CEO - Gadsden County, Florida

[Pages:11]MESSAGE FROM THE

CEO

A s I begin the role of President & CEO at Capital Region- only be accomplished through hard work, attention to detail, al Medical Center, and as my wife Manda and I get set- and a determination to always keep patient care in the fore-

tled in Tallahassee ? I am overwhelmed and delighted with the front of all that we do.

generous spirit and warmth of the people in our community. Our physicians and staff also distinguished themselves

In 2014, Capital Regional leaders, board members, staff and in earning National Accreditations/Certifications of

physicians planted the seeds of what is to become a year of

Distinction for:

expansion of services and growth for our facility. As part of Capital Regional Medical Center's history of high-quality patient care, we are pleased to offer behavioral health services in 2015 for adult patients with the clinical resources of a dedicated staff who are experienced in treating a wide-array of psychiatric disorders. The unit will provide a full-range of inpatient psychiatric services, including group and individual therapies, expressive therapy,

? Spine Surgery ? Stroke ? Total Hip and Knee Joint Replacement

Additionally, Capital Regional was again honored with an "A" rating in the Fall 2014 update to the Leapfrog Hospital Safety Score, a rating of how well hospitals protect patients from

accidents, errors, injuries and infections.

as well as social services, nursing and phar-

Our physicians, nurses, and other clinicians

macy support. Approximately 48 jobs will be

provide care that is measured against

added, including three board-certified psychi-

national best practices. We are so proud of

atrists. Future plans include, adding comple-

our incredible work to decrease Door-to-

mentary outpatient programs. This new unit

Balloon time. This is a critical measure of

and planned partnerships with community

how long it takes a hospital to treat a heart

behavioral health providers is representative

attack patient from arrival to the ER, to

of our commitment to provide quality and

the cardiac catheterization lab, to opening

accessible patient care and will serve to meet

blocked arteries. From the moment the first

the ever-expanding needs of adult patients in

symptoms of a heart attack appear, a race

this area.

against time begins. Currently, our average

As a healthcare provider we have a responsibility to ensure the physicians and staff have everything they need to take the very best

Mark Robinson, President & CEO

is a 38 minute door-to-balloon time and is well below the recommended time of less than 90 minutes.

care of our patients. Plans are underway to open a family

From offering physician seminars, community events and

practice and pediatric clinic with extended hours in the north- health screenings, we look for ways to help others outside

east part of town in the Bannerman Crossing Plaza . Capital of our hospital doors. Our focus on quality care remains at

Regional Medical Care will not only offer family practice and the forefront of everything that we do. With the hard work

pediatric services, but specialties as well. Our leadership

and dedication of all of our physicians, staff and volunteers,

and the team of physicians, clinical staff, ancillary staff and

Capital Regional Medical Center will continue to be a health-

administrators ? have a lot of momentum moving into the

care partner within our community.

future. We want to continue to expand our bandwidth and offer increased access to healthcare, but at the same time stay laser-focused on quality, patient-centric care.

I would like to personally thank each of you who have made Capital Regional Medical Center your hospital of choice.

We continue to strive for excellence in the quality arena. Capital Regional Medical Center is proud to have earned the Chest Pain Center with Percutaneous Coronary Intervention Accreditation by the Society of Chest Pain Centers. This can

Sincerely, Mark A. Robinson President/CEO

LEADERSHIP

TEAM

Left to Right: Alan Keesee, Ann McClean, Ann Smith, Jill Leone, Mark Robinson

CENTERVILLE RD. CA

Leadership Team

Mark Robinson, Chief Executive Officer Alan Keesee, Chief Operating Officer Jill Leone, Chief Financial Officer Ann Smith, Chief Nursing Officer Ann McClean, Assistant Chief Nursing Officer



WELAUNEE BLVD.

CARE DR.

PITAL MEDICAL BLVD.

CE

MICCOSUKEE RD.

NTRE POINTE BLVD.

FIDDLER CT. JACLIF CT. JUNWIN CT.

BUFORD R D. CAPITAL CIRCLE N.E.

2015

COMMUNITY IMPACT

Capital Regional is dedicated to making a difference in the community. Every day members of our staff provide not only monetary contributions but volunteer their time and talents to local charities and hold key Board positions.

Some of the organizations Capital Regional worked with this past year:

? ALS Association ? Alzheimer's Project ? American Cancer Society ? American Heart Association ? American Lung Association ? Big Bend Hospice ? Big Bend Minority Chamber of Commerce ? Capital Medical Society ? City of Tallahassee ? Covenant Hospice ? Children's Home Society ? Choose Tallahassee ? Economic Development Council

of Tallahassee/Leon County ? Florida Commerce Credit Union ? Gadsden County Chamber of Commerce ? Holy Comforter Episcopal School ? Leadership Tallahassee ? Leon County Schools ? Leukemia and Lymphoma Society ? March of Dimes ? OneBlood ? Ronald McDonald House Charities of Tallahassee, Inc. ? Rotary ? Senior Center ? Steele-Collins All Male Charter Academy ? Tallahassee Board of Realtors ? Tallahassee Pregnancy Loss Support Group ? Tallahassee Senior Center ? The City of Tallahassee ? The Greater Tallahassee Chamber of Commerce ? United Way of the Big Bend ? Working Well Tallahassee, Inc.

C apital Regional Medical Center's philanthropic efforts have a substantial impact on our community each year. Capital Regional plays a significant role in the community's major charity events, including but not limited to; the March of Dimes March for Babies, American Heart Association's Heart Walk, American Cancer Society's Relay for Life and Ronald McDonald House Charities Stone Crab Fest. We commit significant dollars to these events and our leadership and staff use their personal time to raise additional dollars for these organizations.

2015 Community Report [ 1

2015

ECONOMIC IMPACT

Patients Treated.........................................................................................................................................................................133,623 Annual Admissions....................................................................................................................................................................... 11,925 Annual ER Visits........................................................................................................................................................................... 93,343 Total Medicaid Patients Treated.................................................................................................................................................... 40,074 Medicaid market share............................................................................................................................................................... 31.07% Indigent Patients Treated.............................................................................................................................................................. 18,678 Indigent Pts Market Share........................................................................................................................................................... 51.69% Hospitals...............................................................................................................................................................................................1 Surgery Centers.....................................................................................................................................................................................1 Diagnostic Imaging Centers....................................................................................................................................................................1 Inpatient Rehab Facilities.......................................................................................................................................................................0 Psychiatric Care Facilities.......................................................................................................................................................................0 OCC Health Sites...................................................................................................................................................................................0 Licensed beds.................................................................................................................................................................................. 246 Total Employees............................................................................................................................................................................. 1,143 Total Physicians................................................................................................................................................................................. 406 Total Volunteers................................................................................................................................................................................. 105 Volunteer Hours........................................................................................................................................................................... 15,991

Total Payroll (Salaries, Benefits, Contract Labor)................................................................................................................. $78,986,625 Cost of Charity and Uncompensated Care.......................................................................................................................... $15,157,115 Federal Income Tax................................................................................................................................................................$7,151,417 State Income Tax......................................................................................................................................................................$872,345 Indigent Care Tax...................................................................................................................................................................$2,280,199 Property Tax...........................................................................................................................................................................$1,447,386 Sales Tax...............................................................................................................................................................................$1,641,738 Other Local Tax......................................................................................................................................................................$2,290,728 Total Taxes.......................................................................................................................................................................... $15,683,813

Capital Investment (5 yr average)..........................................................................................................................................$9,780,000 Local Vendor Support......................................................................................................................................................... $15,081,360 Minority & Women Owned Business Support.........................................................................................................................$1,128,368 Physician Specialty Coverage................................................................................................................................................$4,515,586

Total Economic Impact (1)............................................................................................................................................... $139,204,499

*All physicians with admitting privileges - change from prior year (1) Does not include Minority&Women Owned Business Spend since it is not exclusive of local vendor spend

2 ] CRMC - Community Report

GIVING BACK TO OUR

COMMUNIT Y

Capital Regional Medical Center Recognized by American College of Obstetricians and Gynecologists and

the March of Dimes for Reducing Early Elective Deliveries

Capital Regional Medical Center was honored by the American College of Obstetricians and Gynecologists (ACOG) District XII (Florida) and the March of Dimes for reducing the number of early elective inductions and cesarean deliveries with a special recognition banner. To qualify for this distinction, Capital Regional Medical Center met the criteria, which includes a rate for elective deliveries before 39 weeks of five percent or lower. As well as their policies in place to prevent such deliveries.

"We're proud of our expert team of physicians and nurses who tackled this issue in our community and established policies to avoid scheduling deliveries before 39 weeks of pregnancy, except when medically necessary," said Ann Smith, Chief Nursing Officer, Capital Regional Medical Center.

"We are delighted to present this commemorative banner to Capital Regional Medical Center for adhering to standards that directly benefit the health of babies," said Dr. Karen Harris, Chair of the Program Services Committee for the March of Dimes Florida Chapter. "The last few weeks of pregnancy are extremely important for the baby's brain and lung development, among other organs, so we want to commend this momentous achievement."

"Studies have shown that deliveries that are scheduled for convenience or other non-medical reasons may increase harm to infants, increase health care costs, and worsen medical outcomes," said Dr. Robert Yelverton, Chair of ACOG District XII. "We are extremely pleased with Capital Regional's participation."

Reducing early elective deliveries and improving the health of moms and babies is just one of the key focus areas of the March of Dimes and the "Healthy Babies Are Worth The Wait"

campaign. In an average week in Florida, 549 babies are born preterm and 29 die before their first birthday, many times as a result of their early births. Early elective deliveries can cause lifelong health challenges for the baby, including breathing difficulty, cerebral palsy, and learning disabilities. Even babies born just a few weeks early have higher rates of hospitalization and illness than fullterm infants.

2015 Community Report [ 3

VOLUNTEER

SPOTLIGHT

Left to Right: Nancy Kimbrel, Jimmie Johnson, and Sheila Farmer

We know that volunteering is linked to better physical, mental and emotional health. When people in our community give their time for others ? we all win. In recognition of just a few of Capital Regional's volunteers for 2014 we would like to showcase the following individuals:

Nancy Kimbrel is the cornerstone of our gift shop. Ms. Kimbrel always has a warm and friendly disposition for staff and patients. Visitors have been known to come back later to thank her for her encouraging words. Nancy Kimbrel began volunteering in 2011 and has given 1,083 hours of service.

Jimmie Johnson has many duties as a volunteer at Capital Regional. With sincerity and a genuine spirit he delivers newspapers to our patient's and offers a sense of comfort for each patient he meets. Mr. Johnson also helps patients and

visitors in Same Day Surgery feel at ease and lends an ear when they just need to talk. Jimmie Johnson began volunteering in 2012 and has given 723 hours of service.

Sheila Farmer is the first smiling face visitors see when they enter our lobby. Ms. farmer is a wealth of knowledge and gives our visitors and patients the helpful information they need to

C navigate the hospital or to get to the right physician practice. ARING Sheila Farmer began volunteering in 2009 and has given

GHIEBVOLIATPNCHIGENKRGS 2,416 hours of service.

4 ] CRMC - Community Report

& EQPCAIUTMOI EANPN LTAOICSMTATFIYCE T Y

Right on Target.

Regional Nerve Blocks Provide

Pain Relief for Orthopedic

Patients At CRMC

T he amount of pain that patients at Capital Regional Medical Center (CRMC) experience after a knee, shoulder or ankle surgery is typically less than at other area hospitals, thanks to CRMC's practice of placing regional nerve blocks prior to surgery. Before these orthopedic surgeries, patients visit Capital Regional's block room to have an ultrasound-guided nerve block placed by their anesthesiologist. "After we selectively numb their nerves, our sleeping patients require less anesthesia during their surgery, which in turn decreases their chance of having side effects from anesthesia after they wake up," says Jack Atwater, MD, anesthesiologist at Capital Regional Medical Center. After surgery, patients typically wake up faster and easier, experience less nausea and pain, tolerate physical therapy better and go home sooner. "The vast majority of these nerve block [patients] are using significantly less narcotics [post-operation], and this is significant because decreasing pain medication decreases its side effects, such as constipation and nausea," says Dan Stannard, RN, recovery room nurse manager at CRMC. Capital Regional is the only hospital in the region with a state-of the-art treatment area dedicated to performing pre-operative regional nerve blocks for knee, shoulder and ankle surgeries. "We always want our patients to have the best possible experience," Dr. Atwater says. "By placing regional nerve blocks pre-operation, we are able to greatly reduce discomfort and make the patient's experience much better."

LifeNet

T he LIFENET System can help alert care team members about an inbound EMS patient and provide them the patient's 12-lead ECG and vital signs. EMS is able to wirelessly transmit the ECG from the field to Emergency Department personnel prior to the patient's arrival. This enables the team to confirm a heart attack (STEMI) and then activate the STEMI team. This solution improves patient safety by reducing the time from when the STEMI is identified to when percutaneous coronary intervention occurs.

MEDICAL RECORD ACCESS

Capital Regional Medical Center patients can now conveniently access their hospital clinical information 24/7 through a Patient Portal online. By logging in to their Patient Portal accounts, patients can safely and securely view their lab results, medications and instructions, radiology reports, visit histories and any upcoming appointments. Patients can also grant Patient Portal access to family members who may support and help with their care.

2015 Community Report [ 5

& EQPCAIUTMOI EANPN LTAOICSMTATFIYCE T Y

MyCare Dashboard

E nsuring that proper communication occurs between patients and their caregivers is not always easy to achieve. Communicating with patients typically consists of a white board mounted in the patient's room where caregivers manually write what they feel is key information for the patient. This can be challenging for several reasons, not the least of which is the amount of time an already busy nurse or tech must spend in each patient room writing the same information repeatedly. Typically, the information provided includes the name of the nurse and tech for the shift, but there is so much more that the patient may need to know.

To improve the communication between caregivers and patients in 2014, Capital Regional Medical Center implemented the MyCare Dashboards in patient rooms. Patients will experience a higher level of satisfaction with clear and concise communication.

The MyCare Dashboard will automatically update this information and include the following elements:

? Hospital logo and name ? Room number and room phone number ? Patient's HIPAA compliant name ? Nurse's & tech's name ? Attending MD's name ? Activities (i.e. ambulate, bed rest) ? Goals (daily nursing goals for the patient) ? Diet ? Procedures (this will only indicate upcoming procedures

for the day by category, such as EKG, Radiology, Physical Therapy)

New medication education indicator (an indicator that the patient has had new medications ordered that require teaching) and last documented pain medication administration:

? Current date/time ? Pain score as last reported by patient ? Preferred language ? Anticipated discharge date

In March, Capital Regional Medical Center was the first hospital in the division to implement the dashboard.

CARE ASSURE

Care Assure is Capital Regional's commitment to ensuring appropriate follow-up care for patients after discharge by identifying patients with cardiovascular disease and ensures appropriate follow-up. The Care Assure program uses evidence-based clinical criteria to identify patients with cardiovascular disease. A web-based IT tool identifies patients that meet evidence-based clinical criteria and the Nurse Navigators reach out to patients to assist them with their transition back into the outpatient setting through coaching, scheduling appointments, and ensuring attendance to follow-up visits. The Care Assure teams track patient progress to ensure they receive appropriate care in the outpatient setting. Care Assure enhances healthcare quality and value through improved care coordination and delivery, continuity of care, compliance with evidence-based recommendations and by establishing a longitudinal patient care relationship.

6 ] CRMC - Community Report

Chest Pain Center Accreditation with PCI

Capital Regional Medical Center (CRMC) officially received full Chest Pain Center Accreditation with Percutaneous Coronary Intervention (PCI) from the Society of Chest Pain Centers (SCPC).

"Capital Regional continues to strive to be a national leader in providing clinical quality, patient safety, and customer service," said Janet White, RN, Cardiovascular Service Line Administrator at Capital Regional Medical Center. "Exceeding national standards for care of patients experiencing chest pain can mean the difference between life, death or disability for the patient. We are proud that the Capital Regional team has been recognized with this accreditation for their outstanding care of cardiac patients. Enhancing quality to a national standard is part of achieving our vision. The SCPC reviewer commented that with our Door-to-Balloon times and evidenced-based medicine protocols, "CRMC is a best-practice facility."

Heart attacks are the leading cause of death in the United States, with 600,000 people dying annually of heart disease. More than five-million Americans visit hospitals each year with chest pain. SCPC's goal is to significantly reduce the mortality rate of these patients by teaching the public to recognize and react to the early symptoms of a possible heart attack, reduce the time that it takes to receive treatment, and increase the accuracy and effectiveness of treatment.

The Accredited Chest Pain Center's protocol-driven and systematic approach to patient management allows physicians to reduce time to treatment during the critical early stages of a heart attack, when treatments are most effective, and to better monitor patients when it is not clear whether or not they are having a coronary event. Such observation helps ensure that patients are neither sent home too early nor needlessly admitted. With the increase in chest pain centers came the need to establish standards designed to improve the consistency and quality of care provided to patients. SCPC's accreditation process ensures that centers meet or exceed quality-of-care measures in acute cardiac medicine.

Percutaneous Coronary Intervention, commonly known as coronary angioplasty or simply angioplasty, is one therapeutic procedure used to treat the stenotic (narrowed) coronary arteries of the heart found in coronary heart disease (coronary artery bypass graft is also used). These stenotic segments are due to the build-up of cholesterol-laden plaques that form due to atherosclerosis. PCI is performed by an interventional cardiologist.

As an Accredited Chest Pain Center with PCI, Capital Regional Medical Center ensures that patients with chest pain or discomfort receive immediate treatment to avoid as much heart damage as possible. Protocol-based procedures, developed by leading cardiac care experts to reduce time to treatment in the critical early stages of a heart attack, are part of Capital Regional's overall cardiac care services. Early Heart Attack Care is an important part of the process and CRMC works

with the community to help people recognize the early signs and symptoms of a heart attack. Time is heart muscle with cardiac care, and calling 911 at the onset of symptoms is the most effective way to be effectively treated.

Key areas in which an Accredited Chest Pain Center must demonstrate expertise include the following:

? Integrating the emergency department with the local emergency services

? Assessing, diagnosing, and treating patients quickly ? Effectively treating patients with low risk for acute coronary

syndrome and no assignable cause for their symptoms ? Continually seeking to improve processes and procedures ? Ensuring the competence and training of Accredited Chest

Pain Center personnel ? Maintaining organizational structure and commitment ? Having a functional design that promotes optimal

patient care ? Supporting community outreach programs that educate

the public to promptly seek medical care if they display symptoms of a possible heart attack

2015 Community Report [ 7

QUALIT Y

& PATIENT SA FE T Y

Spine Surgery Certification

Capital Regional Medical Center was awarded spine surgery certification by the Joint Commission, a nationwide organization recognized for its accreditation and certification of excellence in hospital functions. "It's one of the highest honors you can get," says Cindy Hojna, director of orthopedics at Capital Regional.

"They walk in the shoes of the patients... They look at the coordination of

Before awarding certification to a hospital, the Joint Commission examines many aspects of the hospital's care. "They walk in the shoes of the patients," says Thomas Park, MD, an orthopedic spine surgeon at Capital Regional Medical Center. "They look at the coordination of care to ensure best-practices are being put into place." The certification means that patients can be confident that Capital Regional's spine surgery program provides the highest quality care. Hospitals with the Joint Commission's certification show reduced variation in clinical processes, which means that no matter who treats you, you will get the same care. In addition, the certification shows that the hospital has the framework, program structure and management resources in place to support this high level of care. Achieving this certification was no easy task. With Joint Commission certification in mind, Capital Regional launched a comprehensive program to educate and coordinate staff members so they could better serve spine surgery patients. Teamwork was key in its success.

"It's a multidisciplinary approach to ensure that everyone is on the same page," says Matt Lee, MD, an orthopedic spine surgeon at Capital Regional Medical Center. "There has to be detailed communication between the clinicians in order to obtain certification."

care to ensure best-

practices are being

Matt Lee, MD

Orthopedic Spine Surgeon put into place.

" It's a multidisciplinary

approach to ensure that

"everyone is on the same

page... There has to be

detailed communication

Thomas Park, MD Orthopedic Spine Surgeon

between the clinicians in order to obtain

"certification.

8 ] CRMC - Community Report

Fall 2014 Hospital Safety Score CRMC Earns "A" Rating

Capital Regional Medical Center has again earned an "A" rating in the Fall 2014 Hospital Safety Score, which rates how well hospitals protect patients from errors, injuries and infections. The Hospital Safety Score is compiled under the guidance of the nation's leading experts on patient safety and is administered by The Leapfrog Group, an independent industry watchdog. The first and only hospital safety rating to be peer-reviewed in the Journal of Patient Safety, the Score is free to the public and designed to give consumers information they can use to protect themselves and their families when facing a hospital stay.

"We have had a stellar year for accomplishments related to quality and patient safety. These accomplishments are not possible without the hard work and dedication of our employees, physicians and volunteers each and every day," said Alan Keesee, Chief Operating Officer at Capital Regional Medical Center.

Developed under the guidance of Leapfrog's Blue Ribbon Expert Panel, the Hospital Safety Score uses 28 measures of publicly available hospital safety data to produce a single "A," "B," "C," "D," or "F" score representing a hospital's overall capacity to keep patients safe from preventable harm.

More than 2,500 U.S. general hospitals were assigned scores in Fall 2014, with about 31 percent receiving an "A" grade. The Hospital Safety Score is fully transparent, with a full analysis of the data and methodology used in determining grades available online.

To see how Capital Regional Medical Center's score compares locally and nationally, visit the newly updated Hospital Safety Score website at .

2015 Community Report [ 9

PATIENT TESTIMONIALS

SPECIALIZED CARE

A Special Delivery

The Pittman Family Has an "Amazing" Birth Experience at CRMC's Family Center

Audra Pittman, PhD, an art professor, art studio owner,

Cesarean section as the safest option for Audra and the babies. When

community volunteer and wife of

Sean and Audra arrived at the Family

local attorney Sean Pittman, heard

Center, Audra couldn't believe how

good things from women who had

beautiful and calming the environment

given birth at the Family Center at

was. "Everything was very peaceful

Capital Regional Medical Center

and everyone was so welcoming," she

(CRMC). So when she found out she

says. "The rooms were very large and

was expecting for the second time,

there were so many nice amenities. It

she asked about OB-GYN physicians

felt almost like I was on a cruise or in

at Capital Regional. That's when she

a hotel suite instead of a hospital. As

learned about Stephanie Cruz Lee,

an artist, I really appreciate how design

MD, of Capital Regional Women's

and details contribute to an enjoyable

Health. Audra researched Dr. Lee's

atmosphere."

credentials and liked what she learned. Dr. Lee is board certified in

Attentive Care

obstetrics and gynecology, graduated

Audra says the staff were wonderful,

from the Florida State University

too. Nurses helped calm her anxiety

College of Medicine and complet-

Stephanie Cruz Lee, MD

and made sure she understood every-

ed her residency at the University

thing that was happening before the

of Florida College of Medicine in

surgery. After Phoebe Rose and Pilar

Jacksonville. She is also an assistant

Cataleya were born, the staff was so caring and supportive. "I

professor at the FSU College of Medicine and has published felt like there was always someone on the team checking on

research studies in several OB-GYN journals. Meeting Dr. Lee me, supporting me and encouraging me. There was even a

confirmed Audra's feelings. "I really liked Dr. Lee from the

nurse named Phoebe who came to see me when she learned

first appointment," Audra says. "She is right there at Capital that one of my daughters was named Phoebe. She checked in

Regional Medical Center. She was very interested in trying to on me several times, even after I left the hospital." Audra says

give me the birth experience I wanted, and she was always

she wouldn't hesitate to recommend the Family Center at Cap-

available for questions. I felt very comfortable with her."

ital Regional Medical Center and Dr. Lee to expectant moms.

Seeing Double

"Overall, I really enjoyed my birth experience at the hospital. It was amazing."

Soon, Sean and Audra learned that they were expecting twins.

Because of how the babies were presenting, with one being

breach and the other head down, Dr. Lee recommended a

10 ] CRMC - Community Report

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