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July 31, 2008

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Our values consistently show that Dimensions CARES. ... to BHC is a 50,000 square foot Medical Office Building that is fully occupied ... – PowerPoint PPT presentation

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Title: July 31, 2008


1
Executive Briefing For The Prince Georges
Hospital Authority
  • July 31, 2008

2
Executive Briefing Outline
  • Mission, Vision Values
  • Patient Safety and Quality Initiatives
  • System Facilities
  • Key Community Services
  • Demographics and Market Dynamics
  • Selected Operational Issues
  • Desirable Attributes For A New Owner

3
Mission, Vision Values
  • Our mission is to provide high quality and
    efficient healthcare services to preserve,
    restore and improve health status, in partnership
    with our community.
  • Our vision is to be recognized as a premier
    regional healthcare system.
  • Our values consistently show that Dimensions
    CARES. These values include Compassion,
    Accountability, Respect, Excellence, and Service.

Source DHS Strategic Plan.
4
Quality and Patient Safety Initiatives
  • Accreditation and Licensure
  • Initiatives to Meet 2008 National Patient Safety
    Goals
  • Patient Identification
  • Verbal / Telephone Orders
  • Critical Test Results
  • Fall Prevention
  • Appropriate Abbreviations
  • Time Out Wrong Site Surgery
  • Participation with the Maryland Patient Safety
    Center
  • Rapid response teams to reduce code blues LRH
    / PGHC
  • Hand Off Collaborative - PGHC
  • MRSA Collaborative LRH / PGHC
  • Nursing Retention Collaborative - PGHC
  • Perinatal Collaborative LRH / PGHC
  • Critical Care Collaborative LRH / PGHC
  • Core Measures and Quality Scorecards
  • Active Corporate Risk / Trust Committee

5
Prince Georges Hospital Center
PGHC is located in Cheverly and licensed for 248
beds. Services include general medical/surgical,
cardiac care, Level III Perinatal Center, Level
II Trauma Center and behavioral health. PGHC
also operates the Glenridge Medical
Clinic in Lanham.
6
Gladys Spellman Specialty Hospital Nursing
Center
GSSHNC is located on PGHCs campus and is
licensed for 107 beds. Major services include
chronic care for ventilator dependent patients
and comprehensive nursing care. Spellman
also operates the Senior Health
Center in Brentwood.
7
Laurel Regional Hospital
LRH is located in Laurel and licensed for 125
beds. Services include general medical/surgical,
behavioral health, obstetrics, and comprehensive
rehabilitation.
8
Bowie Health Center
BHC is a full service, freestanding emergency
department located in Bowie. Hours of operation
are 8 am to midnight (16 hours/day).
9
Bowie Medical Office Building Surgery Center
Immediately adjacent to BHC is a 50,000 square
foot Medical Office Building that is
fully occupied with physician offices and a busy
Ambulatory Surgery Center.
10
Larkin Chase Nursing Center
Larkin Chase is a 120 bed nursing home located on
the Bowie Campus in partnership with SunBridge
Health (SunBridge 75 DHS 25 ownership).
11
County Health Status
  • Prince Georges County ranks higher than State
    averages for numerous rates of mortality,
    morbidity and prevalence of chronic diseases
  • Indicator Our Response  
  • Death rates for accidents Emergency /Trauma
    Programs
  • and homicide
  • Perinatal indicators, including Maternal /
    Child Program
  • infant mortality and low birth
  • weight
  • Death rates for heart disease Cardiac Programs
  • Death rates for septicemia, Internal Medicine
    Programs
  • Nephritis, and HIV
  • Death rates for diabetes mellitus Diabetes
    Treatment
  • Mental illness Behavioral Health Programs

12
Key Community Services
  • Emergency Services
  • Total emergency visits system-wide (including
    trauma) in FY 2008 were 115,055 or 315 per day.
  • ER physician staffing at PGHC is contracted
    through George Washington University Faculty
    Associates. ER physician staffing at BHC and LRH
    is through EmCare.
  • The ER at LRH has recently been renovated and
    expanded with State grant funds and donations
    from the Foundation/Auxiliary.
  • The ER at PGHC requires extensive renovation or
    replacement.
  • Trauma
  • County has higher mortality rates than the State
    for accidents. (PG 29.7 v MD 25.0) and
    homicides (PG 17.3 v. MD 10.2)
  • PGHC is the second busiest Trauma Center in the
    State with 3,000 patients annually.
  • Serves Prince Georges, Calvert, Charles, St.
    Marys and D.C.
  • 95 save rate.
  • Medical direction of trauma program at PGHC is
    contracted through the University of Maryland.

Sources Internal records and DHMH Vital
Statistics. Age adjusted mortality rates per
100,000.
13
Key Community Services
  • Maternal Child Health
  • Although substantial progress has been made, the
    infant mortality rate in the County continues to
    exceed the State. (PG 8.8 v MD 7.9)
  • 6,800 mothers, newborns and pediatric patients
    annually system-wide.
  • 75 Medicaid and Medicaid Managed Care
    Organizations (MCO).
  • OB/GYN group operates prenatal clinic at
    Glenridge and provides staffing for Health
    Department sites.
  • Level III NICU with 20 bassinets at PGHC. New
    subspecialty affiliation with Childrens
    Hospital.
  • Perinatology program for high risk mothers at
    PGHC currently with physician coverage
    affiliation through Johns Hopkins.
  • Maternal/Child Unit at LRH under cosmetic
    renovation to help attract physicians and their
    patients.
  • Mt. Washington Pediatrics leases a 15 bed unit at
    PGHC for care of post-NICU babies and kids with
    developmental disabilities.
  • Small acute pediatric unit at PGHC.

Sources Internal records and DHMH Vital
Statistics. Infant mortality rates per 1,000
live births.
14
Key Community Services
  • Cardiac Care
  • Heart disease is the leading cause of death in
    the County. (PG 233.2 v MD 205.7)
  • 3,700 inpatient admissions annually system-wide
    for circulatory disorders.
  • Full service cardiac program at PGHC
  • Cath Lab at PGHC performs over 1,500 procedures
    annually
  • Low volume cardiac surgery program represents
    potential opportunity for new owner
  • New Cath Lab being installed at LRH.
  • Cardiac Rehab Unit at PGHC recently renovated and
    expanded.
  • Internal Medicine
  • Cerebrovascular disorders, respiratory diseases,
    influenza pneumonia, septicemia, nephritis and
    HIV are among the top causes of death in the
    County.
  • 7,200 inpatient admissions annually system-wide.
  • Internal medicine training program at PGHC with
    46 residents provides inpatient coverage and
    staffs the Glenridge Medical Center
  • Glenridge has a Ryan White grant to support HIV
    outpatient care
  • RFP for system-wide hospitalist coverage
    currently in process.

15
Key Community Services
  • Diabetes
  • The CDC estimates that the incidence of diabetes
    in the County is 8.8 and that there are 52,000
    diabetics in the County.
  • Care was provided system-wide in FY 2008 to
    nearly 12,000 patients with a primary or
    secondary diagnosis of diabetes.
  • PGHC offers a Diabetes Center for inpatient
    management and outpatient education.
  • Surgery
  • Surgery has largely shifted to an outpatient
    basis with 9,324 ambulatory surgery cases
    performed system-wide in FY 2008.
  • Surgical and anesthesia equipment at PGHC have
    been significantly upgraded through State grants.
  • Rehabilitation and Chronic Care
  • LRH operates the only CARF accredited
    comprehensive rehabilitation program in the
    County.
  • GSSHNC operates the only chronic beds (52) in
    the County for long-term ventilator dependent
    patients.
  • Sources Internal records and Baltimore Sun
    article 6/26/08.

16
Key Community Services
  • Behavioral Health
  • Behavioral health is a major health status issue
    in the County.
  • LRH and PGHC each operate emergency, inpatient,
    and partial hospitalization services.
  • Involuntary admission capabilities exist at PGHC
    and are under consideration for LRH.
  • Nearly 1,800 inpatient admissions annually
    system-wide.
  • LRH has contract with Psychiatric Institute of
    Washington (PIW) and PGHC has contract with
    Allied Behavioral Health for coverage.
  • PGHC operates the designated Sexual Assault
    Center in the County.

17
Projected County Population
Key Point With a population approaching 1
million, the County needs an excellent
healthcare system.
Source Maryland Department of Planning.
18
Projected County Population By Age
Key Point Significant growth is projected in
the age cohort 65 most likely to have chronic
conditions and require healthcare and hospital
services.
Source Maryland Department of Planning.
19
County Physicians By Age
Key Points At the same time that the County
is experiencing growth in the older population
that will increase healthcare demand, it is also
experiencing an aging of the physician work force
with one quarter now over age 60. Significant
physician development will be required.
Source MHA / MedChi Survey..
20
50,000 Inpatients Leave The County
Go To Other Md. Counties
Go To D.C.
Remain In Prince Georges
Go To Montgomery
Key Point At 10,000 per admission,
out-migration represents about half a billion
dollars annually leaving the County.
Out-migration represents a substantial
opportunity for a new owner.
Source 2003 Maryland DC hospital databases.
21
Medicaid / Uninsured Discharges CY 2007
Prince Georges County Hospitals
Baltimore City Hospitals
Key Points Indigent care in the County is
heavily concentrated at PGHC. There is no
major academic center with supporting HSCRC rates
in the County. Source HSCRC Database.
22
Payor Mix Drives Heavy Physician Payments Not
Included In HSCRC Rates
  • PGHC / DHA -11,500,000
  • Key Points
  • The hospital cannot operate without physicians
    to cover ER/Trauma, OB, NICU, Psychiatry,
    Critical Care, and Anesthesia.
  • The physician losses are real and not
    sustainable.
  • Negotiations with physicians are aggressive.
  • Whoever operates the system will need a stable
    source of ongoing funding for un-reimbursed
    physician costs.
  • With an academic affiliation, a portion of these
    costs could be offset through the development of
    additional teaching programs.
  • Source Schedule UR 6 for FY 2007.

23
Age Of Plant Equipment FY 2006
Key Points Competitors have newer plant and
equipment. The MHAs target is 8.5 years.
DHS is now at 22.4 year (5/2008 Financial
Statement) Major construction initiatives are
currently underway at Doctors, Howard County, and
Anne Arundel. Washington Adventist plans to
relocate and build a new hospital. Significant
capital investment is needed to address a decade
of under-funding for plant and equipment.
Source MHA Audited Financial Conditions Report.
24
Desirable Attributes For A New Owner
  • Strong commitment to quality care and patient
    safety
  • Mission driven
  • Multi-institutional experience
  • Academic training programs
  • Primary care network development
  • Access to capital

25
Questions FromThe Authority
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