Adventist HealthCare Shady Grove Medical Center - Maryland

[Pages:40]Adventist HealthCare Shady Grove Medical Center

FY 2018 Community Benefit Narrative Report

PART ONE: ORIGINAL NARRATIVE SUBMISSION

QQ11..

Introduction:

CCOOMMMMUUNNIITTYY BBEENNEEFFIITT NNAARRRRAATTIIVVEE RREEPPOORRTTIINNGG IINNSSTTRRUUCCTTIIOONNSS TThhee MMaarryyllaanndd HHeeaalltthh SSeerrvviicceess CCoosstt RReevviieeww CCoommmmiissssiioonn''ss ((HHSSCCRRCC''ss oorr CCoommmmiissssiioonn''ss)) CCoommmmuunniittyy BBeenneeffiitt RReeppoorrtt,, rreeqquuiirreedd uunnddeerr ??1199--330033 ooff tthhee HHeeaalltthh GGeenneerraall AArrttiiccllee,, MMaarryyllaanndd AAnnnnoottaatteedd CCooddee,, iiss tthhee CCoommmmiissssiioonn''ss mmeetthhoodd ooff iimmpplleemmeennttiinngg aa llaaww tthhaatt aaddddrreesssseess tthhee ggrroowwiinngg iinntteerreesstt iinn uunnddeerrssttaannddiinngg tthhee ttyyppeess aanndd ssccooppee ooff ccoommmmuunniittyy bbeenneeffiitt aaccttiivviittiieess ccoonndduucctteedd bbyy MMaarryyllaanndd''ss nnoonnpprrooffiitt hhoossppiittaallss.. TThhee CCoommmmiissssiioonn ddeevveellooppeedd aa ttwwoo--ppaarrtt ccoommmmuunniittyy bbeenneeffiitt rreeppoorrttiinngg ssyysstteemm tthhaatt iinncclluuddeess aann iinnvveennttoorryy sspprreeaaddsshheeeett tthhaatt ccoolllleeccttss ffiinnaanncciiaall aanndd qquuaannttiittaattiivvee iinnffoorrmmaattiioonn aanndd aa nnaarrrraattiivvee rreeppoorrtt ttoo ssttrreennggtthheenn aanndd ssuupppplleemmeenntt tthhee iinnvveennttoorryy sspprreeaaddsshheeeett.. TThhee gguuiiddeelliinneess aanndd iinnvveennttoorryy sspprreeaaddsshheeeett wweerree gguuiiddeedd,, iinn ppaarrtt,, bbyy tthhee VVHHAA,, CCHHAA,, aanndd ootthheerrss'' ccoommmmuunniittyy bbeenneeffiitt rreeppoorrttiinngg eexxppeerriieennccee,, aanndd wwaass tthheenn ttaaiilloorreedd ttoo ffiitt MMaarryyllaanndd''ss uunniiqquuee rreegguullaattoorryy eennvviirroonnmmeenntt.. TThhiiss rreeppoorrttiinngg ttooooll sseerrvveess aass tthhee nnaarrrraattiivvee rreeppoorrtt.. TThhee iinnssttrruuccttiioonnss aanndd pprroocceessss ffoorr ccoommpplleettiinngg tthhee iinnvveennttoorryy sspprreeaaddsshheeeett rreemmaaiinn tthhee ssaammee aass iinn pprriioorr yyeeaarrss.. TThhee nnaarrrraattiivvee iiss ffooccuusseedd oonn ((11)) tthhee ggeenneerraall ddeemmooggrraapphhiiccss ooff tthhee hhoossppiittaall ccoommmmuunniittyy,, ((22)) hhooww hhoossppiittaallss ddeetteerrmmiinneedd tthhee nneeeeddss ooff tthhee ccoommmmuunniittiieess tthheeyy sseerrvvee,, ((33)) hhoossppiittaall ccoommmmuunniittyy bbeenneeffiitt aaddmmiinniissttrraattiioonn,, aanndd ((44)) ccoommmmuunniittyy bbeenneeffiitt eexxtteerrnnaall ccoollllaabboorraattiioonn ttoo ddeevveelloopp aanndd iimmpplleemmeenntt ccoommmmuunniittyy bbeenneeffiitt iinniittiiaattiivveess.. TThhee CCoommmmiissssiioonn mmoovveedd ttoo aann oonnlliinnee rreeppoorrttiinngg ffoorrmmaatt bbeeggiinnnniinngg wwiitthh tthhee FFYY 22001188 rreeppoorrttss.. IInn tthhiiss nneeww tteemmppllaattee,, rreessppoonnsseess aarree nnooww mmaannddaattoorryy uunnlleessss mmaarrkkeedd aass ooppttiioonnaall.. IIff yyoouu ssuubbmmiitt aa rreeppoorrtt wwiitthhoouutt rreessppoonnddiinngg ttoo eeaacchh qquueessttiioonn,, yyoouurr rreeppoorrtt mmaayy bbee rreejjeecctteedd.. YYoouu wwoouulldd tthheenn bbee rreeqquuiirreedd ttoo ffiillll iinn tthhee mmiissssiinngg aannsswweerrss bbeeffoorree rreessuubbmmiittttiinngg.. QQuueessttiioonnss tthhaatt rreeqquuiirree aa nnaarrrraattiivvee rreessppoonnssee hhaavvee aa lliimmiitt ooff 2200,,000000 cchhaarraacctteerrss.. TThhiiss rreeppoorrtt nneeeedd nnoott bbee ccoommpplleetteedd iinn oonnee sseessssiioonn aanndd ccaann bbee ooppeenneedd bbyy mmuullttiippllee uusseerrss.. FFoorr tteecchhnniiccaall aassssiissttaannccee,, ccoonnttaacctt HHCCBBHHeellpp@@hhiillllttoopp..uummbbcc..eedduu..

QQ22.. Section I - General Info Part 1 - Hospital Identification

QQ33.. PPlleeaassee ccoonnffiirrmm tthhee iinnffoorrmmaattiioonn wwee hhaavvee oonn ffiillee aabboouutt yyoouurr hhoossppiittaall ffoorr FFYY 22001188..

TThhee pprrooppeerr nnaammee ooff yyoouurr hhoossppiittaall iiss:: AAddvveennttiisstt HHeeaalltthhCCaarree SShhaaddyy GGrroovvee MMeeddiiccaall CCeenntteerr

Is this information correct?

Yes

No

YYoouurr hhoossppiittaall''ss IIDD iiss:: 221100005577

If no, please provide the correct information here:

YYoouurr hhoossppiittaall iiss ppaarrtt ooff tthhee hhoossppiittaall ssyysstteemm ccaalllleedd AAddvveennttiisstt HHeeaalltthhCCaarree..

YYoouurr hhoossppiittaall wwaass lliicceennsseedd ffoorr 226666 bbeeddss dduurriinngg FFYY 22001188..

YYoouurr hhoossppiittaall''ss pprriimmaarryy sseerrvviiccee aarreeaa iinncclluuddeess tthhee ffoolllloowwiinngg zziipp ccooddeess:: 2200884411,, 2200885500,, 2200885511,, 2200885522,, 2200885533,, 2200885544,, 2200885555,, 2200887711,, 2200887722,, 2200887744,, 2200887766,, 2200887777,, 2200887788,, 2200887799,, 2200888866,, 2200990066 YYoouurr hhoossppiittaall sshhaarreess ssoommee oorr aallll ooff iittss pprriimmaarryy sseerrvviiccee aarreeaa wwiitthh tthhee ffoolllloowwiinngg hhoossppiittaallss:: HHoollyy CCrroossss GGeerrmmaannttoowwnn HHoossppiittaall,, HHoollyy CCrroossss HHoossppiittaall,, MMeeddssttaarr MMoonnttggoommeerryy MMeeddiiccaall CCeenntteerr,, SSuubbuurrbbaann HHoossppiittaall,, WWaasshhiinnggttoonn AAddvveennttiisstt HHoossppiittaall

20878 20874 20850 20877 20886 20879 20852 20876 20906

QQ44.. TThe nneexxtt twwoo qqueesttiioonnss aasskk aabboouut tthhee aareea whheerree yyoouurr hhoosppittaall diirreeccttss iittss ccommmmuunniittyy bbeenneeffiitt eeffffoorrttss,, ccaallleedd tthhee CCoommmmuunniitty BBeenneeffiitt Seerrvviiccee AArreeaa.. Yoouu mmaayy ffiinnd tthheessee commuunityy hheaalltthh ssttaattiisstiiccss usseffuull iinn pprreepparrinngg yyoouur rreessppoonnsseess.

QQ55.. ((OOppttiioonnaall)) PPlleeaassee ddeessccrriibbee aannyy ootthheerr ccoommmmuunniittyy hheeaalltthh ssttaattiissttiiccss tthhaatt yyoouurr hhoossppiittaall uusseess iinn iittss ccoommmmuunniittyy bbeenneeffiitt eeffffoorrttss..

QQ66.. ((OOppttiioonnaall)) PPlleeaassee aattttaacchh aannyy ffiilleess ccoonnttaaiinniinngg ccoommmmuunniittyy hheeaalltthh ssttaattiissttiiccss tthhaatt yyoouurr hhoossppiittaall uusseess iinn iittss ccoommmmuunniittyy bbeenneeffiitt eeffffoorrttss..

QQ77.. Section I - General Info Part 2 - Community Benefit Service Area

QQ88.. Please select the county or counties located in your hospital's CBSA.

AAlllleeggaannyy CCoouunnttyy AAnnnnee AArruunnddeell CCoouunnttyy BBaallttiimmoorree CCiittyy BBaallttiimmoorree CCoouunnttyy CCaallvveerrtt CCoouunnttyy CCaarroolliinnee CCoouunnttyy

CChhaarrlleess CCoouunnttyy DDoorrcchheesstteerr CCoouunnttyy FFrreeddeerriicckk CCoouunnttyy GGaarrrreetttt CCoouunnttyy HHaarrffoorrdd CCoouunnttyy HHoowwaarrdd CCoouunnttyy

PPrriinnccee GGeeoorrggee''ss CCoouunnttyy QQuueeeenn AAnnnnee''ss CCoouunnttyy SSoommeerrsseett CCoouunnttyy SStt.. MMaarryy''ss CCoouunnttyy TTaallbboott CCoouunnttyy WWaasshhiinnggttoonn CCoouunnttyy

CCaarrrroollll CCoouunnttyy CCeecciill CCoouunnttyy

KKeenntt CCoouunnttyy MMoonnttggoommeerryy CCoouunnttyy

WWiiccoommiiccoo CCoouunnttyy WWoorrcceesstteerr CCoouunnttyy

QQ1199.. Please check all Frederick County ZIP codes located in your hospital's CBSA.

2211770011 2211770022 2211770033 2211774400 2211771100 2211771144 2211771166 2211771177 2211771188

2211772277 2211775544 2211775555 2211775588 2211776622 2211776699 2211777700 2211777711 2211777733

2211777744 2211777777 2211777788 2211778800 2211778833 2211778888 2211779900 2211779933 2211779988

QQ2244.. Please check all Montgomery County ZIP codes located in your hospital's CBSA.

2200770055 2200770077 2200881122 2200881144

2200881155 2200881166 2200881177 2200881188 2200883322

2200883333 2200883377 2200883388 2200883399

2200884411 2200884422 2200885500 2200885511 2200885522

2200885533 2200885544 2200885555 2200886600

2200886611 2200886622 2200886666 2200886688

2200887711 2200887722 2200887744 2200887766

2200887777 2200887788 2200887799 2200888800

2200888822 2200888866 2200888899 2200889955

2200889966 2200889999 2200990011 2200990022

2200990033 2200990044 2200990055 2200990066

2200991100 2200991122 2211777711 2211779977

QQ3333.. How did your hospital identify its CBSA? BBaasseedd oonn ZZIIPP ccooddeess iinn yyoouurr FFiinnaanncciiaall AAssssiissttaannccee PPoolliiccyy.. PPlleeaassee ddeessccrriibbee..

BBaasseedd oonn ZZIIPP ccooddeess iinn yyoouurr gglloobbaall bbuuddggeett rreevveennuuee aaggrreeeemmeenntt.. PPlleeaassee ddeessccrriibbee..

BBaasseedd oonn ppaatttteerrnnss ooff uuttiilliizzaattiioonn.. PPlleeaassee ddeessccrriibbee.. Our hospital identifies the CBSA via the top 85.0 percent of our hospital discharges. The first 60.0 percent of discharges make up our Primary Service Area and the remaining 25.0 percent make up our Secondary Service Area.

OOtthheerr.. PPlleeaassee ddeessccrriibbee..

QQ3344.. ((OOppttiioonnaall)) IIss tthheerree aannyy ootthheerr iinnffoorrmmaattiioonn aabboouutt yyoouurr hhoossppiittaall''ss CCoommmmuunniittyy BBeenneeffiitt SSeerrvviiccee AArreeaa tthhaatt yyoouu wwoouulldd lliikkee ttoo pprroovviiddee??

QQ3355.. Section I - General Info Part 3 - Other Hospital Info

QQ3366.. PPrroovviiddee aa lliinnkk ttoo yyoouurr hhoossppiittaall''ss mmiissssiioonn ssttaatteemmeenntt..

QQ3377.. Is your hospital an academic medical center? YYeess NNoo

QQ3388.. ((OOppttiioonnaall)) IIss tthheerree aannyy ootthheerr iinnffoorrmmaattiioonn aabboouutt yyoouurr hhoossppiittaall tthhaatt yyoouu wwoouulldd lliikkee ttoo pprroovviiddee??

QQ3399.. ((OOppttiioonnaall)) PPlleeaassee uuppllooaadd aannyy ssuupppplleemmeennttaall iinnffoorrmmaattiioonn tthhaatt yyoouu wwoouulldd lliikkee ttoo pprroovviiddee..

QQ4400.. Section II - CHNA Part 1 - Timing & Format

QQ4411.. Within the past three fiscal years, has your hospital conducted a CHNA that conforms to IRS requirements?

YYeess NNoo

QQ4433.. WWhheenn wwaass yyoouurr hhoossppiittaall''ss ffiirrsstt--eevveerr CCHHNNAA ccoommpplleetteedd?? ((MMMM//DDDD//YYYYYYYY)) 04/18/2013

QQ4444.. WWhheenn wwaass yyoouurr hhoossppiittaall''ss mmoosstt rreecceenntt CCHHNNAA ccoommpplleetteedd?? ((MMMM//DDDD//YYYYYYYY)) 12/28/2016

QQ4455.. PPlleeaassee pprroovviiddee aa lliinnkk ttoo yyoouurr hhoossppiittaall''ss mmoosstt rreecceennttllyy ccoommpplleetteedd CCHHNNAA..

QQ4466.. Did you make your CHNA available in other formats, languages, or media? YYeess NNoo

QQ4477.. PPlleeaassee ddeessccrriibbee tthhee ootthheerr ffoorrmmaattss iinn wwhhiicchh yyoouu mmaaddee yyoouurr CCHHNNAA aavvaaiillaabbllee..

A hard copy is available at Shady Grove Medical Center and at the Adventist HealthCare corporate office located in Gaithersburg, MD.

QQ4488.. Section II - CHNA Part 2 - Participants

QQ4499.. PPlleeaassee uussee tthhee ttaabbllee bbeellooww ttoo tteellll uuss aabboouutt tthhee iinntteerrnnaall ppaarrttiicciippaannttss iinnvvoollvveedd iinn yyoouurr mmoosstt rreecceenntt CCHHNNAA..

CHNA Activities

Participated

N/A - Person or

Organization was not Involved

N/A Position or Department does not

exist

Participated Advised

Member of

in

on

CHNA development CHNA

Committee of CHNA

best

process practices

Participated

Participated

in

in primary identifying

data

priority

collection health

needs

in identifying community resources

to meet health

Provided secondary Other

health (explain) data

needs

CCBB// CCoommmmuunniittyy HHeeaalltthh//PPooppuullaattiioonn HHeeaalltthh DDiirreeccttoorr ((ffaacciilliittyy lleevveell))

Participated

N/A - Person or

Organization was not Involved

N/A Position or Department does not

exist

Participated Advised

Member of

in

on

CHNA development CHNA

Committee of CHNA

best

process practices

Participated

Participated

in

in primary identifying

data

priority

collection health

needs

in identifying community resources

to meet health

Provided secondary Other

health (explain) data

needs

CCBB// CCoommmmuunniittyy HHeeaalltthh// PPooppuullaattiioonn HHeeaalltthh DDiirreeccttoorr ((ssyysstteemm lleevveell))

Participated

N/A - Person or

Organization was not Involved

N/A Position or Department does not

exist

Participated Advised

Member of

in

on

CHNA development CHNA

Committee of CHNA

best

process practices

Participated

Participated

in

in primary identifying

data

priority

collection health

needs

in identifying community resources

to meet health

Provided secondary Other

health (explain) data

needs

SSeenniioorr EExxeeccuuttiivveess ((CCEEOO,, CCFFOO,, VVPP,, eettcc..)) ((ffaacciilliittyy lleevveell))

Participated

N/A - Person or

Organization was not Involved

N/A Position or Department does not

exist

Participated Advised

Member of

in

on

CHNA development CHNA

Committee of CHNA

best

process practices

Participated

Participated

in

in primary identifying

data

priority

collection health

needs

in identifying community resources

to meet health

Provided secondary Other

health (explain) data

needs

SSeenniioorr EExxeeccuuttiivveess ((CCEEOO,, CCFFOO,, VVPP,, eettcc..)) ((ssyysstteemm lleevveell))

Participated

N/A - Person or

Organization was not Involved

N/A Position or Department does not

exist

Participated Advised

Member of

in

on

CHNA development CHNA

Committee of CHNA

best

process practices

Participated

Participated

in

in primary identifying

data

priority

collection health

needs

in identifying community resources

to meet health

Provided secondary Other

health (explain) data

needs

BBooaarrdd ooff DDiirreeccttoorrss oorr BBooaarrdd CCoommmmiitttteeee ((ffaacciilliittyy lleevveell))

Participated

N/A - Person or

Organization was not Involved

N/A Position or Department does not

exist

Participated Advised

Member of

in

on

CHNA development CHNA

Committee of CHNA

best

process practices

Participated

Participated

in

in primary identifying

data

priority

collection health

needs

in identifying community resources

to meet health

Provided secondary Other

health (explain) data

needs

BBooaarrdd ooff DDiirreeccttoorrss oorr BBooaarrdd CCoommmmiitttteeee ((ssyysstteemm lleevveell))

Participated

N/A - Person or

Organization was not Involved

N/A Position or Department does not

exist

Participated Advised

Member of

in

on

CHNA development CHNA

Committee of CHNA

best

process practices

Participated

Participated

in

in primary identifying

data

priority

collection health

needs

in identifying community resources

to meet health

Provided secondary Other

health (explain) data

needs

CClliinniiccaall LLeeaaddeerrsshhiipp ((ffaacciilliittyy lleevveell))

Participated

N/A - Person or

Organization was not Involved

N/A Position or Department does not

exist

Participated Advised

Member of

in

on

CHNA development CHNA

Committee of CHNA

best

process practices

Participated

Participated

in

in primary identifying

data

priority

collection health

needs

in identifying community resources

to meet health

Provided secondary Other

health (explain) data

needs

Other - If you selected "Other (explain)," please type your explanation below:

Other - If you selected "Other (explain)," please type your explanation below:

Chair of the Community Benefit Steering Committee which provides guidance and oversight of Adventist HealthCare community benefit,

including the CHNA process.

Other - If you selected "Other (explain)," please type your explanation below:

Member of the Community Benefit Steering Committee which provides guidance and oversight of Adventist HealthCare community

benefit, including the CHNA process.

Other - If you selected "Other (explain)," please type your explanation below:

Member of the Community Benefit Steering Committee which provides guidance and oversight of Adventist HealthCare community

benefit, including the CHNA process.

Other - If you selected "Other (explain)," please type your explanation below:

Other - If you selected "Other (explain)," please type your explanation below:

Reviewed and approved final reports.

Other - If you selected "Other (explain)," please type your explanation below:

Member of the Community Benefit Steering Committee which provides guidance and oversight of Adventist HealthCare community

benefit, including the CHNA process.

Other - If you selected "Other (explain)," please type your explanation below:

CClliinniiccaall LLeeaaddeerrsshhiipp ((ssyysstteemm lleevveell))

PPooppuullaattiioonn HHeeaalltthh SSttaaffff ((ffaacciilliittyy lleevveell)) PPooppuullaattiioonn HHeeaalltthh SSttaaffff ((ssyysstteemm lleevveell)) CCoommmmuunniittyy BBeenneeffiitt ssttaaffff ((ffaacciilliittyy lleevveell)) CCoommmmuunniittyy BBeenneeffiitt ssttaaffff ((ssyysstteemm lleevveell)) PPhhyyssiicciiaann((ss)) NNuurrssee((ss)) SSoocciiaall WWoorrkkeerrss CCoommmmuunniittyy BBeenneeffiitt TTaasskk FFoorrccee HHoossppiittaall AAddvviissoorryy BBooaarrdd

Participated

N/A - Person or

Organization was not Involved

N/A Position or Department does not

exist

Participated Advised

Member of

in

on

CHNA development CHNA

Committee of CHNA

best

process practices

Participated

Participated

in

in primary identifying

data

priority

collection health

needs

in identifying community resources

to meet health

Provided secondary Other

health (explain) data

needs

Other - If you selected "Other (explain)," please type your explanation below:

Participated

N/A - Person or

Organization was not Involved

N/A Position or Department does not

exist

Participated Advised

Member of

in

on

CHNA development CHNA

Committee of CHNA

best

process practices

Participated

Participated

in

in primary identifying

data

priority

collection health

needs

in identifying community resources

to meet health

Provided secondary Other

health (explain) data

needs

Participated

N/A - Person or

Organization was not Involved

N/A Position or Department does not

exist

Participated Advised

Member of

in

on

CHNA development CHNA

Committee of CHNA

best

process practices

Participated

Participated

in

in primary identifying

data

priority

collection health

needs

in identifying community resources

to meet health

Provided secondary Other

health (explain) data

needs

Other - If you selected "Other (explain)," please type your explanation below:

Member of the Community Benefit Steering Committee which provides guidance and oversight of Adventist HealthCare community

benefit, including the CHNA process.

Other - If you selected "Other (explain)," please type your explanation below:

Participated

N/A - Person or

Organization was not Involved

N/A Position or Department does not

exist

Participated Advised

Member of

in

on

CHNA development CHNA

Committee of CHNA

best

process practices

Participated

Participated

in

in primary identifying

data

priority

collection health

needs

in identifying community resources

to meet health

Provided secondary Other

health (explain) data

needs

Participated

N/A - Person or

Organization was not Involved

N/A Position or Department does not

exist

Participated Advised

Member of

in

on

CHNA development CHNA

Committee of CHNA

best

process practices

Participated

Participated

in

in primary identifying

data

priority

collection health

needs

in identifying community resources

to meet health

Provided secondary Other

health (explain) data

needs

Other - If you selected "Other (explain)," please type your explanation below:

Member of the Community Benefit Steering Committee which provides guidance and oversight of Adventist HealthCare community

benefit, including the CHNA process.

Other - If you selected "Other (explain)," please type your explanation below:

Participated

N/A - Person or

Organization was not Involved

N/A Position or Department does not

exist

Participated Advised

Member of

in

on

CHNA development CHNA

Committee of CHNA

best

process practices

Participated

Participated

in

in primary identifying

data

priority

collection health

needs

in identifying community resources

to meet health

Provided secondary Other

health (explain) data

needs

Other - If you selected "Other (explain)," please type your explanation below:

Participated

N/A - Person or

Organization was not Involved

N/A Position or Department does not

exist

Participated Advised

Member of

in

on

CHNA development CHNA

Committee of CHNA

best

process practices

Participated

Participated

in

in primary identifying

data

priority

collection health

needs

in identifying community resources

to meet health

Provided secondary Other

health (explain) data

needs

Other - If you selected "Other (explain)," please type your explanation below:

Participated

N/A - Person or

Organization was not Involved

N/A Position or Department does not

exist

Participated Advised

Member of

in

on

CHNA development CHNA

Committee of CHNA

best

process practices

Participated

Participated

in

in primary identifying

data

priority

collection health

needs

in identifying community resources

to meet health

Provided secondary Other

health (explain) data

needs

Other - If you selected "Other (explain)," please type your explanation below:

Known as the Community Benefit Steering Committee.

Participated

N/A - Person or

Organization was not Involved

N/A Position or Department does not

exist

Participated Advised

Member of

in

on

CHNA development CHNA

Committee of CHNA

best

process practices

Participated

Participated

in

in primary identifying

data

priority

collection health

needs

in identifying community resources

to meet health

Provided secondary Other

health (explain) data

needs

Other - If you selected "Other (explain)," please type your explanation below:

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