2013 ANNUAL REPORT
After my car accident, I couldn’t stand or walk and depended on my care team for everything. Now, I’m the one with the stethoscope, helping my patients at Johnson County Hospitals.” — Briana Barlett RN, former Madonna patient
Believe
in Breakthroughs
“I was nervous and scared about my future. It’s caused me to reevaluate who and what is most valuable in my life. Thanks to Madonna, I’m determined to take on new challenges.” — Jason Leuck, former patient, entrepreneur and owner of Leuck’s Dawg, gourmet hot dog stand
Table of CONTENTS 2013 Highlights……………………………… 4 Advanced Accreditation……………… 8 Community Benefits……………………… 10 Madonna Foundation…………………… 12 Board of Directors………………………… 14
Letter from the President and CEO One of our top priorities this year was planning the proposed Madonna Rehabilitation Hospital campus in Omaha. We hired the global talent of Omaha engineering firm DLR, which is collaborating with renowned design architect Michael Graves, to build the rehabilitation hospital of the future. We continue to work through the many administrative tasks associated with a second campus and look forward to sharing more exciting news as we accomplish key milestones. Concurrent to the Omaha project, Madonna staff continued to implement provisions of the Accountable Care Act and manage the reductions in payment, including sequestration and restrictions in access to rehabilitation, especially in outpatient services. In spite of these setbacks, Madonna staff collectively excelled, concluding the year with the best financial performance in history and the highest levels of patient outcomes. These are outstanding achievements that underscore the quality and expertise of Madonna staff. Operationally, Madonna reduced staff injuries and met or exceeded all quality goals. We implemented several more phases of the Electronic Medical Record (EMR) project, which were specially designed to support our post-acute care programs. We relocated the pediatric outpatient program to the lower level, adjacent to the Alexis Verzal Children's Rehabilitation Hospital, to share equipment and staff and we renovated the St. James patient rooms and the St. Benedict therapy spaces. The St. Jane de Chantal nursing home finished its best year in history; and, despite competition from a large new fitness facility in the area, Madonna ProActive sustained its membership, many of whom have achieved health, wellness and improved quality of life. I wish to thank our volunteer Board of Directors and to welcome our new Sponsor Bishop James Conley and his representative, Fr. John Sullivan, to the Madonna family. We feel incredibly blessed to be able to serve the thousands of inspiring patients, residents and ProActive members and their families who come to us for hope and healing.
Marsha Lommel, MA, MBA, FACHE President and CEO
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FY 2013 Highlights The hospital achieved exceptional
5 58 Inpatient Inpatient TCU LTACH
Brain Injury Program
clinical outcomes this year, serving among the most severely impaired persons in the nation — the top 6
208 Inpatient AR
407 OP/ RDP
percentile. In spite of the medical
Last year, Madonna served 678 individuals with brain injury.
complexity of persons served, more than 72 percent of patients were discharged to community settings, exceeding the industry benchmark of 70 percent. Of the people served
8 TCU
Spinal Cord Injury Program Last year, Madonna served 233 individuals with spinal cord injury (SCI).
55 Inpatient/ LTACH
92 Outpatient/ RDP
78 Inpatient/AR
on the long term acute care hospital level, 47 percent were discharged to a
Outpatient Rehabilitation Day Program
community setting or advanced to the acute level. This significantly exceeded the industry benchmark of 41 percent.
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Acute Inpatient Rehabilitation
Pediatric Program
106 253 Outpatient Program
Last year, we served a total of 379 new adolescents and children.
Preventing Readmission to Accute Hospitals
20 Inpatient TCU Inpatient LTACH
Top 4%
According to data from the Center for Medicare and Medicaid, Madonna is among the top four percent of rehabilitation hospitals in preventing readmissions to an accute care hospital.
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Stroke Program Last year, Madonna served 545 individuals with stroke.
101 243 OP/RDP 200 Inpatient AR
“Madonna truly brought me back to life.” Katie Felton, young woman disabled by acute respiratory distress syndrome secondary to West Nile Virus.
FY 2013 Highlights Alexis Verzal Children’s Rehabilitation Hospital Difficulty with oral feeding is a common problem for infants and toddlers following a traumatic injury or with congenital cardiopulmonary conditions. Madonna purchased the NTrainer system, a revolutionary device that delivers a reliable, quantitative assessment and administers therapy to improve and accelerate a child’s ability to suck and swallow.
Pediatric patient using N-Trainer therapy
Madonna TherapyPlus Madonna TherapyPlus completed a successful year with referral growth, strong clinical outcomes, advanced clinician training and incredible customer satisfaction ratings. TherapyPlus was voted number one for physical therapy in the KFOR Best of Lincoln public survey for the eighth year since 2004 and was voted number two in physical therapy in the Lincoln Journal Star Lincoln’s Choice Awards. Fit for Work Fit for Work successfully increased corporate clients and ProActive memberships, gaining 347 new ProActive corporate members, 71 injury clients and 35 companies for our wellness programs.
Adaptive Sports and Recreation Program Madonna’s Adaptive Sports and Recreation Program served 904 individuals including 161 patients and 575 community members with disabilities. In addition to weekly open recreational outings, the program offered several adaptive sports workshops, an Adaptive Sports Fair and sponsored three competitive sports teams – youth power soccer, the Madonna Magic Wheelchair Basketball team and the Madonna Match Points Wheelchair Tennis team. Madonna hosted two wheelchair basketball tournaments at Madonna ProActive Medical Fitness Center and a tennis tournament at Woods Tennis Center. ProActive ProActive, Lincoln’s first medically based health and wellness facility, grew membership and exceeded national benchmarks in member retention. ProActive trainers introduced 30-minute personal training sessions to expand the offerings to ProActive members and completed 977 health risk assessments and equipment orientations. Trainers also collaborated with inpatient therapists, developing a program to educate patients on exercises they can do in their communities to maintain their rehabilitation gains. Additionally, ProActive Dance grew to more than 300 students with dancers of all ages.
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St. Jane de Chantal St. Jane de Chantal Long Term Care Services offers a holistic approach to care in a welcoming, caring environment. The St. Jane team focused on increasing non-pharmacologic approaches to minimize pain and anxiety associated with aging and geriatric medical issues. Components include aromatherapy, hand massage, Comfort Touch® chair yoga, far infrared heat treatment and life celebrations. A holistic intervention station was part of the nurse aid competency training in June 2013, providing education to over 100 nurse aides and medication aides on the use of non pharmacologic interventions. Institute of Rehabilitation Science and Engineering The Institute for Rehabilitation Science and Engineering partnered with the University of Nebraska-Lincoln’s Nebraska Athletic Performance Laboratory to address human performance, safety and quality of life issues across the ability and age spectrum. Dr. Judith Burnfield, director of Madonna’s Research Institute, directs both research labs and is creating a team that bridges environments to address human function, health and well-being. The distribution network for the ICARE, an Intelligently Controlled Assistive Rehabilitation Elliptical training system, expanded to include not only the U.S., but also Canada, South America and Australia. Development of the ICARE was lead by Madonna Institute staff in collaboration with staff from the University of Nebraska-Lincoln. Funding for the work was provided, in part, by a grant from the National Institute on Disability and Rehabilitation Research to create a device that allows individuals with physical disabilities and chronic conditions to improve their walking and fitness. Two U.S. patents were issued for the ICARE and SportsArt has an exclusive licensing
agreement to manufacture and distribute the ICARE internationally. The ICARE was honored in FY 2013 with an international da Vinci Innovation Award.
Dr. Judith Burnfield and Dr. Carl Nelson, co-investigators for the ICARE research project.
Student Program As a teaching facility, Madonna recruits high ranking students with a variety of majors from top universities across the country to learn from Madonna’s clinical staff. In the past year, Madonna hosted more than 300 students from universities across the country. These students come from a variety of academic disciplines, such as biological systems engineering, computer science education, pre-physical and occupational therapy, pre-speech language pathology, statistics, electrpnic and biochemistry, adding to Madonna’s educational diversity. Madonna Workforce Madonna was awarded a Best Places to Work in Lincoln designation as a “Top 5 Organization” in the large organization category. The hospital was the only healthcare organization to be recognized.
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Advanced Accreditation CARF specialty accreditation means that Madonna meets the highest standards of care relating to staff competencies, programmatic components, best practices, outcomes measurement, education and involvement of the family in care planning, and school/community transition. Madonna Rehabilitation Hospital (MRH) is accredited by CARF for the most programs of any facility in Nebraska. Madonna Rehabilitation Hospital is… • 1 of 6 hospitals nationally accredited in both Pediatric Specialty Rehabilitation and Brain Injury • 1 of 3 hospitals nationally accredited in both Pediatric Specialty Rehabilitation and Spinal Cord System of Care • 1 of 30 hospitals in the US with an accredited Pediatric Specialty Program • 1 of the only rehab hospitals in Midwest that accepts patients on ventilators • 1 of 35 hospitals in the world that is an approved center for rehabilitation following the implantation of a diaphragm pacer device National Reach In FY 2013, Madonna served patients from 25 U.S. states: Arkansas, Arizona, California, Colorado, Florida, Iowa, Idaho, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maine, Maryland, Michigan, Minnesota, Missouri, Nebraska, Ohio, Oklahoma, South Dakota, Texas, Utah, Wisconsin and Wyoming.
FY 2013 referral market results: • 92 hospitals and healthcare facilities referred patients • 533 physicians referred patients • 6,006 patients were served
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Exceptional Satisfaction Madonna’s facility satisfaction rate (percent rating services as excellent) was 82 percent. This data represents the combined results of Acute Rehabilitation Hospital (AR), Long Term Acute Care Hospital (LTACH), Transitional Care Unit (TCU) and Outpatient (OP) services. The graph shows year-to-year comparison for the facility, showing an outstanding history of maintained positive ratings.
ME MN WI
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MI
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KS OK
TX
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AR LA FL
Financials Madonna is pleased to report another successful financial year. The hospital achieved a 7 percent operating margin on net revenues of $99.2 million.
Revenue & Expense Summary Year Ending June 30, 2013 FY 2009 Net Operating Revenue
FY 2010
FY 2011
FY 2012
FY 2013
$86,735,891 $88,302,703 $93,239,066 $95,350,965 $99,181,778
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Community Benefits by the Numbers Madonna’s mission and values were evident every day in the hospital’s daily activities and in the ways the organization gave back to the community:
904 Individuals
Served by the Adaptive Sports and Recreation Program. Seventy-eight percent of who were community members with disabilitites who participated in open recreational activities, competitions and tournaments, and adaptive sports related workshops.
600 People
$13,500 Raised
At the Madonna Chili Cook-Off for the St. Benedict’s Fund, which benefits Madonna residents, staff and patients. Teams decorated booths in music themes, and prepared and served chili to more than 400 attendees. In addition to the sale of food tickets and beverages, guests entered silent bids on items from multiple auction tables.
$575 10
Helped through the blood donations of 196 Madonna employees.
4th Year
Proactive held Pedalpalooza, a three-hour cycling class, raising more than $6,000 to fight cancer for the Livestrong Foundation.
Donated Worth of bed linens and towels by Linen Services to Southwest Lutheran Church to make blankets and bandages for local and overseas charities and Cornhusker Place substance abuse treatment center.
Charity Care Services provided to patients unable to pay for health care totaled $1,404,120 in FY 2013. Madonna provides two avenues for patients to qualify for free or reduced cost services: charity care based on patient income level and St. Benedict funds set aside by the Madonna Foundation to assist patients and families in crisis. Unpaid Cost of Public Programs Madonna absorbed $2,027,053 in losses due to shortfalls between patient care costs and amounts paid by Medicaid in the hospital, TherapyPlus and St. Jane de Chantal. Subsidized Health Services Madonna absorbed $2,234,571 in losses due to shortfalls between patient care costs and the amounts paid by Medicare for subacute and outpatient services. Educational Presentations In FY 2013, 38 Madonna employees made 174 educational presentations on various rehabilitation and health topics to 9,600 people. Local presentations accounted for 112 of the 174 total presentations, while 62 presentations were made regionally and nationally. Community Volunteers Give to Madonna During FY 2013, volunteer resources recorded 393 volunteers serving 18,282 hours, worth $390,504. Serving in 64 different positions, volunteers provided extra attention to patients, residents and visitors while expanding the work of Madonna staff. Madonna staff serving meals at Matt Talbot Kitchen.
Madonna Foundation The mission of the Madonna Foundation is to help donors invest in Madonna’s specialized rehabilitation and research. Because of visionary donors, the Madonna Foundation was able to give $1,431,595 to Madonna Rehabilitation Hospital in FY 2013. Gift income from individuals, corporations and foundations totaled $2,428,504, which represents 11,123 gifts from 1,082 donors. The first quarter of the new fiscal year brought a life estate farm gift valued at $1,521,000. Other notable donations include: GenerosiTEAM The Foundation cultivated philanthropic support among Madonna’s 1,400 employees. Two yearly employee campaigns in November and May focused on thanking current donors and recruiting new payroll-deduction gifts achieving a total of 424 employee donors, which includes employees who are paying on pledges to the Pediatric and TLC campaign and/or the “Madonna @ 50” campaign. Madonna Angel Wings Thanks to grateful patients, the Madonna Foundation presented 163 Angel Wings pins and certificates through the Madonna Angel Wings Program. Forty-one of the honored employees have received multiple angel wings. The Angel Wings program invites grateful patients to make a gift to the Madonna Foundation in honor of an employee or volunteer who made a difference in their care or that of a loved one. Since the inception of the program in 2011, the Foundation has presented 244 Angel Wings and more than $14,000 has been donated by grateful patients in honor of excellent employees and volunteers. 1958 Society The 1958 Society was established to honor individuals and organizations that have five or more consecutive years of giving. Loyalty givers have truly made a difference through their years of generous giving. During the last fiscal year, the Foundation reported 382 members of the 1958 Society; 196 are Madonna employees.
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First Hope Equipment Fund To support patients in their transition back to their homes, jobs, schools and communities, the Madonna Foundation created the First Hope Patient Equipment Fund. The fund was established with a $100,000 gift over four years from the World’s Foremost Bank. The fund accepts equipment requests by therapists working with patients who are unable to access the equipment through insurance, government programs, or family means. Since the inception of the fund last year, $15,847 has been spent to help 16 children and adults more fully participate in their schools and communities. The equipment ordered through the First Hope Fund serves patients with the following diagnoses: traumatic brain injury, spinal cord injury, muscular dystrophy, multiple sclerosis, cerebral palsy, stroke, spina bifida, autism, Down syndrome, seizure disorder and VACTERL syndrome. Equipment purchases include iPads and educational apps, a sports wheelchair, adaptive toys, equipment for an eye gaze communication system mount for a computer, a neuromuscular stimulation device for pediatric foot drop and a special needs bike trailer.
You can help rebuild lives. Learn more and donate online at: www.Madonna.org/supporter
“The nurses were simply awesome going out of their way to offer hugs and cheering her first steps.” Angie Gross, mother of former pediatric patient Mikayla
Madonna Rehabilitation Hospital Board of Directors Officers
Madonna Rehabilitation Hospital Executive Staff
Jim Schulz, Chairperson Senior Vice President, Ameritas Life Insurance Corp. (retired) Rich Herink, Vice Chairperson President, First National Bank Marsha Lommel, MA, MBA, FACHE, President President and Chief Executive Officer, Madonna Rehabilitation Hospital and Madonna Foundation Bishop-elect John Folda, Vice President St. Gregory the Great Seminary Dan Tomes, MD, Secretary Board Certified Neurosurgeon, The Nebraska Neurosurgery Group, LLC John Hanigan, CPA, CSP, Treasurer HBE Becker Meyer Love, LLP
Marsha Lommel, MA, MBA, FACHE, President President and Chief Executive Officer, Madonna Rehabilitation Hospital and Madonna Foundation Paul Dongilli, Jr., PhD, FACHE Executive Vice President and Chief Operations Officer Victor Witkowicz, BS, CPA (Inactive Registrant) Senior Vice President and Chief Financial Officer Tom Stalder, MD Vice President Medical Affairs/Chief Medical Officer Christopher Lee, PT, MSPT Vice President Rehabilitation Susan Klanecky, RN, BSN, CCM, CRRN Vice President Patient Care/CNO/Hospital Programs Paul Nathenson, RN, ND Vice President Long Term Care, Community Services, and Integrative Health Linda Sullivan, BS Vice President Referral Relations David Rolfe, MBA Vice President and Chief Information Officer
Directors Rich Bailey Chairman Emeritus, Bailey Lauerman Carol Beran Community Volunteer John Bergmeyer, JD Harding & Schultz PC, LLO Jan Connolly Senior Vice President and Corp. Secretary, Ameritas Life Ins. Corp (retired) Matt Harris President, Arbor Day Foundation Bill Johnson, MD Nebraska Pulmonary Specialties Lori McClurg Director of Operations, Jeffrey S. Raikes School, University of Nebraska-Lincoln Mike McCrory Director of State Personnel, State of Nebraska (retired) Angie Muhleisen President, Union Bank & Trust Elizabeth Noordhoek, MD Emergency physician, Saint Elizabeth Regional Medical Center Will Scott Founding principal and officer, WRK, LLC Tom Smith Chairman & CEO, Smith Hayes Financial Service Mark Whitehead President, Whitehead Oil Company
EX Officio (voting member) David C. Sundberg, CLU, ChFC, CLTC Chair, Madonna Foundation
Ex Officio (non-voting member) David Buntain, Legal Counsel Cline Williams Wright Johnson & Oldfather Law Firm
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Madonna Foundation Board of Directors Officers David C. Sundberg, CLU, ChFC, CLTC, Chair Mass Mutual Financial Group Marsha Lommel, MA, MBA, FACHE, President President and CEO, Madonna Rehabilitation Hospital Lisa Smith, Vice Chair Smith Hayes Financial Services Tawnya Starr, Secretary Firespring Greg Vasek, Treasurer Linweld (retired president)
Directors Debbie Hallock Cousins Etc. Dan Vokoun Sampson Construction Kevin Werts World’s Foremost Bank EX OFFICIO (voting members) Jim Schulz, Chair, Madonna Board of Directors Senior Vice President Ameritas Life Insurance Corp. Ex Officio (non-voting member) David Buntain, legal counsel Cline Williams Wright Johnson & Oldfather Law Firm
“John had me working harder than any drill sergeant in the Army. Thanks to great rehab at Madonna, I’m back on both feet, ready to take on the next mission.” — Col. Tom Brewer, United States Army war veteran of six combat tours in Afghanistan and recipient of multiple Purple Hearts.
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5401 South Street Lincoln, NE 68506 800.676.5448 www.madonna.org