UNIVERSITY OF VIRGINIA
BOARD OF VISITORS
MEETING OF THE
MEDICAL CENTER
OPERATING BOARD
FOR THE UNIVERSITY OF
VIRGINIA MEDICAL CENTER
November 8, 2012
UNIVERSITY OF VIRGINIA
MEDICAL CENTER OPERATING BOARD
Thursday, November 8, 2012
8:30 – 11:15 a.m.
Small Auditorium, Harrison Institute
Committee Members:
Edward D. Miller, M.D., Chair
Helen E. Dragas
Victoria D. Harker
Andrew K. Hodson, MB.Ch.B
William P. Kanto Jr., M.D.
Constance R. Kincheloe
Ex Officio
Teresa A.
Steven T.
Dorrie K.
Robert S.
Members:
Sullivan
DeKosky, M.D.
Fontaine
Gibson, M.D.
Stephen P. Long, M.D.
Vincent J. Mastracco Jr.
Charles W. Moorman
The Hon. Lewis F. Payne
Patrick D. Hogan
R. Edward Howell
John D. Simon
AGENDA
PAGE
I.
ACTION ITEM

II.
Purchase of Land and Improvements located at 1015
Spring Creek Parkway, Louisa, Virginia, from the
University of Virginia Physicians Group (Zion
Crossroads)
1
REPORTS BY THE VICE PRESIDENT AND CHIEF EXECUTIVE
OFFICER OF THE MEDICAL CENTER (Mr. Howell)
A.
Vice President’s Remarks
3
B.
Magnet Recognition and Nursing Report (Mr. Howell
to introduce Ms. Lorna Facteau and Ms. Dorrie
Fontaine; Ms. Facteau and Ms. Fontaine to report)
4
C.
Operations and Finance Update, including
Continuum Home Health Care Annual Report (Mr.
Howell to introduce Mr. Robert H. Cofield and Mr.
Larry L. Fitzgerald; Mr. Cofield to report on
Operations and Continuum; Mr. Fitzgerald to
report on Finance)
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D.
Capital Projects
30
E.
Health System Development
32
III.
EXECUTIVE SESSION
●
To consider proposed personnel actions regarding the
appointment, reappointment, resignation, assignment,
performance, and credentialing of specific medical
staff and health care professionals, as provided for
in Section 2.2-3711(A)(1) of the Code of Virginia.
The meeting of the Medical Center Operating Board is
further privileged under Section 8.01-581.17 of the
Code of Virginia.
●
Discussion of proprietary, business-related
information pertaining to the operations of the
Medical Center, where disclosure at this time would
adversely affect the competitive position of the
Medical Center, specifically:
– Strategic personnel, financial, and market and
resource considerations and efforts, including
potential joint ventures, outreach, property
acquisition, and other marketing and growth
efforts, long range financial plan and fiscal
budget assumptions, review of Health System
Clinical Strategy Performance Dashboard, and
performance measures, and metrics;
– Confidential information and data related to the
adequacy and quality of professional services,
competency, and qualifications for professional
staff privileges, and patient safety in clinical
care, for the purpose of improving patient care;
and
– Consultation with legal counsel regarding
compliance with relevant federal and state legal
requirements, licensure, and accreditation
standards, and ongoing litigation and arbitration
matters; all of which will involve proprietary
business information and evaluation of the
performance of specific personnel.
The relevant exemptions to the Virginia Freedom of
Information Act authorizing the discussion and
consultation described above are provided for in Section
2.2-3711 (A) (1), (6), (7), (8) and (22) of the Code of
Virginia. The meeting of the Medical Center Operating
Board is further privileged under Section 8.01-581.17 of
the Code of Virginia.
UNIVERSITY OF VIRGINIA
BOARD OF VISITORS AGENDA ITEM SUMMARY
BOARD MEETING:
November 8, 2012
COMMITTEE:
Medical Center Operating Board
AGENDA ITEM:
I. Purchase of Land and Improvements located
at 1015 Spring Creek Parkway, Louisa,
Virginia, from the University of Virginia
Physicians Group (Zion Crossroads)
BACKGROUND: In 2007 the University of Virginia Physicians Group
(“UPG”) (then known as University of Virginia Health Services
Foundation) contemplated acquiring land at Zion Crossroads to
establish a Regional Primary Care clinic employing three or four
physicians. Upon further consideration and working with the
Health System, the initiative grew to an approximately 50,000
square foot multi-specialty clinic, with certain ancillary
technical services. In 2010, UPG purchased 4.79 acres in the
Spring Creek Business Park for $1.6 million. Spring Creek
Business Park is located just north of the intersection of U.S.
Route 15 and Interstate 64 in Louisa, County. UPG has completed
construction of the building shell and core components.
DISCUSSION: The facility is under construction and consists of
a two-story masonry building, containing 48,072 gross square
feet, on 4.79 acres, located on Spring Creek Parkway in Louisa
County. The shell and core building components were completed
in May of this year, and it is expected the building will be
ready for occupancy during the first half of 2013. A medical
facility in this location will create outreach opportunities and
enhance clinic accessibility to those living and working east of
Charlottesville. It is in the best interests of the Medical
Center to own this facility rather than to enter into a longterm lease with UPG.
The facility will consist of two primary service lines: (i)
outpatient clinics; and (ii) imaging services. The Medical
Center’s Clinical Outreach Initiative contemplates the clinics
will be Provider Based requiring the Medical Center to be
responsible for facility operation and maintenance expenses.
The Clinics being considered at Spring Creek include Primary
Care, Dermatology, Allergy, Cardiology, Endocrinology,
Gastroenterology, Nephrology, Pulmonary, Neurology, Urology, and
Sports Medicine. Advanced imaging services will be provided in
the facility through University of Virginia Imaging, LLC.
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The University’s cost to purchase the real property (land and
all improvements thereon) from UPG will be no more than
$18,000,000. The Medical Center will enter into a long-term
lease with the University of Virginia Imaging, LLC for the
imaging space in the building.
ACTION REQUIRED: Approval by the Medical Center Operating
Board, the Finance Committee, and by the Board of Visitors
APPROVAL TO PURCHASE 1015 SPRING CREEK PARKWAY, LOUISA, VIRGINIA
WHEREAS, the Medical Center Operating Board and the Finance
Committee find it to be in the best interest of the University
of Virginia to purchase from the University of Virginia
Physicians Group land and improvements thereon located at 1015
Spring Creek Parkway, Louisa, Virginia (the “Property”) at a
purchase price not to exceed $18,000,000;
RESOLVED, the Board of Visitors approves the acquisition of
the Property; and
RESOLVED FURTHER, the President of the University, or her
designee, is authorized, on behalf of the University, to approve
and execute purchase agreements and related documents, to incur
reasonable and customary expenses, and to take such other
actions as deemed necessary and appropriate to consummate such
property acquisition; and
RESOLVED FURTHER, all prior acts performed by the President
of the University, or her designee, and other officers and
agents of the University, in connection with such property
acquisition, are in all respects approved, ratified, and
confirmed.
2
UNIVERSITY OF VIRGINIA
BOARD OF VISITORS AGENDA ITEM SUMMARY
BOARD MEETING:
November 8, 2012
COMMITTEE:
Medical Center Operating Board
AGENDA ITEM:
II.A.
ACTION REQUIRED:
None
Vice President’s Remarks
BACKGROUND: R. Edward Howell has been the Vice President and
Chief Executive Officer of the University of Virginia Medical
Center since February 2002. Prior to joining the University of
Virginia, he served for eight years as Director and CEO of the
University of Iowa Hospitals and Clinics. He has over 30 years
of experience in administration and leadership of academic
medical centers.
DISCUSSION: The Vice President and Chief Executive Officer of
the Medical Center will inform the Medical Center Operating
Board of recent events that do not require formal action.
3
UNIVERSITY OF VIRGINIA
BOARD OF VISITORS AGENDA ITEM SUMMARY
BOARD MEETING:
November 8, 2012
COMMITTEE:
Medical Center Operating Board
AGENDA ITEM:
II.B
ACTION REQUIRED:
None
Magnet Recognition and Nursing Report
BACKGROUND: Lorna Facteau has been the Medical Center’s Chief
Nursing Officer since 2009. She received B.S.N. and M.S.
degrees from the University of Maryland and a doctoral degree
from the Catholic University of America. Her career spans more
than 40 years, including experience in clinical pediatrics and
academic medicine. She has been an active member of the
Virginia Nurses Association and has served as the organization’s
President.
Dorrie Fontaine received her B.S. in nursing from Villanova
University, a master’s degree from the University of Maryland,
and her Ph.D. from the Catholic University of America in
Washington, DC. Prior to her 2008 appointment at UVA, Fontaine
was associate dean for academic programs and clinical professor
at the University of California San Francisco. Before coming to
UCSF, she held associate dean positions and taught at Georgetown
University School of Nursing.
DISCUSSION:
Magnet Designation – Recommitting to Excellence
Ms. Facteau will provide an overview of the nursing
workforce successes and challenges as the University of Virginia
Medical Center progresses to make an application to the American
Nurses Credentialing Center for Magnet designation in 2014.
The average age of a registered nurse at the University of
Virginia Medical Center is 43.8 years of age. Fifty-six percent
of the nursing workforce is prepared at the baccalaureate level
(BSN) or above. The average length of employment for nurses at
the Medical Center is 9.78 years. Annual nursing turnover is
14.8% and the current vacancy rate is 8.5%.
The Institute of Medicine Study on the Future of Nursing
(2010) proclaimed that 80% of the direct care nursing workforce
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should be baccalaureate prepared by 2020. This standard has
been adopted by the American Nurses Credentialing Center for
Magnet hospitals as well. Initiatives are under way in
collaboration with Human Resources to step up recruitment and
retention programs for nurses. Targeted recruitment plans for
key specialty areas are also being developed for Cardiology,
Thoracic, Vascular, Neuroscience, and Cancer nurses. Data
collection and turnover statistics for new graduate nurses are
also being examined to develop retention initiatives targeting
new graduate nurses to retain them for longer than two years.
Nursing leadership and the Professional Nursing Staff
Organization (PNSO) have been engaged in a restructured approach
to preparing for a Magnet application submission in 2014. The
group has been recommitted to excellence in patient care,
safety, and patient satisfaction, as evidenced by improvement in
the Nurse Sensitive Indicator scores and Patient Satisfaction
scores. An interdisciplinary steering committee has been
established and is guiding the gap analysis and action planning
needed to strengthen areas of potential vulnerability in the
Magnet application, particularly in nurse/physician relations,
recruitment and retention of nurses, and community and cultural
competence.
Additionally, the shared governance model that has been in
place at the University of Virginia Medical Center since 1987 is
being re-designed. After a strategic planning retreat was held
in May 2011, a task force spent the subsequent year designing a
new structure that will better engage bedside nurses in the
governance model. Unit-based councils are being created to
report to the standing committees. A large scale effort was
launched to preview the model changes, including town hall
meetings and educational handouts for the nurses to review. The
PNSO bylaws were revised to reflect the structural changes and
are being voted on by the PNSO membership during the month of
October.
UVA School of Nursing Update
The School of Nursing’s vision is to create healthy work
environments where all can flourish, to foster interprofessional
education and research, and to encourage and leverage diversity.
We remain consistently top-ranked among our peers. We are
ranked 15th for graduate programs (up from 19th in 2007), and are
among the top 2% of nursing schools in the nation. Our goal is
to be among the top 10.
5
The Institute of Medicine’s 2010 “Future of Nursing Report”
identified several critical mandates to which our school is
responding. First, the report asserted that nurses must
practice to the fullest extent of their education. Second, they
advise that nurses be full partners with physicians and others
in redesigning health care for the nation. Third, the report
sets a critical goal for the nation’s registered nurses: that
80% of our nation’s three million RNs earn their baccalaureate
degrees by the year 2020 (the so-called “80 by 20” mandate).
Our approaches to these mandates are organized and
strategic. By 2014, we will double the size of our RN to
Bachelor of Science in Nursing (BSN) program from roughly 50
students to between 100 and 120 students. We will continue to
urge BSN students to continue their education to earn advanced
degrees, increasing the numbers of nurse practitioners (NP) and
doctoral students enrolled in our Doctor of Nursing Practice
(DNP) and PhD programs. We offer flexible part-time programs
and financial resources for nurses working full time, and are
engaging many of our RN colleagues in the Medical Center.
Roughly half of last year’s BSN graduates now work at the
Medical Center, so our school provides a critical pipeline. Our
programs are producing a supply of well-trained, academically
and clinically excellent graduates, a critical ingredient to
bolstering the quality and safety of patient care at the Medical
Center. Study after study asserts that a staff of well-educated
nurses provides better, safer patient care, brings a decrease in
medical errors, and improves patient satisfaction. This is a
key ingredient in returning our Medical Center to Magnet
designation.
The School of Nursing is growing. Our NP program has grown
by a third over the last five years, and we continue to have
exceptional graduation rates. Our PhD and DNP graduation rates
are in fact the highest in Virginia.
The School continues to be a destination for top high
school students as well. For the recently admitted BSN class of
2016, we had more than 10 applications for every opening.
Challenges remain. Twenty-five percent of the faculty
retired, resigned, or was promoted to leadership positions at
other major institutions between 2010 and 2012. In another two
years, a third of our faculty will have retired since 2008. The
average age of a nursing professor nationally is 55; ours skew
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older, averaging about age 62. We must do what we can to
encourage more students into a career in academia.
We are constantly recruiting. The School of Nursing hired
six professors over the last year, including the first Tussi and
John Kluge Chair in Contemplative End-of-Life Care. Professor
Susan Bauer-Wu, who arrives in January 2013 from Emory
University, has a joint appointment in Religious Studies. Her
appointment illustrates one of the President’s goals of
increasing joint and cross-school hires.
Ours is a unique environment. We emphasize
interprofessional education, which brings together nursing and
medical students in the classroom and lab, builds capacity for
collaboration, and encourages teams that will strengthen
practice to promote excellence in coordinated care. Our
interprofessional work earned an $800,000 Macy Grant and a solid
collaboration with many in the School of Medicine.
We are engaged in a Compassionate Care and Empathic
Leadership Initiative, which bolsters mindfulness and resilience
among students, practitioners, and patients. This initiative,
to be headed by Professor Bauer-Wu, is why we are a critical
part of the Contemplative Sciences Center gift from the Sonia
and Paul Tudor Jones family.
In the research arena, our faculty members are engaged in
projects that map onto the Health System’s clinical strategies
for neurology, cardiovascular care, and cancer. In September,
Professor Pat Hollen’s research on decision-making related to
lung cancer treatment garnered a $2 million NIH grant.
Professor Ishan Williams is currently conducting interviews
related to dementia screening among African-American patients at
the Memory and Aging Clinic, and Professor Karen Rose’s
Alzheimer’s research, which examines the link between nighttime
incontinence and agitation, earned nearly $450,000 from the NIH.
Along with Professor Linda Bullock’s $4 million NIH grant, in
partnership with a Johns Hopkins faculty member, for an
intervention to prevent intimate partner violence during
pregnancy, we are positioned to raise our level of collaborative
research and translate this work for the benefit of the public
we serve.
We have a strong partnership between the Medical Center,
its administration, and nurses, and are working together to
improve patient safety and quality. As a recent example,
Master’s graduates Blen Afework and Amy Lee studied the effect
7
of a “pain script” on patients’ satisfaction with their pain
management while at the hospital. Using a velcroed card with
five questions to script nurses’ queries to patients about their
pain, Blen and Amy found that patients who had received the
intervention reported a 23% higher satisfaction with their pain
management. Those pain scripts remain on the nursing carts on
the Medical Center’s 8th floor, and, more importantly, have begun
a discussion about standardization of the assessment process,
according to Nancy Ecksterowicz, a Medical Center nurse
specializing in pain management.
Our undergraduates are conducting meaningful nursing
research on a variety of subjects from infant swaddling and its
effect on pain to the discrepancy of leg and arm blood pressure
readings among Intensive Care Unit patients. With Medical
Center nurses as their guide, this next generation of nurses is
learning best practices from a strong cadre of experienced
nursing professionals and under careful supervision and with
guidance from our nursing professors.
Like all of health care, the School of Nursing is at a
critical point in its 111-year history. The nation’s hunger for
nursing professionals will only grow, and health care practices
will only increase in complexity. We must expand our programs,
consider new routes of entry for non-nurses, and strengthen
programs for RNs seeking a four-year degree and beyond. We will
continue to engage in meaningful nursing research and cultivate
compassionate caregivers and empathic leaders who will engage
their patients and students as 21st century nurses.
8
UNIVERSITY OF VIRGINIA
BOARD OF VISITORS AGENDA ITEM SUMMARY
BOARD MEETING:
November 8, 2012
COMMITTEE:
Medical Center Operating Board
AGENDA ITEM:
II.C. Operations, Finance, and Write-offs
Report
ACTION REQUIRED:
None
BACKGROUND: The Medical Center provides an update of
significant operations of the Medical Center occurring since the
last Medical Center Operating Board meeting. The Medical Center
prepares a periodic financial report, including write-offs of
bad debt and indigent care, and reviews it with University
leadership before submitting the report to the Medical Center
Operating Board.
Robert H. (Bo) Cofield has served as the Medical Center’s
Associate Vice President for Hospital and Clinics Operations
since February 2010. In this position, he is responsible for
the effective daily operations of the Medical Center’s inpatient
and outpatient clinical services. Before coming to the
University of Virginia he served for 10 years in a variety of
leadership roles at the University of Alabama at Birmingham
Health System.
Larry L. Fitzgerald is the Medical Center’s Associate Vice
President for Business Development and Finance. He has held
similar positions with the University of Pittsburgh Medical
Center and American Medical International. He has extensive
experience with health care mergers and acquisitions, the
Medicare and Medicaid programs, and strategic planning.
OPERATIONS REPORT
Clinical Operations
Ambulatory Operations
Care Connection, our concierge services program offered to
Health System and University employees and their families and to
selected companies within our community, has scheduled nearly
18,000 appointments since its inception. Over 100 appointments
9
have been scheduled for MedExpress Urgent Care patients seeking
follow-up care at the Health System and over 350 for patients
searching the HealthGrades Patient Direct Connect Program site.
To increase access for patients, the Pediatric Clinic at
Northridge recently expanded its hours beyond 5:00 pm three
nights a week and on Saturdays. The Family Medicine Clinic at
the Primary Care Center is also making preparations, including
the addition of new providers, to offer clinic hours two nights
a week in the near future.
Patient Care Services
Nursing
The Professional Nursing Staff Organization/Human Resources
Nursing Scholarship Program granted 27 scholarships in fiscal
year 2012 to individuals pursuing bachelor’s and advanced
degrees in nursing. The total allocation for distribution was
$45,000.
The Medical Center’s Magnet re-designation journey efforts
focused on improving processes associated with nurse sensitive
indicators. Improvements continue to be achieved, with six out
of the 10 indicators performing above benchmark for the most
recent reportable quarter. Efforts to reduce hospital-acquired
pressure ulcers have demonstrated dramatic improvement. For the
first quarter of fiscal year 2013, 1.3% of patients surveyed had
hospital-acquired pressure ulcers compared with 3.1% for fiscal
year 2012. Performance on use of restraints and ventilatorassociated pneumonia indicators has also improved steadily over
the last four quarters.
Inpatient, Emergency and Perioperative Services
Renovation of intensive care units continued within the
University Hospital. Refurbishments to the Thoracic
Cardiovascular Post-Operative Unit, Surgical Trauma Burn
Intensive Care Unit, and the Coronary Care Unit are currently in
progress. Replacement of carpet and wallpaper is also in
progress in the pediatric acute care units.
Perioperative Services purchased and installed a new S1 da
Vinci robot in September 2012 and opened two mobile operating
suites at the Outpatient Surgery Center. The Medical Center now
has two surgical robots in use by a wide range of specialties,
and the addition of two mobile operating rooms has facilitated
10
the expected shift of outpatient surgical cases from the main
operating room to the Outpatient Surgery Center.
The Medical Center was awarded $350,000 by the Virginia
Tobacco Commission to help fund a Care Coordination Center which
will provide remote patient monitoring, care coordination,
support for medication compliance, and health coaching to
patients with certain chronic diseases. In addition to the
funding support from the Tobacco Commission, $350,000 in funding
is being provided by the University. The Care Coordination
Center is designed to provide physicians with trended clinical
data and real time clinical alerts concerning changes in patient
parameters. Availability of this information will support
proactive care intervention to avoid potentially preventable
hospitalizations or Emergency Department visits. The Care
Coordination Center is expected to launch in early 2013 and will
serve as the supporting hub for two additional satellite
centers, one in Southwest Virginia and one in Southside
Virginia. The Care Coordination Center will not only support
the Medical Center’s mission to provide comprehensive, exemplary
care to patients, but demonstrates its commitment to providing
improved access and care to patients residing in rural Southwest
and Southside Virginia.
Clinical Ancillary Services
Endoscopy
To improve patient access to convenient screening services,
routine colonoscopy services are now being performed at the
Medical Center’s Outpatient Surgery Center three and a half days
per week.
Medical Laboratories
The Medical Laboratories implemented in-house testing for
measles and mumps, which had previously been sent to external
reference labs. This has resulted in same day turnaround for
results and fewer blood samples to be collected. The Medical
Laboratories also implemented an immunochemical test for the
specific detection of human hemoglobin in feces, replacing the
guaiac-based method, which had diet restrictions.
Radiology and Medical Imaging Services
New Siemens 3.0 Tesla wide-bore Magnetic Resonance Imaging
equipment was installed at the Medical Center and is being used
11
daily to image patients. The wide-bore technology accommodates
larger patients, who no longer have to be sent to the Northridge
outpatient imaging facility.
Neuroradiologists demonstrated great success with use of a
new pipeline embolization device for treatment of giant or wideneck aneurysms. This device directs blood away from an aneurysm
while keeping the parent vessel visible, thus decreasing the
number of coils needed for treatment.
The Diagnostic Imaging team is now using digital or
wireless portable x-ray equipment throughout the Medical Center.
This allows for instant viewing of images taken at the patient’s
bedside and significantly enhances work flow and efficiency.
Future software upgrades will allow scanning functionality using
patient identification bands.
The Breast Imaging team now offers breast tomosynthesis
services. Breast tomosynthesis is newly approved 3-D technology
that reduces or eliminates the tissue overlap effect commonly
seen in breast tissue on a routine mammogram. This will often
resolve the need for recalls and requests for additional imaging
and may become part of routine screening protocols.
Pharmacy Services
The Virginia Commonwealth University School of Pharmacy –
University of Virginia Division debuted on August 20, 2012 with
a class of eight third-year pharmacy students. The
technologically advanced classroom connects local students and
instructors to their classmates and instructors at the Richmond
and Northern Virginia campuses.
In an effort to improve turnaround times and shorten wait
times, a central fill pharmacy model is being implemented to
fill prescriptions in the off-hours. Pharmacy Services is also
implementing a prescription mail delivery process and “employee
only” pick-up and drop-off location to facilitate employee
access to Outpatient Pharmacy services.
The HOPE Augusta Pharmacy opened in early September with a
successful review and licensing by the Virginia Board of
Pharmacy.
Pharmacy Services received accreditation by the American
Society of Health System Pharmacists for three new pharmacy
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residency programs (Oncology, Information Technology, and
Pharmacy Administration).
Therapy Services
Operational oversight of the Medical Center’s Employee
Health and Same Day Clinic will now be provided by Therapy
Services, which already oversees similar programs offered by
University of Virginia-WorkMed. Alignment of these occupational
health and wellness programs will enable the Medical Center to
take full advantage of program strengths and similarities,
assure consistent departmental policies and procedures, utilize
staff resources more efficiently, and offer services to Health
System employees at two locations.
Community Outreach
The Health System provided 41 teams and over 600 volunteers
for the 2012 Laurence E. Richardson United Way Day of Caring.
Participants from the Medical Center, School of Medicine, School
of Nursing, and University Physicians Group represented over
half the volunteers in support of the 75 projects within the
region. This one day event provided support to schools, nonprofit organizations, and special interest groups from
landscaping, painting, and construction repairs to reading to
children in the classroom and visiting with the elderly in
assisted care facilities.
In September, the Medical Center was the primary sponsor
for the annual Alzheimer’s Walk, which brought over 700 people
out in support of research for this disease. The Medical Center
also participated in the annual Remote Area Medicine (RAM)
clinic in Grundy, Virginia on October 6 and 7, where over 150
individuals were provided with primary and specialty care.
Additional partnerships included sponsoring the Center for NonProfit Excellence Philanthropy luncheon and the Arthritis
Foundation “Bone Bash” where two Health System physicians, Drs.
Robert Wilder and James Browne, were recognized.
Environment of Care
Facilities Update
In order to create a green space for the new Battle
Building, the Board of Visitors approved the demolition of the
1224 Jefferson Park Avenue building at its September meeting.
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Facilities staff began work to relocate all employees from the
building by spring 2013. Staff will be relocated to space in
the West Complex, KCRC, and off-site rental locations.
Arts Committee
The University of Virginia Health System Arts Committee
presented an exhibition entitled “Paintings from a Sacred Space”
by artist David Copson in the University Hospital Lobby from
August 31 to November 2, 2012.
Patient & Guest Services
“Sips & Sunsets for Scholarships”, a wine tasting event to
benefit the UVA Hospital Auxiliary Health Scholarship Fund, was
held in September at the Prince Michel Wine Shop atop Carter’s
Mountain.
The UVA Hospital Auxiliary Venture Awards Committee awarded
$23,400 to various programs at the Medical Center that benefit
patients, their families, or in some way provide an improved
service to the Medical Center Community. The funds were awarded
in incremental amounts to multiple recipients.
Sustainability
In September, the Medical Center was named the first winner
of the Sustainability Award by the University Health System
Consortium (UHC), a national organization of academic medical
centers. The award highlighted the Medical Center’s commitment
to sustainability, its development of ways to measure progress
toward its sustainability goals, and its communication efforts.
The Medical Center is a strong participant in university-wide
recycling efforts. In addition, the Medical Center builds
environmentally friendly “green” buildings, participates in the
Local Food Hub program, runs the Reusable Office Supply Exchange
(ROSE) program, and is changing landscaping practices to reduce
water usage and use recycled water for plants. Also,
environmentally friendly cleaning practices and products are
being used, and the Medical Center operates the Medical
Equipment Recovery of Clean Inventory (MERCI) program to recycle
medical supplies and equipment for a variety of uses, including
free clinics and medical mission trips.
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Environmental Services
National Healthcare Housekeeping Week was held in September
and events were held throughout the week to thank the Medical
Center housekeepers for their hard work. A Housekeeping Week
display was on view in the East Cafeteria to explain more about
what housekeepers do every day for our patients, visitors, and
staff.
Nutrition Services
A catered lunch was held in October for the staff of Food
and Nutrition Services to honor them during Healthcare
Foodservice Workers Week.
Human Resources
Compensation
Merit increases were processed effective September 30, 2012
for all Medical Center staff who received performance ratings of
“Fully Meets Expectations” and “Exceeds Expectations”. The
merit increase date was moved up from the historical
January/February time frame to align with the fiscal year and
demonstrates another investment in our employees.
Preparation for the annual compensation market analysis
assessment is currently under way and is scheduled to be
implemented in January 2013.
Recognition and Rewards
Numerous activities to recognize the contributions of
Medical Center employees occurred over the past several months.
Some of these events included:


An employee thank you celebration was held on October 9 to
engage Senior Leaders with employees. Over 5,000 bowls of
pumpkin bisque were served in the Medical Center cafeterias
and nearly 3,000 servings of pumpkin bread and cider were
served to our off-site employees. University of Virginia
Athletics provided a wrist band for all participants to
promote the upcoming Women’s Basketball season and the new
partnership with the Medical Center.
The launch of the updated Uteam Recognition and Rewards
Program was held on October 31 for all leaders. Leaders
were provided a new Uteam Celebration toolkit, giving each
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


leader tools to effectively and consistently recognize and
reward their employees. The leaders engaged in discussions
and learned from industry experts on simple strategies to
effectively move their units/departments forward with
recognition and rewards.
Health System Hoos was launched in conjunction with Uteam
to provide an opportunity for Health System employees to
purchase season tickets to this year’s Women’s Basketball
season. By participating in the program, employees will
receive spirit items to cheer on the women’s team at the
home games. The games will also be used to recognize and
reward employees by honoring them during half-time, to
promote Club Red, and the Emily Couric Clinical Cancer
Center.
Additional Uteam Employee Discounts were announced, giving
employees additional opportunities to save money for being
an employee of the Health System.
“Employee of the Month” celebrations were held and 37 “You
Make A Difference” certificates were distributed to
recognize individuals nominated by their peers.
Over 14 retirement celebrations were planned this quarter
for employees with over 20 years of service with the
Medical Center.
Recruitment
A new Recruitment Manager started in late July with a
focused role of improving Human Resources sourcing methods and
assisting managers with the implementation of new selection
tools. Development of a new, metric driven recruitment strategy
is underway along with a yearlong media and events plan.
Employee Engagement
Medical Center leadership continued to share Employee
Engagement census survey results with staff throughout
September. Formulation of action plans, both systemic and
departmental, progressed through October. Plans are underway to
procure a Health System-wide engagement survey tool by May 2013.
The Health System is currently reviewing proposals from employee
engagement vendors who are interested in partnering with the
Health System in administering and consulting on employee
engagement initiatives.
16
Organizational Development
The Medical Center completed annual performance appraisals.
Approximately 5,500 staff performance appraisals and 230 leader
appraisals were completed this year. In addition, all Medical
Center employees (and contracted staff) as well as credentialed
University Physicians Group staff, medical students, and many
School of Medicine employees completed this year’s annual
mandatory retraining module in the Learning Management System, a
total of approximately 11,400 individuals.
The Uteam Leadership Academy Informal Leader program
graduated another 48 employees. This three month program is
intended to help employees who do not currently hold formal
leadership roles but lead others informally or play a
significant part in the success of their area. Participants
have reported a change in their own behavior up to 95% of the
time. The third cycle of the New Leader Orientation program is
under way. Medical Center executive leadership are the
facilitators for these programs, which provide an opportunity
for attendees to meet and learn how to be a successful manager
at the Medical Center in an intimate educational setting with
meaningful dialogue. In addition, three separate classes of
Best Practices in Management are in progress. The topics
presented are based on areas identified in past employee
engagement surveys. Participants obtain tools they can
immediately use to address issues such as trust, engagement,
managing change, accountability, and developing and recognizing
employees.
Uteam Meetings
The next series of Uteam meetings are slated for December
2012 and will focus on the Health System clinical strategy,
accomplishments achieved to date, recognition, and leaders
sharing their collective vision of our recent successes and
future expectations as a Health System.
Quality and Performance Improvement
The performance improvement Priority Projects (Q17) have
been identified for FY 2013. The projects focus on prevention
of infection or complications, compliance with measures set by
Centers for Medicare and Medicaid Services, and reducing
readmission to the hospital within 30 days. Progress during the
year is reported to the Quality Subcommittee of the Medical
Center Operating Board.
17
Recognition and Awards
The University of Virginia Medical Center was named a 20112012 “Hospital of Choice” for customer service by the American
Alliance of Healthcare Providers (AAHCP).
Becker’s Hospital Review selected the University of
Virginia Medical Center for its new list of “100 Hospitals with
Great Women’s Health Programs.”
David Edward Simmons Jr, MSN, RN, CNN, Kidney Center,
received the National Black Nurses Association 2012 Trailblazer
Award at the 40th Annual Institute and Conference in Orlando
Florida.
Supply Chain
The Medical Center completed implementation of the Low Unit
of Measure supply replenishment system in partnership with its
distributor of medical supplies, Owens & Minor. As a result,
the University is now able to meet its obligation to the County
of Albemarle and transfer occupancy of one third of the Kirtley
Road Warehouse to the County for fire station operations. The
Medical Center ceased operations in the remaining portion of the
warehouse at the end of October. The Low Unit of Measure
program is currently operating as designed and enhancements are
being made as process issues are discovered and corrected.
Resources once consumed by warehouse operations have been
redirected to the Medical Center to achieve higher levels of
service and support for patient care.
Continuum Home Health Care – Fiscal Year 2012 Annual Report
Continuum Home Health Care (Continuum) is structured as a
department of the Medical Center and provides two primary lines
of business: home health and home infusion services. Continuum
is accredited by The Joint Commission and separately
Medicare/Medicaid certified from the Medical Center.
Home health services include the direct provision of
skilled nursing, physical, occupational and speech therapies;
home health aides; and medical social work to patients residing
within an 11 county area which includes the counties of
Albemarle, Greene, Madison, Culpeper, Orange, Louisa, Fluvanna,
Buckingham, Nelson, Augusta, and Rockingham. Additionally
Continuum offers specialty care through its Psychiatric Service,
and interdisciplinary Wound Care Team. Home infusion provides
18
services in these same 11 counties (with Continuum also
providing any needed direct services), and also provides
pharmaceutical services on a statewide basis and out of state as
needed to patients residing in Maryland, North Carolina and West
Virginia. For home infusion patients residing outside of
Continuum’s direct 11 county service area, Continuum works with
another Medicare certified home health agency to provide any
direct nursing services required.
Operations – Growth Performance
Admissions
FY07
FY08
3,676
3,876
Home Health
FY09
FY10
3,748
4,004
FY11
FY12
4,750
4,906
Total Visits 47,981 49,748 48,740 51,881 59,367 52,944
FY07
FY08
Home Infusion
FY09
FY10
FY11
FY12
Admissions
951
1,168
947
1,152
1,317
1,545
Total
Therapy Days 61,499 69,168 72,402 76,352 84,632 97,534
Both home health and home infusion product lines continue
to demonstrate steady growth as many patients become repeat
patients. Gaining new home health patients while delivering
fewer visits overall is supportive of a more positive
reimbursement picture for home health. Continuum grew its home
health admissions 3% in fiscal year 2012 and provided a
conservative average number of visits per patient (10) while
achieving publicly reported patient outcomes which exceeded both
state and national levels.
Continuum home infusion increased its admissions in fiscal
year 2012 by 17% and increased its therapy days by 15%. Many
home infusion patients may be repeat patients or may remain on
service for life (i.e. cycles of chemotherapy, tube feeding, and
Total Parenteral Nutrition patients), so this growth in both
therapy days and admissions is significant.
Continuum’s case mix (a measure of patient acuity) was
1.50, which exceeded the national average of 1.35. This is a
direct reflection of the complexity of patients that Continuum
routinely manages.
19
Significant differences in payer mix continue to exist
between home health and home infusion business lines, adding to
the complexity of intake and pre-authorization requirements.
Traditionally, Medicare Part A & B provide limited coverage for
home infusion therapy. Medicare Part D prescription drug plans
have significantly shifted patients to Medicare D coverage,
helping to eliminate secondary coverage or self-pay needs.
Traditional Medicare continues to be the primary payer for home
health services (60%) while it covers less than 16% of infusion
needs. Commercial payers and Medicaid continue to be the
primary payers for home infusion.
Although reimbursement rates have decreased, both home
health and home infusion continue to demonstrate significant
operating margins and continue to provide services critical to
supporting the institutional goal of timely and effective
patient discharge and supporting the post-hospital needs of
indigent patients. Agency responsiveness and the skill level of
staff allows Continuum to support the discharge to home of
hospitalized patients that many home health agencies cannot, or
will not, service at home. Achieving these operating margins
this year is especially significant in light of the
proliferation of new for-profit entities creating a highly
competitive local market.
Accomplishments this year include:





Successfully completed a full Medicare home health survey
in July 2012 with no deficiencies.
Successfully completed a Joint Commission survey in
February 2012 with home health having no deficiencies and
infusion receiving two findings, both of which were
corrected while on site.
Successfully completed an inspection by the State Board
of Pharmacy (last completed in 2005) with no deficiencies
identified related to scope of service or practice of
pharmacy. Two potential secondary deficiencies were
identified that will be remedied if the Board of Pharmacy
determines they are relevant to Continuum’s setting.
Implemented a paperless scanning process so that all
patient referral information is electronically
transmitted to the clinicians in the field who now have
patient information regarding the hospital discharge and
access to Epic in the field.
Facilitated integration with the University of Virginia
HOPE Cancer Care oncology practices. Continuum now
20

supports all four locations and all patients that are on
protocols requiring continuous chemotherapy at home.
Underwent a CVS/Caremark audit which consisted of a
thorough evaluation from four vantage points of our home
infusion process - prescription accuracy, drug dispensing
legitimacy, proof of patient delivery and billing claims,
and revealed high quality services that were billed
correctly.
Patient Care and Safety
Continuum demonstrated positive movement in all measured
patient outcomes as reported by Centers for Medicaid and
Medicare Services Home Health Compare and outperformed all local
area home health agencies, both proprietary and hospital based.
Continuum exceeded clinical outcome results in all 22 categories
in both state and national comparatives in January and exceeded
21 of 22 in April.
Continuum supports two residents of the UVA-Habitat “Health
Houses” in Charlottesville by providing ongoing tele-health
remote patient monitoring and clinical nursing support. Both of
these residents are University of Virginia employees and
Continuum communicates vital sign trending reports to the
patient’s physicians to facilitate effective chronic disease
management.
In fiscal year 2012, Continuum developed a program to help
reduce blood clots in orthopedic patients by working with the
University of Virginia Orthopedic team to develop and test a
coumadin medication protocol that has resulted in no bleeds or
hematomas.
Continuum secured a contract with Virginia Premier to
administer their “Bridge Program” – a structured educational
program designed to reduce readmissions for Medicaid patients
with diabetes or psychiatric conditions. Continuum sees these
patients in the Medical Center and four area hospitals: Martha
Jefferson Hospital, Augusta Health, Culpeper Regional, and
Rockingham Memorial.
Quality/Outcomes
The Centers for Medicaid and Medicare Services now requires
that home health agency patient satisfaction scores (HHCAPS) be
publicly reported. Continuum’s most recent results exceed both
state and national targets. Continuum home health also
21
continues to increase its Press Ganey survey scores, achieving
an overall mean score this year of 93%. Continuum home infusion
increased its overall patient satisfaction scores to 94%. In
fiscal year 2012, Continuum home health experienced a 94%
likelihood of being recommended and its home infusion program
experienced a 96% likelihood of being recommended. Continuum
also won the Pride in Practice Award for Sustained Excellence in
Patient Satisfaction, July-Sept 2011, from Press Ganey
Associates.
Continuum successfully reduced its patient readmission rate
to 24%, below the national average of 27%. Given the high
acuity level of its patients, Continuum is especially proud of
its continued improvement in this area, particularly because the
national average has moved minimally despite concentrated
efforts throughout the home health industry.
Continuum patient fall rates were 0.6% in fiscal year 2012,
below the 1.3% national average for home health patients. The
agency shared fall prevention successes with the Medical
Center’s patient fall team to support its adoption of successful
practices implemented by Continuum.
Continuum leadership made a presentation regarding its
quality outcomes at three national conferences: the National
Association for Home Care, National Hospice and Palliative Care
Association, and the American Nursing Informatics Association.
In collaboration with the Medical Center’s Emergency
Management Service, Continuum established a Twitter program for
emergency management for its home health field staff to ensure
that staff can be alerted when disaster or weather related
emergencies occur in the counties where staff members are
providing care.
FINANCE REPORT
After two months of operations in fiscal year 2013, the
operating margin for all business units was 10.3%, which was
above the budget of 5.4%. The operating margin for the hospital
and the Outpatient Surgery Center (OPSC) was 9.9% against a
budget of 4.2%. The operating margins for UVA Imaging, OffCampus Dialysis, and the Transitional Care Hospital were also
above budget for fiscal year to date through August.
22
The fiscal year 2013 operating margin for
Center was impacted favorably by a $10 million
expense adjustment resulting from a litigation
vendor. The operating margin for all business
been 5.3% without this adjustment.
the Medical
non-recurring
settlement with a
units would have
During the first two months of the fiscal year, inpatient
discharges were 0.3% below budget and 3.1% above the prior year.
Average length of stay was 5.80 days, which was above the budget
of 5.50 days, but below the prior year’s 5.87 day average length
of stay. Observation patients, outpatient clinic visits,
emergency room visits, and surgeries performed at the OPSC were
above budget and above the prior year. Capacity at the OPSC
increased with the addition of two modular operating rooms in
June 2012.
Total operating revenue for fiscal year 2013 through August
was 1.0% below budget. Total operating expenses were 6.1% below
the $191.0 million budget. Excluding the impact of the
litigation settlement, expenses would have been 0.9% below
budget.
Total paid employees, including contracted employees, were
139 below budget.
FY 2012
Employee FTEs
Salary, Wage and
Benefit Cost per
FTE
2013 Budget
6,309
6,563
6,794
$74,642
$76,516
$76,107
213
262
171
6,521
6,825
6,964
Contract Labor FTEs
Total FTEs
FY 2013
OTHER FINANCIAL ISSUES
The Financial Accounting
in the reporting requirements
report bad debt as an expense
a hospital does not expect to
Standards Board has made a change
for bad debt expense. Rather than
item, the estimate of amounts that
collect must be deducted from
23
gross patient revenue as part of the calculation of net patient
revenue. In accordance with generally accepted accounting
principles, in fiscal year 2013 we have begun recording bad debt
as a reduction to gross revenue rather than as an expense.
The Anthem provider contract terminates for both the
Medical Center and University Physicians Group on December 31,
2014. Over 18% of the Medical Center’s net revenue is received
through the Anthem contract. Anthem has taken an aggressive
stance with providers in Virginia over the last year. In
January, Mary Washington Hospital went through a period of being
a non-participating provider with Anthem before the two
organizations came to terms for their provider contract. The
Virginia Commonwealth University Medical Center recently agreed
to provider contract terms with Anthem but only after a lengthy
and difficult negotiation. In anticipation of a difficult
negotiation with Anthem, we are planning a negotiation strategy
now. Our first step was to consult with the University Health
System Consortium in May. A negotiating meeting with Anthem
will be held before the next Board meeting.
Under the Affordable Care Act, each state must make a
decision about expanding Medicaid coverage for its citizens.
The Virginia Senate Finance Committee’s fiscal analyst has
requested a financial impact statement from the University of
Virginia and Virginia Commonwealth University on the projected
impact of expanded Medicaid coverage and no expansion to
Medicaid coverage. This analysis is not complete, but the short
term impact is small either way. However, if Medicaid coverage
is not expanded, the long term impact will be a significant
reduction of the indigent care funding for both institutions.
WRITE-OFF OF BAD DEBTS AND INDIGENT CARE
Indigent care charges totaling $46.1 million for the period
July 1, 2012 through August 31, 2012, have been written off.
Recoveries during this period totaled $8.1 million.
Bad debt charges totaling $9.8 million have been written
off during the period from July 1, 2012 through August 31, 2012.
During this same period, $3.1 million was recovered through
suits, collection agencies, and Virginia refund set-off.
24
University of Virginia Medical Center
Income Statement
(Dollars in Millions)
Most Recent Three Fiscal Years
Description
Net patient revenue
Aug-11
Aug-12
Budget/Target
Aug-13
Aug-13
$163.0
$177.0
$190.0
$190.0
4.4
5.5
9.9
11.9
$167.4
$182.5
$199.9
$201.9
149.1
159.8
164.0
175.9
Depreciation
9.4
11.8
12.9
12.9
Interest expense
1.4
1.2
2.4
2.2
$159.9
$172.8
$179.3
$191.0
Operating income (loss)
$7.5
$9.7
$20.6
$10.9
Non-operating income (loss)
$9.5
$4.3
$0.2
$2.8
Net income (loss)
$17.0
$14.0
$20.8
$13.7
Principal payment
$3.5
$3.5
$3.8
$3.8
Other revenue
Total operating revenue
Operating expenses
Total operating expenses
25
University of Virginia Medical Center
Balance Sheet
(Dollars in Millions)
Most Recent Three Fiscal Years
Description
Aug-11
Aug-12
Aug-13
Assets
Operating cash and investments
$155.5
$97.7
$132.0
Patient accounts receivables
90.6
110.2
130.4
Property, plant and equipment
579.0
673.4
736.5
Depreciation reserve and other investments
255.3
205.9
237.1
Endowment Funds
341.8
410.0
418.2
Other assets
174.6
229.6
265.0
$1,596.8
$1,726.8
$1,919.2
Current portion long-term debt
$20.0
$24.5
$28.1
Accounts payable & other liab
119.6
114.8
134.6
Long-term debt
331.2
315.9
398.9
Accrued leave and other LT liab
156.3
143.4
137.2
$627.1
$598.6
$698.8
$969.7
$1,128.2
$1,220.4
$1,596.8
$1,726.8
$1,919.2
Total Assets
Liabilities
Total Liabilities
Fund Balance
Total Liabilities & Fund Balance
26
University of Virginia Medical Center
Financial Ratios
Most Recent Three Fiscal Years
Description
Aug-11
Aug-12
Aug-13
Budget/Target
Aug-13
Operating margin (%)
4.5%
5.3%
10.3%
5.4%
Total margin (%)
9.6%
7.5%
10.4%
6.7%
Current ratio (x)
1.8
1.5
1.6
2.4
183.6
170.0
184.0
190.0
Gross accounts receivable (days)
43.7
48.3
48.5
45.0
Annual debt service coverage (x)
5.7
5.7
5.8
5.2
34.5%
30.5%
33.2%
31.8%
6.8%
7.5%
8.5%
7.9%
Days cash on hand (days)
Debt-to-capitalization (%)
Capital expense (%)
University of Virginia Medical Center
Operating Statistics
Most Recent Three Fiscal Years
Description
Aug-11
Acute Admissions
Patient days
SS/PP Patients
Average length of stay
Clinic visits
ER visits
Medicare case mix index
Occupancy %
FTE's (including contract labor)
27
Aug-12
Aug-13
Budget/Target
Aug-13
4,696
4,803
4,950
4,965
28,624
28,177
28,983
28,624
1,553
1,781
1,957
1,714
6.10
5.87
5.80
5.50
114,873
123,888
127,042
123,827
9,789
10,404
10,684
10,253
2.04
2.19
2.03
2.08
6,197
6,521
6,825
6,964
University of Virginia Medical Center
SUMMARY OF OPERATING STATISTICS AND FINANCIAL PERFORMANCE MEASURES
Fiscal Year to Date w ith Com parative Figures for Prior Year to Date - August FY13
OPERATING STATISTICAL MEASURES - August FY13
ADMISSIONS and CASE MIX - Year to Date
Actual
Budget
% Variance
Prior Year
ADMISSIONS:
Adult
Pediatrics
Psychiatric
Transitional Care
Subtotal Acute
4,227
483
197
43
4,950
4,169
534
206
56
4,965
1.4%
(9.6%)
(4.4%)
(23.2%)
(0.3%)
4,058
522
198
25
4,803
Short Stay/Post Procedure
1,957
1,714
14.2%
1,781
Total Admissions
6,907
6,679
3.4%
6,584
Adjusted Admissions
9,188
9,063
1.4%
8,679
CASE MIX INDEX:
All Acute Inpatients
Medicare Inpatients
1.87
2.03
1.95
2.08
(4.1%)
(2.4%)
1.98
2.19
OTHER INSTITUTIONAL MEASURES - Year to Date
Actual
Budget % Variance Prior Year
ACUTE INPATIENTS:
Inpatient Days
Average Length of Stay
Average Daily Census
Births
28,983
5.80
467
292
28,624
5.50
462
285
1.3%
(5.5%)
1.1%
2.5%
28,177
5.87
454
305
OUTPATIENTS:
Clinic Visits
Average Daily Visits
Emergency Room Visits
127,042
3,130
10,684
123,827
3,047
10,253
2.6%
2.7%
4.2%
123,888
3,123
10,404
3,344
1,720
5,064
3,449
1,541
4,990
SURGICAL CASES
Main Operating Room (IP and OP)
UVA Outpatient Surgery Center
Total
(3.0%)
11.6%
1.5%
3,436
1,331
4,767
28
OPERATING FINANCIAL MEASURES - August FY13
REVENUES and EXPENSES - Year to Date
OTHER INSTITUTIONAL MEASURES - Year to Date
($s in thousands)
Actual
Budget
% Variance Prior Year
($s in thousands)
Actual
Budget % Variance Prior Year
NET REVENUES:
NET REVENUE BY PAYOR:
Net Patient Service Revenue
190,083
190,000
0.0%
176,965
Medicare
$ 57,424 $ 56,517
1.6% $
52,640
Other Operating Revenue
9,860
11,877
(17.0%)
5,559
Medicaid
14,747
12,411
18.8%
11,560
Total
$ 199,943 $ 201,877
(1.0%) $ 182,524
Commercial Insurance
41,284
38,577
7.0%
35,930
Anthem
34,976
34,572
1.2%
32,200
Southern Health
5,436
5,982
(9.1%)
5,571
EXPENSES:
Other
36,216
41,941 (13.6%)
39,064
Salaries, Wages & Contract Labor
88,364 $ 88,500
0.2%
81,531
Total Paying Patient Revenue
$ 190,083 $ 190,000
0.0% $ 176,965
Supplies
45,335
44,774
(1.3%)
40,893
Contracts & Purchased Services
30,350
42,585
28.7%
37,383
Depreciation
12,863
12,927
0.5%
11,765
Interest Expense
2,444
2,228
(9.7%)
1,207
Total
$ 179,356 $ 191,014
6.1% $ 172,779
OTHER:
Operating Income
$
20,587 $ 10,863
89.5% $
9,745
Collection % of Gross Billings
32.40%
32.34%
0.2%
34.35%
Operating Margin %
10.3%
5.4%
5.3%
Days of Revenue in Receivables (Gross)
48.5
45.0
(7.8%)
48.3
Non-Operating Revenue
$
183 $
2,832
(93.5%) $
4,305
Cost per CMI Adjusted Admission
$ 10,450 $ 10,852
3.7% $
10,024
Total F.T.E.'s (including Contract Labor)
6,825
6,964
2.0%
6,521
Net Income
$
20,770 $ 13,695
51.7% $ 14,050
F.T.E.'s Per CMI Adjusted Admission
24.66
24.53
(0.5%)
23.46
University of Virginia Medical Center
SUMMARY OF OPERATING STATISTICS AND FINANCIAL PERFORMANCE MEASURES
Fiscal Year to Date w ith Com parative Figures for Prior Year to Date - August 31, 2012
Assumptions - Operating Statistical Measures
Adm issions and Case Mix Assum ptions
Admissions include all admissions except normal new borns
Pediatric cases are those discharged from 7 West, 7 Central, NICU, PICU and KCRC
Psychiatric cases are those discharged from 5 East
TCH cases are those discharged from the TCH, excluding any Medicare interrupted stays
All other cases are reported as Adult
Short Stay Admissions include both short stay and post procedure patients
Case Mix Index for All Acute Inpatients is All Payor Case Mix Index from Stat Report
Other Institutional Measures Assum ptions
Patient Days, ALOS and ADC figures include all patients except normal new borns
Surgical Cases are the number of patients/cases, regardless of the number of procedures performed on that patient
Assumptions - Operating Financial Measures
29
Revenues and Expenses Assum ptions:
Medicaid out of state is included in Medicaid
Medicaid HMOs are included in Medicaid
Physician portion of DSH is included in Other
Non-recurring revenue is included
Other Institutional Measures Assum ptions
Collection % of Gross Billings includes appropriations
Days of Revenue in Receivables (Gross) is the BOV definition
Cost per CMI Adjusted Discharge uses All Payor CMI to adjust
UNIVERSITY OF VIRGINIA
BOARD OF VISITORS AGENDA ITEM SUMMARY
BOARD MEETING:
November 8, 2012
COMMITTEE:
Medical Center Operating Board
AGENDA ITEM:
II.D.
ACTION REQUIRED:
None
Capital Projects
BACKGROUND: The Medical Center is constantly improving and
renovating its facilities. We will provide a status report of
these capital projects at each Medical Center Operating Board
meeting.
DISCUSSION: The current Medical Center capital projects report
is set forth in the following table:
30
The University of Virginia Medical Center
Capital Projects Report
November 2012
Scope
BOV
Projected
Approval
Completion
Date
Date
N/A
2014
Bonds
Feb 2008
2013
Bonds & Other
June 2010
2013
Budget
Funding Source
$117 M
Bonds and Outside
Under Construction
Battle Building:
Fundraising
The groundbreaking ceremony was
held on June 9, 2011. Structural
concrete work is complete. Structural
steel work is nearing completion.
Interior framing and mechanical
rough-ins are in progress.
University Hospital:
Renovation of Radiology Department.
$21.2 M
(52,000 GSF)
Construction of final phase is under
way.
Health System Precinct:
$36.5M
Realignment of Lee St. and
construction of new chiller plant.
Realignment of Lee St. to be
completed in summer of 2013. Steel
erection for the new chiller plant is
complete. Cooling towers have been
set and the mechanical rough-in is
under way.
31
UNIVERSITY OF VIRGINIA
BOARD OF VISITORS AGENDA ITEM SUMMARY
BOARD MEETING:
November 8, 2012
COMMITTEE:
Medical Center Operating Board
AGENDA ITEM:
II.E.
ACTION REQUIRED:
None
Health System Development
BACKGROUND: Health System Development will provide reports of
recent activity to the Medical Center Operating Board from time
to time.
DISCUSSION:
SIGNIFICANT GIFTS
July 1, 2012 – September 30, 2012
Following an August visit from Dean Steven T. DeKosky and
Health System Development staff, a medical alumna and her
husband documented a bequest valued at approximately $6
million to create a need-based scholarship endowment in the
School of Medicine.
A $775,000 expectancy was received in support of the
William F. and Joyce A. Richmond Hospitality Fund in the
Medical Center.
A $597,000 expectancy was received for the McGuire
Professorship in Internal Medicine in the School of Medicine.
The 30th Annual Charlottesville Women’s Four-Miler took
place on September 1, and is on pace to raise more than
$330,000, a record for the event. Proceeds will benefit the
UVA Breast Care Program.
A grateful patient made a $250,000 verbal bequest to the
University of Virginia Children’s Hospital Neonatology
division.
A medical school alumnus and his wife made a $250,000
bequest to the School of Medicine.
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The Banting Foundation committed $120,000 in seed funding
for Dr. Mary Laughlin’s research in reversing the autoimmunity
of type 1 diabetes.
The University of Virginia Department of Anesthesiology
committed $100,000 for the newly created Vesna and Slobo
Todorovic Excellence in Anesthesia Research Award.
A $100,000 commitment was received for indigent care at
the University of Virginia Medical Center.
A $100,000 realized bequest was received in support of
the Department of Neurology.
Other gifts and pledges received include:




A $60,000 commitment for the Eric Miles Scholarship Fund
in the School of Medicine;
A $50,000 unrestricted gift annuity for the School of
Medicine;
A $50,000 realized bequest in support of the Paul H.
Wornom Scholarship Fund in the School of Medicine; and
A $50,000 commitment in support of Dr. David Jones’
research in the Emily Couric Clinical Cancer Center.
OTHER DEVELOPMENT INITIATIVES
On August 10, Dean Steven T. DeKosky welcomed the 156
members of the School of Medicine Class of 2016 at the 16th
Annual White Coat Ceremony, presented by the Medical Alumni
Association.
Dean Dorrie Fontaine and the School of Nursing hosted
several events for nursing alumni and benefactors, including an
August 25 reception for new students and parents, a benefactors’
lunch on September 25, and a Jeffersonian Dinner focused on
interprofessional education on September 17. On September 18,
the School celebrated the naming of the Eleanor Crowder Bjoring
Center for Nursing Historical Inquiry in honor of the lead donor
to the center’s successful $1.2 million endowment campaign.
President Teresa Sullivan and Dean Dorrie Fontaine made remarks.
The Communications team sent fall e-blasts on behalf of the
Cancer Center and Children’s Hospital regarding upcoming
activities, and produced a short video from the recently
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completed 30th Annual Charlottesville Women’s Four-Miler, which
supports the University of Virginia Breast Care Program.
As of September 30, development officers have made 340
face-to-face visits with donors and prospects.
CAMPAIGN PROGRESS THROUGH August 31, 2012
New gifts
New pledges
Total new commitments
New expectancies
Total new gifts, pledges, and
expectancies
FY 13 through
8/31/12
$1,852,889
$79,000
$1,931,889
FY 12 through
8/31/11
$1,336,009
$54,168
$1,390,178
$1,857,067
$3,788,956
$1,500,000
$2,890,178
Campaign for Health totals (through August 31, 2012)
122% of original $500M goal
$612,192,804
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