VISION MISSION. Moving together through change to provide innovative rural health care

Transcription

1 2014 ANNUAL REPORT

2 VISION Moving together through change to provide innovative rural health care MISSION Rural Northwest Health will provide accessible, efficient and excellent care to our community within the Wimmera Mallee Region This report Covers the period 1 July 2013 to Is prepared for the Minister for Health, the Parliament of Victoria and the community Is prepared in accordance with government and legislative requirements and FRD 30 guidelines Should also be read in conjunction with the Quality of Care Report Will be presented to the community at Rural Northwest Health s Annual General Meeting in November 2014 Acknowledges the support of our community Is printed with 100% recycled stock. Rural Northwest Health acknowledges the support of the Victorian Government 2 Rural Northwest Health - Annual Report 2014

3 CONTENTS Board Chair & CEO Report Manner of Establishment & relevant ministers About Our Organisation Management & Structure Organisational Structure Financial Overview Service Performance at a Glance Legislative Compliance Disclosure Index Financial Certification Auditor General s Report Financial Statements FS1-53 Rural Northwest Health - Annual Report

4 Board Chair and CEO Report In Rural Northwest Health has continued to focus on the 13 strategic goals set by the Board of Management and continually improve and deliver services that are of a high quality and as close to home as possible. Our vision is lived every day, as staff work together through change to deliver innovative rural health services. The Finance and Audit Committee led by Matthew Richardson continues to monitor and manage the financial risks and compliance requirements of Rural Northwest Health and provides reports to the Board of Management quarterly regarding the overall financial results, assets, liability and compliance. A full audit was undertaken against Rural Northwest Health s legislation requirements in April, which demonstrated that Rural Northwest Health has systems and processes in place to ensure that they meet all requirements. The financial results continue to demonstrate strong management and a positive return on investment. Challenges continue for the team to manage the costs of ambulance transfers, repairs and maintenance, maintaining and improving our infrastructure and a strong and sustainable income stream across community and aged care services. The introduction of Rural Northwest Health s own radiography service has proven to be a community asset. The current X-ray service numbers are unable to completely cover the cost of the service and therefore the service has been cross subsidised by the organisation. The fleet of vehicles at Rural Northwest Health has been upgraded with the majority of cars in use now a hybrid model. This has resulted in a decrease in petrol consumption across all campuses. A new bus was purchased for Warracknabeal and supported by a RACV community grant, which allowed the bus to be modified with a lift to ensure it is fully accessible for all community members and aged care residents. After community consultation and a risk analysis the decision was made to demolish the rest of the building at Beulah as significant funds would be required to maintain the infrastructure. The building contained a significant amount of asbestos that would continue to be a risk in the immediate and future for all. To ensure Rural Northwest Health complied with all legislation requirements, the air was monitored as the asbestos was removed and the asbestos was disposed of in line with legislation. Leo Casey chairs the Hopetoun Beulah Reference Group and he is supported by Peter Hallam and Michelle Blackwood as the Hopetoun representatives, and Barbara Hallam, Ross Cook and Daryl Burdett as the Hopetoun representatives. Michelle Blackwood has stepped down as a representative after 4 years and we thank her for her expertise and support and welcome Prue McCredden as the new representative. The discussions and the actions decided upon at the meeting are communicated via a media release quarterly to support all community members to be aware of what is happening in their local community regarding or health service. Attracting and retaining appropriately skilled staff continues to be challenging with staff and community members working together to address gaps in podiatry, physiotherapy, nursing, social work and counselling. Maintaining appropriate housing for staff is a continuing test and priority for the Board. The Human Resources and Industrial Relations Committee has appropriately been renamed as the Health and Wellbeing committee. The committee focus on staff wellbeing and introducing a range of initiatives to support the team to undertake innovative options to improve and maintain the staff s physical, psychological, mental, and social wellbeing % of staff took advantage of the flu vaccine program which is a significant increase from 54% in the previous year. Glenda Hewitt provides leadership as the chair of this committee and ensures that the Board of Management members receive detaild reports about any risks and opportunities identified by the committee. The introduction of the National Standards for the acute and urgent care units, the Home and Community Care Standards for community health and impending aged care accreditation audits has allowed Rural Northwest Health to focus on improving clinical systems, reporting and auditing and ensuring that we involve the client/resident/patient in the health experience that they are experiencing. Extensive work has been undertaken on updating all policies and protocols, clinical handover, clinical communication and inter hospital transfers and clinical reporting. The Clinical Governance committee chaired by Marie Aitken, are pleased with the progress that has been made in improving the quality and safety of the services we provide and review a range of clinical data 4 Rural Northwest Health - Annual Report 2014

5 Board Chair and CEO Report (continued) that is reported quarterly. The clinical team have worked hard over the last 12 months to minimise the impacts of falls and pressure areas for residents and clients and have improved the number of clients and residents that have the appropriate risk assessments undertaken in a two hour period. The Community Action Research Group which commenced as part of a research project with Latrobe Rural Health School has continued to work together to inform the Board of Management about key activities that the community members believe will enhance the health and wellbeing of the community. Carolyn Morcom chairs the governance committee which includes representatives from Latrobe Rural Health School, John Aitken the PhD candidate and community representatives Wendy Hewitt from Warracknabeal, Barbara Hallam from Hopetoun and Rita Stewart from Beulah and the CEO. The Community Action Research Group have guided Rural Northwest Health to deliver the to retirement & beyond Expo, commence working with community members to develop community gardens and have continued to work with community members and health service partners to broaden and allow the access to services as close to home as possible. Leo Casey and Patty Kinnersly have monitored and contributed to effective governance of the $9.8 million stage 2 project as Project Control Group members and recommended that Rural Northwest Heath invest a further $800,000 to the project. This recommendation was endorsed and will ensure that a number of extra initiatives will be included in the project. The project will commence in July 2014 and be completed by February The Board of Management led by Leo Casey as the Chairman, Emma Vogel who resigned in March and Brian Hewitt as Vice Chairman and members, Matthew Richardson, Marie Aitken, Glenda Hewitt, Carolyn Morcom, Marie Aitken, Janette McCabe and Patty Kinnersly held the first open access board meeting in Hopetoun in March which included 20 community members and regional service providers. The open access board meeting will become an annual event. The Board members have continued to focus on developing their skills and capability and have attended governance training offered in the Grampians region by the Building Board Capacity working group. The board s hard work, leadership and expertise have supported Rural Northwest Health to be in an exceptionally strong position in relation to their financial results and the delivery of high quality safe services and to have engaged staff. After 17 years which was divided between two terms, Marie Aitken has tendered her resignation from Rural Northwest Health. Her common sense, commitment to strong clinical governance and passion will be missed greatly. We wish her every success with her new Board of Management appointment to Wimmera Health Care Group. On behalf of the Board of Management we thank the community members for their continued support of our services, our fundraising efforts and assisting us with volunteering and providing feedback. Thanks to the support from our regional partners and state and federal governments who assist us to expand and improve service delivery. Sincere acknowledgment and appreciation go to every staff member who get up every day to ensure that the service is delivered 24 hours a day, seven days a week, to provide a responsive and high quality service to the community members that we are privileged to work with. Leo Casey Board Chair Catherine Morley Chief Executive Officer Rural Northwest Health - Annual Report

6 Manner of Establishment and relevant Ministers Rural Northwest Health is a public Agency established under the Health Services Act The responsible Ministers during the reporting period were, the Honourable David Davis MLC Minister for Health and Ageing and the Honourable Mary Wooldridge MP Minister for Community Services, Mental Health, Disability Services and Reform. Objectives, Functions, Powers & Duties Rural Northwest Health is authorised to provide public health ancillary services as authorised under the Act, and operate Residential Care Services under the Aged Care Act The Board of Management consists of persons appointed by the Minister for Health under the Act who are empowered to provide strategic direction for the organisation. Whilst the board provide directions for the Agency and determines what must be done, the responsibility for determining how services are delivered is invested in the Chief Executive Officer. The functions of the board of a public hospital are to oversee the management of the health service; to set the strategic plan and vision for the health service; and to ensure that the services provided by the hospital comply with the requirements of this Act and the objectives of the hospital. The board of a public hospital has such powers as are necessary to enable it to carry out its functions, including the power to make, amend or revoke by-laws. OUR HISTORY 1999 Rural Northwest Health was created from the amalgamation of Warracknabeal District Hospital (including JR & AE Landt Nursing Home), Hopetoun Bush Nursing Hospital (including Cumming House) and Beulah Pioneers Bush Nursing Hospital 2001 The two low care facilities Corrong Village at Hopetoun and Landt Hostel at Warracknabeal were subsequently amalgamated with RNH Responsible Bodies Declaration In accordance with the Financial Management Act 1994, I am pleased to present the Report of Operations for Rural Northwest Health for the year ending. Leo Casey Board Chair Warracknabeal 25 July To modernise Rural Northwest Health s facilities, new campuses have been constructed at Hopetoun and Warracknabeal. Hopetoun s new campus and ambulance station facilities were officially opened in July Stage One of Warracknabeal s redevelopment, including new integrated aged facilities, administration and support services, were officially opened by the Victorian Premier in October Rural Northwest Health - Annual Report 2014

7 About our Organisation Rural Northwest Health is located in the Wimmera Mallee region of Victoria in the Yarriambiack Shire and serves a population of around 7,082 across the communities of Warracknabeal, Hopetoun and Beulah. Between our three campuses we provide a comprehensive range of acute, aged, and primary health services that the community is able to access through in-patient, residential, home or community based services including: Hopetoun Mallee Wimmera Beulah Warracknabeal Victoria After Hours Service GPs and nursing staff provide an After Hours On Call service 24 hours 7 days per week at Warracknabeal and Hopetoun Acute Care RNH has 12 acute beds at the Warracknabeal Campus and 4 acute beds at the Hopetoun Campus. Both campuses provide urgent care services Acute medical Palliative Care Pharmacy Pathology services Accident and urgent care Aged Care RNH has 60 aged care places at the Warracknabeal Campus and 30 aged care places at the Hopetoun Campus High and low care accommodation Respite care Memory Support Unit (Warracknabeal) Lifestyle program Medical Imaging (Warracknabeal) X-ray Ultrasound Community Health Community and Allied Health services are provided across the three campuses at Warracknabeal, Beulah and Hopetoun Ante Natal and Domiciliary midwifery services Asthma education and health plan development Community Health nurse Diabetes education and health plan development District nursing services Health education and promotion Hospital to home Planned Activities Groups (Warracknabeal and Beulah) Post - acute care Allied Health Counselling Dietetics Exercise physiology Massage Therapy Occupational Therapy Physiotherapy Podiatry Social Work Speech pathology Support Services Carer support services Volunteer program Specialties Ear, Nose and Throat Rural Northwest Health - Annual Report

8 Management and Structure Board Members Leo Casey, Board Chair Chair, Hopetoun/Beulah Reference Group Matthew Richardson Chair, Finance Audit & Compliance Committee Emma Vogel Vice Chair, Board of Management (to March 2014) Brian Hewitt Acting Vice Chair, Board of Management (from March 2014) Glenda Hewitt Chair, Health & Wellbeing Committee Marie Aitken Chair, Clinical Governance Committee Janette McCabe Member, Clinical Governance Committee Carolyn Morcom Chair, Community Action Research Group Governance Committee Patricia Kinnersly Member, Project Control Group 8 Rural Northwest Health - Annual Report 2014

9 Organisational Structure Chief Executive Officer Catherine Morley Executive Assistant Sharon Murphy Consultants and PhD student Warracknabeal Campus Manager Wendy James Hopetoun/Beulah Campus Manager Natalie Ladner Innovation & Continuous Improvement Manager Wendy Walters Support Services Manager Ross Wheatland Community Health Manager Ngareta Melgren Acute Unit Manager Hopetoun Unit Manager Quality and Risk Officer Finance Manager Planned Activity Group Coordinator W Beal Yarriambiack Lodge Unit Manager Beulah Unit Manager Education and Quality Coordinator Maintenance Manager Allied Health Team Nurse Practitioner Hopetoun Administration Cognitive Rehabilitation Therapist Administration Team Leader Community Nurses Clinical Support Nurse Cancer Support Nurse Events & Marketing Coordinator IT Contractor Infection Control Nurse Aged Care Events & Volunteers Coordinator Environmental Service Supervisor Radiology Contractor Leisure & Lifestyle W Beal & Hopetoun District Nursing ACFI Coordinator Rural Northwest Health - Annual Report

10 Financial Overview Rural Northwest Health is pleased to report an operating surplus of $234,518 and an entity loss of $1,355,122 after capital income and depreciation for the financial year ending. Revenue from operating activities in was $362,000 down on the previous financial year. Highlights included: Funding from Government Grants to enable Rural Northwest Health to provide acute, community and aged care services increased by $201,000 A smaller amount of funding from Health Workforce Australia was maintained which assisted the team to continue on with the work that was commenced in Wattle, Heath Street and at Hopetoun with residential aged care services delivered to people living with dementia Net Assets increased due to solid investment strategy. In addition to the above, revenue generated from non-operating activities increased by $122,000. This growth was in part due to an increase in the amount of funds held in short term investments resulting in higher interest earnings and the introduction of the Radiology Department where imaging and X-ray services have been implemented. We also received generous donations from the local community which has supported us to continue to be innovative and improve the services we deliver. Fundraising activities were undertaken and donations were received from the Landt Family Estate, Walk for Wattle participants, the Hopetoun Ladies Auxiliary, RACV Community Foundation, Team Outpatients Hopetoun, Dancing with the Stars, WarracknaBeatles, Beulah Blue Flames, Horsham Sports and Community Centre and some wonderful individual community members and organisations including CWA Warracknabeal and Woodbine residents and their families and fantastic support from staff members who participated or ran the fundraising events. Expenses attributable to operating activities were $480,000 higher than the previous year. The majority of this increase can be seen in the area of employee benefits, mainly attributable to increased staffing to allow for the provision of additional services, award driven salary increases and a number of resources and audits to support Rural Northwest Health to achieve compliance with National Accreditation Standards at an audit to be undertaken in July Of the $527,000 reported as repairs and maintenance expenses, $80,000 was due to the Beulah redevelopment site and over 50% relates to the replacement and maintenance of health service equipment. This expenditure is necessary to allow us to maintain and improve our infrastructure and provide high quality and safe services to the community and our team members. All other expenses have been well contained as we continue to improve on the maintenance, efficient use and deployment of equipment and services. 10 Rural Northwest Health - Annual Report 2014

11 Major asset purchases in the financial year included: New imaging machine for the Radiology Department New delivery truck and community bus Refurbishment of the Beulah campus. Fuel, light, power and water had a significant decrease in cost over the last financial year. This was as a result of working with Health Purchasing Victoria which negotiated a better contract pricing arrangement for all Health Services. Liabilities related to employee leave provisions continue to be Rural Northwest Health s largest commitment. Management continues to support staff to utilise their accrued leave to maintain physical and mental wellbeing and to enjoy life and the opportunity to have a break from a busy workplace. The Rural Northwest Health management team will continue to remain committed to support staff to maintain and improve their health and wellbeing and take their leave and maintain the quality of our services at all times. Finance Summary-5 years to $ 000 $000 $ 000 $000 $ 000 Total Revenue 18,843 19,169 18,560 16,842 14,933 Total Expenses 18,608 18,139 16,952 15,931 14,708 Operating Surplus/(Deficit) 235 1,030 1, Retained Surplus/(Accumulated Deficit) 10,911 12,266 13,003 12,937 13,718 Total Assets 51,441 48,945 46,725 47,039 46,004 Total Liabilities 6,963 6,733 7,495 7,875 6,048 Net Assets 44,478 42,212 39,230 39,164 39,956 Total Equity 44,478 42,212 39,164 39,956 41,498 Rural Northwest Health - Annual Report

12 Financial Overview Service Performance at a Glance 2013/ / / / /2010 Inpatient Statistics (Acute) Inpatients Treated Average Complexity (DRG Weight) Inpatient Bed Days 4,030 4,542 4, Average Length of Stay (days) Nursing Home Type (NHT) Bed Days Available Bed Days 7,300 7,300 7, Occupancy Rate 55% 62.23% 62.62% 61.3% 58.3% Aged Care Statistics- (Aged Program) High Care Residents Accommodated Resident Bed Days 12,050 12,792 13, Low Care Residents Accommodated Resident Bed Days 15,885 16,152 15, Respite Residents Accommodated Respite Resident Bed Days Aged Care Occupancy Rate 87.22% 89.17% 90.4% 91.8% 86.5% Outpatient (non-admitted) Occasions of Service Counsellor Diabetic Educator Dietician 903 1, Exercise Physiologist 1,819 1,736 1,619 Foot Care (Beulah) Massage Therapist Occupational Therapist ,063 Physiotherapy 3,367 1,882 1, Podiatry 2,146 2,595 1, Social Worker Speech Therapist 1, Emergency Medicine 2,306 2,138 2, Meals on Wheels 6,486 5,481 4, No. of Emergency cases referred to other hospitals Attestation on Data Integrity I, Catherine Morley certify that Rural Northwest Health has put in place appropriate internal controls and processes to ensure that reported data reasonably reflects actual performance. Rural Northwest Health has critically reviewed these controls and processes during the year. Catherine Morley Accountable Officer Warracknabeal 11 August Rural Northwest Health - Annual Report 2014

13 Statement of Priorities (SoP) The Statement of Priorities is the key document of accountability between the Department of Health and Health Services. The agreement is signed by the Minister for Health, Secretary or relevant Director dependant on the health service and the health service s Board Chair. SoP Part A: Strategic Priorities for SoP Part A purpose: identifies the Victorian Government s priorities and policy directions in the Victorian Health Priorities Framework Priorities: Each SoP identifies how the individual health service will contribute to the achievement of the Government s seven key priorities in , through the articulation of specific Actions and Deliverables. Outcomes: For purposes of the Annual Report, health services are required to report on the outcome of each deliverable articulated in the SoP. Priority Action Deliverable Outcome 1 Developing a system that is responsive to people s needs Implement formal advance care planning structures and processes that provide patients, clients and residents with opportunities to develop, review and have their expressed preferences for future treatment care enacted Develop an advance care plan practitioner group that will undertake accredited training and run information sessions for community members at Beulah, Hopetoun and Warracknabeal twice- throughout the year. Appoint an advance care planning coordinator to develop policies and protocols and provide support for the practitioner group to ensure patients, clients and residents have the opportunity to develop an advance care plan. Staff from acute, residential care, district nursing, community health and clinical administration have undertaken the accredited training course and 10 staff members have actively developed advance care plans with clients. Community forums have been held across all campuses and at a range of community groups including Probus, Senior Citizens and the coordinator presented at the To retirement and beyond expos held at Hopetoun and Warracknabeal which had over 150 community members attend. An advance care planning coordinator was appointed in September and has successfully developed policies and protocols for Rural Northwest Health. Sessions have been delivered to residents at both Warracknabeal and Hopetoun which has resulted in over 75% of residents now having an advance care plan in place. 12 community members have completed an advance care plan and increasing this number will be a focus for In partnership with other local providers apply existing service capability frameworks to maximise the use of available resources across the catchment. Implement activities and undertake actions as documented in the Wimmera Southern Mallee Health Alliance phase two implementation plan and meet the timeframes as set in the plan to RNH have worked with Dunmunkle Health Service, Edenhope Memorial Hospital, West Wimmera Health Service and Wimmera Health Care Group, as the Wimmera Southern Mallee Health Alliance (WSMHA) to achieve the following outcomes: The full implementation of the Cancer Support Nurse role in partnership with the Grampians Integrated Cancer Service Participation in a number of regional forums focusing on improving communication, transfers and outcomes for community members accessing urgent care and emergency services Sharing of resources and expertise to support all health services to be successful with the implementation of the National Standards Working with partners and local health service providers to support expansion and delivery of services identified by WSMHA members as deficient for Wimmera Southern Mallee community members. Rural Northwest Health - Annual Report

14 Statement of Priorities (SoP) 2 Improving every Victorian s health status and experience Improve thirty-day unplanned readmission rate. By June 2014, develop a policy and protocol to ensure effective discharge planning for all acute inpatients to reduce unnecessary readmissions. The allied health team, acute staff, Visiting Medical Officers and the acute inpatients have worked together with local service providers to ensure a seamless transition for inpatients to home. Improvements include: The local pharmacist providing clients to have access to evidenced based medication information about their medications prior to their discharge The introduction of the community rehabilitation therapist for people with cognitive changes or who are living with dementia The allocation of an aged care bed for permanent respite bookings The development of a new protocol and terms of reference for the multidisciplinary discharge planning meeting Improved relationships with HACC providers including providing education to team members Improved internal processes for acute and allied health team members. Deliver care as close to home as possible, when it is safe and effective to do so. By June 2014, facilitate ongoing arrangements with a Psychologist and a Geriatrician to provide local services via telehealth or face-to-face interactions RNH purchased laptop computers to allow for aged care residents to access clinical expertise from a Geriatrician. This has proven to be a beneficial service for the resident, the family, the staff and Ambulance Victoria as the resident is not required to leave the facility. For the residents who are living with dementia the need to not leave an environment where they feel comfortable and safe is another significant benefit. Medicare Local has worked with RNH to ensure that local community members have weekly access to a visiting Psychologist. This service is highly regarded by community members with a minimum 4 week wait for a face to face appointment. 3 Expanding service, workforce and system capacity Work collaboratively with the department on service and capital planning to develop service and system capacity. Work with community members, staff and the Project Control Group to develop plans for the Stage 2 development of Warracknabeal campus. The plans will reflect the needs of the community and RNH capability and will focus on expanding services where safe to do so. An extensive consultation process was held with staff, community members, contractors and service providers including, Ambulance Victoria, IT and radiographer contractors and the appointed consultants to ensure that the design of Stage 2 provides a one stop shop for community members and the ability for staff to work across units and provide a response service if required in an emergency or at night. Community members were keen to ensure that disabled parking was close to the entrance. Residents in aged care commented on the requirements for an accessible and beautiful garden and acute and urgent care clients wanted a well signed entrance for themselves and Ambulance Victoria. The design and tender was completed and signed off by the Secretary on June Increasing the system s financial sustainability and productivity Reduce variation in health service administrative costs. Commence running a local x-ray service in Warracknabeal and use current administration team to make bookings and take payment for the service, thereby increasing productivity. Continue to work with the regions health services to develop a plan for improving payroll services and reducing the amount of administration time spent on payroll procedures every fortnight. A three day a week service was commenced in July 2013 with both ultrasounds and X-Rays available. Due to the current position of X-ray and the need for IT connections for reporting from the radiologists, an administration staff member is required to be available in the area. Stage 2 will allow the role to be shared and RNH has trained three staff up to be proficient in the software program. RNH has worked with our payroll provider, Wimmera Health Care Group (WHCG) to introduce a more efficient timesheet process for staff that work normal hours. This is proving to reduce paper and time and decrease rework as the authorisation of time sheets occurs in a timely manner. WHCG have included RNH s payroll needs in discussions that they are having with other organisations to implement a fully automated payroll system. 14 Rural Northwest Health - Annual Report 2014

15 Statement of Priorities (SoP) 5 Implementing continuous improvements and innovation Develop and implement strategies that support service innovation and co-design. Work with Latrobe Rural Health School to complete the Community Research Project (CARG) and work with participants, PhD student and staff to implement strategies that the Community Action Research Group (CARG) have identified to improve community wellbeing. The CARG project has proven to be a friendly, approachable and evidence based process to introduce community members and service providers to a range of relevant health data for the Yarriambiack Shire. The group members are committed and have met bi monthly and driven RNH to deliver: An aged care expo in Hopetoun and Warracknabeal The development of sustainable community garden committees across Beulah, Hopetoun and Warracknabeal An ICE forum for community members held in Warracknabeal A governance structure that allows the BOM to receive prioritised and evidence based information regarding services that the community would like to see introduced in the area. RNH was fortunate enough to have hosted three Senators from Community Affairs in November 2013 who were investigating the care and management of younger and older Australians living with dementia and behavioural and psychiatric symptoms of dementia (BPSD). The Senators wanted to hear from RNH staff and family members about the capability model and RNH is quoted extensively in the report presented to parliament. Expand RNH s capability model across residential aged care and to community members with mild cognitive impairment and memory loss. A Community Rehabilitation Therapist is working with the discharge planning team, the Shire and family members to provide people living in the community with dementia access to the expertise regarding roles and activities that can assist them to maintain and improve their abilities. The researched based memory support peer support program has commenced in Beulah, Hopetoun and Warracknabeal with excellent evaluations from the participants. 6 Increasing accountability and transparency Prepare for the National Safety and Quality Health Service Standards. Successfully submit the assessment recording tool for standards 1, 2 and 3 by September 2013 and full application and appropriate action plan for meeting the National Standards by May RNH staff have worked consistently over the last 12 months to ensure that systems, processes, protocols and policies reflect the National Standards requirements and demonstrate that staff are providing safe, evidenced based, high quality services. Due to a delay in the start date for the Stage 2 building works the audit was delayed until July The assessment recording tool and action plans were submitted on time and RNH are ready for the full audit to be undertaken. 7 Improving utilisation of e-health and communications technology. Work with partners to better connect service providers and deliver appropriate and timely services to rural and regional Victorians. Implement activities and undertake actions in the phase one implementation plan of the regional e-health project and meet the timeframes as set out in the plan to June 2014 RNH has been an active participant in the WSMHA Cardiac Rehabilitation Telehealth project and have worked with the Project Manager to lobby for funding and support. The project team includes staff from all the Wimmera southern mallee health services, Primary Care Partnership, Medicare Local and a local consumer. The project is delivering to agreed documented timelines. SoP Part B: Performance Priorities Purpose of Part B: lists financial, access and service performance indicators for the health service for Operating Result Target actuals Annual Operating result ($m) Cash Management Target actuals Creditors <60 days 45 days Debtors <60 days 33 days Rural Northwest Health - Annual Report 2014 Examine and Rural Northwest Health Rural Northwest Health has introduced an electronic 15

16 Statement of Priorities (SoP) Service Performance Quality and Safety Target actuals Health service accreditation Full compliance Achieved Residential aged care accreditation Full compliance Achieved Cleaning standards (Overall) Full compliance Achieved Cleaning standards (AQL-A) % Cleaning standards (AQL-B) 85 96% Cleaning standards (AQL-C) 85 92% Health care worker immunisation - influenza 60 Achieved Submission of data to VICNISS Full compliance Achieved Hand Hygiene (rate) 70 Achieved Victorian Patient Satisfaction Monitor (OCI) (July - December 2013) 73 Achieved Consumer Participation Indicator (July - December 2013) Victorian Hospital Experience Measurement Instrument (January June 2014) 75 Full compliance Achieved NA People Matter Survey Full compliance Achieved SoP Part C: Activity and Funding Purpose of Part C: provides an itemised list of the health service s activity targets and corresponding funding levels. Funding type Small Rural Residential Care Activity Achievement $28,756 Achieved Rural Northwest Health Staff by Labour Category Labour Category JUNE Current Month FTE* JUNE YTD FTE** Nursing Administration and Clerical Medical Support Hotel and Allied Services Medical Officers Hospital Medical Officers Sessional Clinicians Ancillary Staff (Allied Health) Rural Northwest Health recruits high quality staff with the right skills to deliver the key objectives of the position, business unit and organisation and will comply with all legislated requirements and reflect a fair and open process with an appointment made based on merit. Rural Northwest Health is an equal opportunity employer. Attestation for Compliance with the Australian/New Zealand Risk Management Standard I, Catherine Morley certify that Rural Northwest Health has risk management processes in place consistent with the AS/ NZS ISO 31000:2009 (or an equivalent designated standard) and an internal control system is in place that enables the executive to understand, manage and satisfactorily control risk exposures. The audit committee verifies this assurance and that the risk profile of Rural Northwest Health has been critically reviewed within the last 12 months. Catherine Morley Chief Executive Officer Warracknabeal 11 August Rural Northwest Health - Annual Report 2014

17 Legislative Compliance Freedom of Information (FOI) The Victorian Freedom of Information Act 1982 provides individuals with rights to access personal documents held by public hospitals and other government agencies. The Chief Executive Officer is the designated FOI Officer at Rural Northwest Health. Application fees and access charges applied in regard to FOI are done so in accordance with State Government regulations. A summary of FOI activity during : Total FOI requests received 8 Number of personal requests received 8 Access granted in full 8 Access granted in part 0 Access denied in full 0 Freedom of Information requests should be in writing and addressed to: The Freedom of Information Officer Rural Northwest Health PO Box 386 Warracknabeal Victoria 3393 Building and Maintenance All building works have been designed in accordance with the Department of Health Guidelines and comply with the Building Act 1993 and the Building Code of Australia Details of Consultancies over $10,000 Consultant Purpose of consultancy Start date End date Total approved project fee (excluding GST) Expenditure (excluding GST) Future expenditure (excluding GST) Cappela Consulting Strategic Planning March 2014 April 2014 $20,000 $14,190 $20,000 Springtech Services Supply and Maintenace review July 2013 March 2014 $25,000 $21,443 $0 Graylin Healthcare & Business Improvements Audits - Acute Department Feb 2013 March 2014 $10,000 $10,333 $10,000 Deloitte Touche Internal Audit July 2013 August 2013 $15,000 $13,589 $15,000 Clare Dewan HR/IR industrial relations consultancy July 2013 June 2014 $38,000 $37,440 $38,000 Details of Consultancies under $10,000 In , Rural Northwest Health engaged 5 consultancies where the total fees payable to the consultants were less than $10,000, with a total expenditure of $24,068 (excl. GST). Occupational Health and Safety Act 2004 Rural Northwest Health is responsible for the health and safety of all staff members in the workplace. To fulfil this responsibility we have a duty to maintain a working environment that is safe and without risks to residents, clients, visitors and our staff members health. Rural Northwest Health have ensured compliance with the OHS Act by: Effective implementation of OH&S policy and protocols Providing opportunities for regular discussion between the Board, Leadership & Management team and staff members Conducting regular workplace inspections and audits are undertaken and appropriate follow up action is taken Providing information, training and supervision for all staff members in the correct use of plant, equipment, chemicals, and other substances used. Rural Northwest Health - Annual Report

18 Legislative Compliance National Competition Policy Rural Northwest Health complies with all government policies regarding competitive neutrality with respect to all tender applications. Victorian Industry Participation Policy Rural Northwest Health abides by the principles of the Victorian Industry Participation Policy. In there were no contracts commenced or completed by Rural Northwest Health under this Act. Financial Management Act 1994 In accordance with the Direction of the Minister for Finance, information requirements have been prepared in accordance and are available to the relevant Minister, Members of Parliament. Carers Recognition Act 2012 Rural Northwest Health has policies and procedures in place to ensure we meet the obligations regarding Carers and Care relationships under the Carers Recognition Act Protected Disclosure Act 2012 Rural Northwest Health facilitates the making of disclosures of improper conduct by employees, provides a system of investigation of such disclosures and protects employees making disclosures from retribution in accordance with the provisions of the Protected Disclosure Act Ex-gratia Payments There where no ex-gratia payments in Attestation for compliance with the Ministerial Standing Direction Insurance I, Catherine Morley certify that Rural Northwest Health has complied with Ministerial Direction Insurance. Catherine Morley Chief Executive Officer Warracknabeal 11 August Rural Northwest Health - Annual Report 2014

19 Disclosure Index The annual report of Rural Northwest Health is prepared in accordance with all relevant Victorian legislation. This index has been prepared to facilitate identification of the Department s compliance with statutory disclosure requirements. Legislation Requirement Page Reference Ministerial Directions Report of Operations Charter and purpose FRD 22E Manner of establishment and the relevant Ministers 6 FRD 22E Objectives, functions, powers and duties 6 FRD 22E Nature and range of services provided 7 Management and structure FRD 22E Organisational structure 9 Financial and other information FRD 10 Disclosure index 19 FRD 11A Disclosure of ex-gratia payments 18 FRD 21B Responsible person and executive officer disclosures FS52 FRD 22E Application and operation of Protected Disclosure Act FRD 22E Application and operation of Carers Recognition Act FRD 22E Application and operation of Freedom of Information Act FRD 22E Compliance with building and maintenance provisions of Building Act FRD 22E Details of consultancies over $10, FRD 22E Details of consultancies under $10, FRD 22E Employment and conduct principles 16 FRD 22E Major changes or factors affecting performance 10 FRD 22E Occupational health and safety 17 FRD 22E Operational and budgetary objectives and performance against objectives 10 FRD 22E Significant changes in financial position during the year 10 FRD 22E Statement of availability of other information 20 FRD 22E Statement on National Competition Policy 18 FRD 22E Subsequent events FS53 FRD 22E Summary of the financial results for the year 11 FRD 22E Workforce Data Disclosures including a statement on the application of employment and conduct principles FRD 25B Victorian Industry Participation Policy disclosures 18 FRD 29 Workforce Data disclosures 16 SD 4.2(g) Specific information requirements 13 SD 4.2(j) Sign-off requirements 5 SD Attestation on data integrity SD Ministerial Standing Direction compliance attestation 18 SD Risk management compliance attestation Rural Northwest Health - Annual Report

20 Disclosure Index Legislation Requirement Page Reference Financial Statements Financial statements required under Part 7 of the FMA SD 4.2(a) Statement of changes in equity In Financial Report SD 4.2(b) Comprehensive operating statement In Financial Report SD 4.2(b) Balance sheet In Financial Report SD 4.2(b) Cash flow statement In Financial Report Other requirements under Standing Directions 4.2 SD 4.2(a) Compliance with Australian accounting standards and other authoritative pronouncements In Financial Report SD 4.2(c) Accountable officer s declaration In Financial Report SD 4.2(c) Compliance with Ministerial Directions In Financial Report SD 4.2(d) Rounding of amounts In Financial Report Legislation Freedom of Information Act Protected Disclosure Act Carers Recognition Act Victorian Industry Participation Policy Act Building Act Financial Management Act In compliance with the requirements of FRD 22E Standard Disclosures in the Report of Operations, details in respect of the items listed below have been retained by Rural Northwest Health and are available to the relevant Ministers, Members of Parliament and the public on request (subject to the freedom of information requirements, if applicable): a. A statement of pecuniary interest has been completed; b. Details of shares held by senior officers as nominee or held beneficially; c. Details of publications produced by the Department about the activities of the Health Service and where they can be obtained; d. Details of changes in prices, fees, charges, rates and levies charged by the Health Service; e. Details of any major external reviews carried out on the Health Service; f. Details of major research and development activities undertaken by the Health Service that are not otherwise covered either in the Report of Operations or in a document that contains the financial statements and Report of Operations; g. Details of overseas visits undertaken including a summary of the objectives and outcomes of each visit; h. Details of major promotional, public relations and marketing activities undertaken by the Health Service to develop community awareness of the Health Service and its services; i. Details of assessments and measures undertaken to improve the occupational health and safety of employees; j. General statement on industrial relations within the Health Service and details of time lost through industrial accidents and disputes, which is not otherwise detailed in the Report of Operations; k. A list of major committees sponsored by the Health Service, the purposes of each committee and the extent to which those purposes have been achieved; l. Details of all consultancies and contractors including consultants/contractors engaged, services provided, and expenditure committed for each engagement. 20 Rural Northwest Health - Annual Report 2014

21 - Annual Report

22

23

24 RURAL NORTHWEST HEALTH COMPREHENSIVE OPERATING STATEMENT FOR THE FINANCIAL YEAR ENDED 30 JUNE 2014 Note $'000 $'000 Revenue from Operating Activities 2 18,249 18,612 Revenue from Non-Operating Activities Employee Benefits 3 (13,537) (13,205) Non Salary Labour Costs 3 (318) (408) Supplies and Consumables 3 (1,072) (934) Other Expenses 3 (3,682) (3,591) Net Result Before Capital and Specific Items Capital Purpose Income Depreciation 4 (2,294) (2,201) NET RESULT FOR THE YEAR (1,355) (737) Other Comprehensive Income Changes in physical asset revaluation surplus 3,621 3,719 COMPREHENSIVE RESULT 2,266 2,982 This Statement should be read in conjunction with the accompanying notes. 1

25 RURAL NORTHWEST HEALTH BALANCE SHEET AS AT 30 JUNE 2014 Note $'000 $'000 Current Assets Cash and Cash Equivalents 5 2,428 11,743 Receivables Investments and Other Financial Assets 7 10,050 0 Inventories Other Assets Total Current Assets 13,328 12,461 Non-Current Assets Receivables Property, Plant and Equipment 10 38,094 36,247 Total Non-Current Assets 38,114 36,484 TOTAL ASSETS 51,442 48,945 Current Liabilities Payables Provisions 12 3,050 3,114 Other Liabilities 14 2,907 2,545 Total Current Liabilities 6,605 6,390 Non-Current Liabilities Provisions Total Non-Current Liabilities TOTAL LIABILITIES 6,963 6,733 NET ASSETS 44,478 42,212 EQUITY Property, Plant and Equipment Revaluation Surplus 15a 12,519 8,898 Restricted Specific Purpose Surplus 15a Contributed Capital 15b 20,935 20,935 Accumulated Surplus 15c 10,911 12,266 TOTAL EQUITY 44,478 42,212 Commitments 18 Contingent Assets and Contingent Liabilities 19 This Statement should be read in conjunction with the accompanying notes. 2

26 RURAL NORTHWEST HEALTH STATEMENT OF CHANGES IN EQUITY FOR THE FINANCIAL YEAR ENDED 30 JUNE 2014 Property, Plant Restricted Contributed Accumulated Total and Equipment Specific Capital Supluses/ Revaluation Purpose (Deficits) Reserve Reserve Note $ $ $ $ $ Balance at 1 July , ,935 13,003 39,230 Net result for the year 15c (737) (737) Other Comprehensive Income 15a 3,719 3,719 Balance at 30 June , ,935 12,266 42,212 Net result for the year 15c (1,355) (1,355) Other comprehensive income for the year 15a 3, ,621 Balance at 12, ,935 10,911 44,478 This Statement should be read in conjunction with the accompanying notes. 3

27 RURAL NORTHWEST HEALTH CASH FLOW STATEMENT FOR THE FINANCIAL YEAR ENDED 30 JUNE 2014 Note $'000 $'000 Inflows / Inflows / CASH FLOWS FROM OPERATING ACTIVITIES (Outflows) (Outflows) Operating Grants from Government 15,737 16,120 Patient and Resident Fees Received 1,801 2,714 Donations and Bequests Received GST (Paid to)/received from ATO 36 (47) Interest Received Other Receipts Total Receipts 18,892 19,653 Employee Expenses Paid (13,586) (13,091) Fee for Service Medical Officers (318) (408) Payments for Supplies and Consumables (931) (1,193) Other Payments (3,446) (3,287) Total Payments (18,281) (17,979) Cash Generated from Operations 611 1,674 Capital Grants from Government NET CASH FLOW FROM /(USED IN) OPERATING ACTIVITIES ,758 CASH FLOWS FROM INVESTING ACTIVITIES Purchase of Investments (7,441) 0 Payments for Non-Financial Assets (584) (677) Proceeds from sale of Non-Financial Assets 98 0 NET CASH FLOW FROM /(USED IN) INVESTING ACTIVITIES (7,927) (677) NET INCREASE /(DECREASE) IN CASH AND CASH EQUIVALENTS HELD (7,172) 1,081 CASH AND CASH EQUIVALENTS AT BEGINNING OF FINANCIAL YEAR 9,256 8,175 CASH AND CASH EQUIVALENTS AT END OF FINANCIAL YEAR 5 2,084 9,256 This Statement should be read in conjunction with the accompanying notes. 4

28 NOTE 1 : SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES These annual financial statements represent the audited general purpose financial statements for Rural Northwest Health for the period ended. The purpose of the report is to provide users with information about Rural Northwest Health's stewardship of resources entrusted to it. (a) Statement of compliance These financial statements are general purpose financial statements which have been prepared in accordance with the Financial Management Act 1994, and applicable Australian Accounting Standards (AASs), which include interpretations issued by the Australian Accounting Standards Board (AASB). They are presented in a manner consistent with the requirements of AASB 101 Presentation of Financial Statements. The financial statements also comply with relevant Financial Reporting Directions (FRDs) issued by the Department of Treasury and Finance, and relevant Standing Directions (SDs) authorised by the Minister for Finance. Rural Northwest Health is a not-for profit entity and therefore applies the additional AUS paragraphs applicable to "not-for-profit" Health Services under the AAS's. The annual financial statements were authorised for issue by the Board of Rural Northwest Health on 21st August, (b) Basis of accounting preparation and measurement Accounting policies are selected and applied in a manner which ensures that the resulting financial information satisfies the concepts of relevance and reliability, thereby ensuring that the substance of the underlying transactions or other events is reported. The accounting policies set out below have been applied in preparing the financial statements for the year ended, and the comparative information presented in these financial statements for the year ended 30 June The going concern basis was used to prepare the financial statements.the service contemplates the continuity of normal trading operations and the realisation of assets and settlement of liabilities in the ordinary course of business. The Department of Health has confirmed in writing its intention to continue to provide financial support to Rural Northwest Health up until September 2015 These financial statements are presented in Australian Dollars, the functional and presentation currency of Rural Northwest Health. The financial statements, except for cash flow information, have been prepared using the accrual basis of accounting. Under the accrual basis, items are recognised as assets, liabilities, equity, income or expenses when they satisfy the definitions and recognition criteria for those items, that is they are recognised in the reporting period to which they relate, regardless of when cash is received or paid. The financial statements are prepared in accordance with the historical cost convention, except for: Non-current physical assets, which subsequent to acquisition, are measured at a revalued amount being their fair value at the date of the revaluation less any subsequent accumulated depreciation and subsequent impairment losses. Revaluations are made and are re-assessed with sufficient regularity to ensure that the carrying amounts do not materially differ from their fair values; The fair value of assets other than land, buildings and motor vehicles are generally based on their depreciated replacement value. 5