Cone Health 2013 Report to the Communities

I feel that the greatest reward for doing is the opportunity to do more.

- Dr. Jonas Salk

MAKING A DIFFERENCE 2014 ANNUAL REPORT TO OUR COMMUNITIES

Never believe that a few caring people can’t change the world.

For, indeed, that’s all who ever have.

- Margaret Mead, Cultural Anthropologist

Making a Difference: Letter to Stakeholders Many believe that caring – an act of shared humanity – is everything. Here at Cone Health we believe in the power of caring because when you care it shows in the quality of your performance, in the purity of your motives and in the clarity of your goals.

Caring is at the heart of all we do at Cone Health. Our values are Caring for Our Patients, Caring for Each Other and Caring for Our Communities. These values inform our decision making as well as our actions.

Strategic Initiatives

Cone Health was founded on the principles of caring.

When The Moses H. Cone Memorial Hospital opened its doors on Feb. 25, 1953, it was with the understanding that “no patient shall be refused admittance because of inability to pay.” That philosophy still holds true today as we celebrated the 60th anniversary of Moses Cone Hospital and the opening of the North Tower in 2013.

When we completed the merger of Alamance Regional Medical Center and Cone Health in May 2013, we had in mind the care of people in our communities. The purpose of the merger was to combine two strong organizations, both of which have caring at the core of their values, to provide people throughout our region with access to a broader range of high-quality, expert medical care.

Later in the year, Alamance Regional expanded its emergency services by opening an addition to its Emergency Department that increased the number of treatment areas to 58. Alamance Regional also completed its 40,000 square foot Cancer Center, which expands its chemotherapy treatment area and provides larger exam rooms to better care for patients and family members.

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Similar to our 2013 merger with Alamance Regional, we entered into a 2012 management services agreement with Carolinas HealthCare System knowing that our patients and our communities would benefit. During the past year, we have learned a great deal from Carolinas HealthCare and have put into place those tools and techniques that are enhancing the quality of our care. We have reciprocated by sharing our own best practices with Carolinas HealthCare.

We also demonstrated our commitment to caring for our patients when we harnessed the power of technology to improve continuity of care and communications. We did so by activating an electronic medical record system and the electronic portal that goes with it – MyChart. MyChart enables easy and secure patient access to various components of the medical record as well as the means to easily and securely communicate with one’s physician via email.

An important component of caring is to serve the needs of the underserved. Cone Health does this in many ways, one of which was this year’s opening of the Sickle Cell Medical Center. This center ensures the most comprehensive treatment to enhance the quality of life for the more than 400 local individuals living with the disease. Patients are offered direct access to distinct treatment measures and protocols for pain

management, hydration, infusion and support. This 24-hour center is a first in North Carolina.

A Dedicated Team

The success of a health network relies on contributions from many different quarters – physicians, nurses, allied health professionals, administrative and support personnel, volunteers and board members. We are proud of and grateful for the more than 10,500 individuals who perform these roles.

This year, we are especially proud that a record 26 nurses from our team were recognized by the Great 100 Nurses program. This is the largest number of nurses from a single health organization in the 25-year history of the Great 100 program. We want to thank this group (shown above) for demonstrating excellence in nursing practice.

We would be remiss if we didn’t recognize two individuals who have contributed numerous years and a great deal of leadership to our organization.

Dr. Hank Smith, stepped down after three years as Chairman of the Board of Trustees, but remains on the board. Dr. Smith has served a total of 13 years as a member of the board, leading this organization through a great deal of growth.

After 27 years at Alamance Regional Medical Center, CEO John Currin announced his retirement, which became effective at the end of 2013. He was part of the executive team that led the merger of Alamance County Hospital and Memorial Hospital in 1986 and was a key driver in the merger with Cone Health.

John will continue his work on Alamance Regional’s Cultivating Hope Capital Campaign to raise money for the cancer center in Burlington. He will also play an important role with Impact Alamance, the new community health fund created as a result of the merger with Cone Health.

We are grateful to both men for all they have done.

Making a Difference

In the following pages, you will see examples of how members of our team have put the Cone Health values of Caring for Our Patients and Caring for Our Communities into action. Our values are more than words on paper; the members of our team live our values. News anchor Tom Brokaw once said: “It’s easy to make a buck. It’s a lot tougher to make a difference.” Not so for the Cone Health team. This team is out in our communities making a difference each and every day.

Sincerely,

Tim Rice Chief Executive Officer

Deborah Hooper Chair, Board of Trustees

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Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around.

- Dr. Leo Buscaglia, Professor and Author

Making a Difference by Caring for Our Patients Program and Service Enhancements

During 2013, we added a number of patient and family-centered programs and services, one of which is the forensic nursing program to assist potential victims of domestic violence. The need for this effort is clear: Sadly, the Greensboro Police Department responded to 13,819 potential domestic violence calls in 2012.

Forensic nurses began collecting evidence of domestic violence in the emergency departments at The Moses H. Cone Memorial Hospital, Wesley Long Hospital, Annie Penn Hospital and MedCenter High Point. The services will soon be available in the emergency department of Alamance Regional Medical Center. Evidence is collected confidentially and kept until potential victims choose to use it to obtain a restraining order or in a criminal trial.

In 2013, new Varian TrueBeam™ linear particle accelerators were installed at Cone Health Cancer Centers at Wesley Long and Alamance Regional. These $4 million machines are the latest pieces of equipment that use highly focused beams of radiation to treat a wide variety of cancers. This technology offers patients shorter treatment times than the devices they replaced.

The TrueBeam also brings capabilities for stereotactic radiosurgery to Alamance Regional.

The Cone Health Cancer Center at Wesley Long added a Calypso™ 4D Localization System to the linear particle accelerator.

The Calypso system tracks the targeted tumors as they move within the body. Motion management has become an important part of accurate treatment delivery because, even though a patient is lying still, organs are always moving. The Calypso watches the tumor and will stop the delivery of radiation if the patient’s breathing or other motion moves the tumor out of ideal position. This spares surrounding tissue leading to potentially better treatment with fewer side effects.

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Cone Health has opened a second clinic for people planning to travel abroad. Travel preparation usually focuses on questions such as what to bring or who will take care of the pets, and overlooks one of the most important parts of travel – how to prevent illnesses.

The focus of the Regional Center for Infectious Disease Travel Clinic is to keep international travelers well by providing country-specific information on disease outbreaks and safety issues, in addition to the necessary pre-travel immunizations.

We aim to improve our care by involving patients and their families in Cone Health’s decision-making processes. The Patient and Family Advisory Council will collaborate with Cone Health leaders, physicians and caregivers to better understand and meet the needs of our patients and families. Their ideas will help design new services and address organizational challenges.

The 20 members of the council, representing a threecounty area, will serve a minimum of one year and may elect to serve a second yearlong term.

Research

We participate in leading-edge medical research to provide the people of our communities with the latest technology and treatments, sometimes many years before approval for widespread use. When selecting clinical trials we focus first on enhancing the compassionate care and successful treatment for all our patients, especially when the best treatment options may be unclear. And we assess new technologies with the highest potential for advancing treatments.

These girls have chest pains and shortness of breath nearly twice as often as their male counterparts, and are often told they have asthma or other breathing problems.

But researchers at Cone Health found that there is a good chance these symptoms may be just a part of growing up. These findings were published in Current Sports Medicine Reports (“Exercise-Induced Dyspnea and Chest Discomfort in Active Adolescent Girls”).

Some of Cone Health’s research is designed to create a safer hospital for our patients. For example, we conducted an infection control study at Moses Cone Hospital, Wesley Long Hospital and Annie Penn Hospital from July 2011 to January 2012. Study results were published in the June 2013 online Journal of Infection Prevention. The study found that Cone Health reduced the rate of hospital-acquired MRSA (Methicillin-resistant Staphylococcus aureus) infections by 56 percent. These results were seen after the implementation of an infection prevention program that combined screening, hand hygiene education and pulsed xenon ultraviolet light room disinfection in patient rooms. The latter technology was developed by Xenex Healthcare Services.

In one such study, the LeBauer Cardiovascular Research Foundation team found that newer drugeluting stents are far safer in heart attack patients than previous versions. Investigators unveiled their findings, plus presented a case study on a rare condition causing heart attacks in young women, at EuroPCR in Paris in May 2013. This study followed 3,464 heart attack patients from Cone Health Heart and Vascular Center and the Minneapolis Heart Institute from 2003 through 2011. It found that patients treated with the latest generation drug-coated stents had a much lower rate of stent thrombosis, an uncommon but serious and sometimes fatal condition in which a blood clot forms within the stent months or years after the initial stent implant.

In another study, LeBauer Cardiovascular Research Foundation investigators evaluated a condition in middle and high school girls who engage in sports.

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Without a sense of caring, there can be no sense of community.

- Anthony J. D’Angelo, Founder, The Collegiate Em Powerment Company

Making a Difference by Caring for Our Communities Cone Health exists to serve its communities. We embrace our responsibilities to promote health as well as to create the kind of community conditions that foster well-being. Toward that end, our organization invested more than $245 million last year alone to provide healthcare for which we were not compensated. On top of that, we donated nearly $3 million in contributions and sponsorships to a variety of community organizations and activities. Beyond the monetary resources we invest in our communities, our caring employees invest their time to build stronger communities.

Community Health Needs

Cone Health recently joined with a number of community partners to identify barriers and gaps in services and resources to improve the health and well-being of residents in Alamance, Guilford and Rockingham counties. We partnered with the Alamance County Health Department, United Way of Alamance County, Healthy Alamance, Guilford County Department of Public Health, Cone Health Foundation, High Point Regional Health System, University of North Carolina at Greensboro’s Center for Social, Community and Health Research and Evaluation, Rockingham County Health Department, Rockingham County Healthcare Alliance and Morehead Memorial Hospital.

This process helped us align our resources, programs and strategies with the priority needs of our communities. Our prioritization process identified the following community health needs for which we have developed implementation plans that will be completed by 2016:

Access to Care

Alamance

✔ ✔ Mental Health ✔ Healthy Pregnancy Chronic Disease

Guilford

✔ ✔ ✔ ✔

Rockingham

✔ ✔ ✔

Those in Need

Imagine having surgery and, once you are discharged from the hospital, the only place you can go is to your makeshift shelter under a bridge. You are homeless, and there is no one to make sure that you take your medicine or help change your bandages.

The Cone Health HOPES program – Healing Opportunities for People Experiencing Sickness – transformed the recovery process for 30 homeless or near homeless individuals in Greensboro in its first 15 months. The program is implemented in conjunction with the Congregational Social Work Education Initiative at The University of North Carolina at Greensboro.

Funded through private donations, HOPES provides comprehensive services for patients admitted into the program. A Cone Health Congregational Nurse provides medical assessment and case management, while a social worker addresses applications for housing, employment and benefits. The patient receives housing at an efficiency motel until the medical condition is stabilized, gift cards for medications and food, and a 31-day bus pass.

The program is unique to North Carolina.

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In another program to help the homeless, nearly two dozen Cone Health employees provided health assessments to more than 110 homeless individuals during a series of one-day events at local churches.

In addition to a variety of health screenings, participants also received dental care, haircuts and job assistance.

In 2013, Habitat for Humanity celebrated its 25th year of service, and 30 Cone Health employees were there to help build a house less than three miles away from Moses Cone Hospital. The Cone Health employees were responsible for roofing, siding and trim, and the installation of windows and doors for the three bedroom, two bath, 1,500 square foot house.

Cone Health employees demonstrated their concern for the less fortunate by collecting 24 winter coats that were distributed to veterans at The Servant Center. The Center provides housing, case management services, limited medical care, food and transportation to homeless and disabled military veterans.

A Cone Health employee also knitted 59 scarves and seven caps that she donated to Street Watch, an organization that visits homeless people in makeshift camps throughout Greensboro. Sandra Casey also collected other items from her co-workers – another 17 pairs of gloves, four scarves, 19 caps, two ear muffs and five headbands – to help keep homeless people warm during winter.

Cone Health employees try to lighten the burden of those deprived of adequate shelter and are equally concerned about and generous toward those who are hungry.

Sadly, 50 million Americans – 16 million of whom are children – may not have food on any given day. In fact, the Greensboro area ranks in the top five nationally in hunger rates. For the second consecutive year, Cone Health employees lent their efforts to help end hunger by collecting nearly 11,000 pounds of food for non-profit pantries in Guilford County.

Social Worker LaTarsha Similarly, a group of Cone Jenkins is shown packing Health employees worked food for hungry Cone Health to end hunger among Cone patients. The food was collected from Cone Health Health patients. Far too many employees, and a van load of times, a social worker would food was donated by a local visit a patient’s home and grocery store. find that there was no food in the house. Through employee donations of food and grocery gift cards, and a van load of food from a local grocery store, those patients in need started the year on a happy note.

In addition to caring for the homeless and the hungry, Cone Health employees also care for the needs of children in our communities.

Each year CareLink, the Cone Health ambulance transport team, transforms into Santa Link and fills its ambulances full of toys for needy children that are distributed by various community services agencies in the area. The toys are donated by Cone Health employees.

Each year Cone Health employees fill ambulances full of toys for needy children, which are transported

by Santa Link to various local social service agencies.

Sandra Casey, an employee at Moses H. Cone Memorial Hospital, cared for homeless people during the winter by knitting and collecting warm head, neck and hand apparel.

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Excellence is never an accident; it is the result of high intention, sincere effort, intelligent direction, skillful execution and the vision to see obstacles as opportunities.

- Anonymous

Making a Difference Through Our Drive for Excellence The recipe for great healthcare is the combination of abundant compassion, unerring service and an unyielding drive toward excellence. Accreditations and quality milestones separate those who provide great care from those who provide mediocre care.

Cone Health has had numerous accreditations and quality milestones to celebrate in 2013: • The Cone Health network earned accreditation from The Joint Commission, which also named five of our hospitals Top Performers on Key Quality Measures for 2013.

• The Stroke Center was recognized for excellence by the American Heart Association and American Stroke Association. The Stroke Center also earned The Joint Commission accreditation.

• Cone Health was recognized as the top hospital in North Carolina in 11 categories and among the top 100 hospitals nationally in 28 categories by the 2014 CareChex® quality awards.

• The addition to Cone Health Cancer Center was awarded Silver LEED certification by the United States Green Building Council for the steps taken to minimize the building’s environmental impact.

• Annie Penn Hospital received the Guardian of Excellence Award for reaching the 95th percentile in employee satisfaction based on data collected from May 2012 to April 2013.

• Cone Health won the Silver Performance Achievement Award in the American Heart Association’s Mission: Lifeline STEMI Receiving Center program for complying with all quality measures.

• The Pharmacy earned American Society of Health System Pharmacists accreditation.

• The Outpatient Rehabilitation program was ranked tops by the Uniform Data System for Medical Rehabilitation.

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• Annie Penn Nursing Center received a five-star rating from The Centers for Medicare and Medicaid Services.

• Cardiovascular Imaging earned Intersocietal Accreditation Commission accreditation.

• Moses Cone and Wesley Long hospitals received Blue Cross and Blue Shield quality designations.

• Alamance Regional Medical Center was named one of the nation’s Most Wired hospitals, one of only six in the state. The award is presented by the American Hospital Association and recognizes the use of technology to achieve higher levels of patient care.

• The Heart Failure Program earned accreditation from the Society for Cardiovascular Patient Care.

• The Cancer Center earned dual accreditation from the American College of Surgeons Commission on Cancer and National Accreditation Program for Breast Centers. The center also earned the Outstanding Achievement Award from the Commission on Cancer.

• Alamance Regional Medical Center was one of only 38 hospitals to win a QUEST Award’s Citation of Merit for safe and efficient care from Premier.

• The Heart and Vascular Center earned a three-star rating from the Society of Thoracic Surgeons.

• The Moses Cone Hospital Trauma Center was reaccredited by the American College of Surgeons.

• Cone Health was highly ranked in the U.S. News & World Report Best Hospital rankings.

• Alamance Regional received the Public Health Partners Award from the North Carolina Association of Local Health Directors.

• Cone Health was recognized by NC Prevention Partners for healthy eating and smoking cessation programs.

• Alamance Regional was named Best in Class among the Triad Business Journal’s Healthiest Workplaces.

Cone Health: Making a Difference by Investing in Our Communities Uncompensated Patient Care (at cost)

$244,570,801

Donations to Community Organizations

$3,105,607

• Cone Health supported many health and community organizations through corporate donations, contributions from our employees and donated medical equipment and supplies.

• Cone Health organized numerous community service activities that reached 37,797 people.

• Support for the Mammography Scholarship Fund helped 917 uninsured women receive screening mammograms.

• Cone Health employees contributed 6,704 hours of their personal time serving our communities as volunteers.

Training and Education for Healthcare Professionals

$9,495,871

Cone Health helped train 47 medical residents.

Cone Health helped train 1,825 graduate students.

Cone Health provided 1,007 continuing education hours.

Cone Health provided clinical training to 1,125 students.

Cone Health professionals gave presentations to 3,545 students and professionals.

• Cone Health professionals spent 19,950 hours mentoring 433 students.

• • • • •

Community Health Education and Outreach

$3,882,404

• The medical libraries were used by 58,200 people.

• Cone Health provided 3,198 people with health screenings (including telephone assessments through the Behavioral Health Hospital HelpLine and Assessment Service).

• Cone Health provided health education, support programs and health fairs to 6,533 individuals through 439 programs.

Caring for Our Communities

$117,773

• In addition to donating their time, more than 808 volunteers raised money to donate equipment and supplies that benefited Cone Health’s patients.

TOTAL

$261,172,456*

*This total does not include contributions, grants, scholarships and other support provided to the community

by Cone Health Foundation, which are shown on the next page.

In addition, Alamance Regional Medical Center is not included.

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Cone Health Foundation: Making a Difference

by Investing in Our Communities Cone Health Foundation distributed $4.6 million in grants to 38 Greensboro-area nonprofit organizations. The median award amount was $55,000, and 52 percent of grant awards were made to increase access to health care.

These awards support agencies working in the Foundation’s four focus areas of grantmaking. Some fall outside of these defined categories and support community collaborations.

Access to Health Care • • • • • • • • • • • •

Cone Health Congregational Nurse Program Family Service of the Piedmont Guilford Adult Health Guilford County Coalition on Infant Mortality Guilford County Department of Public Health Guilford County Department of Social Services HealthServe Initiative to Increase Access to Care for Vulnerable Populations North Carolina A&T State University Partnership for Community Care Triad Adult and Pediatric Medicine The University of North Carolina at Greensboro

Adolescent Pregnancy Prevention • • • • • • • •

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Children’s Home Society of North Carolina Guilford Child Development Guilford County Department of Public Health Outreach Development Partners for Healthy Youth Planned Parenthood Health Systems Triad Adult and Pediatric Medicine Young Women’s Christian Association

HIV/AIDS • Central Carolina Health Network • Cone Health Regional Center for Infectious Disease • Piedmont Health Services and Sickle Cell Agency • Triad Health Project

Substance Abuse and Mental Health • • • • • • • • • • • •

Alcohol and Drug Services of Guilford D R E A M S Treatment Services Guilford Adult Health Guilford CARES Guilford County Department of Social Services Guilford County Schools Malachi House II Mary’s House Mental Health Association in Greensboro North Carolina A&T State University The Servant Center The University of North Carolina at Greensboro

Community Collaborations • • • • • • • •

Action Greensboro Building Stronger Neighborhoods Communities That Care Cone Health Sickle Cell Center Cone Health Workforce Development Guilford Nonprofit Consortium Partners Ending Homelessness United Way of Greater Greensboro

There’s no substitute for rolling up your sleeves and working with people who can make a difference. They get the benefit of your participation and you gain a direct understanding of the real problems and potential solutions, which makes you a more informed giver.

- Michael Milken, Financier and Philanthropist

Leadership that Makes a Difference: Board of Trustees The Board of Trustees of Cone Health is a dedicated group who spend many hours each month helping to guide our organization. Because of the complexities of healthcare, we ask a lot of our board members. They agree to work with us for multiple years – usually nine. They have to learn intricate details about patient services, quality, construction and healthcare finance. They serve as advocates in our community and our legislature, and they help us raise funds.

Our 2013-2014 trustees are: Terrence B. Akin Jacob B. Balsley III Louise F. Brady Carole W. Bruce Deborah Hooper Chair

F. D. Hornaday III Vice Chair

John F. Campbell, MD Edward F. Cone Dwight M. Davidson III Allen E. Gant Jr. Nancy Hemric J. Wayne Keeling, MD J. Edward Kitchen David F. Leeper James H. Maxwell, MD M. Lee McAllister Chapman T. McQueen, MD Rev. Diane L. Givens Moffett, DMin R. Timothy Rice Henry W.B. Smith III, MD Inez Tuck, PhD, RN Peter W. Whitfield, MD

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About Us Cone Health is a not-for-profit network of healthcare providers serving people in Guilford, Forsyth, Rockingham, Alamance, Randolph, Caswell and surrounding counties. Our tagline – “The Network for Exceptional Care” – highlights our commitment to excellence, which is shared by our more than 10,000 professionals, 1,300 physicians and 1,200 volunteers.

As one of the region’s largest and most comprehensive health networks, Cone Health has more than 100 locations, including six hospitals, two medical centers, four urgent care centers, 95 physician practice sites and multiple centers of excellence.

 The Moses H. Cone Memorial Hospital is our flagship. Moses Cone Hospital is a 536-bed teaching hospital and referral center. It includes a Pediatric Emergency Department, Level II Trauma Center and centers of excellence such as the Orthopedics Center, Neurosciences Center, Stroke Center, and Heart and Vascular Center. North Tower opened in 2013 with 16 new operating rooms and all private patient rooms.

 Alamance Regional Medical Center, a 238-bed medical and surgical hospital in Alamance County, joined Cone Health in May 2013. Specialized services include a Heart & Vascular Center, Cancer Center, Women’s Care Center, advanced imaging services and surgical services among others.

 Wesley Long Hospital offers 175 private beds for medical and surgical patients with service areas

focused on oncology, bariatric surgery, urology and orthopedics.

Our modern facility utilizes stateof-the-art equipment such as the da Vinci® surgical robot system and the SpyGlass® visualization system in the Endoscopy Center.

The campus also houses the Cancer Center, Sleep Disorders Center, Wound Care and Hyperbaric Center, Sickle Cell Medical Center and Surgery Center.

 Women’s Hospital, a 134bed facility, is home to one of the area’s most experienced neonatal intensive care teams.

The hospital’s Level II and Level III unit has been providing care to critically ill newborns since 1990. The hospital also houses the nationally accredited Breast and Ultrasound Imaging Center. The hospital’s da Vinci robot provides minimally invasive surgical care for gynecology patients.

 Annie Penn Hospital has 110 acute care beds. This facility includes inpatient and short stay surgery centers, Cone Health Cancer Center at Annie Penn, LeBauer HeartCare at Annie Penn and specialty clinics such as a Sleep Disorders Center and an Endoscopy Center of Excellence.  The Behavioral Health Hospital offers pediatric and adult inpatient crisis stabilization. The 80-bed facility accommodates 50 adults and 30 adolescents. Outpatient care includes numerous group therapy programs as well as individual counseling and day programs. The hospital also offers the community a 24-hour Helpline that provides access to a trained professional. Three additional outpatient Behavioral Health Centers also are located in Greensboro, Kernersville and Reidsville.

Cone Health | 1200 N. Elm St. | Greensboro, NC 27401 | conehealth.com

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