2016 Community Service Plan

Transcription

1 2016 Community Service Plan 169 Riverside Drive Binghamton, NY

2 MESSAGE from the CEO Dear Friends, It was a pleasure to serve the community during Providing community benefit is an important part of our Mission. It represents a vital link to our community and neighbors. Our strength is in our history and Mission. As a leading health care provider, each year we provide millions of dollars in charity care & health education programs to our community. Lourdes is pleased to report to the community the services provided directly or in collaboration with community agencies during True to our Mission, Lourdes paid particular attention to those who are poor and vulnerable. These services addressed the community s health status priorities of obesity and associated chronic diseases, falls prevention among the elderly and mental health and substance use. In order to improve the health status of the community, Lourdes continues to take seriously our stewardship to provide access and coverage to quality health care services. Increasing access is in large part about removing barriers. One way in which Lourdes accomplished this was to take care out into the community in a very different way. We provided two Medical Mission s at Home, one in downtown Binghamton in collaboration with United Health Services where 131 were served; and one in Owego New York in collaboration with the Guthrie Health System where 89 persons of all ages received free medical care. Removing financial barriers to care also helps improve access to care. Lourdes tries to help with removing those financial barriers through the efforts of our financial counselors, the Hope Dispensary, and our charity care policies. This year alone, over 10,500 people were enrolled in the Lourdes financial assistance program; one hundred forty residents received assistance enrolling in an insurance plan through the Affordable Care Act; and nearly $1.1 million in prescriptions were given to people who would not have been able to receive prescriptions otherwise. In April 2016 Lourdes was approved to participate in a federal drug discount program called 340B which helps hospitals like Lourdes to serve rural communities and treat our most economically vulnerable citizens. Under the program, eligible hospitals receive pharmaceuticals at discounted prices from drug companies. The hospitals, in turn, use the savings incurred for community benefit. At Lourdes, savings from the 340B program helped us support the Lourdes Patient Financial Assistance Program, provide discounted and sometimes free medications for the needy, and fund services such as primary care, diabetes, heart and cancer. This year access to primary and specialty care was expanded through the hiring, or recruitment of sixteen providers, all of whom were critical to addressing community health priorities. We also welcomed the employment of a number of providers from Cardiology Associates, now known as Lourdes Cardiology. We took many steps to address the mental health crisis in our community by expanding mental health services, hiring additional mental health providers, providing suicide intervention skills training for caregivers, and expanding our pain and wellness services. Lourdes Binghamton Primary Care Practice located at Robinson Street was selected to be one of ten New York State pilots to integrate behavioral health in to primary care. Over 3,200 persons were screened. Thirty-two percent of those needing additional services were engaged with a behavioral health consultant. In 2016, Lourdes joined several community agencies and residents to launch its first sports injury and addiction prevention seminar in school systems. We are grateful to Senator Akshar, Yes Safe Choices, Broome County Opioid Abuse Council, area schools, and expert panel members for their commitment to this prevention work and look forward to continuing these programs in To address the falls prevention health priority, Lourdes provided beginner, seated, advanced and continuous tai chi classes, serving over 100 residents. Lourdes also certified 100% of Lourdes at Home physical therapists in a falls prevention program; and focused on falls prevention as part of Medicare wellness visits. Beyond the walls of Lourdes, our associates extended our ministry into the community by serving on community boards, participating in community awareness events, providing supplies to elementary schools and participating in food drives. I express my heart felt gratitude to them for living our Mission. Lourdes continued to be an active participant in transforming the Medicaid health care delivery system by working with more than 150 partner organizations. Lourdes associates are committed to participate in transformative work to manage our community s health. As the healthcare needs in our region continue to grow, we remain committed to transitioning our care model to support managing populations of patients. We look forward to continuing to partner with the community. Our relationships inspire us and make our community a stronger, healthier place to live. We invite you to join us as we continue to participate in furthering the healing ministry to which we ve been called. Kathryn Connerton President/CEO

3 Priorities for the Year During 2016, Lourdes collaborated with community agencies under the direction of the New York State Health Department and County Health Departments to identify and address public health issues and underlying causes and contributing factors to health status and chronic disease. This report to the Community demonstrates how Lourdes has continued to work over the last year to help the Greater Binghamton community in the following community health priority areas: CY 2016 Community Health Priorities Access to mental health and substance abuse. Falls Prevention with a focus on helping the elderly. Obesity prevention and managing associated chronic diseases with a focus on diabetes and reducing hospitalizations due to heart failure. The following chart provides an overview of some of the programs and services Lourdes offers that impact the community s health status. More information about these programs is available on our website at PROGRAM CY Community Health Priorities During CY 2016, Lourdes and the Broome County Health Department updated their respective Community Health Needs Assessment (CHNA) and Community Health Improvement Plan (CHIP). The community health status priorities that Lourdes will focus on during the next two years, paying special attention to the socioeconomic poor and vulnerable are: Obesity: Chronic Disease and Prevention & Wellness Behavioral Health: Mental Health and Substance Use In addition to these community priorities, Lourdes remains committed to addressing community needs in the areas of access to health care by increasing access to health care coverage and prescription drug medication, cardiovascular disease, falls prevention, maternal/child/adolescent health, and the frail & elderly. Community and professional outreach and education initiatives were designed to address health priorities. PERSONS SERVED Access To Healthcare Pharmaceutical Access Hope Dispensary Pharmacy Assistance Program Chemotherapy Patient Financial Assistance Program Discounted self-pay accounts 9,325 Facilitated Healthcare Coverage Enrollment LECCO (Lourdes Employee Charitable Contribution Organization) Total Donations 8 Community Agencies which assist with access to services and to persons in need Mobile Mammography Physician Referral Services/Call Center Medical Mission Community Outreach Over 1,000 persons (a 17% decrease) receiving over 1,400 prescriptions. A $320,184 value (a 4% decrease). 131 persons receiving over 400 prescriptions. A $774,586 value. 190 persons receiving a $2,275,222 value. 10,566 enrolled, a 39% increase from last year 1,547 screened with 91% enrolled in a health coverage program. 76% being enrolled in Medicaid or a Qualified Health Plan. $40,000 2,152 served 1,415 persons served 220 persons served, 2 Medical Missions 1 (continued on next page)

4 PROGRAM PERSONS SERVED Behavioral/Mental Health Lourdes Center for Mental Health Behavioral Health Integrated into a Primary Care Site Screenings Persons age with a PHQ-9 score of 10 and above engaged with a Behavioral Health Consultant Mental Health Juvenile Justice Project (MHJJ) Detention Alternative After School Program (DAASP) Binghamton Community and Schools Together (BCAST) Student Assistance Program (SAP) and Alcohol & Drug Education Prevention Team (ADEPT) Screening Brief Intervention & Referral to Treatment (SBIRT) Death from Overdose Recovery & Support Group (DORS) 15,327 visits, an 18% increase, and over 1,000 clients 3,260 screenings, one location 32% 50 clients served 29 clients served 209 clients served Persons served: 10,584 Units of service: 2,992 5 trainings, 37 associates 702 patients screened 28 participants Falls Prevention Home Health Over 56,000 visits with falls risk assessments Persons treated due to a fall 703 patients under age patients age 65+ Tai Chi for Arthritis Over 100 participants, 16 class series Frail & Elderly Hospice Volunteers Palliative Care 31,687 days of care 90 volunteers provided 6,425 volunteer hours; Drove over 37,000 miles to assist patients and families 2,295 consultations and visits Maternal/Child/Adolescent Health 2 DeMarillac Prenatal Program DePaul Pediatric Program Center for Oral Health Sealant Program School Based Sites Community Outreach and Oral Health Education Parents And Children Together (PACT) 3,120 visits 9,499 visits 5,062 patients and 16,147 visits 291 patients and 344 visits 13 sites; 599 patients and 1,017 visits 595 persons at 7 community events 333 families and 4,402 home visits

5 PROGRAM PERSONS SERVED Mission in Action (Community Outreach) School Supply (8 schools), Holiday Programs, Thanksgiving and other services Over 200 families served Community Education, Support Groups Over 2,000 Women s Health Celebration of Women outreach and education 225 attended Community Awareness Events Donations raised by Lourdes Associates & the Medical Staff (American Heart Association, American Cancer Society, Diabetes Walk, March of Dimes, Rescue Mission and other events) Over $51,000 in donations Obesity Prevention Bariatric Services Lourdes Primary Care Services Body Mass Index 94 surgeries 878 nutritional consults 96% children age 3 17 screened 94% adults age screened 85% adults age 65+ screened Preventing & Managing Chronic Disease Cancer Breast Cancer Screening Radiation Therapy Diabetes Newly diagnosed diabetics, Lourdes Primary Care Practices Diabetic and Pre-diabetic Screenings (A1C) Endocrinology Home Health Infectious Disease/Pneumonia Influenza Vaccines 28,854 screenings 2,152 mobile mammography Over 6,500 treatments ,301 14,674 visits, a 6% increase. 56,200 visits, a 14% increase. 12,288 community members Over 2,300 health care workers 3

6 Overview of Programs & Services 4 COMMITMENT TO COMMUNITY HEALTH STATUS Access to Health Care Increased Health Care Coverage Lourdes continues to make a significant impact on healthcare access and coverage to the uninsured and underinsured by our complement of Financial Counselors that are at various locations throughout the hospital and offsite locations. All counselors are CAC s (Certified Application Counselors) through the New York State of Health Marketplace. All Financial Counselors are able to assist individuals and families in enrollment in Affordable Care Act (ACA) plans, such as NYS Medicaid, Child Health Plus, Essential Plans, Qualified Health Plans, and the Lourdes Patient Financial Assistance Program. The number of persons enrolled in the Patient Financial Assistance program continues to see substantial increases which is in part due to the increase in percentage of assistance offered from 2015 to The Federal Poverty Level in 2015 ranged from 250% to 350% and changed to 250% to 400% as of July Those enrolled in the Lourdes Patient Financial Assistance Program (PFAP) grew 39% from 7,598 in 2015 to 10,566 in Financial Counselors are available at six locations throughout the Lourdes health care system: the Emergency Department, Hope Dispensary, Lourdes Vestal (Shippers Road), Lourdes Center for Oral Health, 303 Main Street, and the Business Center. Financial counselors provided enrollment services to the community through participation in two Medical Missions, located in Binghamton (Broome County) and Owego, New York (Tioga County). Service to the Poor and Vulnerable. Lourdes continues to be an active participant in transforming the Medicaid health care delivery system by working with more than 150 partner organizations. As part of this work, Lourdes associates worked to integrate behavioral health in to primary care, assist patients as they transition care settings, and help patients navigate the health system and address social determinates that impact their health, such as transportation. Lourdes received funding from Care Compass Network to implement in 2017, health coaches and navigators in the Emergency Room and to provide video conferencing for patients with depression. Additionally, Lourdes annual Diversity Fair focused on Welcoming our New Neighbors, providing education on how associates can engage diverse perspectives, human gifts, skills, experiences, and knowledge to better serve the community and patients with an emphasis on the poor and vulnerable. Increased Access to Primary Care, Prevention and Specialty Services Lourdes assisted the community in ensuring access to primary and specialty care by employing twenty-three providers specializing in cardiology, primary care, endocrinology, and vascular disease. All of the providers are important to improving the community s health status. Lourdes Center for Mental Health has continued to expand to address the need for mental health services in the community. The center served over 1,000 clients in The Lourdes Student Assistance Program (SAP) and Alcohol and Drug Education Prevention Team (ADEPT) served 2,992 Lourdes associates and local

7 community members on topics including Current Drug Trends, Adolescent Brain Development, Heroin and Prescription Drugs, Gambling and Opioid Overdose Prevention. Mobile Mammography. The Mission in Motion mobile mammography van provides services at 64 locations throughout the Broome, Chenango, Cortland, Delaware and Tioga counties. This year we extended our services through collaboration with community health providers creating local access to screening mammography services. We delivered no charge screening mammography services during three Medical Missions held within Broome and Tioga counties. We continue to focus on reaching into rural populations where transportation is not readily available. Palliative Care and Hospice. Lourdes provides the area s only palliative care services, and is the only hospice provider for Broome and Tioga county residents. Lourdes Hospice provided over 19,800 visits to Broome and Tioga Residents. Increased Access to Behavioral & Mental Health, Substance Abuse, and Maternal, Child and Adolescent Health Lourdes Youth Services provided services to atrisk adolescents through two programs in The Lourdes Mental Health Juvenile Justice Project (MHJJ) worked successfully to keep 100% of the youth served out of detention and out of home placement; while the Detention Alternative After School Program (DAASP) kept 94.5% of the youth served out of placement. This was accomplished by providing intensive counseling and case management as well as providing life skills enhancement groups for the participants. The Lourdes Detention Alternative After School Program (DAASP) provided services to 29 high risk youth during Of these youth, 94.5% were successfully kept out of non-secure detention facilities. The Lourdes DAASP program received additional funding from New York State Office of Children & Family Services (OCFS) to expand programming and add a family programming component to encourage continued success in keeping youth out of detention facilities. Lourdes Youth Services program was selected as one of nine community agencies nationwide, to receive $325,000 per year in Federal funding to implement programming geared toward reducing violence, increasing school engagement and performance, and improving health outcomes for minority youth. This grant is a collaborative effort between the City of Binghamton, Broome-Tioga BOCES and Lourdes Youth Services. The BCAST (Binghamton Community and Schools Together) program serves 45 youth (and their families) annually. Lourdes continued to (1) offer suicide intervention training programs in 2016: ASIST and SAFE Talk programs, associate training; and the Kognito suicide prevention training program for the medical staff; (2) lead a Lourdes specific Substance Abuse and Mental Health Task Force to better address community mental health and substance abuse needs; (3) administer suicide prevention screening in a Lourdes Pediatric practice and (4) provide inpatient and emergency department screening for alcohol and substance abuse. Over 700 persons received SBIRT services (Screening, Brief Intervention & Referral to Treatment). SBIRT screening was also provided in the Palliative care outpatient setting. During 2016 Lourdes Binghamton Primary Care Practice located at Robinson Street was selected to be one of ten New York State Pilots to integrate behavioral health in to primary care. Over 3,200 persons were screened. Thirty-two percent of those needing additional services were engaged with a behavioral health consultant. Due to the success of this prevention and wellness care delivery model, Lourdes will be expanding services into additional primary care locations in

8 6 Increased Access to Prescription Drug Medication In April 2016 Lourdes was approved to participate in a federal drug discount program called 340B which helps hospitals like Lourdes to serve rural communities and treat our most economically vulnerable citizens. Under the program, eligible hospitals receive pharmaceuticals at discounted prices from drug companies. The hospitals, in turn, use the savings incurred for community benefit. At Lourdes, savings from the 340B program helped us support the Lourdes Patient Financial Assistance Program, provide discounted and sometimes free medications for the needy, and fund services such as primary care, diabetes, heart and cancer. Lourdes continued to increase Pharmaceutical Access in the community through the Dispensary of Hope of the Southern Tier. Together with Pharmacy Assistance Programs, Lourdes served over 1,100 persons, filling over 1,800 prescriptions, which resulted in over $1,000,000 in free pharmaceuticals to the community. Access to Chronic Disease Prevention Cardiovascular Disease Awareness and Prevention Education is provided to the public on ways to reduce the risk of cardiovascular disease, early identification of these diseases and how to manage symptoms associated with cardiovascular disease in order to maintain a quality life. Through activities such as participating with the American Heart Association, Lourdes increases community awareness of heart disease prevention. The Cardiovascular Disease Managers at Lourdes coordinate T-Time, a support group for patients with Heart Failure and their caregivers. The program is offered to the public every other month at no charge. Topics have included: healthy eating at the holidays, understanding your medications, coping with chronic disease and many more. These sessions are often led by guest speakers. Fit Friendly Lourdes was welcomed by the American Heart Association to the Fit-Friendly Company Recognition Program and received Gold Fit status. The program recognizes employers who champion the health of their employees by creating healthy eating options and physical activity programs within the work place, such as implementing the Step it Up Fitness Challenge. Obesity Prevention Obesity Prevention, and the treatment of associated chronic diseases such as diabetes and cardiovascular disease is provided throughout the Lourdes system, including primary care, endocrinology, the Lourdes Diabetes Center, and Lourdes Bariatric Surgery Program at Lourdes Riverside Surgical. Lourdes Registered Dieticians are integrated into three Lourdes Primary Care locations. Diabetes Education. Thirty-five providers participated in a professional teaching day, with thirty receiving advanced nursing accreditation. During the year advanced education was provided on durable A1C results throughout the Lourdes Ascension Medical Group locations, and in various nursing forums, resulting in earlier identification of at-risk persons and improved outcomes. There was also a concentrated effort to educate and implement processes on hypoglycemia identification, treatment and inpatient alerts for severe hypoglycemia. Fit and Fun Meals provided at the Lourdes All Spice Café contain a moderate amount of fat, cholesterol, and sodium. Fit meals include a

9 delicious variety of entrees and sides. An Action Station, offers a variety of fresh ingredients, from which health meal options are made while people wait. Superfood of the Month nutritional benefits and recipes is featured in the cafeteria and on the Lourdes Facebook page. Newborn and Pediatric health. Supporting a healthy start for newborns, patients are encouraged to breast feed, as evidenced by an 80% breastfeeding initiation rate. Lourdes is a NYS Department of Health New Beginnings Hospital, and provides lactation and nutritional consultations. Cancer Prevention Lourdes Regional Cancer Center provided outreach and education information for breast, cervical and colorectal cancer through the Cancer Services Program, community health fairs and events, and support groups. In 2016, Lourdes expanded several cancer screening programs around lung cancer, colorectal cancer, and breast cancer. In an effort to prevent lung cancer, Lourdes also provided smoking cessation classes throughout the year. Lourdes associates continued a strong presence and participation in Relay for Life and Making Strides Against Breast Cancer as other ways to increase overall awareness and fundraising around Cancer. Lourdes completed its 10th year of CAMP HOPE for KIDS to help children learn to cope with their loss of a loved one to cancer. Initiatives taken by Lourdes to achieve the NYS Department of Health prevention agenda items to increase access to cancer prevention services included: maintaining National Accreditation Program for Breast Centers (NAPBC) for the Mobile Mammography program and the Lourdes Breast Center; providing 2,152 mammograms to rural populations across 64 locations. NAPBC accreditation demonstrates a firm commitment by Lourdes to offer patients every significant advantage in their battle against breast disease. As a NAPBC accredited center, Lourdes commits to ensure patients will have access to comprehensive care, a multi-disciplinary team approach to coordinate the best treatment options, and information about on-going clinical trials and new treatment options. In August 2016 Lourdes became a certified member of the MD Anderson Cancer Network, a program of MD Anderson Cancer Center. The affiliation provides Lourdes Regional Cancer Center s certified physicians with access to MD Anderson s world-renowned expertise, offering patients enhanced cancer care close to home. Commitment to Health Care that is Safe Lourdes is committed to providing quality care to everyone we serve. By instituting a number of quality improvement initiatives, Lourdes continues to offer improved community health status. Cardiovascular Disease Cardiovascular disease, including stroke and heart failure, remains a significant health concern locally and nationally. Lourdes commitment to improving 7

10 8 community health status around stroke care is evidenced by maintaining its New York State Health Department Stroke Center designation. Lourdes has maintained its Gold Plus award from Get With the Guidelines for exceptional care in the management of patients that present to Lourdes with symptoms of stroke. The award recognizes efficient processes, evidence based care through a multidisciplinary team approach and quality outcomes. COACH (Coordinated Outreach Achieving Community Health) for Heart Failure is a multidisciplinary team that spans the healthcare continuum to improve the coordination of care for this patient population. COACH provides services to patients in the acute care settings, in homes, in primary care and specialty practices. The focus of the program is engagement of persons with heart failure and their caregivers in the management of their chronic disease. Early intervention leads to extended wellness in the community. The program has had success in reducing the readmission rate for these patients. COACH for COPD has also been implemented. Lourdes will be applying the same principles to other diseases. Falls Prevention The need to prevent falls in the community is evident by nearly 3,500 persons visiting Lourdes walk-in s or emergency room upon experiencing a fall. Ways in which Lourdes helps to prevent falls include: Tai Chi for Arthritis. Lourdes is participating in a Broome County-wide initiative to reduce community falls. One evidence-based intervention for falls reduction is Tai Chi. Tai Chi is a low impact exercise program that integrates mind and body through meditative movement, to help improve balance and mobility and reduce pain. Participants commit to completing two one hour classes per week for 8 weeks and to practice what they learn between classes. In 2016, beginner, advanced, and seated tai chi classes were available. Physical Therapy. Lourdes at Home physical therapy staff incorporate fall prevention education along with specific strengthening and balance activities in nearly all ambulatory patients visits to help decrease falls. Lourdes at Home participated in Broome County s National Fall Prevention Awareness Day providing information to the community at the Johnson City YMCA. Lourdes provided over 56,000 home health visits in 2016, assessing falls risk at every visit. Lourdes Physical Therapy provides comprehensive evaluation and treatment of balance and vestibular disorders. Highly trained staff are skilled at helping people prevent falls. Persons who may benefit from balance or vestibular treatment are those who experience balance deficits due to generalized weakness, light headedness, vertigo (spinning sensation) with or without nausea, difficulty walking in visually busy environments or on uneven surfaces, post joint replacement, post fracture or sprains, post stroke, neurologic diagnoses such as multiple sclerosis or Parkinson s disease, malnutrition, and medication side-effects. Joint Academy patients are encouraged to attend Lourdes Pre-op Education class where patients and family members learn about safety in the home including proper use of assistive devices and simple modifications of the home setting such as installing railings, widening pathways, and removing throw rugs. In 2016, Lourdes began collaborating with the YMCA in a pre and post rehabilitation program for patients undergoing joint replacement surgery.

11 Vestibular Therapy is offered at all 4 outpatient locations in Binghamton, Endwell, and Vestal. Primary Care. Falls prevention screenings are performed as part of the Medicare primary care wellness visits, and on patients identified by their provider to be at risk for a fall. Retail Pharmacy & Medication Management. Pharmacists discuss falls prevention with patients as part of their visit to the pharmacy. Whether filling a new prescription that has a fall risk to it or refilling other prescriptions, our pharmacists are aware of falls risk criteria and utilize that while communicating to patients about their prescription use. Occupational Health. Lourdes focuses on creating a safe work environment to prevent associate injury due to slips, trips and falls. On-going communication and guidance is provided through Occupational Health services, known as Employer Solutions, to Lourdes and area businesses on appropriate footwear and body mechanics. Frail & Elderly Lourdes addressed the needs of the frail and elderly and their families through many venues, among which were participation in the Aging Futures community-wide coalition whose mission is to address the needs of the senior population in the community. Efforts focused on Falls Prevention among the frail elderly. Lourdes at Home provided 56,200 home health visits to Broome County residents. 72 telehealth monitors continue to be used at capacity. This evidenced based program has decreased Acute Care Hospitalization rates significantly for patients with Congestive Heart Failure (CHF) and Chronic Obstructive Pulmonary Disease (COPD) as well as CHF. Lourdes continues to be the only Home Health Care Agency to service pediatric patients. Palliative Care and Hospice. Lourdes provides the area s only palliative care services, and is the only hospice provider for Broome and Tioga county residents. Lourdes Hospice provided over 19,800 visits to Broome and Tioga County residents. Lourdes Regional Cancer Center. Lourdes participates in the rapid quality reporting system (RQRS) through the Commission on Cancer in an effort to improve the quality of care to our patients through early reporting on certain quality metrics identified by the Commission on Cancer. Community Education. Lourdes believes that one of the hallmarks of Health Care that is safe is to provide a variety of education programs for our community, including cancer, diabetes, issues of aging, and women s health to name a few. There were over 2,000 community residents that took part in the various offerings in 2016 Patient and Associate Safety Lourdes adheres to a Universal Influenza Vaccination annually to provide for the safety of all those in our care. Over 2,300 health care workers received a vaccination in Lourdes Financial Commitment to the Community 2016 CALENDAR YEAR Charity Care Free Care...$12,306,259 Community Benefit Programs... $15,693,000 Total Charity Care... $27,999,259 Bad Debt...$17,586,373 Medicaid Shortfall... $12,436,000 Medicare Shortfall... $23,109,000 9

12 Our Mission Rooted in the loving ministry of Jesus as healer, we commit ourselves to serving all persons with special attention to those who are poor and vulnerable. Our Catholic health ministry is dedicated to spiritually centered, holistic care which sustains and improves the health of individuals and communities. We are advocates for a compassionate and just society through our actions and our words. Core Values SERVICE OF THE POOR Generosity of spirit, especially for persons most in need. REVERENCE Respect and compassion for the dignity and diversity of life. INTEGRITY Inspiring trust through personal leadership. WISDOM Integrating excellence and stewardship. CREATIVITY Courageous innovation. DEDICATION Affirming the hope and joy of our ministry. About Lourdes For over 90 years, Lourdes has been a cornerstone of our community, offering resources that have made a difference. With our Catholic faith tradition, Lourdes Hospital provides the holistic, compassionate care that every patient deserves. Lourdes is more than an inpatient acute care hospital we are an outpatient ambulatory surgery center we are a Regional Cancer Center. We provide Palliative Care and Hospice Care, an orthopedics program, diabetes care, home health care, and much more. Reaching beyond the boundaries of our main campus, Lourdes has established a network of primary and specialty care physician offices at convenient sites throughout the region. The Mobile Mammography and Mobile Dental Care programs provide women s health and mammography services and dental care through two mobile medical vans, making health care accessible to rural populations and children in need. Lourdes is also a member of Ascension Health, the largest, Catholic, nonprofit health system in the nation with 150,000 associates and 35,000 affiliated providers serving in 1,900 sites of care across 23 states and the District of Columbia. Much has changed in the community and at Lourdes since the Daughters of Charity opened a small 25-bed hospital on Riverside Drive 90 years ago, but one thing remains constant: the commitment and Mission of caring found here each and every day.