2019 ANNUAL REPORT
Tuba City Regional Health Care Corporation
Annual Report 2019
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Tuba City Regional Health Care Corporation TCRHCC CEO MESSAGE
Successful Transitions & Partnerships in Tribal Self Determination in Healthcare
Our organization, through the past and established throughout this past fiscal year, has endured many year. TCRHCC has been tested and changes. Our staff is to be commended surveyed to assure we are meeting for the completed projects, on-going professional accreditation standards transitions and their remarkable while working through internal resilience. We received the Title outcomes as a result of delivery model V Reauthorization from our tribal change and prioritizing safety for our oversight, the Navajo Nation Council, patients. In the end our staff remains for 15 years, renewed our funding resilient to upholding our mission and vision for our community and the health of future generations to come.
Safety (Safe) TCRHCC continues to improve the efficiencies of our Electronic Health Record (EHR). Our Information Technology Governance structure has become more formalized to assure safe oversight of our EHR system. Staff has improved their use of the agreement compact for five years with EHR and has made many successful Indian Health Services, and received adaptations to the use of our electronic all full accreditation through the Joint documentation. Downtime procedures Commission for three years, and was have improved, as well as the successful with Health Resources assurance that workflows are assessed Service Administration (HRSA) for our when EHR usage and documentation Mobile Van Program for three years. must occur. One of our last hurdles This past fiscal year (FY) has been a is that we continue to prioritize data year of affirmation and validation of aggregation and analytics. This will be the enormous responsibility Tuba City placed as a high priority for FY20. Regional Health Care Corporation (TCRHCC) is accountable for in our Access to Care community. Challenges continue for the grand scheme of health care with continued TCRHCC must continuously adapt to shortages in healthcare professionals trends and threats to the sustainability at all levels. While we worry about of healthcare delivery. New endeavors, day to day operations we must also leader transitions and emerging strategically plan for the future, with technologies have been implemented succession plans and educating future 4 TCRHCC CEO MESSAGE
generations. Our northern service area: and a chance for cure; the majority of LeChee, Bodaway/Gap, Coppermine other Americans in the United States and Kaibeto struggle with access have access to this. to primary care. The recruitment of providers has been difficult but ongoing. Quality The grand opening of our Sacred Our ambulatory outpatient care team Peaks Health Clinic will help centralize has worked diligently to improve patient our operations in Flagstaff and for this care through the implementation of community. the Patient Centered Medical Home (PCMH). Components of the PCMH have spurred us to develop the Call Center. This will improve access to services to guarantee information is provided in a timely manner and calls are addressed expediently. The completion of integrating the Arizona Health Information Exchange (HIE) is underway, this component also meets the criteria for PCMH. As I type, we are training staff to assist our physicians and mid-level providers to deliver more informed care within our system via access to the HIE.
Our Customer Service program addresses issues with our own staff resources and is engaged in improving care to our community, as seen from the eyes of the front-line staff. The PEERS Awards are an excellent way for fellow staff to show their appreciation and recognition for one another for the excellent care and work TCRHCC assesses the needs of our that is done daily. Another idea from communities and this past FY we this program was the creation of the have been able to offer Hematology/ Squash Blossom Award. We now have Oncology services to our local four types of peer recognition awards community. This has been a huge that recognize outstanding employee endeavor! The teamwork of our staff performance: PEERS, Daisy Award, was able to make this happen. The Squash Blossom, and Tom Drouhard intensity and urgency of care needed Award. for cancer has long been unaddressed. This service may bring hope for survival 5 TCRHCC CEO MESSAGE
The Journey to Excellence Customer reimbursement, data analytics, Service Program is lead by the improvement, efficiency and following teams: governance. TCRHCC is in constant transformation and transition; • Champions for Change such as in, technology: electronic • Leadership Academy documentation and billing which • Dream Team requires on-going staff training and education. So much of what we do • Team Xtreme requires communication, problem • Retention Rangers solving and critical thinking skills. • Steering Committee
Culturally Sensitive This past year our Office of Cultural and Language Preservation program We work with other PL 93-638 moved into full operation. The focus Healthcare Organizations, Association is to assure that Navajo Medical of Indians for Self Determination in Interpreters are available to healthcare Health (638 Association), to share best personnel in our healthcare service practices and knowledge to improve areas. how we deliver care culturally and respectfully, while adapting to an ever Transition and Partnerships changing national and tribal health care Healthcare delivery is in continuous delivery system. transformation in delivery,
6 TCRHCC CEO MESSAGE
Our Navajo Nation tribal oversight FY2019-21 System Priorities committee, Health Education Human Our health system’s FY2019- Services Committee (HEHSC) and 21 organizational priorities cover Navajo Nation Department of Health many strategic areas. To remain Executive Director have transitioned a sustainable healthcare delivery this past year with new committee system, we address: Financial, Quality, members and director. We share Information Technology, and Service with them our concerns and educate initiatives on a yearly and five-year on the complexity of our systems at projection of need. The four pillars many levels. HEHSC has a great addressed in our Strategic Plan responsibility in that they must consider establish a foundation for our staff to the Social Determinants of Health assess and implement goals to carry challenges that our communities out our Mission and Vision. encounter at all levels. In Conclusion: TCRHCC partners with many advocacy Our strongest attribute at our organizations. We have established the organization is our human capital, Navajo Hopi Health Foundation, within at 1,044 staff strong, that possess a our own system, to address and assure strong commitment to the communities sustainability through philanthropic we serve to assure we are providing avenues. the high quality and culturally sensitive services. Our position as a healthcare delivery entity is to successfully meet the healthcare and wellness needs of those we serve and to address health disparities and educate to uphold our Vision to respect, heal and console.
The FY2020 budget and strategy is a work in progress, and our challenge is to continue to transform our healthcare delivery system to improve health for Our partnership with others such all patients who seek services within as Greyhills Academy High School, our system without the compassion and University of Arizona, Navajo dedication of all staff, this would be an Housing Authority, USDA, Veterans insurmountable task. Administration, Northern Arizona Healthcare, Dine College, all local Ahe’hee’ school systems and numerous other organizations help build upon Lynette Bonar, CEO TCRHCC’s mission and vision in improving the quality of life for all our communities. 7 SERVICE AREA MAP TCRHCC CAMPUSES
TCRHCC Service Unit Area Map
LeChee NAVAJO COUNTY NAVAJO COCONINO COUNTYCOCONINO
Inscription House
Shonto Coppermine Kaibeto
Tonalea Bodeway/Gap
Hopi Partition Land ToNaneesDiziToNanessDizi
Dinnebito Moenkopi
Coalmine Canyon
CameronLeChee NAVAJO COUNTY NAVAJO COCONINO COUNTYCOCONINO
Inscription House
Shonto Coppermine Kaibeto
Tonalea Bodeway/Gap
Hopi Partition Land ToNaneesDiziToNanessDizi
Dinnebito Moenkopi
TCRHCC Service Unit Area Coalmine Canyon Flagstaff Cameron Hopi Reservation
8
Flagstaff TCRHCC CAMPUSES
TCRHCC Service Unit Area Map
Tuba City Regional Health Care Corporation 167 N Main Street P.O. Box 600 Tuba City, AZ 86045
Call Center: 1-866-976-5941
Sacred Peaks Health Center 6300 N Highway 89 Flagstaff, AZ 86004 Call Center: 1-866-976-5941
LeChee Health Center 3 Miles South Coppermine Road (Located North of the LeChee Chapter House) LeChee, Arizona Call Center: 1-866-976-5941
Cameron Dental 466 US-89 (Located North of the Cameron Senior Center) Cameron, AZ 86020 Phone Line: (928) 213-8161
Kaibeto Creek Independent Living Center Kaibeto, AZ 86053 Call Center: 1-866-976-5941
9 USER POPULATION ANALYSIS
Patient Visits For Services
Same Day Appointment
Radiology
Public Health Nursing
Podiatry
Pediatrics (Flagstaff)
Pediatrics
Pediatric Dentistry
Orthopedics
Optometry (Flagstaff)
Optometry
Mental Health
Laboratory
Internal Medicine (Flagstaff)
Internal Medicine
Gynecology
General Surgery
Family Medicine (Flagstaff)
Family Medicine (LeChee)
Family Medicine (TCRHCC)
Ears, Nose & Throat Clinic
Emergency Medicine
Dental
Listed top 22 Clinics out of 82. 0 2,000 4,000 6,000 8,000 10,000 12,000 14,000 16,000
10 WHO WE SERVE
Patient Gender Active Patient Age Distribution
17% 30% 45% 55% 25% 28%
0 –17 years 18 – 39 years
Male Female 40 – 59 years 60 & older
Active Patients (By Tribe)
Navajo Tribe of AZ, NM, and UT 85%
Hopi Tribe 9%
Other Tribe 4%
Non-Native 1%
0 % 20 % 40 % 60 % 80 % 100 %
11 ACTIVE PATIENTS BY TRIBE
• ABSENTEE SHAWNEE TRIBE OF • CROW TRIBE OF MONTANA OKLAHOMA • DELAWARE TRIBE OF WESTERN • ACOMA PUEBLO OKLAHOMA • AK-CHIN INDIAN COMMUNITY • DIEGUENO MIS IND, CAPITAN GRANDE • ALASKAN NATIVES • FT INDEPENDENCE IND COM PAIUTE I • APACHE • FT MCDOWELL MOHAVE-APACHE IND CO • APACHE TRIBE OF OKLAHOMA • FT MOJAVE INDIAN TRIBE, AZ • APACHE, MESCALERO TRIBE, NM • GILA RIVER PIMA MARICOPA IND COM • ARAPAHO TRIBE, WIND RIVER RES. W • GRAND TRAVERSE BAND OTTAWA & CHI • ARIKARA-3 AFF TRB FT BERTHOLD RE • GROS VENTRE (HIDATSA, MINITARI) • ASSINBOINE & SIOUX TRIBE, FT PEC • GROS VENTRE, FT BELKNAP IND RES, • ASSINIBOINE • GROS VENTRE-3 AFF TRB FT BERTHOL • BLACKFEET TRIBE RESERVATION, MT • HANNAVILLE IND COM WI POTAWATOMI • CADDO TRIBE INDIAN OF OK • HAVASUPAI TRIBE RES., AZ • CAHUILLA • HO-CHUNK NATION • CATAWBA TRIBE OF SOUTH CAROLINA • HOPI TRIBE OF ARIZONA • CHEMEHUEVI TRIBE RES., CA • HOPLAND BAND POMO INDIAND, CA • CHEROKEE INDIANS, EASTERN BAND • HUALAPI TRIBE RESERVATION, AZ • CHEROKEE NATION OF OKLAHOMA • INAJA BAND OF COSMIT MISS IND, R • CHEROKEE-SHAWNEE DUAL • INDIAN NON-TRIBAL MEMBER ENROLLMENT • IOWA TRIBE OF KANSAS AND NEBRASK • CHEYENE-ARAPAHO TRIBES OF • IOWA TRIBE OF OKLAHOMA OKLAHOMA • ISLETA PUEBLO, NM • CHICKASAW NATION OF OKLAHOMA • JEMEZ PUEBLO, NM • CHIPPEWA (OBJIBWAY) • KAIBAB BAND OF PAIUTE INDIANS, R • CHIPPEWA TRIBE OF MN, FOND DU LA • KICKAPOO TRIBE OF IND., RES., KS • CHIPPEWA TRIBE OF MN, LEECH LAKE • KIOWA INDIAN TRIBE OF OKLAHOMA • CHIPPEWA, LAKE SUPERIOR, BAD RVR • KLAMATH INDIAN TRIBE OF OREGON • CHIPPEWA-CREE IND. ROCK BOY RES. • LAC COURTE OREILLES BAND RES., W • CHOCTAW NATION OF OKLAHOMA • LAGUNA PUEBLO, NM • CO RIVER IND. TRIBES RES., AZ AN • LOWER ELWHA TRIBAL COMM, RES., W • COCHITI PUEBLO, NM • LUMMI TRIBE RESERVATION, WA • COCOPAH TRIBE OF ARIZONA • MANCHESTER BAND OF POMO IND., CA • COMANCHE INDIAN TRIBE OF OKLAHOM • MIAMI TRIBE OF OKLAHOMA • CONF TRIBE OF CHEHALIS RES., WA • MISS. BAND OF CHOCTAW IND., MS • CONF. TRIBE OF GOSHUTE RES., NV • NAMBE PUEBLO, NM • CONF. TRIBE OF GRAND RONDE COMM. • NARRAGANSETT INDIAN TRIBE, RHODE • CONF. TRIBE OF WARM SPRINGS, RES • NATIVE VILLAGE OF UNGA • COUSHATTA TRIBE OF LOUISIANA • NAVAJO TRIBE OF AZ, NM AND UT • CREEK NATION OF OKLAHOMA • NEZ PERCE TRIBE OF IDAHO, RESERV
12 ACTIVE PATIENTS BY TRIBE
• NOMELACKI • SENECA NATION OF NEW YORK • NORTHERN CHEYENNE TRIBE, RES., M • SHAWNEE TRIBE, OK • OGLALA SOUIX TRIBE, PINE RIDGE R • SHOSHONE • OMAHA TRIBE OF NEBRASKA • SHOSHONE DUCKWATER TRIBE, NV • ONEIDA NATION OF NEW YORK • SHOSHONE TRIBE WIND RIVER RES., • ONONDAGA NATION OF NEW YORK • SHOSHONE-BANNOCK TRIBE RES., ID • OSAGE TRIBE OF OKLAHOMA • SHOSHONE-PAIUTE TRIBE DUCK VALLE • OTOE-MISSOURIA TRIBE OF OKLAHOMA • SIOUX, CHEYENNE RIVER TRIBE • PAIUTE • SIOUX, CROW CREEK TRIBE, SD • PAIUTE INDIAN COLONY, BURNS, OR • SISSETON WAHPETON OYATE, SD • PAIUTE INDIAN TRIBE OF UTAH • SKULL VALLEY BAND OF GOSHUTE IND • PAIUTE SHOSHONE BG PINE BAND OWE • SOUTHERN UTE TRIBE RESERVATION, • PASCUA YAQUI (UNENROLLED) • SPIRIT LAKE SIOUX TRIBE, ND • PASCUA YAQUI TRIBE OF ARIZONA • ST. REGIS BAND MOHAWK INDIANS OF • PAWNEE INDIAN TRIBE OF OKLAHOMA • STANDING ROCK SIOUX TRIBE RES ND • PEORIA TRIBE OF OKLAHOMA • TAOS PUEBLO, NM • PICURIS PUEBLO, NM • TE-MOAK BANDS WESTERN SHOSHONE I • PIMA • THREE AFFILIATED TRIBES OF FT BE • POMO & PIT RVR IND, BG VAL RANCH • TLINGIT • PONCA TRIBE OF INDIANS OKLAHOMA • TOHONO O ODHAM NATION OF ARIZONA • POTAWATOMI IND TRIBE, CITIZEN BA • TURTLE MTN. BAND CHIPPEWA IND RE • POTAWATOMIE • TUSCARORA NATION OF NEW YORK • PUYALLUP TRIBE RES. WA • UNITED KEETOOWAH BAND CHEROKEE I • QAWALANGIN TRIBE OF UNALASKA • UTE INDIAN TRIBE, UINTAH, OURAY • QUECHAN TRIBE OF FORT YUMA IND, • UTE MOUNTAIN TRIBE, RES., CO, NM • RED CLIFF BAND OF LAKE SUPERIOR, • WAILAKI • ROSEBUD SIOUX TRIBE RES., SD • WHITE MOUNTAIN APACHE TRIBE RES. • SAC AND FOX TRIBE OF INDIANS OF • WICHITA INDIAN TRIBE OF OKLAHOMA • SALISH & KOOTENAI, CONF. OF MT • YAKAMA IND, CONF TRIBE & BAND, W • SALT RIVER PIMA-MARICOPA IND COM • YANKTON SIOUX TRIBE OF SOUTH DAK • SAN CARLOS APACHE TRIBE RESERVAT • YAVAPAI-APACHE IND COM CAMP VERD • SAN FELIPE PUEBLO, NM • YAVAPAI-PRESCOTT TRIBE RESERVATION • SAN JUAN OF WASHINGTON • YUROK TRIBE HOOPA VALLEY RES., C • SAN JUAN PUEBLO, NM • ZIA PUEBLO, NM • SANTA ANA PUEBLO, NM • ZUNI TRIBE RESERVATION, NM • SANTA YNEZ BAND CHUMASH MIS IND, • SANTEE SIOUX NATION, NE • SANTO DOMINGO PUEBLO, NM • SAULT STE MARIE CHIPPEWA, MI • SEMINOLE TRIBE OF FL, DANIA, RES
13 USER POPULATION ANALYSIS
Insurance Coverage Medical Billing Revenue Distribution 8% 1% 22% 6% 49%
26% 44% 43%
Private Insurance Revenue Private OTHER Medicaid Revenue IHS Non- Beneficiary Medicare Revenue Medicaid Tribal
Medicare VA
Uncollectable Contractual Allowance (EXCLUDING PHARMACY)
Net Patient Revenue 57% Uncollectable Contractual 43% Allowance
14 BILLABLE PATIENT VISITS
Inpatient and Outpatient Workload
INPATIENT FY FY FY FY 2002 2012 2017 2018
Hospital Discharges 3,458 2,951 2,370 2,370 Swing-Bed – 95 23 37 ACU/PEDS – 2,856 2,347 2,269
Inpatient Days 14,153 11,880 10,622 10,913
Average Daily Census 38.0 32.5 31.7 29.9
Newborns 512 454 444 457
Newborn Days 946 870 868 896
Total Inpatient Days 15,099 12,750 11,021 11,184
Discharges 3,970 3,405 2,791 2,791
ALOS 3.8 3.7 4.5 4.5
OUTPATIENT FY FY FY FY 2002 2012 2017 2018
Total Outpatient Visits 145,035 720,708 664,533 600,115
Tuba City Regional Health – – 401,702 336,157
Sacred Peaks Health Center – – 98,696 94,838
LeChee Health Facility – – 163,387 168,409
Observations – 519 748 711
GRAND TOTAL FY FY FY FY GrandUTILIZATION Total 2002 2012 2017 2018
Inpatient Days & Outpatient Visits 160,134 733,458 667,324 602,906
NOTE: BPV (Billable Patient Visits) = Reimbursable Patient Visits Counted per AHCCCS/OMB
Rev. 10/22/19
15 NUM HE B T ER Y S B
2018 TCHEALTH.ORG
ntered into a Tri al Self-Governance ealth Care System in 2002
10 0 mployees Specialty Clinics Beds Satellite Clinics
Cameron ental 00,11 H LeChee ealth Facility utpatient isits Sacred Pea s ealth Center Across All Settin s in 201 , 1 , 2 Sur eries Total o ile Performed in 201 ealth isits o ile edical ental Unit , mer ency visits in 201 to our 1 ,0 Level III Trauma Center ental Patient isit
10,91 , 0 Inpatient days adiolo y in 201 Patient isit in 201
Providin ealth Care Services to eet the emand of an ver Gro in ative American Population
16 UNWAIVERING COMMITMENT
Over the past few years, Tuba City Regional Health Care Corporation has received recognitions that support our unwavering commitment to being the best community healthcare system on the Navajo Nation. Below is a list of some of the recognitions that help us measure the quality of care we provide our patients every day.
Designated as a Level III Trauma Center by the American College of Surgeons AMERICAN COLLEGE OF SURGEONS Tuba City Regional Health Care is the first and only Veri ed Trauma Center hospital on the Navajo Nation – and one of just eight total organizations – in Arizona designated as a Level III Trauma Centers.
Health Leadership Award for
TC CC is a Tobacco-Free Campus Policy Smoke-Free Facility Tuba City Regional Health Care is a smoke-free Tobacco products at TCRHCC is prohibited. environment, both indoors and outdoors. It is an important step toward patients, visitors, and staff to ensure a safe and healthy environment.
Level II The Arizona Perinatal Trust Accreditations Perinatal Arizona Care Tuba City Regional Health Care Obstetrics Unit Perinatal Trust and Nursery is one of 41 Perinatal Care Centers in Accreditations Arizona, and the only Level II Perinatal Care north of Flagstaff and on the Navajo Nation.
Baby Friendly Hospital Certified Tuba City is one of five designated facilities in the esi nated as a Baby-Friendly USA State of Arizona. The gold standard of care
17 TCRHCC MISSION & VISION
Mission Our Mission is to provide safe, accessible, quality and culturally sensitive healthcare.
Vision Our Vision is embracing healthy living to heal, to respect, to console.
Values We take pride, and honor the dignity in all individuals. We promise to uphold a safe environment dedicated to quality and a vision of excellence for today and tomorrow.
2019-2020 Organizational Advocacy • CMS/AHCCCS Tribal Consultation • Tribal Health Partnerships • Broadband • Public Safety • Correctional Health • Elder Care • PL 93-638 Self Determination • Affordable Housing & Social Determinants of Health • Behavioral/Substance Abuse Inpatient Rehabilitation Center
18 GOLD SEAL OF APPROVAL
Gold Standard in Health Care Tuba City Regional Health Care Corporation is a Joint Commission- accredited hospital recognized for continually assessing and improving key areas of safety in patient care. The accreditation is considered the gold standard in health care. The Joint Commission Gold Seal of Approval™ is an internationally recognized symbol of quality.
Tuba City Regional Health Care Corporation has earned The Joint Commission’s Gold of Seal of Approval for: • Hospital Accreditation • Laboratory • Home Care
19 TCRHCC Organizational Priorities
FY 2020-22 Capital Priorities
1. Health Access Expansion Projects
a. Le Chee Rehabilitative/Health Promotion
b. Bodaway/Gap Health Clinic
c. Joint Venture I.H.S.
2. Long Term Care Construction Funding
3. TCRHCC Facilities Laundry
4. Planning Main Hospital Renovations
5. Storage Center
6. Behavioral Health Services
7. Mental Health expansion
8. Enhance Population Health Infrastructure
a. Patient Centered Medical Home
9. Partnerships:
a. Association Indians for Self Determination in Healthcare
b. Specialty and Tertiary Providers
c. Tribal Public Health Programs
20 TCRHCC Organizational Priorities
FY 2020-22 Operational New & Ongoing Priorities
1. Throughput Priorities- Pre-Op Clinic, Discharge Lounge, and
Step Down Telemetry Unit
2. Customer Service Program Initiatives
3. Leadership Academy Training
4. Succession Planning- Healthcare Leadership Development
5. Employee Engagement
6. Reinforcing a Culture of Safety Initiative
7. Enhance Information Services (Patient Portal & Data Analytics)
8. Patient Centered Medical Home Accreditation
9. Advocate with Educational Institutions for Staff
a. Health Science Programs
b. Staff development, i.e., Certified Medical Assistants,
Pharmacy Technicians, Coders
10. Establish Productivity Standards in all Service Lines
11. Geriatric Service
21 SENIOR LEADERSHIP COMMITTEE
• Lynette Bonar, Chief Executive Officer • Julius Young II, Chief Support Services Officer • Mildred Garcia, Chief Ancillary Officer • William Dey, Chief Quality Officer • Judy Lunbery, Chief Nursing Officer • Sharr Yazzie, Director of Human Resource • Christine Keyonnie, Chief Financial Officer • Dollie Smallcanyon, Chief Community Health Services Officer • Joette Walters, Chief Operating Officer • Shawn Davis, Chief Information Officer • Dr. Robert Sorrentino, Chief Medical Officer • Vanessa Lee, Executive Assistant • Dr. Katherine Glaser, Chief of Staff • Dr. Kathryn Magee, Chief of Family Medicine
22 BOARD OF DIRECTORS
• Christopher Curley, President, Tonalea Chapter • Tincer Nez, Sr., Vice President, Coalmine Canyon Chapter • Kimberlee Williams, Member, Kaibeto Chapter • Dolly Lane, Member, Bodaway/Gap Chapter • Thomas McCabe, Member, Cameron Chapter • Justice M. Beard, Member, Tuba City Chapter • Leila McCabe, Member, Coppermine Chapter • Carmelita Homer, Member, San Juan Southern Paiute
23 Tuba City Regional Health Care Meth & Suicide Prevention Initiative (MSPI) #BeThe1To…
Warning Signs of Suicide #BeThe1To... Most people exhibit one or more warning signs either through what they say or what • ASK they do. • KEEP THEM SAFE Mood Change: • BE THERE • Depression • Anxiety • HELP THEM CONNECT • Loss of Interest • Humiliation/Shame • FOLLOW UP Behavior Change: • Withdrawing from family If your struggling, call & friends 1-800-273-TALK (8255) • Increased use of alcohol and/or drugs • Giving away prized possessions • Isolation
Talk Change: • Have no reason to live • Being a burden to others • Unbearable pain • Feeling hopeless 1-866-976-5941 • tchealth.org
24 Patient Call Center Patient Call Center We are pleased to announce the upcoming opening of our Patient Call Center! Our skilled Call Center Representatives will be happy to serve you in an efficient, friendly, and timely manner.
Along with making it easier to contact our To better serve you, the call center will offices, this new system will provide you handle the following requests for you: the following benefits: PAppointments > Dedicated quality assurance staff PScheduling > Expedited response and reduced time on the phone PCancellation > Phone lines are open for extended PRescheduling hours Pre-visit Registration > Reaching across departments with a P single contact PEfficient Call Transfers > Improved patient experience PAnd So Much More!
To speak to a Call Center Representative call 1-866-976-5941
25 Kaibeto Creek Independent Living Center providing safe, secure home to many seniors
TUBA CITY, Ariz. — It’s been Tenants and their nearly four years since the Kaibeto families are enjoying Creek Independent Living Center the property. opened and it is certainly living up to its expectations of providing One tenant, Polly seniors a place to live longer, Fowler, 87, has been healthier and happier lives through living at the center for housing that accommodates their several months now lifestyles. and she said she likes living there because it The living center was made is local for her. possible through a partnership between Tuba City Regional Fowler said she is Health Care Corp., Navajo Housing originally from Kaibeto Authority and the Foundation for and she raised her family there. Senior Living. Her clans are Tl’izilani (Many Goats Clan), born for Kinyaa’aanii The 7-acre campus, which is (Towering House People), her located in Kaibeto, Arizona, offers paternal grandfather’s clan is apartment-type homes with one Tódích’íi’nii (Bitter Water Clan) and two bedroom floor plans, and she does not remember her fully-equipped kitchens, quality paternal grandfather’s clan. wood cabinetry and flooring, large closets, individually-controlled She remembers Kaibeto as a thermostats, washer and dryer simple community and recalls the hookups, walkout patios and suite- time when only a few homesteads style bedrooms to accommodate scattered the red landscape. guests at a safe and secure She said she herded sheep location. throughout the area as a child
26 and watered them in the nearby She said many of her children and creek. Her family raised cattle and grandchildren work and so they visit other livestock as well and they her when they can. Her children roamed the area where the current take turns watching her at the independent living center is located. center because they either need to return to work or need to take a She spends most of her days at break. home and takes it easy, often going outside to enjoy the outdoors. Polly moved into the center about When she is not enjoying her view two months ago. Before that, of the mesas and landscape, she she lived in her home that had is watching old western movies on running water and electricity, but DVDs that she has collected over her daughter Gwen Fowler, who the years or DVDs her family brings was visiting from Virginia, said she her when they come to visit her. could no longer care for herself and
27 so they decided to move her to the Gwen likes the accommodations of center after her dementia caused her the apartments and the open floor to wonder off from home. plan, especially the large kitchen where they cook her mother’s meals. “From that point, the family decided to put her into [this] facility that is safer “This is a really safe place for her and enclosed, and someone had to now,” she said. “It’s wide and roomy. stay with her 24 hours,” said Gwen. In the other house, her bedroom “She got hurt another time and fell, was so small, her shower was also and got a fracture a couple of years small and it was not the size of the ago. It was [then] recommended that bathroom here at this facility. The she go to a nursing home or a care handicap shower is a big benefit facility.” here, as well as the wide door ways.”
Gwen said the facility in Kaibeto is Gwen recommended an extra pull up very convenient because her mother support rail in the bathroom to help enjoys visits from her family opposed when getting off the toilet. She also to having her mother live in a facility suggested a screen door installation far from home and away from her for the front door so that they could family. open it during the day to allow fresh air flow. “It is very helpful to have such a facility in Kaibeto, it saves a lot of “It’s really pretty in the early mornings heartache for the elderlies,” she said. and evenings here and a screen door would be perfect,” she said.
28 Gwen also said that her mom likes to Kerley also likes the center but said plant and so she also recommended he is often lonely because he is an area for planting. far from home and his people. His relatives do not visit as often as he “She likes to garden. It’s toward the would like them to but he occasionally end of the season, so the only thing makes a trip back to Gray Mountain you can really plant now is probably thanks to transportation provided by pumpkins,” she said. “And maybe Assist To Independence in Tuba City. add some trees in the middle area of the complex where they can garden He said he came to the center and sit outside.” because his home was deemed unsafe and he did not have the “She’s doing good here,” said Gwen infrastructure needed to sustain him. as she pointed out several pictures on the wall of when her mom was “This facility is a lot better than where younger. “I know she’s happy to be I was living,” he said “Where I lived, here—it’s safe for her.” it did not have running water or electricity, or even inside commodes Just a few doors down in the or stuff like that. I had to use an next building is Steven Kerley, a outhouse.” 68-year-old Army veteran from Gray Mountain, just south of Cameron, Kerley explained that he now has Arizona. Kerley’s clan is Naakaii access to running water, electricity Dine’é (Mexican Clan), born for the and all the modern amenities, and Tsi’naajínii (Black-Streaked-Wood he also has enough room for his People). wheelchair.
29 Kerley has been at the center since old western movies on DVDs but he May 2019. A caretaker often visits wishes that he had cable or satellite him during the day to help him with T.V. He recently visited his brother cooking, cleaning and whatever else who sent him home with a bunch of he may need help with. western movies that he was excited about. He also loves to read books, Although he likes the center, he plans mainly western books by Louis L to return back to his home after it ’Amour and Tony Hillerman. is repaired and renovated. He said a recent storm and tornado caused For now, Kerley and the many damage to his home and ripped part residents call Kaibeto Creek of his roof off. Independent Living Center “home” because it provides them a safe and “I miss my family and I know they secure place to live and enjoy their miss me too,” he said. “They’ve been time. calling me asking when I’m going to come back. I just tell them, whenever I get a ride—I’m sort of homesick.”
As a distraction from homesickness, he occupies his time by watching his
30 31 GET SCREENED FOR Breast CANCER DETECT IT TREAT IT DEFEAT IT The first 100 mammography patients who gets their mammogram completed will receive a black laundry bag with our pink logo, a 2020 pocket calendar and pen, remember this is while supplies last.
Mammography Department Tuba City Regional Health Care tchealth.org • 1-866-976-5941
32 Specialty Care Center, Cancer Center running as expected
TUBA CITY, Ariz. — The Specialty cancer treatment. Cancer has Care Center at Tuba City Regional become the leading cause of Health Care Corporation (TCRHCC) premature death among American is meeting its expectations by Indians and Alaskan Natives providing cancer patients with the according to the National Center for care they need closer to home. Health Statistics.
As of August 30, 2019, it’s been Within our service area, the most more than three months since the prevalent cancers are breast cancer opening of the first-ever cancer for women and prostate cancer center on an American Indian for men, and for both genders it is reservation, which marked a major colon cancer. advancement in cancer care for American Indians living within the Dr. Frank Dalichow, one of two service area of TCRHCC. board certified hematologists and medical oncologists, explained that The culturally-adapted cancer the center is running great. center fills a gap in cancer “At this point, we’re seeing all treatment on the Navajo Nation the patients within the Tuba City which previously required patients service area. So, we’re limiting our to travel hundreds of miles off the numbers to try and get a sense of reservation and spend hundreds how many patients are out there of dollars for travel costs to receive and what the need is,” he said. treatment. The closest cancer “And once we have been in full treatment facility is in Flagstaff and operation for several months, we in the Phoenix metro-area. plan to expand our services to Although the Indian Health Service include the entire western Navajo is responsible for providing health Nation, which would include care to federally recognized tribal Kayenta, Inscription House and the members, it does not provide Winslow service areas.” 33 He said the center is in full operation and patients can receive all services that they are receiving in other areas like Flagstaff except radiation oncology, which patients still have to travel to Flagstaff for.
Dr. Johanna DiMento, the other hematologist and medical oncologist, said the number of patient referrals is increasing quickly by the day since they saw their first patient May 14.
“It’s like an exponential increase, meaning one day, [we] may have one referral, the next day two, the next day three,” she said.
She said the word is getting out there that a cancer center exists now in Tuba City. Some people are now calling to inquire about the services and asking if they can have their care here instead of traveling off-reservation.
She explained the types of people said yes, you can get your chemo who are really benefiting are the here,” she said. “And he just started ones that just walk into the clinic his chemo yesterday.” out of curiosity and ask if it is a cancer center. Many patients She said one of the biggest explain that they were told they had benefits of working in Tuba City is to drive all the way to Flagstaff to being able to communicate with a get chemotherapy and ask if they patient’s primary care doctor and can get chemotherapy in Tuba City with their surgeon face-to-face. instead. “When they [primary care doctors] “In fact, one of those gentlemen see someone who was diagnosed was just about ready to start with cancer and is still driving to chemotherapy for colon cancer. He Flagstaff for follow-up care, they walked in about three weeks ago send them to us,” she said. “We and saw Frank [Dalichow] and [he] can do all that right here. I’m just
34 very, very excited that we are able who live and work and pray here,” to give people care who live right he said. “And we provide local here in town.” hematology and oncology care so that patients don’t have to travel Follow-up to cancer care is long distances off the reservation to vitally important. When patients get that care. We’re open and we’re receive chemotherapy in the here to help as much as we can last year or five years ago, the with everybody.” cancer care should not stop when chemotherapy stops. The center also provides assistance to coordinate care when patients “They still need follow-up care have no choice but to seek care for survivorship issues,” said Dr. off the reservation by establishing DiMento. “We have to watch them direct communication with the off- very carefully because they had reservation doctors and facilities. cancer and because they had chemo or they had radiation. So “Even though our patients may we know what things could happen not physically be here, we are down the road—so we have to continuing to follow them very watch out for them.” closely through their treatments,” he said. “[We] are ready and able Dr. Dalichow said they are here to to assume their care once they’re help people. finished with their treatment.” “We’re part of the community here and we live here, we work here and we take care of the patients
35 Sacred Peaks Health Center celebrates grand opening of new location in Flagstaff
FLAGSTAFF, Ariz. — Tuba City Bonar said the event marks an Regional Health Care Corp. important milestone and partnership celebrated the grand opening of with the City of Flagstaff. the brand-new 24,000-square-foot Sacred Peaks Health Center Sept. “We appreciate their partnership 6 at its new location at 6300 N. and we hope this establishes many Highway 89 in Flagstaff. things for the community because we have a large Native American Lynette Bonar, chief executive officer community here and we definitely of the Tuba City Regional Health want to keep solidifying that as we Care Corp. (TCRHCC), said she was go forward,” she said to Flagstaff very happy and has been looking City Council members Regina Salas, forward to this great opportunity to Charlie Odegaard and Jamie Whelan finally open the new state-of-the-art who were in attendance. “We have a facility. lot to offer to make our communities better.” “Our vision started on this clinic in 2009 and 2010,” she said. “We Justice M. Beard, chair of the Navajo are happy about what we have Hopi Health Foundation and member done. Sustainability is our issue of the board of directors of TCRHCC, and that is what we want to do—to also expressed his gratitude and keep improving health care for our excitement for the opening of the new communities.” facility. 36 “I really like the building!” he said. “A lot of work went behind this [project] and a lot of planning. I really appreciate all the efforts [and] the support we got from the community.”
He explained they identified a gap between patients seeing their primary care physicians and a dire need for medical services and treatment in the Flagstaff area for Native Americans. Because of this, they opened Sacred Peaks Health Care Center several years ago to meet the need. The demand was overwhelming which prompted the need for a new location to centralize services.
He said the new facility will serve as a catalyst for extending medical services and to it is sacred ground. We prayed over the growth of the communities they this ground. I knew this would be represent. a beautiful center. Great things will happen here. Congratulations to The growth of services could not everyone here that worked so hard.” have occurred without the help of people like Barbara Peters, the One hard worker that literally worked former executive director of the night and day to get the center open Navajo Hopi Health Foundation. She was Julius Young II, the chief support was instrumental in the creation of services officer at TCRHCC, who Sacred Peaks Health Care Center served as the project manager. and of others programs within the “As the project manager, it was my corporation. job to do two things, stay within “This is a dream come true,” she said. budget and stay on schedule—we “Everyone worked so hard tirelessly, accomplished both,” he explained. trying to make this happen and they “That was a big milestone. We made it happen. This ground here, completed the building in one year.” 37 Young said he enjoyed being part of the Bonar said there are so many people project and he thanked many people to thank for their help on behalf of and organizations for making the facility TCRHCC. She thanked the board of a reality. He also explained Flagstaff- directors of the Navajo Hopi Health based Loven Contracting served as the Foundation for their partnership; the general contractors that constructed board of directors for TCRHCC; Lena the building and Dekker/Perich/Sabatini Fowler, Coconino County Supervisor; of Phoenix were the architects that the City of Flagstaff; and the current designed the facility. and past leaders of the Navajo Nation and council for supporting self- The new location determination of health care. She also consolidates two thanked her hardworking staff. previous separate locations of the Sacred Sacred Peaks Health Center is a Peaks Health Center, non-emergency primary health care one location was on center with services provided by board- Route 66 and the other certified and culturally-competent on the far west side physicians and support staff. Services of Flagstaff. Patients include: primary care; family and and staff had to travel internal medicine; pediatric care; between both locations frequently and diabetes and nutritional services; eye this new facility now centralizes all care services; laboratory; obstetrics/ services under one roof. gynecology; mental health services; pharmacy services; physical and “We made history and we continue to occupational therapy; radiology and move forward as trailblazers in Tuba specialty services. City,” he added.
38 39 TCRHCC EVENTS
Mr. Jonathan Nez Navajo Nation President TCRHCC Specialty Care Center & HPDP/Community Counseling Center Grand Opening • January 11, 2019
Dr. Jager presenting to TCRHCC Marine JROTC December 2018
TCRHCC Specialty Care Center, Health Promotion & Diabetes Prevention, and Community Counseling Center Ribbon Cutting Ceremony Grand Opening • January 11, 2019 Nurses Week May 2019
40 Jill Biden Helps Launch TCRHCC Specialty Care Center Tuba City, AZ May 22, 2019
Community Health Improvement Program (CHIP) Cameron Trail Ribbon Cutting Cameron, AZ February 26, 2019
Dr. Jager presenting to TCRHCC Marine JROTC December 2018
PENN Medicine Site Visit January 29, 2019 Desiree Pelt-Nez, RN Daisy Award Winner September 5, 2019
Kaibeto Creek Independent Living Center (KCILC) Tenant Move-In Day February 26, 2019
41 TCRHCC EVENTS Sacred Peaks Health Center Grand Opening Day September 6, 2019 Flagstaff, Arizona
TCRHCC PEERS Award Winner June 10, 2019 Flagstaff, AZ
Lynette Bonar, CEO SPHC Grand Opening Day TCRHCC Office of Culture & Flagstaff, Arizona Language Resources 42 TCRHCC General Surgeons
TCRHCC Diabetes Treatment & Prevention Services Department
TCRHCC Bio-Medical Department Featured in TechNation Magazine TCRHCC Squash Blossom Awardees Tuba City, AZ • June 3, 2019 October 8, 2019 Tuba City, AZ 43 TCHEALTH.ORG