2020 Report to our Communities

es·sen·tial
/əˈsen(t)SHəl/ : of the utmost importance, indispensable, necessary
REPORT TO OUR
COMMUNITIES
20
20
A few of the 570 dedicated colleagues who provide SKILLED, SAFE, ESSENTIAL services. Every day.
Left to right: Samantha Morgan, Environmental Services Associate; Alyssa Peters, Dining Services Manager;
Judy Simmelink, Lab Med Tech; Rob Bruxvoort, Plant Operations Mechanic;
Laura Woelber, Senior Care Director of Nursing; Dr. James Clemens, Physician

skilled
THE RIGHT CARE ...
Caring leadership forms strong roots.
A message from CEO Marty Guthmiller
What does a “Report to our Communities” look like in a global pandemic? How
does one capture the essence of the heroic actions by caregivers? What does life
look like after COVID-19?
2020 has caused us to ask more questions than we can answer. We must force
ourselves to look beyond COVID to plan for a still less-than-clear future. Let’s start
by defining “community.” With employees from 38 zip codes and babies born
representing 33 zip codes, “community” must be defined – and viewed – more
broadly. We must embrace our role in the region and set a course accordingly.
Emerging from a pandemic, we must engage our communities in determining
Social Determinants of Health with even more fervor than before the existence of
the Novel Coronavirus. Housing, nutrition, fitness – and in short “wellness” – are
vital elements in not only fighting the coronavirus, but any virus. Keeping our
“engines tuned” mentally and physically is critical to our future collective health.
As we move beyond COVID and into 2021, please know that Orange City Area
Health System is here to care for you – for all the communities we serve – and
we will never take that privilege for granted.
As I have concluded each of our community briefings throughout the pandemic:
stay strong, stay vigilant, and stay healthy!
FISCAL 2020: A YEAR IN REVIEW
Health system revenue ......................... $ 74,684,361
Uncompensated care ........................... $ 19,428,554
Health system expenses ...................... $ 56,562,406
Non-operating revenue.............................. $ 944,095
Inpatients admitted.............................................. 826
Outpatient visits.............................................. 66,259
Surgical and endoscopy procedures................ 1,728
Radiology/imaging procedures ...................... 16,260
Marty is standing in front of
a tree planted behind our
Orange City health system
campus in memory of Randy
Jacobsma. The tree is a red
oak, and the plaque in his
honor includes the words
from Jeremiah 29:11.
Laboratory procedures ................................. 306,296
Births celebrated ................................................. 218
Emergency room visits ..................................... 4,037
Ambulance runs................................................... 487
Medical clinic visits......................................... 47,105
Home Health visits............................................ 8,151
Cafeteria meals............................................... 68,473
Average cost per day to operate OCAHS .... $ 154,965
20
NUMBER OF YEARS
Randy Jacobsma,
our board chair, served
Randy was a visionary. His
leadership on our Board of
Trustees was felt for his two
decades of service, and as
Chair since 2014. He had a
passion for the health of
those we serve, and was
never satisfied with the
status quo. We lost Randy
earlier this year from complications
of the Influenza
virus. He is missed greatly
by an organization he cared
deeply for. His mark on
Orange City Area Health
System will live on through
our strategic planning and
our continued pursuit of
excellence. We are grateful
for his life and commitment
to our mission.
FY 2020 health system expenses by category
Wages
and benefits
59%
Inpatient discharges by payor
Commercial
42%
Medicare
47%
38
zip codes
The number of communities
in which our employees live
Contracted services
19%
Utilities 2%
Supplies
and other
12%
Interest and
depreciation 7%
Uninsured and other
5%
Medicaid 6%

THE RIGHT CARE. THE RIGHT PLACE. THE RIGHT TIME.
he·ro
/hirō/: a person admired
for achievements and
noble qualities; one who
shows great courage
We took advantage of a late summer
morning to invite some of our stellar
staff to get outside and shoot a video
called “We care about you!”
Throughout the course of this past year, we heard countless stories about employees and entire
departments – from our hospital to housekeeping, surgery to senior care, physicians to physical
therapy – who stepped up to each new challenge and stepped in to help out wherever needed.
This wasn’t an easy year for healthcare personnel, folks. But it’s super easy to recognize our
super heroes. Skilled and compassionate. The right care at the right time at the right place.
“So thankful for the care I received while in the hospital. Every procedure was done with compassion
and respect in a professional manner. If I have to be in a hospital, I’ll always choose OCAHS.”
Patient comment from April surveys

safe
THE RIGHT PLACE ...
WHAT
COUNTS
Offering safety at the “right place”
Orange City Area Health System offers full-spectrum care
for people of all ages and health needs in the region. Our
Walk-In Clinic was opened to address after-hour medical
needs for non-life-threatening illnesses and injuries.
But being creative with “place” (and safety) this year
required more than opening this clinic off-campus at the
Holland Plaza – and then having to temporarily close
services there during the initial months of the COVID-19
outbreak.
When the pandemic hit this past spring, we quickly
converted a newly-renovated Medical Building on the
west end of our hospital campus (designed for specialty/
outreach services) into a “Well Clinic” to safely care for
people in need of essential services including prenatal/
obstetrics, immunizations, diabetes management,
behavioral health, and more. Our Hospers Medical Clinic
also served as a well clinic during that time. Acute
patients were safely cared for in our Orange City and
Mill Creek Family Medicine Clinics.
The completion of the expanded Medical Building came at an unexpected and opportune time: it served as
a “well clinic” during the height of the pandemic, providing a new, clean, and safe environment for well
patients during that challenging period of caring for people with varying health needs and concerns.
HERE?
CAN i
HAVE IT
$
700,000
APPROXIMATE AMOUNT
SPENT ADAPTING
SPACES, SUPPLIES,
AND STAFF TO SAFELY
CARE FOR PATIENTS
since March 15
4,508
NUMBER OF PATIENTS
TESTED FOR COVID-19
as of mid October
1,167
NUMBER OF TIMES
THE SKYTRON ROBOT
HAS BEEN USED TO
DISINFECT A ROOM
as of mid October
Going above and beyond for safety
Throughout this year, Orange City Area Health System
implemented a number of strategies and protocols to
help ensure the safety and comfort of our patients,
residents, families, and staff, and to respond rapidly and
appropriately to the ever-changing pandemic landscape
in Northwest Iowa. Initiatives include:
• Purchased and installed two Skytron disinfecting
“robots” that are used in various settings
• Purchased “analyzers” to process COVID-19 tests
on site more rapidly as needed
• Opened a Test Iowa site in our Occupational Health
clinic for walk-in active COVID-19 virus tests
• Implemented on-site testing for COVID-19 antibodies
• Implemented daily symptom/health condition screening for all health system staff
• Implemented regular testing of senior care staff
• Closed hospital and senior care campuses to visitors as deemed necessary; closed cafeteria to the public
• CEO provided regular community video briefings on social media
• Converted newly-renovated Medical Building to Well Clinic and utilized Family Medicine Clinic for acute patients

A personal COVID story
THE RIGHT CARE. THE RIGHT PLACE. THE RIGHT TIME.
-presented by Sandy and Dave Harmelink
We traveled to Arkansas, Des Moines, and Branson,
Missouri, the first week of March. COVID was just
starting to be an issue in the Midwest at that
time so when we got home, we decided to stay
home as much as possible. There was a middle
school and high school concert on March 12 that
we went to. Just a few days after that, schools
closed, including Northwestern College. We hosted
a student from Northwestern. She and one of her
friends needed a ride to the airport, so on March
17 we drove them to Omaha. We never left the
house after that. We both started having
symptoms the weekend of March 21, including
headaches, body aches, and fatigue.
The symptoms just kept piling on – no appetite,
intestinal issues, and Dave started showing signs
of confusion and was sleeping most of the time.
Our daughters and their families would visit us at
the family room window. We must not have
looked very good because they were getting
concerned. Dave was seen by doctors a couple
of times and was tested for COVID on March 30
– when he was also admitted to the hospital.
Sandy was sure she would be able to stay home so she could help care for Dave when he got home, but she was tested on
April 2 and needed to be hospitalized as well. Both of us were just plain miserable, terribly fatigued, and weak. Dave spent
five days in the Orange City Area Health System hospital, and Sandy a week.
We were #2 and #3 positive COVID cases in the area. Very little was known at the time about the virus. However, we cannot
say enough good about the compassionate care we received from Doctors Van De Griend, Hanson, Weber, and Laird in the
clinic, ER, and hospital – and also so many nurses and lab and X-ray techs. We would not want to miss any by naming them!
We were so concerned about them getting the virus, but they assured us they were taking all the necessary precautions for
their safety as well as ours and the rest of the hospital staff. After they had all their protective gear on, they looked like
people from the Twilight Zone! Dave had a nurse pray with him, and one afternoon Sandy had a sweet nurse come in and
share the scripture she had read in her quiet time. Both were very comforting and calming for each of us. After our discharge,
Dr. Weber followed up with video clinic visits. That was a great way for him to check up on us – and for us to ask questions
without having to go to the clinic.
We would also like to thank the Incident Command Team and hospital leadership. We learned later about the Incident
Command Team, who spent so many long hours gathering information, which was changing all the time, to help prepare the
entire staff in how to care for the COVID patients and keep the hospital itself safe from the virus.
We are so grateful for Orange City Area Health System!
“Absoutely a great experience from the nurses, doctors, anesthesiologist, and kitchen staff.
This will always be our hospital of choice. We were well respected by everyone.” From June patient surveys

essential
THE RIGHT TIME ...
Essential services by essential staff.
Our over 570 employees serving in the hospital, four clinics, physical therapy centers, sports
medicine clinic, behavioral health clinic, senior care campus, and home health and hospice
live in 383 different communities and represent 153 different positions. Our “20 Year Club”
celebrates a membership of 88 individuals.
$
23,948,239
GROSS ANNUAL WAGES (fiscal year 2020)
$9,646,244
BENEFITS COSTS
Our Core Values
Our Core Values of Integrity, Commitment
to Excellence, Dedicated Colleagues, and
Extraordinary Customer Experience define
our culture at Orange City Area Health
System. These values embody and guide
our daily behaviors, and our employees
apply these in how we interact with patients,
residents, visitors, and co-workers.
Internally, we have a Values program
that reinforces and recognizes employees
for exhibiting our Core Values. Employees
are able to give “Values Coupons” to thank
fellow co-workers for displaying behaviors
and performing actions that exemplify our
Core Values. Here are some examples of
recent Values Coupons:
193
VOLUNTEER PARTNERS
17,524
VOLUNTEER HOURS
SERVED IN 2018
574
NUMBER OF ORANGE
CITY AREA HEALTH
SYSTEM EMPLOYEES
from 38 communities
0.0
NUMBER OF EMPLOYEES
FURLOUGHED/LAID OFF
DURING THE PANDEMIC
$
36
MILLION
HEALTH SYSTEM IMPACT
ON LOCAL ECONOMY
95 %
OF PATIENTS INDICATE
THAT THEY WOULD
DEFINITELY RECOMMEND
ORANGE CITY AREA
HEALTH SYSTEM
“You stayed past your shift to sit with a resident
who had fallen and waited on the
floor with her until the ambulance arrived.
Then even after all of that you answered
call lights because all the other aides were
in rooms.”
“You willingly came in on your day off,
which happened to be your birthday as
well, to assist in surgery on a busy day.”
“You willingly went on a challenging visit
when you were not on call, but you wanted
to be sure a new nurse had the support
and skills to become a great Hospice
nurse moving forward.”

Seated, front to back:
Randy Jacobsma, Chair •Brenda Richardson, Secretary
Russ Adams • Kathy Alons
“We had a wonderful birth and postpartum experience at OCAHS. The renovations in the birth
center are great, and I really appreciated the bigger tub in the delivery room. We felt very well
Standing, left to right:
Chris Immeker • Jerry Henrich • Tim Zeutenhorst, Vice Chair
THE RIGHT CARE. THE RIGHT PLACE. THE RIGHT TIME.
Expanding spaces and services to meet needs ... in unprecedented times
Caring for babies – from conception through pregnancy, birth, and
after the special delivery – has always been an important privilege
and aspect of care at Orange City Area Health System. A safe birth –
for both baby and mom – is our highest priority. Our next priority
when it comes to birthcare is to provide a personalized experience
in a comfortable and pleasant environment for the entire family to
celebrate the new arrival. These priorities – combined with skilled and
compassionate hospital staff – have resulted in annual births in the
low to mid 200’s, representing families from 33 zip codes in the region.
To continue to serve our obstetrics patients in this manner, the
health system recently renovated our Birth Center. The $1.5 million
project was completed in March 2020. There are three primary
elements to the Birth Center expansion and renovation.
First, we added a third labor and delivery room to accommodate
the increased number of births in our hospital. All of our labor and
delivery rooms have a fresh look and appreciated amenities including
a whirlpool tub, a large screen “entertainment” center, and a
sleeper sofa for the new mom’s partner.
The second modification was enhancing security to the Birth Center.
Access to the wing is secured, and visitors are required to check
in at the hospital nurse’s station.
Third, the entire Birth Center received a “facelift” – with new flooring, furniture, wall coverings,
and a comfortable, bright, convenient family area with a nourishment center.
These renovations, combined with our culture of extraordinary patient care, and skilled
physicians and support staff, provide an exceptional and memorable birth care experience.
Another significant renovation and expansion completed just prior to the coronavirus pandemic
is in the Medical Building located at the west end of our main campus, adjacent to our Physical
Therapy and Occupational Health clinics. This nearly $2 million project includes an additional
6,000 square feet of medical clinic space, and renovation of existing spaces. Its primary use is for our “outreach” or specialty
clinic services, including oral surgery, ophthalmology, cardiology,
dermatology, maternal-fetal medicine, occupational medicine, and
more. In addition to 18 exam rooms and four procedure rooms, the
new Medical Building construction includes four
“sleep rooms” for staff to use when an overnight stay is required.
This new clinic space incorporates artwork featuring Northwest
Iowa imagery, including rural scenes and native flowers.
Both of these renovation and expansion projects augment our
commitment to providing skilled, safe, and essential services …
the right care at the right place at the right time … for patients
and families in our region.
218
NUMBER OF BABIES
BORN IN FISCAL 2020
from 33 communities
taken care of and safe during this coronavirus pandemic.” Patient comment from April surveys

2020 Report to our Communities
BEHIND THE SCENES. IN THE TRENCHES.
HICS: an incident
management system
which assists hospitals and
healthcare organizations in
improving their emergency
management planning,
response, and recovery
capabilities for unplanned
and planned events.
The year 2020 didn’t start on March 15. But doesn’t it feel like that? When the pandemic
hit in mid-March, life took a topsy-turvy turn for almost everyone. But perhaps nowhere more
than in healthcare. One of the first things we did was to initiate “Incident Command.” The
Hospital Incident Command System (HICS) is simply a standardized approach to managing
complex incidents. Is Covid-19 complex? I think we can all agree on that! The core of our
HICS team worked hard for months making major adjustments to the way we care for
patients, residents, and staff. From hard decisions like closing our senior care campus and
hospital cafeteria to visitors ... to creating “negative pressure” rooms in our hospital ... to
moving personnel into different roles as needed ... to establishing a LOT of protocols for
safety and response ... this team met regularly and communicated diligently to our employees
and the communities we serve. Pictured are our HICS heroes, back row left to right: Chief Executive Officer Marty Guthmiller, Clinic
Director Steve Walhof, Chief Operating Officer Dan McCarty (now retired), and Chief Medical Officer Dr. Alan Laird. Front row: Director of
Patient Care Laurie Gebauer, Occupational Health and Walk-In Clinic Manager Liza Schouten, and Director of Quality Jeanne Jungers.
Medical clinics in Hospers, Orange City, and Paullina
Walk-In Clinic in Orange City
Main campus clinic/hospital/birth center/surgical center:
1000 Lincoln Circle SE, Orange CIty Iowa 51041
712.737.4984 • ocHealthSystem.org
5,500
NUMBER OF HOURS
THE HICS TEAM MET
FROM MID MARCH TO
MID OCTOBER
Orange City Area Health System is a comprehensive health system encompassing three family medicine clinics, a walk-in clinic, emergency medicine, sports medicine clinic,
behavioral health clinic, award-winning hospital, birth center, surgical center, radiology and laboratory services, occupational health services, specialty outreach services,
physical and occupational therapy, home health and hospice, a retirement community, and a senior care center. The health system campus – designed with privacy and total
healing as its foundation – is situated on 37 acres, including a pond with fountain, a healing garden, and a field of prairie grasses and wild flowers adjacent to the PuddleJumper
Trail. A team of family medicine providers, along with dedicated nurses, medical specialists, and 500 support staff, are committed to serving the region with the Core Values of
Integrity, Commitment to Excellence, Dedicated Colleagues, and Extraordinary Customer Experience. Orange City Area Health System has been recognized as a Press Ganey
Guardian of Excellence in Patient Experience award winner; one of the Top 20 Critical Access Hospitals in the nation; one of Becker’s Hospital Review’s “62 Critical Access
Hospitals to Know” in the U.S.; a National Organization of State Office of Rural Health’s top performer in Patient Satisfaction; A CMS five-star hospital for patient experience;
and a Women’s Choice Award recipient for Outstanding Patient Experience for six consecutive years.