transitions
2011 St. Charles Health System Annual Report
transitions
“Not in
his goals
but in his
transitions
is man
great.”
crossing a new bridge
~ Ralph Waldo Emerson
Much like health care institutions throughout the state and nation, St. Charles Health System has spent
the past few years in a state of transition. We are designing a new system of health care delivery that
we believe will reduce the costs of care, while improving our patients’ experiences and our community’s
overall health and well-being.
While we are focused on the future of what health care can be, we must also continue to operate the
the journey
system as it exists today. We are walking across a new bridge as we build it.
Letter from the CEO .................................................................................................. 3
about health care, we have made many significant changes. From building a strong base of primary
During this time of transition, and what I believe to be truly a total transformation of the way we think
care providers associated with the system to stepping in to support a health coverage program for small
system Summary ....................................................................................................... 4-5
St. Charles Bend ....................................................................................................... 6-7
businesses, I am proud of the work St. Charles Health System has achieved in the past year.
The following pages detail our 2011 journey through financial statistics, clinical information,
St. Charles redmond ................................................................................................ 8-9
achievements and, most importantly, stories from our patients. I hope you enjoy learning more about us.
Pioneer Memorial Hospital ............................................................................... 10-11
As always, we are here for you.
St. Charles Medical Group ................................................................................ 12-13
Be well,
CENTRAL OREGON HEALTH COUNCIL ...................................................................... 14-15
Community Benefit .............................................................................................. 16-17
achievements .............................................................................................................. 18
2012 Board of Directors ......................................................................................... 19
St. Charles Health System 2011 Annual Report
James A. Diegel, FACHE
President and CEO
St. Charles Health System
3
system summary
As a nonprofit organization, every dollar
above operating costs that St. Charles
Health System receives goes back into the
organization to purchase new equipment,
improve our facilities, provide education and
training to our caregivers and much more.
As the largest employer in Central Oregon,
we take our role in the community seriously
clinical statistics
and provide market competitive wages and
Discharges
a robust benefits package for our more
than 3,000 caregivers. In 2011, salaries
and benefits made up 49 percent of our
expenses leading to a more than $250
million impact on our local economy.
2011
2010
2009
2008
-
17,753 17,558 17,607 17,596
We take
our role
in the
community
seriously.
operating expenses
Births
2011
2010
2009
2008
-
Salaries
Benefits
Provider Tax
Professional Fees
Bad Debt Expense
Depreciation & Interest
Supplies and Other Op Expenses
1,990 1,955 1,457 2,231
inpatient Surgeries
For so many reasons, our caregivers, our
patients and our friends and neighbors rely
on us to be financially stable and to be good
-
9,090 8,717 8,834 9,019
outpatient Surgeries
to achieve this each and every day and are
proud that even during difficult economic
emergency Visits
Excess Margin*
2011
2010
2009
2008
Full-Time Employees (FTE)
times, we have adjusted our operations to
create a sustainable organization.
-
-
9,929 10,306 10,275 11,163
63,026 61,315 63,301 62,952
37%
12%
2%
3%
5%
9%
32%
COMMERCIAL
MEDICAID
MEDICARE
SELF PAY
29%
15%
51%
5%
financial summary
2011
2010
2009
2008
stewards of our financial resources. We strive
4
2011
2010
2009
2008
payer mix
2007
2008
2009
2010
2011
Days Cash on Hand
157.6
104.4
134.9
162.5
156.3
Operating Margin
0.31%
-0.08%
5.50%
3.10%
1.74%
-13.30%
9.80%
6.40%
5.20%
1.68%
2,152
2,481
2,472
2,426
2,551
* excess margin includes investment gains and losses
St. Charles Health System 2011 Annual Report
5
bend
St. Charles Bend
When 16-year-old Ryan Berhar visited
“Eric took a moment to notice Ryan as an
the Outpatient Rehabilitation Center at St.
individual; to notice him as someone who
Charles Bend for a wheelchair fitting in the
has a life and a love separate from his
fall of 2011, his physical therapist, Eric
challenges,” said Elisa Jadzak, supervisor of
Ballinger, noticed that Ryan was decked out
Outpatient Rehabilitation at St. Charles.
in a University of Oregon T-shirt and that his
wheelchair was covered in U of O stickers.
to a game and arranged for a private tour
Discharges
2011
2010
2009
2008
-
14,711 14,708 14,725 14,562
Births
Founded in 1918, St. Charles Bend is the largest of the St. Charles Health System hospitals
with 261 licensed beds and nearly 2,400 employees. The Bend facility has received national
recognition for its high quality heart, stroke and cancer care. Our average door-to-balloon
time is less than 50 minutes, placing the facility well within the top 10 percent of hospitals
in the nation. St. Charles Bend is also ranked first in the state for the lowest number of in-
Ryan has a form of muscular dystrophy
of the facilities with Barner as the guide.
called spinal muscular atrophy, a
Photos from the day with Ryan alongside
degeneration of the muscular tissue
many different U of O football players are
that results in severe weakness, causing
framed and hang on his “wall of fame” in
2011
2010
2009
2008
difficulty with maintaining head control,
his bedroom.
inpatient Surgeries
We provide the only Level II trauma center east of the Cascades in Oregon and are a
“It was incredible,” Ryan said.
2011
2010
2009
2008
tertiary referral center for the Central and Eastern Oregon regions. St. Charles Bend has led
limited use of his arms and no use of
his legs. Ballinger asked Ryan if he was
a big Duck fan and the response was
overwhelming. Ryan told him that he’s a
“Meeting everybody, the whole thing,
it was just amazing.”
-
-
1,663 1,659 1,084 1,777
7,905
7,671
7,728
7,976
die-hard fan and that Kenjon Barner is his
outpatient Surgeries
favorite player.
a decision. He contacted the University of
2011
2010
2009
2008
Oregon’s Athletic Department to see if he
emergency Visits
could arrange for tickets to a football game
2011
2010
2009
2008
From that brief interchange, Ballinger made
for Ryan and his family.
6
The University responded with four tickets
clinical statistics
-
-
6,986 7,367 7,292 7,965
hospital deaths due to myocardial infarction.
the health system’s efforts to better coordinate care for patients throughout the region by
launching a Cancer Center of Care in 2011 and an Advanced Illness Management Center of
The Bend
facility has
received
national
recognition
for its high
quality heart,
stroke and
cancer care.
Care in early 2012. Nine more Centers of Care will launch in the near future.
36,239 35,501 36,606 37,202
St. Charles Health System 2011 Annual Report
7
redmond
St. Charles Redmond
“The
nurses,
I love
them all.
I love Dr.
Boone.”
~Judy McDevitt
clinical statistics
Over the past few years, Judy McDevitt has
During one of Judy’s visits to the Redmond
become intimately familiar with many of
Emergency Department, the caregivers
the services provided by St. Charles Health
needed a complete list of her current
System. Five years ago, the 68-year-old
medications. They called the St. Charles
Redmond native was diagnosed with
Medical Oncology clinic located across
multiple myeloma, a cancer of the white
the street and Susie Doedyns, a nurse
blood cells present in bone marrow. She
practitioner in the cancer center, ran over
2011
2010
2009
2008
has undergone chemotherapy and radiation
to check on them. And when the McDevitts
Births
through the St. Charles Cancer Center and
returned from Oregon Health & Science
has also visited the Emergency Department
University last summer, where Judy had
at St. Charles Redmond when her blood
undergone a bone marrow transplant, Pat
count has been low or the cancer has
said the first thing his wife wanted to do
2011
2010
2009
2008
caused her bones to break.
was to visit “the girls” at the Redmond clinic.
“They are just wonderful,” McDevitt said.
“They are like family to me,” Judy said.
“The nurses, I love them all. I love (medical
oncologist) Dr. Boone.”
Discharges
experiences we have gone through have
At the beginning of her cancer journey,
been fantastic,” Pat said. “We have made
McDevitt and her husband Pat would
great friends.”
Center and state-of-the art surgical suites. An expansion of the facility was completed in 2006,
creating private rooms for all patients and an updated, healing environment.
Thanks to generous community donations to the St. Charles Foundation, St. Charles Redmond
inpatient Surgeries
infant bathing sinks, and expanded its Emergency Department. The Emergency Department has
-
-
1,056
933
974
881
recently remodeled its Family Birthing Center, adding Jacuzzi tubs, sleeper beds for family and
a new entrance providing easier access for patients and their families along with private rooms
to improve the patients’ experience.
outpatient Surgeries
for every appointment. Now that St.
2011
2010
2009
2008
Charles offers medical oncology services
emergency Visits
travel to Bend from their Redmond home
in Redmond, they have much more
2011
2010
2009
2008
convenient access to care.
8
2,256 2,102 2,130 2,111
Services include a Level III trauma center, intensive care, respiratory therapy, a Family Birthing
327 296 255 316
2011
2010
2009
2008
“If you have to have cancer, the
-
St. Charles Redmond is a fully accredited, 48-bed hospital with more than 400 employees.
St. Charles Health System 2011 Annual Report
-
-
2,213 2,302 2,325 2,416
In 2011, St. Charles Redmond began implementation of the Aligning Forces for Quality initiative,
a project of the Robert Wood Johnson Foundation geared toward improving the overall quality
of health care in targeted communities.
17,972 17,178 17,492 16,504
9
prineville
Pioneer Memorial Hospital
Pioneer Memorial Hospital is a critical access hospital with 25 licensed beds and about 200
employees in Prineville. The hospital provides surgical services, imaging, intensive care, medical and
emergency care along with an outpatient laboratory and clinic that are located on site. PMH has
been a valued member of the Prineville community since 1950.
In recent years, the PMH team has been committed to recruiting more primary care physicians to
the region and successfully hired four new physicians in 2011. In addition, PMH worked with the
Rimrock Health Alliance and the Community Health Improvement Partnership in Crook County to
bring Advantage Dental to Prineville in order to better serve patients on the Oregon Health Plan
and reduce Emergency Room visits for dental pain.
clinical statistics
Discharges
2011
2010
2009
2008
-
786
748
752
923
System began in Bend in 2010, engaging and empowering frontline caregivers to make changes
that night to await the test results. When
at Pioneer Memorial Hospital, 2011 will
they ended up positive for meningitis, PMH
be widely remembered as the year of
caregivers called and had the girl, who
meningococcal infections. Crook County
became known as “Patient No. 6,” come
experienced a meningococcal outbreak,
back immediately. Antibiotics were started
reporting six cases of the bacterial
and the patient was transferred to St.
infection in 11 months, and caregivers
Charles Bend where she stayed for a week.
inpatient Surgeries
became skilled at recognizing the signs
2011
2010
2009
2008
and symptoms.
-
129
113
132
162
According to the Crook County Health
Department, meningococcal disease is
So when Maria Gattey, a registered
not easily transmittable and is responsive
nurse in the Emergency Department at
to antibiotics, but it can progress quickly
outpatient Surgeries
PMH took a call from a mom concerned
and without treatment can result in
2011
2010
2009
2008
about her teenage daughter who had
brain damage, deafness, paralysis,
fairly severe flu-like symptoms, she didn’t
amputations and even death. Thanks
hesitate to encourage her to bring her
to the quick actions of Gattey and the
daughter in for an evaluation.
entire PMH Emergency Department
-
730
637
658
782
emergency Visits
The Prineville team has embraced the Releasing Time To Care initiative that St. Charles Health
For Emergency Department caregivers
2011
2010
2009
2008
-
“Maria’s response was, ‘Don’t fool
8,815
8,636
9,203
9,246
around. Bring her in,’” the mom, who
asked that she and her daughter not be
at the bedside so that they can spend more time providing direct patient care.
~patient’s mom
team, Patient No. 6 experienced no
complications. She is attending her first
year of college and is doing well.
identified, said. “When we did bring her
“Because we caught it so early, we didn’t
in, we had great care.”
have those problems,” the patient’s mom
They were given masks and gowns while
“Because
we caught
it so early,
we didn’t
have those
problems...”
said. “We are just lucky, lucky, lucky, lucky.”
blood was drawn and the patient was
given fluids. The family was sent home
10
St. Charles Health System 2011 Annual Report
11
COHC
Central Oregon Health Council
Over the past few years, St. Charles Health System has partnered with many local health care
providers and agencies on a project meant to revamp the health care system in Central Oregon.
The Central Oregon Health Council is made up of members from PacificSource Community Solutions,
Mosaic Medical, Deschutes, Crook and Jefferson counties, Bend Memorial Clinic, the Central Oregon
Independent Practice Association, Advantage Dental, some private citizens and St. Charles. The
COHC provides oversight to PacificSource Community Solutions, which was recently one of the first
organizations in the state to be recognized as a Coordinated Care Organization.
Oregon’s version of health care reform, CCOs lay the foundation for the way in which care will
... to build
a better
health care
system and,
ultimately,
to create
a healthier
population.
As 2011 ended, Trish Karr made a New
“We’ve found that patients are really
Year’s resolution to find a way to become
a lot more open to help than we think
healthier. Due to back and stomach pain
they are,” said Kristin Powers, manager
that she hadn’t been able to control, Karr
of the Psychiatric Emergency Services
was taking prescription pain medications
department at St. Charles. “They don’t want
and found herself visiting the Emergency
to go to the Emergency Room.”
Room at St. Charles Bend frequently.
“I started doing yoga and acupuncture and
The program assigned Karr a community
that changed my life,” Karr said. She was
health worker who helps her make
also connected with a community health
appointments with her primary care
worker through a collaborative program
physician and goes with her to ensure that
of the Central Oregon Health Council that
she is communicating well with her doctor.
identifies patients who visit the Emergency
A big part of the program is removing
Room frequently and helps them to better
barriers that prevent patients from keeping
navigate the health care system.
routine health care appointments leading to
Initially, 144 patients were identified as
be coordinated between hospitals, physicians and other providers for the more than 600,000
having visited Emergency Rooms in
Oregon Health Plan patients.
St. Charles is excited to be working with this collaborative group to build a better health care
Karr said that was absolutely true for her.
a need for emergency services – the most
expensive type of care – down the line.
Central Oregon at least 10 times the
“I had been to the Emergency Room five
previous year. In the first year of the
times since January,” Karr said. “I met Cody
program, the number of visits for that
(community health worker) in May and I
group dropped by 67 percent.
haven’t been back since.”
system and, ultimately, to create a healthier population.
12
St. Charles Health System 2011 Annual Report
13
SCMG
St. Charles Medical Group
St. Charles Health System leaders know that medical providers play an integral role in the development
of a coordinated health care system. And St. Charles Medical Group has become a key component in
our effort to build a health care system that provides better health and better care at lower costs.
“To improve is to change;
to be perfect is to
change often.”
Phil Pinheiro never saw himself as the type
of person who would benefit from talking
with a clinical psychologist. But when
~Winston Churchill
his primary care physician, Dr. Nathan
Thompson at St. Charles Family Care in
Redmond, suggested it, Pinheiro agreed.
St. Charles Medical Group is essentially the physician arm of St. Charles Health System. Through the
medical group, we employ physicians and medical providers in specialties including primary care,
neonatology, pulmonology, oncology, general surgery, sleep medicine and more.
In 2011, St. Charles Medical Group provided care to our communities through more than 110,000
patient visits. The group continues to grow and now employs more than 60 physicians and more
than 20 mid-level providers – including nurse practitioners, physician assistants and perfusionists –
who are focused on giving patients a medical home and consistent, coordinated care.
patient visits
Oregon as we all strive to provide the best possible care for our patients.
mass,” Pinheiro, 41, said. “I’m getting
9,393
Medical Oncology, Redmond
4,161
Pulmonology, Bend
Pulmonology, Redmond
Redmond Ob/Gyn
11,295
314
6,253
St. Charles Family Care in prineville
19,117
St Charles Family Care IN Redmond
34,650
Neonatology
Sleep Center, Bend
Immediate Care
weaker and my muscles are atrophying.”
St. Charles Family Care in Bend
2,099
110,417
support patients, knowing that mental health
and physical health are integrally linked.
“To our knowledge, we are the only health
system in the nation rolling out this model
throughout our entire community,” said Robin
Henderson, director of Behavioral Health
teach relaxation techniques for anxiety and
or walking distances. The husband and
prescribe exercise and nutrition regimens to
father of two young children uses a
help with depression. They also developed a
wheelchair when necessary and will likely
chronic pain class that Pinheiro attended.
rely on it fulltime at some point. During
a routine check-up with Thompson,
dealing with the emotional impact of his
1,893
The psychologists work with physicians to
chronic pain and has a hard time standing
880
12,310
St. Charles Family Care medical home model.
Services for St. Charles. The psychologists
the physician asked Pinheiro how he is
4,723
Having a psychologist on site is part of the
Because of his condition, Pinheiro has
3,329
St. Charles Family Care in Sisters
TOTAL
14
where I’m losing muscle tone and muscle
Medical Oncology, Bend
Palliative Care
St. Charles Medical Group is also dedicated to working with medical providers throughout Central
“I have a degenerative genetic disorder
“It has been a real encouragement to me.”
disease. He suggested Pinheiro meet with
Dr. Kim Swanson, a clinical psychologist
embedded in the family care clinic.
“A lot of the depression I was dealing with
was because of frustration at not being able
to make other people understand what I was
going through and not being able to exactly
understand what was going on with me,
myself,” Pinheiro said. “The class gave me a
better idea of what I’m actually dealing with
“The care that I received through Dr.
and a better way to communicate that to
Swanson was really helpful,” Pinheiro said.
other people who aren’t experiencing it.”
St. Charles Health System 2011 Annual Report
15
community benefit
“I’m going to go ahead and say that
SharedCare saved his life.”
~Randa DeLorge
As a nonprofit organization, St. Charles Health System has a responsibility to give back to the Central
Randa DeLorge firmly believes that
assistance so that the program would
SharedCare, a health improvement
continue to be available to local businesses
Oregon community. Through donations of time, services, supplies and dollars, St. Charles provides
program, saved her husband Mark’s life.
and their employees.
more than $100 million in benefits to patients, families and other nonprofit organizations each year.
“Mark never would have been
SharedCare includes two different
diagnosed with his cancer until it was
health plans – a standard option and a
too late, if it weren’t for SharedCare,”
health improvement option. The health
DeLorge said with tears in her eyes.
improvement option has a lower monthly
“I’m going to go ahead and say that
premium and members are required to
SharedCare saved his life.”
make an investment in their own health
We take our role as a community resource seriously and do our best to partner with other local
groups to ensure Central Oregonians have access to the health services they need when they
2011 activity totals
Site
Total
people Served
$2,672,806
12,119
St. Charles Redmond
$306,245
407
Pioneer Memorial hospital
$343,248
7,460
health insurance, the DeLorges had been
$3,322,299
19,986
without coverage for several years before
It was that preventive visit, a physical, that
their employer, Village Properties in
pointed to Mark DeLorge’s prostate cancer
Sunriver, joined SharedCare in December
before it had time to spread.
St. Charles Bend
need them most. Our commitment to the community includes partnerships with organizations
including the United Way of Deschutes County, Project Connect, the KIDS Center and many more,
TOTAL COMMUNITY BENEFIT
but it extends beyond health and human services as well.
These are just a few of the many examples of St. Charles’ community involvement. We are proud
2011 community benefit totals
Due to the high-cost of commercial
2011. At the time, SharedCare was a
grant-funded program providing small
business owners in Crook, Deschutes
of the contribution our community benefit program makes to support a healing environment and a
healthier future for our friends and neighbors.
Benefit Type
Total
people Served
and Jefferson counties the opportunity to
Charity Care at Cost
$26,400,461
12,848
provide affordable health care benefits to
Medicaid Shortfall
$40,259,415
55,005
their uninsured employees.
Medicare Shortfall
$33,289,072
101,720
Total Un-reimbursed Care
$99,948,948
-
$3,322,299
19,986
$103,271,247
189,559
Total Community Benefit
TOTAL BENEFIT
16
through preventive physician visits, wellness
classes and more.
“It had been about four years since I
had a physical. When I did, they found
that I had prostate cancer. We got it in
time, I went and got the operation and
everything worked out really well. I didn’t
have to have any chemo, no radiation and
Toward the end of 2011, the federal
no medication,” DeLorge said. “It was all
grant supporting SharedCare was cut. St.
because of the decision we made to go
Charles stepped in to provide financial
with SharedCare.”
St. Charles Health System 2011 Annual Report
17
2012
board of directors
“Change is the end result of all true learning.”
~Leo Buscaglia
achievements
In 2011, St. Charles Health System was
named one of Thompson Reuters’ Top
50 health systems in the nation for quality
and efficiency for the third year running.
We are the only health system in the
Pacific Northwest to have achieved this
accomplishment for three consecutive years.
18
Sara Mosher was named Pediatric Nurse
of the Year for the state of Oregon by
the March of Dimes for her work as a St.
Charles NICU family advocate.
St. Charles Bend IMCU was awarded a
bronze Beacon Award from the American
Association of Critical Care Nurses.
The Oregon Association of Hospitals and
Health Systems named St. Charles Bend its
Leader in Innovative Excellence for its role
in helping to develop the Central Oregon
Health Council and a variety of health
improvement projects for the region.
Dr. Josh Cook was named Medical Director
of the year for TeamHealth’s Northwest
division for his exceptional leadership in
improving emergency care at Pioneer
Memorial Hospital.
The rate of tooth decay in Prineville K - 5
students has dropped to 29 percent
since 2008 thanks to the Crook County
Community Health Improvement Partnership’s
work to address dental health needs.
In 2011, we were proud to partner with
BendBroadband on its Vault, a new,
environmentally friendly datacenter. By
signing on as the anchor tenant, St. Charles
helped BendBroadband move forward with
the project and, ultimately, supported many
local businesses during the construction.
The St. Charles Health System Palliative
Care program received a $230,000 grant
from the Regence Foundation that will
help the program grow from focusing on
palliative care for inpatients to a broader
advanced illness management program for
the region.
St. Charles Redmond completed a remodel
of its Family Birthing Center and the
expansion of its Emergency Department.
St. Charles Bend has received the
American Heart Association/American
Stroke Association’s Get With The
Guidelines®–Stroke Silver Quality
Achievement Award. The award recognizes
St. Charles’ commitment and success in
implementing a higher standard of stroke
care by ensuring that stroke patients
receive treatment according to nationally
accepted standards and recommendations.
St. Charles Health System 2011 Annual Report
Tom Sayeg
Board Chairman
Dan Schuette
Vice Chairman
Knute Buehler, MD
Josh Cook, DO
Dennis Dempsey
Doug Downer
Megan Haase,
RN, FNP
Jill Hoggard-Green,
RN, PhD
Lauri Miller
Todd Taylor
Bob Hakala, MD
Jim Diegel
President and CEO
St. Charles
19
NONPROFIT
ORGANIZATION
US POSTAGE
PAID
BEND OR
PERMIT NO 473
2500 NE NEFF ROAD bend, or 97701
www.stcharleshealthcare.org