TrinityTALK Tribune June/July 2014 by Trinity Mother Frances

Trinity Mother Frances Employee Newsletter

June/July 2014

In This Issue TMFHC Named to Truven 100 Top LIVEwell Human Resources News System News Foundation News and more

The Road To ICd-10 How ICD-10-PCS ImPaCtS You One of the new challenges ICD-10-PCS presents is that there are no long lists of inpatient code titles. Instead, a code is constructed character by character based on the Medical Record and Operations Report documentation. Think of an ICD-10-PCS code as a fingerprint. Each one is unique and tells a story of the inpatient procedure performed. Each character builds on that story. It is important to know that no matter your healthcare role, the use of codes is pervasive and you need to understand the basics of ICD-10-PCS, how it is used to build codes, how to interpret them, and possibly how to help others use them correctly. Code analysis leads to an understanding of procedures and the ability to decipher ICD-10-PCS codes for the purposes of mapping, reimbursement, and clinical research.

This ICD-10 Tip is brought to you by Precyse University. For more information, go to:

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Overview of ICD-10-PCS ICD-10-PCS replaces ICD-9-Cm Volume 3

ICD-10-PCS... • Is used to represent inpatient procedures • Does not take the place of CPT or Chargemaster driven codes • Allows for more accurate codes to reflect changes in medicine

New procedure codes are always being added, and while the current system is limited in its ability to grow, ICD-10-PCS allows for the expansion.

Mother Frances Hospital Named to Truven 100 Top

other Frances Hospital Tyler was named one of the nation’s 100 Top Hospitals® by Truven Health AnalyticsTM, a leading provider of information and solutions to improve the cost and quality of healthcare. The Truven Health 100 Top Hospitals® study identifies hospitals and leadership teams that provide the highest level of value to their communities, based on a national balanced scorecard. The 100 Top Hospitals balanced scorecard measures hospital performance across 10 areas: mortality; inpatient complications; patient safety; average patient stay; expenses; profitability; patient satisfaction; adherence to clinical standards of care; and post-discharge mortality and readmission rates for acute myocardial infarction (heart attack), heart failure and pneumonia. The study has been conducted annually since 1993. This is the fifth time Mother Frances Hospital Tyler has been recognized with this honor.

In This Issue: Truven 100 Top..............................2-3 Clinic News...................................... 3 Foundation News.............................. 4 LIVEwell........................................... 5 Human Resources News.................... 6 Habitat for Humanity....................... 7 Jacksonville and Winnsboro News..... 8 System News................................9-10 Upcoming Events............................ 11 TrinityTALK tribune Trinity Mother Frances Marketing 500 S. Beckham Tyler, Texas 75701 Email: tribune@tmfhc.org

“We are pleased to celebrate the fact that we’ve been able to achieve a tremendous milestone like this award,” said John McGreevy, CEO, Mother Frances Hospital Tyler and the Louis and Peaches Owen Heart Hospital. “Our designation as a Truven 100 Top Hospital® is an incredible accomplishment, and I am proud of our Trinity Clinic providers and the Trinity Mother Frances team who made this a reality. I believe our distinguished providers are truly first class. They put patient care, quality and comfort before all else.” For the 100 Top Hospitals® study, Truven Health researchers analyzed public information – Medicare cost reports, Medicare Provider Analysis and Review (MedPAR) data, and core measures and patient satisfaction data from the Centers for Medicare and Medicaid Services (CMS) Hospital Compare website. The winning hospitals were announced in the March 3, 2014, edition of Modern Healthcare magazine. “This year’s 100 Top Hospitals represent the highest national standards in hospital care and management today. They set the benchmarks for peers around the country to follow — consistently delivering outstanding quality of care, satisfaction, and community value at a reasonable cost,” said Jean Chenoweth, senior vice president for performance improvement and the 100 Top Hospitals® program at Truven Health Analytics. “The majority of the 2014 award winners have produced year-to-year performance improvement, as well. This speaks to the consistent focus on excellence by the entire organization and the men and women who serve patients.”

Managing Editor Will Knous Editorial Board Jerry Ashworth Dorinda Bentley Cassandra Cooper Patricia Cline Natalie Duncan Laura Lockhart Annette Rios Robin Rowan Brandy Royal Deborah Taylor Randy Thomas Danielle Townsend Graphic Design Betsy Feiden

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Balsamic Garlic Chicken Breast Ingredients 1/4 cup balsamic vinegar 1/4 teaspoon salt 1/4 teaspoon black pepper 1 tablespoon vegetable oil 1 garlic clove, chopped 1/2 teaspoon oregano 1/2 teaspoon thyme 4 (6 ounce) boneless, skinless chicken breasts Preparation Combine vinegar, garlic, salt, pepper and oil. Whisk until well-blended for marinade. Add chicken and toss until evenly coated. Hold refrigerated at internal temperature of 40 F or below for 1-2 hours to marinate. Drain and discard excess marinade. Place chicken on sheet pans, and sprinkle 1/8 teaspoon of oregano and 1/8 teaspoon of thyme over each breast. Place chicken on char-broiler or grill at medium heat. Cook for 5-6 minutes on each side, or until well done.

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The study shows that if all hospitals in the U.S. performed at the level of this year’s winners: • Nearly 165,000 additional lives could be saved • Nearly 90,000 additional patients could be complication-free • More than $5.4 billion could be saved • The average patient stay would decrease by half a day “This recognition from Truven Health Analytics is certainly an honor, and we are proud to receive it… because it’s a confirmation that our goals are in the right place,” said Rob Rose, System Chief Nursing Officer, Trinity Mother Frances Hospitals and Clinics. “It proves that our initiatives on patient safety and process improvements are having a positive effect. It illustrates that if you really care for patients, treat them in mind body and spirit, and if you do everything you can to help them on their journey, then the recognition will come. Trinity Mother Frances has been serving East Texas for more than 75 years, and each time we are recognized for our efforts by a prestigious organization like the Truven 100 Top Hospitals, it is proof positive that the dedication, drive and skill of our people is what makes that possible.”

Clinic News March Madness at the ASB On March 21, the ASB celebrated their accomplishments and teamwork with a day of fun, food and prizes. The ASB consists of the Business Office and P1C and includes: Insurance Verification representatives, Insurance Follow-up, Patient Account Representatives, Schedulers, Patient Account Collectors, Posting Representatives, Account Specialists, Financial Representatives, Telecare Representatives, Referrals and Claims/Billing Coordinators. “What Does March Mean to You?” was the theme of the event. Twelve teams participated in a competition of spirit and food. Tables were decorated with themes such as Mardi Gras, Luck of the Irish, Picnic and Kites, Earth Day, Mad Hatter Tea Party, Make Money Money, Basketball, Easter, Butterflies and Sports. Great themed food included King Cakes, sandwiches, chicken and fried okra, green chocolate fountains, cups of Lucky Charms and a bouquet of cupcake flowers. The event wasn’t just about celebrating teamwork; prizes and drawings were also part of the festivities. The winners of the team competition were: 1st place: The Krewe of Divas (Mardi Gras theme), 2nd place: Money Grabbers (collecting the money), 3rd place: Wind Flyer (kites theme), 4th place: HB Medicaid (summer theme).

Foundation News East Texas Miracle Child Named 2014 CMN State Champion On May 14, Will Butts was named the 2014 Children’s Miracle Network Hospitals State Champion, presented by Delta Air Lines, Marriott International and Chico’s FAS ambassador for the state of Texas. Throughout this year, Will and his family will serve as local, state and national spokespeople, advocating for the charitable need at children’s hospitals across North America. In November, all state Champion ambassadors will travel to Washington D.C., and Orlando, Fla. to share their stories with a national audience. Will was named the 2014 Champion ambassador due to his courageous battle with Hanhart Syndrome, a rare condition diagnosed before he was born which caused him to be a quad congenital amputee. To recognize the Champion’s journey, Courtyard Marriot associates — accompanied by Mayor Barbara Bass; Lindsey Bradley, President, TMFHC; and Steven Keuer, MD, President, Trinity Clinic — hosted a special Champions ambassador launch event for media to attend. Will has always defied odds, starting with a diagnosis before he was born. Hanhart syndrome is an uncommon birth defect characterized by a short, incompletely developed tongue, absent or partially missing fingers or toes, malformed arms or legs and a very small jaw. The severity of these physical abnormalities varies greatly among individuals, and children with this disorder often have some, but not all, of the symptoms. Will’s diagnosis affects all four of his limbs; he was born without feet and with partially formed hands. This hardly

slows him down. Will is so expressive and engaging that others quickly forget what he lacks physically. Although doctors told him that he would never be able to run and jump without ankles, he has since proven them wrong, defying odds once again. CMN Hospitals fully funds the Special Needs Clinic where Will receives his care. The SNC is the only one of its kind between Dallas and Shreveport and treats more than 500 children. The Children’s Miracle Network Hospitals Champions program presented by Delta Air Lines, Marriott International and Chico’s FAS identifies a child from each state, Washington, D.C. and Puerto Rico with a remarkable medical story and passion for advocating on behalf of children’s hospitals. These Champions serve as ambassadors for the 62 kids treated every minute at 170 member Children’s Miracle Network Hospitals. Children’s Miracle Network Hospitals® raises funds and awareness for 170 member hospitals that provide 32 million treatments each year to kids across the U.S. and Canada. Donations stay local to fund critical treatments and healthcare services, pediatric medical equipment and charitable care. Since 1983, Children’s Miracle Network Hospitals has raised more than $4.7 billion, most of it $1 at a time through the charity’s Miracle Balloon icon. Its various fundraising partners and programs support the nonprofit’s mission to save and improve the lives of as many children as possible. Find out why children’s hospitals need community support, and learn about your member hospital, at CMNHospitals.org and facebook.com/ CMNHospitals.

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Keeping TMF Clean Throughout all the beds and rooms and floors and buildings of Trinity Mother Frances Hospitals and Clinics, there is a mostly unseen service that makes it possible for everything to run smoothly and cleanly – and many of us do not even know it is there. The Trinity Mother Frances Laundry facility will process an estimated 3.4 million pounds of linen this year, and they provide linen service to all the Trinity Mother Frances hospitals (except Winnsboro) and all out-buildings and clinics. The Trinity Mother Frances Laundry facility is located at 608 North Glenwood, and has been in operation at this location just over 30 years. About 26 staff members work at the facility, half of which have been at the Laundry over 10 years. Two of those employees, Cecelia Cruz and Gerald Cofer, have been diligently service the system there for 34 years and 24 years, respectively. Gary Kennedy, Manager, TMF Laundry, says says the Laundry department is constantly focused on providing the system with the best quality linen product and service for the lowest cost. “We also continue to seek opportunities to lower our environmental impact through water conservation and recycling efforts,” Kennedy stated. “All unusable, discarded linen and the over 250,000 blue plastic bags that are used for soiled linen, are sold to recycling companies.” 5 TrinityTALK tribune JUNE/JULY 2014

The 2014 Trinity Mother Frances LIVEwell Program is finally here and ready to help you work toward living a healthier lifestyle! The LIVEwell Program currently has many exciting activities such as Zumba and Circuit classes offered at the Main Campus, ASB Building and HealthPark Plaza, and you can find Weight Watchers and an individual weight-management program taught by our Health Coach, Leaha Large. We are currently in the process of creating a summary of all available LIVEwell opportunities. Once this is complete, we will post the finalized listing on Employee Self Service under the LIVEwell section. As we continue throughout 2014, please be sure to keep an eye out for LIVEwell announcements, as we will continue to work on increasing the number of programs and activities in which employees can participate!

Employee Spotlight Eleanor Stolz Congratulations to Eleanor Stolz, a longtime Trinity Mother Frances volunteer who is celebrating an historic milestone. Eleanor has volunteered with Trinity Mother Frances since 1999. She has volunteered for the FamilyCARE Centers, PASS and HealthPark Plaza, and she currently volunteers in our Cardiac Cath Lab Waiting Room and the Louis and Peaches Owen Heart Hospital Fourth Floor Cardiac Clinic. Additionally, Eleanor serves as the Sunshine Chairman and sends out Birthday, Sympathy and Get Well Cards for Volunteer Services. We are blessed to have Eleanor with us in the many roles she has served at Trinity Mother Frances and wish her a very Happy 90th Birthday!

Human Resources News National Healthcare Week Celebration Our annual National Healthcare Week Celebration was held on Wednesday, May 14, at Wisenbaker Conference Center and the TMF Café with over 2,000 employees attending throughout the day and night serving times. We enjoyed a wonderful meal of Sliced Beef Brisket with all of the traditional side dishes prepared by TMF Food Service and served by employees, leadership and staff from all over the system. Both areas were decorated with balloon bouquets in this year’s color scheme – burgundy, purple and pearl white – to reflect our Trinity Mother Frances colors and our recent honor of being named as one of the 2014 Truven Health 100 Top Hospitals in the nation. Games with prizes were offered during the event, and commemorative giveaways were given to everyone as they entered the Café to be served. The ASB, Mother Frances Jacksonville and Winnsboro and our regional clinics also held celebrations at their locations.

Trinity Mother Frances Lake Palestine Celebration

Mother Frances Hospital Winnsboro Dessert Contest Winners 2014

Spinach Spaghetti Ingredients 11-1/4 ounces whole wheat spaghetti 1 1/3 cup roasted tomato sauce (look for low-sodium) 1 3/4 tablespoons freshly chopped garlic 1 3/4 tablespoons freshly chopped shallots 2-2/3 ounces fresh baby spinach Preparation Cook spaghetti according to instructions, then drench with cold water to stop the cooking process. Heat oil in a sauté pan over medium heat. Add garlic and shallots, and sauté for 30 seconds or until fragrant. Add spinach, and cook for 1 minute or until barely wilted. Add pasta and sauce, then toss until evenly coated. Sauté the pasta for 1-2 minutes, or until fully heated through.

Mother Frances Hospital Tyler Celebration

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Habitat for Humanity Building Project Each year, members of the Trinity Mother Frances Hospitals and Clinics team join together to build something special – and not just for themselves and the rest of the TMF team. No, we are talking about hammers and nails, paint and sandpaper. Nurses, friends, family members and other parts of the TMFHC family get together for an annual project in conjunction with Habitat For Humanity. “The idea for nurses to give back to the community has always been a part of nursing in general,” said Patt Loff, MSN, RN, HACP, IRB, Regulatory Coordinator, TMF. “However, it had not been formalized into an ongoing National Nurses Week activity. In 2009, the theme for National Nurses Week was ‘Nurses: Building a Healthy America.’ Trinity Mother Frances’ vision is ‘Creating healthy lives for people and communities.’ The Nursing Practice Council (NPC) meshed the national theme with the TMF vision and began what is now a tradition of nurses giving back to our local community during National Nurses Week.” This year, the home receiving the work was for Ms. Catherine Sinclair, a widow living in the Chapel Hill area. Her husband was a carpenter and did the built the home she still lives in. Habitat for Humanity decided to repaint the exterior of the home, and the TMFHC Team worked in conjunction with the Home Depot Team. “About 40 of us worked on that project,” said Ginnie Covey, BSN, RN-BC, HeartCARE Center, LPOHH “The group of people came from StandUp – emailed and volunteered. There were employees and spouses, and not everyone were nurses. We had nice representation from leadership, as well. There was a variety of people – from the hospitals and the clinics.” The assembled group painted the entire exterior of a house in 2.5 hours. The TMFHC group has performed a variety of worksite jobs.

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This year we painted. But in the past, we have put up roof trusses, decked houses and put up siding. The task is decided by stage of the building, what’s needed at that time. This was Covey’s fifth year to coordinate the event, and the sixth year altogether. “I think Pat said it really well, with nursing being a part of the community, extending that care into community is important. That’s even part of the theme for Nurse’s Week this year. In our first meeting, we were asking: ‘What is something we can do for the community?’ And someone said ‘What about Habitat?’ We contacted them, arranged our first work schedule and here we are today. Now when we call, they know we’re coming each year.” TMFHC always has a good turnout – sometimes with the same faces, sometimes with new, different people. “Sometimes the chaplain will come out and bless the home, and I have swung a hammer beside a Sister, too,” said Covey. “Our goal is to get everyone involved. We want to get together and work together outside of the offices and clinics – in our communities.” In 2011, the TMFHC Team received the award for Best Nursing Team from ADVANCE for Nurses after submitting their essay detailing their work with Habitat for Humanity in East Texas. They received the special recognition, the cover of the May 2011 edition and an award that is proudly displayed in the front lobby of Mother Frances Hospital Tyler.

Jacksonville and Winnsboro News Gold Awards for MFH Jacksonville and Winnsboro The constant efforts to ensure that every clinic, department and facility that comprise Trinity Mother Frances Hospitals and Clinics are of the highest standards took a great step forward this month. Texas Medical Foundation (TMF) Health Quality Institute named both Mother Frances Hospitals Jacksonville and Winnsboro as Gold Hospital Quality Improvement Award winners. TMF Health Quality Institute announced on May 5, that 135 Texas hospitals have won a 2014 Texas Hospital Quality Improvement Award by achieving gains in key clinical areas designated as national healthcare priorities. The award recognizes hospitals that undertake efforts to advance the quality of care in their facilities. “The standards of care throughout Trinity Mother Frances Hospitals and Clinics are built on the idea that we should be constantly improving and seeking new ways to serve our patients,” said Janet Coates, CEO, Mother Frances Hospital Winnsboro. “Our goal is to offer the best possible healthcare to our patients – these are our friends and neighbors, our families. This award demonstrates that commitment that we bring to work every day.” “This recognition is certainly an honor, and it is certainly a testament to how hard our staff works each day,” said Tom Cammack, FACHE, CEO, Mother Frances Hospital Jacksonville. “Their dedication to upholding the Trinity Mother Frances mission to improve community health with compassion, excellence and efficiency is what makes honors like these possible. I have no doubt that that mission will continue to drive us forward, as leader in healthcare in East Texas.” “TMF is proud to recognize these hospitals for promoting quality improvement activities and their senior management for promoting a quality culture,” said Tom Manley, CEO, TMF Health Quality Institute. “Quality improvement is a complex and demanding process, and we thank these hospitals for their commitment to improving the health of Texans and the efficiency of healthcare in our state.” The 2014 Texas Hospital Quality Improvement Awards, based on achievements in 2012 and 2013, honor Texas hospitals that are performing quality initiatives aimed at improving outcomes in patient care by recognizing those hospitals that have improved their performance on specific national quality measures. The award program recognizes three tiers of winners for their performance: Gold,

Silver and Bronze. The criteria include quality data reporting measures as well as readmissions measures. All Inpatient Prospective Payment System (IPPS or Acute Care) Hospitals and Critical Access Hospitals (CAH) across the state were automatically included as participants in the non-competitive 2012-2013 program. Out of all 313 IPPS or Acute Care Hospitals and 80 CAHs statewide, 33 earned the Texas Hospital Quality Improvement Gold Award. The Silver Award went to 45 hospitals, and 57 hospitals earned the Bronze Award. During the program year, hospitals focused on making improvements in clinical areas that have been designated a priority for U.S. healthcare by the Centers for Medicare and Medicaid Services (CMS) and The Joint Commission, an independent, non-profit, standards-setting and accrediting body in healthcare. These measures use data associated with providers’ ability to deliver high-quality care or relate to long-term goals for quality healthcare. TMF Health Quality Institute, the Medicare Quality Improvement Organization for Texas, manages the award program in association with the Texas Hospital Association and the Texas Organization of Rural and Community Hospitals. The award program was established in 2004, and awards are presented every two years. Leaders from each hospital will meet in Austin on June 11, at the Hilton Austin Airport Hotel to receive their awards. At the June 11 ceremony, TMF will honor leadership teams from the 135 award-winning hospitals. The event will feature a keynote address from Ron Culberson, MSW, CSP, author, speaker and humorist.

Thank you for representing what stands for.

i = CARE = (.) =

it starts with me make a personal/emotional connection with everyone it ends with me tmfhc.org 8

System News Service Excellence Award Winners and Nominees Service Excellence is part of the foundation of the Trinity Mother Frances culture. The Service Excellence Award recognizes exceptional performance or behavior that meets or exceeds the expectations of our established Service Standards. Congratulations to the employees who were selected as winners and those that were nominated during the first quarter of 2014, listed below. Nominations may be submitted by co-workers, managers, patients or their families, vendors/contractors, or physicians. There is no limit to the number of times an individual can be nominated, as long as each nomination is for a different effort each time. For more information, please contact Marsha Ballard, Service Excellence Committee Chairman, at ballarm@tmfhc.org or (903) 531-4475. Winner Melissa Barrett

Account Manager

Marketing

Nominees Gwendolyn Bell Brooke Bentley Janice Berry Karla Boles Taylor Burnett Rhonda Butler Whitney Camp Jacob Carrasco Curtis Choice Britney Colter Elaine Cranston Viola Dotzer Tricia Gibson Jackie Gupton Yosmine Hawkins Lidia Ibarra Sandra Jones Ashley Madsen Cheresa Matthews Tineisha Milton Elizabeth Parades Nancy Payne TEAM: Cassie Collins, Glenda Martin, Al Marasse Omar Salazar Jazmyn Shelton Michael Smith Chrystal Spencer Teressa Staples Sarah Stiles Pat Stribly Wendy Vega Beverly Walker Beverly Walker Shannon Webb Andy Yates

Unit Technician Unit Technician Unit Technician Clinic Manager III Unit Technician Clinic Manager II Medical Assistant Respiratory Therapist Unit Technician Housekeeper Procedural Schedule Coordinator Hostess Patient Account Representative Unit Technician Medical Assistant Housekeeper Support Staff Coordinator Clinic Manager Unit Technician Unit Technician Patient Account Representative Secretary Respiratory Therapist Unit Technician Unit Technician PC Support Specialist Unit Technician Housekeeper Unit Technician MT - Lab Assistant Unit Technician Unit Technician Unit Technician Respiratory Therapist Wellness Specialist

6 Ornelas 5Ornelas 4 Dawson Trinity Clinic Physical Medicine and Rehab Nurse Retention Center Trinity Clinic Endocrinology Trinity Clinic Neurology Trinity Clinic Pulmonary Medicine 4 Dawson Integrated Services Trinity Clinic OB/GYN Integrated Services Central Business Office 4 Ornelas Trinity Clinic Neurology Integrated Services The Birth Center Mineola 3 LPOHH 6 Ornelas Trinity Clinic Bariatric Surgery 6 Ornelas NICU 6 Ornelas 4 Ornelas IT 4 Dawson Integrated Services 4 Ornelas Laboratory 4 Dawson 3 Dawson 3 Dawson NICU Cardiac Rehab

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System News Confidentiality Reminders An important part of caring for our patients is protecting their very private and essential medical information. They trust, expect and depend on us to keep this data safe and secure. These simple steps will go a long way in protecting this vital information. •P revent Stolen or Lost Laptops – Keep it with you, lock it up securely before you step away and lock it in the trunk when driving. • S creen Lock or Lockout – Secure workstations prior to walking away, and log out of applications when done. • Screen Privacy – Re-position your computer monitor or request the installation of a privacy screen filter to prevent it from being seen by users who do not have a need to view the specific health data. • Disposal of Media – Personal Health Information on electronic media (USB, CD or DVD) should be given to IT for disposal. • Texting – There is no expectation of real privacy with any text message. Texting should never be used to communicate Personal Health Information. • Photos or Videos – Capturing photos and videos on a personal device is a HIPAA violation. Approved methods of capturing this data are available through ConnectCARE.

• Social Networking – Communicating about any aspects of a patient visit is against company policy. • Conversations – Do not discuss patients in any way other than as part of their care team. This should never be done in public areas where others can overhear (cafeteria, elevator, church, grocery store, etc.). • Clean Desk – Never leave any patient information unsecured or visible on your desk or workspace. •A ccess Must Be Authorized – Do not access any medical information unless your official role gives you a valid reason to do so. All access is logged and tracked. • Faxing – Verify the number and identity of the person to whom you are faxing information. Ensure you are sending the minimum necessary information to meet the recipient’s request. • Logout – Log out of ConnectCARE before you walk away from your workstation to protect patient privacy. If you leave an active session, it is an open invitation to patients or visitors. • Password – Remember to keep your login and password secure and confidential. It is your electronic signature on ConnectCARE.

New Change to Our Employee Assistance Program Beginning March 1, 2014, Case Management Associates will no longer be handling our Employee Assistance Program. The Employee Assistance Program is now being handled by Humana. Employees still receive one FREE visit for professional assistance to help the employee and his/her family resolve problems that may affect their personal lives or job performance. This service is confidential and voluntary. For a confidential appointment please contact Humana at (866) 219-1232.

Black Bean Brownies Makes 9-12 brownies. Ingredients 1-1/2 cups black beans (one 15-oz can, drained and rinsed very well) (250g after draining) 2 tablespoons cocoa powder (add an extra pinch if desired) 1/2 cup quick oats 2 teaspoons baking powder 1/2 cup honey 1/4 cup unsweetened applesauce 2 teaspoons pure vanilla extract 1/2 cup to 2/3 cup chocolate chips (115-140g) (Not optional) * optional: more chips for presentation Preparation Preheat the oven to 350 F. Combine all ingredients (except chips) in a good food processor, and blend them until they are completely smooth. A blender can work if necessary, but the texture (and taste) will be much better in a food processor. Stir in the chips, then pour into a greased, 8x8 pan. *Optional: spring extra chocolate chips over the top. Cook the black bean brownies 15-18 minutes, then let cool at least 10 minutes before truing to cut.

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Trinity Mother Frances Hospitals and Clinics 800 E. Dawson Tyler, Texas 75701

Upcoming Events June 23

Childbirth Preparation Skills

6:30 pm - 9 pm at 802 S. Beckham, Tyler

June 24

Pediatric CPR

6:30 pm - 9 pm at 802 S. Beckham, Tyler

June 26

Childbirth Preparation Skills

6:30 pm - 9 pm at 802 S. Beckham, Tyler

June 30

Childbirth Preparation Skills

6:30 pm - 9 pm at 802 S. Beckham, Tyler

July 1

Breastfeeding Class

6:30 pm - 9 pm at 802 S. Beckham, Tyler

July 3

Cooking Heart to Heart

10 am - 11 am at LPOHH

July 7

Childbirth Preparation Skills

6:30 pm - 9 pm at 802 S. Beckham, Tyler

July 9

Life Line Screening

11 am at 172 Luther Lane, Gun Barrel City

July 10

Childbirth Preparation Skills Life Line Screening

6:30 pm - 9 pm at 802 S. Beckham, Tyler 9 am at 915 S. Palestine, Athens

July 14

Childbirth Preparation Skills

6:30 pm - 9 pm at 802 S. Beckham, Tyler

July 15

Newborn Care

6:30 pm - 9 pm at 802 S. Beckham, Tyler

July 16

Life Line Screnning

11 am at 17320 State Hwy 155 S., Flint

July 17

Childbirth Preparation Skills Cooking Heart to Heart

6:30 pm - 9 pm at 802 S. Beckham, Tyler 10 am - 11 am at FRESH by Brookshireâ&#x20AC;&#x2122;s

July 21

Childbirth Preparation Skills

6:30 pm - 9 pm at 802 S. Beckham, Tyler

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