Lakeland Regional Medical Center 2009 Report to the Community

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1 Lakeland Regional Medical Center 2009 Report to the Community Our Vision Lakeland Regional Medical Center... creating the best health care experiences Our Core Purpose/Mission Improving lives by delivering exceptional health care

2 LRMC 2009 REPORT TO THE COMMUNITY Lakeland Regional Medical Center is committed to improving lives by delivering exceptional healthcare. Our community can be proud of the level of service and quality of care available at their hospital, which is the fifth largest hospital in Florida. Responsibility for upholding our community commitment rests with a Board of Directors, composed of community leaders who devote countless hours to the governance of this hospital. They represent the community, without compensation, with the charge of ensuring the fulfillment of Lakeland Regional Medical Center s vision and mission. Lakeland Regional Medical Center s mission drives the development of our annual goals, objectives, budget, and staff performance measures. At this time, we would like to present an overview of the hospital s performance for fiscal year We are committed to providing our community the best patient experience. One way to do that is to serve patients and families consistent with their individual physical, emotional, spiritual, environmental and socio-cultural preferences. Some of the service and technological improvements we made in 2009 included: The opening of a dedicated Trauma Intensive Care Unit, giving us 72 intensive care beds in four units, to meet the highly specialized needs of this growing patient population. The opening of the Center for Advancing Quality of Life and palliative care service, the first hospital-based palliative care unit in Polk County, designed to manage care and pain for chronically or terminally ill patients. This program allows us to offer quality of life choices for these patients, without the necessity of intensive care. 1

3 The opening of Lakeland Regional Rehabilitation and Sports Medicine Clinic on Harden Boulevard, providing a full-range of physical, occupational, and speech therapy on an outpatient basis. The program also features the area s only certified lymphedema therapists. Outpatient rehabilitation enhances the continuum of care for our orthopedic, neurosurgery, cancer, stroke, and patients with a variety of pain and other problems. The opening of an outpatient pharmacy near the hospital s B entrance, to conveniently serve the discharge prescription needs of our inpatients and ER patients. The implementation of a chest pain observation unit, which has produced positive outcomes for patients and dramatically improved patient throughput. Relocation of the medical library, which serves the education and research needs of physicians, staff, patients, and families. Relocation and expansion of the surgery waiting room, to allow more convenient access and comfort for the families and visitors of our surgical patients. Establishment of the OB Hospitalist program to improve patient flow and continuity for our unassigned obstetric patients. The completion of a number of vital technology implementations and upgrades that support both clinical and business operations. As we continually strive to improve quality of care and patient safety, we achieved several significant recognitions, including: The National Accreditation Program for Breast Centers accreditation at LRCC, becoming only the 2nd program in Florida and 52nd in the country to achieve this prestigious designation. Three-Year Approval with Commendation by The Commission on Cancer (CoC) of the American College of Surgeons (ACoS) for the cancer program at Lakeland Regional Medical Center. Achievement of the 2008 Silver Performance Award from ACTION Registry Get with the Guidelines for Cardiovascular Performance. Achievement of the National Get With the Guidelines Silver Award for Stroke performance by the American Stroke Association. Repeated achievement of a 3-Star Rating, by The Society of Thoracic Surgeons, for our cardiovascular surgery program. This is the Society s highest possible distinction and places LRMC among the top 12% of programs in the nation. Recognized as a Center of Distinction by Diversified Clinical Services for our Wound Care Center. LRMC became one of only 14 of the nearly 285 eligible hospitals throughout the country to achieve this honor. National recognition for organ donation rates for the fifth year in a row. This is a testament to the sensitivity of our trauma, surgery, and intensive care staffs in working with cases appropriate for organ donation. Quality Respiratory Care Department designation from the American Association for Respiratory Care for the third consecutive year. Jean Byers Award for excellence in Oncology Data Services, for the 6th year in a row. 2

4 In addition, Dr. Olu Sobowale, director of our trauma program, performed the second diaphragm pacing surgery in Florida in June. This operation provides the opportunity for better ventilation for high spinal cord injury patients and is expected to be offered in very few centers on a limited basis across the country. Dr. Sobowale has now performed 2 of only 4 cases in Florida. To create the best experience for our patients, we also strive to be the best place to work, providing employees a culture of engagement and accountability for practicing our values and achieving results. As the fifth largest employer in Polk County with 4,615 employees (3,842 full-time equivalents), we recognize the significant role LRMC plays as part of the community workforce. Having been continually recognized by Polk Works Workforce 2020 as one of Polk County s Best Places to Work, LRMC now holds the agency s title of Employer of Distinction award winner. We also continue to place a high priority on the educational development of our staff as a key to delivering quality care. We are proud of the following accomplishments and recognitions among our staff: Betty Workman, RN, was named Polk County Nurse of the Year in the clinical/hospital category. Judy Snow, ARNP, was named Polk County Nurse of the Year in the nurse educator category. Merita Pederzini, RN, from the B6 onocology unit, was named Nurse of Hope by the American Cancer Society and Oncology Nurses Association. Janet Fansler, RN, Chief Nurse Executive, earned the designation of Certified in Executive Nursing Practice from the American Association of Nurse Executives. Our B5 Cardiology nursing unit was named Best in Adaptability by Advance for Nursing magazine. Members of our leadership team have participated in local, state, and national presentations and leadership roles for a variety of organizations. Our commitment to being the best place to work extends to physicians as well. The Lakeland area is fortunate to have a diverse and well-respected physician community, with 516 physicians, dentists, and podiatrists currently serving on LRMC s medical staff. We have worked closely with the physician community to assist in the recruitment of new physicians of various specialties to address physician shortages. We now employ three neurosurgeons, four orthopedic surgeons, and six trauma surgeons to fill these critical shortage areas in our community. Our 3

5 neurosurgery clinic moved to new offices on Lakeland Hills Boulevard to provide much-needed extra space for both the neurosurgeons and trauma surgeons. Lakeland Regional Cancer Center added a fourth urologic oncologist. The number of surgeons performing robotic surgery has increased from five to eleven. As one of our area s largest employers and economic drivers, we also maintain a commitment to community stewardship, ensuring financial viability, while demonstrating social accountability: Community education programs were offered on a variety of health topics, including major forums on heart disease and breast cancer awareness. The Victorian Tea program reached approximately 400 women with the latest information in breast cancer care and treatment. The Matters of the Heart event provided information on LRMC s chest pain center, the newest technologies in lung surgery, and valuable stroke information. LRMC implemented sustainability initiatives, including full implementation of electronic pay stubs and used battery recycling and has developed plans for additional programs in the coming year. We paid tribute to cancer survivors with a Cancer Survivors Day event, held at Lakeland Regional Cancer Center. Hospital employees donated to the United Way campaign, Toys for Tots, and Senior Orphans. Employees also gave nearly $253,000 to the hospital, through gifts to the LRMC Foundation. Lakeland Regional Medical Center also contributes to the financial health of the community in several ways. In addition to the dollars spent on payroll and purchases, the hospital makes an annual lease payment to the City, which totaled $11.1 million this year. The LRMC Foundation continues to play an important role in the hospital s growth and financial wellbeing. A generous donation of $100,000 by Lester Wishnatzki ensured LRMC was able to expand palliative care services after the Wishnatzki family benefited directly from this service. In November 2008, the Women in Philanthropy program chose to donate funding of nearly $35,000: To purchase infant car beds to provide a safe mechanism for parents to transport their premature infant home without the risk of compromising the baby s airway. To provide and implement a Perinatal Bereavement Program that will provide patients exceptional care. To purchase an infant-sized immobilization device to be used during MRI and CT scans. To create a diabetes program for care of newly diagnosed children. To provide educational/play therapy supplies for outpatient treatment of psychiatric disorders in young children. To start an aftercare group for child/adolescent patients who are discharged from inpatient psychiatric treatment. 4

6 To purchase injury prevention equipment and supplies to be distributed to the public by our trauma community education program. To underwrite an educational program for key community leaders on the importance of advanced directives. In addition, the Lights for Life campaign is committed to raising funds to expand and renovate our Pediatric Emergency Department. The Foundation supports various hospital needs and, through philanthropy, allows us to extend our mission. Of course, financial stability is a key component of our community stewardship and underlies our ability to meet all of our goals. Our clinical areas have worked hard to improve our quality as well as contain our costs. In 2009, our cost per adjusted discharge, adjusted for case mix index was $6,813, which was a slight increase from last year s cost of $6,722. Legislative activities at both the federal and state levels have a great impact on LRMC s financial situation. We monitor health care-related legislation and frequently contact our legislators in support or opposition of various proposals. Now I would like to share with you where LRMC s funds came from and where they were applied. First, in fiscal year 2009, LRMC provided care for 37,737 adult inpatients and welcomed 3,519 newborn deliveries. We had 154,062 emergency department visits, and 39,327 outpatient/same day care cases. Our inpatient discharges increased by 2.8% from 2008, and our patient days decreased by 0.5%. There was a 7.8% increase in Emergency Room visits and a 9.5% decrease in outpatient/same day care. LRMC receives funds from charges to patients for inpatient and outpatient services, as well as from non-hospital activities, such as its cafeteria, gift and uniform shops, and physicians answering service. In 2009, these funds totaled $1.989 billion in gross revenue. However, agencies such as Medicare, Medicaid and managed care contracts have limited their levels of payment to hospitals, and they failed to pay for $1.286 billion in patient charges. In addition, we provided $129 million for charity care. Therefore, actual funds available totaled $574 million. On the expense side, LRMC s largest resource is our staff, and we spent $250 million for salaries and benefits. Another $292 million went to supplies, medications, business services, insurance, utilities, maintenance, bad debts, and depreciation, while our lease expense to the city accounted for another $11 million. Total expenses were $553 million, resulting in net operating income of $21 million for When you take into consideration that LRMC generated $55 million in cash flows from operations and spent $30 million for the replacement and improvement of facilities and equipment, this means we increased our cash reserves for future needs by $25 million. Our commitment to our community is represented in the continual re-investment of these resources into the advanced technology, equipment, and facility planning that enables our physicians and staff to provide high quality, comprehensive healthcare services. 5

7 The issues that have challenged the healthcare industry continue to exert pressure on our financial situation. The federal government has continued to make cuts to Medicare payments to hospitals. Managed care companies demand lower rates and continue to negotiate downward. The costs of pharmaceuticals and supplies continue to increase, as do salary and benefits expense. Individuals have held off on elective surgeries, and our procedural volumes have declined. However, in the face of these continuing financial pressures, the entire hospital team has given their utmost to meet the challenges, as we have tightened our budget in ways that have affected both our people and our operations. We are proud of their commitment and contributions. For fiscal year 2010, LRMC implemented a 10% overall rate increase. However, because of fixed reimbursement from Medicare, Medicaid and managed care, we will receive only 3 cents from every dollar of additional revenue generated by that rate increase. In addition, we have budgeted $233 million in write-offs for charity care and bad debt. Overall, we have budgeted for an increase in total operating revenue from $574 million to $590 million. Our expense budget will increase slightly from $553 million this year to $562 million next year, leaving net operating income of $28 million. In 2010, we will continue to be vigilant in our efforts to manage costs while providing quality care to our patients. Lakeland Regional Medical Center is proud to stand as a healthcare leader and to serve the needs of our community and the patients entrusted to our care. 6

8 Lakeland Regional Medical Center... creating the best health care experiences

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