Baylor Scott & White Health Baylor Regional Medical Center at Grapevine

Baylor Scott & White Health Baylor Regional Medical Center at Grapevine Annual Report of Community Benefits 1650 West College Street Grapevine, TX 76051 Taxpayer ID # 75-1777119 For the Fiscal Year Ended June 30, 2014

Baylor Scott & White Health Baylor Regional Medical Center at Grapevine Annual Report of Community Benefits 1650 West College Street Grapevine, TX 76051 Taxpayer ID # 75-1777119 For the Fiscal Year Ended June 30, 2014 Table of Contents Letter from the President I. Effective Dates of the Report II. III. IV. Hospital Description Hospital Mission Statement Description of the Community Served V. Identified Community Health Needs by Priority VI. VII. VIII. IX. Programs Addressing Identified Community Health Needs Charity Care and Government-Sponsored Indigent Health Care Provided Government-Sponsored Health Care Provided Other Types of Community Benefits Provided A. Community Health and Wellness Improvement Services B. Community Benefit Operations C. Financial Donations D. In Kind Donations E. Health Care Support Services F. Medical Education G. Physician Recruitment H. Subsidized Services X. Total Operating Expenses and Calculation of the Ratio of Cost to Charge XI. Report of Community Benefits Provided During Fiscal Year 2014 Page 1

August 31, 2014 Dear Fellow Texan: At BaylorRegionalMedicalCenter at Grapevine, we recognize the importance of community benefit. Being able to share our knowledge, expertise, and range of services with the community is essential in our culture of service excellence. With advanced medical services for cardiovascular health, women s health, neurosciences, stroke, orthopedics, spine, diagnostic imaging, neonatal intensive care, sleep disorders, intensive and emergency care, Baylor Grapevine serves more than 20 cities in the Dallas/Fort Worth Metroplex. Baylor Grapevine is committed to fulfilling the mission: Baylor Scott & White Health exists to serve all people by providing personalized health and wellness through exemplary care, education and research as a Christian ministry of healing. Enclosed is the report of community benefit efforts for Fiscal Year 2014, according to community needs identified by the FY 2013-16 Community Benefit Implementation Plan, Tarrant County, as well as specific focus areas identified by Baylor Scott & White Health. Each year, our facility spearheads a number of health fairs targeted at the underserved, supports local not-forprofit organizations with similar missions, and aims to make the community more aware of conditions such as heart disease, cancer, stroke, respiratory disease, diabetes, and Alzheimer s disease. As a preferred community partner, our commitment is to provide advanced health care for the ever-changing needs of our community. I encourage you to give me feedback for this report. Please address comments to me, in care of Jennifer Coleman, Senior Vice President, Public Affairs, Baylor Health Care System, 3500 Gaston Avenue, Suite 150, Dallas, Texas 75246. Sincerely, Steven R. Newton President Page 2

Baylor Scott & White Health Baylor Regional Medical Center at Grapevine Annual Report of Community Benefits 1650 West College Street Grapevine, TX 76051 Taxpayer ID # 75-1777119 For the Fiscal Year Ended June 30, 2014 I. Effective Dates of the Report The annual report of community benefits provided is for the fiscal year ended June 30, 2014(Fiscal Year 2014). II. Hospital Description Baylor Regional Medical Center at Grapevine (Hospital), an affiliate of Baylor Health Care System (BHCS), is a full-service, fully-accredited not-for-profit hospital serving residents in more than 20 cities throughout the Dallas/Fort Worth region. Focused on being the best place to give and receive safe, quality, compassionate health care, the 314-bed Hospital offers advanced medical services for cardiovascular services, women s services, diagnostic imaging, a neonatal intensive care unit (NICU), sleep disorders, intensive and emergency care. The Hospital has a rich history of providing safe, quality, compassionate health care to each and every one of the communities we serve. A comprehensive team of specialists treat complex medical conditions demanding specialized care. The Hospital has the specialists and the technology needed to help patients heal. The Hospital is named one of the nation s Top Performers on Key Quality Measures by The Joint Commission (TJC), the leading accrediting agency of health care organizations in America. The Hospital was recognized for achieving excellence in performance on its accountability measures during 2011 for conditions including heart attack, heart failure, pneumonia and surgical care. The American College of Surgeons granted the Hospital s oncology program with its Commission on Cancer (CoC) designation and the Baylor Breast Center at Grapevine as a National Accreditation Program for Breast Centers (NAPBC). Receiving care at a CoC and NAPBC-accredited facility provides patients with access to quality, comprehensive care and a multidisciplinary team approach to treatment. The Hospital is certified as a primary stroke center which means it demonstrates the ability to provide the complete continuum of care improving outcomes for people who suffer strokes. Procedures are set in place for the emergency department (ED) to quickly evaluate stroke patients for treatment options, which may include the use of drug therapy for dissolving clots. Drug therapy within the first three hours after the start of stroke symptoms can significantly reduce the effects of stroke and reduce permanent disability. Page 3

The Hospital has received full Cycle III and Cycle II accreditation with percutaneous coronary intervention (PCI) from the Society of Chest Pain Centers. This recognition validates the commitment of the Hospital to provide quality cardiac care for all patients. The Hospital s Level III NICU combines advanced technology and highly trained healthcare professionals to provide specialized care for the tiniest patients. Care is provided for newborns and infants for a variety of reasons including premature births (less than 37 weeks), respiratory distress, birth defects, infections and other illnesses. Staffed by boardcertified neonatologists, specialized nurses and neonatal nurse practitioners, we provide advanced life support and technologies for infants as early as 24 weeks gestation. The Hospital s recently expanded ED diagnoses and treats patients quickly and includes large patient rooms, a spacious new reception area, stream-lined processes and advanced imaging equipment. The nationally recognized Hospital ED provides emergency care to patients of all ages. To provide quality care during an emergency, the Hospital s responsive and dedicated team of physicians, registered nurses and care team are equipped with advanced education in managing critical care conditions. The scope of ED care includes: - A Digital imaging suite, including 64-slice Computed Tomography (CT) scanner - Team collaboration between physicians, nurses and support staff - Treatment of injuries and illnesses from minor to critical - Care plan customized for each patient s need including diagnostic tests, consultants and treatment plans - Follow-up care instructions for treatment response and a post-care plan - Triage upon arrival and bedside check-in The Hospital uses its revenue after expenses to improve the health of Dallas and surrounding communities through patient care, education, and community service. In the fiscal year ending June 30, 2014, the Hospital had 19,170 total adult and special care nursery admits resulting in a total of 51,050 days of care; 2637 babies were delivered and there were 31,625 emergency department visits. As part of the Hospital s commitment to the community, the Hospital provides financial assistance in the form of charity care to patients who are indigent and satisfy certain requirements. Additionally, the Hospital is committed to treating patients who are eligible for means tested government programs such as Medicaid and other government sponsored programs including Medicare, which is provided regardless of the reimbursement shortfall, and thereby relieves the state and federal government of the burden of paying the full cost of care for these patients. Often, patients are unaware of the federal, state and local programs open to them for financial assistance, or they are unable to access them due to the cumbersome enrollment process required to receive these benefits. The Hospital offers assistance in enrollment to these government programs or extends financial assistance in the form of charity care through the Hospital s financial assistance policy which can be located on the Hospital s website at: BaylorHealth.com/FinancialAssistance. III. Hospital Mission Statement Page 4

. Baylor Scott & White exists to serve all people by providing personalized health and wellness through exemplary care, education and research as a Christian ministry of healing. IV. Description of Community Served The System is committed to serving a vast array of neighborhoods comprising is service area and recognizes the importance of preserving a local community focus to effectively meet community needs. Located in Tarrant County, the Hospital serves the Western Region of the System and its total service area (TSA) includes ZIP codes from Tarrant, Parker, Hood and Johnson counties.1 It combines urban, suburban and rural areas with a total 2011 population of nearly 1.2 million residents. An urban/suburban geographic area Service Area Population: 783,365 Service Area Ethnicity: White Non Hispanic = 69.8 percent; Black Non Hispanic = 5.6 percent; Hispanic = 15.2 percent; Asian and Pacific Islanders Non-Hispanic = 6.5 percent; All Others = 2.9 percent Service Area Payer Mix: Managed Care = 50.5 percent; Medicaid = 9.0 percent; Medicare = 31.0 percent; Self Pay/Charity = 9.2 percent; Other = 0.4 percent Service Area Household Average Income = $94,463 Service Area living below the Federal Poverty Level ( FPL ): 4.7 percent (compared to 10.5 percent living below the FPL in the Dallas/Fort Worth Metroplex, and 10.2 percent living below the FPL in the United States) Page 5

Number of other hospitals serving the community: 10 hospitals other than Baylor Grapevine Medically Underserved: Tarrant County is partially medically underserved. The areas designated as underserved by the Texas Department of State Health Services comprise the Diamond Hill area census tracts, the East Side low income census tracts and the Central Tarrant low income census tracts Service Area Education: Less than High School = 2.6 percent; Some High School = 4.7 percent; High School Diploma = 20.6 percent; Some College/Associates Degree = 33.4 percent; Bachelor s Degree or Greater = 38.7 percent Service Area male population = 391,579; Service Area female population = 391,786 Service Area Age: 0-14 = 24.4 percent; 15-17 = 4.5 percent; 18-24 = 8.2 percent; 25-34 = 14.8 percent; 35-54 = 30.9 percent; 55-64 = 10.2 percent; 65+ = 7.0 percent V. Identified Community Health Needs During the fiscal year ending June 30, 2013, the Hospital conducted a Community Health Needs Assessment (CHNA) to assess the health care needs of the community. The CHNA took into account input from persons who represent the broad interest of the community served by the Hospital, including those with special knowledge of or expertise in public health. The CHNA has been made widely available to the public and is located on the website at the following address, BaylorHealth.com/Community. A summary of the CHNA is outlined below including the list of the needs identified in the assessment. Creating healthy communities requires a high level of mutual understanding and collaboration with community individuals and partner groups. The development of this assessment brings together information from community health leaders and providers along with local residents for the purposes of researching, prioritizing and documenting the community health needs for the geographies served by the Hospital. This health assessment will serve as the foundation for community health improvement efforts for next three years. The FY 2013 CHNA brings together a variety of health status information. This assessment consolidates information from the recent community health needs assessment conducted for the Texas Regional Healthcare Partnership Regions 9 and 10 (Region 9 and 10 RHP) and the Consumer Health Report conducted by the National Research Corporation (NRC) for the Hospital, each of which takes into account input from person who represent the broad interest of the community including those with special knowledge of or expertise in public health. The identified community health needs as outlined below were reviewed and prioritized with input from the BHCS Senior Leadership, the BHCS Mission and Community Benefit Committee and approved by the BHCS Board of Trustees. The methodology for prioritization can be found in the CHNA executive summary. Although each identified need is prioritized as high, medium or low, the Hospital will address all identified needs in the Plan. The importance and benefits of compiling information from other recognized assessments are as follows: 1) Increases knowledge of community health needs and resources, 2) Creates Page 6

a common understanding of the priorities of the community's health needs, 3) Enhances relationships and mutual understanding between and among stakeholders, 4) Provides a basis upon which community stakeholders can make decisions about how they can contribute to improving the health of the community, 5) Provides rationale for current and potential funders to support efforts to improve the health of the community, 6) Creates opportunities for collaboration in delivery of services to the community and 7) Provides guidance to the hospital how it can align its services and community benefit programs to best meet needs. In developing a plan to address all identified community health needs, the Hospital and the System found that aggregating the needs allows for significant, crosscutting initiatives. Therefore, this community health implementation plan organizes the needs as follows: A. Access to Care for Low Income/Underserved B. Behavioral Health C. Care Coordination and Care Transitions D. Dental Care E. Emergency and Urgent Care F. Multiple Chronic Conditions G. Preventive Health Screenings H. Patient Safety and Hospital Acquired Conditions VI. Programs Addressing Identified Community Health Needs Program: Community Benefits Operations Description: Community benefit operations include costs associated with assigned staff and community health needs and/or assets assessment, as well as other costs associated with community benefit strategy and operations. Staff costs for managing or overseeing community benefit program activities that are not included in other categories of community benefit. Staff costs for internal tracking and reporting community benefit. Costs associated with community benefit evaluation. Cost of fundraising for hospital sponsored and community sponsored community health improvement programs, including grant writing. Grant writing and other fundraising costs related to equipment used for Hospital sponsored community benefit services and activities. Costs associated with developing a community benefit plan, conducting community forums, and reporting community benefit. Overhead and office expenses associated with community benefit operations. Persons Served: 90,439 Preventive Health Screenings Page 7

Program Title: Community Health Education Description: These events provide education and outreach through support groups that teach residents in the Hospital s area about living with chronic diseases and issues related to care givers of those living with serious life altering injury or chronic diseases to aid in maintaining a healthy lifestyle. This program improves the quality of life for those living with or providing care for those living with chronic illnesses and conditions, and those for whom depression alters their ability to function optimally. Persons Served: 3,137 Access to care for Low Income/Underserved Program Title: Community Support Groups Description: Baylor Regional Medical Center at Grapevine offers free support groups for individuals living with certain medical conditions and their caregivers. The cost of community support groups includes rental and facilitator fees. Community support groups offered at Baylor Grapevine offers prostate cancer, general cancer, breast cancer and weight loss surgery support groups. Persons Served: 878 Behavioral Health Care Coordination and Care Transition Program Title: Donations Financial Description: Baylor Regional Medical Center at Grapevine provides financial support to non-profit organizations that serve residents in the hospital's primary and secondary service area. The hospital supports organizations that address chronic health conditions, support education, and serve the poor and underserved. Behavioral Health Program: Donations In-Kind Description: Baylor Grapevine supports area organizations through the donation of equipment, medical supplies and emergency medical care at community events. This provides a service to cities, municipalities, school districts and non-profit organizations that may otherwise not be provided. Persons Served: 5,250 Behavioral Health Program Title: Donations In Kind - Faith in Action Initiatives Description: The office of Faith in Action Initiatives 2nd Life program provides monetary and medical supplies and equipment reclamation from Baylor Scott and White Health System and community partners for the purpose of providing for the health care needs Page 8

of populations both locally and internationally whose needs cannot be met through their own organization. 2nd Life provides recycled medical equipment to under-served health care organizations, and provides monetary supporting disaster situations in shipment of medical equipment in the U.S. and in third world countries. Persons Served: 68,000 Access to Care For Low Income Populations Behavioral Health Care Coordination and Care Transitions Emergency and Urgent Care Patient Safety and Hospital Acquired Conditions Preventive Health Screenings Program Title: Health Care Support Services Description: Health care support services are provided by the hospital in increase access and quality of care in health services to individuals, especially persons living in poverty and those in vulnerable situations. Persons Served: 1,295 Access to Care for Low Income Populations Program: Health Screenings Cancer Description: Events will focus on educational materials and screenings that will impact lifestyle habits. The focus will be on risk factors associated with a variety of cancers. Events will include the Women s Health Day, Men s Health Day, community and corporate sponsored health fairs, seminars and screenings held throughout the year. Persons served: 313 Preventive Health Screenings Program: Health Screenings Cardiology Description: Events will focus on educational materials and screenings that will impact lifestyle habits. The focus will be on risk factors associated with cardiovascular disease. Events will include the Women s Health Day, Men s Health Day, community and corporate sponsored health fairs, seminars and screenings held throughout the year. Persons served: 3,501 Preventive Health Screenings Program: Health Screenings Pulmonary Description: Events will focus on educational materials and screenings that will impact lifestyle habits. The focus will be on risk factors associated with a variety of pulmonary Page 9

disease. Events will include the Women s Health Day, Men s Health Day, community and corporate sponsored health fairs, seminars and screenings held throughout the year. Persons served: 1,550 Preventive Health Screenings Program: Health Screenings Wellness Description: Events will focus on educational materials and screenings that will impact lifestyle habits. The focus will be on risk factors associated with obesity and other chronic conditions. Events will include the Women s Health Day, Men s Health Day, community and corporate sponsored health fairs, seminars and screenings held throughout the year. Persons served: 941 Preventive Health Screenings Program Title: Lifestyle Improvement Challenge Description: Lifestyle Improvement Challenge's goal is to engage communities in Northeast Tarrant County in a discussion of healthy communities. The key objectives for the initiative were to create sustainable programs that promote wellness and disease prevention, develop healthy lifestyles directly impacting future health care needs and to challenge communities to take charge of their health offerings and services. Communities that participated include: Colleyville, Euless, Grapevine, Haslet, Hurst, Keller and Watauga. Persons Served: 5,398 Preventive Health Screenings Program Title: Medical Education Description: The hospital is committed to assisting with the preparation of future nurses at entry and advanced levels of the profession to establish a workforce of qualified nurses. Through the System s relationships with thirteen North Texas schools of nursing, the Hospital maintains strong affiliations with schools of nursing. Like physicians, nursing graduates trained at the Hospital are not obligated to join the staff although many remain in the North Texas area to provide top quality nursing services to many health care institutions. Persons Served: 176 Access to Care for Low Income Populations Program Title: News Media Generated Community Health Education Description: The Public Relations Team uses news media and social media efforts to equip the community with the latest health and wellness information as well as Page 10

information on when and how to connect with health care professionals, hospitals, and other health care institutions. The scope of the efforts includes but is not limited to: Public health disease specific or injury-specific information identifying community resources for meeting health needs the development of tools and resources needed to get credible information to patients. This is accomplished through: Publishing educational and diagnostic opportunities providing timely, relevant health content on social media sites hosting electronic education events maintaining health education blogs promoting the System health library monitoring and engaging government agencies and industry associations relative to connecting providers and patients promoting the tools and resources needed to improve the quality, costeffectiveness, efficiency, patient-centeredness, safety and access to health care. The Public Relations Team produces opportunities for free health and wellness education for all people whether they are insured, uninsured or under insured patients through well-developed relationships with news media outlets. The goal of the team s work is to educate the public about health issues. Access To Care For Low Income Populations Care Coordination and Care Transitions Emergency and Urgent Care Program Title: Palliative Care Description: Palliative care services provide relief of emotional pain that accompanies end-of-life care through services addressing cultural, spiritual, ethnic and social needs in a manner respectful of the patient's individuality and inherent human dignity and worth. Patients and their families are assisted in coping with stages of illness and grief and planning for the future. Behavioral Health Care Coordination and Care Transitions Program: Physician Recruitment Description: Recruitment of physicians and other health professionals for areas identified as medically under-served (MUAs) or other community needs assessment. The age and characteristics of a state s population has a direct impact on the health care system. The state s population is growing at an explosive pace twice as fast as the national average. During this 10 year period, Texas had the fourth highest percentage growth and ranked first in the number of residents added during this period. And, like the rest of the country, the Texas population is aging and in need of Page 11

more health care services, which puts added demands on the system. The Hospital seeks to allay the physician shortage, thereby better managing the growing health needs of the community. Access to care for Low Income/Underserved VII. Charity Care and Government-Sponsored Indigent Health Care Provided For Fiscal Year 2014, Baylor Regional Medical Center at Grapevine provided $9,513,598 in unreimbursed costs of charity care and government-sponsored indigent health care. VIII. Government-Sponsored Health Care Provided For Fiscal Year 2014, Baylor Regional Medical Center at Grapevine provided $17,592,626 in unreimbursed costs of government-sponsored health care. IX. Other Types of Community Benefits Provided $1,560,809 Baylor Regional Medical Center at Grapevine is committed to improving the quality of life for the many citizens living and working in its area. Baylor Regional Medical Center at Grapevine was pleased to allocate funds to the following community benefit activities. A. Community Health and Wellness Improvement Services $71,708 B. Community Benefit Operations $172,744 C. Financial Donations $30,095 D. In Kind Donations $41,998 E. Health Care Support Services $93,003 F. Medical Education $475,077 G. Physician Recruitment $605,018 H. Subsidized Services $71,166 X. Total Operating Expenses and Calculation of the Ratio of Cost to Charge As required by Section 311.046 (a)(4), Baylor Regional Medical Center at Grapevine reports $194,957,754 in total operating expenses. As required by Section 311.046(1) (5), the ratio of cost to charges was 30.59%. Please see the attached worksheet for the full calculation. Page 12

XII. Report of Community Benefit Provided During Fiscal Year 2014 In a commitment to fulfill its mission, Baylor Regional Medical Center at Grapevine benefit to the community, conservatively estimated, was $28,667,033 for Fiscal Year 2014.Baylor Regional Medical Center at Grapevine is filing its Annual Statement of Community Benefits Standard (Statement) as a consolidated system with the other affiliated hospitals of BSW excluding those that qualify as Medicaid disproportionate share hospitals). Through community benefit activities, BSW-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 Jennifer Coleman, Senior Vice President, Consumer Affairs, Baylor Scott and White Health,3600 Gaston Avenue, Suite 150, Dallas, Texas 75246. Page 13