Expanding Quality HEALTHCARE. In Tampa Bay 2014 COMMUNITY REPORT 2014 ANNUAL REPORT

Transcription

1 HEALTHCARE Expanding Quality In Tampa Bay 2014 COMMUNITY REPORT 2014 ANNUAL REPORT

2 HCA WEST FLORIDA LEADERSHIP Peter A. Marmerstein, FACHE President & Chief Executive Officer Timothy Burroughs Chief Financial Officer Larry J. Feinman, D.O., FACOS Chief Medical Officer HCA WEST FLORIDA

3 A MESSAGE FROM OUR PRESIDENT This was a year of unprecedented growth and change for HCA West Florida, as we became the Tampa Bay area s largest healthcare system and 14 of our eligible 15 hospitals at the time were named Top Performers On Key Quality Measures by The Joint Commission, a highly regarded industry accolade. We were pleased to welcome Memorial Hospital of Tampa, Palms of Pasadena and Town & Country hospitals to the HCA family. In addition to enabling us to serve new communities, they enhance our behavioral health, home health, bariatric and robotic surgery offerings. Last year, HCA West Florida hospitals cared for more than a half million patients in our emergency departments. Our Trauma Centers at Blake Medical Center and Regional Medical Center Bayonet Point provided life and limb saving care to 2,770 patients. We are committed to continuing and expanding our emergency services, with a robust focus on improving both quality and efficiency. Over the next several years, our mission is expanding with the development of graduate medical education training opportunities for physicians in a state where the physician shortage remains acute, and barriers to access healthcare services continue to be observed. Historically, physicians often remain in the community where they complete their residency training. Regional Medical Center Bayonet Point, Oak Hill Hospital and Brandon Regional Hospital earned ACGME institutional accreditation, which will provide a platform for the development of physician training programs in a wide array of specialties. Additionally, Regional Medical Center Bayonet Point earned AOA accreditation for an Internal Medicine Residency program that will begin in July 2014, as will our first ACGME accredited Internal Medicine Residency program at Oak Hill Hospital. These programs are in addition to our highly regarded AOA accredited programs at Largo Medical Center, Northside Hospital and St. Petersburg General Hospital. With a local economic impact of more than $1.5 billion in 2013, HCA West Florida s contributions to the health of Tampa Bay are extensive. As the area s largest healthcare system, and one of the largest employers and tax payers, we hope that you will take a few minutes to review the many successes we enjoyed in 2013 as we look forward to serving you in Sincerely, Peter A. Marmerstein, FACHE President & Chief Executive Officer 2014 ANNUAL REPORT 1

4 THE FACILITIES OF HCA WEST FLORIDA CITRUS, HERNANDO & PASCO COUNTIES Oak Hill Hospital Medical Center of Trinity & West Pasco Campus Regional Medical Center Bayonet Point PINELLAS COUNTY Edward White Hospital Largo Medical Center & Indian Rocks Rd Campus Northside Hospital Palms of Pasadena Hospital St. Petersburg General Hospital BEDS HILLSBOROUGH COUNTY Brandon Regional Hospital Memorial Hospital of Tampa South Bay Hospital Tampa Community Hospital MANATEE, SARASOTA & CHARLOTTE COUNTIES Blake Medical Center Doctors Hospital of Sarasota Englewood Community Hospital Fawcett Memorial Hospital BEDS Total Number of Licensed Beds = 4,000 2 HCA WEST FLORIDA

5 HCA WEST FLORIDA STATISTICS FACILITIES & SERVICES COMMUNITY IMPACT Hospitals 16 Total Patients Treated 986,015 Hospital Campuses 18 Annual Hospital Admissions 154,033 Accredited Cancer Programs (ACoS CoC) 8 Annual Emergency Visits 528,017 Ambulatory Surgery Centers 12 Total Medicaid Patients Treated 145,933 Freestanding Imaging Centers 3 Medicaid Market Share 15.80% Graduate Medical Education Hospital Sites 6 Total Uninsured Patients Treated 1 113,081 Inpatient Rehabilitation Centers 4 Uninsured Market Share 28.15% Inpatient Behavioral Health Care Programs 6 (1) excludes Medicaid patients treated Number of Licensed Beds Obstetrics Programs 4,000 3 ECONOMIC IMPACT Occupational Health Sites 10 Total Salaries & Benefits $ 1,042,736,350 Robotic & Surgical Innovation Sites 7 Cost of Charity & Uncompensated Care $ 169,922,641 Trauma Centers (Level II) 2 Taxes Paid: OUR HEALTHCARE TEAM 16,807 4,003 Federal Income Tax State Income Tax Indigent Care Tax Property Tax Sales Tax Other Local Tax Total Taxes Capital Investment 1 Total Local Vendor Support Minority & Women Owned Business Support Physician Specialty Coverage for Emergency Care $ 31,867,797 $ 6,917,953 $ 26,376,245 $ 13,412,229 $ 14,322,948 $ 196,112 $ 93,093,284 $ 98,671,352 $ 160,120,185 $ 1,588,395 $ 30,417,627 Total Cost of Charity & Uncompensated Care 10.7% TOTAL Economic Impact $ 1,594,961,439 (1) 5 year annual average FY 2013 statistics for 13 hospitals of HCA West Florida and 4th Qtr 2013 for the three former IASIS hospitals acquired on October 1, 2013 Local Vendor Support 10.1% Total Taxes 5.8% Total Salaries & Benefits 65.4% Capital Investment 6.2% Physician Specialty Coverage for Emergency Care 1.9% 2014 ANNUAL REPORT 3

6 HCA West Florida employees volunteer for many organizations, including taking part and raising funds for the American Heart Association and their annual Tampa Bay Heart Walk. GIVING BACK TO THE COMMUNITY HCA West Florida hospitals provide financial and volunteer support to countless civic organizations, schools, colleges, community projects and charitable organizations in their communities. Our hospitals also sponsor a wide range of community health information programs, screenings and seminars, which are posted on hospital websites, in the Classes and Events calendar. BENEFIT ENROLLMENT ASSISTANCE Our hospitals are committed to helping our patients navigate today s complex health care benefits environment. Each hospital offers on-site benefit education and Medicaid enrollment assistance. These individuals can assist in helping uninsured patients quality for local and state health benefits programs. They are also available to assist patients in enrolling in the Health Exchange plans now available as part of the Affordable Health Care Act. Where To Go For More Information On The Affordable Health Care Act The new health care law provides real choices to people who haven t been able to get insurance coverage. The healthcare marketplace for Florida is being run as part of a national program. The primary websites that have information are: Si solo hablas espanol, ve a Or call for information from the Department of Health & Human Services. Hospital Based Resources For Our Patients You may ask to speak with Benefit Enrollment Assistance at your local HCA hospital or you can call our Local Information Line at or us at AffordableHealthCareAct-Tampa@Parallon.com. Our hours of operation are Monday Friday, 8 am 5 pm. 4 HCA WEST FLORIDA

7 CONSULT A NURSE The hospitals of HCA West Florida sponsor a toll-free number, around the clock, as a community service. Free physician referral and health information are available by calling Registered nurses are available for consultation through this bilingual call center, which also registers people for the numerous community education classes and programs sponsored by our hospitals. GOING GREEN HCA hospitals are involved with green initiatives at the facility level and in many cases in the greater community. HCA is an active member of Practice Greenhealth, an industry leader in sustainable, eco-friendly practices. It is part of our commitment to have a comprehensive environmental strategy in concert with our mission of the care and improvement of human life. 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 HCAWestFlorida.com. 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. VOLUNTEERING Countless hours of volunteering were performed by members of HCA West Florida last year. From providing medical care and expertise on mission trips, to serving on Chamber Boards and nonprofit advocacy, our staff, volunteers and physicians give back to our communities, inside and outside of our facilities. Dr. Shawn St. Marie is one of the volunteers from St. Petersburg General Hospital s GME program who joined Dr. Romeo Acosta s annual visit to provide free medical care in Nicaragua. A PARTIAL LISTING OF ORGANIZATIONS BENEFITING FROM OUR INVOLVEMENT Alzheimer s Family Organization American Cancer Society American Heart Association American Red Cross Argus Foundation Autism Speaks Better Breathers Club (Lung Association) Boys and Girls Club Brandon Sports & Aquatic Club Buddy Baseball C.A.R.E. Center for Abuse and Rape Emergencies Chambers of Commerce Chamber Leadership Programs Charlotte County Homeless Coalition Citrus County Harvest Community Aging and Retirement Services (CARES) Community Foundation of Tampa Deputy Darlings Diabetes Support Group Disabled Veterans of America Wheelchair Races Economic Development Councils Education Foundations Falls Prevention Coalition Florida Blood Services Good Samaritan Services Goodwill Great American Teach-in Habitat for Humanity HCA Hope Fund H2U Partners Club Hillsborough Community College Foundation Hospice Junior Achievement Junior League Juvenile Diabetes Research Kiwanis Clubs LifeLink LifeSouth Community Blood Center Lighthouse for the Blind & Visually Impaired Make A Wish March of Dimes Meals on Wheels Medical Associations & Societies Metropolitan Ministries Ministerial Associations Mothers Helping Mothers Muscular Dystrophy Association Pasco Aging Network Pasco County Mobile Medial Unit Pasco Sheriff s Charities Patriots Club Riverview Chamber of Commerce Rotary Salvation Army Sarasota Tiger Bay Club Sarasota County Library Foundation Sheriff s Youth Ranch St. Petersburg Free Clinic Sun City Center Emergency Squad Suncoast Community Blood Bank United States Military United Way YMCA 2014 ANNUAL REPORT 5

8 QUALITY AND PATIENT SAFETY Putting Patients First is the foundation of our culture and passion for providing high quality healthcare. As affiliates of the nation s leading healthcare company, HCA West Florida hospitals have access to a vast clinical data warehouse, allowing us to adopt best practices to ensure the best possible outcomes for our patients. CLINICAL EXCELLENCE Under the leadership of our Chief Medical Officer (CMO) Dr. Larry Feinman, HCA West Florida is committed to a robust quality and patient safety agenda. Through collaboration with hospital CMOs and medical staff leadership, we are reducing clinical variation, expanding our graduate medical education commitment and improving patient care, with significant progress this past year in sepsis reduction and blood utilization. Individual hospitals are also working on local initiatives to improve performance and enhance patient care. INDUSTRY LEADING PERFORMANCE We continue to perform well on public clinical measures, including CMS Core Measures. HCA West Florida hospitals completed third quarter 2013 with a Core Measures composite inpatient score of 99.49%, above the 90th percentile nationally. Additionally, 14 of our hospitals earned national recognition as Top Performers on Key Quality Measures TM from The Joint Commission. 6 HCA WEST FLORIDA

9 PATIENT CENTERED CARE Our hospitals are saving lives, reducing complication rates and eliminating unnecessary costs through a strong focus on quality and patient safety. 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 evidence based medicine to the bedside in community hospitals nationwide. ANTIBOTIC MANAGEMENT The public health concerns created as a result of the inappropriate and overuse of antibiotics are well documented. Through education and clinical order sets, we are ensuring antibiotic stewardship in all of our facilities. BLOOD UTILIZATION Recent data shows improved survival and outcomes for patients when a more conservative approach to blood utilization is adopted. Many of our hospitals are creating committees to help monitor and encourage best clinical practices. ELECTRONIC HEALTH RECORD Healthcare is technology dependent, from our sophisticated diagnostic and treatment equipment to the elaborate information systems that gather, communicate and store results. For the past several years, we have been shifting all of these systems to the Electronic Health Record. Today, the hcare Clinical Portal allows physicians and other healthcare providers to login and access patient data from our hospital websites from virtually any location where there is internet access. The patient portal will launch in 2014, allowing patients to access their personal health care information in much the same way. FLU SEASON PREPARATION HCA is a leader in making hospitals safer for patients and visitors, by providing free vaccines to staff and requiring vaccinations of health workers with direct patient contact. When a vaccine is not possible, the caregiver must wear a mask. GRADUATE MEDICAL EDUCATION TRAINING FUTURE DOCTORS Nationally there is a projected shortfall of 130,000 physicians by While Florida has increased the number of medical school graduates, the number of residency slots has not increased at the same rate. As a result, graduates are leaving the state to complete their graduate medical education (GME) training. HCA West Florida is responding to this problem by increasing our number of residency programs, with two new accredited GME programs opening in 2014 at Oak Hill Hospital and Regional Medical Center Bayonet Point. Hospitals currently sponsoring GME programs include Largo Medical Center, a Statutory Teaching Hospital and home to one of the largest osteopathic teaching program in the southeast, Northside Hospital and St. Petersburg General Hospital. Last year, more than 200 physicians came to the area to complete their medical education at our hospital sponsored GME programs ANNUAL REPORT 7

10 Studies indicate that many of these physicians will make the community where they complete their advanced medical training their permanent home. MEDICAL RESEARCH Improving trauma care in Florida is a key focus of HCA West Florida through our collaboration with USF Health. Level II Trauma Centers at Blake Medical Center and Regional Medical Center Bayonet Point are participating in gathering information that will be used to develop best practices in trauma care. HCA West Florida hospitals also participate in a number of research efforts through our affiliation with HCA s Sarah Cannon Research Institute (SCRI) of Nashville and our GME programs. MOTHERS & CHILDREN Improving patient safety for our expectant mothers, babies and children has been a key focus in our hospitals nationally. We were the first US healthcare system to test newborns for kernicterus, now an industry standard. More recently, we teamed up with the March of Dimes and other national organizations by participating in initial research studies to minimize or eliminate elective deliveries before the 39th week of pregnancy. Study results showed a positive impact on the health of babies and this is now a standard practice in our hospitals. All of our hospital ERs, nurseries and pediatric units are equipped with the Broselow System, a sophisticated medication safety program for infants and children. The Broselow system ensures the proper dosing and administration of drugs to infants and children. Our obstetrics programs adhere to the latest in patient safety guidelines, with Brandon Regional Hospital providing Level III Neonatal Intensive Care Unit (NICU) services, the highest level available. The hospital also offers a Pediatric Intensive Care service, with pediatric intensive care physicians available around the clock to accept transfers from other hospitals and ERs. SEPSIS PROGRAM Severe sepsis is now one the most common causes of death in ICUs nationally. We are aggressively working to reduce this patient safety threat, and have made significant progress in reducing both sepsis with shock and severe sepsis in our hospitals. 8 HCA WEST FLORIDA

11 SPECIALIZED CARE EMERGENCY EXCELLENCE & TRAUMA CARE HCA West Florida hospitals are leaders in improving ER processes to enhance patient care and reduce wait times. From stroke care to heart attacks, we are saving lives and improving the quality of lives through advanced technology, delivered quickly. Last year 528,017 patients received care in one of our ERs. ER wait times are posted on hospital websites and digital billboards throughout west Florida. You can also text ER to to find out the wait time for hospitals closest to you. The HCA Trauma Network includes Blake Medical Center and Regional Medical Center Bayonet Point, where more than 4,000 patients have been treated since November More than 90 percent of these patients come from the hospital s local community. In addition to improving access to trauma services, we are working with USF Health to determine best practices in trauma care. We are also extending our ER care beyond hospital walls through freestanding ERs, which operate around-the-clock and are staffed, equipped and function as a hospital ER, but can be located in communities needing better access to services. Brandon Regional Hospital opened the Plant City ER in 2012 and Largo Medical Center will open a Clearwater ER in All of our hospitals treat pediatric emergencies with Brandon Regional Hospital and Oak Hill Hospital offering separate Pediatric ER services. Pediatric ER wait times are tracked and posted separately on these two facility websites. EMERGENCY CARE SUCCESSES HCA West Florida hospitals continue to outperform national goals on many metrics, including the below. Hospital ER Wait Times and STEMI times are posted on hospital websites. n Average ER Wait Time: 18 Minutes (National Average 60 Minutes) n Average Pediatric ER Wait Time: 18 Minutes n Median STEMI Time: 59 Minutes (National Goal is 90 Minutes) n Average Time Arrival to Discharge: 153 minutes 2014 ANNUAL REPORT 9

12 BARIATRIC SURGERY The Florida Bariatric Centers provide a surgical approach to weight loss management with the area s foremost bariatric surgeons. We provide a caring and supportive staff with multiple facilities around the Tampa Bay area. Information on our bariatric programs or educational seminars can be found by calling or visiting us online at BEHAVIORAL HEALTH A wide range of programs and services are available at our hospitals, including inpatient programs at five facilities and medical stabilization for substance abuse at two additional hospitals. We are able to provide the full spectrum of care for patients of all ages, from children to geriatric-aged adults, in the acute care environment for immediate access to all hospital services, if needed. Outpatient services are available to assist and support our patients as they transition back to their community, homes and daily living. COMPREHENSIVE CANCER CARE We are committed to providing the highest quality of care by striving to meet or exceed the many standards for accreditation. Eight HCA West Florida hospitals have earned the Accredited Cancer Center distinction by the American College of Surgeons Commission on Cancer (ACoS CoC). Tumor Board reviews, screenings and education programs, and access to the latest diagnostic and treatment technologies are just a few of the ways we accomplish this. From digital mammography to robotic surgical technology, our hospitals are providing physicians and surgeons the latest techniques and services to treat patients safely and effectively. Through our relationship with HCA s Sarah Cannon Research Institute (SCIR) in Nashville, patients also have access to one of the largest clinical research programs in the nation. This allows them to receive the latest oncology treatments and participate in clinical trials, right in their own community. SCIR is affiliated with more than 700 physicians nationwide, including many on Florida s west coast. HEART & VASCULAR NETWORK Our cardiovascular network ensures that life-saving technology and minimally invasive techniques are available. The latest surgical techniques for vascular, minimally invasive mitral valve and atrial fibrillation repair provide a safer alternative for patients suffering from these conditions. 10 HCA WEST FLORIDA

13 Afib Centers at our cardiac hospitals offer the latest diagnostic services and minimally invasive treatments for atrial fibrillation, the most common heart arrhythmia condition. Our Valve Clinics can identify patients early in the disease process, when more treatment options are available to improve outcomes and quality of life. The TAVR procedure, available at Blake, offers patients who are unable to undergo traditional open-heart surgery, or chose not to, a minimally invasive option to surgical aortic valve replacement therapy. Several of our hospitals have earned certifications and recognition for the outstanding cardiac and cardiovascular care they provide. These are listed on the hospital information sheets. H2U Health to You (H2U) provides wellness solutions through its consumer and employer based programs. Among the many benefits of membership are a Personal Health Assessment, Online Health Portal and Subscriptions to ehealth news, national discounts on products and services, and quarterly magazines. For information on joining, visit and click on H2U in the About Us section. Inpatient Rehabilitation Centers Our success in Inpatient Rehabilitation is grounded in a multi-disciplinary approach, where a team of specialists from many different fields of rehabilitation is assembled to focus on each patient s individual needs and 2014 ANNUAL REPORT 11

14 abilities. Our team s talents and experience are backed by innovative technology and evidence-based therapies, combined to ensure the best possible outcome for the patient. NEUROSCIENCES & STROKE CARE Neurosciences is a key focus at many of our hospitals, with neurologists and surgeons skilled in treating everything from epilepsy to brain tumors and severe back pain. Our ERs use the latest protocols and treatments to ensure optimal outcomes for stroke patients. Northside Hospital is a state designated Comprehensive Stroke Center with onsite interventional neuroradiology services. ORTHOPEDICS National recognition for clinical excellence has been awarded to many of our orthopedic programs, including Disease Certifications from The Joint Commission. Our surgeons are committed to performing the latest innovations in their field including minimally invasive procedures. Many of our hospitals offer classes in advance of surgery to assist patients with planning their hospital stay and recovery after discharge. Several hospitals offer luxury accommodations and amenities to encourage quick return to daily activities and family involvement, often in conjunction with spine programs. SPINE CARE Spine injuries and illnesses can greatly impact an individual s quality of life. Our network offers a full spectrum of resources to provide an accurate diagnosis and treatment plan, and many programs have earned Joint Commission Certifications. Our spine surgeons perform the most minimally invasive procedures available today, with outstanding outcomes and greatly reduced hospital stays. Medical teams affiliated with our hospitals include some of the area s most dedicated neurosurgeons, orthopedic spine surgeons, experts in pain management, and specialists in physical medicine as well as physical therapy and rehabilitation. Doctors Hospital of Sarasota is now performing state-of-the-art spine surgeries using Mazor Robotics Renaissance. In many cases, this means minimally invasive surgery with only a few incisions, pinpointing the exact location with extreme precision. Before entering the OR, surgeons use it to pre-plan the optimal surgery in a CT-based 3D simulation of the patient s spine. SURGICAL SOLUTIONS & ROBOTICS HCA West Florida offers some of the most efficient and well equipped operating rooms in the area. Advanced systems from scheduling to pre-op and discharge planning ensure that patients receive the care they need, while individual facilities provide a variety of enhanced communications such as waiting room monitors, free wi-fi and text messages to keep the family updated on the patient s progress. From single incision surgery through the navel to the da Vinci robotic system now available at eight of our hospitals, we are providing surgeons the tools they need to perform complex and delicate procedures through tiny incisions. In addition to inpatient and outpatient surgical programs at our hospitals, our network includes 12 freestanding outpatient surgery centers. WOMEN S SERVICES Some 5,386 babies were welcomed last year in one of our hospital delivery rooms, to the delight of parents and staff. Three of our hospitals offer obstetrical services to their communities with Brandon Regional Hospital offering Level III NICU, the highest level available. St. Petersburg General Hospital is a GYN Robotic Epicenter, one of only two designated in Florida to train surgeons on the latest available robotic equipment. Oak Hill Hospital and Medical Center of Trinity feature dedicated women s imaging centers. Our commitment to women s services, from childbirth to digital mammography to minimally invasive surgery and robotics is unsurpassed. 12 HCA WEST FLORIDA

15 HCA WEST FLORIDA NETWORK HCA s West Florida Division provides a complete continuum of high quality programs and services to meet the healthcare needs of residents and businesses throughout west Florida. In addition to our 16 hospitals, our network includes: AMBULATORY SURGERY CENTERS Our 12 free-standing Ambulatory Surgery Centers are located throughout west Florida and are equipped with the most sophisticated technology to provide a wide range of same-day outpatient surgical procedures, pain management procedures and selected diagnostic procedures. The Centers are accredited by the Joint Commission or the American Association of Ambulatory Centers and adhere to HCA s rigorous standards of quality and patient safety. IMAGING CENTERS Equipped with a broad range of diagnostic technology, these Centers provide a comprehensive array of outpatient imaging services. Positron emission tomography, also called PET imaging, is provided by a mobile service. PHYSICIAN SERVICES HCA Physician Services is comprised of locally managed physician practices, with several located throughout west Florida. We provide innovative, value added solutions that help physicians deliver high quality, cost effective healthcare to support our commitment to the care and improvement of human life. HCA West Florida offers physicians in residency and fellowship graduate medical education programs the opportunity to train on the most advanced surgical systems ANNUAL REPORT 13

16 BLAKE MEDICAL CENTER th Street West I Bradenton, Florida (941) AND CERTIFICATIONS: Accredited Hospital (The Joint Commission) Accredited Chest Pain Center with PCI (SCPC) Accredited Community Cancer Program (ACoS CoC) Accredited Inpatient Rehabilitation (CARF) Certifications The Joint Commission: Acute Myocardial Infarction, Advanced Primary Stroke Center, Heart Failure, Joint Replacement Hip, Joint Replacement Knee Top Performer in Key Quality Measures for Heart Attack, Heart Failure, Pneumonia and Surgical Care (The Joint Commission) Verified Level II Trauma Center (FL Dept. of Health) BlakeMedicalCenter.com ADDITIONAL SERVICES: 24-Hour Emergency Services Adult Critical Care Breast Care Center Cardiopulmonary Rehabilitation Company Care Occupational Health Comprehensive Cancer Program Diabetes Education Heart & Valve Institute (with Cardiac Surgery) Inpatient Rehabilitation Center Joint Care Center Medical Imaging Minimally Invasive Surgery Primary Stroke Center Robotic Surgery Sleep Disorders Center Spine Care Center TAVR Trauma Center Level II HOSPITAL STATISTICS # of Licensed Beds Total Annual Admissions Total Annual Emergency Visits Total Patients Treated* Total Payroll Taxes Paid ,225 39,739 84, ,522 $114,136,705 $8,461,820 * Includes Admissions, ED Visits, OP Visits, OP Surgery, and OP OBS Visits numbers unless otherwise noted. Blake Medical Center is dedicated to caring for patients and our community. From the physicians and clinical staff to the support team and volunteers, every member of the Blake family is committed to your health. In addition to providing high quality care, Blake Medical Center strives to continually expand life improving and life saving offerings, including the latest advancements in Trauma and TAVR, a life-saving heart procedure. Daniel Friedrich, FACHE Chief Executive Officer 14 HCA WEST FLORIDA

17 BRANDON REGIONAL HOSPITAL 119 Oakfield Drive I Brandon, Florida I (813) AND CERTIFICATIONS: Accredited Hospital (The Joint Commission) Accredited Bariatric Surgery Center of Excellence (ASMBS) Accredited Breast Center (NAPBC) Accredited Chest Pain Center with PCI (SCPC) Accredited Echocardiography Laboratory (ICAEL) Center of Excellence for Metabolic and Bariatric Surgery (Surgical Review Corporation) Highest 3-Star Heart Surgery Excellence Rating (Society of Thoracic Surgeons) Certifications The Joint Commission: Acute Myocardial Infarction, Advanced Primary Stroke Center, Coronary Artery Bypass Graft, Heart Failure Top Performer in Key Quality Measures for Heart Attack, Heart Failure, Pneumonia and Surgical Care 2nd Consecutive Year (The Joint Commission) BrandonRegionalHospital.com ADDITIONAL SERVICES: 24-Hour Emergency Services The Baby Suites The Behavioral Health Center The Breast Center The Emergency Center Florida Bariatric Centers The Heart & Vascular Center Neonatal Intensive Care Unit - Level II & Level III The Neuroscience Center The Orthopedic Center Pediatric Services The Reflux Center The Sinus Center The Spine Center The Women s Center The Women s Center at Brandon Regional Hospital offers comprehensive services in beautiful surroundings. From childbirth/newborn classes to all private rooms in the Baby Suites and Level III Neonatal Intensive Care, we are here to provide the highest level of care, compassionately, for women and their families. The Women s Center also includes the latest in minimally invasive and robotic surgery options and a wide range of breast care and screening services. Bland Eng, FACHE Chief Executive Officer HOSPITAL STATISTICS # of Licensed Beds Total Annual Admissions Total Annual Emergency Visits Total Patients Treated* Total Payroll Taxes Paid , , , ,229 $138,118,339 $21,155,407 * Includes Admissions, ED Visits, OP Visits, OP Surgery, and OP OBS Visits numbers unless otherwise noted ANNUAL REPORT 15

18 DOCTORS HOSPITAL OF SARASOTA 5731 Bee Ridge Road I Sarasota, Florida I (941) AND CERTIFICATIONS: Accredited Hospital (The Joint Commission) Accredited Chest Pain Center (SCPC) Accredited Community Cancer Program (ACoS CoC) Advanced Heart Failure with PCI (Society of Cardiovascular Patient Care) Best Places To Work (Modern Healthcare) 4th Consecutive Year Breast Imaging Center of Excellence (ACR) Certifications The Joint Commission: Advanced Heart Failure, Advanced Primary Stroke Center, Diabetes, Joint Replacement Hip, Joint Replacement Knee, Spinal Fusion Thomson Reuters Top 100 Hospital and Everest Award Top Performer in Key Quality Measures for Heart Attack, Heart Failure, Pneumonia and Surgical Care 3rd Consecutive Year (The Joint Commission) ADDITIONAL SERVICES: 24-Hour Emergency Services Adult Critical Care Breast Care Center Cardiovascular Services Diagnostic Imaging General Surgery Gynecologic Oncology Neurology Neurosurgery Oncology Orthopedic and Spine Institute Percutaneous Coronary Intervention (PCI) Rehabilitation Services Robotic Surgery Single Incision & Mazor Serenity Place (Voluntary Behavioral Health for Adults) Urology Wound Management and Hyperbaric Medicine DoctorsofSarasota.com The customer service at Doctors Hospital is absolutely amazing. It is very comfortable, very friendly and very clean, and they do a great job of catering to your dietary needs. Three weeks after hip surgery, I was pain-free for the first time in three years and back to doing the things I enjoy. JP Knaggs Chef Owner of the Bijou Café and Hip Surgery Patient Robert Meade Chief Executive Officer HOSPITAL STATISTICS # of Licensed Beds Total Annual Admissions Total Annual Emergency Visits Total Patients Treated* Total Payroll Taxes Paid 155 7,490 23,534 51, $46,417,600 $4,613,381 * Includes Admissions, ED Visits, OP Visits, OP Surgery, and OP OBS Visits numbers unless otherwise noted. 16 HCA WEST FLORIDA

19 EDWARD WHITE HOSPITAL th Avenue North I St. Petersburg, Florida (727) AND CERTIFICATIONS: EdwardWhiteHospital.com Accredited Hospital (The Joint Commission) Accredited Chest Pain Center (SCPC) Accredited CT and Ultrasound (ACR) Certifications The Joint Commission: Advanced Primary Stroke Center, Joint Replacement Hip, Joint Replacement Knee Top Performer in Key Quality Measures for Pneumonia and Surgical Care (The Joint Commission) ADDITIONAL SERVICES: 24-Hour Emergency Services Center for Wound Care and Hyperbaric Medicine Company Care Occupational Health Diagnostic Imaging Orthopedics Center Rehabilitation Institute Sinus Center Skilled Nursing Unit Spine Center Edward White Hospital was nominated for Business Partner of the Year by the Pinellas Education Foundation for their outstanding support of St. Petersburg High School. HOSPITAL STATISTICS # of Licensed Beds Total Annual Admissions Total Annual Emergency Visits Total Patients Treated* Total Payroll Taxes Paid 162 3,139 11,145 27, $25,014,035 $1,263,901 * Includes Admissions, ED Visits, OP Visits, OP Surgery, and OP OBS Visits numbers unless otherwise noted. Sharon D. Hayes, RN, BSN, MBA Chief Executive Officer 2014 ANNUAL REPORT 17

20 ENGLEWOOD COMMUNITY HOSPITAL 700 Medical Boulevard I Englewood, Florida I (941) EnglewoodCommunityHospital.com AND CERTIFICATIONS: Accredited Hospital (The Joint Commission) A Hospital Safety Score (Leapfrog Group) Accredited Chest Pain Center (SCPC) Accredited CT, Mammogram, MRI, Nuclear Medicine, Ultrasound (ACR) Advanced Primary Stroke Center (AHCA) Certifications The Joint Commission: Heart Failure, Joint Replacement Hip, Joint Replacement Knee Top Performer in Key Quality Measures for Pneumonia and Surgical Care 2nd Consecutive Year (The Joint Commission) ADDITIONAL SERVICES: 24-Hour Emergency Services Cardiology Comprehensive Rehabilitation Diagnostic Imaging Dialysis (Inpatient) Electrophysiology Endoscopic Ultrasound Gastroenterology General and Vascular Surgery Gynecology Hospitalists Infectious Disease Joint Care Center and Orthopedics MRI Nephrology Opthalmology Podiatry Pulmonology Respiratory Services Sleep Disorder Center Teleneurology Urology Women s Center Wound Care Center 18 HCA WEST FLORIDA Englewood Hospital presents an $18,000 check to the Englewood Community Care Clinic to support its mission of providing free episodic care to the uninsured and working poor in the community. (L to R) are Chris Murtha, Joni Hyde, Beth Harrison, Raymond James, DO, Kathy James, Dale Alward, CEO Englewood Community Hospital, Bob Melvin, David Dignam and Liz Rigney. Dale F. Alward, FACHE, MHA, MPA Chief Executive Officer HOSPITAL STATISTICS # of Licensed Beds Total Annual Admissions Total Annual Emergency Visits Total Patients Treated* Total Payroll Taxes Paid 100 3,231 15,809 40, $22,469,876 $1,567,144 * Includes Admissions, ED Visits, OP Visits, OP Surgery, and OP OBS Visits numbers unless otherwise noted.

21 FAWCETT MEMORIAL HOSPITAL Olean Boulevard I Port Charlotte, Florida I (941) AND CERTIFICATIONS: Accredited Hospital (The Joint Commission) A Hospital Safety Score (Leapfrog Group) Accredited Chest Pain Center with PCI (SCPC) Accredited Community Cancer Program (ACoS CoC) Accredited Inpatient Rehabilitation Program (CARF) Best Hospital & Best ER by Readers of Charlotte Sun Best Hospital by Readers of Florida Weekly Certifications The Joint Commission: Advanced Primary Stroke Center, Joint Replacement Hip, Joint Replacement Knee, Spine Surgery Top Performer in Key Quality Measures for Heart Attack, Heart Failure, Pneumonia and Surgical Care 2nd Consecutive Year (The Joint Commission) FawcettHospital.com ADDITIONAL SERVICES: 24-Hour Emergency Care Cancer Care Cardiovascular Services Diagnostic Imaging Company Care Emergency Care General Surgery Inpatient Rehabilitation Center Neurosciences Outpatient Rehabilitation Open-Heart Surgery Physical Therapy Spine & Orthopedic Center Stroke Center Surgical Services Weight Loss Women s Services Wound Management & Hyperbaric Medicine The care I received at Fawcett Memorial Hospital last year was exemplary. It started with my surgeon, Dr. Jason Reiss, who is incredibly talented, and highly respected. Marsha Mason, RN, Fawcett s Patient Navigator, immediately put me at ease and took time to explain all aspects of my surgery and what would occur while I was there. I was so impressed by the nursing staff on The Orthopaedic & Spine Center floor as everyone was so professional, warm and caring. I would recommend Fawcett to anyone who wants 5 star care. Thomas J. Rice, FACHE Chief Executive Officer HOSPITAL STATISTICS # of Licensed Beds Total Annual Admissions Total Annual Emergency Visits Total Patients Treated* Total Payroll Taxes Paid Nan Leonard Anterior Hip Replacement Surgery ,050 26,069 68, $64,885,114 $4,418,094 * Includes Admissions, ED Visits, OP Visits, OP Surgery, and OP OBS Visits numbers unless otherwise noted ANNUAL REPORT 19

22 LARGO MEDICAL CENTER th Street SW I Largo, Florida I (727) Indian Rocks Road I Largo, Florida AND CERTIFICATIONS: Accredited Hospital (The Joint Commission) A Hospital Safety Score (Leapfrog Group) Accredited Breast Center (ACoS) (NAPBC) (ACR) Accredited Chest Pain Center with PCI (SCPC) Accredited Community Cancer Program (ACoS CoC) Accredited Graduate Medical Education Programs (AOA) Accredited Inpatient Rehabilitation Program (CARF) Certified Advanced Primary Stroke Center (The Joint Commission) Top Performer in Key Quality Measures for Heart Attack, Heart Failure, Pneumonia and Surgical Care 3rd Consecutive Year (The Joint Commission) LargoMedical.com ADDITIONAL SERVICES: A Teaching Hospital 24-Hour Emergency Services Behavioral Medicine Emergency Services Behavioral Medicine Cardiovascular Services Center for Wound Care and Hyperbaric Medicine Clinical Research Company Care Occupational Health Florida Bariatric Centers Florida Breast Institute Florida Knee & Orthopedic Pavilion Florida Spine & Neuro Center Florida Sports Medicine Center Graduate Medical Education Program Hospitalists Inpatient, Outpatient & Cardiopulmonary Rehabilitation Robotic Surgery Sleep Disorders Laboratory Valet Services Largo Medical Center s sports medicine program is proud to partner with Largo High School athletes to provide student sports physicals and an on-site certified athletic trainer for practices and games. Anthony Degina Chief Executive Officer HOSPITAL STATISTICS # of Licensed Beds Total Annual Admissions Total Annual Emergency Visits Total Patients Treated* Total Payroll Taxes Paid ,086 44,756 81, ,737 $111,012,097 $10,577,926 * Includes Admissions, ED Visits, OP Visits, OP Surgery, and OP OBS Visits numbers unless otherwise noted. 20 HCA WEST FLORIDA

23 MEDICAL CENTER OF TRINITY 9330 State Road 54 I Trinity, Florida I (727) AND CERTIFICATIONS: Accredited Hospital (The Joint Commission) Accredited Community Comprehensive Cancer Program (ACoS CoC) Accredited CT, Mammogram, MRI, Nuclear Medicine, Ultrasound (ACR) Certified Advanced Primary Stroke Center (The Joint Commission) MRI Accreditation (ACR) State Approved Percutaneous Coronary Intervention Program (PCI) Top Performer in Key Quality Measures for Heart Attack, Heart Failure, Pneumonia and Surgical Care 3rd Consecutive Year (The Joint Commission) MedicalCenterTrinity.com ADDITIONAL SERVICES: 24-Hour Emergency Services (Main Campus/Trinity) Behavioral Health (West Pasco Campus) Cancer Care Diagnostic Imaging Heart and Vascular including Open Heart Surgey Men s Health Obstetrics Spine And Orthopedics Surgical Specialties including Robotic Assisted Surgery Women s Health Women s Imaging Center Wound Care and Hyperbaric Medicine HOSPITAL STATISTICS # of Licensed Beds Total Annual Admissions Total Annual Emergency Visits Total Patients Treated* Total Payroll Taxes Paid ,463 50,273 79, ,358 $86,809,249 $6,599,918 * Includes Admissions, ED Visits, OP Visits, OP Surgery, and OP OBS Visits numbers unless otherwise noted. At Medical Center of Trinity, we take matters of the heart seriously. Building on our reputation for excellence, we ve expanded our cardiovascular services to include a new Open Heart Surgery program. So whether it s an emergency or a planned procedure, trust Medical Center of Trinity s respected team of medical professionals to take good care of you and your heart, close to home. Leigh Massengill Chief Executive Officer 2014 ANNUAL REPORT 21

24 MEMORIAL HOSPITAL OF TAMPA 2901 Swann Avenue I Tampa, Florida I (813) AND CERTIFICATIONS: Accredited Hospital (The Joint Commission) Accredited Mammography and MRI (ACR) Accredited Sleep Lab (American Academy of Sleep Medicine) Bariatric Surgery Center of Excellence (ASMBS) College of American Pathologists Accreditation Quality System Certification (DVN Healthcare) MemorialHospitalTampa.com ADDITIONAL SERVICES: 24-Hour Emergency Services 64-Slice CT Scanner Bariatric Surgery Behavioral Medicine Cardiovascular Services Center for Wound Care & Hyperbaric Medicine Diagnostic Cardiac Catheterization Lab Diagnostic Sleep Lab Digestive Health Digital Mammography Health 4 Seniors Infectious Disease Services Inpatient & Outpatient Physical Rehabilitation Intensive Care Unit Interventional Radiology Ophthalmology Orthopedics Pain Management Plastic Surgery Speech Language Services Urology Services Women s Health Services Between the doctors and Memorial, and the type of care I received, the expertise from both the doctor and the nurses that care for you everybody that s involved I have complete trust in them. Janet Holt Retinal Surgery Patient John Mainieri Chief Executive Officer HOSPITAL STATISTICS # of Licensed Beds Q Admissions Q Emergency Visits Q Patients Treated* Q Payroll Q Taxes Paid 183 1,492 3,777 12, $8,930,721 $885,664 * Includes Admissions, ED Visits, OP Visits, OP Surgery, and OP OBS Visits. Data reflects 4th Quarter 2013 only. 22 HCA WEST FLORIDA

25 NORTHSIDE HOSPITAL th Street North I St. Petersburg, Florida I (727) AND CERTIFICATIONS: Accredited Hospital (The Joint Commission) Accredited Chest Pain Center with PCI (SCPC) Accredited CT, MRI, Nuclear Medicine and Ultrasound (ACR) Accredited Graduate Medical Education Programs (AOA) Certified Advanced Primary Stroke Center (The Joint Commission) Comprehensive Stroke Center (AHCA) Top Performer in Key Quality Measures for Heart Attack, Heart Failure, Pneumonia and Surgical Care 2nd Consecutive Year (The Joint Commission) Top Work Places 2nd Consecutive Year (Tampa Bay Times) NorthsideHospital.com ADDITIONAL SERVICES: 24-Hour Emergency Services Cardiac Clinical Research (Sarah Cannon Research Institute) Cardiopulmonary Outpatient Rehabilitation Company Care Occupational Health Diagnostic Services Graduate Medical Education Program Hospitalists Interventional Neuroradiology Neuroscience Institute Spine and Orthopedic Institute Tampa Bay Heart Institute (with Cardiac Surgery ) Compassionate Care. Superior Service. A hardworking team of dedicated Northside Hospital employees proudly display the hospital s new mission statement. HOSPITAL STATISTICS # of Licensed Beds Total Annual Admissions Total Annual Emergency Visits Total Patients Treated* Total Payroll Taxes Paid 288 9,324 32,708 44, ,043 $71,447,870 $3,784,941 * Includes Admissions, ED Visits, OP Visits, OP Surgery, and OP OBS Visits numbers unless otherwise noted. Dia Nichols, FACHE Chief Executive Officer 2014 ANNUAL REPORT 23

26 OAK HILL HOSPITAL Cortez Blvd /SR 50 I Spring Hill, FL Citrus: (352) /Hernando: (352) AND CERTIFICATIONS: Accredited Hospital (The Joint Commission) Accredited Chest Pain Center with PCI (SCPC) Accredited CT, Mammography, MRI, Nuclear Medicine and Ultrasound (ACR) Accredited Community Cancer Program (ACoS CoC) Accredited Graduate Medical Education Program (ACGME) Accredited Heart Failure Center (SCPC) Certifications The Joint Commission: Advanced Primary Stroke Center, Joint Replacement Hip, Joint Replacement Knee, Spinal Fusion OakHillHospital.com ADDITIONAL SERVICES: 24 Hour Emergency Care Center Consult-A-Nurse/Physician Referral Critical Care Intensivist Program Diagnostic Imaging Services Graduate Medical Education Program/ Internal Medicine Heart Institute (with Cardiac Surgery) Hospitalist Services Medical Digital Imaging with 24/7 On-Site Radiologist Coverage Minimally Invasive Spine Surgery Orthopaedic & Spine Institute Pediatric Emergency Care Center Pediatric Care Robotic Assisted Surgical System Vascular Surgery Women s Imaging Center HOSPITAL STATISTICS # of Licensed Beds Total Annual Admissions Total Annual Emergency Visits Total Patients Treated* Total Payroll Taxes Paid ,896 42,967 80, ,164 $72,185,906 $10,101,924 * Includes Admissions, ED Visits, OP Visits, OP Surgery, and OP OBS Visits numbers unless otherwise noted. Pictured is the registration lobby to the newly completed $52 million North Tower OR & Bed Tower expansion. Currently two stories high, the North Tower can accommodate expansion to six stories. The first floor features this gorgeous family waiting area for loved ones, private patient registration booths, pre-operative area, six surgical suites, new robotic assisted surgical capabilities and an eighteen bed Post-Anesthesia Recovery Unit. The second floor includes 36 private Intensive Care Unit (ICU) rooms. All ICU patients are cared for by a team of intensivists who are Board Certified and Fellowship Trained in Critical Care. Mickey Smith Chief Executive Officer 24 HCA WEST FLORIDA

27 PALMS OF PASADENA HOSPITAL 1501 Pasadena Avenue I St. Petersburg, Florida I (727) AND CERTIFICATIONS: Accredited Hospital (The Joint Commission) A Hospital Safety Score (Leapfrog Group) Accredited CT, Mammography, MRI and Nuclear Medicine (ACR) Bariatric Surgery Center of Excellence (ASMBS) College of American Pathologists Accreditation Primary Stroke Center (DNV Healthcare) Quality System Certification (DNV Healthcare) PalmsPasadena.com ADDITIONAL SERVICES: 24-Hour Emergency Services 64 Slice CT Scanner BCIR Breast Center Endoscopic / Digestive Health Center Florida Bariatric Centers Hernia Center Hospitalists Inpatient Rehabilitation Center Joint and Spine Center Outpatient Nutritional Counseling Center Outpatient Rehabilitation Pain Management Sleep Disorders Center Stroke Program Wound Care Before surgery, obesity affected my life in many ways including my selfesteem, confidence, daily activity level, and health. I wanted to be my best, both physically and mentally, to provide my sons with the best life possible. Kelly Patrick Bariatric Surgery Patient HOSPITAL STATISTICS # of Licensed Beds Q Admissions Q Emergency Visits Q Patients Treated* Q Payroll Q Taxes Paid 307 1,158 3,387 14, $9,197,780 $1,001,589 * Includes Admissions, ED Visits, OP Visits, OP Surgery, and OP OBS Visits. Data reflects 4th Quarter 2013 only. Sharon D. Hayes, RN, BSN, MBA Chief Executive Officer 2014 ANNUAL REPORT 25

28 REGIONAL MEDICAL CENTER BAYONET POINT Fivay Road I Hudson, Florida I (727) AND CERTIFICATIONS: Accredited Hospital (The Joint Commission) A Hospital Safety Score (Leapfrog Group) Accredited Community Cancer Program (ACoS CoC) Accredited CT, MRI, Nuclear Medicine, Ultrasound (ACR) Accredited Graduate Medical Education Program (AOA) Certifications The Joint Commission: Acute Myocardial Infarction, Advanced Primary Stroke Center, COPD, Coronary Artery Bypass Graft, Heart Failure, Joint Replacement Hip, Joint Replacement Knee, Lung Cancer, Pneumonia, Wound Care Verified Level II Trauma Center (FL Dept. of Health) ADDITIONAL SERVICES: RMCHealth.com 24-Hour Emergency Care Arrythmia Center of Florida Cardiopulmonary Rehabilitation Center Company Care & Occupational Health Consult-A-Nurse Electrophysiology Lab The Heart Institute (with Cardiac Surgery) Minimally Invasive Surgery Neuroscience Center of Excellence Orthopedics Sleep Disorders Center Spine Care Centers of West Florida Trauma Center Level II Vascular Wound & Hyperbaric Medicine HOSPITAL STATISTICS # of Licensed Beds Total Annual Admissions Total Annual Emergency Visits Total Patients Treated* Total Payroll Taxes Paid ,927 40,803 79, ,264 $83,250,721 $9,142,763 * Includes Admissions, ED Visits, OP Visits, OP Surgery, and OP OBS Visits numbers unless otherwise noted. TRUST IS STRONG MEDICINE and Forest Ranger Jared Dorrier knows importance of timing. When seconds mattered, he trusted the trauma team at Regional Medical Center Bayonet Point and today credits his life to their care. Shayne George, MBA, MHA, FACHE Chief Executive Officer 26 HCA WEST FLORIDA