Delivering on the promise of a healthier future

Delivering on the promise of a healthier future Annual Report 2013 Lancaster General Health Leadership AS OF september 2013 Lancaster General Healt...
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Delivering on the promise of a healthier future

Annual Report 2013

Lancaster General Health Leadership AS OF september 2013 Lancaster General Health is a not-for-profit health system led by community and business leaders from throughout Lancaster County. They volunteer their time and expertise, and provide vision to ensure that the healthcare services we deliver reflect the values and traditions of the communities we serve.

Lancaster General Health Board of Trustees Thomas E. Beeman, PhD Rebecca S. Bumsted F. Nicholas Grasberger Alexander Henderson, III, Esq. Keith R. Kuhlengel, MD Joanne B. Ladley Robert F. Latshaw, MD Bruce R. Limpert C. Clair McCormick Lori Pickell Charles H. Rodenberger, MD Carolyn F. Scanlan Michael W. Van Belle Philip R. Wenger Patrick D. Whalen

T. Raymond Foley, MD President, Physician Services Gary R. Davidson Senior Vice President and Chief Information Officer Lee M. Duke, II, MD Senior Vice President and Chief Physician Executive Geoffrey W. Eddowes Senior Vice President, Post Acute Care

Robert P. Macina, Esq. Senior Vice President, Chief Administrative / Legal Officer and Corporate Secretary

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B uilding a personalized network of care that helps patients become more knowledgeable and accountable for their health and well-being. We want to keep people well, not just treat them when ill.

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E nsuring our patients’ needs remain our primary focus and the care we deliver is coordinated and effective.

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E nsuring our health system is fiscally sound and can effectively adapt to a changing environment.

Regina M. Mingle Senior Vice President and Chief Leadership Officer Karen Flaherty-Oxler Senior Vice President, Hospital Operations / Chief Nursing Officer Joseph A. Puskar Senior Vice President, Customer Support Services Susan Wynne Senior Vice President, Business Development Jay R. Bucher Vice President, Development

We introduced new services and technologies that improved our clinical effectiveness; were recognized nationally for our quality and safety; and developed new models of care and partnerships that position us for the future.

Margaret F. Costella, Esq. Vice President, Legal Services and Assistant Secretary Lisa R. Hess Vice President, Marketing and Relationship Management

C. Clair McCormick Chairperson

Elizabeth D. Hills Vice President, Risk Management and Corporate Compliance

Philip R. Wenger Vice Chairperson

Denise A. Kennedy Vice President, Financial Services

Thomas E. Beeman, PhD President and Chief Executive Officer of LG Health

Edward Maloney Vice President, Information Technology Operations

Jan L. Bergen Executive Vice President and Chief Operating Officer

Mary B. Miskey Vice President, Human Resources Operations

Marion A. McGowan, RN Executive Vice President and Chief Population Health Officer

Douglas W. Rinehart Vice President, Controller

On the cover: In 2013, Lancaster General Health’s Ann B. Barshinger Cancer Institute became the first in the country to offer the next-generation CyberKnife® M6™ System. This state-of-the-art radiation therapy system brings new hope to patients with tumors that are too large or too complex to be removed surgically.

Over the past year we have made steady progress in advancing our three strategic priorities:

Norma J. Ferdinand Senior Vice President, Chief Quality Officer

Officers

Dennis R. Roemer Executive Vice President and Chief Financial Officer

Healthcare reform is changing the way we deliver care locally, and across the nation. However, long before the passage of the Affordable Care Act, Lancaster General Health was making preparations – exploring innovative solutions, new markets, expanded services and effective partnerships – all focused on our Vision of delivering on the promise of a healthier future.

F. Joseph Byorick Chief Financial Officer Emeritus and Treasurer

Christine M. Stabler, MD Vice President, Academic Affairs Kay Brady Vice President, Human Resources

Innovative Leadership

Message to our community

C. Clair McCormick Chairperson, Board of Trustees Lancaster General Health

Thomas E. Beeman, PhD, FACHE President & CEO Lancaster General Health

LG Health will continue to undergo a complex and challenging transformation. Our success will not be measured by how many people we treat, but by how well we keep people healthy. We will form new relationships and partnerships with payers, innovative companies, and like-minded providers, who can help us deliver on our Vision. We will continue to educate and guide people to become more engaged in their own health, and pursue new ways to decrease costs and enhance quality. Our Vision calls for the continued transformation of an indispensable community asset on which many lives and livelihoods depend. We believe the course we are establishing, along with your support, will assure our transformation meets the evolving needs of the communities we serve.

Planting seeds for a healthier community A healthy community begins with healthy habits. Data from the PA Department of Health suggests 64 percent of adults and 54 percent of youth in Lancaster County are overweight or obese. This means more than a quarter million of our neighbors are at greater risk for diabetes, heart disease, cancer and other chronic conditions. Through education, advocacy and action, Lancaster General Health and our partners are fighting the obesity epidemic, engaging people of all ages, in every corner of our communities, to adopt behaviors that lead to healthier living.

Making healthy easy

Keeping people healthy

This year, we continued to advocate for walkability and bikeability throughout the county, making it easier for people to be more active.

We’re transforming healthcare with the Patient-Centered Medical Home model at Lancaster General Health Physicians Family Medicine practices. The goal is to keep patients healthy through preventive care and management of chronic conditions like diabetes and heart disease.

With a wide range of health and wellness classes and initiatives, and easy-to-remember messages like 5-2-1-0, we’re offering guidelines on nutrition, physical activity, and healthy lifestyle practices. n

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Eat 5 or more servings of fruits and vegetables per day Spend no more than 2 hours a day in front of a screen (TV, computer, phone, video games, tablet) Get at least 1 hour of physical activity per day Drink almost no sugary beverages (soda, sports drinks, juice)

Innovative Programs

More than 66,500 patients have enrolled in MyLGHealth (MyLGHealth.org) and are now accessing personal health information, connecting with their doctors’ offices, and managing their health online.

We’re not afraid to get our hands dirty. In fact, we recommend it. Our teaching gardens are currently providing hands-on experiences for students in local elementary schools like Wickersham Elementary, and female inmates at Lancaster County Prison.

These real-life laboratories are opportunities to share the basics of gardening and nutrition, along with the value of fresh foods and how to process and eat them. Healthy Shopping Tours, conducted by LG Health registered dietitians, guide participants through the aisles of local grocery stores where they learn to compare food labels and make healthier choices.

Technology driven Patient focused

Inspired by cancer patients, survivors and their families, the Ann B. Barshinger Cancer Institute at Lancaster General Health opened its doors on July 8, 2013, redefining cancer care in the communities we serve. From the tranquil healing garden to advanced diagnostic and treatment technology, every feature contributes to patients’ physical, emotional and spiritual well-being. An extensive care team surrounds patients with multidisciplinary expertise and personalized nurse navigation. Our long-standing partnership with the Penn Cancer Network gives patients access to the expertise and resources of one of the nation’s foremost cancer centers, Penn Medicine’s Abramson Cancer Center in Philadelphia.

Supported by our community Lancaster County residents opened their hearts and wallets to support the largest communitybased campaign in County history. You & I Will Change Lives Cancer Campaign raised $25 million toward the $46 million Ann B. Barshinger Cancer Institute. Ann B. Barshinger’s leadership gift of $5 million inspired more than 825 individual donors and more than 50 corporate donors to contribute to the campaign.

Advanced radiation technologies include the first CyberKnife® M6™ in the nation. The CyberKnife M6 system enables the precise treatment of tumors anywhere in the body with reduced radiation exposure to surrounding tissue.

Redefining cancer care

Radiation Oncology Team (from left): Jeffrey Eshleman, MD, Director; Kenneth Berkenstock, MD; and Kishor Singapuri, MD, in front of the first CyberKnife® M6™ in the nation. This technology enables precise treatment of tumors, with reduced radiation exposure to surrounding tissue.

On June 27, 2013, the vision for redefining cancer care in our region was realized as the Ribbon Cutting ceremony for the Ann B. Barshinger Cancer Institute marked the opening of a remarkable, state-of-the-art facility.

Advocating for tobacco-free living TEACH ME how to say no. ASK ME whether I use tobacco products at every visit. PROTECT ME from second-hand smoke. You may have heard these powerful messages in public service announcements (PSAs) on television, in the waiting room of your Lancaster General Health Physicians office, or before a movie at Penn Cinema. Developed by six Lancaster County youth as part of advocacy training conducted by LG Health, the Southeastern Tobacco Free Coalition, the Tobacco Free Coalition of Lancaster County, LiveWELL Lancaster County and the PA Department of Health, the PSAs deliver targeted and compelling messages about tobacco-free living.

Columbia, Donegal and Warwick high school students, from left, Miriam Abdelmasseh, Gabriela Veneziana, Nevin Khalil, Daniela Hidalgo, Alexandra LeVasseur, and Edan Edmonson, created public service announcements advocating smoke-free communities.

The TEACH ME spot encourages adults to model positive behaviors while teaching youth general life skills. ASK ME encourages healthcare providers to ask young patients about tobacco use at every visit. PROTECT ME stresses the importance of businesses maintaining a smoke-free workplace. The approach reminds us that we all play a role in advocating for a smoke-free community. To view the students’ PSAs, visit youtube.com/user/TobaccoFreeLancaster

Innovative Approach

Do you need help to quit tobacco? Our free group and individual programs have helped thousands quit for good. Open to anyone in the community, the programs provide support and tools to obtain and maintain a tobacco-free life. Learn more at LGHealth.org/quitsmoking

Getting to the heart of it Through our nationally recognized Lancaster Heart & Vascular Institute, we are committed to advancing cardiovascular care and groundbreaking clinical research to help patients feel better and live longer. By combining the capabilities of a cardiac catheterization lab with a cardiac surgery operating room, our new Hybrid Operating Room offers the latest treatments for complex cardiovascular conditions. Working side by side, vascular surgeons and cardiac surgeons, interventional cardiologists and imaging cardiologists, and anesthesiologists perform transcatheter aortic valve replacement, or TAVR. This latest FDA-approved treatment for patients over age 65 suffering from severe aortic stenosis is benefiting patients who are at high risk for open heart valve replacement or open heart surgery.

The Lancaster Heart & Vascular Institute’s Hybrid OR combines the capabilities of a cardiac catheterization lab with a cardiac surgery operating room to treat patients who need complex cardiovascular surgeries

Innovative Treatment

Ventricular Assist Device (VAD) therapy is giving end-stage heart failure patients a new lease on life. An implanted heart pump (VAD) can be a destination therapy – a permanent solution to assist a patient’s weakened heart – or a bridgeto-transplant until a heart becomes available. The Lancaster Heart & Vascular Institute is one of the few centers nationwide accredited to offer VAD technology as a destination therapy. A special clinic at Lancaster General Hospital provides a dedicated team to help VAD patients manage their care.

Ground-breaking research And as a regional leader with more than 400 clinical trials conducted in the past 20 years, the Lancaster Heart & Vascular Institute can offer patients in Lancaster County the opportunity to participate in

the latest research without having to travel to an academic medical center. Patients also have access to investigational treatments not available elsewhere. National high-profile studies in which we participate include: using a device that allows doctors to monitor pressure inside the hearts of patients with heart failure and instruct them to adjust their medications accordingly; and implanting a cardiac monitor that alerts patients to significant changes in the heart so they can seek medical attention before another heart attack happens.

When he was a resident in Lancaster General Hospital’s Family Medicine Residency Program, Dr. Jeffrey Martin began volunteering with Vantage House, a program of Gaudenzia/Lancaster. Sixteen years later, Dr. Martin, now Associate Director of Family and Community Medicine, still volunteers at the East King Street residential drug and alcohol treatment center for women with children, and is contracted to be their medical director. Each week he provides medical services and education, often reducing residents’ visits to the emergency room for non-emergent issues like colds and ear infections. Dr. Martin also provides primary obstetrical services at LG Health Physicians Family and Maternity Medicine, in recent years serving 54 Vantage House women. Because of the comprehensive care, only one child born required any NICU intervention.

Partnering to lend Helping Hands

Recognizing Our Employees’ Volunteerism

Dr. Martin is just one of many in the LG Health family who reach beyond the health system, offering their hearts and hands to those in need in our local community and beyond. LG Health affirms this commitment to volunteerism by making available annual Helping Hands grants to not-for-profit organizations with which employees and medical staff members volunteer. This year on Dr. Martin’s behalf, Vantage House was one of seven grant recipients. Since 2001, almost $150,000 has been awarded to 55 not-for-profit organizations that align with our community health priorities.

Dr. Jeffrey Martin at Vantage House of Gaudenzia/ Lancaster. Because of a Helping Hands grant, the drug and alcohol treatment center was able to purchase an otoscope and opthalmoscope (pictured on wall) to more accurately diagnose and treat the women and children it serves.

Other 2013 Helping Hands Grant Recipients: Hands-on House Children’s Museum Kairos Ministries Life Connection Mission Mental Health America of Lancaster County Power Packs Projects Serving at the Crossroads

Lancaster General Health Center in Parkesburg, Chester County, is bringing LG Health services to one of the fastest growing areas in the region.

Growing to meet our community’s needs Healthcare reform is changing the way we deliver care locally, and across the nation. Long before the passage of the Accountable Care Act, LG Health was preparing for the law’s requirements, along with an expected surge of newly insured patients, many of whom may have put off seeking care for long periods of time.

Expanding primary and specialty care In 2013, Lancaster General Health Physicians opened Family Medicine practices in Parkesburg and Mount Joy, bringing primary care services to new neighborhoods in Lancaster and Chester counties. Specialty Centers in Elizabethtown, Ephrata and Parkesburg are making it easier for patients to see specialists they may need to help prevent or manage chronic conditions like arthritis, diabetes and cardiovascular disease. Lancaster General Health Center in Parkesburg also offers Urgent Care, and outpatient lab and imaging testing.

Building partnerships We continuously explore innovative ways to improve the patient experience, improve the health of the population, and create more affordable healthcare. In September 2013, we formed a consortium with six other nationally recognized health systems in Pennsylvania and New Jersey. AllSpire Health Partners will carry out joint activities in traditional areas of patient care services, research and education to enhance the value of healthcare communities receive. Learn more at AllSpireHealthPartners.org

Dr. Harrison McGrath at Lancaster General Health Physicians’ newest practice, Mount Joy Family Medicine.

U.S. News & World Report Nationally ranked in four specialties: Cardiology & Heart Surgery Diabetes & Endocrinology Gastroenterology & GI Surgery Orthopedics Ranked 6th in Pennsylvania overall

14 Outpatient Centers ……… Primary Care Practices ………20 Specialty Care Practices …… Urgent Care ……

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LG Health Express …… As demonstrated on the pages of this report, Lancaster General Health has strategically aligned its priorities to achieve the best possible outcomes in today’s healthcare environment. By leveraging innovative approaches, LG Health strives to improve the health of the population and provide quality, efficient and effective care for all in our community.

LG Health by the numbers

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National Certifications Magnet Certification One of the first hospitals in Pennsylvania to receive Magnet designation for excellence in nursing practice from the American Nurses Credentialing Center

Joint Commission Disease-Specific Certifications Recognized as a highest quality provider in Hip Replacement, Knee Replacement, Hip Fracture, Stroke, Ventricular Assist Device (VAD)

112,960 436,525 36,770

4,321 39,052 $1.0 billion

690 39

7,100+ 30,396 925+

Emergency visits

LG Health Physicians office visits

Beds in service at both campuses FY2013

Operating Rooms

Inpatient discharges (includes births)

939,625 Outpatient registrations

Births

Surgeries

Employees

Annual health system revenues

Urgent Care visits

Physicians (Medical Staff)

Caring for all in the Community LG Health provides care to anyone, regardless of their financial means. The following summary describes our cost during our last fiscal year to provide healthcare services to people with little or no ability to pay:

Supporting our community’s health and financial needs Supporting the City of Lancaster Lancaster General Health continues its direct financial support of Lancaster City government by providing $1.38 million annually in cash. The funding is in addition to what we pay in city property taxes.

Building a healthy community extends beyond providing healthcare. We support local governments, school districts and community improvement initiatives in addition to caring for those who are medically underserved.

Supporting the School District of Lancaster LG Health’s direct financial support of the School District of Lancaster began more than a decade ago. Today, we provide more than $1.5 million in cash and health services for students of every age, as well as school district employees. The funding is in addition to what we pay in property taxes to the school district. Among other things, our support helps students stay healthy, enhances access to primary healthcare and provides an entry point toward rewarding careers in healthcare.

$67 Million

$11.79 Million

$10.43 Million

Unpaid cost of healthcare services provided by LG Health to financing disadvantaged people enrolled in federal and state insurance programs (Medicaid).

Cost of medical care provided by LG Health for patients with little or no health insurance (Charity Care).

Unpaid cost to train promising physicians, nurses, technicians and other healthcare professionals to care for future generations of county residents.

Payment of Property Taxes

Tax Payments to Municipalities

Most properties within the city and county owned by LG Health and its affiliates (excluding Lancaster General Hospital at 555 N. Duke St., Lancaster, and Women & Babies Hospital at 690 Good Dr., Lancaster) are fully maintained on the tax rolls – even when such properties are used to further our charitable mission, rendering them legally taxexempt. This ensures that LG Health pays more than $3.44 million in additional tax revenue to several local municipalities and school districts.

To Lancaster County

$468,000

To Lancaster City

$237,000

To East Hempfield Township

$135,000

To Other Municipalities

$48,000

TOTAL $889,000

Tax Payments to School Districts To Hempfield School District $1.9 million To School District of Lancaster $445,000

+ City of Lancaster $1.38 Million

= $2.88

School District of Lancaster $1.50 Million

Million

To Warwick School District

$51,000

To Columbia School District

$70,000

To Other School Districts

$84,000

TOTAL

$2.55 million

*Financial figures based on Lancaster General Health’s fiscal year, which started July 1, 2012, and ended June 30, 2013. All items listed as community benefit and based on categories, definitions and reporting guidelines outlined in “Guidelines and Standard Definitions for the Community” published by the Catholic Health Association of the United States and VHA Inc.

Lancaster General Health Consolidated Statement of Operations and Changes in Net Assets Years Ended June 30, 2013 and 2012 (in thousands of dollars)

Unrestricted net assets

2013

2012

Unrestricted revenue and other support Net patient service revenue

$914,301 $905,547

Provision for bad debt

(41,425)

(37,087)

Net patient service revenue, less provision for bad debt

872,876

868,460

Medical services

10,031

17,225

Capitation revenue

1,524

878

Other revenue

31,017

26,981

Net assets released from restrictions for operations

3,980

2,593

Contributions

317

505

919,745

916,642

Operating expenses

832,004

824,299

Depreciation and amortization

51,232

54,929

Interest

7,932

5,955

Provision for bad debts

111

76

Total expenses

891,279

885,259

Operating income

28,466

31,383

Total unrestricted revenue and other support

Expenses

This statement encompasses the financial performance of all members of the Lancaster General Health system, including Lancaster General Hospital, Women & Babies Hospital, Lancaster General Health Physicians and Lancaster General Health Outpatient Facilities. As a not-for-profit organization, any profits realized at year-end are reinvested in new technology, our employees and facilities to better serve our community. Note: The annual net operating revenues associated with joint-venture companies for which LG Health is a significant business partner, is approximately $90 million per year. For these entities, LG Health reports approximately 49 percent of its share of the net earnings of these joint ventures through non-operating income. When these are taken together with operating revenues and expenses shown above, the approximate and effective annual operating revenues associated with LG Health is approximately $1 billion, and its effective annual operating income is approximately $35 to $40 million.

Lancaster General Health Foundation The Lancaster General Health Foundation advances the culture of philanthropy within the Lancaster General Health system. The Foundation also provides oversight of the fundraising activities for the Ann B. Barshinger Cancer Institute, the Lancaster Heart & Vascular Institute, the Pennsylvania College of Health Sciences, Women & Babies Hospital, and other LG Health affiliates. Philanthropy provides vital funds to improve patient care, to advance research, and to increase the margin of medical excellence available for our patients and their families. Fiscal year 2012 was a record-breaking year with $7,953,442 contributed to the LG Health Foundation. For more information about the LG Health Foundation, visit LGHealth.org/Foundation

2012-2013 Contributions by Donor Type Individuals $ 4,301,077 Organizations $ 1,822,153 Government $ 1,197,131 Corporations $ 293,268 Foundations $ 304,231 Schools

$ 26,949

Anonymous $ 8,633

anon schools

foundatio corp

governm

Lancaster General Health Outpatient Centers: 14 Primary Care Practices: 20 Specialty Care Practices: 18 Urgent Care: 3 LG Health Express: 1

Berks

Lebanon

Dauphin

Lancaster

York

Lebanon

Chester

Berks

Dauphin

Location Key

(as of Dec. 2013)

The Ann B. Barshinger Cancer Institute offers a full spectrum of radiation technologies, including the leading-edge TrueBeam™ system developed to deliver more accurate and precise radiation treatments using image guidance.

Note: Some outpatient locations include multiple physician practices. For detailed information, go to LGHealth.org/locations Lancaster

York

Chester

Hospital Outpatient Center Physician Practice Urgent Care LG Health Express

Lancaster General Health 555 North Duke Street PO Box 3555 Lancaster, PA 17604-3555

Our Mission –

Our Vision –

To advance the health and well-being of the communities we serve.

Delivering on the promise of a healthier future.

Contacting Lancaster General Health For more information on our programs to improve community health, visit www.LancasterGeneralHealth.org and click on About Us. There, you’ll find additional details on our community commitment, as well as electronic versions of our monthly newsletter, Community Benefit Update. Please contact us with any suggestions or questions about our community health programs. This Annual Report to the Community is published by the Lancaster General Health Department of Public Relations & Corporate Communications.

John Lines Director of Public Relations & Corporate Communications [email protected] (717) 544-5054 Alice Yoder, RN, MSN Director of Community Health [email protected] (717) 544-3283 Jill Gross Editor [email protected] (717) 544-5053 LancasterGeneralHealth.org

BD/IPLR/011-13

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