Report to the Community 2013

Key accomplishments 3 Putting patients first 5 Community connections 6 TMH financials 7 Report to the Community 2013 The Memorial Hospital Medical Clinic The Memorial Hospital Rehabilitation Center

2 Administration John Rossfeld Chief Executive Officer Tim Howard Interim Chief Financial Officer Beka Warren, RN Chief Quality Officer Jennifer Riley Chief of Marketing and Business Development Jill Spencer Chief Human Resource Officer Dr. Scott Ellis Chief Medical Officer Terri Jourgensen, RN, BSN, OMS Clinic Practice Administrator Chris Kalinowski, RN Interim Chief Nursing Officer Board of Directors Don Cook, Chair Forrest Luke, Chair Elect Todd Jourgensen, Secretary/Treasurer Gary Ellgen Cathrine Blevins Don Myers Alman Nicodemus Department Leaders Denise Arola Controller Amy Knights, RN, WCC Diabetes and Wellness Education Katrina Geis Diagnostic Imaging/Cardiopulmonary Services Elizabeth Metcalf, RN Emergency Department Richard Nichols EMS Cindy Archuleta Environmental Services David Mucha Facilities Engineering Cindy Simpson Dietary Services Mary Hammond Health Information Management Kristine Cooper Laboratory Luke Schneider Management Information Systems Gerard Geis Materials Management Wendy Furman, RN, WCC Patient Care Planning Kyle Miller, PharmD Pharmacy Luke Geer, PT, DPT Physical Therapy and Rehabilitation Sandra Chamberlain Revenue Cycle Annette Saylor, RN Surgical Services Words from the CEO John Rossfeld, CEO 2013 was a year of growth for The Memorial Hospital. We continued to move forward with our goal of adding more services and providers for our patients, as well as expanding our community connections and education efforts. Our driving goal has always been to provide a high quality care experience for patients. With that goal in mind, we made several improvements in 2013. In upcoming pages, you ll read about our new electronic health record system in the Emergency Room that allows us to quickly access your health information so we can provide fast, efficient care. Hiring a nurse navigator for our women s health services and cancer patients, and starting a suction clinic for young babies who need respiratory support, were also key accomplishments. Upon community request, improvements were also made in the way we deliver and bill our medical clinic and laboratory services. In 2013, we provided over 17,000 direct patient care experiences in the hospital alone, with several thousand more at our medical clinic and physical therapy and rehabilitation center. In addition, we ran over 65,000 lab tests and completed over 5,000 radiology scans. You can read more on the breakdown of provided services in later pages. Going forward, it is our sincerest desire to continue listening to you, the patient, and to meet and exceed your expectations of care. We are pleased that many of you have given us high marks in many areas. We ve also taken to heart your requests for specific improvements that will make your stay even better. We look forward to a successful 2014. In health and wellness, John Rossfeld, CEO Mission To improve the quality of life for the communities we serve through patientcentered care and service excellence. Vision To be the hospital of C.H.O.I.C.E. for patients, physicians and employees. Values C.H.O.I.C.E. - Compassion, Humility, Ownership, Integrity, Commitment, Excellence TMH At a Glance 7 * Full-Time Staff Physicians Nurses Volunteers 23 Employees 64 223 *1: Family Medicine, 2: Pediatrician, 2: OB/GYN, 2: General Surgeon We are proud to announce that we ve once again earned the Joint Commission s Gold Seal of Approval for accreditation in 2013! We voluntarily met national standards for healthcare quality and safety, which means you can rest easy when you or a loved one stays with us.

1 2 Key Accomplishments in 2013 Increased patient satisfaction with hospital stays TMH continues to see increased patient satisfaction with our in-house doctors, or hospitalists. Our hospitalists, board-certified physicians who specialize in hospital medicine, are in house 24/7 and always available to staff, patients, and families. How hospitalists benefit patients: Decreased wait times for transfer from ED to Inpatient floor Lowered wait times for adjustments to pain medicines Decreased physician response times for critical events Improved Emergency Department Outpatient Services at TMH 65,905 lab procedures 5,695 radiology procedures In 2013, several improvements were made in the Emergency Department, including: Implemented epowerdoc, an electronic heath record system, that allows staff 5,656 ER Visits 1,270 surgeries and scopes 9,544 physical therapy treatments and doctors to access patient information in a more timely manner. In addition, physician orders are input directly into the system allowing departments like lab and radiology to access We are thrilled to have a them quickly. This means group of dedicated, fulltime ED physicians on decreased wait times for patients. staff. They are invested Increased staffing in the department to ensure in TMH, and invested in patient care happens people in our community. quickly and efficiently. This Elizabeth Metcalf, RN, included hiring manager, ED Manager Elizabeth Metcalf, RN. Elizabeth s extensive experience in emergency department care will benefit staff and patients. Treated an average of 470 patients per month. Recently, TMH hired two fulltime ED physicians and is looking to hire another, bringing the total to four. 3 4 5 Created Nurse Navigator Program In order to provide exceptional care, TMH added a nurse navigator to its staff. Jackie Smith, RN, works with cancer patients out of Women s Health Services. When a patient receives a cancer diagnosis, she is there to help them navigate their questions, decisions and resources from diagnosis to treatment to recovery. Women s Health Services took on a sweeter approach to care including scents, soft music, low lighting and chocolate. Implemented the Suction Clinic At the suggestion and direction of TMH Pediatrician Kelly Follett, parents can now bring their babies to the TMH Suction Clinic for deep suctioning to ease the symptoms of respiratory illness. A respiratory therapist evaluates and treats the child to ensure healthy breathing. The clinic is Nurse navigators offer support at every step of the cancer experience. I am there after a woman is diagnosed and receives the news from her doctor. She hears she has cancer and thinks what now? I help answer that question and others, assuage her fears and help her understand the multitude of treatment options. Jackie Smith, RN, Nurse Navigator open 24 hours a day, 7 days a week. Parents visit their doctor and get a prescription for the clinic. It can be used up to 4 times a day for a week, no appointment needed. The cost is much cheaper than an ED visit and is billed to insurance. Enhanced Employee Input on Patient Care As part of a journey to become patient-centered in every aspect of care we deliver, we asked at every level: What is in the best interest of the patients? How can we better serve patients? We went to those who know best, our employees. We have a large board in our hospital main hallway where employees, patients, families and visitors post suggestions on increasing patient safety and enhancing their care experiences. We ve implemented some incredible changes to best serve our patients. 3

Quality Efforts & Successes Did you know that TMH s infectionfree rates are much HIGHER than the national average? TMH 99% National Average 96% We take pride in keeping you safe. TMH Physicians William Baker, M.D. Cardiology Shannon Becker, M.D. Family Medicine Bryan Bomberg, M.D. Orthopedics Timothy Byers, M.D. Ophthalmology Amandeep Chadha, M.D. Hospitalist Stacy Childs, M.D. Urology Terry Clower, M.D. Hospitalist X. Alexis Driggs, M.D.* General Surgeon Scott Ellis, D.O.* OB/GYN How We Compare According to HCAHPS, the Hospital Consumer Assessment of Healthcare Providers and Systems*, TMH receives higher marks than many hospitals in Colorado when it comes to key care issues. The data below represents the average top-box scores where patients responded Always to each of the ten HCAHPS measures at the state and national level. TMH Top Box Scores Kelly Follett, M.D.* Pediatrics Sandra Guidry, M.D. Hospitalist Jonathan Hamilton, D.O.* Family Medicine Mark Hancock, M.D. Oncology Howard Hezmall, M.D. Urology George Holmes, M.D. Pathology Diana Hornung, M.D. Family Medicine Tinh Huyn, M.D.* Emergency Medicine Care Item TMH Colorado Fred Jones, M.D. Radiology Communication with Nurses 85.3% 79% Roland Kafuuma, M.D. Hospitalist Communication with Doctors Responsiveness of Hospital Staff Pain Management Communication about Medicines Cleanliness of Hospital Environment Quietness of Hospital Environment Discharge Information Overall Hospital Rating 83.7% 80.9% 76.4% 72.7% 79.9% 69% 89.6% 63.4% 81% 69% 72% 65% 75% 63% 87% 74% Larry Kipe, M.D. Family Medicine Robert Lile, M.D. Radiology Katherine McClanahan, M.D. Hospitalist Alexander Meininger, M.D. Orthopedics James Merrell, M.D. ENT Gerald Myers, M.D. Cardiology Clay Pendleton, M.D. Urology Recommend the Hospital 68% 75% Andreas Sauerbrey, M.D. Orthopedics *Data represents July 2012-June 2013 Clay Schneiter, M.D. Hospitalist Source: www.medicare.gov/hospitalcompare Michael Sisk, M.D. Orthopedics John Sharp, M.D. Gastroenterology and Internal Medicine Did you know 100% of our employed physicians are board certified? James Summers, D.O.* OB/GYN Malaika Thompson, M.D. Radiology Virginia Tjan-Wettstein, M.D. Oncology 4 hospital. My recent experience changed my attitude about our local Thank you! Patient Jamie VanOveren, M.D. Urology Brook Wager, M.D.* Emergency Medicine Susan Watson, D.O.* Emergency Medicine Jeff Womble, M.D.* General Surgery Kristie Yarmer, M.D.* Pediatrics *denotes physician employed by TMH

Putting Patients First Our Medical Clinic Just Keeps Getting Better Improvements in 2013 Dedicated on-site lab Added physicians and services Easier billing options Improvements to phone system We have high quality doctors who enjoy a high quality of life in Craig, and in return they offer our community high quality care. TMH Medical Clinic Team By the Numbers 13,709 patient visits in 2013 at the TMH Medical Clinic 9,544 patient treatments in 2013 at the TMH Rehabilitation Center Quality and Patient Safety Highlights in 2013 In 2013, key departments, including nursing and pharmacy, implemented nationally-known best practices that increase patient safety and satisfaction. Highlights include: Medication Barcode Scanning guarantees patients get the right medicine, in the right amount at the right time. Nurse Navigator Program a specially-trained nurse walks the cancer journey with patients. TMH Rehabilitation Services Team Patient safety is a top priority. We have several exciting new nursing initiatives that engage our nursing staff and promotes more time at the bedside. Christine Marks-Neece, Inpatient Supervisor, Medical-Surgical and SCU Nursing I was treated like a queen. The nurses took great care of me, made me very comfortable and really cut down my stress level. Patient 5

6 Our Community Connections Community Partner Spotlight: Moffat County Schools Superintendent Brent Curtice says having a trained medical professional on the sidelines is the epitome of quality service for our student athletes. In the fall of 2013, TMH launched the Sports Medicine Program with Moffat County School District to support their sport programs We have always had a and give parents peace of mind. good relationship with the We have never had a dedicated sports trainer hospital, and the sports and we always wanted one for our athletic medicine program is just programs. We met with the hospital for ideas a start. and they opened their doors completely. They Brent Curtice, Superintendent, took on the task and committed to having trained Moffat County School District medical personnel on the sidelines for games and practices. It s a huge commitment to the kids of this district, Curtice says. It s reassuring to local parents who know that if they have a question about how to treat and tape a sprained ankle, treat a concussion, or care for a cut or bruise they ve got an expert right on site to ask before, during and after practices and games. Moving forward, the hospital is offering First Aid and CPR classes to all coaches at a minimal fee. We have always had a good relationship with the hospital, and the sports medicine program is just a start, Curtice concludes. Recipients of community education: Community connections and partners: 150 Attendance of annual community health fair & Back-to-school health fair : 500 40 Signature education events during 2013 Weekly Men s Health Series, June Total Joint Replacement Seminars, October Mammos & Margs, breast health awareness, October Breast Health and Prevention Seminar, Dr. Womble, Dr. Summers and Dr. Malaika Thompson, October Community Connections Bear River Young Life Bella Voce Musical Association Back-to-School Health Fair Boy Scouts of America Bonfils Blood Center Blood Drives Christmas for Kids Christmas for Seniors CNCC Career Fair Community Health Fair Connection for Kids Art Show Craig Boys and Girls Club Craig Chamber of Commerce Craig Daily Press Go Getters Craig Rotary Club Craig Seasharks Craig Youth Hockey Association EMS Community BBQ Friends of Moffat County Education Hayden Chamber of Commerce Hayden Cog Run Lifeline Miner s Clinic in conjunction with National Jewish Hospital Missoula Children s Theater Moffat County Cancer Society Moffat County Fair Moffat County High School Career Fair Moffat County School District Northwest Colorado Legal Services Northwest Colorado Regional EMS/ Trauma Advisory Council Northwest Colorado VNA Hospice Peabody Energy Leaders in Education Rally for a Cause St. Michael s Community Kitchen Steamboat Marathon TMH Community Kitchen TMH Community Education Seminars TMH Foundation Golf Tournament TMH Mammos and Margaritas TMH Men s Health TMH What To Expect Birthing Tour Yampa Valley Partners

TMH 2013 Financials Where it comes from: Medicare reimbursements 17,881,917 Medicaid reimbursement 7,258,148 Private insurance 21,772,939 Self-pay 3,375,892 Other (donations, grants, county support, etc.) 2,510,306 TOTAL: $52,799,202 Deductions: Insurance contract adjustments 13,535,300 Charity care 2,870,193 Self-pay bad debt 2,158,379 TOTAL: $18,563,872 Where it Goes: Salaries & wages 13,340,239 Employee benefits & training 2,942,930 Purchased services & professional fees 5,173,917 Minor equipment 181,266 Supplies & other 6,663,944 Depreciation & Amortization 3,126,268 Interest expense 3,049,350 Loss on asset disposal 226,256 TOTAL: $34,704,170 NET INCOME -$468,840 TMH s Financial Impact on Community 223 employees directly employed by TMH indirectly support over 500 jobs in the community Tax Revenue in annual indirect state and local tax revenue generated by TMH operations $3.5m $70.7m annual economic impact in the state s economy, including $30 million in spending by the hospital. This supports another $40.7 million in additional economic activity. WIN-WIN You spend Your Tax $ Your tax $. support TMH and Clinics You get Quality Healthcare Close to Home The community gets Positive Economic Impact jobs local spending tax revenues Amazing staff and facility. Everyone was friendly and helpful. Excellent OB and surgery staff. Patient Why Doctors Enjoy Working at TMH What I really love about working for TMH is the people. I like the pride our staff has in their jobs. I like the people I take care of, and enjoy getting to know them and their families. My patients lives remind me of the positives I had growing up in Oklahoma cattle ranching, and the love of the outdoors. Dr. Jon Hamilton, Family Medicine, joined TMH in 2013 The people at TMH are some of the best in their specialty areas. We provide exceptional care in every department. Dr. Kristie Yarmer, Pediatrician, joined TMH in 2012 The leadership at the hospital is great at providing physicians with the equipment that we need. We are thrilled to be able to offer the 4D ultrasound to our expectant parents. This is really cutting edge equipment, and really enhances the care that we can give. Dr. Scott Ellis, OB/GYN, joined TMH in 2008 7

The Memorial Hospital Foundation The Memorial Hospital Our Mission: To cultivate relationships and partnerships within our community to generate financial and related resources to enhance the hospital s capacity to provide quality healthcare. Foundation Highlights - 2013 Electronic Medical Records (EMR) system for the emergency department Free bike helmet program for 200+ children Cardiac ultrasound for the emergency department Surgical equipment for orthopedics Water heating and cooling pumps and pads for surgery Crib for pediatrics For more information about how to make a taxdeductible contribution, contact Eva Peroulis, Foundation Executive Director at (970)826-2424 or visit the Foundation s website at www. thememorialhospital.com/community/foundation. Hospital Loop Co Rd 7 13 N The Memorial Hospital Rehabilitation Center Victory Way Yampa Ave 13 Russell St 40 thememorialhospital.com 40 The Memorial Hospital Medical Clinic Grants Received: $50,000 Colorado Department of Public Health & Environment $25,000 Peabody Twentymile Coal Company $10,000 Trapper Mining, Inc $5,000 Questar Corporation $2,000 Nathan B. and Florence R. Burt Foundation $1,500 Rocky Mountain Radiologists $1,000 Yampa Valley Electric (Helmets) $1,000 Yampa Valley Electric (Therapy equipment) $1,000 City Market Donors in 2013 Steve Martinson & Jennifer Riley $2,600.00 John & Paula Kinkaid $2,000.00 New York Life - Bill & Diane Terrill $1,600.00 Gerard & Katrina Geis $1,200.00 Frank & Tammie Hanel $1,000.00 Bryan & Michele Chalmers $850.00 Drs. Dennis & Pamela Kinder $ 850.00 Amy Knights $650.00 Christine Marks $650.00 Tinneal Gerber $600.00 Kathy Bailey $520.00 Mary Hammond $520.00 Amy Updike $520.00 Marie Kettle $520.00 Margaret Perez $520.00 Caplan and Earnest LLC $500.00 Bank of Colorado $500.00 Cook Chevrolet $500.00 Kahl Insurance Services, LLC $500.00 QHR $500.00 Jet Marketing $500.00 Corporate Benefits Connection, LLC $300.00 Craig Daily Press $300.00 Mountain West Insurance $300.00 Best Western Deer Park Inn $300.00 Northwest Title $300.00 Richard & Lynn Nichols $280.00 Pat Padilla $260.00 Rebecca Warren $260.00 Karen Zimmerman $220.00 Bridget Sanders $210.00 Jackie James $200.00 Bob Johnson $200.00 Rebecca Moore $150.00 Layle Dees $120.00 American Legion Post No. 62 $100.00 Steamboat Orthopaedic Assoc. PC $100.00 LPL Financial $100.00 Fiesta Jalisco $100.00 Jacksons Office Supply $100.00 Julie Jantz $30.00 Kim Welder $25.00 Todd Erickson $50.00 Clara Simones $20.00