Cleveland Clinic Main Campus

2013 Community Health Needs Assessment – Cleveland Clinic Main Campus Founded in 1921, Cleveland Clinic is an academic medical center offering patient care services supported by research and education in a nonprofit group practice setting. More than 3,000 Cleveland Clinic staff physicians and scientists in 120 medical specialties care for more than 5 million patients across the system. Patients come to Cleveland Clinic locally, from all 50 states and from more than 132 nations around the world. Cleveland Clinic’s main campus, located in midtown Cleveland, includes a hospital with 1,288 staffed beds; an outpatient clinic; a medical school; a research institute; 26 specialty institutes; and supporting labs and facilities in 46 buildings on 167 acres. Cleveland Clinic patients represent the highest CMS case-mix index in the nation. Comprehensive services include heart care, digestive disease, nephrology and urology, cancer, neurology, diabetes and endocrinology, otolaryngology (ENT), rheumatology, gynecology, orthopaedics and pulmonology. Cleveland Clinic’s health system in Northeast Ohio consists of an academic medical center, two children’s hospitals and eight community hospitals. Each hospital is dedicated to the communities it serves. We verify the health needs of our communities by performing periodic community health needs assessments (CHNAs). These formal assessments are analyzed using widely accepted criteria to determine and measure the health needs of a specific community. In accordance with Internal Revenue Code Section 501(r)(3), each hospital has conducted its own community health needs assessment. Upon review of all of the community health needs assessments for all of our Northeast Ohio facilities, Cleveland Clinic has identified five community health needs that are present in the ma- jority of hospital communities we serve. They are: Chronic Disease, Wellness, Access to Affordable Health Care, Access to Community Services, and Economic and Community Development. Cleveland Clinic Main Campus identified all five needs in its CHNA. We are pleased to share the following CHNA report with you. CLEVELAND CLINIC MAIN CAMPUS COMMUNITY HEALTH NEEDS ASSESSMENT TABLE OF CONTENTS Page % INTRODUCTION ........................................................................................................... 1 % PROJECT MISSION ....................................................................................................... 5 % OBJECTIVES .................................................................................................................. 6 % COMMUNITY DEFINITION ......................................................................................... 7 % SUMMARY ..................................................................................................................... 12 % METHODOLOGY .......................................................................................................... 13 % PRIORITIZATION CRITERIA ...................................................................................... 18 % KEY COMMUNITY HEALTH NEEDS ........................................................................ 19 % APPENDICES ................................................................................................................. 30 % Appendix A: Cleveland Clinic Main Campus Community Secondary Data Profile A-1 % Appendix B: Primary Data Resource Organizations B-1 % Appendix C: Cleveland Clinic Main Campus Interview Summary – Key Stakeholder Group C-1 % Appendix D: Cleveland Clinic Main Campus Focus Group Summary – Adult Residents of Communities Adjacent to Cleveland Clinic Main Campus Group D-1 % Appendix E: Cleveland Clinic Main Campus Focus Group Summary – Family Health Center Physicians Group E-1 % Appendix F: Cleveland Clinic Main Campus Focus Group Summary – National Community Physicians Group F-1 % Appendix G: Inventory of Community Resources G-1 i INTRODUCTION CHNA Purpose In response to its community commitment, the Cleveland Clinic engaged Tripp Umbach to facilitate a comprehensive Community Health Needs Assessment (“CHNA”) for the Cleveland Clinic Main Campus (the “Main Campus”). The community health needs assessment was conducted between October 2011 and April 2012. During the community health needs assessment process, the Main Campus collaborated with other Cleveland Clinic Health System hospitals: % Cleveland Clinic Children’s Hospital % Cleveland Clinic Children's Hospital for Rehabilitation % Euclid Hospital % Fairview Hospital % Hillcrest Hospital % Lakewood Hospital % Lutheran Hospital % Marymount Hospital % Medina Hospital % South Pointe Hospital This report fulfills the requirements of a new federal statute established by the Patient Protection and Affordable Care Act (“PPACA”) requiring that non-profit hospitals conduct community health needs assessments every three years. This Main Campus community health needs assessment, with project management and consultation by Tripp Umbach, includes extensive input from persons representing the broad interests of the communities served by the hospital facility, including those with special knowledge of public health issues. Tripp Umbach worked closely with senior leadership from the Main Campus to accomplish the assessment. Separate reports were written for each collaborating hospital listed above. 1 Background The Cleveland Clinic is a non-profit multi-specialty academic medical center integrating outpatient clinical and hospital care with research and education. It is in a unique position, along with other national academic medical centers, to assess the health needs of both its communities and the public at large, and serve as a health resource for national and international patients. The Main Campus is located in the City of Cleveland and includes a tertiary care hospital; a children’s hospital; a medical school; a research institute; an outpatient clinic; 26 specialty institutes including for heart care, digestive disease, cancer, and eye care; and supporting labs and facilities on a 162 acre campus. The Cleveland Clinic Health System operates nine community hospitals and 18 family health centers, including eight ambulatory surgery centers, in Northeast Ohio. The Cleveland Clinic was established in 1921 with the same mission that continues today: Better care for the sick, investigation of their problems and education of those who serve. Consistent with its tripartite mission, Cleveland Clinic’s activities are patient care provided on a charitable basis, medical research, and education of both medical professionals and the community. Patient Care Cleveland Clinic’s services are provided via patient-oriented institutes, which are structured on the basis of organ system or disease. The institutes facilitate a multidisciplinary approach and are designed to enhance convenience for patients and the exchange of knowledge, research and educational collaboration for better patient outcomes. Some of the Institutes include: Cole Eye, Digestive Disease, Endocrinology & Metabolism, Glickman Urological & Kidney, Head & Neck, Miller Family Heart & Vascular, Neurological, Ob/Gyn & Women’s Health, Orthopaedic & Rheumatology, Pediatric & Children’s Hospital, Respiratory, Taussig Cancer and Wellness. Cleveland Clinic is ranked 4th among the nation’s nearly 5000 hospitals.1 Cleveland Clinic has been recognized for its quality of care and was ranked America’s number one center for cardiac care for the 17th year in a row, and its gastroenterology, kidney disorders and urology programs were ranked second in the nation. Thirteen specialties earned top 10 rankings. Cleveland Clinic has one of the highest Medicare case mixes of hospitals with more than 500 beds, an indicator of the acuity of care provided. It provides specialized care in more than 120 1 U.S. News & World Report’s Best Hospitals 2011. Data reprinted with permission from U.S. News & World Report. 2 medical specialties and subspecialties, including to patients transferred from nearly every state and twenty countries due to the unavailability of such high level care in their local community. Research Cleveland Clinic’s mission includes conducting research to advance biomedical science and improve patient care provided here and across the world, to prevent disease and to find cures for medical issues that impact us all. Cleveland Clinic’s Lerner Research Institute (“LRI”) is home to a complete spectrum of laboratory-, translational-, and clinical-based research. LRI is one of the leading NIH-funded research institutes in the United States and has made numerous advances in the diagnosis and treatment of complex medical problems. Scientists and their teams are pursuing a wide range of biomedical questions at LRI, including those related to cardiovascular, cancer, neurological, musculoskeletal, and metabolic diseases, to improve the health status of patients and residents of the Cleveland Clinic’s communities and the public at large. LRI has more than 150 faculty-level scientists organized in the following departments: Biomedical Engineering, Cancer Biology, Cell Biology, Genomic Medicine, Immunology, Molecular Cardiology, Molecular Genetics, Neurosciences, Pathobiology, Quantitative Health Sciences, and Stem Cell Biology and Regenerative Medicine. In addition to basic pre-clinical research, the Cleveland Clinic and its staff physicians participate or are primary investigators in many clinical trials. In 2011, Cleveland Clinic was involved in approximately 1000 clinical trials. The ongoing

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