Baylor Scott & White Health Baylor Scott & White Medical Center Hillcrest Annual Report of Community Benefits 100 Hillcrest Medical Blvd. Waco, TX 76712 Taxpayer ID # 74 1161944 For the Fiscal Year Ended June 30, 2017
Letter from the President Annual Report of Community Benefits 100 Hillcrest Medical Blvd, Waco, TX 76712 Taxpayer ID # 74-1161944 For the Fiscal Year Ended June 30, 2017 Table of Contents I. Mission Statement of II. III. IV. Effective Dates of the Report Description of the Community Served Identified Community Health Needs V. Programs Addressing Community Health Needs VI. VII. VIII. Charity Care and Government-Sponsored Indigent Health Care Provided Government-Sponsored Health Care Provided Other Types of Community Benefits Provided A. Community Health Improvement Services B. Financial and In Kind Donations C. Other Community Benefits IX. Total Operating Expenses and Calculation of the Ratio of Cost to Charge X. Report of Community Benefits Provided During Fiscal Year 2017
June 30, 2017 Dear Friends of Baylor Scott & White Medical Center Hillcrest: For nearly a century, residents of Waco and surrounding communities have put their faith and trust in us to care for their health and wellbeing. While we continue to focus on providing quality care to our patients in the hospital, we are also investing in keeping the community well. We are collaborating with other health care providers, physicians, community groups, area employers and others to enhance the value of our health care services to those who put their wellbeing in our hands, wherever and whenever they need us. I am pleased to provide this Community Benefit report for fiscal year 2017. The report highlights the many programs and services supported by Baylor Scott & White - Hillcrest that extend our care into the community and beyond. Year after year, we have continued strengthening our commitment to serving those outside our walls through unique partnerships and innovative programs. Our Board of Trustees, physicians, employees and volunteers take our responsibility to the community seriously. We are dedicated to providing high-quality care to each person in need, regardless of his or her ability to pay. This is the promise that allows us to care for the community and improve the overall health of the population within our service area. How are we able to accomplish so much in the community? A key to our success is the fact that we are part of the largest not-for-profit health care system in Texas, Baylor Scott & White Health. With 48 hospitals and more than 1,000 patient access points in our system today, plus the Scott & White Health Plan, Baylor Scott & White Research Institute and Baylor Scott & White Quality Alliance, Baylor Scott & White - Hillcrest has the strength and resources necessary to anticipate and provide for the needs of the community. This strength enables us to provide personalized health and wellness through exemplary care, education and research as a Christian ministry of healing. The community benefit goal at Baylor Scott & White - Hillcrest is to improve access to health care and empower residents to make healthy life choices. We provide a significant variety of community benefit activities including immunizations, health screenings, support groups and free health education classes throughout Central Texas. We place particular emphasis on making appropriate resources available to underserved and uninsured individuals, and explore innovative approaches to community work through collaboration with other nonprofits through the Prosper Waco initiative. These efforts are measurably improving the lives of the people of the Greater Waco community. For example, the Nurse Family Partnership (NFP) initiative at BSW Hillcrest began in January, 2016 and served 141 families in its first year. As these families work with NFP nurses, they learn better prenatal care for each unborn child as well as better early childhood development skills to benefit each newborn. While the average length of stay for premature newborns in our neonatal intensive care unit (NICU) is 14 days, our premature NFP babies requiring NICU services averaged only a five-day stay. Through regular community health needs assessments, we identify priority areas of focus that enable us to maximize our community benefit resources in specific areas such as addressing the causes of obesity, decreasing the prevalence and severity of chronic illnesses such as diabetes and cancer, reducing the use of tobacco to lessen its negative impact on the health of our community; while increasing access to overall health care, mental health resources, and prenatal care. By concentrating on these and other key areas of focus, Baylor Scott & White - Hillcrest is positioned to move the needle toward a healthier community. I look forward to hearing from you about this report. Please address comments to me, in care of Tara Stafford, Director of Community Benefit, Baylor Scott & White Health, 2401 S. 31 st Street, Mailstop: MS-09-C600A, Temple, TX 76508. With thanks and gratitude, Glenn A. Robinson, FACHE, President Page 2
Baylor Scott & White Health Annual Report of Community Benefits 100 Hillcrest Medical Blvd, Waco, TX 76712 Taxpayer ID # 74-1161944 For the Fiscal Year Ended June 30, 2017 I. Mission Statement, an affiliated hospital of Baylor Scott & White Health System (BSWHS), is committed to fulfilling its mission: we exist to serve all people providing personalized health and wellness through exemplary care, education and research as a Christian ministry of healing. II. III. Effective Dates of the Plan The annual report of community benefits provided is for the fiscal year ended June 30, 2017 ( Fiscal Year 2017 ). Description of the Community Served serves McLennan County, where the majority of its patients reside. The primary community served was determined based on: 1) Examination of inpatient and emergency department utilization data for fiscal year 2) Majority of total hospital discharges live in McLennan County 3) All Hillcrest hospital campuses and clinics are located in McLennan County IV. Prioritized Identified Community Health Needs from the 2016 Assessment (BSWHealth.com/CommunityNeeds) A. Access to Care B. Chronic Disease Management and Prevention C. Mental Health Resources D. Prenatal Care E. Obesity F. Tobacco Use V. Programs Addressing Community Health Needs Programs Addressing Access to Care: Drive Thru Flu Annual Drive Thru Flu Clinic to provide easy access to vaccinations for the entire community. Faith Community Health Faith Community Health is a branch of Faith In Action Initiatives in the Office of Mission and Ministries of Baylor Scott & White Health (BSWH). Faith Community Health strives to form relationships and collaborate with faith communities to improve the health of those people in their congregations and communities. Congregations and communities are supported by integrating faith and health through health educators, faith community nurses, home visits, and church volunteer members. Page 3
Nurse Family Partnership Nurse-Family Partnership is an evidence-based community healthcare program that empowers low-income, first-time mothers to become confident parents and strong women by partnering with nurse home visits. Nurse home visits begin early in the mother s pregnancy and continue visitation until the child s second birthday. Nurses provide support, resource connections, education and counseling on health, behavioral and self-sufficiency issues. NFP is one the most rigorously tested programs of its kind randomized; controlled trials conducted over the past 30 years demonstrate positive multi-generational outcomes for families and their communities. These include improved prenatal health, fewer subsequent pregnancies, increased maternal employment, improved child school readiness, reduced criminal involvement, and less child abuse, neglect and injuries. Programs Addressing Chronic Disease Management & Prevention (including Tobacco Cessation): Breast Health - Community Education The Hillcrest Breast Center supplies breast health information to organizations and events across the community. Information includes proper screening guidelines and how to access services to reduce the incidence of late stage cancer going undetected. Cancer Center Outreach and Programs Hillcrest supplies cancer screening and prevention information to organizations and events across the community. Information includes proper screening guidelines and how to access services to reduce the incidence of late stage cancer going undetected. The Center also provides regular programming for people living with cancer and their family members including support groups, appropriate exercise, etc. DONATION: Health Improvement BSWH donates funds often to local charitable, not for profit organizations whose efforts to improve community health align with the identified health needs in our community. We do so to support their efforts to improve the overall health of the community through education, prevention, health advocacy, or disease management education. Funds that go to improving the health infrastructure of our community are counted after subtracting the fair market value of participation by employees or the organization. For Women For Life and It s a Guy Thing Regular health exams and tests can help find problems before they start. They also can help find problems early, when the chances for treatment and cure are better. Through For Women For Life and It s a Guy Thing events, the Hospital provides health services, screenings, and treatments, assisting women in taking steps that help their chances for living a longer, healthier life. This annual event for women focusing on proactive health care including preventive health screenings, seminars and healthy lifestyle information. HEALTH FAIRS BS&W regularly participates in health fairs all over the communities we serve in order to provide access to educational materials that will help impact healthy lifestyle habits. Page 4
Cancer Health Screenings- Skin, Colon, Breast, etc.) BS&W offers occasional screening days to reach out to both men and women of Central Texas on the importance of early detection and preventive care of various types of cancer offering free or reduced cancer screenings in the clinical setting. SUPPORT GROUPS Baylor Scott & White Healthcare provides support group services for patients and their families that are specific to a disease or social concern Programs Addressing Obesity: COMMUNITY HEALTH EDUCATION-Community Based Baylor Scott & White Health consistently looks for opportunities to educate the community on health issues to support our mission and vision. The programs and services that fall into this category extend beyond patient care activities and include services directed to both individuals and larger populations in the community. They include such things as educational information about preventive health care, lectures, or presentations held by BSWH physicians and staff about health related topics like understanding various conditions and diseases, when to seek treatment, and the treatment options available. COMMUNITY HEALTH EDUCATION-School Based BSWH recognizes the importance of teaching about health and health professions to students in our school systems. Programs and services in this category are geared towards students K-12 and provide educational opportunities for students in the local ISD's to learn about the importance of making healthy living choices starting at an early age. DONATION: Health Improvement BSWH donates funds often to local charitable, not for profit organizations whose efforts to improve community health align with the identified health needs in our community. We do so to support their efforts to improve the overall health of the community through education, prevention, health advocacy, or disease management education. Funds that go to improving the health infrastructure of our community are counted after subtracting the fair market value of participation by employees or the organization. Farmers Markets Farmers Markets onsite offer fresh fruits and vegetables to the community throughout the summer months. HEALTH FAIRS BS&W regularly participates in health fairs all over the communities we serve in order to provide access to educational materials that will help impact healthy lifestyle habits. Prosper Waco Hillcrest provides supports for Prosper Waco initiatives including the community health worker program. Page 5
WELLNESS PROGRAMS: Community Based Baylor Scott & White Health offers free and/or reduced cost services and programs geared towards enhancing the well-being of individuals in the community. Programs Addressing Prenatal Care: Nurse Family Partnership Nurse-Family Partnership is an evidence-based community healthcare program that empowers low-income, first-time mothers to become confident parents and strong women by partnering with nurse home visits. Nurse home visits begin early in the mother s pregnancy and continue visitation until the child s second birthday. Nurses provide support, resource connections, education and counseling on health, behavioral and self-sufficiency issues. NFP is one the most rigorously tested programs of its kind randomized; controlled trials conducted over the past 30 years demonstrate positive multi-generational outcomes for families and their communities. These include improved prenatal health, fewer subsequent pregnancies, increased maternal employment, improved child school readiness, reduced criminal involvement, and less child abuse, neglect and injuries. Programs Addressing Mental Health Resources: Faith Community Health Faith Community Health is a branch of Faith In Action Initiatives in the Office of Mission and Ministries of Baylor Scott & White Health (BSWH). Faith Community Health strives to form relationships and collaborate with faith communities to improve the health of those people in their congregations and communities. Congregations and communities are supported by integrating faith and health through health educators, faith community nurses, home visits, and church volunteer members. TelePsych The ED treats many patients that come in suffering from anxiety and depression. Due to the lack of resources to meet mental health needs it is not uncommon for patients to wait days or weeks before being able to secure available space for continued mental health care. The hospital is utilizing a TelePsych component to expedite placement and to help Trauma and ED providers determine need for a patient s placement in a mental health facility allowing for patients in the unit to consult directly with a mental health provider remotely. VI. Charity Care and Government-Sponsored Indigent Health Care Provided For Fiscal Year 2017, provided $17,259,923 in unreimbursed costs of charity care and government-sponsored indigent health care. VII. VIII. Government-Sponsored Health Care Provided For Fiscal Year 2017, provided $6,950,460 unreimbursed costs of government-sponsored health care. Other Types of Community Benefits Provided is committed to improving the quality of life for the many citizens living and working in its area and was pleased to allocate a total of $1,962,196 the following community benefit activities. Page 6
A. Community Health Improvement Services $1,428,390 These are costs associated with programs and services that extend beyond patient care activities and include services directed to both individuals and larger populations in the community. These services include such things as educational information about preventive health care and treatment for specific diseases, informational health lectures to help understand various conditions and diseases as well as available treatment options, opportunities that promote healthy activity and wellness initiatives, health fairs and screenings, and support groups. B. Financial and In Kind Donations $522,623 Baylor Scott & White provides community benefit grants and support to other non-profit organizations through dedicated community benefit funds as well as donations of staff time, medical supplies or equipment to other non-profit organizations. C. Other Community Benefit $11,183 Baylor Scott & White provides other services with the goal of improving the overall health of the community including ongoing assessment of community health needs and evaluation of community health programs and services. IX. Total Operating Expenses and Calculation of the Ratio of Cost to Charge As required by Section 311.046 (a) (4), reports $242,020,555 in total operating expenses for the prior audited fiscal year ending June 30, 2016. As required by Section 311.046(1) (5), the ratio of cost to charges was 21.51%. Please see the attached worksheet for the full calculation. X. Report of Community Benefit Provided During Fiscal Year 2017 In a commitment to fulfill its mission, benefit to the community, conservatively estimated, was $ 26,172,579 for Fiscal Year 2017. Baylor Scott & White Medical Center - Hillcrest is filing its Annual Statement of Community Benefits Standard (Statement) as a consolidated system with the other affiliated hospitals of BSWHS (excluding those that qualify as Medicaid disproportionate share hospitals). Through community benefit activities, BSWHS - affiliated hospitals provided: quality patient care and subsidized services otherwise not available in the community; medical education, training for medical technicians, hospital chaplains, nurses, and future physicians; and medical research that will speed the time between scientific finding and its application to improving medical care. Any comments or suggestions in regard to the community benefit activities are greatly welcomed and may be addressed to Tara Stafford, Director of Community Benefit, Baylor Scott & White Health, 2401 S. 31 st Street, Temple, TX 76508. Page 7
Total Operating Expenses and Calculation of the Ratio of Cost to Charge Baylor Scott & White Health Total Operating Expenses Section 311.046(a)(4) For the Fiscal Year Ended June 30, 2016 242,020,555 Calculation of the Ratio of Cost to Charge Section 311.046(a)(5) Total Patient Revenues (a) 1,153,720,784 (from 2016 Medicare Cost Report, Worksheet G-3, Line 1) Total Operating Expenses (b) 235,278,378 (from 2016 Medicare Cost Report, Worksheet A, Line 118, Col. 7) Initial Ratio of Cost to Charge ((b) divided by (a)) (c) 20.39% Application of Initial Ratio of Cost to Charge to Bad-Debt Expense Bad Debt Expense (d) 63,077,747 (from 2017 audited financial statements) Multiply "Bad Debt Expense" by "Initial Ratio of Cost to Charge" ((d)*(c)) (e) 12,861,553 Add the allowable "Bad-Debt Expense" to "Total Operating Expenses" ((b) + (e)) (f) 248,139,930 Calculation of Ratio of Cost to Charge ((f) divided by (a)) (g) 21.51% Page 8