Central Florida REGIONAL HOSPITAL. Our Commitment To Excellence COMMUNITY REPORT. Central Florida Regional Hospital 2013 COMMUNITY REPORT

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1 Central Florida Regional Hospital Central Florida REGIONAL HOSPITAL Our Commitment To Excellence Central Florida Regional Hospital breaks ground for the Oviedo ER, an 11,000 square foot freestanding ER in Oviedo, Florida, scheduled to open in the fall of COMMUNITY REPORT COMMUNITY REPORT

2 Our Commitment To Excellence A Message From Our CEO Wendy H. Brandon, FACHE Chief Executive Officer I am proud to share with you all our team has accomplished for our patients over the past year. We completed renovations of our EP lab, Cardiopulmonary Department, short stay surgery, pre-admission testing and one of our main radiology rooms, allowing us to better serve our patients. We brought robotic surgery, the latest innovation in minimally invasive surgery, to Central Florida Regional Hospital with the installation of the da Vinci Surgical System. And we recently opened The Rehabilitation Center at Central Florida Regional Hospital, providing the first facility in Seminole County for acute inpatient medical rehabilitation. In December 2012 we broke ground on the Oviedo ER, a department of Central Florida Regional Hospital, which will bring much needed emergency health care services to our neighbors in east Seminole County. Oviedo ER is scheduled to open in the Fall of But perhaps our greatest accomplishment this year is thanks to something that hasn t changed our commitment to quality patient care. For the second year in a row, Central Florida Regional Hospital was named a Top Performer on Key Quality Measures by The Joint Commission. Only 18% of the nation s hospitals earned this recognition this year. We are the only hospital in our area to be recognized and the only hospital in Central Florida to achieve this prestigious recognition in two consecutive years! On behalf of our entire team, I want to pledge our commitment to ALWAYS providing the quality care every patient expects and deserves and to our mission to improve the quality of life and health of our community. Sincerely, Wendy H. Brandon, FACHE Chief Executive Officer Central Florida Regional Hospital Leadership Wendy H. Brandon, FACHE Chief Executive Officer Chris Taramasco Chief Nursing Officer Glenn Carney Chief Operating Officer Richard Read Chief Financial Officer CENTRAL FLORIDA REGIONAL HOSPITAL From L to R: Chris Taramasco, Glenn Carney, Richard Read, Wendy Brandon

3 Central Florida Regional Hospital HCA Central Florida Facilities H H HOSPITALS CENTRAL FLORIDA REGIONAL HOSPITAL Sanford, Florida OSCEOLA REGIONAL MEDICAL CENTER Kissimmee, Florida SURGERY CENTERS FLORIDA SURGERY CENTER Altamonte Springs, Florida KISSIMMEE SURGERY CENTER Kissimmee, Florida MERRITT ISLAND SURGERY CENTER Merritt Island, Florida SAME DAY SURGICENTER OF ORLANDO Orlando, Florida IMAGING CENTERS OSCEOLA IMAGING & BREAST CARE CENTER Kissimmee, Florida MT. D O R A 429 A P O PKA 429 WALT D I S NEY WORLD ALTAM ONTE S P RINGS W INTER PA R K O R L A N D O LAKE MONROE H K I S S I M M E E H 1 S ANFO R D 46 L A K E MAR Y Central Florida Regional Hospital Accreditations and Certifications: Accredited ACUTE CARE Hospital (Joint Commission) Accredited Chest Pain Center WITH PCI (SOCIETY OF CHEST PAIN CENTERS) ACCREDITED ULTRASOUND, MAMMOGRAPHY AND NUCLEAR MEDICiNE (AMERICAN COLLEGE OF RADIOLOGY) Certified Advanced Primary Stroke Center (Joint Commission) CERTIFIED DIABETES EDUCATION PROGRAM (AMERICAN DIABETES ASSOCIATION) Services: The Only Full Service Heart Program in Seminole and West Volusia Counties 24-Hour Emergency Services Accredited Chest Pain Center with PCI The Baby Suites Certified Primary Stroke Center Diabetes Care, Education and Support Diagnostic Imaging Services Hyperbaric Medicine and Wound Care Neurohealth Sciences Sleep Disorders Laboratory Rendering of freestanding emergency department in Oviedo at the intersection of Red Bug Lake Road and the 417 Greenway. Central Florida Regional Hospital, an affiliate of HCA, will bring state of the art emergency care to Oviedo in Fall 2013 with a full-service emergency room providing 24/7 emergency care for both pediatric and adult patients. The new facility will offer comprehensive emergency services including a dedicated trauma room as well as laboratory and imaging services. Spine Care Center 2013 COMMUNITY REPORT 1

4 Our Commitment To Excellence 2013 Community Impact Summary Statistics Number of Licensed Beds Total Patients Treated Annual Hospital Admissions Annual Emergency Visits Total Medicaid Patients Treated Medicaid Market Share Total Uninsured Patients Treated 1 Uninsured Market Share ,857 10,276 47,051 18, % 12, % (1) excludes Medicaid patients treated Our Hospital Family Total Employees Total Physicians Total Volunteers 1, Ratan Ahuja, M.D., winner of the 2012 Iron Heart Cook Off, and his sous-chef with Bob Frier, WOFL FOX35 News Anchor. Central Florida Regional Hospital hosts the Iron Heart Cook Off to benefit the American Heart Association. 2 CENTRAL HCA WEST FLORIDA REGIONAL HOSPITAL

5 Central Florida Regional Hospital Economic Impact Total Salaries & Benefits $ 68,631,848 Cost of Charity & Uncompensated Care $ 16,103,387 Taxes Paid: Federal Income Tax $ 1,139,385 State Income Tax $ 259,738 Indigent Care Tax $ 1,648,472 Property Tax $ 848,667 Sales Tax $ 774,652 Other Local Tax $ 6,011 Total Taxes $ 4,712,925 Capital Investment 1 $ 3,105,051 Total Local Vendor Support $ 13,236,860 Minority & Women Owned Business Support $ 29,163 Physician Specialty Coverage for Emergency Care $ 1,419,612 TOTAL Economic Impact $ 107,209,683 (1) 5 year annual average FY 2012 statistics Total Cost of Charity & Uncompensated Care 15% Local Vendor Support 12.4% Total Taxes 4.4% Total Salaries & Benefits 64% Capital Investment 2.9% Physician Specialty Coverage for Emergency Care 1.3% 2013 COMMUNITY REPORT 3

6 Our Commitment To Excellence Giving Back To Our Community Central Florida Regional Hospital and its employees provide both financial and volunteer support to countless civic organizations, schools, colleges, city projects and nonprofit and charitable organizations in their local communities. Additionally, our hospital sponsors a wide range of community health information programs, screenings and seminars, which are posted on hospital websites in the community calendar section. Here too, you can find our online physician directory, where physicians can be searched by name or specialty, you can also find physicians who are credentialed to be on the hospital s medical staff. Green Team The Green Team at Central Florida Regional Hospital was established in June 2009 and its purpose is to create eco-friendly practices within our workplace. Some of the accomplishments of the team include: hospital-wide recycling, minimizing printing, turning off lights and equipment when not in use and utilizing reusable cups instead of disposables. Central Florida Regional Hospital has been recognized as a Green Business by the Greater Sanford Regional Chamber of Commerce Let s Think Green Committee and the Practice Greenhealth Environmental Excellence Awards. Benefit Enrollment Assistance We are committed to helping uninsured patients qualify for local and state health benefits programs. Each hospital offers on-site benefit education and Medicaid enrollment assistance. Social Media HCA West Florida and many of our hospitals now have a social media presence to engage our patients and the communities we serve as fully as possible. Links to Facebook, Twitter, and other channels can be found on our hospital websites. Health Partners We partner with a wide range of resources, including HealthGrades and itriage, to bring our communities the latest health information, quickly and conveniently. For information on downloading the itriage mobile application, visit our hospital websites or Hurricane Preparedness We offer one of the most comprehensive hurricane preparedness plans to ensure our patients and our staff who care for them are safe before, during and after a storm. HCA West Florida has contracts with vendors from around the state and nation to provide support from on-site security, to generators, to food. Transfer processes and plans with our network of hospitals across the country also exist should patients need to be relocated. 4 CENTRAL FLORIDA REGIONAL HOSPITAL Consult a Nurse Free physician referral and health information are available around-the-clock by calling HCA-DOCS ( ). Registered nurses are available for consultation through this bilingual community service, which also registers people for the numerous community education classes and programs sponsored by the HCA hospitals in central and west Florida.

7 Central Florida Regional Hospital Volunteering Volunteers donated 23,898 hours of service to the patients, visitors and staff of Central Florida Regional Hospital in The hospital currently has 144 volunteers and 114 are active. In 2012 they provided support to Harvest Time International, Hospice of the Comforter, Christian Sharing Center, Safe House of Seminole, Seminole High School Leadership Class, Domestic Abuse Council and the American Heart Association and individual employee scholarships for a total of $20,995. Awards and Recognition n Joint Commission Key Quality Measures Top Performer n Joint Commission Acute Care Accreditation n Joint Commission Primary Stroke Center Certification n Accredited Chest Pain Center with PCI from the Society of Chest Pain Centers n Action Registry GWTG Gold Performance Achievement Award from the American College of Cardiology and the American Heart Association for acute myocardial infarction n American Heart Association/American Stroke Association GWTG Gold Plus Performance Achievement Award n Laboratory CAP Accreditation Primary Stroke Center Certification Accredited Chest Pain Center w/pci n Cardiopulmonary CAP Accreditation n Cardiopulmonary CAP Rehabilitation Accreditation n American Association of Cardiovascular and Pulmonary Rehabilitation Accreditation n Blue Cross Blue Shield s Blue Distinction Center Designation for Knee/Hip Replacement, Spine Surgery and Cardiac Care n American Diabetes Association Certified Diabetes Education Program n Mammography Quality Acts Certification A Partial Listing of Organizations Benefiting From Our Involvement: American Cancer Society American Heart Association Boys & Girls Clubs Central Florida Zoo and Botanical Gardens Enterprise Preservation Society, Inc. Harvest Time International Kids House of Seminole Leadership Seminole, Inc. Oviedo Rotary Rescue Outreach Mission Rotary Club of Lake Mary Seminole County Regional Chamber of Commerce Seminole County Healthy Start Sanford Regional Chamber of Commerce Sanford Rotary Club Seminole County Public Schools Shepherd s Hope The Foundation for Seminole County Public Schools The Foundation for Seminole State College of Florida Wayne Densch Performing Arts Center YMCA of Central Florida 2013 COMMUNITY REPORT 5

8 Our Commitment To Excellence Quality And Patient Safety Putting Patients First is the foundation of our culture and passion for providing quality healthcare. Many of our initiatives serve as national models today, as we lead the way in adopting best practices to eliminate clinical variations. Clinical Excellence HCA West Florida hospitals achieve industry leading performance on public clinical measures, including CMS Core Measures. We completed 2012 with a preliminary fourth quarter Core Measures composite inpatient score of 99.78%, and 12 of our 15 hospitals earned national recognition as Top Performers in Key Quality Measures from The Joint Commission in the areas of Heart Attack, Heart Failure, Pneumonia and Surgical Care. We earned 10 A Hospital Safety Score ratings in 2012, which uses national performance measures from the Leapfrog Hospital Survey, the Agency for Healthcare Research and Quality (AHRQ), the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare and Medicaid (CMS) to produce a single score representing a hospital s overall performance in keeping patients safe from preventable harm and medical errors. Our hospitals are saving lives, reducing complication rates and eliminating unnecessary costs through a strong focus on quality. We are achieving and exceeding national clinical goals and benchmarks. These efforts are strongly supported by HCA s Clinical Services Group, an industry leader in bringing evidenced based medicine to the bedside in community hospitals nationwide. AIM for Zero The goal is to eliminate Central Line- Associated Blood Stream Infections (CLABSI) through the consistent application of proven techniques to protect patients from preventable blood stream infections during their hospital stay. Flu Season Preparation We are making our hospital safer for our patients and visitors through our flu vaccine initiative. This includes providing free vaccines to staff and requiring vaccinations of health workers with direct patient contact. When a vaccine is not possible, the caregiver wears a mask. Airstrip OB & Cardiology Central Florida Regional Hospital has adopted this technology that allows physicians to remotely access and view patient monitors from their smartphones. Broselow System for Acute Pediatric Administration of Drugs Central Florida Regional Hospital s emergency department, nursery and pediatric program are equipped with this sophisticated medication safety system to ensure the proper dosing and administration of drugs to infants and children. 6 CENTRAL FLORIDA REGIONAL HOSPITAL

9 Central Florida Regional Hospital Maternal/Fetal Safety Initiatives HCA took a leadership role with the March of Dimes and other national organizations by participating in initial research studies to minimize or eliminate elective deliveries before 39 weeks gestation. Study results showed a positive impact on the health of babies. Central Florida Regional Hospital has Better than Targeted results posted on the Leapfrog Group website for the excellent results they have achieved in eliminating or virtually eliminating all elective deliveries before 39 weeks in our facility. We were the first US healthcare system to perform a blood test to screen newborns for kernicterus, which can cause permanent brain damage and physical impairment. If identified immediately, it is easily treatable. Today, this screening is a standard of care in hospital newborn nurseries across the county and as a result the incidence of kernicterus has been dramatically reduced. Radiation Right Radiation Right applies patient safety principles and actions to medical imaging and radiation therapy with the goal of protecting patients from the harmful effects of radiation overexposure. Radiation Right focuses on providing each patient with the Right Exam, of the Right Site, in the Right Dose. Initially developed by the HCA Clinical Services Group, this program has been adopted by all HCA West Florida hospitals and imaging centers. Sepsis Program Severe sepsis is now one of the most common causes of death in ICUs nationally. We are aggressively working to reduce this patient safety threat through hospital and community-wide focus on early recognition and management. MRSA ABC s A new strain of antibiotic-resistant staph, or MRSA, is spread easily and is much more difficult to treat than ordinary staph bacteria. The growing prevalence of MRSA in our communities and in our hospitals is creating new challenges for the healthcare community. In response, HCA hospitals across the nation, under the leadership of Dr. Jonathan B. Perlin, HCA s chief medical officer, have implemented 2013 COMMUNITY REPORT 7

10 Our Commitment To Excellence more aggressive infection prevention protocols to tackle this issue. Central Florida Regional Hospital also has a proactive education campaign for patients, visitors and staff to prevent infections from occurring and spreading. We see MRSA as a national challenge affecting hospitals and communities alike, and would like to share our materials as a way of contributing to the education and more importantly the eradication of MRSA. Please feel free to use the tools from our MRSA campaign, available on our hospital website at home, work, or school, and join us in the fight to eradicate MRSA. STEMI Initiative A STEMI (ST-Elevation Myocardial Infarction) is a deadly type of heart attack, which is identified on an EKG. Early treatment to the blocked coronary artery minimizes the extent of the heart muscle damage and preserves the pumping function of the heart, thereby increasing survival and reducing or eliminating complications. Central Florida Regional Hospital is saving lives through an aggressive focus on treating STEMI patients quickly. Partnering with EMS has allowed medical treatment to begin immediately on the scene, before the patient arrives in our emergency department. STEMI times are defined as the time it takes to reestablish blood flow and the American College of Cardiology, the American Heart Association and The Joint Commission have established that this should occur in 90 minutes or less. Our hospitals are averaging times well below this and, in most cases, are posting STEMI times on their hospital websites. Vitals Now We piloted this technology to enable the automatic capture of patient vitals from the bedside into our clinical system, making them immediately available for review by clinicians. 8 CENTRAL FLORIDA REGIONAL HOSPITAL

11 Central Florida Regional Hospital Specialized Care Emergency Excellence Highly skilled emergency physicians and nurses combined with best practices and the latest technology benefitted over 43,000 patients in the Central Florida Regional Hospital Emergency Room last year. Protocol driven care that can begin in the field through direct communications with local EMS teams, and meeting stringent standards to earn Chest Pain Center Accreditation with PCI and Primary Stroke Center Certification by The Joint Commission are all part of our commitment to improve quality at Central Florida Regional Hospital s emergency room. Our strong focus on enhancing care and improving ER processes has also dramatically reduced wait times to below national averages. You can find our average ER wait times posted on our hospital website, by text messaging ER to or by viewing on billboards located on I-4 in Lake Mary and Sanford. Heart & Vascular Network Central Florida Regional Hospital is one of only 135 hospitals nationwide to receive the American College of Cardiology Foundation s NCDR ACTION Registry Get With The GuidelinesTM Gold Performance Achievement Award. The Gold Performance Achievement Award signifies Central Florida Regional Hospital has reached an aggressive goal of treating coronary artery disease patients with 85 percent compliance to core standard levels of care outlined by the American College of Cardiology/American Heart Association clinical guidelines and recommendations. Central Florida Regional Hospital provides comprehensive cardiac and vascular care services to the community by combining the talents of our cardiologists, electrophysiologists, radiologists, cardiothoracic and vascular surgeons. Our program provides a 47-bed cardiac 2013 COMMUNITY REPORT 9

12 Our Commitment To Excellence unit, a 12-bed cardiovascular intensive care unit and two specially designed, fully staffed and equipped operating suites reserved exclusively for cardiovascular surgery. In addition, two state-of-the-art digital catheterization labs for invasive studies, an electrophysiology lab, non-invasive cardiology services and cardiac rehabilitation make Central Florida Regional Hospital the only full-service cardiac facility in Seminole and West Volusia counties. Cardiac Rehabilitation The Cardiac Rehabilitation program at Central Florida Regional Hospital is designed to improve cardiovascular function and endurance. It is safe and beneficial for both men and women of all ages. With a combination of exercise, education and making heart healthy choices, cardiac rehabilitation can improve the patient s or individual s sense of well-being and quality of life. Available on an inpatient or outpatient basis, individuals appropriate for the program include those who have experienced: n Heart disease such as angina, heart attack or heart failure n Coronary bypass surgery, balloon angioplasty or stent placement n Heart transplant n Stable angina Cardiopulmonary Services Respiratory Therapy Services include a full range of inpatient and outpatient respiratory care including pulmonary function testing, metabolic exercise stress testing, breathing treatments, oxygen evaluation including pulse oximetry and arterial blood gasses. Non-invasive Cardiac Diagnostic Services Services include a wide range of cardiac testing for inpatients and outpatients, therapeutic treatments, EKGs, transthoracic echo, transesophageal carotid ultrasound, cardiac stress testing and holter monitoring. Sleep Disorders Laboratory Assists in the diagnosis and treatment of obstructive sleep apnea. The sleep disorder test involves the patient spending the night in a specially designed bedroom. An overnight recording of the patient s sleep activity is obtained and used to develop a personalized treatment program. Neuro-diagnostic Services Includes EEGs, EMGs and state-of-the-art equipment for intra-operative monitoring used to diagnose strokes and seizures. 10 CENTRAL FLORIDA REGIONAL HOSPITAL

13 Central Florida Regional Hospital Cancer Care Cancer is the second leading cause of death in the country, and Central Florida Regional Hospital is committed to meeting and exceeding the many standards required for the American College of Surgeons Commission on Cancer by going through the cancer accreditation process. To become accredited in cancer services, the hospital has committed to regular meetings of the Cancer Committee and monthly cancer conferences which includes surgeons, medical oncologists, radiation oncologists, pathologists, radiologists and hospital clinical and support staff to proactively review patient cases. Neurohealth Sciences and Spine Care Our Neurohealth Sciences Center offers comprehensive stroke, spine and movement disorder programs, neurooncology services, and functional magnetic resonance imaging. The spinal program offers both comprehensive and minimally invasive services such as spinal compression fracture repair for osteoporosis. In addition, our spine care team provides a comprehensive approach to back pain treatment and recovery for both chronic and degenerative conditions. STROKE WARNING SIGNS If you notice one or more of these signs, don t wait. Stroke is a medical emergency. Call for emergency medical services. Get to a hospital right away! The American Stroke Association wants you to learn the warning signs of a stroke: n Sudden numbness or weakness of the face, arm or leg, especially on one side of the body n Sudden confusion, trouble speaking or understanding n Sudden trouble seeing in one or both eyes n Sudden trouble walking, dizziness, loss of balance or coordination n Sudden, severe headache with no known cause 2013 COMMUNITY REPORT 11

14 Our Commitment To Excellence Advanced Surgical Services Our Surgical Services Department performs a full range of procedures, from the most complicated cases to minimally invasive laparoscopic surgery, on both an inpatient and outpatient basis. Our surgical specialties include general surgery, gynecology, cardiovascular surgery, colon & rectal, podiatry, thoracic and vascular surgery, neurosurgery, orthopedics and urology. Imaging Services Central Florida Regional Hospital provides a comprehensive array of outpatient imaging services. Our facility is equipped with a broad range of diagnostic technology. n CT n 64-slice CT n Coronary Calcium Scoring n DEXA Bone Density Scan n Echocardiogram n EKG n Fluoroscopy n Interventional Radiology Procedures n Digital Mammography n MRA/MRI n Nuclear Medicine n PET/CT Scan n Stereotactic Breast Biopsies n Ultrasound n X-Ray The Baby Suites Central Florida Regional Hospital has welcomed more than 22,000 babies over the past 28 years. The birth of a baby is a special time and should happen in a special setting. Our delivery suites combine the comfort of a beautifully decorated room with the personalized services that you 12 CENTRAL FLORIDA REGIONAL HOSPITAL

15 Central Florida Regional Hospital deserve. Post-partum suites are private and our convenient location makes it easy for growing families in Seminole and West Volusia counties to be together at this important time. In addition we provide: n Nurses who are certified in neonatal resuscitation and fetal heart monitoring n 24-hour epidural anesthesia coverage n Dedicated caesarean section surgical suite n Prenatal education classes Diabetes Center Central Florida Regional Hospital s diabetes program has been awarded the prestigious American Diabetes Association (ADA) Education Recognition Certificate for providing a quality self-management education program to our community. In addition, we provide monthly diabetes education classes. To learn more, or to find out about our free diabetes education classes, call ext Hyperbaric and Wound Care Central Florida Regional Hospital s Hyperbaric and Wound Care Center specializes in the treatment of non-healing wounds such as arterial insufficiency, venous insufficiency, diabetic foot ulcers and resolution of wound complications caused by radiation therapy. Our team includes physicians and registered and certified hyperbaric technologists with advanced training in wound care management, specializing in the care of chronic wounds. It is our goal to provide individualized interventions for each patient. H2U Health to You (h2u) provides wellness solutions through its consumer and employer wellness programs. Currently, more than 1,400 individuals belong to the program at Central Florida Regional Hospital. Among the many benefits of membership are a Personal Health Assessment, online health portal and subscriptions to a monthly newsletter and quarterly magazine and a variety of exercise classes and health and wellness education events. Central Florida Regional Hospital offers a host of activities and events in our community for members to support social as well as physical health. Hannah Curlee, Runner-up on NBC s The Biggest Loser-Season 11, is the Director of Health Engagement at h2u and is traveling to h2u sites around the country to share her story. H2U also provides a program for employers enabling a wide range of health and wellness benefits for their employees. Living well and staying healthy are easier with a little help from H2U and this program will enable employers, both small and large, to select from a menu of health and wellness services to create a customized program for their employees. The H2U program can provide the education, support and tools you need to achieve your health and wellness goals. Membership is just $20 per year. For more information visit or call (407) Company Care Company Care delivers occupational health and worker s compensation programs specifically tailored to the needs of any business or government organization. Services include: n Case management to service the Worker s Comp Network n 24-hour access to medical care n Managed care services n Emergency care and follow-up for injured workers n Injury prevention education n Physical rehabilitation n Diagnostic testing n Pre-employment, executive and D.O.T. physicals n Drug screening and physical exams n Return-to-work programs n Utilization review n Ergonomic site assessments n Nutritional counseling 2013 COMMUNITY REPORT 13

16 Our Commitment To Excellence Central Florida Regional Hospital is located in Sanford on Lake Monroe, 3.6 miles east of I-4, between State Road 46 and Highway SEMINOLE TOWNE CENTER 4 15 CENTRAL FLORIDA ZOOLOGICAL PARK UPSALA RD 46 17/92 W AIRPORT BLVD LAKE MONROE N MANGOUSTINE AVE H W 1st ST W 1st ST 417 SEMINOLE EXPRESSWAY W 13th ST CENTRAL FLORIDA REGIONAL HOSPITAL West Seminole Boulevard I Sanford, Florida (407)