24%,and the demand for health care services of all types, particularly inpatient care, is expected tocontinue to increase. As a result, one of Delnor’s most pressing priorities has been and willcontinue to be expanding its services and facilities.In 2010, Delnor Express Care immediate carecenters opened in Batavia and South Elgin, providing area residents with a convenient and costeffective option for the treatment of minor illnesses and injuries. In 2008, Delnor completed athree-story addition to the hospital with private patient rooms on the 2 nd and 3 rd levels. The firstfloor and lower level accommodates additional outpatient and support services. The additionalpatient rooms have assisted in addressing the area’s rapid population growth and demand forinpatient care. Delnor also continues to offer services to meet the needs of our community,including a comprehensive pain management center and a wound treatment center whichprovides clinical care for patients with wounds that have not responded to conventional treatment.Resource Hospital for Emergency Medical Services and Paramedic TrainingIn keeping with our commitment to providing high quality emergency medical services, Delnor haslong served as the resource hospital for the Southern Fox Valley Emergency Medical System(EMS) network. EMS is a system of services organized to provide rapid response to seriousemergencies, including medical care and patient transport to definitive care at an appropriatemedical facility. The regional program coordinated by Delnor provides continuing education for1200 paramedics and other personnel. In 2010, Delnor’s cost for this initiative was $292,708.2011 Community Benefits PlanIn 2007, the Community Benefits Task Force was created to review the community health needsassessment and to determine further strategies to achieve the identified Community Benefits Planobjectives. In addition to the continuation of the above listed initiatives and programs, Delnor hasdeveloped strategies to further address the needs of our community. Each of these strategies willcontinue to enhance the portfolio of community benefits that Delnor will offer in 2011.

7Provide access for the uninsured, the underinsured, those in financial needConnecting to CareThere are over 13,000 individuals in our service area who do not have health insurance coverage.In addition, many more residents have limited access to specialty care resources, includingspecialty physician care. Delnor has developed an innovative approach to this situation by workingwith Tri-City Health Partnership to link patients with the specialty care they need. Delnor also plansto work collaboratively with specialty physicians to care for referred patients.Program Goal:(1) Decrease the number of residents in the Delnor Primary Service Area (PSA) thatindicate that they had difficulty accessing healthcare from 29.2% to 20% by 2011 asmeasured by the community health needs assessment.Improve the health status of area residents by providing free or low cost healtheducation programs, screenings and other resourcesHealthy Families. Healthy Kids.Childhood obesity is an increasing epidemic within our primary service area. The Centers forDisease Control has reported that 24.9% of children in Illinois are overweight. Community healthneeds assessment data also suggest that children in our service area are not eating therecommended amounts of fruits and vegetables and are not engaging in the recommended amountof physical activity. Delnor has developed an innovative program for children and their family thatfocuses on how to exercise, eat and communicate in a healthy way. This program is facilitated byeducation specialists, dieticians, mental health providers, and fitness professionals.In addition to the on-site program for children in our community, Delnor has received grant fundingto create a coalition to address policy opportunities to improve the health of our children. In May,2009, the Fit4Kane Coalition was formed, and a comprehensive assessment of our builtenvironment was completed. The assessment data has been used to assist agencies within ourcommunity in implementing programs and policy changes to contribute to a healthy community.Program Goals:(1) Reduce the age-adjusted diabetes death rate per 100,000 population from 27.1 to24.0 by 2011 as measured by the IDPH Database for Kane County and State Data.(2) Increase the number of children eating the recommended amount of vegetables perday from 35.8% to 50% by 2011 as measured by the community health needsassessment.(3) Increase the number of children meeting physical activity recommendations from55% to 65% by 2011 as measured by the community health needs assessment.Cuff ‘Em! Blood Pressure Checks for AdolescentsStudies have shown an increase in undiagnosed high blood pressure in children and adolescents.This has also been tied to the increase in obesity among children, which can lead to serious healthproblems later in life. Furthermore, community health needs assessment data also indicates thatmany children have not had their blood pressure checked in the previous year. Delnor is working topartner with school systems in the primary service area to provide blood pressure screenings andeducational programs to local high school students.Program Goal:(1) Increase the number of children that have had their blood pressure checked in thepast year from 94.4% to 98% by 2011 as measured by the community health needsassessment.

8Senior Vitality: Stroke Risk AssessmentSeniors and those caring for them represent a significant portion of Delnor’s service area. Focusgroup feedback has identified a clear demand for more health-related resources within thecommunity for this population. Stroke is also a significant health concern and leading cause ofdeath in our community. Delnor has developed a stroke risk assessment and education program toincrease awareness and provide education on the risk factors that contribute to a stroke. Thisprogram is the only one of its kind in Delnor’s service area.Program Goal:(1) Reduce the age-adjusted stroke death rate per 100,000 population from 58.8 to 53.8by 2011 as measured by IDPH Database for Kane County and State Data.Continue to provide needed clinical services and facilities to meet themedical/health care needs of the service areaChronic Disease Management After DischargeAdherence to a prescribed medication and at-home management protocol is essential in the controlof chronic illness. One determining factor of whether or not a patient will stick to their plan of care athome is health literacy; the ability to maintain, process and understand health services in order tomake appropriate health decisions. Delnor has proposed a program to connect with patientsadmitted with a diagnosis of Congestive Heart Failure while they are in the hospital and to ensurethat they understand the medications and treatment that has been prescribed. Patients then will beprovided support after discharge to ensure ongoing compliance.Program Goals:(1) Decrease hospital readmission rate in Congestive Heart Failure patients from 26.7%to 19% by 2012 as measured by hospital readmission data.(2) Decrease overall hospital readmission rate from 8.1% to 6% by 2012 as measured byhospital readmission data.

9Community Benefits Expenses: Fiscal Year 2010Charity Care (Policy Attached)Delnor Hospital’s Cost of Charity Care $3,668,178Total Charity Care: $3,668,178Bad DebtsDelnor Hospital’s Cost of Bad Debts $2,553,405Total Bad Debt: $2,553,405Language Assistant ServicesPhone Line Assistance $27,750Medical Interpreters for the hearing impaired $9,178Total Language Assistant Services: $36,928Government-Sponsored Indigent Health CareMedicare Shortfall $28,946,446Medicaid Shortfall $8,748,276Total Government Sponsored Indigent Health Care: $37,694,722DonationsCommunity Programs Funded by the Delnor FoundationPrograms funded by the Delnor Foundation $40,000Donations to Support Community Groups, Causes and Health FairsDelnor donations to and/or participation in community health fairs, festivals,causes and organizationsDelnor employee donations to charitable causes (American HeartAssociation, American Cancer Society, Multiple Sclerosis Society, RedCross, Food Bank, and more)$18,000$19,299Donations of Supplies and Equipment to MissionsCost of supplies donated to missions $197,919Total Donations: $275,218Volunteer ServicesVolunteers (Non-Employees): 64,748 Hours $517,984Total Volunteer Services: $517,984

10EducationHealthcare Student Training: Staff cost to provide clinical setting,orientation and support to healthcare students for hospital-based internshipsand clinical rotationsOperating Room: Staff cost for education provided for nursing, paramedic,respiratory therapy, and physical therapy studentsContinuing Medical Education(CME): Cost to provide CME programs forphysicians$584,580$23,550$38, 425Total Education: $646,555ResearchClinical trials for cancer patients $58,500Subsidized Health ServicesInpatient & Outpatient Specialty Services Yielding a Financial Loss*Inpatient ServicesTotal Research: $58,500FY2010FinancialLossObstetrics, Neonatology and Normal Newborns $4,591,531Behavioral Health $191,578Cardiac Services $288,671Neurosurgery $70,074Thoracic Surgery $52,769Gynecology $239,611Urology Surgery $105,899Outpatient ServicesFY2010FinancialLossDiabetes Education $120,858Cardiac Cath $150,952Cardiac Rehabilitation $394,578Pulmonary Rehabilitation $36,056Wound Care Therapy $58,909Psychological Services $80,514Perinatology Services $939,553Genetic Counseling $24,615Total Inpatient & Outpatient Services Yielding a Financial Loss $7,346,168*Excluding Medicare, Medicaid and Bad DebtCommunity Health EducationOperating cost for Community Health and Outreach Department (net ofrevenue)$518,088Maternity and Infant ServicesHome care visits $42,975Breastfeeding and Post-Partum Support Groups $6,790Car Seat Safety Checks $5,512Scholarships for Childbirth Education Class $815

11HealthRideHealthRide (a program providing free transportation for patients to and fromthe hospital)$199,072Physician Referral ServicePhysician Referral Service for the Community $71,500Total Subsidized Health Services: $8,190,920Other Community BenefitsLivingWell Cancer Resource CenterOperational expenses for the LivingWell Cancer Resource Center $886,498Hospital Patient Advocate ProgramPatient Advocate Program providing free assistance to patients and theirfamilies with a wide variety of needs during and after their hospital stayResource Hospital for EMS and Paramedic TrainingHospital expense associated with being the Southern Fox Valley resourcehospital for coordinating emergency medical services and paramedic trainingand continuing education$70,558$292,708Total Other Community Benefits: $1,249,764Total Community Benefits Expenses: $54,892,174