Howard Memorial Hospital 2011 Annual Report

F R A N K R . H O WA R D M E M O R I A L H O S P I TA L

2 0 11 A N N UA L R E P O RT

H M H 2 0 1 1 A N N U A L R E P O R T

Frank R. Howard Memorial Hospital

is a family of caring professionals

committed to providing the

highest quality of service.

In partnership with physicians

and community leaders,

our purpose is to improve

our patients’physical, mental

and spiritual well-being,

and to enhance the health

of our community.

OurMission

H M H 2 0 1 1 A N N U A L R E P O R T | 1

2 Northern California Network

3 From the New CEO

4 FromtheChiefofStaff

5 Good Samaritan

6 Physician of the Year

8 New Hospital Update

10 Interim CEO

11 Former CEO

12 Top 100

14 Carpal Tunnel Surgical Technique

16 HMH’s Service Awards

18 Financial Report

20 Community Outreach

22 Volunteers

23 Commonwealth Gardens

24 Planetree/Patient Satisfaction

25 Credits

Table ofContents


“...we exist to improve our patients’ physical, mental and spiritual well-being, and to enhance the health of our community.”HMH CEO, Rick Bockmann

RickBockmann

Our New CEO

MESSAGE FROM RICK

This year and every year, our mission at Frank R. Howard Memorial Hospital (HMH) provides clear direction in the face of constant change and transition. In partnership with physicians and community leaders, we exist to improve our patients’ physical, mental and spiritual well-being, and to enhance the health of our community.

During the past twelve months, HMH has become part of Adventist Health’s new Northern California Network, and I was fortunate enough to be chosen as HMH’s new Chief Executive Officer. As we learn to work together with sister hospitals in new ways, we’ve had an opportunity to reflect on what is uniquely and wonderfully “Howard Hospital.”

As part of our journey, we’ve dedicated ourselves to becoming a Planetree designated or “Gold” hospital. Planetree is a national organization that helps hospitals deliver patient-centered care by encouraging patients to actively participate in their care. (To learn more, visit www.planetree.org.)

And, true to our roots, we are a community hospital in a small town that historically has had to fend for itself because of its remote geography. It makes our residents both independent and willing to help each other in times of need. Our tagline, Neighbors Helping Neighbors, truly describes our daily work.

In part because we are taking care of our neighbors, we believe excellent clinical care is best delivered in a nurturing environment. Encouraging human touch, a pleasant environment, and the support of family and friends allows for emotional and spiritual support in healing.

While our focus is firmly on our patients and our local community, Howard Hospital must respond to state and federal health care trends and policies. We have weathered financial and political health care storms in the past, and we will continue to work within whatever structures we must to thrive in current and future health care environments.

I have enjoyed my start here at HMH and am looking forward to celebrating our new accomplishments as we continue to honor our heritage.

Sincerely,

Rick Bockmann, CEO

LAST SEPTEMBER, RICK BOCKMANN brought his extensive expertise in health care leadership to his new role of Chief Executive Officer (CEO) of Frank R. Howard Memorial Hospital (HMH).

Before joining the HMH team, he had worked in the Napa Valley since 2007. He served as vice president for physician services at St. Helena Hospital Napa Valley and as CEO of Adventist Health/California Medical Group. He was responsible for physician/hospital business relationships, and also contributed to the $100 million of growth at St. Helena Region Hospitals.

Before working in St. Helena, he was the Vice President of Human Resources and Vice President of the Rural Market Service Area at Centura Health in Denver, Colorado. He owned a health care consulting group that specialized in leadership services, as well as the acquisition and development of physician groups. He holds a MBA from the University of Phoenix and is a member of the Medical Group Management Association.

In addition to his leadership role at HMH, Bockmann is Vice President for the Northern California Network (NCN) of Adventist Health. Under the leadership of Terry Newmyer, Bockmann participates on the NCN Executive Council which directs initiatives to provide hospital care for the broader region of Napa, Mendocino, and Lake Counties.

INTRODUCING: ADVENTIST HEALTH NORTHERN CALIFORNIA NETWORK

THE EMPLOYEES AT HMH have chosen to work here for a variety of reasons; personal, financial, professional. Though every employee has a different reason for being here, a different function, a different title, one thing unites everyone…purpose. Overwhelmingly our co-workers identify that they are moved by the mission, and that their purpose, regardless of daily assignments, is to further the mission of Sharing God’s Love.

Adventist Health hospitals across Northern California share in our conviction and dedication to the mission. This year we have united these teams under the banner of a common purpose by way of introducing the Northern California Network of Adventist Health (NCN)

Led by Terry Newmyer, President and CEO, the NCN will support our mission by employing two key strategies:

• Clinical integration to improve patient access

• Shared services to improve performance

In January of 2012, these functions officially came together under the formal structure provided by the NCN. Based throughout the region, select areas of focus will promote the themes of quality, efficiency, and reach of our services in Mendocino, Lake, Solano, Sonoma and Napa Counties.

Frank R. Howard Memorial Hospital is part of Adventist Health, a faith-based, not-for-profit integrated health care delivery system serving communities in California, Hawaii, Oregon and Washington. Our workforce of 28,700 includes more than 21,000 employees; 4,500 medical staff physicians; and 3,000 volunteers. Founded on Seventh-day Adventist health values, Adventist Health provides compassionate care in 19 hospitals, more than 150 clinics (hospital-based, rural health and physician clinics), 14 home care agencies, 6 hospice agencies and 4 joint-venture retirement centers. We invite you to visit HowardHospital.org for more information.

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TerryNewmyerPresident & CEOAdventist Health, Northern California Network


Many of us predicted this year at Howard would be pivotal: we anticipated several changes and challenges with regulatory agencies and our business partners. My intent as Chief of Staff has been to revitalize the medical staff and stimulate my colleagues to re-engage as we prepare for the radical changes in the medical care delivery environment. By restructuring the medical staff and acquiring the vocabulary to understand the upcoming challenges, we began to craft a foundation for increased competency around change management and innovation.

Our first major internal change was to streamline twenty-two compartmentalized committees into five cohesive service lines. As a self-governing organization, this more sophisticated structure allowed us to meet our goals of increasing transparency, communication and timeliness. Several physicians have in turn devoted time to leadership development, which I hope will allow us to experience the benefit of enhanced leadership skill and durability.

No less critical was to nurture the roots of what we refer to as the Howard Culture. We have been well-served by nursing, operations and administrative staff who strive to abide by “Neighbors Helping Neighbors.”

We have also benefitted from the loyalty and longevity of many physicians who, for decades and through many challenges, continue to personify our compassionate

human touch culture.

To advance our desire for a warm care experience to the highest level, we began a rapid and brilliant journey to Planetree certification. Planetree is a program that identifies patient-centered care through all the key components of care delivery in an effort to provide more personal and human care. This year, our hospital recognized Dr. William Bowen as a model Planetree physician. Similarly our partner, Adventist Health, defines certain qualities and ideals in physicians and then asks us to identify a meritorious physician each year. Dr. Charley Hott was elected physician of the year for 2011. Having worked alongside both Dr. Hott and Dr. Bowen for several years, their devotion to Howard Hospital, their coworkers, patients and patient-centered ideals is, in a word, ideal. Identifying a model plan of the concepts and the providers who exemplify them will further embed what we call our culture into the quality and joy expressed in our work.

Of the external changes that were expected this year, the most significant has been the roll out of the final phase of Project IntelliCare with the Computerized Provider Order Entry in September. Gone, for the most part, are paper records and the attendant risk of illegibility, lost data or even missing charts. In its place, however, we’ve asked busy professionals to patiently navigate unfamiliar, less-than-intuitive software, adding hours of anxiety and frustration to their already-full schedules. As we round the corner approaching a

year of use, most of our active physicians have demonstrated greater facility with the program. We are now looking past the adjustment phase and are beginning to see potential returns – those opportunities for technology in real time to enhance the speed and evidence-based quality of our care and reporting.

The high performing medical organization of the future will have safety, efficiency, continuous quality improvement and innovation woven into the fabric of its culture. By safety we mean a patient’s physical safety based on their clinical care, plus the “safety” or security of their personal medical information. Safety also includes a culture shift to a more egalitarian approach to medicine in which the opinions of all members of a care team are elicited and respected. Efficiency is tied to enhancing safety as well as a component of value-based care. Continuous improvement, as the name implies, is at its best relentless and built in. Innovation is the element often at odds in an environment traditionally driven by safety and efficiency - as we seek an ever more precise and consistent best practice. However, innovation is the next “must have” core competency. Therefore, the ability to identify and subsequently adapt relevant new products and practices allows us to differentiate ourselves. In the future that will be a key driver to improved service and successful practice.

With a vital, organized, engaged staff we enhance our ability to achieve each of these foundational objectives. I have been deeply and tirelessly devoted to upholding these ideals in the past year. In my office, I have a framed piece of art that says, “Sometimes the only available transportation is a leap of faith.” As Chief of Staff I would like to say a heartfelt thank you to the many who have leaped with me and continue to have faith that we are on the right path. I look forward to the coming year in which we further nurture the growth and development of the people, process and culture.

Kimberly Faucher, M.D.

Chief of Staff

From theChief of StaffKimberly Faucher, M.D.


RECENTLY, WHEN HOWARD MEMORIAL Hospital (HMH) Physical Therapy Director Matt Whitaker was headed to work, he saw a big rig parked on the side of the highway onramp with its hood up. Then, his attention was riveted to the ground where the driver of the truck was lying in the road, apparently having some sort of major medical trouble. Whitaker stopped his car and got out as another man arrived on the scene.

The man on the ground was gasping, taking infrequent breaths and appeared to be having some sort of seizure. Whitaker, trained in cardio-pulmonary resuscitation (CPR), immediately felt for the truck driver’s pulse and didn’t find one. The other person on the scene was calling 911 for an ambulance, so Whitaker began to perform CPR.

“I started chest compressions and breathing for the man,” Whitaker said. “It’s a somber moment when you know what you are doing may contribute to saving someone’s life. It was a case of being in the right place at the right time and I had the privilege of helping in this situation.” As Whitaker continued with the CPR, other motorists stopped. One directed traffic to keep Whitaker and the truck driver safe, and another employee from Howard Memorial Hospital, Maggie Stephens, also stopped to lend support.

The Redwood Valley Fire Department responded to the 911 Call first. Whitaker said, “I helped the firefighters place the AED [Automated External Defibrillator] pads, and they shocked the man to get his heart going again. Within minutes, we had a pulse.” They put an Ambu bag on the patient and Whitaker used it to continue to help the patient breathe while firefighters started an IV line. Shortly thereafter, the ambulance arrived to transport the patient to the nearest hospital, Ukiah Valley Medical Center (UVMC), and eventually on to Santa Rosa where he received a pacemaker.

“The patient called me after he was discharged to thank me. He had no memory of the event, but he is now recovering,” Whitaker said.

“Matt exemplifies the type of people who make HMH the wonderful place it is to receive care. It appears his thoughtful and competent approach saved that man’s life,” said HMH CEO Rick Bockmann. The UVMC Emergency Department Director Tim Rohan echoed Bockmann’s sentiments, “Matt’s amazing. I think he deserves a commendation from the County.”

HMH Good Samaritan Helps Save a Life

GoodSamaritanMatt Whitaker

“Matt exemplifies the type of people who make HMH the wonderful place it is to receive care.”HMH CEO Rick Bockmann


EVERY YEAR ADVENTIST HEALTH asks Frank R. Howard Memorial Hospital (HMH) staff to identify a physician who embodies the mission to care for patients physically, emotionally and spiritually. HMH is pleased to announce that Charles Hott, M.D., Emergency Department Director, has been named the 2011 Physician of the Year. As a physician who has been with HMH since 1993, he is used to being appreciated for his technical expertise. With this award, he is reminded that his loving kindness is also deeply valued.

Each day Hott, like many of us, takes the same drive to work. However, instead of allowing his mind to drift, he makes an effort to seek what’s new, fresh, and special about his route. He is mindful of his surroundings. He takes that mindfulness to the Emergency Department where he works, and inspires others to be thoughtful and aware of each other’s needs and the needs of their patients.

“Charley is a great person,” said Amy Buckingham, Emergency Department Manager. “He’s a genuine human being and that reflects in the way he practices medicine.”

Hott also serves as Director of Phoenix Hospice, where a cohesive team of social workers, volunteers, registered nurses, home health aids, spiritual advisors, and medical physicians work together to care for patients who are passing and patient families. In caring for hospice families, he said, “All you can do is be receptive, sensitive,

and try to focus on what they need at that moment. It’s all about seeking information, listening, and caring.”

In hospice work, and in all he does, Hott believes that compassion is paramount. “Loving Kindness is a phrase I try to remember,” he said. “By being kind to people, you are being kind to yourself.”

In a world where we are under pressure to go, go, go, Hott knows it’s important to stop and take time to listen. He recognizes his own inclination to move quickly through his day, so he has incorporated a physical reminder to help him slow down. He moved his watch to his right arm to make room for a Tibetan bracelet on his left that reads, “Compassion for All.” When he looks down at his left wrist to check the time, he is instead reminded to be present in the moment and make decisions from the heart.

Hott doesn’t limit his loving kindness to our community, but shares it worldwide. In 1970 Hott and his wife, Lynne Coen, M.D., went to Roatan, Honduras to work at the Government Hospital for three months with a group from Oakland Children’s Hospital. When they arrived, local ER personnel were accustomed to having sewage flow into the ER. They didn’t use proper hand-washing techniques, didn’t have consistent access to basic medications, and often waited hours for urgent X-ray and lab results. Hott was able to help the Hondurans implement processes to address all these issues, enabling them to better serve their patients for years to come.

Charles Hott, M.D.Physician of the Year

“By being kind to people, you are being kind to yourself.”Charles Hott, MD.

An Inspiration to Others


From 1986 to 1988, Hott traveled to Malawi, Africa as one of the first ten physician volunteers in the history of the Peace Corps. While there, he worked at one of only two hospitals in the area that, together with eight clinics, served 340,000 people. There were only two paved roads, neither of which led to the hospital. People typically arrived at the hospital on foot or via ox cart. Hott was able to incorporate his hobby of fixing things to keep local ambulances running. “It’s amazing what you can do with a pocket knife, vise grips and bailing wire,” Hott said with a chuckle.

Hott fully embraced the Malawian culture, living with a local family and learning the language. The family lived in an old colonial house with no running water. Still, they selflessly gave back to the community by opening an orphanage to house children who had lost their family to the AIDS epidemic. Hott and his host family built a life-long relationship as they shared a spirit of service to help these children, placing them with extended family when possible, paying for school, and providing supplemental food and clothing.

In 2001 he returned to Africa with his pre-teen daughter, not only to share the experience of traveling abroad, but to teach her that, “Life is all about service.” During their three-month stay he taught at Malamulo Hospital, the first Adventist Health teaching hospital abroad. He reconnected with his original host family who he now

considered part of his own extended family. He helped the family’s youngest son, Moses, by bringing him to the United States to attend college at Golden Gate University. (Now Moses is an auditor at Ernst & Young and Hott is the proud “grandpa” of Moses’ twin baby girls.)

Back home, Hott continues to care for patients as he embodies his philosophy: Do your best. Be kind.

“Do your best. Be kind.”Charles Hott, MD.


AS WE WAIT PATIENTLY for the construction to start on our new hospital, Project Manager Amy Ford works tirelessly behind the scenes to keep things moving. Building a new hospital is a process full of bureaucratic hurdles, and thankfully Amy is up to the task. We submitted the initial set of architectural drawings for review and permitting to OSHPD (Office of Statewide Health Planning and Development) on April 22, 2011. On September 15, 2011, OSHPD sent us their first round of comments. We updated the documents to address their comments, and sent them back to OSHPD on October 21, 2011.

“HBE, our design-build firm, has been responding quickly to OSHPD’s concerns,” Amy said. “It will be a ‘dance’ as HBE continues to work with OSHPD, communicating back and forth to resolve all the comments OSHPD has on the drawings; however, we are expecting their next round of comments back by the end of the year, and we anticipate breaking ground in the summer of 2012.” This new design is structurally simplistic to facilitate a smoother approval process with OSHPD.

The new design includes about 75,000 square feet of new hospital space and an on-site helipad. The two-story building will house an Emergency Department including six standard treatment bays and two trauma bays; a Laboratory; Radiology with CT, MRI, General Radiology, Fluoroscopy, Mammography, Stress/Echo, Bone Density, and Ultrasound/Vasoguard; as well as Central Supply, Administration, Pharmacy, In-Patient Physical Therapy, and a larger kitchen with adequate dining space for the community to come and enjoy gourmet food from the HMH culinary team. The new hospital will also house twenty-one private Med/Surg rooms, four private ICU rooms, and an expanded Surgery unit that includes four fully equipped suites. All departments will have more elbow room than our existing 85-year-old hospital currently allows.

Beginning Construction in the summer of 2012.


New Hospital Update

The new design includes about 75,000 square feet of new hospital space and an on-site helipad.

A sign has been erected on the building site depicting a rendering of what the new facility will look like. Many details remain to be fine-tuned on the exterior of the building, such as paint color, textures, finishes, signage, and landscaping. So, the actual hospital may look different than the image on the sign when it’s all completed. However, the general dimensions and shape of the building will stay essentially the same.

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HANSEN NAMED INTERIM PRESIDENT AND CEO OF HOWARD MEMORIAL HOSPITAL

TERRENCE A. HANSEN served as interim president and CEO of Frank R. Howard Memorial Hospital (HMH), June 1 through September 23.

“We are pleased that Terry agreed to serve in this interim role,” stated Scott Reiner Executive Vice President and COO. “His management skills and vast health care experience—especially in small, rural hospitals—benefited HMH and its community until Rick Bockman, HMH’s current CEO assumed his role.”

Hansen is no stranger to the hospital or the Howard Foundation: in 2010, he served as a consultant on the development of a hospital-based wellness center. In addition, Hansen has capably filled short-term interim CEO roles for other Adventist Health hospitals in California.

Prior to his retirement in November 2004, Hansen was the president and CEO of Paradise Valley Hospital in National City, California. He also served as executive vice president and COO for Loma Linda University Medical Center (LLUMC), a 797-bed tertiary care academic medical facility in Loma Linda, California. Prior to joining LLUMC, he was president of Hospital Governance, Inc., a health care consulting firm that specialized in turnaround projects. Hansen also served in various executive capacities at St. Helena Hospital Napa Valley.

Terry HansenInterim CEO

“We are pleased that

Terry agreed to serve

in this interim role.

His management skills

and vast health care

experience – especially

in small, rural hospitals

– benefited HMH and

its community...”

H M H 2 0 1 1 A N N U A L R E P O R T | 1 1

FORMER CEO OF HOWARD MEMORIAL HOSPITAL – KEVIN ERICH

AFTER 14 YEARS as president and CEO of Frank R. Howard Memorial Hospital, Kevin Erich was named president and CEO of Feather River Hospital in April of 2011. Erich assumed his new role on May 16. During his tenure Erich, together with his administrative team and physician leadership, moved the hospital to a position of financial security and high patient satisfaction. In 2002 HMH became a Critical Access Hospital. Erich was instrumental in making this change and a key player in helping to promote and develop the new California Critical Access Hospital Network, comprising all 31 California Critical Access Hospitals.

“We have been through a lot together,” Kevin told his employees in his farewell message. “When I arrived close to 14 years ago I didn’t have a clue what was in store for me, my family and this wonderful little hospital. I have no regrets – the time I have spent here has helped make me a better person and the love that you have shown me and my family will always be remembered and treasured.”

“Kevin has been with Adventist Health for over 19 years,” stated Larry Dodds, former Executive Vice President and COO of Adventist Health, “and has a great track record of strong leadership. We are very pleased to have dedicated leaders like Kevin within our system.”

Kevin ErichFormer CEO

“Frank R. Howard

Memorial Hospital is a

very special place and a

very special family.”


ON SEPTEMBER 28, 2011 Frank R. Howard Memorial Hospital (HMH) was named as one of only four Critical Access Hospitals (CAHs) in California to be among the Top 100 CAHs in the nation, according to the National Rural Health Association (NRHA).

The NRHA reviewed patient satisfaction, safety, quality, financial viability, and more, and HMH scored well against more than 1,300 other CAHs in this first-ever national review.

“This is great news. NRHA’s review is the most comprehensive on the market, and HMH scored in the top eight percent. I couldn’t be more proud,” said HMH CEO Rick Bockmann.

The CAH designation is only given to non-profit hospitals that participate in the Medicare program and have no more than 25 patient beds. CAHs must be located in a rural area and be separated from surrounding hospitals by 35 miles (or by 15 miles if the terrain is mountainous or makes the hospital difficult to reach).

“Critical Access Hospitals face unique challenges because of their size and location, and for us to be recognized as one of only four hospitals in the state to make the Top 100 list is a real honor,” said HMH CFO Carlton Jacobson.

The NRHA is a non-profit organization that works to improve the health and well-being of rural Americans. It provides leadership on rural health issues through advocacy, communications, education and research. For the Top 100 rating, the NRHA used more than 50 criteria to judge hospitals on three types of strength: market, value and financial. Market strength includes competitive strength and growth factors. Value strength includes quality, patient satisfaction, and reasonable pricing. Financial strength includes income statements and balance sheets that indicate long-term viability.

One of America’s Top 100 Critical Access Hospitals

HMH Awarded Top Honors

Value strength

includes quality,

patient satisfaction,

and reasonable

pricing. Financial

strength includes

income statements

and balance sheets

that indicate long-

term viability.


“Critical Access Hospitals face unique challenges because of their size and location,

and for us to be recognized as one of only four hospitals in the state

to make the Top 100 list is a real honor.”


A CHICAGO FILM CREW came to document Howard Memorial Hospital’s orthopedic surgeon, William Bowen, M.D., perform the MANOS technique in a live surgery. MANOS, a carpal tunnel release system developed by Thayer, a privately held company based in San Francisco, California, is a minimally invasive procedure that can be performed in 10 minutes. The incision is only 2.1 mm, and has a one to two week recovery time, compared to the potential six weeks needed for full recovery from traditional carpal tunnel surgery. This innovative procedure was first performed at HMH and it is the only hospital north of Santa Rosa to offer this service.

“We are so pleased to be able to offer this breakthrough technology to our community,” Terry Hansen, HMH Interim President said. “Patients do not need to leave Willits to reap the benefits of the latest technological advances in medicine.”

“We look for only the most qualified physicians to work with and train on the MANOS technique,” David Undercoffler, Thayer

Representative said. “It is a pleasure to work with surgeons who make such an astounding difference in the lives and daily activities of the people who choose to undergo the MANOS technique by relieving patients of their carpal tunnel symptoms.”

Both of HMH’s orthopedic surgeons have been trained in this innovative surgical procedure, and presently there are only 150 MANOS-trained surgeons nationally.

“I’d had the traditional carpal tunnel surgery done on my right hand about 11 months ago,” Ginger, an HMH patient sharing her testimony about the MANOS technique said. “I needed surgery done on my left hand and learned of the new technique that could be used. The tingling in my left hand was gone instantly. I would recommend this procedure to anybody. It’s the greatest thing!”

HMH Offers Cutting Edge Carpal Tunnel Surgical Technique

Carpal Tunnel Surgery

EDWARD EYSTER, M.D.


“We are so pleased to be able to offer this breakthrough technology to our

community. Patients do not need to leave Willits to reap the benefits of the latest

technological advances in medicine.”


Jodie Dalton, Information Technology/Payroll, 30 YearsON MAY 4, 1981 Jodie Dalton started what was to be a six-week stint as a Key Punch Operator to enter patient information for the installation of the first computer system. She was working two jobs at a school and a market, when she received a phone call telling her to get to the hospital immediately for an interview, even though she had on jeans and a t-shirt at the time. Her interview lasted all of ten minutes and she was asked to begin the next day.

After four or five months Jodie asked when her six weeks were going to be up and was told to get back to work and not ask that anymore. A year later to the day, she became the Data Processing Clerk, then moved to Chief Data Entry Operator in 1988. In June of 1991 she was appointed the Computer Services Supervisor, and then moved to Information Systems Support in 1994, Operations Support in 1998, and PC Support Tech in 2006. Her payroll duties, which have run concurrently with her Computer Services role, have enabled everyone to become acquainted with her.

Thirty years is a long time to work at one place, especially when it takes 25 years to graduate from a table to one’s own desk. But consider how much IT has changed during that time. Jodie’s IT background not only pre-dates our Cerner clinical information systems, it predates the AS/400 financial and admitting system which Adventist Health purchased in 1983. When she started there wasn’t a network at the hospital and “end-users” didn’t have “Personal Computers,” spreadsheets or PowerPoints. There was no corporate IT department. In fact, the hospital wasn’t even under Adventist Health management.

Jodie’s infectious laugh, good spirit, and care for others are greatly

appreciated. She’s always busy helping anyone she can with their IT needs and we hope she will be around for many more years.

Julie Harris, Human Resources, 35 YearsJULIE HARRIS HAS BEEN an integral part of the Adventist Health family for the past 35 years, and the HR guru for 14 of those years. Whenever anyone wants to know about their benefits, salary, or any HR issue, Julie maintains an open door policy. She is always ready to provide a listening ear and does her best to get the right answer for the employee.

Julie always finds a way to bring a little bit of humor into her work. Always quick to provide a smile, or tell a joke, she finds ways to make the work environment a fun place to be. In an effort to make sexual harassment training hold the employee’s attention, Julie at times incorporates Sexual Harassment Panda, a character from a television show, into her new employee orientation presentation.

Julie moved to Willits with her husband Jeff in 1975 after working at Feather River Hospital in Paradise, CA, and proceeded to raise her family here. Over her 33 years with HMH, Julie has had the opportunity to work in various departments and become well versed in the hospital’s overall operation. Julie began her career at HMH in the Nutritional Services department, then moved on to Registration, and finally found her home in Human Resources in 1998. Julie has gotten to know not only our employees but our patients and community. Julie is an incredibly important part of our team and a joy to work with. We look forward to spending the next 35 years with her here at HMH.

Thank you so much Julie, for all that you do to make HMH a fun and great place to work!

BRITT GRABLE JODIE DALTON JULIE HARRIS


Britt Grable, Operating Room, 25 YearsBRITT GRABLE HAS BEEN a “Nurse of all Trades” for 25 years and is invaluable as a resource, provider of care, and a dedicated employee. Britt is a Covelo native who first became acquainted with Howard Hospital as an EMT with the Covelo Fire Department while she was attending the Covelo Christian High School. Britt graduated from Pacific Union College in 1986 and was hired at HMH as a Med/Surg RN on the night shift. In October of that year she married Ryan Grable and they will be celebrating their 25th wedding anniversary this year as well. In 1987 Britt transferred into the ICU where she excelled as a skilled and confident nurse. Following the birth of her daughter, Amber, Britt moved into an open position in Surgery as a circulating nurse and a recovery room nurse. Britt’s aptitude for logical thinking and attention to detail made her a perfect candidate to train as a scrub nurse. Britt has a delighful sense of humor that helps her patients and co-workers cope with the stresses of surgery.

Outside of the hospital Britt was very active in FFA, raising goats with her daughter before Amber went off to college. Britt enjoys camping with her family and friends and is an avid NASCAR fan. In the past Britt planned her vacations around her husband’s fire season schedule and now she plans her vacations around the NASCAR circuit!

The patients and staff at HMH have benefited from Britt’s skills and expertise as well as her compassion. It has been a privilege and a joy to have worked side by side with Britt for the past 25 years. Although she is confident she can retire in the next couple of years, colleagues say it would be a benefit to our patients and if that dream is postponed for a bit longer.

Decades of Dedication

Celebrating Employees Who Have Been with HMH for 25 Years or More


Financial Report

2011 Actual 2010 Actual Variance

Net Patient Revenue & Other Income 43,220 40,988 2,232

Operating Expenses: Employee Compensation 21,403 20,171 1,232 Professional Fees 3,740 4,099 (359) Supplies 7,125 6,646 479 Purchased Services 3,795 3,158 637 Depreciation 1,018 970 48 Other Expenses 2,906 2,492 414

Total Expenses 39,987 37,536 2,451

Net Profit (Loss) - Operations 3,233 3,452 (219)

Net Gain (Loss) from prior year non-recurring settlements from government insurance programs and other non recurring events 2,613 3,855 (1,242)

Funds available for equipment, plant and property improvement, working capital needs and repayment of long-term debt 5,846 7,307 (1,461)

Admissions 1,314 1,401 Emergency Visits 9,705 9,623 Outpatient Visits 25,430 25,884

INCOME STATEMENT COMPARISON

Year Ended Dec. 31, 2011 (In thousands of dollars)

CARLTON JACOBSON

Vice President of FinanceJULIE VICHI

Controller


2011 Actual 2010 Actual Fiscal YTD Change

Assets Current Assets 33,647 27,076 6,571 Held by Trustees 403 111 292 Property and Equipment, Net 8,964 4,343 4,621

Total Assets 43,014 31,530 11,484

Liabilities Current Liabilities 4,154 3,088 1,066 Other Noncurrent Liabilities 484 359 125

Total Liabilities 4,638 3,447 1,19

Net Assets Unrestricted 38,308 27,834 10,474 Temporarily Restricted 68 249 (181)

Total Net Assets 38,376 28,083 10,293

Total Liabilities and Net Assets 43,014 31,530 11,484

ADVENTIST HEALTH: FRANK R. HOWARD MEMORIAL HOSPITAL BALANCE SHEET

Year Ended Dec. 31, 2011 (In thousands of dollars)


HONDURAS

In February, ten employees from Howard Memorial Hospital went to Valle de Angeles, Honduras to provide assistance to the local hospital and La Finca orphanage. The team provided nurse training and education, technological, building and plant improvements, and taught English to the children at the orphanage. With the support of HMH employees and the Willits Community, the team was able to raise all of the funds for the trip by hosting bake sales, a car wash, a silent auction and more. Each year since 2007 HMH employees have donated their time to the community. This year, HMH officially adopted the hospital as its sister hospital ensuring that it will be able to serve its community.

SIP SOME SOUP

Sip Some Soup is the major fundraiser for Willits Daily Bread, a non-profit organization that serves evening meals four days a week to those in need at St. Anthony’s Church Hall in Willits. At this annual event, attendees have the opportunity to sample a variety of soups made by local businesses and organizations in the community as they compete to have the best soup in Willits. Delicious breads and jams were provided by Emandal.

This year, under the direction of Chef Kyle, Anona Ayala and the HMH Cafe team made a Lemon Grass Soup. The soup tied three ways for third place. Kristen Meadows and Holly Sears served the soup and decorated the table with a Thai theme.

NEW CHAPLAIN

Dennis Long has had a wide variety of life experiences that have prepared him to be the leader he is today—passionate about making a difference in people’s lives.

Not one to emphasize a particular belief system or religion, Dennis uses the “Three Gs” - grace, growth and glory - to bring comfort and hope to the patients, families and employees of the hospital.

“My job is to help people on their journeys,” Dennis said. Whether you believe in fate, Mother Nature, karma, or a higher being, there is no doubt a higher being guided Dennis through his journey to the HMH family.

MENDOCINO COLLEGE DONATION

CEO Rick Bockmann presented Mendocino College with a donation for $20,000. The intent of this donation is to provide support to Mendocino College’s nursing program. Howard Memorial’s contribution is one of three donations expected from area hospitals.

Nursing shortages are common on a national level, and hospitals have struggled to fill all of their nursing positions. It is an important goal for all three participating hospitals to help increase the availability of trained nurses in Mendocino and Lake Counties. To combat this problem, Howard Memorial has partnered with Ukiah Valley Medical Center and Sutter Lakeside Hospital to support this initiative.


CPOE

Howard Memorial Hospital (HMH) implemented computerized provider order entry (CPOE), which allows direct entry of medical orders by physicians and other health care providers into Project IntelliCare, the hospital’s electronic medical record system.

“As with other computer technology, things are always improving with electronic medical records. The latest development at HMH will enhance patient safety and facilitate evidence-based/best practice medicine. HMH Spokesperson Kristen Meadows said, “Information that used to be transcribed from a doctor’s hand-written notes or recorded messages will be instantly available electronically. CPOE will improve efficiency, which is good for patients.”

OMNICELL

Thanks to a generous donation by an appreciative patient last year, Howard Memorial Hospital installed the most advanced G4 Omnicell Automated Drug Dispensing Cabinets. The technology uses bar-codes and guiding light technology to verify that the physician’s order is correctly followed from the moment the order is given, through the pharmacy, to the nurse, and on to the patient.

The new technology is also excellent for record keeping. The Omnicell software records every dose given, time of administration, and provides detailed reports to assure safe, appropriate use of narcotics. It also offers reports to track expired products, as well as other security issues.

Paulette Dancause-Paulsen, Pharmacy Director, said, “Howard Memorial is taking a giant leap toward safer patient pharmaceutical care with the installation of Omnicell.”

EXPANDED LAB HOURS

Howard Memorial Hospital has expanded its Outpatient Laboratory hours. The new hours are:

• Monday – Friday 6:30 a.m. – 6:00 p.m.

• Saturdays 8:00 a.m. – 5:00 p.m.

• Sundays & Holidays 8:00 a.m. – noon

Patients can now get lab work done before or after traditional office hours and on weekends. “We understand that people have many responsibilities, and sometimes getting to the lab is difficult. Hopefully, these expanded hours will help,” said Lab Director Arpad Peter.

2011 Highlightsand Community Outreach


Our Volunteers

Howard Memorial Hospital is pleased to have a wonderful group of volunteers who worked a total of 3,800 hours in 2011. They lend their services throughout the hospital in the following areas:

• The Information Desk

• Health Information Department

• Orthopedic Joint Program Lunches

• Outpatient Physical Therapy Department

• Chaplain Services

They also participated in the HomeTown Healthy Fair and hosted an Employee Appreciation Tea.

In addition, the Auxiliary supports fundraising for hospital purchases of equipment.


COMMONWEALTH GARDENS

The Frank R. Howard Foundation’s five-acre organic garden, which is a component of the new medical campus in Willits, continued to build infrastructure in 2011 with the hope of providing produce to the hospital in 2012.

Prior to 2011, we completed the following: fencing around the entire garden site, a drilled and developed well and pumphouse, PG&E power installed, planting of a 50+ tree orchard, installation of irrigation to orchard and Christopher’s Healing Knoll, a gazebo, start of ADA-compliant pathways, and cover crops planted in the 2+ acre vegetable planting area.

2011 proved to be a busy a year for the garden infrastructure with a 30 ft. x 96 ft. complete greenhouse kit, donated by Sparetime Supply, being installed. This very large project was headed by Keith Johnson and the $5,000 Community Foundation of Mendocino County grant was helpful in covering a portion of the costs incurred for pouring the concrete slab foundation for the greenhouse.

The construction of the concrete slab started with many tons of rock being donated and brought in by Northern Aggregates in Willits. Ron’s Quality Construction was able to donate design time toward the foundation and Pete Mihechelic donated his time and equipment, both in compacting the rock and in installing the greenhouse side and overhead framework and covering. Chamberlain Creek Conservation Crew helped with getting the covering installed over the whole greenhouse, and Keith Johnson installed power and water to the greenhouse as well as built greenhouse benches with the help a few friends.

And, all this done on a deadline so that the greenhouse could host the Hospital’s Leadership dinner that was held early in December 2011. The greenhouse was decorated by hospital staff and looked stunning for the Christmas holiday dinner that was prepared by the hospital’s Chef, Kyle Evans and his team.

And, yes, the finishing touches (water and power to the greenhouse), were being installed the very afternoon of the dinner. Cheers to everyone’s hard work and incredible donations that keep the Commonwealth Gardens project moving toward its goal of providing organic produce for the hospital so that patients, staff and visitors can be fed the most wholesome and nutritious food possible.

CommonwealthGardens


IN MARCH 2011, DIANE Moratti and Patsy Broeske attended Coordinator training in San Diego, and our Planetree journey began. As 2011 rolled by, the awareness for a better patient experience became part of each and every day.

Founded by a patient in 1978, Planetree is a not-for-profit organization committed to enhancing health care from the patient’s perspective. Through organizational transformation, the Planetree patient-centered care model assists hospitals in the creation of healing environments in which patients can be active participants and caregivers are enabled to thrive. During our journey, we are learning that each one of us is a caregiver, and each of us has a voice in making the patient experience better.

In the Spring, introductory informational sessions were offered to all staff, volunteers, and physicians to provide information on Planetree and patient-centered care approaches. Following those sessions, Planetree consultants came on-site for an organizational assessment, including leading focus groups with patients and staff.

The Planetree Steering Committee was formed in June with a cross section of managers, staff and physicians. The steering committee is responsible for integrating the Planetree concepts into patient care, reviewing recommendations from the action teams, and measuring the results from Planetree interventions that enhance the HMH culture. The committee began to meet monthly, and also began to form action teams for each of the Planetree components.

PLANETREE RETREAT

In the Fall, 14 employee facilitators were trained to lead the 20 full-day retreats, which took place in the beginning of 2012. Each employee, physician, volunteer, contract employee and board member was invited to attend. The experiential retreats gave each person a chance to explore the patient experience in a different way. Held off campus, each participant was treated to a day away from their usual job, given an opportunity to get to know a fellow staff member better, and a chance to really think about the patient experience. We were pleased with our 86 percent attendance rate.

Of all the retreat ideas, communication seemed to be a common thread as an area to improve upon, so we loaded links, minutes and agendas from the Planetree Steering Committee, as well as updates and articles on the Planetree section of the Connect Site. The hospital newsletter includes a monthly “Tea Time with Planetree” article.

The year ended with a Planetree buzz in the halls, and anticipation that we can continue to make the patient experience better, even though HMH has consistently done very well in our patient satisfaction surveys. Our Planetree journey is an evolving journey, and we are well on our way to providing an extraordinary health care experience to patients and families as well as for physicians, staff and volunteers.

Our Planetree Journey

Designated as a

File Name: BDC KHR H.eps

Center for Knee andHip Replacement


Frank R. HowardMemorial Hospital

2011 Annual Report

CHIEF EXECUTIVE OFFICER: RICK BOCKMANN

VICE PRESIDENT OF FINANCE: CARLTON JACOBSON

VICE PRESIDENT OF PATIENT CARE: KAREN SCOTT

EDITOR IN CHIEF: KRISTEN MEADOWS

PHOTOGRAPHY: RON GREYSTAR

The Orthopedic Joint Center at Frank R. Howard Memorial Hospital has received the Blue Distinction Center designation for Knee and Hip Replacement.

Frank R. Howard Memorial Hospital is accredited by The Joint Commission.

Frank R. Howard Memorial Hospital has been named as one of the only four Critical Access Hospitals (CAHs) in California

to be among the Top 100 CAHs in the nation, according to the National Rural Health Association.

Frank R. Howard Memorial Hospital has committed to enhancing health care from the patient’s perspective by adopting and implementing the Planetree patient-centered care model.

2011 ANNUAL REPORTOne Madrone Street, Willits, CA 95490 • (707) 459-6801 • www.HowardHospital.org

Documents

Howard Memorial Hospital 2011 Annual Report