East Florida Division Community Report

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1 2014 East Florida Division Community Report

2 Over the past twelve months, HCA East Florida has continued to take a leading role in fundamentally transforming the way healthcare is provided. Each of our team members, from our physicians to our nurses to our staff, volunteers and board members, is deeply committed to providing quality, compassionate care every day. We continue to involve our patients and their families in healthcare decisions through our patient-centered, evidence-based, best-practices approach. The HCA East Florida Division is extremely proud of our achievements in We continued to deepen our commitment to better care, using the latest technologies in imaginative ways, improving our outcomes among all patient segments. New programs such as itriage, hcare HUB, Care Assure, eclinical Works, Scheduling Hub and many more allowed patients and medical experts to communicate with each other at depths never imagined even a few years ago. And then there was our commitment to the community. Last year, our economic impact was well over $2 billion. We provided more than $34 million in healthcare services to those without the ability to pay for their care. We also contributed $131,289,752 in taxes that help maintain local schools, contribute in the development and renovations of our roads, support police, fire & EMS and provide other services vital to support and sustain our local economy. And if you consider that we treated nearly 675,000 ER patients and more than 2,500 trauma patients through the year, 2013 was a year we can all be proud of. HCA East Florida will continue to bring breakthroughs in emergency care, orthopedic and joint replacement surgery, oncology care, cardiac surgery, diagnostic and interventional services, women s services, behavioral healthcare and a complete range of inpatient and outpatient services to the communities we serve. As we continue to provide the highest level of quality care, we look forward to being here for your healthcare needs in 2014 and for years to come. Michael Joseph President & CEO HCA East Florida 02

3 Raulerson Hospital Lawnwood Regional Medical Center & Heart Institute JFK Emergency Care Services Palm Beach Gardens West Palm Hospital Palms West Hospital JFK Emergency Care Services Boynton Beach University Hospital & Medical Center St. Lucie Medical Center JFK Medical Center Northwest Medical Center HCA East Florida HCA HCA s roots date back to 1968 when Dr. Thomas Frist, Sr. led a group of physicians to build a hospital in Nashville, Tennessee. Over four decades of hard work and dedication have made HCA Hospital Corporation of America the nation s leading provider of quality healthcare services, with locally managed facilities that include approximately 163 hospitals and 109 outpatient surgery centers in 20 states and throughout Great Britain. In Florida, there are 41 hospitals and 31 surgery centers, three division offices and several other service facilities affiliated with HCA. HCA East Florida With headquarters in Ft. Lauderdale, the HCA East Florida Division encompasses 14 hospitals spanning from the Treasure Coast to South Dade County, in addition to multiple ambulatory surgery centers and imaging centers, two free-standing emergency care facilities, a supply-chain center and an integrated regional laboratory. Together, the network employs more than 13,900 individuals and has nearly 5,000 physicians on staff. Westside Regional Medical Center Plantation General Hospital Locations Kendall Regional Medical Center Aventura Hospital & Medical Center Mercy Hospital & Sister Emmanuel Hospital Treasure Coast Lawnwood Regional Medical Center & Heart Institute Raulerson Hospital St. Lucie Medical Center Broward County Northwest Medical Center Plantation General Hospital University Hospital & Medical Center Westside Regional Medical Center Palm Beach County Miami/Dade County West Palm Hospital Aventura Hospital & Medical Center JFK Medical Center Kendall Regional Medical Center JFK Emergency Care Services Palm Beach Gardens & Boynton Beach Palms West Hospital Mercy Hospital Sister Emmanuel Hospital 2014 East Florida Division Community Report 03

4 HCA East Florida 12 Surgery Centers 4,829 Total Employees Number of Licensed Beds Total Physicians 15, ,928 At A Glance 12 Psychiatric Care Facilities Graduate Medical Education Programs 5 Diagnostic Imaging Centers 1 Regional Laboratory Total Volunteers 14 Hospitals 04 1,353

5 Leading the Way in Quality SEPSIS Hand washing initiative Hand Hygiene remains one of the critical factors in reducing infections at our facilities. In 2013, East Florida Division launched the implementation of a Hand Hygiene technology that tracked compliance of nursing staff members with defined targets. Outfitting the staff and soap dispensers allows our system to capture when a staff member washes their hands. In March 2013, we had 236,784 handwashes registered in the system. HCAHPs/Patient Safety Our clinicians and physicians have developed and implemented two screening processes to quickly identify and treat some of our most common diagnoses: Stroke and Sepsis. With early warning systems in place for these two serious conditions, our staff is better prepared to recognize and respond to these warning signs both in the Emergency Department, as well as among our inpatients. In regards to radiation, we have a Radiation Right Program to consider the right exam, right site and right dose. We consider alternative exams to achieve the desired test result and minimize exposure to radiation. We verify that patients receive the right test or procedure using the Joint Commission Universal Protocol. We also follow nationally accepted guidelines to assure that we always give the lowest effective dose of radiation possible. 308 ADDITIONAL lives saved in 2013 as a result of full implementation of our sepsis program East Florida Division Community Report 05

6 Giving Back to the Community Our single most important contribution is ensuring that Floridians have access to quality healthcare close to home. But there are other ways that we make a positive impact on the communities we serve. Here are a few examples: Improving the health and quality of life of the individuals and communities we serve is woven through the values and actions of our organization and employees. Our community-benefit activities encompass charity care, corporate charitable giving, employee giving and volunteerism to benefit a wide variety of charitable organizations. HCA s overall commitment to the health of the community includes providing care to those without the ability to pay. Wellness Community Volunteer Education Commitment Above and beyond our organizational efforts are countless hours and the steadfast resolve of our employees and physicians to provide support through wellness education and volunteering to support those who need it most. We are fortunate to partner in these initiatives with outstanding health, educational, civic and social service institutions who share our vision for a healthier community. Service Health Support 06

7 Taking care of our own the HCA family HCA Hope Fund The Hope Fund helps our HCA colleagues who may be facing any number of difficult situations. The HCA Hope Fund is an employee-run, employee-supported 5019(c)(3) not-for-profit organization. The Fund s goal is to be an effective, reliable and permanent way for HCA employees to help one another, providing hope and financial assistance in times of need. The Hope Fund offers financial aid for illnesses, injuries, disasters and other special circumstances, such as domestic violence, that create an unavoidable financial strain. To learn more about the Hope Fund, please visit The Hope Fund has become an important part of our HCA culture, demonstrating that HCA is committed not only to the communities we serve, but also to our own HCA family. Helping those in Need Our commitment to ensuring delivery of much-needed healthcare to area residents, regardless of their ability to pay, remains strong. Last year, HCA East Florida provided more than $317,896, in healthcare services to those without the ability to pay for their care. Fueling the economy As a for-profit healthcare system we play a key role as an economic engine helping to support many cities throughout South Florida, various counties and even the state of Florida through our tax base. Last year, HCA paid $190,720,467 in taxes including property tax which helps maintain local schools, contributes in the development and renovations of our roads, supports police, fire & EMS as well as provides other services vital to support and sustain a thriving economy East Florida Division Community Report 07

8 Connections & Social Media When an ailment or health condition presents itself, in many instances, the first contact that someone has with healthcare information is through the internet. In fact, it is reported that 4 out of 5 people research health information online and 1/3 of US adults access health-related social media sites. As such, we believe that it is critical to engage people in health conversations through various communication outlets. Providing useful, real-time health information, HCA is poised to connect and engage with our communities with personalized solutions that can empower them in their healthcare decision process. Below is a list of platforms and tools: Consult-A-Nurse Health Care Referral and Information As a community service, the hospitals of HCA East Florida provide a toll-free number with 24/7 access to nurses. By calling HCA-Docs, community members can speak to registered nurses who provide consultation and prompt answers for a variety of health-related questions. Our nurses do not diagnose conditions, but provide health information in an effort to help you find an answer to your health questions. They also provide free physician referrals, helping to connect callers with the appropriate physician or specialist. In addition to being a healthcare information resource, Consult-A-Nurse provides community members with information about health services, hospital programs and also registers people for numerous community education classes and events hosted by our hospitals. Health Information and ER Check-in at your Fingertips From a mobile device, or from a home computer, knowing where to go and how long the wait time is in the ER is now as simple as point and click with: itriage - itriage combines health information on thousands of symptoms, diseases and medical procedures with GPS and mapping to help consumers find care whether at home or on the road. It also allows patients to find emergency room wait times, get healthcare cost information and view quality reports. itriage is available as a free app for iphone, Android TM, Blackberry & Palm smartphones or at inotify - inotify offers consumers a fast, convenient way to notify our HCA facilities of a pending ER visit, directly from their smartphone. When looking to itriage for healthcare answers, a potential patient can utilize inotify to convey that they are coming into the ER for treatment. Through the online system, inotify securely alerts the ER triage team of the pending visit and related illness or injury, which streamlines the care coordination. Use inotify to let our ER staff know you re on your way to our ER, saving time when it matters most. By the time you come through the doors, our staff will be waiting with the help you need. Access to health information at the right time InformER TM Consult-a-Nurse TM Websites Patient Portal Share Care Social media, P-doc YouTube 08

9 Connections & Social Media To further connect with our community members and increase access to health-related information, the HCA East Florida hospitals use various online platforms to share valuable health information and help improve the healthcare knowledge-base of the communities we serve. Through the use of social-media channels we seek to forge even better relationships with our community members, develop further trust and look forward to being the go-to source for health information for our neighbors. Electronic exchange of patient clinical results with physician providers hcare HUB - The ability to send patient results directly into physicianoffice Electronic Medical Records (EMR) systems. Data includes radiology/ cardiology results, lab results, discharge summaries and many other clinical results. This allows for more efficient and timely patient care. It also allows the physician to view a complete medical record including the information from their patients facility visits. Patient follow-up based on clinical results Care Assure - A web-based clinical navigation tool that ensures patients receive the care they need during and after their inpatient stay. The Care Assure program is comprised of clinical and technical resources focused on early follow-up with patients based on their clinical results. Leveraging various rules based on clinical criteria, a team of Nurse Navigators uses a web-based dashboard to reach out to our patients in order to provide them with immediate guidance on their follow-up care. Results are available to these navigators as soon as results are ready to ensure that prompt and accurate follow-up is done. Enhancing physician communication - A comprehensive physician website was developed in order to increase communication with our physician community from anywhere. The site, focused on presenting physicians with key information they need in order to access and use the various technical solutions we have, has proven to be a great asset. From anywhere they have internet access, physicians can find links and information on how to access our cardiology, radiology and other clinical systems. This enables them to respond to emergent needs efficiently without having to worry about where to access the information they need. Physician office Electronic Medical Records (EMR) eclinicalworks - The East Florida HCA Physician Services (HCAPS) continues to be more and more reliant on the paperless, comprehensive solution of eclinicalworks (ecw). We began implementation of this comprehensive system in 2013 and deployed to over 90 providers and 25 practices. We continue the roll out adding to its reach and impact in Scheduling Hub - In 2013 we implemented the Scheduling Hub, providing enterprise-standard access to physician-practice schedules for internal-facing applications as well as third-party retail partners. Online physician profiles, call center agents and third-party applications now have the ability to work from one centralized calendar. Meaningful Use (MU) - IT&S continues its commitment to ensure that East Florida HCA achieves Meaningful Use requirements according to federal guidelines and deadlines. We successfully achieved MU Stage 1 in 2013 at all of our eligible facilities. We continue our focus and efforts in 2014 with MU Stage 2. Advanced Clinicals - The Advanced Clinicals body of technology was one of IT&S s top focuses for 2013, and major advancements were made throughout the year, most notably in connection with computerized physician order entry (CPOE). CPOE provides digital management of patient information for medications and other hospital services and offers unique features such as error checking for allergy and drug interactions and duplicate orders. This technology is critical for improving patient care and patient safety. We have completed the rollout of Advanced Clinicals to 12 of our eligible facilities. But mere implementation was not enough; strong efforts were also made to increase physician adoption. Number of Providers Utilizing Electronic Ordering and Documentation Percentage of Orders Entered Electronically 8, % Vitals Now - Real-time documentation and alerting of vital signs was implemented at our facilities with the use of the Vitals Now wireless technology. Blood Pressure, Pulse, Respiratory Rate and Level of Consciousness are wirelessly updated to our Electronic Health Record at the time of completion and analyzed to provide clinicians an early warning of any change in the patient s condition East Florida Division Community Report 09

10 Emergency Services Excellence In an emergency, timing and treatment go hand in hand. And 15 HCA East Florida hospitals are all about fast action. From stroke care to heart attacks, 24/7 we are saving lives and improving the quality of lives through advanced technology, delivered quickly. Patients can count on minimal wait times and timely care delivered by highly skilled physicians and staff. We take great pride in the fact that our ER wait times consistently fall below the national average, and we proudly post them on hospital websites and digital billboards throughout East Florida. Additionally, patients can text ER to to find out wait times for the facility closest to their location. Our emergency department experts are renowned for their care and compassion. Every year, a multitude of patients rely on us for our superior care and many more enjoy peace-of-mind knowing we are close to home. Total ER Patients 674,526 To better meet the needs of the community in Palm Beach County, JFK Medical Center opened two off-site emergency care facilities. One is located in the Palm Beach Gardens area and the other is located in western Boynton Beach. Physicians at the off-site ERs are Board Certified in Emergency Medicine and are committed to providing their patients with the highest level of care and personalized attention. 10

11 Emergency Services Excellence Level II Trauma Centers South Florida Trauma at Kendall Regional Medical Center and Treasure Coast Trauma at Lawnwood Regional Medical Center and Heart Institute: These are part of the University of South Florida/HCA Trauma Network, joining forces with one of the state s top medical schools, which allows HCA to reach its goals for research, quality, safety and better outcomes for its patients. The joint initiative enables HCA hospitals to meet local needs for trauma services through an affiliation with a major academic university and medical school. All Florida residents will benefit from centralized, statewide data collection for trauma research and coordination of services not readily accessible in underserved areas of the state. Total trauma Patients 2,569 Neurosciences & Stroke Care Our neuroscience services encompass comprehensive collaborative care coupled with advanced technology and research to offer patients amazing new possibilities. Diagnosis and treatment for a variety of neurological conditions ranging from epilepsy and brain tumors to strokes are available, including Deep Brain Stimulation (DBS) for treatment of symptoms of Parkinson s disease and essential tremors. Orthopedic & Spine Care Our network of hospitals offers patients suffering from orthopedic and spine issues access to a full spectrum of resources for accurate diagnosis and treatments. From conservative measures and pain management to minimally invasive procedures and reconstruction of spinal deformity, our hospitals offer an integrated model of care to help patients get back to their everyday activities as quickly and safely as possible East Florida Division Community Report 11

12 Women s Services Heart & Vascular Network Our commitment to women s health is demonstrated in the wide array of programs and services provided to meet the unique healthcare needs of women at various stages of life. Our hospitals offer a spectrum of services ranging from digital mammography and minimally invasive surgery for gynecologic issues to pregnancy and menopause management. Women count on our network of hospitals to provide unparalleled care and medical expertise. Six of our hospitals offer obstetric services with Levels I, II and III neonatal intensive care units. An awardwinning facility, Plantation General Hospital is recognized by the Joint Commission as a center of excellence in neonatal services - one of only three in the nation. Our hospitals have a reputation for excellence in heart and vascular care providing comprehensive services including prevention, diagnostic modalities, lifesaving technology, minimally invasive techniques, rehabilitation and additional support for patients with heart disorders. Our active participation in clinical trials allows us to bring the most cutting-edge treatments and procedures to our communities. Dedicated to using minimally invasive techniques, our cardiac cath labs feature the latest imaging technology to assist in the detection and treatment of coronary-artery blockages. We offer advanced treatment for the cure of atrial fibrillation, the most common heartarrhythmia condition. And for patients who are unable - or choose not to - undergo traditional open heart surgery, we offer a minimally invasive option to surgical valve replacement called TAVR (trans catheter aortic valve replacement). 12

13 Behavioral Health A wide range of programs and services are available at our hospitals, including treatment for addictive disorders and mentalhealth issues. From children to seniors, services are available in a range of formats to best treat both the patient and the illness from inpatient to partial hospitalization to outpatient services. Comprehensive Cancer Care We are a recognized premier provider of cancer services incorporating the latest breakthroughs in technology, research, psycho-social services and survivorship programs to ensure the best clinical outcomes for our patients. Cyberknife DaVinci Minimally Invasive Procedures In the fight against cancer, we are utilizing sophisticated tools such as IMRT, a treatment that allows for precise radiation of tumor cells without harming surrounding healthy tissue. IMRT has proven effective in the management of tumors previously deemed untreatable. Our facilities meet or exceed the many standards for accreditation, and many have been awarded distinction by the American College of Surgeons Commission on Cancer (ACoS COC). Imaging Services, Ambulatory Surgery Centers & IRL The HCA East Florida network of affiliated hospitals provides the most comprehensive array of outpatient imaging and outpatient surgery centers. Part of the HCA family of services includes Florida Open Imaging Centers (FOIC) which owns and operates full-service outpatient imaging facilities conveniently located throughout Palm Beach County. Our 12 Ambulatory Surgery Centers were founded to provide our patients and physicians with the finest quality of outpatient care, delivered in a compassionate and efficient manner. Our physicians are supported by a highly skilled team of registered nurses and surgical technicians specially trained in surgical recovery and care. Our staff is carefully selected for their dedication to providing personalized care and service. The standards of care required by Medicare and other regulatory bodies are strictly adhered to. Our surgery centers are accredited by the Accreditation Association for Ambulatory Health Care. We have five centers located in Dade County, two in Broward, three in Palm Beach and two in St. Lucie County. Integrated Regional Laboratories (IRL) is a system of hospitalbased laboratories and a sophisticated high-volume core laboratory supporting the clinical laboratory testing needs of over 250 acute care and rehab hospitals, surgery centers, large physician practices and commercial accounts across the United States and the Caribbean. Visit our website at East Florida Division Community Report 13

14 Rehab To help ensure the best possible recovery after an injury or illness we offer a multi-disciplinary approach to rehabilitative therapy. With a personalized and patientfocused model, our expert therapists work with the patient, family members and caregivers to develop treatment plans. We offer the highest level of rehabilitative care through evidence-based therapies. Our commitment to excellence is reflected in the talented staff who work with our patients throughout their recoveries. 42.4% Orthopedic 16% Stroke Bay View Rehab: Case Mix 10.2% Debility 9.2% Neuro 8.4% Brain 4.4% Spinal 4.0% Other 3.5% Cardiac 1.9% Amputation Bay View Rehab: Patient Outcomes Average Age Average Length of Stay Discharged to Home/Community Discharged to Long Term Care Facility BVRU REGIONAL NATIONAL % 4.5% % 8.9% % 9.1% * Based on UDSMR 2013 annual reporting which included 313 patients. 14

15 Rehab Lawnwood Rehab: Patient Outcomes Average Age Average Length of Stay Discharged to Home/Community Discharged to Long Term Care Facility LAWNWOOD REGIONAL NATIONAL % 15.4% % 13.6% % 16.4% 30% Orthopedic 19% Stroke Lawnwood Rehab: Case Mix 14% Brain 12% Neuro 8% Cardiac 5% Pulmonary 5% Other 3% Spinal 3% Amputation 1% Multiple Trauma * Based on UDSMR 2013 annual reporting which included 664 patients East Florida Division Community Report 15

16 Pediatric Services While all of our facilities are kid-friendly, HCA hospitals are pleased to offer pediatric inpatient care at Kendall Regional Medical Center, Northwest Medical Center, Plantation General Hospital and Palms West Hospital. The pediatricians and pediatric specialists on staff expertly treat most conditions. With many years of experience in caring for little ones, we know how to make kids feel safe, comfortable, and most of all, better. 16

17 2013 Hospital Statistics $131,289,752 Total Taxes $46,758,330 Federal Income Tax $17,097,381 Sales Tax $42,881,000 Physician Specialty Coverage in the ED $34,539,106 Indigent Care Tax 206, ,526 Annual Hospital Admissions Annual Emergency Visits $18,704,651 Property Tax $317,896,151 Cost of Charity and Uncompensated Care $10,296,767 State Income Tax 194,366 Total Uninsured Patients Treated $419,839, % Medicaid Market Share Total Local Vendor Support $2,251,421,000 Total Economic Impact $23,831,000 Minority- and WomenOwned-Business Support $1,230,813,000 Total Salaries and Benefits 2014 East Florida Division Community Report $158,040 Other Local Tax $3,735,477 Unemployment Tax $108,703,000 Capital Investment 1,225,897 Total Patients Treated 272,723 Total Medicaid Patients Treated 17

18 1700 S. 23rd Street, Fort Pierce, FL LawnwoodMed.com Greg Lowe Chief Executive Officer $5,615,230 Federal Income Tax $281,637 Unemployment Tax $41,356,000 Total Local Vendor Support $37,930,000 Cost of Charity and Uncompensated Care $13,121,552 Taxes Paid $1,205,910 Sales Tax $7,520,000 Capital Investment 1,297 Total Employees 370 # of Licensed Beds 19,842 Total Annual Admissions $0 Other Local Tax $1,219,327 State Income Tax 86,901 Total Patients Treated 63,507 Total Annual Emergency Visits 376 Total Physicians $1,648,000 Minority- and Women-Owned-Business Support $3,613,368 Indigent Care Tax $222,578,000 Total Economic Impact $1,186,080 Property Tax $113,548,000 Salaries, Wages & Benefits $9,103,000 Physician Specialty Coverage in the ED 18

19 Our Service Lines Include : Heart & Vascular Care Vascular Care Open Heart Procedures Cardiac Catheterization & Angioplasty Cardiac Rehabilitation Vascular Rehabilitation Infusion Center Kidney Dialysis Emergency Medicine Occupational Health Services Orthopedic Surgery Neonatal Intensive Care l & II Neonatal Intensive Care Level III Kid-Friendly ER Pediatric Emergency Center Pediatrics Pediatrics Intensive Care Psychiatric Adult Rehabilitation Center Wound Care Specialty Care/Vent Services JCAHO Primary Stroke Center Primary Stroke Center Robotic Assisted Surgery Obstetrics & Birthing Suites Trauma Center- Level II Provisional Level III NICU, Pediatric Intensive Care Unit and Level II Trauma Center 1406 trauma patients treated First in the Treasure Coast to offer the Mazor Robotics (has proven to improve patient recovery and results in fewer complications and less pain) Safety Net Hospital (providing significant quality care to uninsured, low-income and vulnerable populations) Most experienced open-heart program on the Treasure Coast. Lawnwood gave me exceptional care with patience and understanding. - James Rigal 2014 East Florida Division Community Report 19

20 1796 Highway 441 North, Okeechobee, FL RaulersonHospital.com Robert Lee Chief Executive Officer $2,279,381 Federal Income Tax $100,706 Unemployment Tax $6,392,000 Total Local Vendor Support $7,241,000 Cost of Charity and Uncompensated Care $4,466,116 Taxes Paid $340,725 Sales Tax $1,744,000 Capital Investment 431 Total Employees 100 # of Licensed Beds 5,615 Total Annual Admissions $960,646 Indigent Care Tax $494,814 State Income Tax 57,686 Total Patients Treated 26,488 Total Annual Emergency Visits $53,360,000 Total Economic Impact $270,880 Property Tax 40 Total Physicians $364,000 Minority- and Women-Owned-Business Support $18,964 Other Local Tax $32,868,000 Salaries, Wages & Benefits $648,000 Physician Specialty Coverage in the ED 20

21 Our Service Lines Include : Emergency Medicine Occupational Health Services Orthopedic Surgery Kid-Friendly ER Rehabilitation Center Sleep Disorders Center Wound Care Pulmonary Rehabilitation Hospice Breast MRI Digital Mammography At Raulerson Hospital the patient is number one. All of the staff are professional, knowledgeable, empathetic, caring and keep the patient informed about their care. Board Certified surgeons offer minimally invasive joint replacement options. Raulerson Hospital is recognized as a Top Performer in Key Quality Measures in Surgical Care by the Joint Commission. Okeechobee s only 24/7 emergency services provider. Our ER treats kids too! Celebrating our 35th year of providing our community quality healthcare with a personal touch. - Rodney Forrest ER and ICU patient 2014 East Florida Division Community Report 21

22 1800 S.E. Tiffany Avenue, Port St. Lucie, FL StLucieMed.com Jay Finnegan Chief Executive Officer $5,534,586 Federal Income Tax $227,380 Unemployment Tax $23,742,000 Total Local Vendor Support $15,030,000 Cost of Charity and Uncompensated Care $11,617,657 Taxes Paid $1,284,864 Sales Tax $7,123,000 Capital Investment 970 Total Employees 229 # of Licensed Beds 14,336 Total Annual Admissions $58,378 Other Local Tax $1,207,463 State Income Tax 74,782 Total Patients Treated 46,360 Total Annual Emergency Visits 304 Total Physicians $844,000 Minority- and Women-Owned-Business Support $2,390,606 Indigent Care Tax $142,765,000 Total Economic Impact $920,380 Property Tax $83,955,000 Salaries, Wages & Benefits $1,298,000 Physician Specialty Coverage in the ED 22

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