North Carolina Baptist Hospital
2006 Community Benefit Report
December 11, 2006
Medical Center Blvd.
Winston-Salem, NC 27157
Organization: North Carolina Baptist Hospital
Address: Medical Center Boulevard
Winston-Salem, NC 27157
Telephone: (336) 716-3089
Contact: H. Gregory Bray, Controller
For Fiscal Year Ending: June 30, 2006
1. Statement of organization’s mission and commitment to community health improvement.
See Attached
2. Describe geographic service area and target populations for community initiatives.
See Attached
3. How are the programs in which you are involved funded?
See Attached
4. Describe your methodology for determining community priorities and how you collaborate with others.
See Attached
5. List current community service programs sponsored or co-sponsored.
See Attached
(Exhibit A)
North Carolina Baptist Hospital
Community Improvement Plan
Executive Summary
1. Statement of organization’s missions and commitment to community health improvement:
NCBH’s involvement in community health initiatives has continued to increase as a result of our ongoing focus on improvement in community health status for the citizens of Forsyth County and the NCBH referral area. Our mission is:
Ø We excel at providing the highest quality specialized health care services in a manner that represents value to those we serve;
Ø We advance clinical standards of patient care through research and education programs and share our knowledge and expertise; and
Ø We support community health initiatives that enhance the health and wellness of all.
NCBH is committed to community health and has a division responsible for coordinating community activity.
The Hospital participates in an ever expanding number of community projects on a financial and in-kind basis. The in-kind participation may consist of board and committee participation, supplying meeting space at the Medical Center, administrative support, providing office equipment, printing and copying services.
2. Describe geographic service area and target populations forcommunity initiatives:
NCBH is a regional health care facility and referral center for the residents of northwestern North Carolina and southwestern Virginia. The Medical Center serves as a regional, national and international resource for medical education and biomedical research.
Many of NCBH’s community health initiatives are focused on the medically underserved populations of Forsyth County. An example of community health initiatives includes the Downtown Health Plaza, a primary care center which provides primary and preventive care to the citizens of Forsyth County. A second targeted area includes the counties of Davie and Yadkin, where NCBH, in cooperation with the Ronald McDonald Foundation, Yadkin County Health Department, and Davie County Health Department, established clinics for the underserved populations of those counties.
NCBH also targets populations based upon their ages. Best Health focuses on older members of the community and their specific areas of health care interest. School age children and their families are targeted via the Forsyth County School Health Alliance which provides mental health, nutritional, dental and other medical services. NCBH participates with a gift in kind to the Early Childhood Partnership or Smart Start, which funds early childhood education, child daycare and other programs to assist infants and children in preschool programs.
In addition, through our Community Health and Alliance for Health departments, NCBH works collaboratively with other providers throughout our service area to identify other opportunities to meet community health needs.
3. How are the programs in which you are involved funded?
In order to ensure the economic viability of NCBH, all external funding sources are pursued in support of our various community benefit initiatives, including governmental and private reimbursement, foundation grants and reasonable user fees when appropriate. Some of the outside funding organizations include: Forsyth County, Kate B. Reynolds Poor and Needy Trust, The Duke Endowment, SmartStart, United Way, Winston-Salem Foundation and Wachovia Bank.
In combination with all the above funding, NCBH uses internal resources in support of it Community Health initiatives.
4. Describe your methodology for determining community priorities and how you collaborate with others:
NCBH works and collaborates with a number of community organizations and resources in the establishment of community health initiatives and objectives. The primary source of cooperation exists with the Forsyth County Health Department and other area county health departments, which are required to perform a community health assessment every other year. Some of these assessments are very elaborate and identify targeted populations and diseases where community resources should be devoted. The Forsyth County Health Department, along with other community organizations, including NCBH, worked to form the Healthy Carolinians Coalition, whose primary purpose is identifying the community’s health needs and addressing those needs.
An additional collaboration, the Winston-Salem Foundation, United Way, Forsyth Medical Center, Forsyth County, Davie/Forsyth/Stokes Medical Society and NCBH have undertaken a study over the past year to determine the needs of the medically uninsured in Forsyth County. This was a year-long project in which all the stakeholders came together to address the primary care and maternity care needs in our community and how to best meet those needs in the future.
United Way Medically Uninsured Committee – In collaboration with the Davie/Forsyth/Stokes Medical Society, the United Way, the Winston-Salem Foundation, Forsyth County, and Forsyth Medical Center and NCBH have joined in an effort to study how best our community can meet the indigent care needs of those requiring primary, specialty and obstetrical medical care. The goal of the committee is to organize and develop a system whereby the medically uninsured will be able to gain access to healthcare when appropriate, rather than waiting for problems to become more complex and costly.
Forsyth HealthCare, Incorporated (FHC) was the result of this committee’s efforts. It is the most recent effort to address indigent care in Forsyth County, and is based on the Project Access model in Buncombe County, NC. FHC will focus on recruiting physicians and medical providers to equally divide indigent care among all providers.
NCBH supports numerous organizations within the community either financially or through active participation. Please see the attached description of activities. All of the organizations listed have a methodology for determining community priorities through the collaboration of multiple community organizations.
(Exhibit B)
North Carolina Medical Care Commission
Community Benefits Report
(Hospitals)
Organization: North Carolina Baptist Hospital
Address: Medical Center Boulevard
Winston-Salem, NC 27157
Telephone: (336) 716-3089
Contact: H. Gregory Bray, Controller
For Fiscal Year Ending: June 30, 2006
1. Cash Donations $281,796
2. In-Kind donations (estimated) 41,393
3. Non-billed services 2,118,848
(E.g.: free clinics, patient education, screenings, immunizations,health promotions, support groups, free outreach programs)
4. Subsidized Community Services 5,411,186
(Community Benefits expense “minus” offsetting revenues)
(E.g.: Preventive medicine, community wellness, Hospice,
Medication Assistance, Safe-Kids/Injury Prevention, mobile services)
5. Total Charity Care Cost 11,104,708
6. Non reimbursed cost of treating Medicare & Medicaid 37,088,194 Patients
7. Non reimbursed medical education and research costs 35,825,701
TOTAL $91,871,826
(Exhibit C)
NORTH CAROLINA BAPTIST HOSPITAL
TIN 56-0552787
FYE 6/30/06
Statement #6
North Carolina Baptist Hospital (Hospital) is an 821-bed teaching hospital that serves as a major regional care facility as well as a major referral center to the residents in northwestern North Carolina and southern Virginia. The Hospital, in combination with the Wake Forest University Health Sciences, forms the Wake Forest University Baptist Medical Center (Medical Center). Together this team makes up one of the major academic medical centers in the United States. The Medical Center serves as a regional, national, and international resource for medical education and biomedical research.
The Medical Center has 20 subsidiary or affiliate hospitals and conducts 87 satellite clinics throughout the region. It provides a continuum of care that includes primary care centers, outpatient rehabilitation, dialysis centers, home health care, and long-term nursing centers.
Although its primary service area is a 26-county region in northwestern North Carolina and southwest Virginia, the Medical Center in the past year has served patients from 91 North Carolina counties, 39 additional states and several foreign countries.
MISSION
North Carolina Baptist Hospital
Ø We excel at providing the highest quality specialized health care services in a manner that represents value to those we serve;
Ø We advance clinical standards of patient care through research and education programs and share our knowledge and expertise; and
Ø We support community health initiatives that enhance the health and wellness of all.
The Medical Center's component institutions carry out a joint mission of patient care, education, research, and community service. The partnership includes three major members: Wake Forest University Health Sciences, North Carolina Baptist Hospital, and Wake Forest University Physicians.
The comprehensive range of medical services offered include: the state’s only Level I Trauma Center for both children and adults, with approximately 80,000 emergency room visits last year. Centers of Excellence have also been established for the prevention, diagnosis, and treatment of health problems throughout life. These include one of the top comprehensive cancer centers in the nation, a highly acclaimed Eye Center, and the first Voice Center in North Carolina, the first center in the state for cleft palate and craniofacial deformities and a world-class Hypertension Center. The Women’s Health Center of Excellence was created to develop and evaluate state of the art women’s health programs for women and healthcare professionals. The Prostate Cancer Center of Excellence makes the Medical Center one of a handful of dedicated centers in the nation committed to the treatment of this disease.
The Medical Center boasts 149 of the more than 600 North Carolina physicians currently listed in “Best Doctors in America.” This database is compiled by asking more than 30,000 physicians throughout the United States to rate the clinical abilities of other physicians in their areas of specialization. Only those physicians who earn the consensus support of their peers are included. Also, 34 of the Medical Center’s doctors were listed among the nation’s finest in the latest edition of “America’s Top Doctors.” A total of 170 members of the Medical Center faculty served as editors or are on editorial boards of almost 350 journals or publications. A total of 81 faculty members were elected to serve as president or chair of major professional or scientific societies, 131 faculty members served as consultants to the National Institutes of Health and other federal agencies, and 98 faculty members received formal awards and/or recognition for excellence in teaching, research and/or clinical services. The Medical Center has consistently been ranked as one of “America’s Best Hospitals” in U.S. News & World Report. In 2005 the Medical Center ranked 36th nationally in cancer. The Medical Center’s ALS Center has been certified by the ALS National Association, making it one of 19 prestigious centers throughout the country recognized for excellence in caring for patients with amyotrophic lateral sclerosis, or Lou Gehrig’s disease. The Medical Center’s Brenner Children’s Hospital was named one of the top 30 best children’s hospitals in the nation in 2003 by Child magazine, based on criteria including survival rates, staff qualifications, nurse-to-patient ratios and comforts such as Child Life specialists.
The Medical Center has received two awards that demonstrate the excellence we strive to achieve. The first award, the “Magnet Recognition Award”, is the highest level of recognition for excellence that the American Nurses Credentialing Center can award to an organized nursing service. Institutions that receive the award are designated “Magnet Hospitals.” The term “magnet” is used to symbolize that members of the healthcare team as well as the consumers are drawn to a hospital that is committed to quality patient care. It is a prestigious award that reflects the interconnectedness of all departments within the institution. The Medical Center achieved Magnet Hospital Redesignation for the period 2003-2007. The Medical Center was the 14th hospital in the nation and the first in the Carolinas to achieve Magnet designation, as well as being the first hospital in the Carolinas to be redesignated as a Magnet Hospital. Redesignation signifies that continued commitment has been made to excellence in patient care, professional practice environment for nurses, and a multidisciplinary approach to patient care. The second award we have received is the “Consumer Choice Award” from the National Research Corporation, which we have won for six years straight. The Medical Center rated highest among all area hospitals on quality, reputation, and its medical and nursing staffs in a survey of consumers in Greensboro, High Point, and Winston-Salem. Seven of the 100 North Carolina nurses selected for 2005’s “Great 100” were from Baptist Hospital. The Medical Center’s patient satisfaction ratings put it in the 99th percentile of “peer” hospitals and in the 98th percentile of more than 800 hospitals of all sizes and types, a level of excellence that has been maintained since 2002.
The Medical Center offers outpatient and ambulatory surgery services along with many diagnostic, laboratory, and clinical treatment services. The Medical Center offers an air ambulance service, known as AirCare. AirCare serves 75 hospitals within 150 miles of Winston-Salem. It operates 24 hours a day and averages two flights daily. Since service began in 1986, more than 11,059 patients have been transported. The Medical Center operates two neonatal ambulances specially equipped for neonatal intensive care transport and the transport of children under four with severe respiratory infections or other critical medical conditions. In 2000, the Hospital added a critical care ground ambulance for the inter-hospital transfer of adult and pediatric patients that are critically ill. This ambulance is equipped to care for patients while being transported by ground. The ground ambulance has made 1,867 trips since the service began. In 2006, this service was expanded to two vehicles.
During the fiscal year ended June 30, 2006, the Hospital had a total of 34,625 admissions, 212,446 patient days, 132,466 outpatient visits, 79,958 emergency department visits, 11,437 inpatient surgical procedures, and 16,026 outpatient surgical procedures. For the same fiscal year end, the Hospital's average occupancy was 73.6%. To accomplish this, the Hospital employed an average of 6,767 full-time employees.
In 1998, North Carolina Baptist Hospital purchased a facility from Forsyth County that historically provided healthcare for the economically depressed and minority-based communities in our area. Ensuring that adequate healthcare continues in all segments of our community, a new 47,638 square foot building was constructed and equipped with state of the art medical technology. The new center called the Downtown Health Plaza, provides high quality healthcare to a countywide and demographically diverse community. The general health services include Obstetrics and Gynecology, pediatrics, adult medicine, and many other specialty services. The center also houses an eye center, dental clinic and pharmacy.
In 2004 the Hospital opened a state of the art Outpatient Comprehensive Cancer Center. This 257,350 square foot building consolidates all of the outpatient oncology services. This is one of the most advanced and complete cancer treatment facilities in the region and emphasizes our presence as a national leader in cancer patient care and research.
Educational Emphasis
The Hospital carries out part of the educational emphasis in the mission by providing and/or participating in several educational endeavors, which are outlined below.
The Nurse Anesthesia Program was established in 1942 as one of the professional schools at the Medical Center. In collaboration with the University of North Carolina in Greensboro, a Master of Science in Nursing (M.S.N.) Degree is offered with an anesthesia nursing concentration. Academic knowledge is correlated with applied practice experiences, and clinical training includes approximately 800 cases with more than 1,800 hours of clinical practicum experience. In addition to earning the M.S.N., the student who successfully completes the 24-month program is required to take the certification examination administered by the Council on Certification of Nurse Anesthetists in order to become a Certified Registered Nurse Anesthetist (C.R.N.A.). This is the oldest Nurse Anesthesia program in North Carolina and one of the oldest in the country. To date, over 561 individuals have completed this program.
The Medical Technology Program was also established in 1942 as one of the professional schools at the Medical Center. Since then, it has graduated over 790 medical technologists who serve in medical laboratories throughout the country. This 53 week long program is designed to train allied health professionals and to help them develop a theoretical knowledge base and learn practical skills in clinical laboratory science. The Program in Medical Technology is accredited by the Committee on Allied Health Education and Accreditation of the American Medical Association through review by the National Accrediting Agency for Clinical Laboratory Sciences. The program is affiliated with 10 area colleges and universities that offer a combined degree. Students enrolled in the combined degree program complete 3 years of a prescribed curriculum at the affiliated institution and 13 months at the Medical Center. Upon successful completion of the combined degree program, each student receives a baccalaureate degree from the affiliated institution and a medical technology certificate from the Medical Center.
The School of Pastoral Care at North Carolina Baptist Hospital recently celebrated 59 years of service. With its first graduating class in 1947, the School of Pastoral Care began providing services to patients at Baptist Hospital, as well as pastoral counseling services to the larger community. The Department of Chaplaincy and Pastoral Education, Division of Pastoral Care is accredited by the Association for Clinical Pastoral Education, Inc. (ACPE) to offer 3 levels of training for ministry professionals and qualified laypersons. Pastoral Care offers six different training sessions during the year and maintains 12 full-time residency positions. It provides hands-on education for ministers and seminarians from across the nation and abroad. Residents and interns are trained to offer both crisis and routine spiritual support to persons struggling with the events of illness and recovery. During the past five decades, more than 3,030 ministers were spiritually nourished and guided within the walls of this school. This department has become one of the largest training centers of its kind in the world. In addition to training for ministry, this department provides in-service education for medical staff, educational workshops for clergy and faith groups throughout North Carolina, and Virginia.
The Hospital supports 51 accredited doctor residency training programs, which employs 598 residents per year. These programs give doctors the additional education and experience they need to begin practicing independently. These residents are trained in their specialty under the supervision of doctors already trained and experienced in their field. These residency programs offer the team approach to patient care, which offers the patient a broader contribution of knowledge to their care.
The Hospital also participates in several training programs in connection with local colleges. Two examples of these are nursing and radiology. The Hospital Radiology staff participates in classroom lectures and labs as requested by Forsyth Technical Community College. The Hospital serves as one of the college’s clinical teaching facilities for Nursing and Imaging programs. Student clinical rotations provide “hands on patient care” experiences under the direction of experienced Nursing and Imaging faculty. A new collaborative partnership has begun with Winston Salem State University featuring an interactive clinical skills experience.
Charity Care and Bad Debt
NCBH continues to face the national and local crisis of the growing number of uninsured individuals. NCBH provides services without charge or at amounts less than its established rates, to patients who meet the criteria under NCBH’s Charity Care policy. The cost of charity care provided was approximately $11,104,708.
Non-Reimbursed Cost of Treating Medicare and Medicaid Patients
NCBH estimates the net unreimbursed cost of providing care to patients covered under the Medicare and Medicaid programs was $37,088,194 in fiscal year 2006.
Medical Education and Research
As a preeminent Academic Medical Center, NCBH invests in medical education and research initiatives. The hospital attracts residents and students into Winston-Salem from outside Forsyth County and the state of North Carolina. In fiscal year 2006, NCBH provided $35,825,701 of unreimbursed medical education and research costs.