McCready Health Edward W. McCready Memorial Hospital 201 Hall Highway, Crisfield, MD Community Benefits Fiscal Year 2016

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McCready Health Edward W. McCready Memorial Hospital 201 Hall Highway, Crisfield, MD 21817 Community Benefits Fiscal Year 2016

I. GENERAL HOSPITAL DEMOGRAPHICS AND CHARACTERISTICS Bed Designation: FY16 4 licensed Med/Surg beds Inpatient Admissions FY16 Primary Service Area Zip Codes: 288 21817 21838 21871 All other Maryland Hospitals Sharing Primary Service Area 1. Peninsula Regional Medical Center (Wicomico Co.) 2. Atlantic General Hospital (Worcester Co.) Percentage of Uninsured Patients by County 14% of Somerset County residents are uninsured. (2,489) Source: 2013 County Health Rankings conducted by the Univ. of Wisconsin. Percentage of the hospital s patients who are Medicaid Recipients by County 24.8% Source: McCready Health Patient Accounts Percentage of the hospital s patients who are Medicare Beneficiaries 42.4% Source: McCready Health Patient Accounts 2. Community Benefit Service Area Demographic Characteristic Description Source Zip codes included in the organization s CBSA, indicating which include geographic areas where the most vulnerable 21817 21838 21871 populations reside. Median Household Income within the CBSA $36,716 2010-2014 American Community Survey 5- Percentage of households with incomes below the federal poverty guidelines within the CBSA For the counties within the CBSA, what is the percentage of uninsured for each? Percentage of Medicaid recipients per within the CBSA Life expectancy by within the CBSA (including by race and ethnicity where data are available) Year Estimates 25.5% 2014 Small Area Income and Poverty Estimates (SAIPE) 12.3% 2010-2014 American Community Survey 5- Year Estimates 41.7% SHIP data 76.6% Prevention and Health Promotion Administration

Mortality rates by within the CBSA (including by race and ethnicity where data are available) Access to healthy food, transportation and education, housing quality and exposure to environmental factors that negatively affect health status by within the CBSA (to the extent information is available from local or jurisdictions such as the local health officer, local officials, or other resources) Available detail on race, ethnicity, and language within CBSA. Access to healthy food 27% In Crisfield (21817) there is 1 grocery store providing access to fresh foods. There are 2 national fast food chains in Crisfield (Subway and McDonalds) College degree - 14.3% (State rate is 37.1%) Adult smokers = 13% Transportation remains an issue; limited public transportation is available via Shore Transit or a local taxi service. Unemployment of those 16+ is 9.9% vs. the state rate of 6.6% The rate of Primary Care providers (per 100,000) is 38.0 vs. the state rate of 117.8 7.5% of households do not speak English Spanish is spoken in 3.3% of households County has a large migrant population May October. Rural migrant camp is approx. 20 mi. from hospital. Prevention and Health Promotion Administration SHIP data SHIP data

II. Community Health Needs Assessment 1. Has your hospital conducted a Community Health Needs Assessment that conforms to the IRS definition detailed on pages 4-5 within the past three fiscal years? X Provide date here. 10/01/2014 It is attached as a pdf document No 2. Has your hospital adopted an implementation strategy that conforms to the definition detailed on page 5? _X No III. Community Benefits Administration a. Is Community Benefits planning and investments part of your hospital s internal strategic plan? _X No b. What stakeholders in the hospital are involved in your hospital community benefit process/structure to implement and deliver community benefit activities? (Please place a check next to any individual/group involved in the structure of the CB process and describe the role each plays in the planning process (additional positions may be added as necessary) i. Senior Leadership 1. _x CEO 2. _x CFO 3. x Other (please specify) Community Relations Director, Chief Nursing Officer

The Community Relations Director collects all the data and completes the required narrative report based on the information received. The Chief Nursing Officer, along with clinical leadership, organize and are actively involved in the CB activities including the completion of CB reporting forms. The CEO and CFO review the report and communicate with the HSCRC on related issues. ii. Clinical Leadership 1. Physician 2. _x Nurse 3. Social Worker 4. x Other (please specify) Director of Quality, Department Supervisors The Director of Quality and Department Supervisors, along with senior leadership (noted above), organize and are actively involved in the CB activities including the completion of CB reporting forms. iii. Population Health Leadership and Staff 1. Population health VP or equivalent (please list) 2. Other population health staff (please list staff) Describe the role of population health leaders and staff in the community benefit process. iv. Community Benefit Operations 1. x Individual (please specify FTE) - Director of Community Relations, 1.0 FTE 2. Committee (please list members) 3. Department (please list staff) 4. Task Force (please list members) 5. _x Other (please describe) Department managers are responsible for reporting the community benefit activities of their staff/departments The Director of Community Relations collects all data, researches statistics, and completes all necessary CB reports.

c. Is there an internal audit (i.e., an internal review conducted at the hospital) of the Community Benefit report? ) Spreadsheet x yes no Report is reviewed by the CEO and CFO prior to submission Narrative x yes no d. Does the hospital s Board review and approve the FY Community Benefit report that is submitted to the HSCRC? Spreadsheet yes x no Narrative yes x no They are aware of it and info, including copies of documents and reports, is shared with them. Our board has given the authority to the executive staff for completion and submission of all reports. IV. COMMUNITY BENEFIT EXTERNAL COLLABORATION a. Does the hospital organization engage in external collaboration with the following partners: x Other hospital organizations x Local Health Department x Local health improvement coalitions (LHICs) x Schools x Behavioral health organizations Faith based community organizations x Social service organizations

b. The meaningful, core partners with whom the hospital organization collaborated to conduct the CHNA. Organization Name of Key Collaborator Title Collaboration Description Somerset County Health Dept. Craig Stofko Health Officer Together with our CEO, determined strategies needed to provide the most accurate and thorough data for our. George Washington University Cherise B. Harrington, PhD, MPH Principle Investigator Led a team of students and colleagues in a needs assessment unique to the. Developed questions, conducted survey throughout the, created document. c. Is there a member of the hospital organization that is co-chairing the Local Health Improvement Coalition (LHIC) in the jurisdictions where the hospital organization is targeting community benefit dollars? yes x no d. Is there a member of the hospital organization that attends or is a member of the LHIC in the jurisdictions where the hospital organization is targeting community benefit dollars? x yes no

V. Hospital Community Benefit Program and Initiatives Identified Need Access to Care Access to Care and Transportation Access to Care Diabetes Obesity Hospital Initiative Recruit new providers Patient transport Health Insurance resource Awareness, education and coalition membership Community Field day # of People within the target population # People reached by initiative Primary objective of the Initiative To increase # of providers 1,605 Eliminate barrier to services 1,000 To increase # of people with insurance To increase awareness of diabetes and links to care To focus on issue, provide resources for residents or Multi year time period Key Partners Impact/ Outcome Local providers Hired three additional Physician Assistants Community, media, other providers MD Lower Shore Health Exchange Providers, Area Health Depts., Tri- County Diabetes Alliance Healthy Somerset Coalition 1,605 people served; 2,072 staff hours Health Exchange staff are on-site once a week to answer questions, assist with insurance signup; est 416 hours Attended mtgs; made submissions to SCHD for their diabetes education program; est 16 staff hours Over 1000 attended Prep for event. 4 staff at event Evaluation of Outcomes New staff hired to address limited providers access in area. Increase in use of service Increase in # of persons obtaining insurance. Continuat ion of Initiative Expense yes $270,000-300,000 in salaries $18,130 in salaries; $3,624.52 in vehicle maintenance /gas Allow in-kind room space in our Volunteer Office. $1,600 in salaries, travel

Access to Care/ Uninsured Other (Training) Preventative care Access to Care, Awareness of Resources Charity Care Students / Interns Flu Shots Health Fairs Provide financial assistance 20 Provide learning opportunity for future health care workers 243 Prevent spread of flu 69 To increase awareness and links to services LS Health exchange, Dept. of Social services UMES, Wor-Wic College Approved 70 applications for financial assistance 20 interns, 1488 staff hours in PT, Outpatient Clinic and Pharmacy Media 243 people vaccinated UMES, community Less applications due to increase in coverage by Health Exchange An increase from last year in staff time. Students receive extensive hands-on training N/A $80,052 in salaries 2 events $4,825.10 Awareness of resources Educational presentatio ns To increase awareness Wor-Wic College, Crisfield Elementary 3 events 765 people educated Preventive Health care Health screens 69 To educate public and link to treatment or services as needed UMES 69 people screened; venipunctures, glucose, LDL $4,825.10 Coalition and Community Building Improving community To provide expertise in planning strategies to improve health and economy SCHD, Tri- County Workforce, United Way 22 mtgs totaling est 50 hours $4,600 in staff salary

Donations Donations community (cash and in-kind) To serve our community and improve health care and access Crisfield High School, Crisfield Chamber of Commerce, MAC, Wor-Wic College, Somerset County Parks and Rec, National Child Safety Council, Del-Mar-Va Council Boy Scouts of America, the American Foundation for Suicide Prevention Cash to support events, scholarships and health/safety programs Use of space donated 61 times 10 hours volunteer time for events Able to support community partners $2,260 in contributions VI. Physicians McCready Health is a primary care facility that offers primary care through the McCready Health Outpatient Center. We have two board certified physicians, a surgeon and a nurse anesthetist on staff full-time. We also have a gynecologist on staff one day per week. We have contracts with several specialty providers including cardiology and podiatry. The Emergency Department is staffed by the Emergency Services Associates group providing doctors 24 a day. The McCready Immediate Care & Imaging Center is staffed with Physician Assistants and supervised by our physicians. All providers at McCready Health are employed. VII. Appendices 1. Financial Assistance Policy (FAP): McCready Memorial Hospital posts its financial assistance/charity care policy along with necessary contact information in all patient care/registration areas. Upon admission, each patient also receives the same information about the program. Patients who are uninsured or underinsured receive assistance with determining eligibility for governmental programs or the hospital s financial assistance program through one-on-one financial counseling, including assistance in filling out all necessary paperwork. In addition, self-pay patients whose balances remain unpaid after three consecutive billing cycles receive a financial assistance

application with instructions and contact information in their final statement before being sent to collections. Every effort is made to identify and assist patients in receiving the financial assistance they need. Additionally, we partner with the Lower Shore Health Insurance Exchange. We provide them a private space year round, for onsite consultation to help residents navigate through the system with advice on the best plan, completion of the enrollment forms and further guidance once the process is completed. Our Financial Assistance Policies are attached. 2. Mission, Vision, Value Statement Our Mission: Provide high quality, compassionate healthcare through an efficient and diversified service network, maintaining and improving the health of the people and communities we serve over their lifetime. Our Vision: A healthy community with access to the expertise, tools and information needed to maintain wellness. Our Values: 1. Service - Driven to provide the highest levels of service to our customers and communities 2. Quality- Providing superior care across all platforms is our reason for being 3. Dedication - Committed to compassionate healthcare throughout all of our entities 4. Caring - Promise that our hearts and minds are connected to all we do McCready Health embodies the description community hospital in every sense of the word. We are located in the heart of a rural, somewhat isolated area where high-paying jobs are scarce and per-capita income is low. Our healthcare team provides compassionate quality care to those in need of hospital and health services, regardless of a person s ability to pay. Many employees live in the and personally know the patients; often it s neighbors caring for neighbors. That quality and tradition has endured for nearly 100 years.