what it means to be healthy: our impact on our community
TRANSCRIPT
What It Means To Be Healthy: Our Impact on our Community
2 0 1 8 M I D Y E A R C O M M U N I T Y R E P O R T+ 2 0 1 7 A N N U A L R E P O R T
Published July 2018
NANCY J JOHNSON, RN, PhD
Chief Executive OfficerEl Rio Health
ADMINISTRATION
450 W Paseo RedondoTucson, AZ 85701
www.elrio.org
Cover Photo: Jade Beall
WHAT IT MEANS TO BE HEALTHY: OUR IMPACT ON OUR COMMUNITYThe past year has been full of growth and innovation for El Rio Health as we watch the passionate discussion about healthcare quality and cost across our nation. Through it all, El Rio continues to focus on providing what great healthcare looks like for our community-access to comprehensive, quality, compassionate, convenient and affordable primary healthcare.
Over the past year, we continue to reaffirm that our organizational values and beliefs are “on spot” as we ponder what it means to be healthy? We recognize that “being healthy” includes access to great healthcare and having the continuity of a “preventive health home” such as El Rio. However, this is just one part of “what it means to be healthy.” Individuals need affordable housing, good employment, transportation, safe neighborhoods, access to needed education, and strong support systems for emotional well-being and healthy habits as part of that equation for being healthy. El Rio’s growing locations, new services, commitment to prevention, and partnerships support easy connections for our patients to improve their health.
As you read through this report, you’ll see not only our commitment to keeping our over 39,000 El Rio children healthy through screenings and research, but also the stellar quality our healthcare providers have documented around healthy pregnancies and births, as well as decreased emergency room visits and hospital readmissions. We also have included an inside transparent look at our quality improvement processes and how we work to continue our journey to excellence. Lastly, and most powerful, we are honored to share some stories from our patients on the impact that El Rio Health has made on their health and quality of life.
Daily I am inspired by our El Rio team with their commitment to excellence around quality, cost and creating world class experiences for our over 103,000 patients. We also take great pride that more than 65% of our 1,300 employees and their families receive their healthcare at El Rio. Our beliefs shared within this report, guide our actions and decision making. We appreciate the trust and support our community has given us and are delighted to share this report. Thank you.
Nancy J Johnson, RN, PhD Chief Executive Officer
OUR VISIONTo be a national model of excellent healthcare.
OUR MISSIONImproving the health of our community through comprehensive, accessible, affordable, quality, and compassionate care.
OUR CULTURAL BELIEFS Honor Patients “I always put the patient first.”
Create Tomorrow “I embrace effective change and seek innovative solutions.”
Step Up “I am accountable for making El Rio a world-class health center.”
Break Boundaries “I work with others to achieve success.”
I Matter “I make a difference by voicing my opinion and knowing I am heard.”
Value Health “I take time for my own health to promote yours.”
Photo: Dominic Ortega
Paul Loucks, President, El Rio Foundation
Board of Directors
Enrique Serna, President, El Rio Health Board of Directors
OUR STRATEGIC PRIORITIES 2018-2019
GROWTHIn 2017, over 8,000 new community members chose El Rio Health as their health home-accessing medical, dental, behavioral health and many other primary care services at our various locations. We plan to continue to grow our locations, adding services available such as e-visits, medication assisted therapies, occupational health services, and physical therapy in the coming year. We’ll have our new Cherrybell Health Center open by the end of 2018 and the expansion of the Southeast Health Center in 2019. Both will require additional physicians and healthcare providers. We are committed at El Rio to honor our over 103,000 patients and grow 10% by the end of 2019.
HEALTHCARE WORKFORCEOur people are our most valued resource around improving the health of our community! We continue to provide continuing education funds and workforce development programs for our over 1,300 employees as well as annual Leadership Development Fellowship opportunities. We are a Teaching Health Center with medical students, family medicine residents, pharmacist residents, nursing students, public health interns and many other graduate and undergraduate students across our many health center locations. Over the next year, we will continue to strive to be a healthcare employer of choice across our community.
SUSTAINABILITYThe healthcare system continues to evolve and change quickly in terms of locations of care, types of care and how healthcare is funded. El Rio Health has developed analytic models to identify our true cost of delivering healthcare and making sure it is as efficient as possible to save money for our patients and families, employers and the community. El Rio continues to start the conversations around affordable, quality care with our community partners, patients, insurance companies, and others involved in assuring our community has a robust and sustainable healthcare system. You will continue to see El Rio advocating for affordable, quality healthcare for all of our community.
COMMUNITY PARTNERSHIPSCommunity partnerships have always been a crucial piece of El Rio’s mission. Our robust network of community partners helps provide the optimal care coordination for our patients as well as our ability to create change in healthcare and health policy. Our ongoing partnerships with city and county government, local hospitals, business development organizations, and our academic institutions will yield collaborations in the coming year. In addition, El Rio Health will focus on strengthening and measuring community partnerships with organizations addressing disparities and social determinants of health-such as food, transportation, employment and other critical resources that impact health.
EL RIO BIRTH AND WOMEN’S HEALTH CENTER EARNS “TRIPLE AIM” BEST PRACTICE DESIGNATION This designation recognizes practices which meet the Institute for Healthcare Improvement “Triple Aim” of improving the patient experience, decreasing the cost of care, and improving the health of populations. This is measured by high breastfeeding rates (>81%), low preterm births (<11.4%) and low cesarean rates (<23.9%), and reporting fiscal variables. Of the 257 practices participating in the 2017 American College of Nurse Midwifery Benchmarking Project, 29 were accredited Birth Centers and the El Rio Birth and Women’s Health Center is one of those! Over 168 babies were born at the Birth Center in 2017.
In 2017 we had 168 birth center births, 79 of which were water births
Overall cesarean rate for both BWHC & TMC (including clients with prior cesarean birth) = 11%
Our Primary cesarean rate for NTSV (Nulliparous, term, singleton, vertex) = 17%
For clients eligible for and planning birth center births, our primary cesarean rate is 8%
For clients eligible for birth center and admitted in active labor our cesarean rate is 4%
Successful VBAC rate = 75% of clients who labored.
Preterm birth rate 1.6%
>99% of clients are planning to breastfeed
>95% are breastfeeding within 1hr of birth
>90% are exclusively breastfeeding at 24 hr and 6 wks postpartum
>92% of newborns had no complications
HEALTHON BROADWAY AT THE WORKSITE: PROMOTING PREVENTION AND HEALTH IMPROVEMENTHealthOn Broadway was invited in the past year to provide worksite flu immunizations for both Pima County and the City of Tucson. Flu shot clinics and health and wellness information was provided at over 30 worksite locations with 1,634 employees receiving immunizations against the flu.
This coming Fall of 2018, in addition to returning to the City of Tucson and Pima County, the HealthOn Broadway team will be providing worksite flu shots for Pima Community College employees as well as Tucson Electric Power employees.
HealthOn Broadway has now been open about 15 months and has met their milestones for the first year of operation-watch for a second location, HealthOn University, opening mid-2019 as part of the Trinity Development.
HealthOn Broadway, a member of the El Rio Family of Great Healthcare is powered by Tucson Medical Center and El Rio Health and located at 1 W. Broadway.
WHAT IT MEANS TO BE HEALTHYIMPROVING CHILDREN’S HEALTH THROUGH PREVENTION
Virginia G. Piper Charitable Trust funded a community-based research study with El Rio Health Pediatric Director, Dr. Andrew Arthur partnering with the University of Arizona Visual Development Laboratory and Dr. Kimberly Gerhart. The two investigators studied the relationship between visual abilities and growth and development in toddlers. Toddlers who failed their vision screening at well child visits were invited to participate in the study. Over 350 children and their families participated, resulting in valuable learnings from this two year study that will continue to develop visual technology for use by populations of young children.
DECREASING EMERGENCY ROOM VISITS AND PREVENTING READMISSIONS TO HOSPITALS
For over four years, El Rio Health’s team of registered nurses have received state and national recognition for their top tier rankings on some of the lowest rates of emergency room visits and hospitalizations in the state and the nation through their 24/7 RN Triage telephone line, telephone follow ups, care coordination programs and discharge care clinics. The El Rio Health family of health centers also includes St. Elizabeth’s Health Center, who this year, was also able to demonstrate a 25.1% reduction in emergency room visits resulting in 880 avoided visits and an estimated cost savings of $323,090 for the healthcare system, reported by their medical director, Dr Mark Schildt.
Andrew Arthur, MD, PhD is a board-certified pediatrician earning his medical degree from Johns Hopkins University Medical School, and his doctorate in epidemiology from the
Johns Hopkins University School of Hygiene and Public Health. He completed his pediatric residency at the University of Arizona. He has been involved in award-winning quality improvement projects in childhood immunization, care for children with asthma, child development, and vision screening.
BADGES AND BACKPACKS
A new partnership has formed between El Rio Health and the Pima County Sheriff’s Team with the “Badges and Backpacks” back to school event held at the Tucson Convention Center July 28, 2018. El Rio Health’s dental team as well as our dental residents were able to screen and apply fluoride varnish for 278 children. Fifty - four percent of these children were between the ages of 6 -11 years old and 59% did not have a regular dentist. There were 100 of these children who required dental care which means that either decay and/or periodontal issues were suspected in 1 or more teeth. El Rio’s dental team is helping these children establish dental health homes to prevent dental problems in the future.
Mark Schildt, MD completed medical school at Temple University and his residency at Williamsport Family Medicine Residency Program. He continues to be committed to
quality, compassionate health care for the entire community in his leadership role.
EL RIO FOUNDATION IS A QUALIFIED ARIZONA CHARITABLE TAX CREDIT ORGANIZATION Donations of any amount are valued and appreciated. El Rio Foundation is a Qualifying Charitable Organization under Arizona Personal Income Tax Code. Donations to El Rio Foundation are eligible for the Charitable Tax Credit for Arizona taxpayers. Single and head of household taxpayers can donate up to $400 (couples filing jointly up to $800) and your Arizona tax bill can be deduced dollar for dollar given! Consult your tax advisor for more information.
You can give online today— click DONATE at elrio.org or call 520-205-4947.
You can join our Legacy Club! Planned and estate gifts help El Rio Foundation to provide quality health care to those in need well into the future. Estate gifts can also offer tax and income advantages.
Please contact us at 520-205-4947 to discuss gifts related to stock transfers, life insurance policy, bequests or IRA donations. Call 520-205-4947 or [email protected] for more information.
EL RIO FOUNDATION IS A QUALIFIED ARIZONA CHARITABLE TAX CREDIT ORGANIZATION Donations of any amount are valued and appreciated. El Rio Foundation is a Qualifying Charitable Organization under Arizona Personal Income Tax Code. Donations to El Rio Foundation are eligible for the Charitable Tax Credit for Arizona taxpayers. Single and head of household taxpayers can donate up to $400 (couples filing jointly up to $800) and your Arizona tax bill can be deduced dollar for dollar given! Consult your tax advisor for more information.
You can give online today— click DONATE at elrio.org or call 520-205-4947.
Please contact us at 520-205-4947 to discuss gifts related to stock transfers, life insurance policy, bequests or IRA donations. Call 520-205-4947 or [email protected] for more information.
Photo: Braden Stuchen
Miguel Rojas
CREATE TOMORROWMiguel Rojas, one of the original incorporators for “El Rio Santa Cruz Neighborhood Health Center” tells his story...
As we approach the 50th year of El Rio serving the community, I reflect back on the three groups that came together in the early 70’s and my role with all of them! At the time, the Tucson community was undergoing a lot of growth-not unlike today-and community members were anxious about their neighborhoods, their health care and where this growth would take them. Amidst this, the University of Arizona College of Medicine, 12 different neighborhood associations representing the south and west side of the community, and Pima County came together and identified access to medical and healthcare as a priority need for these 12 neighborhoods -who only had one obstetrician, one family medicine physician and one dentist across their neighborhoods.
Next, Dr. Herb Abrams from the College of Medicine, helped secure some initial funding that allowed El Rio to begin seeing patients, with the help of physicians and medical students. They utilized space at the old Mother Higgins juvenile detention center which Pima County leased to them for $1/year. Those small rooms were great first exam rooms to see patients!
At the same time, President Lyndon Johnson had helped with the passage of Public Health 330 which provided a window for funding for neighborhood health centers in the early 70’s. Dr. Abrams helped bring these three groups together to apply for the grant -which was successful and provided the initial funding for El Rio to be incorporated and build the very first location at 839 W. Congress St. We started with 35 employees and today have over 1,300 employees providing health care for over 103,000 individuals within the community!
Not only am I proud to be an original incorporator and 45 year plus supporter of El Rio Health and their impact on our community, but I’m also proud that myself, as well as my family and many relatives, are El Rio patients - receiving medical, dental and other health care at various locations across the community. I continue to serve on the Board of Directors of El Rio Health and look forward to our continued innovation and growth!
HONOR PATIENTSMy name is David Lopez Jr. and I was diagnosed with Diabetes in 2002. I was surprised, because I always thought I had an adequate and healthy diet. That year was my first experience with a glucose machine and lancet strips to measure my blood. My glucose level was more than 550 and my A1C was 12.6. That year my “new life” began with Diabetes, but even so, the first scare was not enough because I trusted and neglected myself. I was able to control my diabetes early on with food, exercise, and losing weight, but the result of not continuing with the medication had its consequence a few years later.
When this disease “exploded” my weight climbed to 290 pounds and suddenly within a span of six months my weight dropped to 175 pounds, far less than my ideal weight of between 220 to 230 pounds. At that point, I suddenly began to develop symptoms; lack of energy, urinating continuously, extreme tiredness, depression, lack of interest in living, and a taste for everything sweet. I would eat and I kept losing weight.
It was in 2007 that I first went to El Rio and met Dr. Jackson who is still my provider to this day. When she checked me the first time, my glucose was around 480. At first, I did not understand my situation very well and I did not know the disease. El Rio provided me with classes and additional visits to monitor my progress.
I want to say thank you to my clinical pharmacist Soledad Granillo for her interest and professionalism. She suggested I take exercise classes with Gloria Montijo, which is the best decision I have ever made. Gloria is an excellent instructor, motivator, and good person who knows how to listen. As a patient of El Rio, I have taken advantage of other programs, from which I have learned a lot. Even now, I have a program that I think is the best and very complete.
Photo: Braden Stuchen
David Lopez Jr. and daughter Monserrat
I MATTERMy name is Nancy Schulte and I’ve been at El Rio Health since July of 2013. El Rio hired me for the Health and Wellness Program. When I started, I began suffering with stiffness on my left side, mainly in my typing hand and a twitch in my left foot.
In January of 2014, I had a DatScan performed on my brain. Unfortunately, this test was very expensive and left me with a balance owed to the hospital. I was informed by another employee about the money in the Employee Assistance Fund through the El Rio Foundation. I completed an application and was granted assistance from the Foundation to help pay off my hospital balance.
My diagnosis was Parkinson’s disease. It has been a long road but El Rio has supported me throughout my journey over the past four years. I have tried many different forms of therapy, medications, and acupuncture, and lastly a deep brain stimulation, all with help from the Employee Assistance Fund. El Rio has been supportive of my time off recuperating from the surgery, and I can’t imagine working anywhere else. I am so happy to be able to give back to the Employee Assistance Fund. In fact, my husband recently started to work for El Rio and he is giving to the fund, as well. I feel so valued and it is comforting to know that my employer supports and values me, as an employee.
Photo: Braden Stuchen
Nancy Schulte
VALUE HEALTHMy name is Helena Mendoza and I’ve been a patient at El Rio Health since I was a baby. My mother would take our family to El Rio starting with our baby well checks. My mother was a patient and also suffered from diabetes. Since El Rio was so close to our Barrio Hollywood neighborhood, we would hop on the bus for a one -way trip to the clinic, and another one-way trip back to our house. If we were unable to pay the $0.20, we would just simply walk to the clinic. My mother utilized El Rio for all of our family medical needs. This continued well into my adulthood, and when I needed prenatal care, I chose El Rio. Just like my mother, I too began my children’s baby well checks and immunizations there that continued up to their adulthood. When my family began expanding with grandchildren, my children also chose El Rio for their prenatal, baby well checks and immunizations.
When my daughter and I were experiencing emotional hardship and stressful times, El Rio was able to provide services that helped the both of us. My daughter received massages that left her feeling less stressed. I learned that I suffered from panic attacks when under a lot of anxiety. The providers are amazing, because they didn’t just treat my symptoms, they really took the time to educate me on anxiety. They also provided me with useful, informational media like CDs and an App that I was able to download to my Smartphone for dealing with my anxiety. My provider thoroughly explains my medications in detail as well as alternatives like diets, herbs, teas, and vitamins that aid me with my condition. She treats me like a human being and listens to any issues that I am willing to voice to her.
El Rio has a variety of health programs that they can offer to anyone like: BARRE, Senior Fitness, Zumba, Tai Chi, Yoga, and Acupuncture. This is why I have chosen El Rio because of their great quality of service that they have provided to my family, from generation to generation. In the future, I know that my great grandchildren will also be El Rio patients.
Photo: Braden Stuchen
Helena Mendoza
BREAK BOUNDARIESMy name is Robert Thompson and I’ve been an employee and patient at El Rio Health for over 40 years. In 1977, Jose Maltos, El Rio’s first CEO and CFO Marty Kaplan along with Hugh Young, IT manager, invested 5% of our annual budget to purchase one of the earliest mini-mainframe computer systems in the state of Arizona. I was hired in 1977 to be the programmer/operator. This took us out of punch card billings and into computerized billing and reporting.
In the mid 90’s, Robert Gomez led us into the future with software development and Windows networks for AZ Health centers. From there, we moved to data centers and then came Electronic Medical Records that changed healthcare technology forever.
Soon after starting at El Rio Health, I became a first time father. Then, in 1982 my daughter arrived, and another son in 1983, both delivered by El Rio midwife Sue Ann Breens.
Our first two grandchildren were born in 2012. One of them is Taylor, a patient of El Rio Health’s Pediatrician Dr. Andrew Arthur. I am proud to share she is also a third generation El Rio Health patient. The years go by so quickly. My family and I have used El Rio Health’s medical, dental, and healthcare since I started in 1977. The quality, convenience, and full service healthcare is, and continues to be, exceptional.
All of our children were seen by El Rio Health pediatricians. Now, they all have families and have given us six beautiful grandchildren.
Photo: Braden Stuchen
Robert Thompson
How do we do this? One aspect is inviting various quality accreditation organizations to examine our systems, our clinical practices and patient outcomes. In 2010, El Rio Health became the first outpatient organization in Southern Arizona to be nationally accredited by The Joint Commission, an independent credentialing body that looks at all aspects of patient care and delivery of care for patient safety and evidenced based standards of care. Also, in 2010, El Rio was recognized by the National Council on Quality Assurance (NCQA) as exemplifying the highest level (level 3 recognition) of Patient Centered Medical Home standards of outpatient practices based on national benchmarks and measures. We continue to achieve these high standards through monthly “safety tracers” in all of our health center locations- reviewing our processes, studying patient outcomes, and visiting with patients about their experiences.
DOUGLAS J SPEGMAN MD, MSPH, FACPChief Clinical Officer
FLU SHOTS: Healthy People 2020's National Goal is that 80% of the population receives a flu shot annually. As you can see, the adult population at El Rio experienced a drop last year in this measure. Quality improvement efforts at all our locations
now offer “walk-in” flu shots for our patients, extended hours for greater convenience, and additional education campaigns to stress the importance. We’ll see how these strategies impact the 2018-2019 immunization rates.
53.1% 53.4%56.1%
48.1%
80.0% 80.0% 80.0% 80.0%
0.0%
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20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
2015 2016 2017 2Q18
FLU SHOTS (18-64) 2015-2Q18
El Rio Performance
Healthy People 2020 Goal
QUALITY REPORT This is what “Create Tomorrow” looks like to me... Transparent sharing of quality outcomes with our Community!Ten years ago, El Rio began a journey of continuous quality improvement. Today, we have a robust quality department that daily asks the question: “What else can we do to improve quality of care for our patients and improve their health?”
Another essential aspect of great health care is having healthcare professionals collaborate with analysts on studying patient health outcomes and efficiently identifying methods and strategies to continuously improve. El Rio Health has long been involved in transparently and openly sharing our outcome data on preventive care and chronic disease management on 22 different quality
62.2% 62.3%
63.6%
66%
61.20% 61.20%
58.0%
59.0%
60.0%
61.0%
62.0%
63.0%
64.0%
65.0%
66.0%
67.0%
2015 2016 2017 2Q18
HYPERTENSION CONTROL (18-85) 2015-2Q18
El Rio Performance
Healthy People 2020 Goal
HYPERTENSION (HIGH BLOOD PRESSURE) CONTROL: Healthy People 2020's National Goal is that 61.20% of the population maintain a blood pressure less than 140/90. You can see that El Rio has surpassed the national goal for our patients having their blood pressure under control-but much more work is needed with the new lower recommendations for blood pressure in the past year. We know that just a 2mm drop in blood pressure can greatly reduce the chance of stroke. Our clinical pharmacists, providers, and RN Care Coordinators generate reports that identify patients who have not been seen for blood pressure control, or have not continued to fill blood pressure medication and we reach out to them to help.
measures through the Federal Uniform Data System database -known as the UDS system. El Rio's scorecard of all those measures is available for all consumers, payers, employers, and others to review. We believe in transparency in all healthcare measures and are proud to have shared our data for over 40 years -illustrating our progress in quality improvement and patient safety.
What methods and tools do we use to continually improve?
WELL CHILD VISITS: Our Southwest Pediatric team has surpassed the HEDIS quality indicators for well-child visits by a significant percentage -88% versus the goal of 72%. This is an excellent example of achieving quality healthcare with a team of pediatricians, nurses, behavioral health consultants and medical assistants. They have identified children missing well visits and/or immunizations and are actively reaching out to overcome any barriers to close gaps in care. Primary prevention at its finest! This SW team was recently recognized at the annual Community Health Center conference with an award
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10%
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40%
50%
60%
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80%
90%
100%
2015 2016 2017 2Q18
EL RIO SOUTHWEST WELL-CHILD (3-6) 2015-2Q18
75%
87%85.0%
88%
72% 72% 72%
El Rio Southwest Clinic Performance
HEDIS
72%
2015 2016 2017 2Q18
Who uses these Scorecards? Our various clinical specialties such as pediatrics, family medicine, internal medicine, and behavioral health, but also by differing El Rio locations and individual providers to continually improve the quality and consistency of care provided. All healthcare providers have daily access to their patients’ quality data through a data analytics tool called Relevant. This supports all the team members to see the needed updates, preventive care and other needs of patients in real time.
Monthly “Deep Dives” into our Quality Measures?
Every month, El Rio takes a “deep dive” into three different quality measures through the use of statistical process control charts which allow us to see if the changes in data are significant or just normal variation. This allows our interdisciplinary teams of healthcare professionals to see if our quality improvement strategies are working to improve health for our patients. We compare our performance to the most robust national benchmarks we can identify -many times that is the national goals of Healthy People 2020. We share with you four of our quality indicators that are challenging for healthcare organizations but essential to healthy lives as well as prevention and early diagnosis of chronic diseases.
QUALITY REPORT CONTINUED
COLORECTAL CANCER SCREENING: Healthy People 2020’s National Goal is 70.5% of the population screened for a highly
curable disease-colorectal cancer. This is unfortunately a test many adults decline to complete. El Rio has made significant improvement in screening our ~40,000 patients over age 50, jumping from a baseline of 40% to a current 59% successfully screened. Our improvements have been due to teamwork around reaching out to those needing the screening test, educating them on its importance, sharing different options on how
you can choose to be screened, and providing options that people can more easily accept, right at the point of receiving care in our clinics.
What it means to be Healthy We believe being healthy requires primary healthcare providers who are committed to creating great healthcare systems that transparently share their quality data and work to develop convenient and effective models of healthcare delivery. We share this first transparent view into our quality work because this is what great healthcare looks like -continually improving on the road to excellence and assuring our patients have the resources, clinical care and providers to optimize health. We look forward to sharing additional quality data with our community and welcome your questions and visits to our healthcenters.
COLORECTAL CANCER SCREENING (50-75) 2015-2Q18
40.00%
52.10%
60.30%59%
70.50% 70.50% 70.50% 70.50%
38.30%
39.90% 40.00% 40.00%
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20.00%
30.00%
40.00%
50.00%
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2015 2016 2017 2Q18
El Rio Performance
Healthy People 2020 Goal
UDS National Mean FQHCs
2,282TOTAL JOBS
24%LOWER COSTS FOR HEALTHCENTER MEDICAID PATIENTS
$120 MillionSAVINGS TOMEDICAID
1,157HEALTH CENTER JOBS
1,125OTHER JOBS IN THE COMMUNITY
$134,442,960DIRECT HEALTH CENTER SPENDING
$158,870,849COMMUNITY SPENDING
$10,373,305STATE AND LOCAL TAX
$29,379,422FEDERAL TAX REVENUES
$293,313,809TOTAL ECONOMIC IMPACTof current operations.
$39,752,727ANNUAL TAX REVENUES
JOBS and other positive impacts on theECONOMY
SAVINGSto the health system
BIG PICTURE OF EL RIO HEALTH’S IMPACTFederally Qualified Health Centers, such as El Rio Health, provide tremendous value and impact to their communities-from JOBS and ECONOMIC STIMULUS to local communities; SAVINGS to the health care system; ACCESS to care for all populations. Highlights of 2017 contributions are shown below.
2,282TOTAL JOBS
24%LOWER COSTS FOR HEALTHCENTER MEDICAID PATIENTS
$120 MillionSAVINGS TOMEDICAID
1,157HEALTH CENTER JOBS
1,125OTHER JOBS IN THE COMMUNITY
$134,442,960DIRECT HEALTH CENTER SPENDING
$158,870,849COMMUNITY SPENDING
$10,373,305STATE AND LOCAL TAX
$29,379,422FEDERAL TAX REVENUES
$293,313,809TOTAL ECONOMIC IMPACTof current operations.
$39,752,727ANNUAL TAX REVENUES
JOBS and other positive impacts on theECONOMY
SAVINGSto the health system
101,536People Served
Medicare11%
Uninsured13%
Private Insurance20%
Medicaid (AHCCCS)57%
Patients by Insurance
Status(2017)
34,438Children 0-17 (33%)
56,532 Adults 18-64 (55%)
10,566 Seniors 65+ (10%)
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and healthontucson.org
28Educational Partnerships
2017 EL RIO HEALTH INFORMATION
AdultMedicine
BehavioralHealth
Dental
Exercise &Wellness
FamilyMedicine
Tele-Health
Midwifery OB/GYN Pediatrics
Pharmacy Physical Therapy Radiology &Lab
SpecializedCare
TransgenderMedicine
Transportation
365,000+ Annual Patient Visits
14 Locations in Tucson
$10-$12m Annual Charity Care
20+ Languages Spoken
REVENUE TREND 1990 .......$9,978,264 2000 .......$24,371,165 2010 .......$79,856,149 2016 .......$130,373,911 2017 .......$140,165,030 2018 .......$148,000,000 (estimated)
NUMBER OF EMPLOYEES 1990 .......275 2000 .......400 2010 .......800 2016 .......1,047 2017 .......1,295 2018 .......1,324 (July 2018)
2017 FINANCIALSEl Rio Health Revenue Patient Revenue ...........................$120,104,068 ...... 85.7% (Includes Medicaid, Medicare, Private Insurance, and Self-Pay Patients) Federal Grants ............................$10,495,929 ......... 7.5% Other Grants ..............................$5,631,747 ........... 4.0% *El Rio Health Center Foundation ...$1,110,170 ........... 0.8% In-Kind Contributions ....................$2,823,116 ........... 2.0% Total Revenue and Public Support ..$140,165,030 ..... 100.0%
Expenses Direct Patient Services ..................$119,479,738 ... 88.87% General and Admin .....................$8,197,404 ......... 6.10% Depreciation ...............................$3,762,852 ........ 2.80% Interest .......................................$179,850 ............ 0.13% In-Kind Expense ...........................$2,823,116 ......... 2.10% Total Expenses ..............................$134,442,960 ..... 100.0%
Total Increase in Net Assets Excess of Revenue and Public Support Over Expenses .....$7,077,304 Change in Fair Value of Interest Rate Swap ...................$74,859 Capital Grants .........................................................$525,000 El Rio Health Center Foundation-Restricted Funds ............$350,713 Total Increase in Net Assets ........................................$8,027,876 Total Uncompensated Charity Care ..............................$10,630,289 Total Ending Net Assets ................................................$75,966,419
Note: (4) El Rio Health Center Foundation Revenue is the net of unrestricted revenue w/o In-kind donation
El Rio Health Center Foundation: Foundation Program Services .........82.6% Fundraising.................................10.6% Administrative .............................6.8%
Revenues & Support Grants and contributions ..............$964,093 ............ 44.4% Special events revenue ................$496,790 ............ 22.9% Net investment income .................$650,843 ............ 30.0% In-kind contributions ......................$60,877 ................ 2.8% Total Revenue ...............................$2,172,603 ........ 100.0%
Expenses Program services .........................$1,012,009 ....... 68.34% Management and general ............$247,500 .......... 16.71% Special events and fundraising ......$ 160,565 ......... 10.84% In-kind expenses ..........................$60,877 .............. 4.11% Total Expenses ..............................$1,480,951 ......... 100.0%
Net Assets Increase in net assets ...................$691,652 Net assets, beginning of year .......$6,562,235 Total Ending Net Assets .................$7,253,887
EL RIO BOARD MEMBERSEL RIO HEALTH BOARD Enrique Serna, PresidentRobert Ramirez, Vice PresidentRocio Galvez-Martinez, Second Vice President Frank Valenzuela, TreasurerRobert Rauh, Vice Treasurer Brian Flagg, Secretary Kathryn S. Beatty, Member Alec Berens, Member Francisco Muñoz, Member Gail Olson, Member Melvin “Pete” Reisinger, Member Miguel Rojas, Member Andrea Romero, PhD, Member Kirk Saunders, Member Barbara Soehnlen, Member Mary Spoerl, Member Hal Strich, Member Mary Wright, Member
EL RIO HEALTH CENTER FOUNDATION BOARD Paul Loucks, President Cynthia Jones, Vice PresidentKate Breck Calhoun, Vice PresidentTracy Sole de Hoop, SecretaryMark C. Mansfield, TreasurerRicky AbudRaul AguirreRob AssenmacherMatthew GaspariRick GregsonJoanie HammondStephanie HealyChristine HelinLinda Immerman-StoffersLars LarsonAlex LevinDominic OrtegaAnthony SchaeferPatricia A. WallaceMike Webb
EL RIO SENIOR MANAGEMENT TEAM Nancy J Johnson, RN, PhD Chief Executive OfficerLisa Cummings Chief Operating OfficerDouglas J Spegman, MD Chief Clinical OfficerCarlos Rico Chief Financial OfficerRobert Thompson Chief Information Officer
George Toy Chief Human Resources Officer Josh Carzoli, PharmD Director of OperationsTara Radke, MPH Director of Grant Development and ManagementBrenda Goldsmith Foundation Executive DirectorMark Hodges, RN, MSN Director, Quality and Risk ManagementRichard Spaulding Strategic Planner and Facilities Director
Photo: Tom Spitz
EL RIO VECINOS Sarah Davis, PresidentJosh Plicht, Vice PresidentShaima Namazifard, SecretaryRyan Maese, TreasurerAngela Mattix, Past PresidentBobby Bakos, Event ChairAlexis Chavez, Event Co-Chair
DONORS - 2017 - $400+Michael & Sally AboudRicky AbudFrederick & Mari AdlerAetnaAGM Container ControlsJoel & Lidia Hernandez AllenAllergy Asthma Associates, PCSamia Al-Scheikh & Tarek Al NassifAmerican Cancer Society, IncAmos Realty ServicesGregory Anderson & Carl EynatianLinda Anderson & Peter WarrenAnonymousArizona Alliance of Community
Health CentersArizona Diamondbacks FoundationRoxanne & J. Manuel Arreguin, MDTami Arthur, LMTKathleen & Andrew Arthur, MDCindy Ashton & G. Starr RoundsAshton Family FoundationAsthma & Airways Disease
Research CenterAvellaBobby BakosKara BallietBank of America Charitable Gift FundBank of America FoundationBank of America Matching GiftsBank of the WestBank of the West Employee Giving ProgramBank of TucsonBanner University Health PlansAnne BarrettJuan Bautista, MDPamela & James BaygentsBBVA CompassKathryn & Cecil BeattyLinda & David BeauchesneThe Benevity Community Impact FundDavid BergThe Bert W Martin FoundationBFL Construction Company Inc.Terri A BirkholzVirginia BlackmanJennifer BlairBMO Wealth Management
Tricia BohnetJames BoothGail and John Boulet, MDDavid Tiers & Sue Ann Breems, CNMBettina BrentanoDrs. Daryll & Melissa BrosandersRichard BrownRobert Stephen BrowningKeith Brust & Amy Beiter, MDHolly BryantFrank & Patrice BuschBWS ArchitectsKatherine ByrneCAID IndustriesKevin CambergTerrence Carden, MDCare1st Health Plan of Arizona, Inc.CareMore Health Plan of ArizonaScott CarlsonDrs. J. Kevin Carmichael & Tejal ParikhCarondelet Health NetworkGordon & Tara CarrJosh & Lisa CarzoliCasino Del SolCBIZ Benefits & InsuranceCDG Architects Ltd.Cenpatico Integrated Care /
Arizona Complete HealthSheong & Yew Onn ChanAmy ChavezCirrus VisualCITIThe Click Family FoundationWilliam and Elizabeth Russo ClydeBranson CobbCODAC Health, Recovery, & Wellness IncMichael & Jean CodyGail & Alan Cohn, MDColon Cancer Coalition /
Get Your Rear in GearCommunity Foundation for Southern ArizonaCommunity Partnership of Southern ArizonaJames W ConcidineConnie Hillman Family FoundationConsulado de México en TucsonConsultants in GastroenterologyContact One Call Center, Inc.
The Betty Lynn Cooper FundSusan L CordtsCatherine Cosentino, MDDiana CotaCox CommunicationsCrest Insurance GroupKaren & Jim CritchleyClay & Lisa Cummings, OTR/L.MBAStephen & Tracy CurtinChristine CurtisRina & Amram Dahukey, DPMMichael A DattolaNorma DavenportThomas & Julie DavisDelta Dental of ArizonaDependable Health Services, Inc.Desert Diamond Casinos & EntertainmentDesert View Lath & Plaster, Inc.Patrick DesmondDave DexterThe Diary CorpDenise DinkelDonal DrayneThe Estate of Clifford Noel D’SouzaDSW Commercial Real Estate LLCAmelia DukeEaglet Fund held at Community Foundation
for Southern AZEastside Dental ServiceDon & Joanne EdwardsStephen & Susan EggenDavid & Marjorie EisenhauerEl Rio OB/GYN AssociatesHanea El-hizawiHortensia Enriquez & Robert OchoaEphibianRichard & Merrill EvansShannon L. Fennie, FNP-CFester & Chapman, PCRicky FinchSusan FinchFinley DistributingFinley Family FoundationBianka & Ryan FlannaganAnthony R. Fonze & Rebecca J. HarrisRebecca Freeman, CNM & William BemisRichard & Maria Gallegos, FNP
Rocio Galvez-MartinezRussell & Mary GarrettMatthew & Tracy GaspariGBP Risk SolutionsCatherine Gehrig de ChavezGreta Gill, CNMLawrence & Julie GlassMichael & Candi GoelzMichal W. GoforthBarbara Segal & Gerald Goldberg, MDBrenda GoldsmithAndrea GomezRobert & Diana GomezKaren GoodkinGoodwill Golf TournamentJesse GranadosSoledad A GranilloDean & Mel GreenbergRick & Lynn GregsonHeather GrieshabetKathy & Steve Griffin, SBCSRichard GroganDanya GuillenJaime & Linda GutierrezDiane HaegerJoanie & Marc HammondJeff & Yvonne HamstraWade & Dolora HamstraHamstra Heating & Cooling, IncGary Myers & Karen L. Hardy-Myers, RDH Lupita HaroHarris Environmental Group, Inc.Robert Hay, MDHealth Choice ArizonaHealthSouth Rehabilitation InstituteChristine HelinTrent & Janine HendersonPaula HendricksHenry ScheinJessica Hensel, MDSusan Hetherington, CNMRichard HillDrs. CJ Hindman & Judy BecknerWendy HintzGabriel HintzscheSandra & Mark Hodges, RN, BSNHope Matters Breast Cancer Foundation
Jim & Mary HorvathHughes Federal Credit UnionHumanaIbarra Rosano Design ArchitectsIBM Employee ServicesLinda Immerman-Stoffers & Bill StoffersINDEVCO Architecture LLCIntuitIridius Capital Investment Advisors LLCHenry M & Ruth M JacobsonJani-King # 56, Karen Blanck, OwnerJani-King SouthwestMarketa & Milan Jansky, MDSteven & Teresa JarrettJasam Foundation of ArizonaJewish Community Foundation
of Southern ArizonaJoshua Jih, DMDJim Click Automotive TeamNancy J Johnson &
Lane Johnson, MD, MPHJames & Cynthia JonesWilliam & Anita JonesFrank Kalil & Lea RallisPatricia KambourianCharles KaplanSidmon & Barbara KaplanMary KeerinsStanley & Karen KissingerKnisely Family FoundationChris & Lynda KopachAaron KoralHenry & Janis KreisDrs. Michael Kushner & Carolyn QuigleyArabella O & Greg LaChance, DDSElham & Nabeeh Lahood, MDNancy Laney & Timothy DennehyRay & Leyla LaraLars & Ann LarsonMichael D LaveryThe Chris Lawler Team at
NOVA Home LoansDongwook Lee, DDSSteven LeutholdSteven Leuthold Family FoundationAlan & Janice LevinAlex & Kimberlee Levin
You can join our Legacy Club! Planned and estate gifts help El Rio Foundationto provide quality health care to those in need well into the future.
Estate gifts can also offer tax and income advantages.
DONORS - 2017 - $400+Laura LevinMichael & Claudia LevinLevin Risk ManagementGary Wayne Benna &
Lori Benna Levine, MDMichael & Tracy LevyIrvin & Elisabeth LindemuthLloyd ConstructionBob & Jill LongLong Realty Cares FoundationPaul LoucksSean LovittLovitt & TouchéWilliam Lowe, MDRyan MaeseGaynell & Jim MagersMark & Jennifer MansfieldMariposa Community Health CenterJustin MartinezMaria & Arthur Martinez, MDPeter Matlock & Sharon Crouse MatlockMaximum Impact Physical Therapy ServicesNancy MayerhoferDr. Robert McCulloch &
Camerone Parker McCullochDebrah & Edgar Jr McCulloughMcKesson Health SystemsMary McMillan & Theodore Waldron, Jr.MEDNAX Services, Inc.James H. MeisterMercy CareReuben Merideth, DVMMesch Clark & RothschildStephen MichaelGeorge & Sharon Milan, CNMMargaret S & Joseph Mills, Sr, MDMillwork By Design, IncMark Falconer & Joy R. Mockbee, MDShanta & Mukund ModakRajiv M. Modak, MDBianca MolinaBrenda & Robert MolinaThe Mona Private FoundationMonty C Morales, MDJeffrey Morgan, DO, MA, FACOISusan Morton
Marla Motove & David HackmanAlbert MoussaTom & Lynn MurphyNational Association of
Community Health CentersSunil NatrajanBarbara C & Craig E Nelson, MDNetwork For GoodNextGen Healthcare Information SystemsCharis & Richard Ober, MDJorge O’Leary, MDHoracio Ore-Giron, MDDrs. Robert & Debra OroDominic & Myriam OrtegaDavid Ortega & Rosemary GannonSoco & Pedro Pacheco, MD Ashley & Eric PageRoberta & Howard PaleyRachael & Simon Paul, MDNatalie A. Perkins, PharmDJennifer & Kenneth Peters Jr.Patricia Petralba, MDSean Small & Christine Pham, MDPICOR Charitable FoundationAdam and Paula PietruskiewiczPima Heart PhysiciansPima Medical InstituteMaria Pia Platia & Michael BookmanTara & Anthony PleseJohn & Candy Katich PoelsTodd M. PortzDanielle PotterShelley PozezTeresa Preciado, MDTimothy & Kathleen ProutyBernadette QuihuisR&A CPAsRadiology Ltd.Tara Radke, MPHRobert & Katherine RamirezAnthony Ramirez IIRandomLyfeJanet & Ted RanneyMark Raven & Ellen ShenkarowRaytheon Charitable GivingRBC Foundation - USA
Becky & Norm RebenstorfBart & Sonia ReidyDrs. Jeffrey Rein & Mridulla AggarwalRetirement EvolutionsRobert RibbeckCarlos & Cecilia D RicoHani Rizk, MDStephen & Lee Anne RoachJill & Lou RodriguezMiguel RojasScott Carvajal & Andrea Romero, PhDPaul & Lela RossierDerek & Marisa L Rowen, PharmDsRusso, Russo & Slania, PCRon & Patricia SableDrs. Jed & Alissa SadallaRogina & Pierre Sakali, MDSalazar Medical Group PCRogelio Samorano, MDDrs. Sarah Samoy & Robert HomChristina & Victor SanchezKirk Saunders & Dr. Ann PetersonAnthony & Emily Wysocki SchaeferSchaefer Present & Stoffers Investment Group
at RBC Wealth ManagementMary SchechnerJeremy SchudyRobyn & Edward Schwager, MD, FAAFPArthi SenraEnrique & Lorena SernaNeelam & Gulshan Sethi, MDDawn ShemenskyHenry & Pat Mary ShirahSimply Bits, LLCAllison Duffy & Basil Skeif, MDVince & Judy SmedesAndrew W & Nancy SmithMarc SmithHarold & Kathleen SnyderBarbara SoehnlenTracy Sole de Hoop & Lance WillettVictor Braitberg & Lisa Soltani, MDSonora Quest LaboratoriesSouthwest Decision ResourcesSouthwest Electrical GroupSouthwest Gas
Richard SpauldingPatty & Doug Spegman, MDSpera Dental PLLCSpiritsChildGloria Dicenso & Joseph Sprietsma, PhDSt Elizabeth’s Health CenterJacque StarkStark Electric, Inc.Linda StaubitzMarion & Jack D Steele, PhDLawrence & Jacqueline SternHoward N StewartPriscilla Storm & Michael ReuwsaatJulia StrangeSteven StrattonGriffin & Mary Pat StrawIan StuartRobert & Bobbie StuartJ. William & Helen D., Stuart FoundationSean & Rebecca StuchenR Michael & Laura SullivanSun CorridorSun MechanicalDonna & Chris SweeneyPaul R. SwensonBehnoud Taghavi-Farahi, DMD &
Pari EskandariTarget CorporationNathan & Jan TenneyAlicia & Ken ThompsonRobert & Milena ThompsonKelly Rae Thompson, MDJohn ThorupMatt ThrasherThrasher Law Offices PLLCMahesh & Deepali Rastogi TipirneniTohono O’odham Gaming EnterpriseDrs. Alicia Tonnies & Hella NordbergMary Puig TorresJudith TreistmanTsu-Shuen Tsao & Lisa RezendeTucson Appliance Co.Tucson Commercial Carpet, Inc.Tucson Electric PowerTucson Federal Credit UnionTucson Frozen Storage
Tucson Medical CenterUMR/UnitedHealthcareUnion Pacific FoundationUnited Way - City of Tucson & Pima County
Employee Combined Appeal ProgramUnitedHealthcare Community PlanThe University of Arizona FoundationFrank Valenzuela & Donna WhitmanLaw Office of Eugene Vamos, PLLCVantage West Credit UnionAdrian & Vanessa VerduzcoJane M. VillarealVirtusDr. Richard & Madeleine WachterMartha & Ray Wagner, MDFrances Ann WalkerPatricia Wallace & Jan KonstantyBarbara H Warren, MD, MPHMichael Webb & Rochelle CunninghamJan Wehrle & Dennis StadelWells FargoWells Fargo Community Support CampaignHolly & Cory Wertz, DDSCarol & Neil West, MDJoAnna & Bill WestcottDavid & Janet West-WattJohn & Penny Whitley, RNLinda Williams, MDDarrin Woodring &
Jesus Alberto Velarde-GodinezMary Wright & Nik McCarthyLinda & Sam Yalkowsky, PhDSonia YanezDrs. Mark & Julie ZaettaAndrew Zale, DMD, MSDYuan ZhangNicole Zuckerman & Ken MorrisZuckerman Community Outreach Fund held
at Community Foundation for Southern AZ
Please contact us at 520-205-4947 to discuss gifts related to stock transfers, life insurance policy, bequests or IRA donations. Call 520-205-4947 or
[email protected] for more information.
839 West Congress Street Tucson, AZ 85745
What Great Healthcare Looks Like