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1 health watch OCTOBER 2014 DUBUQUE, IOWA MERCYDUBUQUE.COM WANT TO RUN? We ve got tips to get you started page 5 Mother and daughter share why they chose Mercy Birth Center page 2 Pictured: Amanda and Tom Rauen, Dubuque, Iowa health watch October

welcome A LETTER FROM THE PRESIDENT Russell M. Knight, President and CEO My attention was drawn recently to a pair of stories on the financial condition of America s non-profit community hospitals.

That isn t really a surprise, considering how difficult it can be to maintain an organization s financial health in an environment of lower payments, higher expectations, and increased regulation.

2 welcome A LETTER FROM THE PRESIDENT Russell M. Knight, President and CEO My attention was drawn recently to a pair of stories on the financial condition of America s non-profit community hospitals. The first article reported that according to an annual survey of hospital executives, financial challenges have ranked as their number one concern for ten years in a row. That isn t really a surprise, considering how difficult it can be to maintain an organization s financial health in an environment of lower payments, higher expectations, and increased regulation. But shouldn t an administrator s main areas of focus be patient care, employee relations, and physician collaboration? In the past, it might have been safe to So far, the situation at Mercy has been different. Despite the impact of Medicare payment reductions (such as the 2% sequestration cut and other measures), our revenue grew 4.6% last year. This is primarily because we saw increases in outpatient activity, emergency department visits, surgical procedures, and obstetrical deliveries. Our operating margin of 4.5% was more than double the average reported by Standard and Poor s. We achieved this by improving productivity and reducing the average cost per case. This is good news, not just for Mercy, but for everyone in the community who depends on us to be solvent, stable, and state-of-the-art. Because we have no This is good news, not just for Mercy, but for everyone in the community who depends on us to be solvent, stable, and state-of-the-art. assume that careful attention to the needs of patients, co-workers, and members of the medical staff would lead naturally to financial health and stability. That isn t necessarily the case today, as the circumstances facing hospitals have grown more difficult and complex. The second article to catch my eye reported that nonprofit hospitals are being squeezed as revenue growth shrinks to an all-time low. According to a report issued by Moody s Investor Services, hospital revenues increased less than 4% in 2013, after growing more than 5% in 2012 and 7% in the years before that. Because expenses have gone up more rapidly than revenues, hospital operating margins have come under pressure. Moody s says that one out of four hospitals lost money in And Standard & Poor s says the average margin last year was around 2%. individual owners or shareholders, the money we earn is reinvested in our services, facilities, and equipment to make the care we provide at Mercy better for you and your loved ones. Across the country, not every hospital is still able to do that. We are under no illusion that our current financial strength can be taken for granted. The pressures affecting hospitals are many and severe; and Mercy is not immune. The years ahead will be filled with tough challenges. Fortunately, we are well-positioned to deal with them successfully. You can share the confidence of our Board of Trustees, employees, and medical staff that we will continue to meet the tests of the future just as we have in the past, no matter how difficult the environment might become. Health Watch is published six times per year by Mercy Medical Center Dubuque. Information contained in Health Watch is intended for general information and should not be construed as medical advice or instruction. For diagnosis and treatment of specific conditions, consult your physician Mercy Medical Center Dubuque 3 health watch October 2014 President/CEO: Russell M. Knight Marketing Staff: Holly Brimeyer, Matthew J. Daughenbaugh, Jennifer Faley, Keri Gockel and Natalie Reittinger General information:

3 quick tips cancer» FACTS and FIGURES About half of all men and one-third of all women in the U.S. will develop cancer during their lifetimes. MORE THAN HALF of all cancer deaths could be prevented by making healthy choices. 1,665,540 The number of new cancer cases in the United States expected to be diagnosed in THE GOOD NEWS The survival rate is improving all the time. The five-year survival rate for all cancers diagnosed between 2003 and 2009 is 68 percent, up from 49 percent in DECREASE YOUR RISK of developing cancer by making healthy choices like:» not smoking» staying at a healthy weight» eating right» keeping active» getting recommended screening tests Source: American Cancer Society OCT 16 NUTRITION FOR CANCER PREVENTION Food choices and eating habits can play a key role in preventing cancer. Join Mercy dietitian Christine Nanke, RD, LD, as she presents evidence-based dietary guidelines shown to reduce the risk of developing cancer. Thursday, October 16 6:30 7:30 p.m. Mercy, sixth floor auditorium 250 Mercy Drive, Dubuque No fee. Registration required at mercydubuque.com/events or at health watch October

4 in focus GENER AT IONS giving birth at Mercy Pictured: (left to right) Kasen Herrig, Tana Herrig, Aviana Herrig, Laural Ploessel 2 health watch October 2014

Laural Ploessel and her daughter, Tana Herrig, of Bellevue, Iowa, have both had their babies at Mercy.

Everyone is friendly, accommodating, and makes me feel comfortable. Laural had three babies at Mercy and says she was always treated like a queen.

Many moms describe an amazing bond that is formed with their nurses when giving birth. By the time you leave the hospital, they re actually a part of your family.

Lori and Jane were with Laural for her second and third deliveries, too with Jane even coming in on her day off to be there.

She made such an impact, says Tana. This is one of the most important days of my life, and for Jenny to share in that is so meaningful.

5 Laural Ploessel and her daughter, Tana Herrig, of Bellevue, Iowa, have both had their babies at Mercy. They know all about the accolades that set Mercy apart, but for them, there s something that matters more. For me, it s about the experience and the care you get. Everyone cares, describes Tana. Everyone is friendly, accommodating, and makes me feel comfortable. Laural had three babies at Mercy and says she was always treated like a queen. During her first birth, she developed relationships with her nurses, Lori and Jane, that have continued to this day. Many moms describe an amazing bond that is formed with their nurses when giving birth. By the time you leave the hospital, they re actually a part of your family. I still talk to Lori and Jane, Laural remarks. You carry that connection on. Lori and Jane were with Laural for her second and third deliveries, too with Jane even coming in on her day off to be there. Tana has now delivered two babies at Mercy and shares a similar experience as her mom. She still has a relationship with her nurses, and I ve kept in touch with my nurse, Jenny. She made such an impact, says Tana. This is one of the most important days of my life, and for Jenny to share in that is so meaningful. Both Laural and Tana were impressed with Jenny s knowledge and techniques and felt that she was a big reason why Tana s labor and delivery went so well. She was phenomenal, says Tana. I truly believe it s because of Jenny that everything was so easy. She had that wow factor and made everything just amazing. Laural s experience now as a grandparent has been wonderful, too. I just feel that they all treat us very well. Even as a grandparent, they let me be a part of it. And, of course, when Tana delivered, Lori and Jane were there to check in. Hopefully we ll be having more babies, Tana says with a smile. And I just know that Mercy is where we ll always go. For me, it s about the experience and the care you get. Everyone cares. Tana Herrig (Left) Laural with Tana in the Mercy Birth Center. (Middle) Tana and her husband following Kasen s birth. (Right) Mercy nurses Jenny Kilburg and Katie Muller hold Kasen. health watch October

Q&A hot topics Q: I m not sure when I should start getting mammograms or how often. Can you help?

recommendations have been considered the standard.

breast exams should be performed by a health care provider about every three years for women in their 20s and 30s and every year for women

their breasts normally look and feel and report any breast change promptly to their health care provider Mercy recommends that you discuss

Whether you re male or female, if you feel a lump, have breast pain, nipple discharge, or other breast symptoms, it s especially critical

Sonja Boles, director of imaging services, Mercy Dubuque Join us for an evening of breast cancer awareness on Monday, October 27 at our

4 health watch October 2014 INDEPENDENT LIVING APARTMENT Mercy s new independent living apartment offers a simulated home environment to

The room offers a simulated home environment so that patients can experience real-life situations such as getting in and out of a regular

The independent living apartment is a great benefit for our patients, says Jackie Bierman, director of rehabilitation and skilled nursing.

6 Q&A hot topics Q: I m not sure when I should start getting mammograms or how often. Can you help? There seems to be some confusion about the minimum age for annual screening mammograms, but historically, the American Cancer Society recommendations have been considered the standard. Those guidelines were changed a bit in the last few years to now suggest:» Breast self-exams should begin for women in their 20s» Clinical breast exams should be performed by a health care provider about every three years for women in their 20s and 30s and every year for women 40 and over» Yearly mammograms should begin at age 40 and continue for as long as a woman is in good health» Women should be aware of how their breasts normally look and feel and report any breast change promptly to their health care provider Mercy recommends that you discuss annual screening recommendations with your physician or health care provider. Whether you re male or female, if you feel a lump, have breast pain, nipple discharge, or other breast symptoms, it s especially critical that you see your health care provider right away. Sonja Boles, director of imaging services, Mercy Dubuque Join us for an evening of breast cancer awareness on Monday, October 27 at our Pink Ribbon Party. See the back cover for more information. 4 health watch October 2014 INDEPENDENT LIVING APARTMENT Mercy s new independent living apartment offers a simulated home environment to help rehabilitation patients make the transition to living at home a lot easier. The room offers a simulated home environment so that patients can experience real-life situations such as getting in and out of a regular bed, cooking meals, or washing dishes. The independent living apartment is a great benefit for our patients, says Jackie Bierman, director of rehabilitation and skilled nursing. It will give them real-life practice before returning home and also the confidence of knowing they have the skills to succeed at home. The apartment was made possible in part by a $10,000 grant from the Dubuque Racing Association. WALK INTO CHRISTMAS GIFT SHOW AND BAKE SALE Sunday, November 2 11 a.m. 5 p.m. FLU SHOT Do your fall and winter plans include nausea, fever, muscle aches and fatigue? If not, get a flu shot. The influenza vaccine is recommended for all adults and is available at Mercy Family Pharmacy. Call for more information. MERCY GIFT SHOP Monday and Tuesday, November 3 and 4 9 a.m. 7 p.m. Proceeds benefit children s needs at Mercy Medical Center

RUN FOR YOUR LIFE Want to add running to your walking routine? Consider these tips:» Start gradually.

Running requires a properly fitted shoe, so head to a shoe store to be fitted for the right shoe for you.» Listen to your body.

Use free running apps on your smart phone to keep track of your progress, map your routes, and even challenge your friends.

7 RUN FOR YOUR LIFE Want to add running to your walking routine? Consider these tips:» Start gradually. Begin by incorporating small bouts to your walking routine and increase your time a little each week. Download Mercy s plan at mercydubuque.com/healthwatch.» Lace up. Running requires a properly fitted shoe, so head to a shoe store to be fitted for the right shoe for you.» Listen to your body. Sore muscles are expected when increasing your physical activity, but don t ignore sharp pains.» Get techy. Use free running apps on your smart phone to keep track of your progress, map your routes, and even challenge your friends. Our cover models, Amanda and Tom Rauen, enjoy running and have completed several half and full marathons. Running is great exercise, both physically and mentally. If I m stressed out, I always feel better after running, says Amanda. Tom adds, It s also become really popular from the social aspect, whether training together in a group or seeing people at the races. We asked our Facebook fans to name their favorite places to run in the tri-state area. Here are the most popular picks: #1: SOUTH GRANDVIEW #2: RIVER WALK/ FLOOD WALL #3: HERITAGE TRAIL #4: MINES OF SPAIN #5: THEIR NEIGHBORHOOD #6: BERGFELD POND RECIPE BALDWIN PUBLISHING, INC. HEART HEALTHY DIABETES FRIENDLY PUMPKIN BREAD MAKES 14 SERVINGS SERVING SIZE: ½ ¾-inch thick slice INGREDIENTS 2 cups whole wheat flour 1 cup sugar 2 teaspoons baking powder ¼ teaspoon baking soda 1 teaspoon ground cinnamon ¼ teaspoon ground nutmeg 1 cup pumpkin purée ½ cup applesauce ½ cup egg substitute 2 tablespoons canola oil 1 teaspoon vanilla extract INSTRUCTIONS 1 - Preheat oven to 350. Lightly coat a 9 x 5-inch loaf pan with nonstick cooking spray. 2 - In a large bowl, combine flour, sugar, baking powder, baking soda, cinnamon and nutmeg. In another bowl, combine pumpkin purée, applesauce, egg substitute, oil and vanilla and whisk until smooth. Add the pumpkin mixture to the dry ingredients and mix well. 3 - Pour batter into prepared pan and spread evenly. Bake for 50 to 55 minutes, or until a toothpick inserted in the center comes out clean. 4 - Cool bread in pan for 10 minutes. Remove loaf from pan and transfer to a wire rack to cool completely. health watch October

JOIN US FOR THE PINK RIBBON PARTY breast cancer information mini chair massages 20% discount at Mercy Gift Shop

Eric Engelman's presentation, Let's Talk about Breast Cancer. Registration required at mercydubuque.

Individuals throughout the tri-state area are taking the pledge this October to schedule their annual mammogram

Mammograms offer the best chance to detect breast cancer early when it is easier to treat and before it causes

Together you can decide what's best for you based on your individual breast cancer risk.

com/pledge Connect with us on social media for breast cancer awareness information throughout October.

PUMPKIN BREAD The flavors of fall come together in this moist, delicious healthy recipe for pumpkin bread.

8 JOIN US FOR THE PINK RIBBON PARTY breast cancer information mini chair massages 20% discount at Mercy Gift Shop pink refreshments Monday, October 27, 5 6:30 p.m. Mercy Gift Shop corridor Stay for Dr. Eric Engelman's presentation, Let's Talk about Breast Cancer. Registration required at mercydubuque.com/events or Mercy Medical Center - Dubuque 250 Mercy Drive Dubuque, IA I pledged for. Individuals throughout the tri-state area are taking the pledge this October to schedule their annual mammogram and encourage women throughout our community to do the same. Mammograms offer the best chance to detect breast cancer early when it is easier to treat and before it causes symptoms. Talk with your primary care provider about your personal screening schedule. Together you can decide what's best for you based on your individual breast cancer risk. Join us, and tell us why you are taking the pledge at mercydubuque.com/pledge Connect with us on social media for breast cancer awareness information throughout October. Kelley Schiesl (Dubuque, Iowa) with son Nathan and daughter Hannah RECIPE BALDWIN PUBLISHING, INC. PUMPKIN BREAD The flavors of fall come together in this moist, delicious healthy recipe for pumpkin bread. Great for a quick on-the-go breakfast or snack. This recipe is high in fiber, low in saturated fat and high in antioxidant vitamins A, C and E. Kristie Jacobsen, RD, LD FLIP FOR RECIPE NUTRITIONAL INFORMATION: 145 calories, 2g fat, 0g saturated fat, 0g cholesterol, 93mg sodium, 29g carbohydrates, 3g fiber, 13g protein

health watch Mary Beth s Story: Learn about her recovery following a stroke page 2

health watch Mary Beth s Story: Learn about her recovery following a stroke page 2 health watch SPRING 2018 DUBUQUE, IOWA MERCYDUBUQUE.COM Mary Beth s Story: Learn about her recovery following a stroke page 2 Should you be concerned if your child walks on his or her toes? page 4 Learn