2021A-012 Wabash General Hospital

Response to Application for Funding

Healthcare Transformation Collaboratives

Prepared for: Wabash General Hospital District and The Illinois Department of Healthcare and Family Services

CONFIDENTIALITY NOTE: The contents of this document are confidential and are intended exclusively for Wabash General Hospital District and the Illinois Department of Healthcare and Family Services.

Table of Contents

Table of Contents Executive Summary Who We Are Community Input Community Data and Needs Health Equity and Outcomes Quality Metrics Care Integration and Coordination Access to Care Budget Milestones Equity Minority Participation Jobs Sustainability Governance Structure Sources Cited

2 | Page Wabash General Hospital District response to Illinois Department of Healthcare and Family Services Application for Funding

CONFIDENTIAL: The contents of this document are confidential and are intended exclusively for Wabash General Hospital District and the Illinois Department of Healthcare and Family Services. Distribution or sharing of this information with persons or entities for which it is not intended is prohibited.

Executive Summary

In response to the State of Illinois Department of Healthcare and Family Services Application for Funding Healthcare Transformation Collaboratives, Wabash General Hospital intends to transform the way care is delivered in Southeast Illinois by investing in new technologies, partnerships, and people.

We believe that we can improve the quality of care delivered, remove and reduce the most prevalent barriers to care, introduce new service lines that are currently unavailable, and address the social determinants of health that are most impactful in our community.

Our request is for $6 Million in year one, and $500,000 in years two through five. These funds will be used to: • Implement the Epic HER and Premier ERP, • Obtain the hardware and technologies needed for wide-spread telehealth care, • Address our patient population’s most pressing service needs.

These improvements will help Wabash General Hospital reduce ongoing costs, increase revenues and reimbursements, provide new services, improve the quality and accessibility of all services, and cultivate a sustainable future.

This investment would be for the benefit of patients in the Marion Health Region as identified by HFS. Per the CDC Social Vulnerability Index Percentile, this region ranks third-highest of all Illinois regions, behind only the two Chicago regions.

Our proposal will be effective in the areas of Adult Behavioral Health, Child Behavioral Health, Maternal and Child Health, and Equity as key pillars of improvement. Wabash expects to make quantifiable changes in the quality, speed, and types of service available.

As a Federally Qualified Critical Access Hospital, our organization has proven the ability to provide care for underserved populations in a low income region.

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Who We Are W ABASH G ENERAL H OSPITAL D ISTRICT is a FEDERALLY QUALIFIED critical access hospital located in Mount Carmel, Illinois. It provides quality health care to residents of Wabash County as well as those living in surrounding communities.

The sole purpose of Wabash General Hospital is to provide high quality, cost effective healthcare in the Wabash and surrounding counties, and promote the general health of its residents.

Our federal designation as a critical access hospital identifies us as a community hospital with 25 inpatient beds and 24-hour emergency care. Due to this status, Wabash General can offer a special inpatient rehabilitation program called Swing Bed.

In addition to the Rehab to Home Program, inpatient and emergency care, our team offers family medicine (including pediatrics) and a variety of services. They include: six orthopedic and sports medicine clinic locations, athletic trainers in 13 schools at no cost (high schools and junior colleges), cardiology, general surgery, audiology, oncology/hematology, pain management, surgical podiatry, pulmonary medicine, sleep medicine, neurology, geriatric psych, ENT, outpatient behavioral health and women's health.

O UR PATIENT POPULATION includes approximately 40,000 people and is centered in Wabash County. The most significant needs identified by individual interviews and community focus groups are for improved mental health services along with substance abuse services. Additionally, community members identified other major needs including direct access to obstetrics, dermatology, and gastroenterology specialists, pharmacies, elderly services, and dental/oral surgery.

Today, our health system utilizes a combination of un-integrated technologies, which has contributed to the lack of direct access to care. Planned improvements in information technology, system selection, and service delivery are all underway as a part of an organization-wide attempt to reach a more sustainable future state.

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To best serve our patients, we are embarking on a transformative shift that focuses on expanding access to a variety of health services in Wabash and surrounding counties. This is being accomplished by taking a strategic approach to the improvement of the patient experience, by listening to what the community has requested and finding ways to bring missing services to our area.

What We Need T HE E PIC INVESTMENT TO IMPROVE SERVICE DELIVERY AND PROVIDE NEW SERVICES Remove Barriers to Care by Improved Service Delivery

Epic is the market leader in building software that puts patients at the center, covering nearly 238 million Americans. Approximately 90% of medical students and residents train on its systems, and it’s ranked #1 by customers. Epic products deliver on expectations and release on a predictable schedule, creating care continuity by unifying, simplifying and supporting communication among people, processes and systems.

An integrated connection to the complete patient record for the 2.9 million patients within the Pointcore database Full integration of inpatient and ambulatory data across the entire patient experience, from registration through billing A shared clinical record when a relationship exists Financial data is partitioned in the system, separated from other entities All product upgrades are performed by Pointcore on a predictable schedule

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Implementation, ongoing support and maintenance from Pointcore’s 450+ skilled IT labor pool

Improved Provider Recruitment and Retention Alleviating burnout Custom forms and orders Specialty-specific documentation tools Automated billing and revenue cycle integration Improving recruitment Providers-in-training expect to use the tools they trained on and are considered industry-best

Improved Operating Margins2 Increased organizational performance Fewer errors Better reimbursement Productivity enhancement Dedicated revenue cycle functionality Integration with ancillary systems Cost reductions Elimination of paper charting Consolidation of technology contracts

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Suite of Services Pointcore’s Epic offering includes a variety of products and services in addition to EHR, such as E- prescribing, document imaging and faxing, end user training, patient education and more. • Speech to text and fluency direct with 3M / M*Modal • Electronic prescription of controlled substances with Imprivata • Patient education with Krames Staywell • Prescription coverage and estimation with RxRevu

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Premier ERP Technology

Premier is an Enterprise Resource Planning system that utilizes industry-standard technology to integrate General Ledger, Materials Management, Accounts Payable, and Fixed Assets records for health systems.

Implementing the Premier ERP will contribute to cost-savings efforts, improve timelines around item procurement, and streamline documentation across the organization.

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Collaborative Partners

COMMUNITY PARTNERSHIPS

P OINTCORE, I NC. was founded in 2014 as a subsidiary of OSF HealthCare with the intent of extending proven excellence in patient focused care to external clients from resources who are living it every day. It is the part of the organization that allows OSF HealthCare to extend resources, share cost and utilize common infrastructure with external clients.

W HY P OINTCORE? E XPERTISE Pointcore has shown the ability to take the model used to implement Epic at each of OSF’s 14 hospitals to successfully implement Epic Enterprise at a 300 bed nonaffiliated hospital. Pointcore’s philosophy is to create a partnership with external entities, extending our skilled leaders, tools, templates, and playbooks. Leverage Key Process Pillars to streamline the implementation and allow your organization to more quickly return to “steady state” post go-live.

E PIC I MPLEMENTATION E XPERIENCE AT C OMMUNITY C ONNECT S ITES Community Connect Sites Implementation of and currently hosting on OSF Enterprise instance of Epic • University of Illinois College of Medicine at Peoria § (100+ Providers) on OSF Enterprise instance of Epic • Decatur Memorial Hospital and Medical Group § (300 Bed and 275,000 annual ambulatory visits) on OSF Enterprise instance of Epic • FQHC and Resident Clinic with 192 physicians • Cancer Care Center with 30 Providers in 19 locations • Hannahville Indian Community Clinic – Tribal FQHC in Michigan • Illinois Department of Public Health § 23 Mobile COVID-19 Testing locations across Illinois § COVID 19 Vaccination locations across Illinois • Multiple Independent Ambulatory Family Practice and Specialty Clinics

B ASIC ITS is a women-owned small business based in Washington, IL that provides a variety of technology service solutions throughout Illinois. They are leveraged to staff projects and provide equipment by healthcare organizations across the state. Their role is to complement existing IT departments, allowing clients to effectively manage the needs of their business. BITS is a trusted partner of several key technology vendors, such as HP and Microsoft, and allows us to leverage their relationships with larger corporations to realize the most financially sustainable solution available.

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Community Input

• Community data collection o Specifically sought out every three years as a part of their Community Health Needs Assessment as required for tax-exempt hospitals § 3 community focus groups with 30 participants o Strategic Planning process that includes Medical Staff, Board Members and Administration was completed alongside the Community Health Needs Assessment. • Patient data collection o Wabash General Hospital collects information from patient surveys through SMS text, email, or IVR outreach from NRC Health after a visit. NRC Health transcribes the comments as real-time feedback and with their natural language processing, they are able to alert to patient complaints left in the comments. o Trends found are issues with timely access to patient records, access of care due to patients having difficulty with accessing two separate patient portals for Evident and NextGen, and interfacing issues between Evident and NextGen causing patient results entering in the wrong chart. Trending of incidents since 2018 found HIPPA concerns created the largest area of IT incidents and patient identification issues are second. • Staff data collection o Strategic Planning process was completed alongside the Community Health Needs Assessment. o Included 25 individual interviews from leadership and staff o Included Community Focus Group Participants o A Strategic Plan for 2019-2022 was developed with 6 pillars adopted. • Inclusion of local leaders o Local leaders participated in the Community Focus Group included the Wabash County Chamber of Commerce, Dean of Wabash Valley College, Superintendent of District #348, Chief of Police, Mt. Carmel Police Department, Illinois State Trooper, Youth in Action, Wabash County Health Department, President of Wabash Container Corporation, Mayor of Mt. Carmel, Illinois, Wabash County State’s Attorney, CVS Pharmacist, Edwards County Commissioner, Wabash County Commissioner, Wabash County Sheriff and President of First National Bank.

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Community Data and Needs

The results of our 2019 Community Health Needs Assessment demonstrate a collective need for substance abuse services, mental health services, and expansions of primary and specialty care. Our service area’s primary challenges are having a high percentage of patients age 65+, below-average income, and premature deaths.

• 19% of population are in the age 65+ cohort (compared to 15% nationally)1 • Higher mortality rates across service area • Significantly higher rate of heart disease in Lawrence, Edwards, and White counties • Cancer deaths notably higher in Wabash and White counties • Cancer incidence rates indicate White county is above State rates in nearly all cancers • Lung cancer in Lawrence, Edwards, and White counties significantly higher than state rate

Prioritization of Needs and Improvements • Substance abuse services

o We continue to have a lack of access to mental health and substance abuse providers. o In effort to make improvements: Wabash General Hospital collaborated with the Wabash County Health Department and formed a Look-alike FQHC. Wabash General Hospital opened a Senior Enrichment Department in 2020 Wabash General Hospital offered a scholarship to Leann Lear, Psychiatric Mental Health Nurse Practitioner to improve access to care. Leann started practice in 2020. • Mental health services

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o Wabash General Hospital has no access to Psychiatric Physician care in the Emergency Department. The lack of access to mental health services stresses the Emergency Department physicians, nursing staff, and unfortunately during security breaches the local police department. The patients in need of mental health services average 10 hours in the Emergency Department and sometimes will have extended one-on-one care up to 4-6 days waiting for inpatient placement that is extremely limited. o Wabash General Hospital has limited access to Psychiatric Physician oversight for the Nurse Practitioner and Crisis Counselors. • Expansion of primary care services o PCPs would now have access to the integrated record of the patient with specialty visits, ED admissions, IP stays, test results, medication reconciliation, problem lists, transportation barriers, and pharmacy preferences. • Expansion of specialty services o Telehealth consults built into the system for mental health, and additional specialties that are hard to recruit and retain in a rural area. o Easy referrals to reduce barriers to access for all patients • Lifestyle/dietary education focus o Epic’s patient education (Krames) o Wabash General Hospital works to promote lifestyle changes, with a focus on nutrition, within the community. The Registered Dietitian works with the local community college, Wabash Valley College, as a guest speaker in the Nutrition class discussing lifestyle diseases and general nutrition. The Registered Dietician also writes four articles that are published in the local newspaper annually. Prior topics have been sodium in your diet, body mass index, and beverage choices. The Registered Dietitian also interviews with the local radio station discussing healthy holiday eating and eating during a pandemic. Wabash General Hospital has CDC accredited Diabetes Prevention Program that it offers to the members of the community at no cost to the individual. Wabash General Hospital gifts the services of the Registered Dietitian for those patients referred by a health care provider.

In order to be a community partner in improving the health and wellbeing of residents Wabash General Hospital Collaborates and supports the following community-based programs: o Wabash Community Health Center, Federally Qualified Health Center (FQHC) look alike is a collaboration between Wabash General Hospital and Wabash County Health Department. o Wabash General Hospital employees volunteered 1,153 hours in the communities of Wabash County and surrounding areas. o Wabash General Hospital, Wabash Valley College and Mt. Carmel High School host a Health Occupation Program for local students to receive dual college credits. o Illinois Eastern Community College and Wabash General Hospital host nursing students obtaining their LPN or RN degree, EMS students, and radiology students. o Wabash General Hospital provides Edwards County Emergency Management Services their ESO medical record system and billing services.

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o Wabash General Hospital Administrative Staff serve on the following Boards: Wabash County 911 Board, Wabash County Crime Stoppers, ICAHN Board Member/Education Committee, Mt. Carmel CEO Board Member, Mt. Carmel Rotary Club, Lawrenceville Rotary Club, Wabash Valley College Foundation Board, Wabash County Chamber of Commerce/Special Advocate, Wabash Rally Against Cancer and the Guardian Center.

Service Area County Health Rankings – Select Measures

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Barriers to care

Historic The hospital’s information system CPSI is nearing 30 years of service to Wabash General Hospital. The physician practice’s information system is Nextgen and has been in service 15 years. There are other multiple systems such as T-Systems for the Emergency Department and A2C in the Rehab Services Department. The multiple systems affect quality of care to patients due to patients having to access multiple patient portals and limitations of the hospital’s ability to acquire sub-specialties. It also makes the hospital vulnerable for cyber security breaches due to the management and upgrades of multiple systems. The ability for Wabash General Hospital with its aging and deficient technology hinders the hospital’s ability to serve its aging population, migrant workers, and behavioral health needs. Productivity of providers and other staff members suffer due to the constraints of the technology and data entry into multiple systems.

Cultural Wabash General Hospital is a leading healthcare provider of choice in Wabash and surrounding counties. The sole purpose of Wabash General Hospital is to provide high quality, cost effective healthcare.

Economic Manufacturing and healthcare is primary employment Primary employers being the most common provider of insurance Shrinking population Wealth migration Logistical Lawrence County has a much higher percentage of 18-24 year olds without a high school diploma compared to other service area counties, as well as the State non-metro benchmark Wabash county residents have lower access to health foods as measured by residents’ proximity to the nearest supermarket (more than 10 miles)

Social Determinants of Health

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Economic stability

Clinical Care Measures

Education

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Housing In 2018, the median property value in Wabash County, IL was $80,500, and the homeownership rate was 76.3%.

Transportation Most people in Wabash County, IL drove alone to work, and the average commute time was 19.5 minutes. The average car ownership in Wabash County, IL was 2 cars per household.

Food security There is one grocery store located in Wabash County, IL. The next closes grocery stores are located in Princeton, Indiana, Lawrenceville, Illinois and Albion, Illinois.

Environmental quality Participants of the 2019 community focus group identified coal burning and air pollution from the nearby power plant, as well as pesticide and ammonia exposure from nearby farms as concerns. River contamination due to the power plant was also cited.

The Governor of Illinois, JB Pritzker, declared all counties in the State of Illinois a disaster area on March 9, 2020. Wabash General Hospital activated its incident command on March 10, 2020 and the Illinois Department of Public Health issued guidance on March 16, 2020 recommending the cancelation of all elective or non-emergent surgeries and procedures. Wabash General Hospital experienced its first day of revenue decline on March 17, 2020. Incident Command was active daily for the first several months of the pandemic and has continued to meet on a weekly basis. Incident Command has a multi- discipline participants including the Chief of Medical Staff. Community needs and information needs, access to supplies, changes in providing safe healthcare such as a Hotline, COVID-19 testing outside of laboratory services, curb-side check in, to name a few. Wabash General Hospital has performed to- date 5,001 test and 484 test were positive. Health Equity and Outcomes Metrics monitored today are childhood immunization status 31%, breast cancer screening 41%, cervical cancer screening 14%, and controlling high blood pressure 56%. This data is currently being monitored through ECQM’s on our NextGen system. Documentation in the current system is cumbersome and creates opportunity for inconsistencies to occur in the current EHR system. We have been working to improve our workflows and one all-inclusive system would improve our quality measures.

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Quality Metrics

Equity: Wabash General Hospital strived to increase availability of digital mammography services to rural communities by partnering with 3 rural hospitals and offered a digital mammography mobile unit. Our breast cancer screening rates for our primary care patients are 41% or 838/2020 patients for 2020. We are working to expand this service to increase breast cancer screening by bringing mammography services in house to offer the service 5 days a week. Issues we have with the current EHR system are finding the results of the mammogram in the current EHR system and having the health maintenance records update to capture the completed mammogram.

Maternal Child: The percentage of children ages 2 years and under who have had all required childhood immunizations is monitored in our pediatrics office. Currently we are at 31% for 2020. We have had EHR issues with some immunizations not capturing in the ECQM and showing in the numerator when they have received all of their childhood immunizations. The documentation of all immunizations will be in the chart and documented correctly and the patient may not show up in the ECQM.

Improving Community Placements: Wabash General Hospital has a Chronic Care Management program that assists patients with 2 or more chronic medical conditions by providing education, medication referrals, assisting with transportation needs, assisting with arranging patient appointments, and assisting with community referrals as needed. The Chronic Care Management program also works with patients who are discharged from Wabash General Hospital through the transitional care program with a 2 day follow up call to check in on patient and verify how the patient is understanding their discharge instructions. Discuss with the patient any barriers to obtaining their medications and reconcile their medications and see if they have any questions. The transitional care provider arranges for a 7 day follow up with their primary care provider and verifies the patient has all of their labs, and x-rays completed and the provider has this information. Our current EHR makes this a cumbersome process with delaying the coordination of care at times due to lacking of the needed patient care documents at the primary care office.

Care Integration and Coordination

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Implementing Epic will help facilitate the provision of services needed in this area (such as primary care, specialty, mental health and substance abuse) by making care documentation easier, bringing patients and providers closer, and utilizing industry-wide technology to request and share important information.

Automated data-sharing and requests with other record systems via CareEverywhere allows our providers to retrieve information on our patients from other systems through a secure transfer process.

Integrated ambulatory and inpatient records create a seamless experience for patients and staff alike. Data from previous emergency or ambulatory visits, images, historical notes, and more facets of the complete medical record are all available. Access to Care

Following a comprehensive strategic plan and community health needs assessment, the Wabash General Hospital Board approved a series of campus-wide improvements to address the current needs of the hospital. Wabash General Hospital partnered with Design-Builder O’Shea Builders and BLDD Architects on the master plan. Wabash General Hospital has also contracted with ADG – Architectural & Design Group of Mount Carmel, Illinois to be its owner representative.

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Construction is scheduled to begin May 3, 2021 which includes the construction of a two-story, 32,000- square-foot medical office building adjacent to the main hospital location.

The two-story Medical Office Building is expected to house 50 existing employees and six medical providers. The Administrative Officers, Oncology Department, Pediatric Services and Primary Care Services will be offered at the Medical Office Building.

The hospital’s Orthopedic/Rehab Building, will undergo renovations and an addition to facilitate a growing orthopedic practice. The building is currently 7,200 square feet and with the addition it will increase to 9,941 square feet.

Renovation of the hospital’s cafeteria, business office, IT and various meeting rooms. The increase in staff and services has caused a need to increase space in the main hospital. The administrative offices will be moved to the new medical office building. The business office and IT will relocate to the current administrative office space. The cafeteria will be renovated and acquire additional space from the meeting rooms. The meeting rooms will be moved into the business office and IT space.

The Wabash Community Health Center is a collaboration between Wabash General Hospital and Wabash County Health Department. The collaboration is an effort to better meet the physical health and mental health of the community. Wabash Community Health Center provides comprehensive medical care from infants to elderly adults. Wabash Community Health Center offers behavioral health services to help patients struggling with mental health and substance abuse. The services offered include psychiatric services for adults and children, plus counseling and therapy.

The implementation of integrated video visits3 will provide our patients with a greater level of care through increased availability and the removal of logistical barriers, such as travel or health restriction. It will contribute to a better working environment for providers and staff as it creates a more flexible schedule and increases their productivity. Advantages include a reduction in costs, such as rooming staff or clerical workers, a more efficient schedule, and the ability for quarantined providers to provide care, which mitigates the potential loss of a highly needed resource. Current challenges with this model include acquiring adequate technology infrastructure, which is part of the reason for this grant application. Budget $6,000,000 in year one $500,000 in annual costs for years two-five Budget Form Included in Packet

Milestones

10 months

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Our first Milestone is to implement the technology necessary to allow scalable growth as the continuum of care expands. We will focus on building a network of physicians and providers to grow our service area.

18 months Our second milestone is to expand the services offered. With the right foundation of technologies in place and the collaboration of other care organizations, we will be adding telehealth and other digital health capabilities.

48 month timeline Our final milestone is to sustain growth and innovate care delivery.

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Equity Increasing reliance on employer-provided insurance Rising costs Decreasing availability, as major corporations are leaving this part of the country Distance to care

Minority Participation

Basic ITS Jobs As of April 6th, 2021, the Hospital has 306 full-time and 39 part-time employees. There are no union groups represented in the Hospital workforce. The Hospital believes that its employee relations are favorable. Wabash General Hospital is the largest employer in Wabash County. An increase in a full-time provider of services increases staffing a minimum of 2 full-time employees per new provider. Sustainability The hospital’s mission includes financial strength: Responsibly using, preserving and enhancing our human and material resources as a not-for-profit community controlled organization

Wabash General Hospital’s current annual spend is $674,111 on information technology and annual labor cost to maintain the systems is $405,107 for a total of $1,079,218. Collaborating with Pointcore to secure a single electronic health record system will help preserve our human and material resources by allowing staff to offer additional services, send and receive information from other healthcare facilities, and to acquire services through telemedicine.

The following table estimates the sustained growth of services after implementation of EPIC electronic health record and the new building construction and remodel of Wabash General Hospital.

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Wabash General Hospital Estimated Growth including EPIC Electronic Health Record Audited Audited Audited Projected Projected Projected Projected Projected 2018 2019 2020 2021 2022 2023 2024 2025

Net Patient Service Revenue 42,948,746 50,284,308 48,583,488 52,295,680 53,603,072 55,211,164 56,867,499 58,004,849 Other operating Revenue 2,716,904 2,143,606 7,597,675 2,207,914.18 2,274,152 2,342,376 2,412,647 2,460,900 Total Operating Revenue 45,665,650 52,427,914 56,181,163 54,503,595 55,877,224 57,553,541 59,280,147 60,465,750

Operating Expenses: Salaries & Benefits 23,118,771 26,563,408 27,858,525 27,094,676.16 28,415,695.50 27,907,516.44 28,984,009.41 28,744,741.94 Supplies & Services 18,463,079 19,016,072 19,801,715 20,385,992.49 20,997,572.26 21,627,499.43 22,276,324.42 22,944,614.15 Depreciation, amortization 1,884,778 2,076,237 2,177,404 2,288,712 3,440,000 3,347,000.00 3,380,470.00 3,414,274.70 Total Operating Expense 43,466,628 47,655,717 49,837,644 49,769,381 52,853,268 52,882,016 54,640,804 55,103,631

Total Nonoperating Revenue (Expense) 245,080 418,804 (366,657) 427,180 439,995 453,195 466,791 480,795

Net Income 2,444,102 5,191,001 5,976,862 5,161,394 3,463,952 5,124,720 5,106,134 5,842,914

Source: Hospital Management .

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Governance Structure

Board of Directors The nine members of the Board of Directors of the District are appointed for staggered terms by the County Board Chairman with the consent of the County Board. The current members of the Board of Directors and their terms of office are: Current Term Began Term Expires Member Office (January 1,) (December 31,) Rob Coleman Chairman 2019 2021 Toni Brines Vice Chairman 2021 2023 Doug McPherson Secretary 2019 2021 Janet Storey Treasurer 2020 2022 Bill Easton Director 2019 2021 John Evans Director 2021 2023 Kevin Raber Director 2021 2023 Nate Stevenson Director 2020 2022 David Miller Director 2020 2022

Hospital Administration

Karissa Turner, President & CEO; 2019-Present. As a Mt. Carmel native, Ms. Turner has served Wabash General Hospital for 13 years, beginning her tenure as a Practice Manager in 2005. Ms. Turner has held various leadership roles throughout the Hospital, including Director of Physician Services, Vice President of Hospital Operations, and Executive Vice President of Hospital Operations/Chief Operating Officer. Ms. Turner received her Associate in Science and Arts from Wabash Valley College in 2003, before receiving her Bachelor of Science in Accounting and Professional Services in 2005 from the University of Southern Indiana and her Master of Business Administration from Southern Illinois University – Carbondale in 2014. Ms. Turner is actively involved in the Mt. Carmel Rotary Club and is a board member for the Mount Carmel Creating Entrepreneurial Opportunities.

Tamara Gould, Senior Executive Vice President of Hospital Operation/Chief Operating Officer; 2019- Present. Ms. Gould began working at the Hospital as an EMT in 1994 while attending Oakland City University to earn her bachelor’s degree in science in 1995. Ms. Gould earned her associate’s degree in nursing from Wabash Valley College in 1998. She began working as an emergency room RN in 1998, and was promoted to a nursing supervisor in 2001. Six years later in 2007, Ms. Gould became the Vice President of Clinical Services/Chief Nursing Officer. In 2019, Ms. Gould began her current role as the Senior Executive Vice President of Hospital Operation/Chief Operating Officer.

Lynn Leek, Executive Vice President of Finances/Chief Financial Officer; 2019-Present. Ms. Leek, a Certified Public Accountant, has over 25 years of hospital revenue cycle, reimbursement and financial management experience. Ms. Leek assumed the role of Vice President of Finances/Chief Financial

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Officer in October 2019. She earned a Bachelor of Science in Accountancy degree from University of Southern Indiana.

Kim Pearson, RN, CPHQ, CPPS, Executive Vice President of Clinical Services, Chief Nursing Officer; 2019-Present. Ms. Pearson joined the Hospital in 2011, and served as the Quality Director and Risk Manager for eight years, gaining valuable leadership experience. Ms. Pearson received her Associates Degree in Nursing at Wabash Valley College in 1995; Certification in Healthcare Quality and Certification in Patient Safety in 2013. Prior to joining Wabash General Hospital, Ms. Pearson served as a nurse in the VA Medical Center in Danville, Illinois on the Medical floor. She also worked at another Critical Access Hospital where she gained experience in the Emergency Room Department, Med/Surg, ICU, Obstetrics, and as a Nursing Supervisor. Ms. Pearson also worked at a private practice Family Medicine office for several years. In her current role, Ms. Pearson provides leadership and direction for the nursing staff and is responsible for planning, organizing, directing and controlling all functions of nursing including Inpatient Services, Surgery, Case Management, Respiratory, Sleep Lab, Laboratory and Anesthesia departments.

Danielle Stevens, Executive Vice President of Business Development & Foundation. Ms. Stevens joined the Hospital in 2014. She completed her Bachelor of Science degree in Paralegal Studies from Southern Illinois University in Carbondale and completed her Master of Business Administration degree with a concentration in Marketing from Southern New Hampshire University in 2018. Prior to joining the Hospital, she worked as a paralegal. Ms. Stevens is responsible for marketing new and existing services at Wabash General Hospital, as well as being the lead on the hospital’s Foundation.

M. Bridget Shepard, CPA, Executive Director of Human Resources. Ms. Shepard has worked at the Hospital for 20 years. She received a Bachelor of Science Degree in Accounting from the University of Evansville. Shorty following her graduation, Ms. Shepard earned her certification in public accounting. Ms. Shepard started her career at Kemper CPA Group where she worked as a Certified Public Accountant for nine years specializing in taxation, government and construction contractor audits and benefits plan management. Next, she worked at Citizens Bank/Fifth Third Bank as an Accounting System Specialist for four years where she was responsible for the financial accounting and analysis of the Western Division of a multi-billion dollar corporation. In her current role at the Hospital, Ms. Shepard is responsible for the Human Resources support of over 400 employees. Her experience includes executive level management, leadership development, benefits development, training/employee development, and employee relations. She is also responsible for the direction of the Payroll and Dietary areas.

Medical Staff Appointment to the Medical Staff of the Hospital is a privilege extended to professional, competent physicians and practitioners licensed in the State of Illinois who can document their background, experience, training, and competence, adherence to the ethics of the profession and the ability to work cooperatively with others. The Hospital Board of Directors, upon recommendation of the Hospital Committee, makes appointments to the Medical Staff and determines clinical privileges.

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The Medical Staff is divided into two categories; active and associate/courtesy. Physicians in the active category regularly provide patient care including emergency service care and consultation assignments, as appropriate, and are in close proximity to the Hospital. Active Staff members hold office and are required to attend Medical Staff Committees. Physicians in the courtesy category must have evidence of membership on the active staff of another hospital that is accredited by an organization that requires quality review activities similar to the Hospital’s. Courtesy members are not allowed to vote, hold office, or serve on committees.

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Sources Cited 1. The Wabash General Hospital 2019 Community Health Needs Assessment conducted by M13 Management Partners. https://wabashgeneral.com/About-Us/Documents-About-Us/Wabash- General-hospital-CHNA-2019 2. Moro Visconti R, Morea D. Healthcare Digitalization and Pay-For-Performance Incentives in Smart Hospital Project Financing. International Journal of Environmental Research and Public Health. 2020; 17(7):2318. https://doi.org/10.3390/ijerph17072318 3. Devin M Mann, Ji Chen, Rumi Chunara, Paul A Testa, Oded Nov, COVID-19 transforms health care through telemedicine: Evidence from the field, Journal of the American Medical Informatics Association, Volume 27, Issue 7, July 2020, Pages 1132– 1135, https://doi.org/10.1093/jamia/ocaa072 4. Hospital Management. 5. Datausa: https://datausa.io/profile/geo/wabash-county

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