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WORKING SIDE BY SIDE Community Benefits Report WORKING SIDE BY SIDE Contents Collective efforts to serve patients and community 2 Charity care in Emory Healthcare Few people in Atlanta’s history have ever made such a lasting 11 4 Emory University Hospital impact as our center’s namesake, Robert W. Woodruff. It was largely hospitals 5 Emory University Hospital Midtown his vision, leadership, kindness, and generosity that helped make 6 Emory Rehabilitation Hospital Atlanta a dynamic, world-class city with a highly diverse and rapidly growing population. 250 7 Winship Cancer Institute That dynamic population outpatient locations 8 Emory Saint Joseph’s Hospital brings increasingly complex 9 Emory Johns Creek Hospital health challenges to which no 10 Emory at Grady Hospital 2,673 one medical professional can 11 Emory at Atlanta VA Medical Center inpatient beds possibly have all the answers. 14 Local and global community: Instead, modern health and Helping neighbors near and far healing require interdisciplinary, 2,800 16 Teaching tomorrow’s health professionals interprofessional teams working physicians 17 Making research possible side by side across education, research, and clinical care to most 18 Spurring the economy effectively prevent and treat disease. SUSTAINING A VISION 30,000 21 Woodruff Health Sciences Center components FOR THE COMMUNITY Working side by side harnesses the extraordinary talents of our employees Robert W. Woodruff—the medical professionals, educators, and investigators to improve quality health sciences center’s namesake On the cover: of life for all the people we serve. Through the collective efforts and Inpatient pharmacy and longtime leader of The Coca- 5,700 staff and trainees dedication of our entire Woodruff Health Sciences Center, we provide Cola Company—dedicated his life at Emory University to supporting the community, and students and trainees Hospital Midtown. Front value to our patients and our community and help ensure continued his legacy lives on in work like that cover, l to r: Candice Sanders, Michael health and well-being for the city, the state, the region, and beyond. described herein. Stuckey, Shawn Lubic, Reggie Thomas, Alacia Troutman, Jessica $8.8 b Hicks, Ivory Childs. Back cover, l to r: Alex Medders, Shailly Shah, annual economic impact Karen Hamilton, Lauren Riley, Montalita Burch, Jessica Walton, Jonathan S. Lewin, MD Erich Brechtelsbauer Executive Vice President for Health Affairs, Emory University Patient stories throughout this book are real, but patients’ names and Executive Director, Woodruff Health Sciences Center $89.1 m identities have been changed to protect their privacy. President, CEO, and Chairman of the Board, Emory Healthcare annual charity care Emory University is an equal opportunity/equal access/affirmative action employer fully committed to achieving a diverse workforce and complies with all federal and Georgia state laws, regulations, and executive orders regarding nondiscrimination and affirmative action. Emory University does For more details, see pages 2, 18, 19, 21 not discriminate on the basis of race, age, color, religion, national origin or ancestry, gender, disability, veteran status, genetic information, sexual orientation, or gender identity or expression. 2 << WOODRUFF HEALTH SCIENCES CENTER COMMUNITY BENEFITS REPORT n 2018 >> 1 Charity care in Emory Healthcare EMORY HEALTHCARE PROVIDED $89.1 MILLION IN CHARITY CARE IN FISCAL YEAR 2017-2018. “Charity care” includes (1) indigent care for patients with no health insurance, not even Medicaid or Medicare, and no resources of their own and (2) catastrophic care for patients who may have some coverage but for whom health care bills are so large that paying them would be permanently life-shattering. The box below details the charity care provided at individual Emory Healthcare facilities. Included else- where in this book is information about uncompensated care provided by Emory physicians who practice at Grady Memorial Hospital and at other facilities. In addition to charity care, Emory Healthcare provides many other services to help improve access to care, advance medical knowledge, and relieve or reduce dependence on taxpayer-funded community efforts. In fiscal year 2017-2018, this total for Emory Healthcare was $102.7 million. Examples of what this total includes are as follows: n $61.4 million shortfall between Emory Healthcare’s cost to provide care to Medicaid patients and Medicaid reimbursement n $27.7 million in costs to Emory Healthcare for the Georgia provider tax, Charity care totals which supports the state’s Medicaid budget and helps maintain pay- ment levels for all Medicaid providers Fiscal year 2017–2018 n Emory University Hospital and (millions) $13.6 million for activities such as discounted/free prescription drug Emory University Orthopaedics programs; programs and contracted services for indigent patients; in-kind & Spine Hospital $27.4 donations to organizations such as MedShare; transportation services; Emory University Hospital Midtown 27.2 flu shots; blood drives; subsidized continuing care, nursing home care, Emory Rehabilitation Hospital 1.9 and home care; sponsorship of selected charity health awareness Emory Saint Joseph’s Hospital 6.2 events; and educational programs for the public, future health profes- Emory Johns Creek Hospital 1.8 Emory Clinic and Emory Specialty sionals, and patients Associates 24.4 Budd Terrace skilled nursing facility 0.2 Total $89.1 2 << WOODRUFF HEALTH SCIENCES CENTER COMMUNITY BENEFITS REPORT n 2018 >> 3 EMORY UNIVERSITY HOSPITAL EMORY UNIVERSITY HOSPITAL MIDTOWN When West’s body began failing from the virulent infection that seemingly came Continuing care after hospitalization out of nowhere, it took a team, including BEFORE MYRA COLLINS ARRIVED AT EMORY ICU physician Kate Nugent, to keep him UNIVERSITY HOSPITAL MIDTOWN’S EMERGENCY According to hospitalist Willie Smith (here with social going. ROOM, SHE HAD BEEN LIVING IN A PERSONAL CARE worker Shonda Knox), the hospital stay sometimes HOME. An aunt checked in on her regularly, but Collins required more care than she seems like the least complicated part of what a patient could provide. The 48-year-old woman needs to keep doing well. could barely see, was hard of hearing, and had moderate cognitive disability. At Emory Midtown, she received swift, textbook-perfect treatment for rectal can- cer, including surgery and chemotherapy. Collins seemed to settle in. She smiled when doctors and nurses asked her how she was doing, and she responded to the warmth and patience of the nurses teaching her about her colostomy. Soon, she was in stable condition. According to protocol, she was ready for discharge, with the need to return for daily outpatient radiation and follow-up on her colostomy. But her care team did not believe, given her challenges and the In disaster, courage (and support) count limits of the personal care home where she had been living, that she would be able to BRAD WEST WAS TIRELESS. HE RUSHED HOME FROM HIS LANDSCAPING Halting deadly spread of the infection would require ampu- manage logistics of transportation, appoint- JOB TO WORK IN HIS OWN GARDEN, PLAY BASKETBALL WITH HIS SON, tation. Surgeons Thomas Dodson and Robert Fang were ments, and colostomy care. Her case was VOLUNTEER AT CHURCH. When he developed fever and chills, the called in to save the young man’s life. presented at the hospital’s Complex Patient 35-year-old assumed he would soon shake it off. But he had After two months of intensive care, the bacteremia was Care Committee, headed by Willie Smith, never before faced streptococcal bacteremia (and never found gone, and West’s heart, lungs, kidneys, and other organs had medical director of care coordination. The out where the uncommon infection came from). By the time recovered. But he now had to learn to cope without his legs committee, consisting of various clinicians he got to Emory University Hospital, the bacteria already had and arms. His bravery, determination, and unquenchable and social workers, routinely sees patients released chemicals in his bloodstream, setting off inflammato- good nature and the support of his wife and extended family like Collins whose complex personal sit- ry responses throughout his body, lowering his blood pressure in the face of this disaster had an enormous impact on the uations create “barriers to discharge.” The and reducing the heart’s ability to pump blood to vital organs. team caring for him, including Dodson, ICU doctors Kate committee works hard to find ways to Despite a course of increasingly stronger IV antibiot- Nugent and Prem Kandiah, bedside nurses, ICU social work- overcome these barriers and ensure all patients have a safe dis- Collins’ medical costs while she was an inpatient. But from ics and blood pressure support, West’s condition rapidly er Courtney Faulkner, physical therapist Primrose Mlilo, charge back into the community or to another level of care. the moment she checked out, housing, transportation, med- worsened. At one point, his heart spiraled into an abnormal occupational therapist Rebekah Kirk, and speech therapist After hearing Collins’ case, the committee decided she ical, and other costs all were paid by Emory Midtown. The rapid beat, requiring the ICU team to shock it back into a Stuart Schleuse. They encouraged West as he healed and could leave the hospital—but not return to where she had hospital arranged for Collins to receive mail-order colostomy stable rhythm. Shortness of breath progressed to reliance prepared to get his prosthetic limbs. Since West had no been living. Oncology social worker Shonda Knox arranged supplies at no cost and is now working with Collins’ relatives on a mechanical ventilator. Dialysis was initiated to support insurance, Emory set in motion his application for Medicaid. a six-week stay in a closer, more experienced personal care to see if Medicaid/Medicare will agree to let her stay in the his kidneys. Dry gangrene began spreading across his arms In the meantime, the hospital wrote off more than $770,000 home.

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