Adventist Rehab of Maryland Narrative Report

Adventist HealthCare Rehabilitation Hospital: Community Benefit Narrative Report FY2014

COMMUNITY BENEFIT NARRATIVE Effective for FY2014 Community Benefit Reporting

Health Services Cost Review Commission 4160 Patterson Avenue Baltimore, MD 21215 December 15, 2014

Adventist HealthCare Rehabilitation Hospital: Community Benefit Narrative Report FY2014

I. GENERAL HOSPITAL DEMOGRAPHICS AND CHARACTERISTICS

1. Please list the following information in Table I below. For the purposes of this section, "primary services area" means the Maryland postal ZIP code areas from which the first 60 percent of a hospital's patient discharges originate during the most recent 12 month period available, where the discharges from each ZIP code are ordered from largest to smallest number of discharges. This information will be provided to all hospitals by the HSCRC.

Table I

Bed

Inpatient Primary Service Area

Designation Admissions

ZIP Codes

All other Maryland Hospitals Sharing Primary Service Area

87

1574 20906 ? Silver Spring Holy Cross

20878 ? Gaithersburg 20904, 20902, 20906,

20850 ? Rockville

20901, 20910, 20853,

20874 ? Germantown 20783, 20912, 20877

20852 ? Rockville

20874, 20852, 20886

20854 ? Potomac

20902 ? Silver Spring Frederick Memorial

20877 ? Gaithersburg 21701

20853 ? Rockville

20901 ? Silver Spring Johns Hopkins

20904 ? Silver Spring 21701, 20854, 20904,

20814 ? Bethesda

20878

20910 ? Silver Spring

20855 ? Derwood

Adventist HealthCare

20876 ? Germantown Washington Adventist

20886 ? Montgomery Hospital

Village

20782, 20901, 20904,

20817 ? Bethesda

20902, 20910, 20906

20783 ? Hyattsville

20912 ? Takoma Park Montgomery General

20879 ? Gaithersburg 20906, 20853, 20904,

20815 ? Chevy Chase 20882, 20902

20882 ? Gaithersburg

20782 ? Hyattsville Suburban

21701 ? Frederick

20874, 20902, 20878,

20906, 20850, 20817,

20814, 20854, 20852

Percentage of Uninsured Patients, by County

Montgomery County: 3.19%

Percentage of Patients who are Medicaid Recipients, by

County Montgomery County: 2.70%

(Percentage of patients in each county with self-pay option)

Adventist HealthCare Shady Grove Medical Center 20874, 20878, 20850, 20877, 20886, 20879, 20876, 20852

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Adventist HealthCare Rehabilitation Hospital: Community Benefit Narrative Report FY2014

Adventist HealthCare Behavioral Health and Wellness Services Rockville 20850, 20874, 20878, 20877, 20906, 20886, 20876, 20879, 20904, 20902, 20854, 20853, 20852, 20855

2. For purposes of reporting on your community benefit activities, please provide the following information: a. Describe in detail the community or communities the organization serves. (For the purposes of the questions below, this will be considered the hospital's Community Benefit Service Area ? "CBSA". This service area may differ from your primary service area on page 1.) This information may be copied directly from the section of the CHNA that refers to the description of the Hospital's Community Benefit Community.

Adventist HealthCare Rehabilitation Hospital primarily serves residents of Montgomery County, Maryland. Therefore, for the purpose of this Community Health Needs Assessment, we will focus on local data from Montgomery County. Figure 1 shows the percentages of discharges by county for Adventist HealthCare Rehabilitation Hospital in 2013.

County

Percentage

Montgomery

66%

Prince George's

18%

Frederick

4%

District of Columbia

4%

Other

8%

Figure 1. Adventist HealthCare Rehabilitation Hospital's Discharges by County, 2013

Approximately 80 percent of discharges come from our Total Service Area, which is known as Adventist HealthCare Rehabilitation Hospital's Community Benefit Service Area "CBSA" (see Figure 2). The CBSA is divided into Primary and Secondary Service Areas.

Sixty percent of discharges fall into the Primary Service Area, which includes the following ZIP codes and cities:

Silver Spring (20906, 20902, 20901, 20904, 20910); Gaithersburg (20878, 20877, 20879, 20882); Rockville (20850, 20852, 20853); Germantown (20874, 20876); Potomac (20854); Bethesda (20814, 20817); Derwood (20855); Montgomery Village (20886); Hyattsville (20783); Takoma Park (20912); Chevy Chase (20815); Hyattsville (20782); Frederick (21701).

The Secondary Service Area accounts for 20 percent of discharges and includes the following ZIP codes and cities:

Beltsville (20705); Bethesda (20816); Boyds (20841); Capitol Heights (20743); Clarksburg (20871); Clinton (20735); College Park (20740); Damascus (20872); District Heights (20747); Fort Washington (20744); Frederick (21703); Greenbelt (20770); Hyattsville (20785, 20784, 20781); Ijamsville (21754); Kensington (20895); Lanham (20706); Laurel (20708, 20707); Mount Airy (21771); Olney (20832); Riverdale (20737); Rockville (20851); Silver Spring (20903, 20905); Upper Marlboro (20774).

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Adventist HealthCare Rehabilitation Hospital: Community Benefit Narrative Report FY2014

Figure 2. Map of Adventist HealthCare Rehabilitation Hospital's Primary (purple) and Secondary (orange) Service Areas, based on 2013 Inpatient Discharges

Our Community Benefit Service Area (CBSA), encompassing 80 percent of all discharges, includes 1,674,611 people from the racial/ethnic categories below (see Figure 3).

Community Benefit Service Area (CBSA)

White

743,849 44.42%

Black/AF American 533,118 31.84%

2014 Estimates Asian Native

American 173,757 8,013 10.38% 0.48%

Native HI/PI 1,226 0.07%

Hispanic/ Latino 312,623 18.67%

Primary Service Area (PSA)

503,553 184,352 123,798 53.06% 19.42% 13.04%

4,885 0.51%

756 0.08%

202,390 21.32%

Secondary Service Area (SSA)

240,296 348,766 49,959 3,128

470

110,233

33.12% 48.07% 6.89%

0.43%

0.06% 15.19%

Figure 3. Population Estimates (2014) by Race/Ethnicity for Adventist HealthCare Rehabilitation Hospital's Total Service

Area (80% of discharges), Primary Service Area (60% of discharges) and Secondary Service Area (20% of discharges)

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Adventist HealthCare Rehabilitation Hospital: Community Benefit Narrative Report FY2014

Population demographics are rapidly changing in the state of Maryland, particularly among residents living in Montgomery County. We serve one of the most diverse communities in the United States, constantly undergoing the economic, social and demographic shifts that result from an ever-changing and growing population. Over the past decade, Montgomery County has become the most populous jurisdiction in Maryland, the second largest jurisdiction in the Washington, D.C. metropolitan area, and the forty-second most populous county in the nation, with a population of greater than one million (U.S. Census Bureau, 2013). Racial and ethnic diversity has increased concurrently with the expanding population. Non-Hispanic whites now comprise only 47 percent of the Montgomery County population, a decrease of more than 20 percent over the last two decades. For the first time, minorities account for more than half of Montgomery County's population making it a "majority-minority" county (U.S. Census Bureau, 2013). The percentage of Hispanics or Latinos in Montgomery County, currently at 18.3 percent, is also more than double the total percentage of Hispanics or Latinos in the state of Maryland (9 percent) (U.S. Census Bureau, 2013).

According to the U.S. Census Bureau, Maryland is one of the top ten destinations for foreign-born individuals, with 41 percent of the foreign-born in Maryland residing in Montgomery County.1 The County's foreign-born population has gone from 12 percent in 1980 to greater than 30 percent today.2 Immigrants contribute greatly to our community, and our hospital providers are committed to understanding their needs and working to treat them in a culturally competent manner.

As racial and ethnic minority populations become increasingly predominant, concerns regarding health disparities grow. Persistent and well-documented data indicates that racial and ethnic minorities still lag behind non-minority populations in many health outcome measures. These groups are less likely to receive preventive care and are more likely to suffer from serious illnesses such as cancer and heart disease.

Further exacerbating the problem are challenges around access that racial and ethnic minorities often disproportionately face. Minority populations may encounter barriers to accessing quality care due to being uninsured or underinsured or due to living in a community that lacks quality care facilities or providers. As the proportion of racial and ethnic minority residents continues to grow, it becomes even more important for the healthcare system to understand the unique characteristics of these populations in order to meet the health needs of the community as a whole. As a result, this report examines the health status and health outcomes among different racial and ethnic populations in Montgomery County, with the goal of eliminating disparities, achieving health equity, and improving the health and wellness of all groups.

b. In Table II, describe significant demographic characteristics and social determinants that are relevant to the needs of the community and include the source of the information in each response. For purposes of this section, social determinants are factors that contribute to a person's current state of health. They may be biological, socioeconomic, psychosocial, behavioral, or social in nature. (Examples: gender, age, alcohol use, income, housing, access to quality health care, education and environment, having or not having health insurance.) (Add rows in the table for other characteristics and determinants as necessary).

1 "Literacy, ESL and Adult Education." Literacy Council of Montgomery County. 2 "Foreign-Born Population of Montgomery County Region, 1950-2000-Census Years." Montgomery Planning. 2000.

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