Hospital Community Benefit Report

The past, the present, and the future

Dear Friend:

As we enter the last year of the twentieth century, I cannot help but feel somewhat nostalgic. Yes, I anticipate that the millennium will bring our service area many new innovations in health care. I look forward to helping Hospital & Healthcare System grow to meet your needs. However, while we herald what is to come, I feel it is also important to examine where we are now, and how we got here. In this light I am pleased to present to you "Summing up the Century," the BH&HS 1998 Report to the Community.

This report describes some of the steps we took in the 1997-98 fiscal year to better serve you. We view these steps as achievements, since they are changes we made that allow us to better meet our primary goal of serving our community. For instance, we entered the first phase of a facility master planning process that will focus on enhancing the capabilities and capacities of some of our core services. We took our "show on the road," as some might say, by providing more services to our surrounding counties than ever before. We invested in the future of our community by expanding our community health education program. In these and many other ways we strengthened our ability to meet your needs.

Our founding organization, the Local Council of Women, celebrated its hundredth anniversary last May. This presented me with a wonderful opportunity to look back at the early days of Hospital. And, it reminded me of how we have grown.

Thus, as I gathered my thoughts to prepare this annual report for you, I decided to present it in a historical perspective. It can help us refocus on the original purpose of our organization, so eloquently stated in the Daily Telephone, Wednesday, November 29, 1905: "When the City Hospital is opened tomorrow, will take another advance step -- one that marks the kindly disposition as well as the charity of our people, who by their free will offerings dedicate this institution in the name of the city for the cause of humanity."

I encourage you to examine this report of our most recent year and its accomplishments, as we march forward together for the "cause of humanity" toward the twenty-first century.



The sum of the parts...

At BH&HS we believe wholeheartedly that the whole is greater than the sum of its parts. Yet we also believe that the stronger the individual parts, the greater the whole.

Into Our Counties

A major focus in fiscal year 1997-98 was increasing our accessibility. You told us that you would like more convenient access to our health care providers, and we did our best. We "took the show on the road," so to speak, and expanded our outreach so that we now have a greater physical presence in our outlying counties. We view this as one of our highest achievements this year.

For instance, in January we were fortunate to have Dr. Stearley's family practice in Gosport join BH&HS. Then later in the year, we added a nurse practitioner to Gosport Family Practice. Soon after, we opened Mitchell Family Health Care Center, with two doctors and three nurse practitioners. To increase your options in short and long-term convalescence, in May we added The Residence at McCormick's Creek in Spencer. Within just weeks of receiving its Medicare/ Medicaid certification, the nursing home was completely full with a waiting list. The assisted living wing now has eight residents.

We also brought new physicians and their specific skills to our existing Southern Medical Group (SIMG) outreach offices. Residents of Spencer no longer have to travel to for treatment for cardiology, neurology, gynecology/obstetrics, dermatology, oncology, ENT, and orthopedics. Specialists in these areas are now keeping hours at Owen County Hometown Healthcare one or more days a month. Similarly, there is now a visiting podiatrist at Gosport Family Practice, and visiting heart specialists at both Odon Family Practice and Salt Creek Family Practice in Nashville.

Last May we began the new Vigor exercise program in Bedford, which already involves 108 participants from Lawrence County. The Vigor program is a senior citizens' exercise program using Nautilus exercise equipment. Participants must have a doctor's clearance before starting the program, which is supervised by a therapist.

In January 1998, responding to a frequently-cited community health need, Hospital Home Health Services began offering psychiatric home care. This program provides top quality psychiatric nursing services such as psychiatric and medical evaluation and management, medication management and education, and the provision of problem solving skills in crisis situations. It also means broader access to quality health care for homebound patients with major psychiatric diagnoses.

Fiscal year 1997-98 also saw the introduction of 19 new physicians and the addition of Winslow Health Care primary care physicians to Hospital's medical staff. So, in addition to expanding the range of our services, we "deepened our bench" by increasing the actual number of physicians we have on staff to meet your needs.

And our plans to improve your access to health care do not stop here. Plans were developed in FY 1997-98 for a dialysis center in Linton, which will be complete in the current fiscal year. Radiation oncology and MRI services are also planned for Bedford. We are continuously evaluating your health care needs, and working to ensure that we deliver the best care possible in the most convenient manner for you.


Since our inception as a 10-bed hospital, any physical growth we have experienced has been planned to ensure we are providing the most complete range of health care services possible. As medical innovations have opened new doors, we have "added new doors" to make sure that you have access to all that medical science has to offer.

Please take a look at the physical changes we have undergone throughout the century. In fiscal year 1997-98, we were proud to introduce the next stage of our physical development: the Facility Master Plan.

Improving Access and Convenience

1905: LCW purchased a ten-room brick farm house on 4.5 acres to be used as a hospital. The dedication was held on Thanksgiving Day. The cost of this first home of Hospital: $6,000. It had 10 beds.
1917: Construction began on a new stone building to replace the old brick house, which became the nurses' home. BH now had 35 beds.
1947: This major renovation involved a new wing added in front of the 1917 building. It was funded with a federal grant and matching community funds. The hospital was divided into three floors.
1965: In this, our largest expansion, BH gained 212,755 square feet and grew to over 200 beds. We added many new departments and services at this time. The cost of this expansion: $12,521,000.
1982: The size of the Hospital's physical plan was increased to 349,000 square feet. The number of beds increased to 343. A new laundry facility was constructed near the hospital. New medical/surgical beds were added and pediatric beds were reduced. Space was added for ancillary and support services.
1992: Our most recent construction provided us with more space for Maternal/Child Services, our new cardiovascular surgery unit, and the laboratory.

Planning for Our Future

Last year, recognizing our service area's growth and the increased demands for specific services, we entered the first stage of our facility master planning process. We interviewed physicians, staff and board members. We studied patient satisfaction surveys and hired an architectural consulting firm with expertise in health care.

Through in-depth analysis of space and patient needs, we settled on two main areas of concentration: outpatient diagnostic services and Maternal/Child Services (OB). The former was constructed in the 1965 renovation -- well before improvements in technology produced a major shift to outpatient testing and care. We recognize that it is no longer meeting our clinical needs or your convenience needs.

OB was actually expanded in 1992. Yet the demand for this wonderfully satisfying service has exceeded our expectations. Contrary to early nineties' indicators that suggested we would see a stable birth rate, we are actually seeing an increase, due in some part to the number of patients in outlying counties that are choosing to get their prenatal care from specialists. Combined with a trend toward longer hospital visits for new mothers (largely a result of recent legislation), this area of our hospital must be expanded to meet the demand.

The recommendation was thus made to the hospital board of directors to focus our resources on enhancing these core services. The master plan has been approved by the board, and will enter the next stage of development in the current fiscal year.

Adding to our community

BH&HS recognizes that promoting a healthy community involves more than simply providing excellent health care -- it takes education, prevention, and involvement. So we are devoting substantial resources to providing programs that may help you avoid unnecessary hospitalization.

Hospital Employee Wellness Program

Hospital is in the unique position to contribute twice to the health of our community -- by taking care of patients and by visibly committing to the health of our employees (we're the third largest employer in Monroe County). We introduced a comprehensive wellness program for our employees last year featuring a Health Investment Plan (HIP) for those employees on the hospital's health insurance plan. Over 800 employees participated in the program; 78% of those participating met the health criteria of the program and received a "health bonus" upon completion. This comprehensive program was a pilot, and versions of it will be available to local employers soon.


Many health problems can be avoided or controlled through early detection and preventive treatments. Last year we focused on helping you stay healthy through offering free screenings for a variety of serious health risks.

For instance, stroke is the third leading cause of death and the primary cause of adult disability in the United States. Eighty percent of all strokes are preventable. Partnering with the faith community through the new Parish Nurse Ministry, over 13 community locations offered a stroke prevention screening which included a second, more comprehensive exam with a neurologist for those identified at-risk for stroke.

We also offered screenings for skin cancer, cholesterol, glucose, blood pressure, and hearing; provided free and confidential HIV testing on National HIV Testing Day; teamed up with University Counseling and Psychological Services to offer free screenings for eating disorders (anorexia and bulimia) on campus and in the community; and featured mammograms on site by the Mobile Mammography Service for Women at the Women's Health Fair at Crestmont.

Since many of our community's employers share our concern for prevention, we provided health screenings, workshops and health fairs to many medium and large sized employers.

Promoting Healthy Choices

A healthy lifestyle can prevent some illnesses, and the right choice may avert an accident or injury. But the choices are not always clear. To share with you our experience in how to make healthy choices (and why), we spread the word on a variety of topics. Here are just a few:

With a gun in approximately half of all American households, it is the parents' responsibility to teach children gun safety rules. To assist them, we distributed free gun locks and gun safety information.

Kids are great -- and, as you know, kids can get hurt. To share some prevention tips, BH&HS conducted a health and safety fair for residents of Crestmont and their children under five years old. We gave away bike helmets and car seats, as well as many other health and safety devices.

Hospital Foundation funded a project called TAP and TEG to provide tobacco education for youth. Hospital tobacco educators teach adolescents about the dangers and negative consequences of tobacco use. Monroe County students who violate the school's tobacco policy can choose to participate in the TEG program as a pre-trial diversion option. This program is a partnership among the prosecutor's office, the hospital and the Monroe County Health Department.

Emergency nurses and paramedics also gave frank presentations to middle and high school students about underage alcohol abuse and the hazards of drinking and driving through the EN C.A.R.E. (Emergency Nurses Cancel Alcohol Related Emergencies) program.

The More You Know

Operating under the theory that the more you know about your health care choices, the more comfortable you will be with the choices you make, we have developed programs to disseminate timely information on a variety of health care issues.

We began Tuesday Talks, to provide you with informative updates on wellness topics such as acupuncture, herbs and vitamins, seasonal affective disorder, relaxation and self-healing. We also brought Glen Gaesser, Ph.D., a nationally known health promoter to our community to speak, filling every one of the 222 seats in Wegmiller Auditorium. The author of the book Body Shape Obsession in America: Cost & Consequences, Gaesser challenges conventional wisdom about weight loss and health.

From beginning to end...

It is our goal to provide you with the complete complement of health care services. With the addition this year of Promptcare East and Promptcare West, we have added one more critical ingredient: urgent care. Now, when the emergency department may not seem right but your doctor is not available, you have a reliable source for urgent care.

The Year as a Whole

Hospital & Healthcare System (BH&HS) is a not-for-profit regional referral center serving a patient base of 310,000 in nine counties in south central , including: Brown, Daviess, Greene, Lawrence, Martin, Monroe, Morgan, Orange and Owen. Forty percent of BH&HS inpatients live outside of Monroe County.

Vital Statistics

  • 297 licensed beds
  • 14,889 annual admissions
  • 1,795 full-time equivalent employees
  • 49,506 emergency department visits
  • 243 physicians trained in 38 medical specialties
  • 1,794 births
  • 1,526,435 outpatient procedures
  • 4.3 days, average acute care length of stay

    In Summation

    Hospital & Healthcare System is adding to our community every day by providing health education and health services to the 310,000 residents of our service area. Many of these services are offered at little or no cost.

    This is a partial list of community benefit activities provided by Hospital during fiscal year 1997-1998.

    Fiscal Year 1997-1998 Financial Summary for 1998 Report to the Community
    (shown in millions)

    $ we billed for all patient services $196.6

    $ not paid by Medicare/Medicaid $38.3
    $ discounted/allowed to other payers $13.2
    $ in Charity (those who couldn't pay) $6.0
    $ we collected for all patient services $139.1
    $ from other hospital activity* $4.7
    Total $ available to run Hospital $143.8

    $ spent to run BH: salaries, supplies, fees, services $127.0
    $ written off as bad debt (uncollectible) $6.6
    Total $ in costs to Hospital $133.6

    Non-hospital sources, e.g., interest income $2.4

    Total $ available to re-invest in Hospital staff, facility and equipment

    * Other hospital activity includes food services, parking, kid's club, grants, foundation/auxiliary, and education services

    Cost of Providing Services at No Charge
    (shown in actual dollars)

    Community Health Outreach $450,454
    Health Careers Education $1,101,556

    Cost of Subsidizing Selected Clinical Services
    (shown in actual dollars)

    Adult Day Services $130,625
    Ambulance Service $88,567
    Children's Therapy Clinic $256,851
    Diabetic Clinic $182,900

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    ©Hospital & Healthcare System, 1999

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