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2013ANNUALREPORTTOOURCOMMUNITYQualityTransformationEngagementTrustYourRegionalHealthcareResource 2ConcordHospitalsAnnualReportispublishedasaserviceforourcommunitymembersfriendsandsupporters.Toberemovedfromourmailingliste-mailyourrequesttopublicaairscrhc.orgorcall603227-7000ext.4215.ConcordHospital2014.AllRightsReserved.PhotographyFrontBackCoversPg1319peoplephotosThinkstockAllRightsReserved.Allmodelsusedforillustrativepurposesonly.Pg23BillTruslowPhotographyPg3davewhitephoto.comPg5RixonPhotographyPg9ShutterstockInc.Pg18NurseryphotoJosephSt.PierrePhotographyBackgroundandInfographicArtThinkstockAllRightsReserved.ConcordHospitalwillcontinuetoadaptandinnovateputtingpatientsrstalwaysguidedbyourcharitablemissiontomeettheneedsofthosewhodependuponuswithoutregardtotheirabilitytopay.RobertP.Steigmeyer2014PresidentChiefExecutiveOcer 32013CONCORDHOSPITALANNUALREPORTTOOURCOMMUNITYMurielSchadeeCPA2013ChairBoardofTrusteesGregoryThesingMD2013PresidentMedicalStaAMessagetoOurCommunityHealthCaresFutureHasArrivedatConcordHospitalTodayFiscalYear2013willberememberedasayearoftransformationtrustandtransitionasConcordHospitalcontinueditsevolutionasaregionalhealthcareresourcewithafocusonservicevalueandpopulationhealthmanagement.Whilewehaveseenmanychangesrestassuredweremaindedicatedtoourmissionasacharitableorganizationwhichexiststomeetthehealthneedsofindividualsinourcommunity.Overthepastyearourtreatmentadvancesandorganizationalaccomplishmentsweremany.Mostnotablywehavecreatedasolidfoundationclinicallynanciallyandintellectuallyafoundationthathaspreparedourhealthsystemwellforembracingthefutureofhealthcarewithoutabandoningourhistoricalcommitmentofinvestinginthehealthandwell-beingofeachpatientandthecommunitymorebroadly.TheHospitaltogetherwithmorethan235clinicalprovidersoftheConcordHospitalMedicalGroupCHMGandotherhealthpartnerscontinuedtotransformcarewellbeyondthewallsoftheHospitaltoaddresshealthneedswherepeopleliveandworktokeeppeoplehealthyandengagethemaspartnersintheircare.Thetenetsthatdrivethistransformationincludeensuringeverytreatmentisprovidedsafelyandecientlyensuringdecisionsaboutpreventivecareandtreatmentaresharedandunderstoodbypatientsaspartnersandensuringpatientstrusttheyarereceivingtherighttreatmentfortherightreasonsattherighttimebymedicalproviderscommittedtotheircareandwell-being.Ourhealthsystemfurthereditscommitmenttoreengineeringcareforvaluethroughtheadoptionofthemedicalhomeconceptasthecaremodelofchoicethatwillimprovethepatientscareexperienceandhealthoverallreducethecostofprovidingmedicalcareandincreasecarequality.Wealsoremainsteadfastinourcommitmenttoprovideaccesstovitalstate-of-the-artspecialtyservicesoncologyurologyorthopaedicscardiologyandwomenshealthservicescommunitymembersandneighborsthroughoutCentralNewHampshirehavecometodependupon.Onceagainourhealthsystemproveditstrustworthinessprovidingfortheneedsofvulnerablecommunitymembersanddevelopingplanstoaddressidentiedcommunityhealthneeds.LastyearConcordHospitalinvestednearly41millioninitscommunitybenetprogramsandservices.TheyearalsobroughttransitionastheorganizationpreparedtosayfarewelltoitsPresidentandCEOMichaelB.Greenwhose21yearsofservicecametoacloseonDecember31.InoneofitsmostimportantresponsibilitiestheHospitalBoardselectednewPresidentandCEORobertP.SteigmeyerwhowillleadConcordHospitaltofuturesuccess.Todayhealthcareissurroundedbymorequestionsthananswers.ButConcordHospitalwillcontinuetoadaptandinnovateputtingpatientsrstalwaysguidedbyourcharitablemissiontomeettheneedsofthosewhodependuponuswithoutregardtotheirabilitytopay.RespectfullysubmittedRobertP.SteigmeyerPresidentChiefExecutiveOcerMurielSchadeeCPAChairBoardofTrusteesGregoryThesingMDPresidentMedicalSta ConcordHospitalisacharitableorganizationwhichexiststomeetthehealthneedsofindividualswithinthecommunitiesitserves.MISSIONSTATEMENTrearmedbyBoardofTrustees9232013ConcordHospital2013BoardofTrusteesD.ThomasAkeyMDDianeE.WoodAllenRNCHIEFNURSINGOFFICEREX-OFFICIOSolAsmarMaryE.BoucherSECRETARYPhilipBoulterMDVICECHAIRC.ThomasBrownWilliamL.ChapmanEsq.MichelleChicoineMichaelB.GreenPRESIDENTCEOEX-OFFICIOChristianHallowellMDGaryS.JonesMDJereyS.KippermanCPADavidRuedigMurielD.SchadeeCPACHAIRDavidA.StevensonMDTheHonorableMichaelF.SullivanGregoryThesingMDMEDICALSTAFFPRESIDENTEX-OFFICIOJereyK.TowleClaudiaWalkerBruceR.BurnsTREASURERNOTMEMBEROFTHEBOARD4 Becausewecareeveryday.ConcordHospitalStatementofRevenuesandExpensesFiscalyearendingSeptember30inthousands20132012Netpatientrevenues414144397542Otheroperatingrevenues2602627386Operatingrevenues440170424928Salariesbenets226360216967Servicessupplies139300133675Depreciationinterest2976729513Communitycharitycare1340514532Medicaidenhancementtax1654116175Operatingexpenses425373410862Gainfromoperations1479714066Non-operatingrevenues29186063Excessofrevenuesoverexpenses1187920129ConcordHospitalConsolidatedBalanceSheetFiscalyearendingSeptember30inthousands20132012Cashothercurrentassets8017194148Long-terminvestments282120212472Propertyplantequipment-net156147157101Otherassets2143013478Totalassets539868477199Currentliabilities6867266222Long-termliabilities175883180512NetassetsUnrestricted262946200823Temporarilyrestricted1412712890Permanentlyrestricted1824016752Totalliabilitiesnetassets539868477199RevenuesandExpensesStatementGuideNETPATIENTREVENUESReectgrosschargeslesscontractualallowancesanddiscountsincludinguncompensatedcare.COMMUNITYCHARITYCARERepresentschargeswrittenoforservicestopatientswhowereunabletopaystatedatcost.MEDICAIDENHANCEMENTTAXAtaxleviedbytheStateofNewHampshirebasedonhospitalnetrevenue.GAINFROMOPERATIONSExcessofrevenuesoverexpensesfromallpatientandcontractservices.NONOPERATINGREVENUESIncludesrevenuesandlossesfrominvestmentscontributionsandsupportfromendowments.BalanceSheetGuideLONGTERMINVESTMENTSIncludesfundsrestrictedbydonorsoroutsideagenciesaswellasfundsdesignatedbytheBoardofTrusteesforlong-terminvestment.NETASSETSRepresentsthevalueofConcordHospitalthatisavailabletomeetfuturefacilityequipmentandstrategicneeds.Temporarilyrestrictedrepresentsfundsrestrictedbydonorsforspecicpurposes.PermanentlyrestrictedrepresentsfundsrestrictedbydonorstobemaintainedasapermanentendowmentwithearningstobeusedtosupportHospitalactivities.52013CONCORDHOSPITALANNUALREPORTTOOURCOMMUNITY 6MostWiredConcordHospitalhasreceivedMostWiredrecognitionfor12consecutiveyears2002-2013.MostWired1isanationalprogramwhichrecognizeshospitalswhoseuseofinformationtechnologyexcelsinfourcategoriesclinicalqualityandsafetyclinicalintegrationbusinessandadministrativemanagementandinfrastructure.SAFETYQUALITYSAFETYQUALITYDiabetesAspartofitsNationalDiabetesPreventionProgramtheCentersforDiseaseControlandPreventioncitedConcordHospitalasoneofonlythreeinstitutionsinNewHampshiretohaveeectivelydeliveredalifestylechangeprogramtopreventType2diabetes.AtConcordHospitalwedontsimplytreatillnessesormendbrokenbones.Wecareforindividualsfocusingeverydayonimprovingcareandprovidingitinasafehealingenvironment.PatientCommunicationBoardsAllourpatientroomsnowincludeaPatientCommunicationBoardspeciallydesignedtoprovidepatientsfamilymembersandcareprovidersauniformeasy-to-readsourceforeachpatientscareplanforthedayon-dutycaregiversdietandanyspecialsafetyconcernssuchaswhetherthepatientisatriskforfalls.PatientsreporttheCommunicationBoardshavehelpedkeepthemandtheirfamiliesbetterinformed.1The2013MostWiredSurveyisconductedincooperationwithMcKessonCorp.ATTtheCollegeofHealthcareInformationManagementExecutivesandtheAmericanHospitalAssociation. Becausewecareeveryday.72013CONCORDHOSPITALANNUALREPORTTOOURCOMMUNITYGuardianofExcellenceAwardSMWeprideourselvesonprovidingexcellentcaretoourpatientsandtheynotice.In2013ConcordHospitalwasnameda2013GuardianofExcellenceAwardwinnerbyPressGaneyAssociatesInc.Theawardrecognizestop-performingfacilitiesthatconsistentlyachieveandmaintainthe95thpercentileinpatientsatisfactionforinpatientcareduringtheoneyearreportingperiod.2FewerthanvepercentofPressGaneys10000clientsreachthisthreshold.Zeroofourintensivecarepatientshaveexperiencedacentrallineinfection3in2013.Zeroofourintensivecarepatientshaveexperiencedaventilator-acquiredinfectionforthreeyears.4Ourhandhygienecompliancerateis97ascomparedtothestatewideaverageof93.599ofthemedicationdosesweadministerusingbarcodingensuretheverights.2May2012April20133Centrallinebloodstreaminfectionscanoccurwhenatubecatheterisplacedinalargeveinonapatientsbody.4October2010October20135Incomparisontoavailablestatewidecompliance.SourceFoundationforHealthyCommunities2012data.PatientEducationInitiativeHospitalizedpatientscaneasilybeoverwhelmedbytheamountofinformationtheyreceivefromnumeroushealthcareprovidersabouttheirtreatmentandfollow-upcare.ThatswhyConcordHospitalbeganitsPatientEducationInitiativetostandardizeeducationmaterialsforpatientsthroughouttheirHospitalstay.OurnursesnowusethenationalPatientEducationReferenceCenterPERCtoaccessevidence-basedmedicalhandoutsforpatientsandtheirfamiliesorganizingtheminoneGreenEnvelopetohelppatientskeeptheinformationinoneplace.PatientstaketheGreenEnvelopewiththemwhentheyleavetheHospitalandareencouragedtoshareitwiththeirprimarycareproviders.RightpatientRightdoseRightdrugRighttimeRightroute99 SAFETYQUALITY8PatientSatisfactionPatientfeedbackisimportanttousandhelpsuscontinuouslyimproveourprogramsandservices.OnemeansofgainingfeedbackisthroughPressGaneysurveyswhicharemailedtopatientsafterdischarge.Findingsarerankedagainstsimilarfacilitiesnationwide.Top10NATIONWIDEAllConcordHospitalMedicalGrouppracticesforpatientsratingofcareduringavisitDeliriumEducationPreventionandManagementInitiativeConcordHospitalhasmadeitatopprioritytorecognizepreventandmanagedeliriumasuddensevereconfusionthatoftenmaybeexperiencedbyelderlypatients.TheHospitalhasimplementedarangeofnewproceduresincludingspecializedtrainingfornursestoreducetheincidenceofdeliriumdecreasecomplicationsofacuteconfusionsuchasfallsandincreaseawarenessofdeliriumamongmedicalproviderspatientsandtheirfamilymembers.Aftercompletingthetrainingnursesreportedtheirknowledgeandcondenceincaringforpatientswithdeliriumincreasedsignicantly.CONFIDENCEINASSESSINGRISKFORDEVELOPINGDELIRIUMINCREASEDRECOGNITIONTHATUNTREATEDPAINCONTRIBUTESTODELIRIUMINCREASEDTop8NATIONWIDEConcordHospitalMedicalGroupFamilyTreeHealthCare-WarnerTop9NATIONWIDEAllConcordHospitalMedicalGrouppracticesoverallratingIn2013weranked56946090October12012September302013 Becausewecareeveryday.92013CONCORDHOSPITALANNUALREPORTTOOURCOMMUNITYExceptionalOrthopaedicCareCitingclinicalexpertiseandqualityofcareAnthemBlueCrossandBlueShieldofNewHampshirehasdesignatedConcordHospitalasaBlueDistinctionCenterforKneeandHipReplacementSurgery.TheawardrecognizesthesurgeonsandstaatTheOrthopaedicInstituteatConcordHospitalconsistentlyprovideexpertreliablekneeandhipreplacementcare.TheOrthopaedicInstituteisalsoachartermemberoftheAmericanJointReplacementRegistrywhichisanationalorganizationfordatacollectionandqualityimprovementinitiativesfortotalhipandkneereplacement.Theregistrystorescomprehensiveinformationaboutjointreplacementsthathospitalswillbeabletoaccesstohelpdoctorsandpatientsmakebetterdecisionsaboutreplacementsurgery.ConcordHospitalisdesignatedasaforKneeHipReplacementDesignatedbyBlueDistinctionCentersarehospitalsrecognizedfortheirexpertiseindeliveringspecialtycare.MoreNewHampshireresidentschooseTheOrthopaedicInstituteatConcordHospitalforjointreplacementsurgerythananyotherhospitalinNewHampshire.NHUniformHospitalDischargeDataSet2009Top2NATIONWIDEConcordHospitalProgressiveCareUnitConcordHospitalRadiationOncologyDepartmentvs.otherfacilitiesthatoerradiationonlyTop4NATIONWIDEConcordHospitalBreastCareCenterTop5NATIONWIDEConcordHospitalVascularLaboratoryConcordHospitalMedicalGroupTimethecareproviderspentwithyouthepatientTop6NATIONWIDETheOrthopaedicInstituteAllConcordHospitalMedicalGroupspecialtypracticesConcordHospitalMedicalGroupInternalMedicine-HorseshoePondTop7NATIONWIDEConcordHospitalMedicalGroupConcordFamilyMedicineBecausewecareeveryday. 10SAFETYQUALITYCHMGQualityConcordHospitalMedicalGroupCHMGadherestorigorousqualitystandardstoensuresafehigh-qualitycareforeachpatient.Evaluatingandassessingeachpatientsfallsriskanddevelopingactionstepstoreducetheirriskwhilehospitalizedandathome.Providinginformationandplanningtoolstoassistpatientswithexecutingadvanceddirectivesandincludingthemaspartofeachpatientselectronichealthrecord.Identifyingtestingandtreatingasthmapatientswithstandardizedcomprehensivetreatmentplans.Vaccinatingallpatientsage65orolderwithapneumovaxvaccinetoprimarilyhelppreventpneumonia.WhatQUALITYeortsareunderwayPartneringwithpatientstomonitorandadheretovequalitymeasuresaimedathelpingthempreventandorbettermanagediabetesloweringcholesterolbloodpressureandglucoseadailyaspirinregimenandsmokingcessation. Becausewecareeveryday.112013CONCORDHOSPITALANNUALREPORTTOOURCOMMUNITYTRANSFORMATIONTRANSFORMATIONConcordHospitalstransformationtorespondtoachanginghealthcareenvironmenthasnotoccurredovernight.Itbeganwiththoughtfulplanninganddecision-makinglongagoandwillcontinueintothefuturewithonecentralgoaltomeetthehealthneedsofourpatientsandourcommunitymemberseveryday.GraniteHealthcareNetworkGraniteHealthcareNetworkGHNisauniquecollaborationofveindependentNewHampshirecharitablehospitalsleadingthetransformationofhealthcaredeliveryinthecommunitiestheyserve.ConcordHospitalElliotHealthSystemLRGHealthcareSouthernNewHampshireHealthSystemandWentworth-DouglassHospitalarecommittedtosharingresourcestoprovidemorecoordinatedcarecosteectivelytohelpcreateahealthierNewHampshire.GHNinnovationsincludeAdoptingacommonsetofcoreprinciplesandbestpracticesfordecreasingunnecessaryreadmissionsImplementingacommondepressionscreeningprocessinallGHNprimarycarepracticesasarst-stepapproachtohelpidentifypatientssueringwithadepressivedisordertoensuretheyareappropriatelytreatedinatimelymannerBeginningin2014patientswithchronicandpersistentasthmawhoseekcareinaGHNprimarycarepracticewillreceiveanasthmaactionplanandbecontactedbyacertiedasthmaeducatortoansweranyquestionsabouttheirdisease.granitehealth.org TRANSFORMATION12LeanAphilosophyofstructuredimprovementLeanisaimedatincreasingthevalueofourpatientsexperiencesbyimprovingqualitysafetytimelinesseectivenesssatisfactionandnancialimpact.ConcordElliotACOTheMedicareSharedSavingsProgramacomponentofthe2010PatientProtectionandAordableCareActpromotesthedevelopmentofaccountablecareorganizationstoachievetheInstituteforHealthcareImprovementThreePartAimimprovingtheexperienceofcareimprovingthehealthofpopulationsreducingthecostofhealthcare.Morethan10000MedicareFee-for-ServicebeneciariesinourregionarenowbenettingfromtheConcordElliotAccountableCareOrganizationACOaninitiativedesignedtocoordinateandimprovetheircarewhilehelpingstemtheriseinhealthcarecoststhroughtheirrelationshipwithConcordHospitalMedicalGroupCHMGandElliotHospitalproviders.KeyConcordHospitalachievementsoverthepastyearincludeCreatingNationalCommitteeforQualityAssurancerecognizedpatient-centeredmedicalhomeswithinallprimarycarepracticestofosterteam-basedcareandenhancewellnessEmbeddingnursecaremanagersinourmedicalhomestoworkcloselywithpatientsandtheircareteamstobettermanageillnessavoidunnecessaryhospitalizationsandEmergencyDepartmentvisitsScreeningforpotentialhealthissuessuchassmokinghighbloodpressureobesitycolorectalcancerdiabetesdepressionandriskoffalling.1.7hoursJanuary20121hourorlessSeptember2013TREATMENTTIMEIn2013LeaneortswereimplementedatourWalk-InUrgentCareCenterwithafocusofreducingthelengthoftimeapatientspendsattheCenter.Todaythattimehasbeenreducedby60percentandpatientsarenowtypicallyinandoutoftheCenterinanhourorless. Becausewecareeveryday.132013CONCORDHOSPITALANNUALREPORTTOOURCOMMUNITYUseofDataAnalyticstoFocusonPopulationHealthAspartoftheConcordElliotACOanditsroleinkeepingourcommunitymembershealthyConcordHospitalandCHMGhealthcareprovidersareusingdataincludingMedicareclaimsandrecordsofclinicalvisitstobetterunderstandthehealthneedsofMedicareFee-for-Servicebeneciariesandfocusresourcestoaddressthoseneeds.Theinformationhelpsbuildacomprehensivehealthriskprolethatsupportsthepatientshealthcareteaminbuildingindividualcareplanstomeettheneedsofpatientsandtopromotelifestylechangesmedicationorotherinterventionsthatmaybesthelplowerindividualrisksandprovideabetterqualityoflife.Anewenvironmentforpatienthealingwasachievedwiththeredesignofamedicalsurgicalpatientcareunit6North.ThedesignteamutilizedLeantoplananddesignanenvironmentthatsupportsclinicalstainprovidingecientsafeeectivepatient-centeredcare.Usingsimulationmodelingwewereabletocomparecurrentwalkingdistancesoverthecourseofashiftfornursingstatothenewpatientcareunitdesign.Thepreliminaryresultsshowthattheredesigneortswillyieldpositiveresultsreducingthedistancenursingstawalkduringasingleshiftby50.EmergencyDepartmentovercrowdingcontributestopatientsleavingwithoutbeingtreatedLBTatarateof2.6nationally.AlthoughConcordHospitalaveragedbelownationalaveragein20122.1-2.7recentprocessimprovementsresultedinasustainedLBTrateof1-1.4.WhatdoesthismeantopatientsNursesareabletospendmoretimebedsidewiththeirpatientsImprovedpatientandfamilyinteractionswithcaregiversMoreecientspaceenhancesandimprovesthetimelinessandeectivenessofcare.14milesto7miles50reduction ENGAGEMENT14ENGAGEMENTCaringreallycaringeverydayishowConcordHospitalengagespatientstobecomemoreactivemembersoftheirhealthcareteam.WearededicatedtoasystemofcarethathealspatientswhentheyareillkeepsthemhealthywhentheyleavetheHospitalandhelpspreventillnessintherstplace.Asourhealthpartnerspatientsmayfeelcondenttheyaregettingtherighttreatmentfortherightreasonsattherighttime.YourMedicalHomeTheMedicalHomeisanevolvingapproachtohealthcarethatsupportspatientsasactivepartnersofatrustedteamdedicatedtoprovidingcarethatiscoordinatedcomprehensivecompassionateaccessibleandpatient-centered.AllofConcordHospitalMedicalGroupsCHMGprimarycareprovidershavebeenrecognizedasNationalCommitteeforQualityAssurancesPatient-CenteredMedicalHomesforembracingthemedicalhomeconceptandimplementingevidence-basedproceduresthatimprovequalityandlowercostswhileconstantlystrivingtohelppatientsunderstandandmanagetheirhealth.FrailEldersProgramFrailelderslivinginthecommunityfacemanybarriersincludingmobilitylimitationsthatmakeitdicultforthemtoobtainneededmedicalcare.OurConcordHospitalFamilyHealthCenterFrailEldersProgramprovideshousecallstothesepatientstonotonlybetheprimarycareprovidertotreattheirmedicalconditionsbutalsoprovideavitalcommunicationlinkbetweenpatientsfamilymembersandothermedicalprovidersandpotentiallyavoidtheneedforhospitalizationoremergencycare. Becausewecareeveryday.152013CONCORDHOSPITALANNUALREPORTTOOURCOMMUNITYCollaborativeEffortswithCommunityPartnersConcordHospitalknowsthatfocusingoncommunityhealthmeansembracingcollaborationswithcommunitypartners.Forcomplexhigh-riskpatientsinparticularearlyandconsistentconnectionswithbehavioralhealthhomehealthandothercommunity-basedresourcesarecriticaltoimprovingapatientsqualityoflifeandoptimizingtheirwellness.ConcordHospitalandConcordHospitalMedicalGroupareworkingcloselywithRiverbendCommunityMentalHealthandConcordRegionalVisitingNurseAssociationtobettercoordinateservicesthroughoutourcommunitytoimprovehealthandwellnessandreduceEmergencyDepartmentvisitsandHospitaladmissions.CommunityandOrganizationalWellnessConcordHospitalCenterforHealthPromotionCHPisactiveincommunityandorganizationalwellness.InadditiontobeingtheleadorganizationforTheCapitalAreaWellnessCoalitionCHPalsoprovidesleadershiptotheWellnessCoordinatorsCouncilofNHwhichisopentoanyoneintheStatewhoisresponsibleforabusinesswellnessprogram.ThroughnetworkingandeducationalsessionstheCouncilhelpsbusinessesdevelopmoreeectivewellnessprogramsaimedatkeepingtheiremployeeshealthy.MedicalHomeNavigationProgramAspartoftheMedicalHomeourMedicalHomeNavigationProgramincludesNurseCareManagerswhohelppatientsandtheirfamiliesnavigatetheincreasinglycomplexhealthcaresystemwithkeenfocusonbuildingtrustingrelationshipswitheachpatientandtheirentirehealthcareteam.WhatdoNurseCareManagersdoListentounderstandandthenaddressfearsandconcernsabouttreatmentServeasaresourcewithintheprimarycareteamtopartnerwithpatientsmanagingtransitionsofcarewhichmayincludespecialisttospecialisthospitaltohomeorhospitaltonursinghomeorrehabilitationDevelopaplanofcareandwellnessthatrespectseachpatientsmedicalneedsandvaluesProvideone-on-oneeducationaimedatimprovingapatientshealth.Helppatientsmanagetheirmedications 16ENGAGEMENTConcordhospital.orgConcordHospitallaunchedanewresponsivewebsitein2013thatprovidesmoreinformationmoreeasilytoallvisitorsregardlessofwhattypeofdevicetheyuse.Withmorepowerfulsearchtoolsthesitehelpsvisitorsmakeinformeddecisionsandimprovetheirhealthwitheasyaccesstoinformationaboutdoctorsandhealthservicesincludingvideosdecisionaidsandaninteractivesymptomchecker.OVERALLVISITSTOTHESITEINCREASED78April2012August2013Patient-CenteredCommitteeAspartofaneorttoexpandtheMedicalHometeamConcordHospitalConcordHospitalMedicalGroupandavarietyofcommunitypartnerswhocareforresidentsfromchildbirththroughtheirelderlyyearsareworkingtoimprovethewaytheirpatientsmovefromonestageofcaretoanother.AsasteptowardstrengtheningrelationshipsandfosteringpartnershipstohelppatientsofallagesthePatient-CenteredCommitteeprovidesitsmembersinformationabouttheservicestheyprovideandthetypesofpatientstheyservewiththegoalofgeneratingcomprehensivepatienteducationtoolsandcommunityresourcesforpatients.PATIENTREPRESENTATIVECLINICALDATAANALYSISCONCORDHOSPITAL Becausewecareeveryday.172013CONCORDHOSPITALANNUALREPORTTOOURCOMMUNITYTRUSTThroughourinvestmentinmedicaltechnologyskilledcareprovidersandcollaborativepartnershipsourcommunitymemberscantrustthatConcordHospitalworkshardeverydaytoprovideexceptionalmedicalcareforallincludingourmostvulnerableneighbors.PaysonCenterforCancerCareConcordHospitalPaysonCenterforCancerCarecelebratedits10thanniversaryin2013.InitsrstdecadetheCenterhasearnedanationalreputationasacomprehensivecommunity-basedcancercenteroeringpatientsinourregionthehighestqualitycancerdiagnosistreatmentandsupportclosetohome.HyperbaricMedicineDepartmentAccreditationOurWoundHealingCentersHyperbaricMedicineDepartmentwhichbringsreliefeachyeartohundredsofareapatientswithslow-healingwoundswasawardednationalaccreditationin2013bytheUnderseaHyperbaricMedicalSocietymakingittheonlyCenterinNewHampshiretoachievesuchlevelofexcellence.TRUST TRUST18TheFamilyPlaceSpecialCareNurseryOurnewSpecialCareNurseryisdesignedfornewbornswhoneedextramedicalattentionallowingparentstostayovernightandclosetothemwhiletheirhealthimproves.Approximately10-20percentofthe1300babiesbornannuallyatConcordHospitalaretreatedintheSpecialCareNurserysomeforseveralhourssomeforextendedperiodsoftimeuntiltheyarewellordevelopedenoughtogohome.StrokeTreatmentCerticationConcordHospitalisthersthospitalinNewHampshiretobecertiedasaPrimaryStrokeCenterHospitalbyDNVHealthcareahospitalaccreditationorganization.Thethree-yearcerticationmeansConcordHospitalsstrokeresponsestafollowsthebestmethodstofast-trackpatientssuspectedofstrokesodoctorsmaybeginbrain-savingtreatmentsimmediately.Thenationalgoalistoopenapatientsblockedarterywithin90minutesofreachingahospital.ConcordHospitalpatientsaverageis70minutes.CenterforCardiacCareAccordingtotheCentersforDiseaseControlandPreventionheartdiseaseisthesecondleadingcauseofdeathinNewHampshiresecondonlytocancer.OurCenterforCardiacCareprovidespersonalizedcomprehensivecardiacservicesusingevidence-basedmedicineandpatient-centeredcareincludingadvanceddiagnostictestingcardiacinterventioncardiothoracicsurgeryandrehabilitation.CentersforDiseaseControlandPrevention.WISQARSLeadingCauseofDeathReports2010. Becausewecareeveryday.192013CONCORDHOSPITALANNUALREPORTTOOURCOMMUNITYIn2013weinvestednearly41millionofourresourcestofulllourlong-termcommitmenttomeetingthehealthneedsofindividualsandfamiliesprovidingamedicalsafetynetformanyassuringaccesstomedicalcarebroadlymostespeciallyforourregionsmostvulnerableresidents.Ourcommunitybenetinvestmentincludes13404802incharitablecarefor7927patients.2626473investedinprovidingcommunityhealthservicesto114119communitymembersandpatients.19454474inprovidingsubsidizedhealthservicesto38151patients.Yourcontributionmakesadierence.Pleaseusetheenclosedenvelopeforyourpledgeorvisitch-trust.orgtomakeasecureonlinegift.Thankyou.ConcordHospitalCenterforUrologicCareConcordHospitalCenterforUrologicCaresPelvicMedicineContinenceandSexualHealthProgramoersanadvancedinnovativemultidisciplinaryapproachtothediagnosisandtreatmentofurologicandurogynecologicconditionsmakingittheonlyprogramofitskindintheState.Theprogramsteamincludesurologistsgynecologistscolorectalsurgeonsphysicaltherapistsbehavioralandsextherapistsnursespecialistsdietitiansandschedulingcoordinators. TRUST20GregoryThesingMDPresidentDouglasEwingMDPresident-electKevinRivieraMDSecretaryTreasurerStephenP.ImgrundMDImmediatePast-PresidentAllergyJoanL.CassettariDOLauraM.JarmocMDAnesthesiologyCarrieAyersMDWilliamEnnisMDDeanJ.GalatisMDRobertS.KramerMDRobertJ.LaamMDKathrynS.LemmonMDRobertM.MaccaniDOKeithR.NicholsMDThomasS.PedersenMDMargaretA.PittsMDRomanV.PlachintaMDJohnM.RicheyMDDavidJ.SnyderMDRobertF.SpencerMDRichardJ.SteeleMDSarahA.WittMDCardiologyDonnaD.AdamsMDRichardA.BossJr.MDPatrickF.CassellMDDonP.ChanMDAdamChodoshMDKennethA.DelogeMDGerardA.DillonMDHusamH.FarahMDCarlM.FierMDMelkonHacobianMDJohnJayneMDJereyT.LockhartMDR.JereyLootensMDMichaelR.NewtonMDJohnRobbMDKirkeW.WheelerMDCharlesWicksMDCardiacSurgeryLakiRousouMDGeraldSardellaMDDentalRogerA.AchongDMDShannonN.ArndtDMDMichaelC.BenenatiDMDArnoldS.BurdickDDSPatrickF.CapozziDDSRachelDavisDDSJereyS.ForgoshDMDJamesHaasDDSDanielleHintonDMDDouglasW.JohnsonDMDShannonMillsDDSManishaPatelDDSDermatologyAnthonyJ.AversaMDStephenM.DelGuidiceMDPascalFerzliMDEmergencyMedicineJeremyArnoldMDPeterBlumeMDJaneL.BurkeMDDouglasM.ConnorMDJohnD.EstabrookMDGeoreyM.FitzgeraldMDChristopherA.ForeMDDavidHirschMDAndrewM.JaeMDRussellS.KayMDBryceD.LambertMDMichaelT.LynchMDRobertRixMDLonJ.SetnikMDMaryN.ValvanoMDMatthewP.WardenMDFamilyMedicineOmotayoAkinmadeMDChristopherAllenMDLisaE.AtkinsonMDBassemAzkulMDBryanBannisterMDJohnF.BarksdaleMDJohnC.BassiMDEdwardBenoitMDFrankA.BetchartMDTerriL.BrehioMDPatriciaE.ClancyMDElizabethA.ClardyMDJohnA.DiPastinaDODouglasR.DreerMDLynnA.DurandMDDanielF.EubankMDGailL.FayreMDKatharineT.FoxMDPatrickFoxMDDominicF.GekenMDBarryL.GiglioMDAngelaGoldmanKlinglerMDP.TravisHarkerMDFrancisE.HayesJr.MDEmilyM.JonesMDStevenH.KaitzMDPatriciaB.KegelMDRobertS.KiefnerMDCynthiaG.KingMDBoguslawaKremznerMDEricA.KroppMDStephenJ.LawrenceMDJohnD.LloydMDJosephE.LowneJr.DOHongbaoMaMDMichaelP.MadanMDLauriAnnMaitlandDOAmyL.MartelMDMichaelM.McLeodJr.DODeborahN.MeesarapuMDFrancisJ.MilliganMDJacquelineM.MorseMDA.RavindraNathMDRichardS.NelsonMDCarolA.NiegischMDRobertW.NiegischMDA.JohnOrzanoMDEricF.PollakMDRoryRichardsonMDLouisE.RosenthallMDElizabethA.SandersMDMathewM.SawyerMDMargaritaShugolDOW.KentSmithMDGaryA.SobelsonMDMichelleT.SpencerMDRobbJ.StidwillMDShawnI.SuttonMDGregoryJ.ThesingMDMichaelTsoMDAndrewG.WestbrookMDAshleyL.WoodMDAngelaYerdonMcLeodDOGastroenterologyRobertT.ChehadeMDMichaelJ.GilbertMDBurrJ.LoewMDSamuelC.SomersMDRobertD.ThomsonMDGeneralSurgerySharonI.GunsherMDMelissaHoytMDJosephP.MeyerMDRichardK.MurphyMDMichaelD.PaulMDJosephR.SnowMDRussellA.StrongMDWilliamJ.TanskiIIIMDChristianWilkeMDPeterH.WilsonMDMichaelJ.WoodMDHospitalistStephenBissahMDTomaszBlaszczakMDKarenM.BryantMDSudhamChandMDWilliamL.CrawfordMDMaryK.EckertMDKevinS.FlemingMDJimmyC.FuneMDAlexanderE.GadboisMDToniT.HadjievMDSuzyA.IversonDOKlevisJ.KadiqiMDMustaphaKaranouhMDChristinaL.KirkpatrickMDSantoshKumarMDInderLalMDChristopherMertzMDTracyOHaraMDMaynardPangMDPhilipD.SprungerMDDanaAllenYoungMDValerieZiesmerMDInfectiousDiseaseJenniferF.GittzusMDJamesT.NobleMDInternalMedicineNicoleM.AntinerellaDOIoanC.BadauMDRogerE.BelsonMDJuliaF.BurdickMDAnneG.ChehadeMDCarlCiakMDPaulR.ClarkMDBeverlyJ.EntwisleMDRalphFalkMDDavidS.JohnsonMDLynLindpaintnerMDPushkalaMuralitharanMDAmitRastogiMDRobertRzepkaMDKellySeichepineMDJasmineA.ShahMDTanjaVanderLindeMDIanWaggettMDConcordHospitalMedicalSta-ActiveProvisionalAssociateandActiveAmbulatory Becausewecareeveryday.212013CONCORDHOSPITALANNUALREPORTTOOURCOMMUNITYNephrologyOlgaV.CharlatMDRudolfPullmanMDNeurologyMonicaBurkeDOAnnCabotDOMildredH.LaFontaineMDMarkA.LombardoMDChristopherMartinoDONeurosurgeryN.RossJenkinsMDMarkV.LarkinsMDNealLutherMDObstetricsGynecologyAshishC.ChaudhariMDMonicaChunMDDavidC.ConwayMDMaryA.DancaMDMarcDuhaimeDOTimothyJ.FisherMDMaryFiskeMDHeidiHallonquistMDCourtneyB.JonesMDEllenM.JoyceMDRajaniKancharlaMDMarkS.KegelMDH.SidneyMitchellMDMariaD.PadinMDRichardS.SalchunasMDDavidA.StevensonMDNicoleVarastehMDAnnickWestbrookMDChungHwaCathyYiMDOglesbyH.YoungMDOncologyHematologyFrederickM.BriccettiMDCharlesH.CatcherMDPeterCrowMDJeannaH.WalshMDOphthalmologyAndreA.dHemecourtMDPaulG.DeGregorioMDErinS.FogelMDEliotFoleyMDBradfordS.HallMDChristieL.MorseMDMaxwellA.SneadIIIMDMarkA.SzalMDPeterWassermanMDDavidA.WeinbergMDMaynardB.WheelerMDLloydM.WilcoxJr.MDOralandMaxillofacialMarkM.ScuraDMDPatrickVaughanDDSOrthopaedicSurgeryKarenJ.BoselliMDRussellBrummettMDWilliamJ.BrutonMDSeanBurnsMDPatrickJ.CaseyMDDavisW.ClarkMDRobertS.CummingsMDScottR.DevannyMDStephenJ.FoxMDChristopherGentchosMDDerekJenkinsMDLanceKlinglerMDCliordM.LevyMDAnthonyV.MollanoMDDouglasJ.MoranMDPeterG.NoordsijMDJohnJ.OConnorMDRonaldB.ResnickMDPaulJ.UrbanekMDJereyW.WileyMDGaryL.WoodsMDOtorhinolaryngologyMarkA.CarwellMDChristopherH.DaniellMDWilliamNumaMDAshokReddyMDPathologyTimothyE.GormanDOCristinaE.TaylorMDGaryL.YorkMDPediatricsThomasAlbushiesMDTimothyBabaMDMarkD.CarneyMDDollyR.CourtemancheMDElizabethCramerMDGeorgeA.DeVitoJr.MDLeslieDickMDPatriciaM.EdwardsMDNathanW.FaulknerMDLauraM.GreerMDUrsulaKneisslMDCaraA.OConnorMDStanleyS.ParasMDMatthewPicconeDOSarahV.RadwanMDEricA.ShulmanMDWilliamR.StoroMDNancyJ.VanVrankenMDRogerH.WicksmanDOEarnestWuMDPhysicalMedicineandRehabilitationAdamP.CugaljDOStuartJ.GlassmanMDPowenHsuMDCarolineKooMDDavidJ.NagelMDPlasticReconstructiveSurgeryToddE.BurdetteMDWayneK.StadelmannMDPsychiatryPercyBallantineMDOsvaldoEvangelistaMDSonyaL.KellyMDKavithaKittuMDAlexandraKuftinecMDRobertA.MurrayMDDianaWeinerMDPulmonaryMedicineD.ThomasAkeyMDMartinBlackMDStephenP.ImgrundMDMichaelG.LaidlawMDAlejandroS.SaranglaoMDPatrickTangneyMDRadiationOncologyStephenL.HarrisMDKlaudiaU.HunterMDArulMahadevanMDAndreaB.McKeeMDSuMetcalfeMDBrianP.RoweMDThomasA.SheldonMDPingZhouMDPhDRadiologyConstantineP.BrocoumMDJohnCameronMDMatthewH.DiMasiMDDouglasK.EwingMDMarkA.HadleyMDDavidHouMDTimothyJ.McCormackMDTadT.RenvyleMDKevinRiveraMDCoreySidesMDJosephVenusMDRichardJ.WaiteMDD.TylerZaptonMDRheumatologyIreneOrzanoMDAndreeClairePhillipsMDHokeH.ShirleyIIIMDSleepMedicineIrenaR.DanysMDDavidC.PicardMDThoracicSurgeryG.DarbyPopeMDUrologyScottJ.FabozziMDDavidF.GreenMDThomasL.JacksonMDBrianK.MarksMDRobertE.MitchellMDWilliamF.SantisMDPaulM.SnyderMDVeronicaTriacaMDRonaldL.YapMDAsof09302013 TRUST22CapitalOrthopaedicSurgeryCenter264PleasantStreetConcordNH03301603224-336814TsiennetoRoadSuite100DerryNH03038603425-6966LICENSEDBYNewHampshireDepartmentofHealthandHumanServicesDivisionofPublicHealthServicesConcordAmbulatorySurgeryCenterCHMedicalOcesatHorseshoePondOneCorporateCenter60CommercialStreetSuite301ConcordNH03301603415-9460ACCREDITEDBYAmericanAssociationforAmbulatoryHealthCareInc.CentersforMedicareandMedicaidServicesLICENSEDBYNewHampshireDepartmentofHealthandHumanServicesDivisionofPublicHealthServicesConcordEndoscopyCenterCHMedicalOcesatHorseshoePondOneCorporateCenter60CommercialStreetSuite201ConcordNH03301603415-9450ACCREDITEDBYAmericanAssociationforAmbulatoryHealthCareInc.LICENSEDBYNewHampshireDepartmentofHealthandHumanServicesDivisionofPublicHealthServicesConcordEyeSurgeryCenter246PleasantStreetConcordNH03301603224-6503ACCREDITEDBYAmericanAssociationforAmbulatoryHealthCareInc.CentersforMedicareandMedicaidServicesLICENSEDBYNewHampshireDepartmentofHealthandHumanServicesDivisionofPublicHealthServicesAliationsandAccreditationsConcordHospital250PleasantStreetConcordNH03301603225-2711ACCREDITEDBYAccreditationCouncilforGraduateMedicalEducationAmericanAcademyofSleepMedicineAmericanAssociationofBloodBanksAmericanCollegeofRadiologistsCTMammographyMRINuclearMedicinePETAmericanCollegeofSurgeonsTheCommissiononCancerAmericanMedicalAssociationCouncilonMedicalEducationCentersforMedicareandMedicaidServicesLaboratoryCollegeofAmericanPathologistsCommissiononAccreditationofAlliedHealthEducationProgramsDNVHealthcareHospitalAccreditationInternationalCommissionforAccreditationofVascularLaboratoriesNationalAccreditationProgramforBreastCentersNewHampshireMedicalSocietyonEducationUnderseaHyperbaricMedicalSocietyAPPROVEDBYDepartmentofHealthandHumanServicesSocialSecurityAdministrationMedicareNewHampshireBureauofFamilyCommunityHealthNewHampshireOceofEmergencyManagementDESIGNATEDASBaby-FriendlybirthfacilitybyBaby-FriendlyUSAInc.PrimaryStrokeCenterHospitalDNVHealthcareTraumaCenterLevelIIEmergencyMedicalServicesCouncilRegionIVTraumaCenterLevelIIIAmericanCollegeofSurgeonsLICENSEDBYDrugEnforcementAgencyFoodandDrugAdministrationNewHampshireBureauofChildCareNewHampshireBoardofPharmacyNewHampshireBureauofRadiologicHealthNewHampshireDepartmentofHealthandHumanServicesDivisionofPublicHealthServicesPublicHealthClinicPharmacyAFFILIATIONSAmericanHospitalAssociationAssociationofCommunityCancerCentersConcordElliotACOMedicareSharedSavingsProgramGraniteShieldInsuranceExchangeaVermontCaptiveInsuranceCompanyGraniteHealthcareNetworkNewEnglandLifeCareFoundationforHealthyCommunitiesNewHampshireImagingServicesInc.YankeeAlliancePremierItistheestablishedpolicyofConcordHospitaltoprovideservicesonthesolebasisofthemedicalnecessityofsuchservicesasdeterminedbythemedicalstawithoutreferencetoracecolorethnicitynationalorientationsexualorientationmaritalstatusreligionagegenderdisabilityorinabilitytopayforsuchservices. Becausewecareeveryday.232013CONCORDHOSPITALANNUALREPORTTOOURCOMMUNITYConcordHospitalMedicalGroup250PleasantStreetConcordNewHampshire03301RECIGNIZEDASNationalCommitteeforQualityAssurancePatient-CenteredMedicalHomesAllCHMGprimarycareprovidersConcordImagingCenter248PleasantStreetConcordNewHampshire03301603225-0425CHMedicalOcesatHorseshoePondOneCorporateCenter60CommercialStreetSuite101ConcordNH03301603415-9444CHMedicalOcesEast1990DoverRoadEpsomNH03234603736-6235ACCREDITEDBYAmericanCollegeofRadiologyMammographyUltrasoundCTMRIAPPROVEDBYDepartmentofHealthandHumanServicesSocialSecurityAdministrationMedicareCERTIFIEDBYFoodandDrugAdministrationCertiedMammographyFacility 250PleasantStreetConcordNewHampshire03301NonProtOrg.U.S.PostagePAIDPermitNo.256ManchesterNH2013AnnualReporttoOurCommunityconcordhospital.orgQualityTransformationEngagementTrustFacebookisaregisteredtrademarkofFacebookInc.