Parker Adventist Hospital 2012 Community Health Needs Assessment Parker Adventist Hospital Community Health Needs Assessment 2012 1 TABLE OF CONTENTS 1 INTRODUCTION.............................................................................................................................................. 3 1a Brief description of hospital, history and services provided .................................................................... 3 1b Mission statement, vision andalues ......................................................................................................... 6 1c Organizational commitment to community benefit ................................................................................. 7 1d Commitment statement to the uninsured and underinsured .................................................................. 7 2 COMMUNITY HEALTH NEEDS ASSESSMENT .................................................................................................. 9 2a Community ............................................................................................................................................... 9 2a i Definition of community served by the hospital ............................................................................. 9 2a ii Demographics of the community .................................................................................................... 9 2a iii Uninsured persons, low-income persons, and minority groups .................................................... 11 2b Data collection ........................................................................................................................................ 17 2b i Process used to gather data .......................................................................................................... 17 2b ii Information gaps ............................................................................................................................ 18 2c Health needs of the community ............................................................................................................. 18 2c i Process to identify and prioritize needs ................................................................................................ 18 2c ii Prioritized list and description of community health needs .......................................................... 19 2c iii Healthcare resources available in the community to meet the needs .......................................... 21 3 CONTACT INFORMATION ............................................................................................................................. 22 Attachment A: CHNA Priorization Guide ......................................................................................................... 23 Parker Adventist Hospital Community Health Needs Assessment 2012 2 1 INTRODUCTION 1A BRIEF DESCRIPTION OF HOSPITAL, HISTORY AND SERVICES PROVIDED Parker Adventist Hospital, located at E-470 and Parker Road, opened in 2004. Parker Adventist Hospital is sponsored by the Adventist Health System and is connected to Centura Health, Colorado’s health care leader, and its integrated statewide network of 13 hospitals, seven senior living communities, medical clinics, affiliated partner hospitals, Flight For Life® Colorado, and home care and hospice services. Parker Hospital has 134 licensed beds, including six pediatric beds licensed by The Children’s Hospital. Distinctive Services The Hospital provides leading medical experts, cutting edge technology and a broad array of clinical services. Its distinctive services are listed below. • “Emergency Department with Level III trauma designation • Cardiovascular Services with Cath Lab • The BirthPlace with a Level IIIa NICU caring for babies born as early as 28 weeks. More than 9,385 babies have been born at Parker Hospital's BirthPlace, and features private rooms, 24-hour in-house anesthesiology coverage and a neonatal intensive care unit with 24-hour coverage by neonatal nurse practitioners from The Children's Hospital • Neurosurgery program providing diagnostic, consultative and therapeutic services for treatment of routine and complex disorders of the brain and spine • Comprehensive total joint replacement program with a special pre and post surgical rehabilitation program and a unique pain management protocol • Comprehensive breast services including digital mammography, breast ultrasound, MRI guided biopsy, and stereotactic biopsy in The Trio Breast Center • Stroke program with 24/7 neurology and neurosurgery coverage, education, rehabilitation, and prevention programs. • Bariatric weight loss surgery performed using minimally invasive techniques Parker Adventist Hospital Community Health Needs Assessment 2012 3 • Outpatient Imaging Services including MRI, CT, ultrasound, diagnostic x-ray and PET/CT • A special pediatric wing offered in collaboration with The Children's Hospital, including emergency, specialty and inpatient care for kids • Rehabilitation services include inpatient and outpatient physical, occupational and speech therapy • Sleep Disorders Center that treats more than 70 distinct sleep disorders • Anorectal Physiology Lab offers comprehensive diagnostic testing that provides important information about the function and anatomy of the anus and rectum • Operating rooms with computerized access to radiology images and capability for minimally invasive surgery”1 Community and Patient Resources • “Parker ASK-A-NURSE®, offers free health information and physician referrals: 303-777-NURSE (6877) • CarePages at www.parkerhospital.org offers a free personalized Web page to help family and friends communicate during hospitalization and recovery. • That's My Baby online nursery at www.parkerhospital.org allows family and friends to see photos of your newborn. • The Parker Hospital Foundation supports the important work of the hospital.”2 Awards and Honors Parker Hospital is committed to excellence in health care. Ranked among the top hospitals in the nation for patient satisfaction, Parker Adventist Hospital has received many awards: • “Parker Adventist Hospital is recognized for consistently delivering evidence-based, quality care for Bariatric Institutes of Quality. • Parker Adventist Hospital was named in The Denver Post’s Top 100 Workplaces in 2012! Parker was awarded 7th in the large company category and was one of only two Colorado hospitals that received this designation. • The Bariatric & Metabolic Center of Colorado at Parker Adventist Hospital has been designated as a Bariatric Surgery Center of Excellence by the American Society for Metabolic and Bariatric Surgery. • The readers of Colorado Parent Magazine voted Parker Adventist Hospital as one of the top five hospitals in Denver in the 2011 Family Favorites edition. Top 5 in Colorado Parent Magazine! • Parker Adventist Hospital has received American College of Radiology (ACR) accreditation for both Breast Ultrasound and Breast MRI. ACR accreditation is recognized as the gold standard in medical imaging. Both of these certificates affirm our commitment to providing the highest level of image quality and patient safety. 1 http://www.parkerhospital.org/body.cfm?id=16 2 http://www.parkerhospital.org/body.cfm?id=16 Parker Adventist Hospital Community Health Needs Assessment 2012 4 • Parker Adventist Hospital has been voted "Best of the Best" in the Parker Chronicle and Centennial Citizen newspapers in the Best Hospital category for 2011! Thank you for this wonderful recognition and for the honor to serve our incredible community! • Parker Adventist Hospital was recently awarded the 2011 annual Patient Satisfaction Award from the Get Well Network in Washington DC! The Interactive Patient Care Award for Patient Satisfaction formally recognizes one facility that has demonstrated the greatest measurable impact on patient satisfaction through interactive patient care and a commitment to patient engagement throughout the care process. Parker beat out eight other hospitals across the country for the top honors! • The American Heart Association proudly recognizes Parker Adventist Hospital as a Get With The Guidelines - Heart Failure Gold Performance Achievement Award Hospital for 2011. This award highlights Parker's achievement of a consecutive 12 month interval of 85% or higher adherence to all "Get With The Guidelines" Heart Failure Performance Achievement Indicators to improve quality of patient care and outcomes. • The Stroke Program at Parker Adventist Hospital is a Primary Stroke Center with the Joint Commission Seal of Approval for exceptional stroke care. Our program uses a multi-disciplinary approach that provides stroke treatment according to nationally accepted standards and recommendations. Parker's program is proud to participate in the American Stroke Association's "Get with the Guidelines" treatment protocols. Stroke patients taken to hospitals that follow these guidelines had a better chance of survival than patients taken elsewhere, according to a study published in February 2010. • The Trio Breast Center at Parker Adventist Hospital has received the "gold standard" in accreditation for breast centers nationally. After a recent survey, the National Accreditation Program for Breast Centers (NAPBC), which is administered by the American College of Surgeons, granted the three-year full accreditation designation to Parker's breast program. This accreditation means that women in the Parker and surrounding communities have access to a comprehensive breast cancer program that meets the highest standards in patient care, including offering the most current treatments to achieve the best possible outcomes as evidenced by medical research. • Parker Adventist Hospital is a recipient of the 2011 HealthGrades Outstanding Patient Experience Award™. This distinction recognizes hospitals for offering exemplary service to patients, and is only awarded to the top 10% of hospitals in the country. A recent survey found almost half of all patients say patient satisfaction ratings were an important factor in choosing their most recent hospital. Two thirds of patients who switched hospitals say they changed because of bad service. • Parker Adventist Hospital received the Healthstream Research 2009 Excellence Through Insight Awards for Overall Physician Satisfaction. • Parker Hospital received the bronze award for the 2009-2010 Flu Vaccination Challenge through Joint Commission Resources. The challenge is put in place to recognize hospitals that make important strides to improving patient quality care. (May 2010) • Parker Adventist Hospital was honored with the prestigious Cornerstone Award from the Parker Economic Development Council. The Cornerstone Award honors leaders in the Parker community who have shown a commitment to helping pioneer and nurture the growth and development of Parker. This award recognizes the highest level of civic and professional involvement in our community for deeds, vision, commitment and leadership that has helped set the course for Parker's present and future growth.”3 For more information about Parker Adventist Hospital, visit www.parkerhospital.org. 3 http://www.parkerhospital.org/awards Parker Adventist Hospital Community Health Needs Assessment 2012 5 1B MISSION STATEMENT, VISION ANDALUES Our Mission: We extend the healing ministry of Christ by caring for those who are ill and by nurturing the health of the people in our communities. Our Vision: To fulfill a covenant of caring for our communities to become their partner for life. Our Core Values: Compassion- In serving our customers, their families and each other, we will: Honor the individuality of each person; o Treat each person with dignity, taking the time to be present, to listen, to explain and to o understand; Create a caring environment that exudes humanity, humility, grace and love. o Respect- In working with each other, we will: Encourage and value the contributions of each person, and make each feel supported, reassured o and empowered; Listen well, communicate openly and honestly, and encourage others to do the same; o Treat others as we would like to be treated ourselves, relating so well with them that they actively o seek to associate with us. Integrity- In all of our interactions, we will: Foster trust by being truthful, empathetic and consistent; o Be authentic and courageous, aligning what we are thinking, saying, feeling, and doing; o Be responsible for and follow through on the commitments we make. o Spirituality- In honoring the missions, ministries, and heritages of our Catholic and our Adventist sponsors, we will: Add meaning and purpose to the lives of our associates, physicians, and partners; o Celebrate the role of spirituality in healing for each individual; o Serve each other and our communities in harmony with the inclusiveness, wholeness and touch o that characterized Christ's healing ministry. Stewardship- In managing the natural, human, and financial resources to which we have been entrusted, we will: Seek ways to appropriately utilize resources, allowing us to become more effective and productive; o Act responsibly, taking only those actions that align with our mission; o Be accountable to the organization and to each other for our actions and the outcomes they o produce. Imagination- In seeking to grow our ministry, we will: Look beyond the challenges of the present and envision what is possible; o Cultivate and reward innovation and risk taking; o Embrace continuous learning and positive technological advancement. o Excellence- In all we do, we will: Put forth our personal and professional best, providing the highest quality of care of which we are o capable; Commit ourselves to continuous improvement, seeking to set the recognized performance o standards within our industry; Parker Adventist Hospital Community Health Needs Assessment 2012 6 Deliver a superior experience for all of our customers, sensing their needs and exceeding their o expectations. 1C ORGANIZATIONAL COMMITMENT TO COMMUNITY BENEFIT Colorado’s needs are growing. To live our mission in an economy that challenges more people than ever before, Centura Health continues to lead the way in helping Coloradans access quality health care. The connected network of facilities, entities and foundations that form the Centura Health family are serving community needs through education, preventive care, safety initiatives, health advocacy, counseling and support groups. Our work in our communities is born out of the second part of our mission, which compels us to serve others “…by nurturing the health of our communities.” From access for the uninsured, to serving as a voice for health care in the state legislature, to community classes and education to build strong, healthy communities, Centura Health is a partner for life. We are more committed than ever before to making our world a better place, and we seek to make the most impact in every community we touch. Parker Adventist Hospital provided $20,352,456 in total community benefit in fiscal year 2012.4 1D COMMITMENT STATEMENT TO THE UNINSURED AND UNDERINSURED According to Centura.org, more than 700,000 Coloradans are without health insurance and, as a result, growing numbers are facing difficulties paying for medical care. Centura Health believes that hospitals should have the ability to offer discounts to those who are unable to obtain insurance and do not meet charity care criteria. It is the policy of Centura Health to provide uninsured patients with discounted rates for all hospital bills. The discount is applied to all hospital inpatient, outpatient and Emergency Room bills that have been screened and do not have third-party insurance, Medicare, Medicaid, Champus, or other governmental payer programs and do not meet the Centura charity guidelines. Centura Health strives to compassionately serve uninsured patients with an understanding of the financial burdens they may face. Centura supports and advocates for meaningful and appropriate changes in legislation that improve access to affordable, quality medical care for the uninsured. Centura Health will treat uninsured patients in the following manner: Uninsured patients will be treated fairly and with respect during and after treatment, regardless of their ability to pay. Uninsured patients will be provided with financial counseling, including assistance applying for local, state and federal health care programs such as Medicare, Medicaid and the Colorado Indigent Care Program. Uninsured patients will be informed of and assisted in applying for charity care available through Centura Health as appropriate. Centura Health utilizes a charity discount schedule that takes into account state or federal poverty guidelines to aid in the qualification of patients seeking assistance in meeting their financial obligations. 4 Source: Jaime Contreras, Rocky Mountain Group Accounting, April, 2013 Parker Adventist Hospital Community Health Needs Assessment 2012 7 Financial counselors will attempt to meet with all uninsured patients prior to discharge from the hospital. Financial counselors will use best efforts to personally contact uninsured patients before any collection activities are initiated. Uninsured patients that do not qualify for assistance will receive a 30 percent discount off billed charges. This will automatically be adjusted during the billing process, so that all statements and collection efforts will be based on the discounted amount. Centura will also offer an additional 15 percent Prompt Pay Discount for accounts paid in full within 60 days of receiving the first statement of patient liability. If at any point an alternative payment source is identified, all discounts stated in this policy will be reversed. A call center is available so that patients may speak to an individual who can help them with questions on their bills; the call center phone number is prominently displayed on all billing correspondence. Hospital-based physicians and related entities will be encouraged to follow the Centura Health Principles Regarding Uninsured Patients but this is done at their discretion. Centura Health will not engage in the following activities: Centura Health will not pursue legal action for nonpayment of hospital bills against any patient who has worked with Centura to demonstrate his or her inability to pay and who is unemployed or otherwise financially unable to pay. Centura Health will not pursue legal action for nonpayment if the only way to collect payment would be to place a lien on the patient's home. Centura Health always has distinguished itself from other hospitals and systems in its treatment of the uninsured: Centura Health hospitals will continue to treat patients in their emergency rooms without regard to the patient's ability to pay. All patients will continue to be triaged and treated as appropriate. Centura Health has provided numerous outreach programs to the community in its pursuit of healthy communities and constantly seeks opportunities to advance its health care ministry. It is not the practice of Centura Health to place a lien on a patient's home when it is the patient's only asset. Centura Health will continue to work for increased access and coverage for the uninsured through legislative and community activity. It is the practice of Centura Health not to pursue legal action for nonpayment unless it has first examined the patient's eligibility for other assistance or charity care. Parker Adventist Hospital Community Health Needs Assessment 2012 8 2 COMMUNITY HEALTH NEEDS ASSESSMENT 2A COMMUNITY 2A I DEFINITION OF COMMUNITY SERVED BY THE HOSPITAL To ensure alignment with publicly available Colorado Department of Public Health and Environment (CDPHE) data, Centura Health leaders decided that Colorado counties would comprise the geographic area for the 2012 Community Health Needs Assessment (CHNA). Individual Centura hospital facilities then examined their primary market areas and identified Colorado counties where at least 10% of their patient population resided. The counties identified by each facility comprise the “Primary Service Area” used in the data reports. The Primary Service Area for Parker Adventist Hospital includes Arapahoe and Douglas Counties. Arapahoe County Douglas County 2A II DEMOGRAPHICS OF THE COMMUNITY The demographics in Parker Adventist Hospital‘s primary service area are categorized by Douglas and Arapahoe Counties. Additional information on Jefferson and Denver Counties is included in this section since those counties are part of the Centura Health South Denver Operating Group. However, the information on these additional counties is for comparison purposes only and is not intended to be part of Parker Hospital’s primary service area. Within the South Denver Operating Group, Denver is the most populous county, followed closely by Arapahoe and Jefferson Counties. Douglas is the smallest county of the group. In the past decade, Douglas County experienced the most growth of all counties in the Centura Health network. Fueling the growth in Douglas County is the large number of young families moving and settling into the county. The population under 5 years of age will keep Douglas County growing for a long time. Arapahoe County is not far behind with the growth in its young population. These counties have the greatest need for pediatric, family practice and obstetrical services both now and in the future. Counties with the highest percentage of residents over age 65 are in Jefferson County, which surpasses the state average. Hospitals serving these populations have a larger proportion of their patient populations requiring services for chronic disease and the more expensive cancer and cardiovascular services. Douglas County has the lowest percentage of seniors. Parker Adventist Hospital Community Health Needs Assessment 2012 9 The population in every county is predominantly of White race, which includes Hispanics self-identifying White race on the 2010 census. Douglas and Jefferson Counties have the largest percentage of White populations. People reporting two or more races are prevalent in many counties, too. The populated urban counties of Arapahoe and Denver have the largest percentage of Black residents. Arapahoe, Douglas and Denver Counties all have Asian populations that are greater than the state average. The largest populations of Hispanic residents are found in Denver County, which exceeds the state average. Douglas, Jefferson and Arapahoe all have rates below the state average. Many of the counties that have large Hispanic populations also have large populations that speak languages other than English in their homes. Denver and Arapahoe Counties have the largest bilingual and/or non-English speaking populations. Hospitals serving these populations need to make sure that their communications methods and materials are in Spanish (the most likely language). Douglas and Jefferson are lower than the state average. Douglas County has the highest level of education among the South Denver Operating Group. The most highly educated populations are located near economic centers that require a highly skilled workforce. Denver County has the smallest percentage of high school graduates. Coloradans with the highest median household incomes reside in Douglas County, followed by Jefferson County. Denver County’s median income is lower than the state rate. Arapahoe County’s rate is close to the state average. Many counties reporting high income levels also have high education levels, as reported previously. Many counties reporting high incomes also have high housing costs, such as Douglas County. Jefferson County exceeds the state average, while Arapahoe and Denver are close to the state rate. Housing costs are highest in areas with robust employment. Denver County’s unemployment rate is higher than the state average. Douglas County has the lowest unemployment rate in the South Denver Operating Group. Jefferson and Arapahoe have rates that are close to the state’s rate. In 2009, Denver County had one of the highest poverty levels in the state. Many of the counties with higher poverty levels also tend to have higher numbers of elderly, diverse races and ethnicity, and lower education levels. Douglas and Jefferson Counties have poverty levels much lower than the state average. Arapahoe County’s rate is close to the state rate. Poverty is frequently high within single parent households, in which the parents have low education levels, are foreign born, and are unemployed. When examining counties that have the highest proportion of female households with children and no husbands present, Arapahoe County exceeds the state rate, while Denver County is close to the state average. Douglas and Jefferson Counties have rates lower than the state. Parker Adventist Hospital Community Health Needs Assessment 2012 10