Methodist Le Bonheur Healthcare 2017 Community Benefit Report

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Methodist Le Bonheur Healthcare 2017 Community Benefit Report For nearly 100 years, Methodist Le Bonheur Healthcare (MLH) has been committed to giving back to Memphis and the Mid-South. As a faith-based healthcare system our mission is to ensure we provide high-quality patient care regardless of ability to pay. In 2017 MLH contributed more than $226 million in community benefit to Memphis and the Mid-South through various efforts including, charity care, Medicare/TNCare shortfall, medical education, and community health improvement services. Further information on the education and health services is included in this report. MLH also provided more than $1 million in cash and in-kind contributions to charitable organizations, in addition to the $226 million in community benefit.

A Brief History of MLH Concerned about the conditions of the hospital where his sick pastor was being treated, Mississippi planter John Sherard dreamed of building a hospital that would provide excellent care for all patients. In 1918, that dream became a reality as the Lucy Brinkley Women's and Children's Hospital was donated to Methodist while construction was underway on a new hospital. In 1924 Methodist Hospital was opened on Union Avenue in Memphis, eventually becoming Methodist University Hospital to recognize our affiliation with the University of Tennessee Heath Science Center. Methodist le Bonheur Healthcare has grown from one small hospital to a large not-for-profit faith based organization comprised of the following: 5 adult hospitals 1 children's hospital 2 Wound Healing Centers 58 Adult Primary and Specialty Care locations 24 pediatric clinic locations 4 Adult Minor Med clinic locations 2 Pediatric Urgent Care locations 5 Surgery Centers 8 Diagnostic/Breast center locations 4 Cancer Treatment Centers 3 Employer-based Clinics Residential Hospice Sleep Disorder Center Transplant Institute Sickle Cell Center Employee Assistance Program Home Health and Home Hospice Programs Home Medical Equipment

Specialties MLH strives to provide our patients with the most compassionate care, by partnering with highly-trained staff and offering state-of-the-art technology at our facilities. A cornerstone of care at MLH is patient and family-centered care, where we welcome family members/partners in care to be active in the treatment and care of our patients both as an inpatient and after discharge at home. For the eighth year in a row, Methodist Hospitals of Memphis has been recognized as a best regional hospital in the Memphis metro area by U.S. News & World Report. Methodist Hospitals of Memphis was recognized as high performing in nephrology and also recognized in the following Procedures and Conditions categories: Heart Failure Colon Cancer Surgery COPD Knee Replacement Le Bonheur Children s Hospital has been named a Best Children s Hospital by U.S. News & World Report. This is the eighth consecutive year Le Bonheur has been included in the prestigious list with recognition in eight specialties. Among those specialties recognized were: Cardiology and Heart Surgery, Gastroenterology and GI surgery, Neonatology, Neurology and Neurosurgery, Nephrology, Orthopedics, Pulmonology Urology

Methodist Le Bonheur Healthcare Adult and Pediatric Outreach Activities In 2017, MLH participated in a wide variety of programs throughout West Tennessee, North Mississippi and Southeast Arkansas. Here is an example of the activities and the number of persons served: 34 ministry-related health education classes serving 519 individuals 11 health fairs serving 2,285 individuals 24 Congregational Health Network presentations serving 1,022 individuals 22 support groups serving 253 individuals 24 health profession classes serving 332 individuals 338 free prescriptions / home medical equipment / home health visits serving 3,752 individuals Transportation vouchers serving 2,336 individuals 55 mother and child education classes serving 4,930 individuals 7 car seat safety events serving 49 individuals 9 family education classes serving 202 individuals Community HIV Programs serving 15,076 individuals Early Intervention and Rehab Development serving individuals 6,769 Medical Legal Partnership serving 340 individuals Memphis CHiLD serving 340 individuals Teen Pregnancy Prevention serving 3,483 individuals Be Proud Be Responsible serving 3,445 individuals Teen Health Literacy serving 27 individuals Youth Advisory Council serving 11 individuals Maternal Child Programs serving 7,243 individuals Nurse Family Partnership serving 197 individuals Healthy Families America serving 135 individuals Tennessee Breastfeeding Hotline serving 6,285 individuals Breastfeeding Clinic serving 251 individuals Parent Support Warm line serving 375 individuals Asthma Program serving 386 individuals CHAMP (active clients) serving 386 individuals Injury Prevention and Safe Kids serving 40,000 individuals West TN Outreach serving 8,380 individuals Le Bonheur on the Move serving 1,573 individuals Health Education Classes serving 431 individuals Health Council Meetings serving 374 individuals Screenings serving 1,744 individuals Health Fairs serving 4,258 individuals Delta Rural Health serving 290 individuals RN Health Education serving 274 individuals Behavioral Health serving 16 individuals (started in September 2017) Tipton County Nursing serving 10,852 individuals Total: 128,621 individuals served in 2017

Congregational Health Network (CHN) The goal of the Congregational Health Network (CHN) is to build stronger relationships between the faith communities and MLH to improve the patient's journey through the MLH system and beyond. MLH has 394 active churches in the area that help train liaisons to help patients after discharge from the hospital and to be a point of contact at churches when a parishioner is admitted to the hospital. In 2017, the CHN held 39 education classes for 1,057 individuals on topics ranging from Diabetes Empowerment and Living with Stroke, to Understanding Your Role as an Active Participant in Your Healthcare. MLH contributed $851,081 to fully fund this program. The CHN also works closely with the United Methodist Board of Global Ministries and has been recognized as a leader in their field.

Monetary & In-Kind Donations In 2017, MLH made donations to more than 75 not-for-profit organizations either through financial means or with in-kind donations of equipment or printing services. Among these organizations were: American Heart Association April 4 th Foundation, Inc. Bluff City Medical Boys & Girls Club of Greater Memphis Make a Wish Foundation Campbell Foundation Cystic Fibrosis Foundation Make a Wish Foundation March of Dimes Memphis Branch NAACP Memphis Jewish Home Memphis Shelby Crime Commission Memphis Theological Seminary Muscular Dystrophy Association New Memphis Institute Overton Park Conservancy Salvation Army Shelby County Mayor Charitable Fund University of Memphis Women's Foundation for a Greater Memphis YMCA of Memphis & Mid-South

Methodist Healthcare Foundation The Methodist Healthcare Foundation raises funds to benefit and strengthen the Methodist Hospital Programs and Centers of Excellence. Funds raised enhance clinical and research initiatives, underwrites costs for facilities, technicians and equipment, and help bridge the gap between what hospital reimbursement covers and what is necessary to stay on the cutting edge of medical science. In 2017, the Foundation raised $6 million and spent $5 million in support of various programs, all which benefited the community. Many years ago, the Methodist Foundation established The Humanitarian Fund which helps Methodist Associates in times of crisis (i.e., fire, crime, death). In 2017, the Foundation provided $406,559 in support of these Associates. In 2017 the MLH Population Health Program continued efforts to identify health care needs and expand opportunities for preventive care for the citizens living in zip code 38109. The estimated population of this area is around 45,000 residents most of whom confront the social determinants of health on a daily basis. With few resources for income, transportation, and accessible health care, they routinely face difficult decisions in managing their health care needs. In response to these concerns, the MLH Population Health program has created opportunities for patients to be more informed and to take action to prevent or manage chronic disease. Our strategy for affecting change in this community is through a process of engaging the community, providing information and screening, and delivering follow up contacts for high-risk cases. MLH community engagement involves two steps. Through connecting with local church congregations, schools, and other groups we build trust and win the right to offer information and engage individuals in preventive care discussions. Through that relationship we promote attendance at a series of health fairs in a local neighborhood center. The health fairs provide health care information, health screening, and feedback to individuals regarding their screening results and next steps in follow-up care. After the events those person with troubling screening results receive a letter that re-states results and the recommendations. There are follow-up phone calls to these persons to support the next steps through connecting the patient with a community resource who can help them overcome the barriers to care. Through this process the program seeks to meet the goals of improving health care outcomes for the patients through providing education, support, and connection to resources. Overview of Health Care Events In 2017 the Population Health program sponsored seven health fair events at the Riverview/Kansas Community Center under the auspices of the Wellness without Walls program. The details of these seven screenings are described below. Additionally, the Population Health staff provided health screening services at ten health events organized by other partners including the Jerusalem Baptist Church, Church of God in Christ (COGIC) Jubilee, Memphis Grizzlies, Friendship United Methodist Church, a specific COGIC congregation, and three events serving the Hispanic community in Memphis. 38109 Wellness without Walls Activities in 2017

A total of 572 unique persons attended seven official 38109 Wellness without Walls events in 2017. Vendors and community partners were present at these events to provide resource information for attendees on various health care topics. At each event the attendees are asked to complete a questionnaire asking for demographic information and other items related to health care choices. The questions inquired about access to PCP, current medication taken for chronic disease, health insurance, choices for sick care, and the number of hospital based encounters in the previous 12 months. During each event, participants had the opportunity to receive screening for blood pressure, cholesterol, and blood glucose. During the year 304 screenings were conducted for 225 unique individuals. Our trusting presence and relationships with the congregations in the community have created strong collaboration with other social services that address the social determinants of health in 38109. For example, we know that poverty is one of the greatest social determinants affecting the health of this population. We have developed programs with our local workforce investment network (WIN) to partner with the congregations to train their members to be WIN Ready- to be prepared when they apply for jobs. We know that a lack of affordable child care hampers women's ability to seek employment; therefore, we are working with a local organization to evaluate needs in order to seek funding for new initiatives. We support a variety of needs in the elementary and charter schools. All of this impacts the health of the community, as much as providing medication and navigation. We are in the process of conducting research to more dearly identify the impact of this work in a variety of areas. Cancer education and awareness to encourage mammography screenings: Through philanthropy efforts, MLH created an education and outreach initiative to address cancer disparities in Memphis and the Mid-South, particularly breast cancer mortality among black women. We place a high priority on this work because research indicates that Memphis has one of the highest disparities in breast cancer mortality rates between African American and Caucasian women, with African American women being twice as likely to die from breast cancer. Through a generous grant from Susan G. Komen Memphis-Mid-South Affiliate in 2017 (sixth year of partnership) and a close collaboration with oncology provider partner, The West Cancer Center (WCC), MLH worked to increase community awareness about the importance of preventive breast health screenings and to navigate underserved, uninsured women to free screenings, diagnostic exams and ultrasounds. During the 2017 calendar year, as a result of Komen funding, Methodist connected over 400 women from underserved areas (in Shelby and Tipton counties in Tennessee and from Desoto and Tunica counties in MS) to free screenings and/or diagnostics- 200 of which were completed on the Methodist Mobile Mammography Bus. The collaboration between the Congregational Health Network Navigators and the WCC team has aided in the success of the program. The CHN Navigators and WCC team members worked with churches, community organizations, businesses and other health care providers to educate and navigate at-risk women to screenings. After the Komen funds were exhausted, MLH and WCC continued to navigate women to screenings funded by Methodist Foundation fundraised dollars.

Mental Health Services: MLH continues to provide mental health (depression, anxiety, suicide) information and support services through the Dennis H. Jones living Well Network. In 2017 there were 1152 referrals to the Living Well Network; 96 % of the referrals were from Methodist Healthcare aligned medical practices. Of the 1152 referrals, 786 people were successfully connected to a behavioral health provider in the community. In addition, as of Jan 1, 2017 all aligned Methodist Healthcare medical groups began screening for depression upon annual exam using the PHQ9 depression screen. Most who screened positive for depression were referred to the Living Well Network. The LWN associates kept in contact with those patients as well as their primary care doctor to ensure continuity of care. The 3 rd annual Mental Health Breakfast to benefit the Dennis H. Jones living Well Network occurred in early 2017 with keynote speaker Dan Harris, ABC correspondent who discussed his journey with depression, substance abuse and anxiety. Approximately 550 people attended the breakfast including the Memphis and Shelby County Mayors, Shelby County Health Department representatives, businesses, primary care groups, mental health agencies and local universities. Scholarship Support: The Methodist Foundation awarded college scholarships to children and dependents of Associates who plan to pursue a career in a health-related field of study. IN 2017, the Foundation awarded 17 college scholarships totaling $20,000 to Associate Dependents to pursue a career in a health-related field, as well as 14 nursing scholarships, made possible by generous donors, in the amount of $20,000.

Le Bonheur Foundation The Le Bonheur Foundation (LBF), in partnership with donors and volunteers, promotes philanthropic investment to support Le Bonheur Children's Hospital's (LBCH) mission of providing high quality patient care, research and advocacy. During the year, the foundation raised more than $20.7 million, and LBF provided $11.5 million for research, education, and the FedExFamilyHouse and capital improvements. The FedExFamilyHouse (FEFH) is a home away from home for out-of-town families whose children are receiving treatment at Le Bonheur Children's Hospital. More than 16,000 families have stayed at the FEFH house since it opened its doors in December of 2010. LBF created a leadership group of young professionals within the community to serve as the Associate Board for Le Bonheur Children's Hospital Foundation. These young leaders serve as the voice of Le Bonheur in their personal and professional circles, and are key advocates in the successful delivery of our mission. In 2017, Le Bonheur Foundation distributed $211,840 to aid in the research of RSV, Arrhythmogenic Cardiomyopathy, the Role of Adipose Tissue Lipolysis in the Development of Diet-induced Hepatic Steatosis, as well as other health related studies. In addition to the community benefit our staff members provide in their professional roles, Le Bonheur Associates also volunteer for the following community organizations: Grizzlies Prep Charter School, Give 365, Leadership Memphis, Children's Homes, Inc., Hope Presbyterian, NAMI Children's and Family Outreach, ZTA Foundation, Mrs. Flynn's Closet, LEAD, Junior League, Mid-South Nonprofit Leadership Collaborative Alumni Association and Memphis City Schools CONNECT Volunteer Mentor Program. The LBF staff also had multiple speaking opportunities to community organizations including schools, rotary clubs, churches, etc. These provide opportunities for member engagement within Le Bonheur programs, both inside and outside the hospital walls.

Collaborations/Partnerships/Affiliation MLH strives to work with a wide variety of resources in the communities we serve to further help our patients in Memphis and the Mid-South. Each of these provides their own expertise and niche in each of the Memphis and Mid-South communities. Church Health Center (CHC) - MLH provides patient care free of charge to CHC patients, as well as making financial donations throughout the year. MLH supports the Memphis Plan (employer sponsored health plan for small businesses and self-employed) through yearly donations. Christ Community Health Services (CCHS) - these centers are placed strategically throughout Shelby County to provide physical, emotional and spiritual care. MLH has many Associates that serve on various boards and committees around Memphis that are directly related to the community health. MLH has Family Partner Councils at each facility. These individuals are instrumental in helping to change policies, design new facilities, establish guidelines revolving around families/partners in care and educate associates on the healthcare journey from a family perspective.