Fall Newsletter 2016/Community Benefit Report 2015


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Quarterly La Paz Regional Hospital Newsletter

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Spring 2016 Health Matters A LA PAZ REGIONAL HOSPITAL NEWSLETTER Featuring our 2015 Community Benefit Report To subscribe to our newsletter via email, visit our website! www.lapazhospital.org


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Dear Reader, This issue is dedicated to updating you on the progress we have made in delivering quality care to our communities. La Paz Regional Hospital is committed to improving the overall health status of our community, and specifically, the health problems of medically underserved populations. In the following pages we have listed some of our top priorities for the hospital and our medical clinics located in Bouse, Parker, Quartzsite and Salome. We have developed these priorities by identifying existing and future health needs in the communities we serve. We address these needs through new or existing health initiatives including education, prevention and screening programs. Our mission at La Paz Regional Hospital is serving you, and ensuring that we meed your health care needs. Sincerely, Norm Simpson Chairman of the Board Cardiac Rehab Cardiology/Echo Colonoscopy Endoscopy General Surgery Gym Services offered at La Paz Regional Infusion/Chemotherapy Laboratory Mammography Medical Surgical MRI/MRA Nuclear Medicine Orthopedics Physical Therapy Radiology/Ultrasound Respiratory/Cardiopulmonary Skilled Nursing Program Telestroke with Mayo Clinic La Paz Regional Clinics La Paz Healthcare: Parker Clinic 601 W. Riverside Dr. Parker, Arizona 928-669-5550 Parker Podiatry 1713 Kofa Ave. Suite K Parker, Arizona 928-669-3033 La Paz Medical Services 150 Tyson Rd. Quartzsite, Arizona 928-927-8747 Tri-Vally Medical Center 38726 Harquahala Mine Rd. Salome, Arizona 928-859-3460 Bouse Clinic 44031 E. Plomosa Rd. Bouse, Arizona 928-851-2177 La Paz Regional Specialty Clinic Located at La Paz Regional Hospital 1200 West Mohave Rd. Parker, Arizona 85344 Cardiology - Fadi Atassi, M.D. Ear, Nose,Throat - Devin Cunning, M.D. General/Vascular - Abedon Saiz, M.D. Surgery Oncology - Paul O’Neill Orthopedics - Steven Anderson, D.O. John Lankenau, M.D. Theron Tilgner, D.O. Rheumatology/ - Summer Tilgner, D.N.P. Orthopedic 669-5482 486-3650 453-2900 854-4497 854-3333 453-2211 854-3333 854-5368 When you schedule your appointment, request to be seen closer to home at the La Paz Regional Specialty Clinic!


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Priority 1 Provide health and wellness education and emergency procedure education to improve community health care working knowledge, 1understanding and ability. Community Outreach and Education La Paz Regional Hospital makes it a priority to ensure community members are receiving information that is vital to their health. In a small rural area such as ours, it is crucial that everyone has access to pertinent information and resources as easily as possible. To help with this need, La Paz Regional Hospital hired Melissa Wright as a Community Relations Liaison. Having a staff member that is dedicated to community outreach and education is essential to achieving this priority. LPRH designed and launched a new website to make navigating and finding information easier. A Facebook page has also been revitalized and now has nearly 500 followers. Both of these strategies have helped to engage the community in the health and wellness conversation. Regular health fairs are scheduled throughout the year for patients to receive preventative screenings and receive health education from the hospital as well as other community organizations who collaborate in these events. Attending community events throughout La Paz County has also helped to advance the hospital’s overall mission. Staff have been encouraged to do more outreach within their community and keep everyone updated on the services that are offered at the Hospital and Clinics. Staff Education There’s nothing like hands on experience when training to become a healthcare professional. La Paz Regional hospital works with Arizona Western College, Mohave Community College, Pima Medical Institute, Palo Verde College, Regional Center for Border Health and more, to provide internships and onsite training. In 2015, LPRH hosted 45 Radiology Techs, 5 Surgical Techs and 3 Physical Therapy Assistants. Flu Vaccinations Heather Ruiz, Angela Ramirez and Kevin Murphy attended the Palo Verde College Nursing Program and graduated in June, 2015. As Heather tells it, “I fell in love with patient care and my desire to make a difference in the way people receive care has always been important to me.” LPRH hosts regular education for La Paz County Emergency Medical Services staff. LPRH staff also receive Advanced Cardiovascular Life Support, Pediatric Advanced Life Support and CPR training twice a year. Marie Twyman, Lisa Hammack, Whitney Collett and Sylvia McGuire received a Trauma Nursing Certification. Teri Forbis, Rachael Taylor, and Jackie Switzer received ICU Critical Care Education. Zafer Genc, the new Director of Pharmacy, received Diabetes Empowerment Education Program training and received his certification in Psychiatric Medications and Anticoagulation Management. Emergency Preparedness Once a year, LPRH collaborates with other local area agencies such as Indian Health Services, La Paz County Emergency Preparedness Department, law enforcement agencies, River Medical, local fire departments and AMR to practice mock emergencies. The community drill allows agencies to practice People Served: 582 with a unified incident command. Each drill simulates a different type of incident, letting Wellness services provided: 5,500 agencies see what needs to be fixed and find the gaps are in responsiveness.


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Priority 2 Create and administer programs designed to reduce readmissions to less than 10% annually, using discharge planning and post-discharge 2communication as needed. Hospital Readmissions Reduction Back: Chris Robertson PTA, Alvin Rodgers PT, James Gates Front: Raven Leal, Diane Brown RN, Pam Brown PT Tech One of the best ways for communities to reduce healthcare costs quickly and improve patient care in the process is to implement initiatives to reduce hospital readmissions. This is why La Paz Regional Hospital has set a goal of reducing readmissions to less than 10% annually. For 2015, the readmissions Alicia Torres, RN rate was 5%. Strategies the hospital has implemented to reduce readmissions include: • Enhanced admission assessment of discharge needs • Formal assessment of risk of readmission • Accurate medication reconciliation at admission • Patient education • Identify primary caregiver, if not the patient, and include them in the discharge process • Use teach-back methods • Send discharge summary care plan to primary care provider within 24-48 hours • Collaborate with post-acute care such as the Skilled Nursing Program • Before discharge, schedule follow-up medical appointments • Conduct post-discharge follow-up calls within 48 hours. The length of time a patient stays in the hospital is not as long as it used to be. Medicare and insurance payers expect patients to be discharged as soon as they no longer need acute care. Patients who are receiving acute care are being monitored and cared for by nurses 24 hours a day. Just because a patient no longer needs acute care, does not mean they no longer need support and supervision. Skilled Nursing Program LPRH started the Skilled Nursing Program in late 2013 in recognition for enhanced discharge planning needs of at-risk patients. Since last year, LPRH has increased admissions to the Skilled Nursing Program by 25%. It is a valuable and quickly growing department. Skilled Nursing is a service provided by LPRH that is like a bridge from the hospital to your home. It gives patients time to heal and adjust after an acute illness before returning to everyday life. Patient Days: Patients hospitalized elsewhere can 2,921 transfer to our Skilled Nursing Program Skilled Nursing closer to home to reduce the need for Days: 683 traveling. Medicare patients can be eligible for this program.


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Priority 3 Increase access to primary and preventive care by recruiting needed primary and specialty physicians and 3working with local providers. The Medical Staff at La Paz Regional increased its active and consulting members in 2015. There are a total of 15 active physicians along with over 63 consulting. There are also 14 Emergency Department members and 5 Hospitalists. Steven Anderson, D.O. from Orthopedic Innovations, recently expanded to the Specialty Clinic here in Parker weekly. Dr. Dr. Steven Anderson Anderson specializes in total hip, knee and shoulder repair and complex reconstruction of ligaments, cartilage and tendons. Shawn O’Haver and Jani Herrel are both enrolled in Family Nurse Practitioner Programs and are to graduate the summer of 2016. LPRH supports and encourages locals to advance in their careers. Shawn O’Haver, RN Nephrologists from Arizona Kidney Disease & Hypertension Center can consult inpatients 365 days a year, 24/7 for the hospital. LPRH added infusion services to the many services the hospital already offers. The infusion staff are able to care for patients with a variety of medication needs, with qualifications to administer chemotherapy, antibiotics, fluids, injections, specialized medications and blood products. Two private rooms in the surgery building have been reserved to provide privacy and comfort. “Chemotherapy and infusion have been one of the board’s strategic goals for the last two years,” said Norm Simpson, Board Chairman. “Cancer patients see doctors in Phoenix, Yuma and Havasu. La Paz doesn’t have the population to support a full time oncologist, but bringing chemotherapy here is a big step. Our staff can coordinate chemotherapy with the patient’s doctor and save a lot of travel time.” Dr. O’Neill is the Medical Director for this department Rhonda Conlin, RN and is committed to the comfort and well-being of his patients. He coordinates services with a patient’s primary oncologist or hematologist. Rhonda Conlin, RN has over 7 years experience in oncology and will be handling the infusion cases that come to La Paz Regional Hospital. The Association of American Medical Colleges projects a shortage of more than 91,500 physicians by 2020, a number that is expected to grow to more than 130,600 by 2025. This shortage is distributed among primary care and medical specialties such as general surgery, cardiology and oncology. Because of this, LPRH has intensified its recruitment strategies. Maureen Walker has recently started at La Paz Medical Services in Quartzsite as a Certified Family Nurse Practitioner. Maureen has worked many years in the Emergency Department and is excited to join the clinics team. LPRH utilizes many online job recruiting sites, many of which are specialized for medical positions. LPRH also reaches out to physician colleges both in Arizona and beyond. Recruiting agencies have also been utilized, though this strategy has yielded the least results.


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Priority 4 Improve service integration and the continuum of care by assisting care providers and/or providing those 4services internally. Training was offered to key staff at the hospital from Press Ganey regarding Customer Service strategies. From this training a Customer Service Committee was formed and meets twice a month to address patient and staff needs. This group is working towards increasing the Hospital Consumer Assessment of Healthcare Providers and Systems survey scores for LPRH. The hospital continues to refer patients to the Chronic Disease Self-Management Program (CDSMP) offered through the La Paz County Health Department. Sponsored by the La Paz County Health Department, hospital case managers actively refer patients to this program to take charge of their health and work for maximum wellness. Our Case Managers are a significant referral source for the CDSMP. LPRH participates in the Healthy La Paz Chronic Disease monthly meetings to help address the many health needs of our community. La Paz County ranks #1 among all Arizona counties for both the most poor physical Physical health days among Therapy Treatments: 9,247 adults and for self-reported poor or fair health. Four workgroups were Clinic Visits: established to help 15,663 address these issues and the needs of the community: • Utilizing social media and digital platforms to create resource and partner lists • Community outreach and promotion of community events • Create and maintain a referral system • Implementing healthy community designs Referrals are also made to the Ashline which is a State-sponsored tobacco cessation assistance program. Hospital and Clinic staff encourage tobacco users to enroll in the AshLine program and refer interested parties to the La Paz County Health Department for support. LPRH Telestroke Program through Mayo Clinic has been running since 2012. Last year, LPRH was awarded a Community Reinvestment Grant for telemedicine and plans to offer telebehavioral health in the Emergency Department and our Clinics. Francis Kennedy has worked at La Paz Regional for 11 years as a Clinic Representative and is now our new Clinics Coordinator. She splits her time between La Paz Medical Services in Quartzsite, Tri-Valley Medical Center in Salome and the Bouse Clinic. She originally started working in the healthcare profession because she wanted to help Francis Kennedy, LPRH people on a daily basis. Clinics Coordinator Follow us on Facebook at facebook.com/lapazregional


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Priority 5 Improve chronic disease management, including Chronic Obstructive Pulmonary Disease, Congestive 5Heart Failure, Cancer and Obesity. A chronic disease is one lasting three or more months, according to the U.S. National Center for Health Statistics. As many as half of all adults has one or more chronic health conditions and one in four adults had two or more chronic health conditions. The last health needs assessment shows that La Paz County has a high number of people with chronic disease including obesity, Chronic Obstructive Pulmonary Disease (COPD), congestive heart failure, diabetes and cancer. La Paz Regional has a number of programs that help address these issues and also work to educate staff and the community about prevention strategies, how to manage a chronic disease and overall awareness. This is a collaborative effort between LPRH and many other agencies such as the La Paz County Health Department. Maria Beckwith, Lab Tech Director of Pharmacy, Zafer Genc, received Diabetes Empowerment Education Program training to learn how to actively engage and educate newly diagnosed diabetic people and their families. This program trained Zafer to be a facilitator in diabetes education to help gain active participation among participants. La Paz Regional Hospital’s Cardiac Rehabilitation Program is patient driven. Your care is individualized based on your diagnosis, medication, current physical status and your physician’s recommendations. This past year our program has increased by 60%. Diane Brown, RN has implemented the following strategies to increase patient referrals to this program: Diane Brown, RN • Follow up with inpatient Cardiac Rehab nurse at St. Josephs Hospital in Phoenix. • Continue to keep in touch with AZ Heart in Phoenix for referrals. • Establish referral system with cardiac surgeons in Lake Havasu City. Patricia Reddicks is a Dietitian certified in Renal Nutrition. She is available for consults with patients and can consult with community members for private sessions with a referral from their Primary Care Physician. The Physical Therapy gym is open to the public and has increased its memberships by over 400%. Members are encouraged by staff to participate in the monthly challenges led by Chris Robertson, PTA. One example is the Plank Fitness Challenge. Planking times were taken throughout the month and the winner’s start time Lab increased from 1:04.4 to Tests: 121,555 3:53 by the end of the month! Both staff and community members Imaging Tests: 21,183 participated in these challenges. Cardiac Rehab Treatments: 875


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Community 2015 Benefit Report La Paz Regional Hospital & Clinics • Unpaid cost of Medicaid/AHCCCS ......................................... • Charity .................................................................................... • AHCCCS Hospital Assessment for AHCCS Expansion .......... $ 1,123,023 133,736 221,498 Charity and Other uncompensated Care .............................. $ • Health Professional Education ................................................ • Physician Recruitment ............................................................. • Health Fairs ............................................................................. • Community Education ............................................................. $ Community Benefit Activities at Cost ................................... $ 25,000 63,569 22,000 10,000 1,478,257 ______________ ______________ 120,569 2015 Total Community Benefit .............................................. Cost of Bad Debts/Accounts Not Paid ................................. $ $ 1,598,825 701,672 GRAND TOTAL ................................................................... $ 2,300,497 In addition, La Paz Regional contributed to our communities economic success with $10,277,171 payroll dollars and $1,038,349 in capital invested in property.



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