Epiphany for clinics 2 International recruitment 7 Executive changes 7 PERIODICAL RATE PUBLICATION
FEBRUARY 2024 VOLUME 40, NUMBER 2
Catholic Health CEO reconfigures services to better meet needs in Western New York New leader is exploring solutions to respond to health care challenges in post-COVID world
Valerie Schremp Hahn /@CHA
By JULIE MINDA
Dr. Joanne Waltman talks with patient Pat Niemeyer at the 65 Prime+ Clinic in Festus, Missouri. The clinic is the second of its kind opened by Chesterfield, Missouri-based Mercy.
Mercy 65 Prime+ clinics give more time, resources to older patients’ treatment By VALERIE SCHREMP HAHN
FESTUS, Mo. — Pat Niemeyer, 76, had been seeing Dr. Joanne Waltman for 14 years for primary care. Recently, at her first visit with Waltman at Mercy’s new 65 Prime+ clinic here in the exurbs of St. Louis, Niemeyer noticed things were different. Waltman had more time to review Niemeyer’s medications. She had more time
to talk to Niemeyer about her social life, her support system, her exercise routine. “OK, so you’re not a drinker,” said Waltman. “Now what are you doing for exercise these days?” “Sitting in my chair,” Niemeyer said wryly. “Thinking about it?” Waltman asked, encouragingly. “I do a lot of that,” Niemeyer replied.
The Mercy 65 Prime+ clinic opened in September, Mercy’s first in the St. Louis region. It’s modeled after the success of a Mercy 65 Prime+ clinic that opened a year ago in Joplin, Missouri, in the southwest part of the state. The clinics, geared toward Medicare patients who are 65 and older, offer longer and more frequent appointments so Continued on 4
When Joyce Markiewicz became president and CEO of Catholic Health in September, she took the helm of a system grappling with formidable challenges: Some communities in its Western New York service area are among the most impoverished and their residents have some of the worst health outcomes in the nation. But Markiewicz has made a name for herself Markiewicz over her 19-year career at Catholic Health as someone who can get things done, and she’s already spearheading some changes to tackle the issues that are vexing communities in the Buffalo, New York-based system’s service area. The four-hospital Catholic Health has Continued on 6
Oklahoma City respite facility ensures care for unhoused patients after discharge By NANCY FOWLER
‘IT CREATED A SENSE OF NORMALCY IN A VERY ABNORMAL SITUATION.’
Catholic Medical Center’s NICU suites promote family bonding with infants By JULIE MINDA
When Janelle Lorento gave birth to her daughter this summer at 30 weeks’ gestation, she quickly knew she wanted to be transferred to a different hospital for what she anticipated would be an extended stay. She wanted to go where she and her family could “room in” with new arrival Ivy Quinn and spend as much time as possible bonding with the preemie. About two weeks after Ivy’s birth, mom and baby were transferred to the Neonatal Intensive Care Unit & Family Suites at Catholic Medical Center in Manchester, New Hampshire. Janelle says when she arrived at Catholic Medical Center, “I felt like I could take my first deep breath in weeks.” Unlike most NICUs across the U.S., the Continued on 5
The rooms in the Neonatal Intensive Care Unit & Family Suites at Catholic Medical Center in Manchester, New Hampshire, contain the equipment needed to care for both mom and baby.
Catholic hospitals in Oklahoma City are partnering with a nonmedical respite care facility to help unhoused adult patients recover safely as they build a more stable life. Cardinal Community House in the city’s downtown area has 40 private rooms in four dormitories where patients can recuperate from illness or injury after discharge. Mercy Hospital Oklahoma City, part of Chesterfield, Missouri-based Mercy, and SSM Health St. Anthony Hospital — Oklahoma City are among the five local hospitals that rely on the respite center. The two Catholic institutions refer 65% of all the center’s patients. The nonprofit Homeless Alliance estimates that there are more than 1,400 people without housing in Oklahoma City. This population experiences the full spectrum of health issues. But Kelli Ude, Cardinal Community House’s executive director, says many of those living on the streets are Continued on 8
2 CATHOLIC HEALTH WORLD February 2024
FIND MORE CHA RESOURCES ONLINE chausa.org
JOB POSTING: SENIOR DIRECTOR, MEDIA RELATIONS
Capital projects
Vivid memories linger
Delving into DEI
A look at some of the larger projects completed by Catholic systems in recent months, including a new headquarters for CHRISTUS Health in Irving, Texas.
Sr. Jane Marie Klein, who prayed beside Rev. Martin Luther King Jr. just after his death in Memphis, Tennessee, shares her recollections from that tragic day in 1968.
A Health Progress Diversity, Equity and Inclusion Discussion Guide offers a means to move toward greater understanding of one another and patients.
Epiphany event at Saint Alphonsus draws clinics into mission By LISA EISENHAUER
At a meeting in August of Saint Alphonsus Health System mission and medical group leaders, the question arose of how to better integrate the 73 clinics under the Boise, Idaho-based system’s umbrella into its Catholic mission. Most patient visits take place at those clinics spread across Idaho and Oregon. However, just as many of the clinics are physically disconnected from Saint Alphonsus’ four hospitals, the leaders at the meeting worried the clinics might feel removed from the mission and vision of the system and its parent, Trinity Health. “The hospitals are very aware of mission, of what we do in mission, and of chaplaincy as well,” explained Ted Marconi, director of mission integration at the system’s flagship, Saint Alphonsus Regional Medical Center. “What Marconi we’ve discovered over the last few years is our clinics don’t know that we have a mission leader and that we have chaplains. And so, our goal across Trinity Health is to integrate mission in the clinics.” With the help of technology, he and other leaders at Saint Alphonsus organized an event in January to “make sure the clinics knew they were seen and heard,” Marconi said. The event brought people from all the clinics together virtually for a shared mission-related experience on the Feast of the Epiphany. It was Marconi who, at the meeting in August, proposed the idea of centering the event on Epiphany. The holy day, traditionally marked Jan. 6, commemorates the biblical story of the visit by the Magi to the baby Jesus. As part of the Christian celebration of Epiphany — which in Greek means manifestation — many observers mark their thresholds. The marking for 2024 was 20+C+M+B+24. The current year is at the beginning and the end of the marking. The letters stand for the traditional names of the Magi, which are Casper, Melchior and Balthazar, and the Latin phrase Christus mansionem benedicat, which means “May Christ bless this dwelling.” The four crosses between the letters and figures represent north, south, east and west, indicating that all people are included in the revelation of the Christ child to the entire world.
Gathering support In Marconi’s view, the marking reflected the Saint Alphonsus mission statement: “We, Trinity Health and Saint Alphonsus, serve together in the spirit of the Gospel as a compassionate and transforming healing presence in our communities.” The others at the summer meeting backed his idea for the Epiphany observance, agreeing it was a way to celebrate the new year together. The event was set for Jan. 8, the Monday after the feast day.
A woodcut plaque marks the threshold of a Saint Alphonsus Health System clinic for a Feast of the Epiphany service. The system’s 73 clinics used various materials to create their markings.
The planners then presented the idea to the eight directors of the Saint Alphonsus Medical Group. Once the directors were onboard, the planning widened to include more spiritual care and mission leaders and Sisters of the Holy Cross, the system’s founding congregation. Meanwhile, the local clinics partnered with leaders in deciding on participation; what ways they would display the marking; who would create the marking and with what material; and who would recite readings at the event. A calendar appointment went out to all the clinics and other participants before the Christmas break. A week before the event, the readers of the eight passages that were chosen for the service did a practice run at a virtual gathering. That gathering prompted them to agree that it would be best if they were all in Boise to ensure the actual event went smoothly.
Connected in spirit On the big day, the service started at 7:45 a.m. sharp. Fifteen people, including the readers, were together in Boise and a person or groups of people from each clinic
Vice President Communications and Marketing Brian P. Reardon
Editor Lisa Eisenhauer leisenhauer@chausa.org 314-253-3437 Associate Editor Julie Minda jminda@chausa.org 314-253-3412 Associate Editor Valerie Schremp Hahn vhahn@chausa.org 314-253-3410
attended virtually. The service lasted all of about 10 minutes, Marconi said, and went off without any glitches. Afterward, as the clinics displayed photos of their marked thresholds, the Microsoft Teams screen lit up with heart, smile and applause emojis. The threshold markings showed various levels of creativity and investments of time by the clinics. Some had used chalk for the markings, others used laminated printouts and others created wooden engravings. “Nobody was judging,” Marconi said. “Everybody was just enthused by the creativity that people had for how they translated what we were going to do.” He said Saint Alphonsus is continuing to look for more ways to better connect its clinics to its mission. Given the success of the Epiphany blessing in its inaugural year, that event will be repeated annually. Marconi said the event was a good example of subsidiarity, the Catholic principle of empowering those closest to the work. “When everybody’s involved across the system in a great way, I think it’s just a better representation of who we are,” he said. leisenhauer@chausa.org
Catholic Health World (ISSN 8756-4068) is published monthly and copyrighted © by the Catholic Health Association of the United States. POSTMASTER: Address all subscription orders, inquiries, address changes, etc., to CHA Service Center, 4455 Woodson Road, St. Louis, MO 63134-3797; phone: 800-230-7823; email: servicecenter@ chausa.org. Periodicals postage rate is paid at St. Louis and additional mailing offices. Annual subscription rates: CHA members free, others $29 and foreign $29. Opinions, quotes and views appearing in Catholic Health World do not necessarily reflect those of CHA and do not represent an endorsement by CHA. Acceptance of advertising for publication does not constitute approval or endorsement by the publication or CHA. All advertising is subject to review before acceptance.
CHA seeks candidates for the position of senior director, media relations. The Catholic Health Association of the United States (CHA), representing more than 600 hospitals and 1,600 long-term care and other health facilities in all 50 states, advances the ministry of the Catholic Church in caring for people and communities. Grounded by our core values of respect, integrity, stewardship, and excellence, CHA team members work collaboratively to bring hope and healing to those we serve as we advocate for health equity and access to care for all. CHA and our members promote a culture of inclusion and belonging that brings together people of diverse faiths and backgrounds in our belief that every person is a treasure, every life a sacred gift, and every human being a unity of body, mind and spirit. Through our mission and values, we will empower bold change to elevate human flourishing. This position is responsible for creating and telling the story of Catholic health care in the United States in a compelling manner. The senior director will support the development and implementation of a bold communications strategy that proactively advances the vision, mission, and values of CHA. This position will also provide strategic counsel and guidance to CHA leaders and members that advance CHA’s advocacy, brand and policy objectives in the media. The position will be primarily responsible for earned media relations and ensure that CHA’s crisis communication plan is in place and followed. The position will partner with advocacy colleagues and external partners to advance federal policies important to CHA and its members. Periodic travel will be required. CHA seeks candidates with a minimum of seven years of related experience; vision and aptitude for developing and executing thoughtful, proactive communications strategies; proven track record of earning media with top-tier outlets. Political and/or public policy experience is preferred. Experience in Catholic health ministry, nonprofit organizations, and/or the health care industry are desired. Knowledge of Catholic social teaching is desired. This position requires a bachelor’s degree in journalism, communications or a related field; a master’s degree is preferred. Interested parties should direct resumes to Attention: Cara Brouder Senior Director, Human Resources Catholic Health Association HR@chausa.org CHA is an equal-opportunity employer and offers a competitive salary and a comprehensive benefits package. To view a more detailed posting for this position, visit the careers page on chausa.org.
Graphic Design Norma Klingsick Advertising ads@chausa.org 314-253-3477
© Catholic Health Association of the United States, February 2024
We Will Empower Bold Change to Elevate Human Flourishing.SM
February 2024 CATHOLIC HEALTH WORLD 3
Ministry to have significant presence at Harvard moral injury conference Virtual event in March to explore how to help people heal from trauma CHA and some ministry systems are among the sponsors of a virtual conference in March that will explore moral injury and trauma and their impacts, how people can heal from this distress and the role of spirituality in that healing. Presented by the Human Flourishing Program at Harvard University, the 2024 World Congress on Moral Injury, Trauma, Spirituality and Healing will take place March 11-13. Among the dozen-plus sponsors are CHA, Ascension and Providence St. Joseph Health. The Catholic University of America also is a sponsor. The conference is designed for chaplains, faith leaders, clergy, spiritual care directors, mental health providers, clinicians, health care leaders, wellness professionals, researchers, policy makers and others. Among the topics that presenters will cover are how to identify and assess moral injury and trauma, innovations in treating those ailments, spiritual perspectives on the topic, healing and forgiveness, collec-
2024 World Congress on Moral Injury, Trauma, Spirituality and Healing When • March 11-13 Host • Human Flourishing Program at Harvard University Location • Virtual Cost • $150 for those not seeking a certificate for their participation, and $250 for those who wish to earn a Certificate of Completion in Trauma Informed Spiritual Care. Those prices will increase as the conference nears. To learn more and register • hfh.fas.harvard.edu/. Click on “events.”
tive trauma, psychotherapy approaches to trauma, spiritual therapies, clinical perspectives, and techniques to use to improve well-being. The conference will include a keynote by best-selling author Thomas Moore and remarks from Tyler VanderWeele, director of the Human Flourishing Program at Harvard; and Dr. Harold Koenig, director of the Center for Spirituality, Theology and Health at Duke University.
Other speakers include: Peter Kilpatrick, president of the Catholic University of America, on the role of Catholic organizations in preventing moral injury. Dr. Arpan Waghray, CEO of Providence Well Being Trust, and Antonina Olszewski, vice president of spiritual care for Ascension, on innovation in providing wellness and spiritual care in health care. Rev. Cathy Chang, director of ondemand spiritual care for Ascension, on how to integrate chaplains into the health care team as part of a panel that will explore strategies in health care for addressing moral distress. William Foster, Trinity Health vice president of spiritual care, on how to integrate spirituality into clinical practice. Jill Fisk, CHA director of mission services; Theresa Vithayathil Edmonson, Providence St. Joseph Health vice president of spiritual health; and film director Michael Collins on mindfulness and meditation. Fisk says the conference will provide a much-needed platform for discussing the importance of both mental health and spiritual health in recovery from trauma. She says conference organizers hope the event will lead to the creation of a network
of spiritual care providers and others who are knowledgeable about spiritual care of abuse survivors. “This is really important work,” says Fisk. The conference is part of a body of work by Jennifer Wortham, research associate with the Human Flourishing Program at Harvard. Her brothers were abused by the family’s parish priest decades ago, and Wortham made a promise to her dying grandmother that she would do what she could to address clergy sexual abuse. Wortham has since been investigating and researching the topic and holding events and discussions to raise awareness of the issue. She spoke personally to Pope Francis about the concern. She successfully lobbied the United Nations to create a World Day for the Prevention of and Healing from Child Sexual Exploitation, Abuse and Violence. Wortham tells Catholic Health World it is important to her to expand the discourse around moral injury, including to spur discussion of the moral injury to the soul from abuse and how to heal. She says abuse claims numerous victims, and its impacts are far-reaching. She wants spiritual, mental health and clinical care providers to be better trained to prevent such abuse and to help people to heal.
Upcoming Events from The Catholic Health Association
Webinar — IRS 990, Schedule H: An Overview and Update on Current Tax-Exemption Issues Feb. 20 | 1 – 2:30 p.m. ET
Slow and Simple
CONTEMPLATIONS FOR THE LENT AND EASTER SEASON The 14-week series of reflective images and meditations offers two ways to engage:
Diversity and Disparities Networking Call Feb. 21 | 2 – 3 p.m. ET
Deans of Catholic Colleges of Nursing Networking Call Feb. 26 | 1 – 2 p.m. ET
Webinar — What Counts as Community Benefit and Accounting for Community Benefit
✦O rder printed sets of prayer cards from the CHA store. ✦ I mmerse yourself in an enriching online experience.
April 23 | 1 – 2:30 p.m. ET
CHAUSA.ORG/LENT
July 9 | 1 – 2 p.m. ET
Assembly 2024 June 9 –11
Faith Community Nurses Networking Call
chausa.org/calendar
We Will Empower Bold Change to Elevate Human Flourishing.
SM
4 CATHOLIC HEALTH WORLD February 2024
Mercy clinic From page 1
providers can better cover patients’ concerns and needs. The clinics’ services include flu shots and other immunizations; Medicare annual wellness visits; general medical evaluations and wellness exams; treatment of minor illnesses and injuries; cholesterol checks; and a special focus on diabetes, hypertension, incontinence, Alzheimer’s disease, dementia and early memory loss, osteoporosis, and Parkinson’s disease and other movement disorders. “The ministry-level population health administrators wanted to create this kind of new model for senior-focused health care, and so they put together a framework for what they wanted and sent it to us and we pulled it off,” said Dustin Parker, the practice manager for the clinic in Joplin. “I think it’s going very well Parker for being so new. We get very, very positive reviews from patients. I think it’s a great model.”
A personal connection Waltman joined Chesterfield, Missouribased Mercy 14 years ago, taking over the practice of a retiring geriatrician. When she learned Mercy was going to open a second clinic geared toward seniors, she jumped at the chance to spend more time with a population she loves. “They just appreciate everything you do,” she said. “They want to be very involved in their care.” Waltman, a mother of four, attends church with many of her patients. She enjoys the personal relationship she’s established with them. “They come in, and I ask, ‘Is there anything else that you want to talk about?’ And they’re like, ‘Yes, I’m going to need to see pictures of your children.’” In addition to Waltman, the clinic has a nurse practitioner and two medical assistants. There’s also a registered nurse, a front desk receptionist, an office manager and two office coordinators. The Joplin clinic has a doctor, a primary case nurse, a nurse practitioner, two medical assistants, a practice manager and a receptionist. A medical assistant at each clinic acts as a care navigator. Parker explained that in a typical pri-
Providence to fund mental health services for school system Providence St. Joseph Health plans to fund mental health services for students of the Renton, Washington, School District over the next three years. Providence’s headquarters are in Renton. The funds, which come from Providence’s Well Being Trust, will enable the district to strengthen its mental health support efforts by offering every child in all 27 Renton public schools access to virtual therapy either at their school or home. Dr. Arpan Waghray, CEO of Well Being Trust, said in a release that “our youth’s future success is partly driven by the quality of their health and wellness today.” He said, “Providence and the district are focused on establishing short- and longterm mental wellness practices by creating an academic environment where students can prioritize their health and develop lifelong coping and well-being practices to support them for years to come.” Given the diversity of students in Renton public schools, the district is committed to ensuring that students are paired with diverse, bilingual mental health professionals who can provide high-quality care that meets each child’s specific needs, Providence said in the release.
mary care visit, a patient might get about 20 minutes with a care provider. With the senior care model, the first visit is an hour, giving the provider and patient time to create a plan of care for the rest of the year. Patients are placed in one of three tiers, depending on how healthy they are. The tiers determine how often they return for visits. Someone who is healthier might come back in six months, but someone who needs more care might get appointments every month.
Navigating care and getting help The care navigator follows up with phone calls about appointments and schedules patients with social services if they need them. “It sometimes gets scary for our senior patients when you’ve got five or six different doctors and people telling you, ‘You need to be here at this time or here at this time,’” said Parker. “With that care navigator, if a patient needs help, she can walk them through
“I think it’s going very well for being so new. We get very, very positive reviews from patients. I think it’s a great model.” — Dustin Parker
from the moment they come through our door the very first day all the way through the entire process of their health care journey.” The clinics’ patient pools are smaller as well. The one in Festus is set up to see about 1,000 patients, which allows for longer and same-day visits. Waltman’s previous clinic cared for about 2,200 patients. Now, she typically sees eight to 12 patients a day. Often, family members or caregivers accompany patients to the clinics, and the exam rooms are large enough to accommodate them. “A patient came in here and we spent that full hour going over everything,” said Waltman. “And then her daughter who had brought her said, ‘Can I get a new patient packet?’ Since the patient was 90, her daughter was old enough.” The area the Festus clinic serves has limited public transportation, so its staff works with a local disability resource group to arrange rides. The clinic also helps patients with financial challenges get lower-cost or even free medications. In addition, clinic staff can coordinate home health care and help patients write advance directives. In the future, Waltman hopes to establish an intensive behavioral therapy group for people with obesity. The clinic’s staff also hopes to trial a program to help those with early valvular heart disease as well as a program to assess gait and balance, which would be like one in Joplin. That clinic
uses a camera to take photos and video of a patient walking, standing and sitting. A computer program then uses that information to assess fall risk.
‘Someone who cares’ One benefit of longer visits is to give the clinics’ staff time for follow-up services that might otherwise need a separate appointment. During Niemeyer’s visit, she showed Waltman her Apple Watch and noted that it had detected abnormal heart rhythms. Waltman asked to look at Niemeyer’s phone, where she noted a pattern of similar alerts on a health app. Waltman asked for an EKG, which was performed in the exam room. It showed a pattern of atrial fibrillation. Waltman prescribed Niemeyer a blood thinner and referred her to a cardiologist. After the appointment, Niemeyer praised Waltman as an attentive and respectful doctor. She appreciated the extra time with Waltman at the clinic. “Oh, I was amazed over that,” she said. “Usually, it’s in and out.” She said she planned to tell her friends about Mercy 65 Prime+. “I think it’s a good idea because I’m old now,” Niemeyer said matter-of-factly. “And it does make a difference when you have someone who cares. And I believe in her heart, she really does care, and she really tries to help.” vhahn@chausa.org
February 2024 CATHOLIC HEALTH WORLD 5
as possible bonding instead of being separated from their baby, which is typical for NICU families. “This speaks to our Catholic mission and values,” says Maloney. She notes that the same integrated care model is used in Catholic Medical Center’s Mom’s Place, the labor and delivery and postpartum unit of the hospital for moms and babies not requiring specialized NICU care.
The suites in the NICU at Catholic Medical Center have room for mom, baby and family members.
NICU suites From page 1
one at Catholic Medical Center exclusively offers family suites. Each is a private room with enough space for the baby and mom to receive care as inpatients and for other family members to stay. In the Lorentos’ case, Janelle and her husband held, fed, changed and assisted with the care of Ivy in their hospital room. Ivy’s brother and sister were able to stay in the room during daytime hours, spending time with their new sister and playing card games, completing homeschool work, eating meals and taking family photos. Janelle, in a press release from the hospital, says the group enjoyed “making memories as a family of five — all in the comfort of our own, calm, private room.” “It created a sense of normalcy in a very abnormal situation,” she says. Ivy was discharged Oct. 30.
Nation’s first Catholic Medical Center says its family suites, opened in 2010, were the first NICU suites in the nation. Tanya Ricci, nursing unit director of the NICU & Family Suites, says a few other hospitals now have such suites and more are adding them. Catholic Medical Center has four suites designed for when moms are inpatients and four smaller suites for Ricci when just the infant is an inpatient. Each suite has an isolette, bassinette for the baby, a radiant heater, and sleeping accommodations for the baby’s primary caregiver. Each room has hidden storage areas containing the equipment required to care for the baby. The suites all get communal access to a sink, refrigerator, microwave, toaster and coffee maker; a washer and dryer; a private bathroom with a shower and locker; and a family lounge. Ricci says the NICU suites’ setup is “totally different” than what is the norm for most NICUs. What is typical is to have a bay,
The Lorento family opted to transfer to Catholic Medical Center in Manchester, New Hampshire, after Ivy Quinn arrived early.
or a large open area, with the babies’ isolettes and a chair or two next to each for parents or other visitors. There usually is a curtain to pull around each isolette for privacy.
Care for the whole family Catholic Medical Center created the suites to offer not just a different type of space but also a different type of care for NICU families. Called integrated care, couplet care, or mom-baby dyad care, it is focused on treating the mother and infant — as well as the other family members — as a unit. Key to the philosophy is that parents and family members should become the primary caregivers of their babies and collaborate with and work alongside the health care team. The concept also calls for a different staffing model. Ricci says in standard NICUs, a team of nurses usually cares for the babies and most activity happens on a
regimented schedule, with the nurses handling virtually all medical interventions. While moms are inpatients, they usually are on a separate hospital unit, cared for by a separate nursing team until their discharge. In contrast, at Catholic Medical Center, mom and baby are cared for in one room and stay in that room almost all of the time, with medical care delivered there. Just one nurse works with that family per shift. All of the NICU nurses have expertise in postpartum care of new moms and the care of highrisk infants. The unit is equipped to provide babies with respiratory support, central venous and arterial access, supplemental nutrition, developmental care and bedside medical care, including eye exams. Trained nurses can provide the eye exams needed for premature babies at risk of retinopathy. The NICU is staffed by neonatologists and advanced practice providers from Darthmouth Health Children’s. Ricci says that in 2021 about 11% of the more than 1,100 births at Catholic Medical Center were to families that stayed in the NICU suites.
Around-the-clock bonding At Catholic Medical Center, family members are encouraged from the start to take an active role in their baby’s care. They can hold their babies when they wish and they can change their diapers. Clinicians teach the parents to administer the routine medical care the babies need. Renee Maloney, service line director of maternal, child and women’s health for Catholic Medical Center, Maloney says it is usual for families to have to continue medical interventions at home after discharge. She says all the tubes and wires can be very scary to parents, so getting them acclimated to that medical equipment and its use from the start can make them feel much more in control and comfortable when discharge time comes. Ricci says the essence of this integrated care is that families can spend as much time
Shift of control The integrated care approach can be jarring for new team members used to other care environments, acknowledges Ricci. Ceding control of extremely fragile infants to parents who may not have a medical background can be difficult for clinicians to do. It helps, Ricci says, that Catholic Medical Center onboarded a team at the same time it opened the unit so all clinical staff “knew what they were getting into.” Her team has consulted other NICUs experimenting with integrated care and the transition is more difficult when moving from a standard to integrated care approach, she says. Ricci says the integrated care model has great potential to improve patient care. Research has shown that the approach can decrease new parents’ anxiety and decrease the incidences of postpartum depression. It’s also been shown that babies who are born to mothers with substance use disorder often require less pharmacological intervention when they are treated with integrated care. And, moms and babies have decreased lengths of stay under this care model than those in typical NICUs. “It’s a whole different philosophy,” says Maloney. “Our nurses are very good at building trust with families. It’s a trusted relationship from the beginning. Our nurses do a lot of coaching.” “It’s a unique, compassionate, caring place,” she says. Visit chausa.org/chw for links to more information and resources on Catholic Medical Center’s NICU suites. jminda@chausa.org
The Lorento family had the space in Catholic Medical Center's Neonatal Intensive Care Unit & Family Suites to gather in the same room as baby Ivy.
Mercy Health — Kings Mills Hospital opens in suburban Cincinnati with room for growth Mercy Health — Cincinnati opened its Mercy Health — Kings Mills Hospital in Mason, Ohio, on Jan. 21. The $200 million, 175,000-square-foot hospital and two-story medical office building are on the 30-acre former site of the College Football Hall of Fame. The hospital is the first hospital to be built in greater Cincinnati in nearly a decade. “The opening of this facility addresses the need for an acute care hospital in Mason
and neighboring communities,” Jason Asic, president of Mercy Health — Kings Mills, said in a release. “Closer proximity means shorter ambulance rides, faster medical interventions, and better outcomes for area patients.” The 60-bed acute care facility is the first hospital located in Mason. Mercy Health also operates five others in greater Cincinnati: Mercy Health — West, Mercy Health — Anderson, Mercy Health — Cler-
mont, Mercy Health — Fairfield and The Jewish Hospital —Mercy Health. The hospital’s emergency department includes 16 treatment spaces and has adjacent shell space to allow for expansion. In addition to emergency care, the hospital will provide general and orthopedic surgery, a Level 1 catheterization lab, an intensive care unit, four operating rooms, three procedure suites, and additional shell space for eventual expansion.
An attached medical office building will offer specialist care, including ENT, audiology, general surgery, pulmonology, orthopedics, cardiology and lab services. The medical campus is positioned for growth or other changes to meet the demand for care. Mercy Health — Kings Mills has hired over 200 staff members with plans to expand its workforce as needed. Mercy Health — Cincinnati is part of Bon Secours Mercy Health.
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I speak about finding joy in your work. I’m committed to helping them feel joy. I want them to understand the importance of the work they’re doing.
Bishop Michael W. Fisher of Buffalo, New York, and Joyce Markiewicz, Catholic Health president and CEO, prepare to take a ride in a Mercy Flight helicopter following the blessing and dedication of Lockport Memorial Hospital in October.
Catholic Health CEO From page 1
six campuses throughout Western New York. Early in her career, Markiewicz helped orchestrate a dramatic turnaround in Catholic Health’s home care division. She later assumed leadership of the system’s nursing homes, Programs of All-Inclusive Care for the Elderly, and women’s, orthopedic, imaging, and laboratory services. In her most recent role as executive vice president and chief business development officer, she expanded service lines and forged partnerships that led to the construction of a new “neighborhood hospital” in Lockport, New York. That hospital is a campus of the system’s Mount St. Mary’s Hospital in nearby Lewiston, New York. Markiewicz spoke to Catholic Health World about how Catholic Health is taking on the challenges before it. Her responses have been edited for length and clarity. What are some of the dynamics of the Western New York communities Catholic Health is serving that are driving decisions your system is making? We are a very diverse community with a mix of races and nationalities. We have many pockets of different immigrant groups in our community, and that is a beautiful thing. But when you look at Erie County, and Buffalo, which is the major metropolitan area we serve, you see that there is much poverty. Buffalo has the seventh highest poverty rate in the U.S. We have pockets where there is high poverty, urban food deserts, and low median incomes. And we see a correlation between the poverty and problems with the education system, where some groups have much less education. In Niagara County there are some of the worst health outcomes in all of New York state, in terms of mortality, obesity and chronic disease. These are some of the major reasons we were motivated to build our new facility, Lockport Memorial Hospital, after the community’s hospital closed. Something else we looked at was our population declining, with young people leaving the region. But then there was a renaissance happening in Buffalo and there was an uptick in population and things were stabilizing. Something else that’s top of mind for us is that we have a very, very large aging population. What are some of the top challenges your system is facing? Our challenges are no different than
what the majority of health systems are facing now. The pandemic made a huge impact on our finances. And we have a laser focus on how we get ourselves into the position of having a sufficient number of days’ cash on hand. We were in a good position prior to the pandemic and that has eroded. It’s not just because of supply chain costs but also because of workforce issues. We have to solve this issue as a nation — there is a lack of workforce when it comes to nurses and really in all areas of health care. An area that has grown tremendously across the country is agency staffing. We’re paying agencies exorbitant rates and that
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We are fortunate to be part of a health system where we can change how we think of things and how and where we deliver care, be it in the hospital, or outpatient or home care setting.
has a great effect on the bottom line. There’s a reimbursement issue here, and we need payers to recognize this. What are some of the ways Catholic Health is being innovative in addressing the challenges it is facing? The Lockport Memorial Hospital we opened recently is a good example. When we decided to go into that market, people expected that the new hospital would look like the old one, but we found that that wasn’t a sustainable model. We are fortunate to be part of a health system where we can change how we think of things and how and where we deliver care, be it in the hospital, or outpatient or home care setting. We ask, “Where is the best place for the patient to get care?” “Where should the patient be?” It’s not in the emergency department. For the community where the bankrupt hospital was located, we did a deep dive into the demographics, where people access care, and where the gaps were in services. We saw that people had to travel far for high-end care. And we saw that they had maternity services but were delivering less than one baby a day. In that situation,
Joyce Markiewicz, then-Catholic Health executive vice president and chief business development officer, at right, speaks with Tara Ellis, president of FeedMore WNY at the October 2021 launch of the Food Farmacy. That collaboration between Catholic Health, D’Youville College and FeedMore WNY enables primary care providers to link patients at risk for food insecurity to nutritional food and nutrition education.
you’re not delivering the highest quality care because it’s difficult if you don’t have the volume. And the same was true for surgery. They had difficulty recruiting surgeons and anesthesiologists. So we took over operations of an ambulatory surgery center that was part of the shuttered hospital, to better meet the surgical needs of patients throughout Niagara County, where Mount St. Mary’s and Lockport Memorial hospitals are located. We looked at the scope of practice and the low acuity of the patients admitted on campus at (the closed) Eastern Niagara Hospital. We decided that for higher acuity procedures we could stabilize people at Lockport Memorial and then transport them to the right level of care at our other hospitals. And all this enabled us to look at the workforce differently at the new hospital. We cross-trained our nurses to work in emergency as well as in inpatient settings as well as our radiology techs to be proficient in various imaging modalities. So far it is working beautifully. And as it turns out we only needed to transfer a small number of patients to higher-acuity settings. The bottom line is that we’re looking at how to get people to the best level of care at the best location. And we’re using this as a model to look at concierge care and for using more telemedicine and having it in every room in the new hospital. And we’re using Lockport Memorial to test technology and maximize the use of our Epic electronic medical records system. What are some of the ways Catholic Health is addressing the workforce issue? We are going upstream, working with colleges and universities in our market. We’re supporting schools to provide the workforce of the future. For instance, we’re putting some of our services on their campuses. We’re collaborating with one school to fund scholarships for our associates to become nurses and clinical professionals. Additionally, we’ve started our own staffing agency where nurses can pick and choose shifts. We’ve also started residencies to give new nurses opportunities to get more clinical experience as they join our system. We’ve also been looking at benefits, financial compensation and recognition programs. Most of our campuses have nursing councils and we learn from them. Our associates can share their input about the changes they’d like to see. What are some of the main messages you’re sharing with your own employees about what’s ahead? I attend every orientation session. I speak to new hires about the pressures in society and how it is so important to be kind to each other. I speak about finding joy in your work. I’m committed to helping them feel joy. I want them to understand the importance of the work they’re doing. And I’ve been going around and meeting with associate and physician groups around our system. And I’m finding there is a sense of hope. We know it’s been a difficult couple of years and we’re not out of the woods yet, but we have a sense of hope that if we work together, we can get to the other side and be successful. We still believe in Catholic health care and in the work we do. Visit chausa.org/chw for additional insights from Markiewicz. jminda@chausa.org
February March 1,2024 2022 CATHOLIC HEALTH WORLD 7
KEEPING UP PRESIDENTS
Nariman El-Mofty/Associated Press
Dr. Gurvinder Kaur to president and market leader for Saint Agnes Medical Center, Fresno, California, from chief medical officer and vice president of Adventist Health, Central Valley Network. Saint Agnes is part of Trinity Health. Matt Brown to the interim region president of the CommonSpirit Health mountain region, following the departure of Peter Banko.
Kaur
Tammaro
Ecker
Ziegler
Espinoza
Lewis
McCullough
Spugnardi
Ashmore-Ruppel
A surgeon prepares to operate on a man's severely infected toe inside the Sudanese Red Crescent Clinic in eastern Sudan in 2021. Sudan is on the watch list that the World Health Organization keeps of nations that are especially stressed by health care worker shortages.
CHA paper discusses ethics and consequences of recruiting health care workers internationally By VALERIE SCHREMP HAHN
If a hospital in a wealthy nation like the United States can’t find health care workers in its own country, why not recruit them from low- or middle-income countries? It’s a seemingly simple solution, but one that a CHA research paper warns has the potential for unintended consequences. While recruiting health care workers from other countries isn’t new, it has rapidly accelerated in recent years. That prompted CHA to release a discussion paper outlining the ethical considerations and repercussions of luring skilled staffers from countries facing considerable needs themselves. “The Future of Health Workforce Discussion Paper: Insights and Opportunities to Transform International Health Workforce Recruitment and Capacity” was researched and written to help sponsors and executives as they talk about and discern the topic as well as how to respond as members of the Catholic health ministry. It was released last year and is available at chausa.org/ globalhealth. Among the specific concerns the paper raises are: The world is projected to have a shortage of 10 million health care workers by 2030. A growing dependency by wealthy nations on poorer ones for medical workers “is driving dangerous depletion of health care capacity for the most poor and vulnerable countries.” Bruce Compton, CHA’s senior director for global health, noted that the motivations for writing and promoting the paper align with CHA’s vision statement, “We will empower bold change to elevate human flourishing.” Compton “I think our new vision statement is very relevant to this conversation,” he said. “Human flourishing doesn’t happen just in the United States. Human flourishing is about all of us.” The paper notes these themes apply to the world’s wealthier economies including the United Kingdom, Italy, Germany, Canada and Australia. CHA’s Working Group on Global Health Workforce for the Future collaborated with the global consulting company Accenture to produce the paper. The work included reviewing literature and interviewing more than 30 people from high-, medium- and low-income countries. Many were associ-
ated with the Catholic health ministry. Camille Grippon, system director of global ministries for Bon Secours Mercy Health, is the chair of the working group. “I began the project thinking and believing everybody knows this is an issue but since we really need staff on the ground, we are forced to recruit from anywhere we can,” she said. Grippon “A lot of people I shared this with had no idea of the depth of the issue. I think it’s good that we brought awareness.”
Challenges here and abroad Challenges such as the COVID-19 pandemic, burnout, workplace violence, recruitment issues, and lack of instructors to train health care workers have depleted the workforce pipeline here and abroad, the paper notes. But while the need to recruit workers continues to grow, that may put more countries at higher risk for not being able to attend to their own workforce and health needs. The paper cites the example of the more than 150,000 nurses from the Philippines that have been recruited for jobs in the United States since the 1960s. The paper notes the Philippine Nurses Association recently raised concern about the nation’s ability to provide essential care to its own citizens. The Philippine government has considered emergency responses like scholarships and incentives to get nurses to stay. Compton noted that because of the shortage, hospitals in the Philippines have allowed unlicensed nurses to start practicing there. “Our solutions can’t be creating other people’s problems, because eventually they’ll become our problems again,” he said. Despite the concerns about its health care workforce, the Philippines isn’t on a watch list the World Health Organization keeps of nations that are especially stressed by the shortage and in need of safeguards. Those countries “are experiencing some of the world’s lowest health care workforce density numbers,” the paper says. The group added eight countries to the list in March 2023, bringing the total to 55. Many are in Africa. Working toward solutions As awareness of the worker shortage grows, some countries have agreed to help
one another. A partnership between the Irish Health Service Executive and the Ministry of Health in Mozambique focuses on exchanging knowledge, training and improving local resources. Because of this agreement, maternal mortality has decreased by as much as half in some parts of Mozambique, the paper says. The paper also highlights the Tropical Health and Education Trust, an organization based in the United Kingdom that partners with and trains health workers in Africa and Asia. Recruiting and aiding workers domestically, including upskilling unlicensed hospital staff, providing flexible staffing and supporting the mental health and wellbeing of staff can help workers stay, the paper says. The paper notes that “Catholic health will always support humane and peopleled migration of health care workers that is mutually beneficial to the origin countries.” But it adds: “What we must collectively address and reexamine is the ethics of international recruitment practices, so that we can practice responsibly for global health care capacity and resilience.”
Possible solutions The paper suggests many ways to address the brain drain from poorer nations. Groups can help bolster and reinforce education in countries where many potential workers drop out of school because of lack of funds. Health care systems can use recruiting agencies that promote ethical and sustainable practices and establish accountability for those agencies. They can establish a training fund for sender countries and develop long-term, reciprocal partnerships with them. They also can look at their definition of “ethical” and expand it to take on a more globally inclusive approach. “My hope is that we begin to see the U.S. as part of the broader global community,” said Grippon. “Unfortunately, it’s been my experience in 20 years of global health work that the U.S. sees itself as the U.S. and the rest of the world is the rest of the world. I want people to take away that your actions at home have an implication abroad.” “Reflecting on the Interconnectedness of the Global Health Workforce: What Can Your System Do To Bolster the International Workforce?” in the Winter 2024 edition of Health Progress includes member viewpoints on ethical practices in international recruitment. vhahn@chausa.org
ADMINISTRATIVE CHANGES Holy Name of Teaneck, New Jersey, has made these changes: Suzanne Tammaro to chief marketing officer, Donald Ecker to vice president of integrated services and Cynthia Ziegler to vice president of revenue cycle management. Tessa Espinoza to chief philanthropy officer for Dignity Health French Hospital Medical Center in San Luis Obispo, California. The hospital is part of CommonSpirit Health. Cassie Lewis to chief nursing officer for the Richmond, Virginia, market of Bon Secours Mercy Health, effective Feb. 11. Angel McCullough to chief nursing officer of St. Mary Medical Center in Langhorne, Pennsylvania, and Nazareth Hospital in Philadelphia. Those hospitals are part of Trinity Health’s Mid-Atlantic region. St. Louis-based SSM Health has announced changes to the leadership of its sponsoring body, SSM Health Ministries, as well as to its governing board. Sr. Mary Noel Brown, CSA, to president/chair of the sponsor board. She succeeds Fr. Michael Rozier, SJ, who completed his term but will continue to serve on both SSM Health’s sponsoring body as well as its board of directors. SSM Health also has named two new members of the sponsoring board, who also will serve on the governing board: Fr. Thomas Nairn, OFM, and Therese B. Pandl, who is a consultant who formerly headed ministries within Hospital Sisters Health System. Indu Spugnardi to senior director, community health and elder care, and Lori Ashmore-Ruppel to senior director of mission services management, both at CHA.
GRANT PeaceHealth Southwest Medical Center in Vancouver, Washington, has received a $5 million gift from Julie and Bill Reiersgaard and their family. The medical center will use the funds to support caregiver education and to purchase equipment. In recognition of their gift, the hospital has renamed one of its facilities the Julie and William Reiersgaard Health Education Center. Reiersgaard was president of Gaard Automation and of IPEC Automation. The businesses supply robot systems to high-tech electronics manufacturers, metals foundries, and plastics companies.
8 CATHOLIC HEALTH WORLD February 2024
IN BRIEF HSHS announces upcoming closure of two hospitals in Wisconsin Hospital Sisters Health System announced in January plans to close HSHS Sacred Heart Hospital in Eau Claire and HSHS St. Joseph’s Hospital in Chippewa Falls as part of a “complete exit” from the Western Wisconsin region. Prevea Health, a physician network offering primary and specialty care, also will close all its locations in the Western Wisconsin Chippewa Valley. Most of the closures will be complete by April 21. The Prevea residency clinics will close by June 30. The Eau Claire and Chippewa Falls facilities are among 15 hospitals that
Springfield, Illinois-based HSHS has across Illinois and Wisconsin. “We made this decision with a heavy heart as HSHS Sacred Heart and HSHS St. Joseph’s have been treasured ministries of the Hospital Sisters for more than 140 years,” Damond Boatwright, president and CEO of HSHS, said in a press release. “We extend our deepest gratitude to our colleagues, physicians and volunteers for their countless contributions — all of which have shaped the Hospital Sisters’ healing legacy. The mission behind that legacy will guide and sustain us as we move forward.” Boatwright is the chair of the CHA Board of Trustees. HSHS said in a release that “the difficult
decision comes after prolonged operational and financial stress related to lingering impacts of the pandemic, inflation, workforce constraints, local market challenges and other industry-wide trends.”
CHA signs letter urging support for maternal, infant health legislation CHA joined dozens of other organizations with a stake in health care in a letter to congressional leaders supporting two bills that would continue maternal and infant health programs and related research. The letter, sent Jan. 17, was in regard to the PREEMIE Reauthorization Act and the Preventing Maternal Deaths Reauthorization Act.
“These critical bills will reauthorize essential maternal and infant health programs and research at a time when maternal and infant death rates, especially in communities of color, have increased dramatically,” the letter states. The letter notes that in 2021, preterm birth rates hit a 15-year high and the maternal mortality rate continued to rise, making the U.S. one of the most dangerous places to give birth in the developed world. The letter cites a recent report from Centers for Disease Control and Prevention’s National Center for Vital Statistics showing that infant mortality increased by 3% in 2022, the first year-over-year increase in more than two decades.
Respite facility From page 1
hospitalized after being hit by vehicles or for conditions caused or exacerbated by exposure to harsh weather. “We see quite a few individuals who have an underlying condition such as a diabetic neuropathy issue,” Ude says. “Before respite care was available, they might leave the hospital and then have nowhere to go and be out in the eleUde ments — and that would maybe lead to something more severe like amputation.” Ude says Cardinal Community House’s respite services prevent such drastic outcomes by giving people who leave the hospital with no home to return to a safe, comfortable space in which to heal. Caring for them as they convalesce is a privilege, Ude says. “I know this sounds cliché,” she says. “But it’s 1,000 percent the truth that it is just so rewarding.”
Wraparound services The average stay at Cardinal Community House is 30 days. Patients benefit from case management, social workers, home health visits and medication services. They’re provided with three meals a day, clothing and hygiene supplies. They also receive education and therapy for substance abuse along with help with permanent housing, official identification, family reunification and transportation. Recently, a patient arrived with a new diagnosis of kidney disease, and instructions to undergo dialysis. During his stay, Cardinal Community House not only made sure he kept his dialysis appointments but also took him to apply for Social Security benefits. “Now he has an income to support himself in his chronic medical condition,” Ude says. Cardinal Community House has a long history of serving the unhoused. It first opened as a shelter in 1966. Later, it became the Oklahoma City Halfway House
A colorful community room at Cardinal Community House in Oklahoma City has tables, vending machines and a television.
for inmates completing prison sentences, transitioning back to its original mission during the height of the COVID-19 pandemic. In 2021, the center began offering respite care to a small number of clients through the Oklahoma City-County Health Department. SSM Health participated in a Cardinal Community House pilot program hoping to find a better option for its patients experiencing homelessness. “For a lot of people, we discharge them and say, Ochs ‘Rest up for a few days,’” says Andrew Ochs, SSM Health regional vice president of mission integration. “But when unhoused patients were ready, we didn’t have a safe place to discharge them to, and
Hospital beds and recliners donated last fall by Mercy are among the furnishings in a room at Cardinal Community House in Oklahoma City.
we would keep them in the hospital for longer than we would have liked — or they would have liked.”
Two models From his previous work with Ascension Saint Thomas in Nashville, Tennessee, Ochs was familiar with a homeless shelter in that city whose residents include patients recovering from illness and injury. Like Cardinal Community House, Nashville’s Room In The Inn partners with local medical systems. “I had this desire to get something like that up and running in Oklahoma City,” Ochs says. “Around the same time, our partners down the street at Catholic Charities came to us with the same idea.” Patrick Raglow, executive director of Catholic Charities of the Archdiocese of Oklahoma City, had recently learned about the transitional respite program at House of Charity in Spokane, Washington. The 10-year-old program operates in conjunction with Catholic hospitals and the Diocese of Spokane. To Raglow, the idea of respite care made sense not only as a Catholic mission but also for the financial health of local hospitals. He says spending money to keep patients without medical reason isn’t cost-efficient. “But you can send them to a place like Cardinal Community House for pennies on the dollar,” Raglow says. SSM Health St. Anthony Hospital granted the respite center $40,000 in November 2021 to help with initial costs. After a trial period, the hospital entered into a formal agreement in February 2022 to pay a per-patient, per-day fee. Later that year,
Mercy Hospital Oklahoma City began partnering with Cardinal Community House under a similar accord, paying $130 a day for each room. Cindy Maggart, Mercy’s executive director of post-acute care services, stresses the arrangement is truly a partnership that includes weekly interdisciplinary care plan meetings at Cardinal Community House. Maggart “How are our Mercy patients? How are they progressing? We want to know,” Maggart says. “Our goal is to make sure that we get them well and that they don’t end up back in the hospital.” Both Catholic hospitals are still gathering hard data about readmission rates.
Part of a bigger picture This past September, while cleaning out a storage area, Maggart discovered 50 beds Mercy purchased during the pandemic that were unneeded afterward. The hospital donated them along with 30 unused reclining chairs to Cardinal Community House. “While we can’t solve all of the problems with homelessness and access and social determinants of health, respite care is a step in the right direction,” Maggart says. Raglow hopes other cities will begin looking to Cardinal Community House as a model for caring for their unhoused populations. As for the Oklahoma City partnership, he says the collaboration speaks distinctly to the Catholic mission “to value the dignity of each person and to work with all others of goodwill to serve the common good.”