MOUNTAIN COMMUNITIES HEALTHCARE DISTRICT. Accomplishments. Note from the President of Mountain Communties Healthcare District

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1 MOUNTAIN COMMUNITIES HEALTHCARE DISTRICT Trinity Hospital 60 Easter Avenue * P O Box 1229 * Weaverville CA (530) Note from the President of Mountain Communties Healthcare District Accomplishments Formation of the Mountain Communities Healthcare District with adoption of Bylaws Recruited and hired Chief Executive Officer Transfer of licenses and operation to Mountain Communities Healthcare District Modernized billing system and billing department Contracted with collection agency and started an aggressive collection plan Upgraded chemistry analyzer in the Laboratory Hired full time Dentist for Dental Clinic Adoption of budget for fiscal year 2008 and monthly financial data Provided Mobile Mammography services to Trinity County Post operative infection rate of 0% and less than 1% for hospital acquired infections "In June, 2008, the District will celebrate its 1 st anniversary as the operator of Trinity Hospital. During that time healthcare in our community has weathered a variety of financial tribulations, from State budget crises to replacement of obsolete equipment to dealing with inherited past-due accounts. The quality of medical care provided has been consistently high. For that we all owe heartfelt thanks to the entire staff at Trinity Hospital and the doctors in our community. The coming year promises more severe challenges. The communities in the District will hear much about the State budget and Medi-Cal payments, about accounts payable that the District inherited from past operators, about determinations surrounding the parcel tax, about whether to purchase the clinic in Hayfork, about the complex processes of providing medical care in California (and getting paid for it). In short you will hear about the issues and struggles inherent in operating an enterprise that provides $10,000,000 worth of medical services every year. The Board of Directors and the District will do our very best to confront these and other tests openly and with community input. We strive to earn your continuing support and we solicit your participation in our efforts." Matthew Hudson President MISSION STATEMENT The mission of Mountain Communities Healthcare District is to ensure the availability of and accessibility to emergency medical care, and primary and preventive health care in a cost effective and fiscally responsible manner to all the people in the communities we serve..

2 Services Available 24 Hour Emergency Room with Physician on duty at all times Full Service Hospital General Surgery, Endoscopy and Anesthesia Laboratory Full Service Walk-in Health Clinic Dental Clinic X-ray, CT and Ultrasound Mobile Mammography Inpatient Hospital Care Skilled Nursing Services Home Health Care Telemedicine Activity Summary Medical- Surgical Surgical Procedures Acute Care Admissions 431 Inpatient 35 Patient Days 1204 Outpatient 197 Average Length of Stay 2.85 Scopes 406 Clinical Lab Tests 218,269 Skilled Nursing Skilled Nursing Admissions 42 Diagnostic Imaging Procedures Patient Days Skilled Nursing 8563 General Radiology 3903 CT Scans 1092 Ultrasounds 559 ER Visits 4,829 Admitted 343 Health Clinic Visits 5748 Transfers 181 Critical Patients Lives Saved 22 Dental Clinic Visits 790 Total 4,829

3 Board Relations Our link to the community Board of Directors Matthew Hudson, President Mary Nixon, R.N., Vice President Carol Bethke, R.N., Clerk Clarence Rose, Treasurer Donald Krouse, M.D., Director Jerry H. Cousins, MA/MSW, Director (Resigned October 17, 2007) (Appointed November 28, 2007) Trinity Hospital Auxiliary The Auxiliary has 21 regular members and 3 associate members who have donated over 1870 hours of service to Trinity Hospital and its patients, visitors and employees. These volunteers offer services ranging from activities for residents of the Skilled Nursing Facility such as a Valentine s Day Party, Thanksgiving Luncheon and weekly bingo to assisting with paperwork and answering the phone. The Auxiliary s main source of income includes a Christmas Bazaar, donations, and fundraising luncheons and raffles. This year, the Auxiliary donated funds for the installation of a new floor in the skilled nursing facility dining room. They also received a bequest from the estate of Richard Russell and those funds, approximately $120,000 will be received in 2008 and will be used to purchase capital equipment for the hospital. TRINITY HOSPITAL MISSION STATEMENT The mission of Trinity Hospital is to provide for the health, safety, and comfort of our patients, their families and the communities we serve by ensuring the best quality professional care and service Physician Relations Teaming with Physicians. There has been an effort to build the partnership between our Medical Staff and Administrative Leadership. The Medical Staff Leadership has been consistently attending the Board of Directors Meetings and Board members are attending the Medical Executive Committee Meetings. Information is being shared in both directions. Physician leaders have been approving new policies and procedures and practices to ensure regulatory compliance. Mountain Communities Healthcare District is currently recruiting for a family practice physician.

4 Strategic Planning & Business Development The business of operating Mountain Communities Healthcare District requires the ability to envision our community s healthcare needs for tomorrow and plan for the future. A special Board meeting dedicated to strategic planning was conducted in February The Board of Directors, Medical Staff, and managerial staff participated in the session. The focus of the planning session was to examine the current operational and financial status of the Healthcare District and to explore the resources needed for future opportunities for health care in Trinity County. Operations Management In March, the interim Chief Executive Officer (CEO), Stan Oppegard, replaced the outgoing Chief Financial Officer with Dev Mahadevan. Dev had only planned on assisting us for 60 days but has continued with us and has instituted a financial reporting system and established a budget for operations. In May, the executive leadership of the organization changed with the departure of Stan Oppegard as the Interim CEO. Interim leadership was replaced with a permanent Chief Executive Officer, Claire M. Kuczkowski. Recruitment of staff for critical departments such as nursing, laboratory and diagnostic imaging has allowed us to eliminate the high cost of travelers and registry personnel. Clinical Quality and Service Advancing the Quality and Safety of Patient Care Trinity Hospital is very pleased to participate with Lumetra and the Institute for Healthcare Improvement (IHI) on its 5 Million Lives Campaign. This campaign is designed to encourage hospitals nationally to protect patients from five million incidents of medical harm over a two-year time period (December 2006 December 2008). Department of Public Health/Centers for Medicare and Medicaid Services Surveys (DPH/CMS) All accreditation surveys as well as the State Life Safety Survey have been conducted throughout the year and passed successfully. Mobile Mammography In December of 2007, Trinity Hospital began sponsoring the mobile mammography unit from St. Joseph s Medical Center in Stockton, CA. The high-tech mobile mammography clinic is complete with a waiting room, dressing room and is equipped with digital screening technology.

5 Trinity Hospital had not offered mammography services since October 2006 and we were eager to find a way for women in Trinity County to obtain mammograms. The unit will continue to visit Weaverville and we hope to bring the service to Hayfork in the near future. Patient Safety Trinity Hospital recently participated in a survey which was designed to cultivate a strong hospital safety culture. Out of this project we have participated in educational programs, networked with other Critical Access Hospitals, and implemented interventions based on scientific evidence designed to enhance the strong safety culture at Trinity Hospital. Community Relations and Activities In 2007, our staff invested a portion of their time participating in activities benefiting the community: Trinity County Multidisciplinary Committee Trinity County Emergency Preparedness Committee First Five Commission Commission on Aging HRN Elder Services Needs Assessment Statewide Disaster Planning and Emergency Preparedness Fire Chiefs Association Skin Cancer Screening Health Fair in collaboration with Trinity County Public Health 16 th Annual Children s Festival Trinity County Fair Participated in NorCal EMS system and Trauma Registry Sponsored many different programs within the County Financial Management Fiscal Responsibility Balance Sheet on December 31, 2007 Assets Current Assets $3,242,393 Current Liabilities $3,086,220 Fixed Assets (Net of Depreciation) $2,069,268 Long-Term Liabilities $ 972,700 _ Fund Balance $1,252,741 Total Assets $5,311,661 $5,311,661 Income Statement for the Period June 1 to December 31, 2007 Revenues from Patients & Hospital Activities $ 5,757,574 Tax Revenues 673,857 Total Revenues $ 6, Expenses $ 6,682,672 Net Loss ($ 251,241)