Ensuring the very best healthcare for our community.

Milford Regional Medical Center, Inc. 2013 Report to the Community This Annual Report is dedicated to the memory of Nancy Gannett, whose extraordinary contributions of time, energy and material resources, helped to make Milford Regional Medical Center the institution it is today.

Her spirit was – and will always be – an inspiration to our community. A Message from our Chief Executive Officer

Today there are very few things that we can really count on to last. healthcare, it could be easy to lose sight of the fundamental reason And a very small number of people we can expect to be there for us, we exist…to provide the very best healthcare to our patients. Milford day in and day out, when they are needed the most. However, since Regional’s rich history of service to our community has always been July 24,1903 at 2PM, when Eben Draper formally presented the land, built on this premise. building and furnishings that were to become Milford Hospital, our Thanks to the wonderful people in this community who provide community has been certain of one critical fact. We know that this the care, compassion, thoughtful leadership and medical expertise at institution, now Milford Regional Medical Center, will be there for Milford Regional, this has been our mission since the beginning and our families in times of sickness and wellness, caring and supporting it will continue to determine the course of our future. them through both difficult and joyous moments as lifelong partners

in healthcare from one generation to the next. Always, When the doors actually opened on September 1, 1903, residents could never have imagined a distant future filled with the advanced diagnostics, leading-edge technology and life-saving Francis M. Saba CEO, Milford Regional Medical Center, Inc. treatments provided by Milford Regional over a century later. Nor could they have fathomed the enormous complexities and challenges now facing the delivery of medical care today. By working together with our community, Milford Regional’s physicians, nurses, staff, volunteers and auxilians will enable our healthcare system to adapt to the requirements of healthcare reform that include new payment mechanisms and delivery models. This is an era in the history of healthcare where collaboration and teamwork will determine which systems will survive and prosper. A strong partnership between our community and Milford Regional has always been a hallmark of this outstanding institution. In this ever-changing world of

Philip J. Ciaramicoli Francis M. Saba Edward J. Kelly John J. Burns Mark C. Skiba, MD, PhD President, Tri-County CEO, Milford Regional President, Milford Regional Chairman, Milford Regional President, Medical Staff Medical Associates, Inc. Medical Center, Inc. Medical Center, Inc. Medical Center, Inc. Milford Regional Medical Center, Inc.

1 2 Quality

Quality is the foundation of everything we do at U.S. News & World Report ranked Milford Regional as a

Milford Regional Medical Center. This focus on quality Best Regional Hospital for the third consecutive year, adding us to has served both the community and the hospital well a list of just 732 hospitals out of 4800 nationwide to receive this for more than a century and has allowed our healthcare distinction. In addition, Milford Regional was ranked high perform- system to flourish. ing in geriatrics and pulmonology and scored high in patient safety,

demonstrating a commitment to reducing accidents and medical

Quality care. Quality technology. Quality leadership. This is not a mistakes. We also exceeded both the statewide and nationwide static condition. Milford Regional’s success has been shaped by average in patient satisfaction surveys. our commitment to continuous improvement and its impact on In 2013, Consumer Reports issued its second annual safety providing the highest quality of care to the community. Internally, rating issue – this time focusing on surgical safety – and Milford departments throughout the hospital demonstrated this in 2013 Regional ranked second out of 51 hospitals. through initiatives such as a hospital-wide endeavor to optimize The Leapfrog Group, an independent national nonprofit run patient flow for those admitted to Milford Regional. Through a by employers and other large purchasers of health benefits, also collaborative effort, Milford Regional streamlined operations and recognized Milford Regional in the fall of 2013 for achieving reduced patient wait times from the emergency department to a high level of safety. a patient room from 70% (waiting more than 2 hours) in 2010 to Still, while the careful analysis and systematic ranking of hospitals

23% in 2013. Another initiative involved a collaboration between by these prestigious organizations helps to highlight the success anesthesia and the endoscopy suite to provide patients with a choice of our quality initiatives at Milford Regional, the most important to have either heavy or moderate sedation. In both cases, quality indication of our success is through patient feedback. This comes in and patient satisfaction were the impetus that inspired these the form of patient satisfaction surveys, emails and letters we receive improvements. from patients and their families, as well as the continued Reader’s

Over the years, we have been repeatedly recognized Choice Awards that have been garnered not only for our hospital for these efforts; 2013 was no different. as a whole, but also for a number of our physicians in 2013.

“Excellence is a habit.” – Aristotle

3 Partnerships

A key component of providing quality care lies in always Our collaboration with UMass Memorial Medical Center (UMMC)

monitoring the needs of our community and identifying new dates back more than two decades and has provided the blueprint

partners that can help to enhance our offerings. One of the for bringing unique expertise closer to home. In 2013, this leader

hallmarks of our leadership team has been the ability to forge in bariatric surgery once again partnered with us as we opened

relationships with prestigious healthcare institutions that can The Center for Weight Loss Surgery at Milford Regional and

help us to deliver the quality care and institutional excellence launched FreshStart, an interdisciplinary weight loss program.

for which we continually strive. The depth of expertise provid- This collaboration allowed us to address a critical healthcare

ed by these partners right here in our community eliminates need in our community.

the need for our patients to travel far from home to access Over the past year, a team

world-class care. This is the true mission of a of Milford Regional nurse practitio-

community healthcare system. ners, dietitians, behavioral health

counselors and physical therapists

has worked together to guide

close to 100 patients through the

various stages of this very personal

Colleen Berg, MSN, DNP, NP-C, CBN, weight loss journey. The highly CPN, coordinator for The Center for Weight Loss Surgery, helps guide skilled UMMC bariatric surgeons, patients through their weight loss journey. performing surgery at Milford

Regional, have resulted in positive outcomes that have truly changed

the lives of many in our community for the better.

4 David Eckbold of Whitinsville enjoys a family outing having lost 40 pounds just five weeks after undergoing sleeve gast- Here is Janice Lavallee of Upton five months rectomy surgery, better known as vertical after having gastric bypass surgery at Milford sleeve. He chose surgery to improve his Regional. She dropped 70 pounds and went health for himself and his family. Since from a size 24 to 16! But most importantly, she then, David is off his diabetes and blood is off her blood pressure and diabetes medica- pressure medication. The future looks tions as well as her lung inhaler. She feels great, bright and his family couldn’t be happier. looks great and says she has so much energy she “doesn’t know what to do with herself!”

5 6 Partnerships

This year also marked a milestone in Milford Regional’s Milford Regional, as well as newborns in the Maternity Center, now partnership with Dana-Farber Cancer Institute and Brigham benefit from around-the-clock care provided by Children’s and Women’s Hospital as Dana-Farber/Brigham and Women’s pediatric hospitalists. Boston Children’s Hospital specialists in pediat-

Cancer Center at Milford Regional celebrated its five-year anniver- ric gastroenterology and general surgery are also offering specialty sary. Since opening in 2008, patient volume has more than doubled clinics at Milford Regional. In addition, future plans are underway in medical oncology with more than 78,000 exams and 56,853 for a partnership in our emergency department. infusions being performed over the past five years. In radiation On the behavioral healthcare front, Milford Regional oncology, total treatments have gone from 369 in 2009 to more and Riverside Community Care have enhanced their 17-year than 10,000 in 2013. collaboration by creating a formal division of behavioral medicine

In addition to becoming the facility of choice for hundreds of inside Milford Regional’s internal medicine department. Riverside cancer patients, the Cancer Center has achieved accreditation and psychiatrist David Horn, MD, is chief of the new division. This evolved recertification and added several physicians and new programs. partnership, which is overseen by Milford Regional Director of Care

Now patients are able to benefit from various second opinion and Management Ann Wilkins, provides the framework for a much more specialty clinics, as well as new tumor board conferences in thoracic, proactive approach to patient care. This new structure allows the breast, genitourinary, head and neck cancers. In addition, physicians behavioral health specialists to do far more than provide consultations now do hematology rounds in Milford. Key upgrades to equipment on a case-by-case basis, as they did in the past. The fully integrated and technology, and the launch of a prostate brachytherapy implant team can now anticipate patient challenges through programs like program, have resulted in better diagnostics and treatment for their Delirium Task Force, which is helping reduce confusion and men and women throughout the . Also, just five years after disorientation in older hospital patients. In another significant move, opening, we are now offering clinical trials in our community. they have instituted behavioral health rounds in the emergency

In 2013, Milford Regional forged a new partnership with department (ED). This additional health assessment is intended to

Boston Children’s Hospital to bring the expertise of one of the reduce chronic ED visits through more comprehensive care plans and nation’s top-ranked hospitals in pediatric care closer to those living to help identify and then address underlying emotional issues in in Metrowest and . Children admitted to a medical problem through resources in the community.

Above left: Dr. Huma Rana, a Dana-Farber geneticist, now sees patients once a month at Dana-Farber/Brigham and Women’s Cancer Center at Milford Regional. Above right: Dr. Jeanne McCoy, a Boston Children’s Hospital pediatric hospitalist, is now the director of inpatient pediatric services at Milford Regional. Pictured here with four-year-old Sami Sell. Bottom: The new division of behavioral medicine at Milford Regional created this past year with Riverside Community Care provides a much more comprehensive approach to behavioral care. Pictured left to right: Ann Wilkins, MSW, LICSW, CPUR, director of care management; Matthew Colonna III, LICSW, assistant director of Riverside Emergency Services; and Dr. David Horn, chief, division of behavioral medicine at Milford Regional.

7 Technology

Our community is dynamic, with evolving healthcare For several years, Milford Regional’s leadership has carefully

needs. It is our job as a quality healthcare system to always monitored the advent of robotic surgery, assessing if and when an

grow and adapt to meet these ever-changing challenges investment of both financial resources and the personal dedication

and opportunities. A key component in this quest is the of our surgeons would be required to embrace this advancement in

continuous identification and investment in new technology medical care. After very careful consideration, Milford Regional saw

that is integral to advancing the primary and specialty care the tipping point in 2013, and decided to introduce the da Vinci®

needs of our community through superior diagnostics Surgical System, a sophisticated robotic platform designed to expand

and treatment. the surgeon’s capabilities and offer patients a minimally invasive

option for major surgery.

Doctors Clough, DiGiovanni, Kumar, Michli, Cohen and

McNamee have undergone intensive training and have completed

more than 74 robotic-assisted surgeries in Milford, with new cases

being scheduled regularly. The benefits for our patients are impres-

sive coming in the form of shorter hospital stays, reduced pain,

lowered risk of infection, less blood clots, fewer transfusions, less

scarring, faster recovery and quicker return to normal activities.

While gynecology and urology were the first two specialties to offer

robotic surgery, it wasn’t long before Milford Regional became the

first hospital in Central Massachusetts to offer Single-Site™ da Vinci®

robotic-assisted gallbladder surgery. With young physicians graduat-

ing with a full orientation in robotic surgery, this investment positions

Milford Regional well for recruiting the best and brightest in

the future.

8 The introduction of robotic surgery at Milford Regional in 2013 was hugely successful because of our surgeons who invested their time and energy to become experts in this highly advanced technology. Pictured are several of our robotic surgeons who have taken mini- mally invasive surgery to a whole new level at Milford Regional. Right: Drs. Eddie Michli (seated) and Sanjaya Kumar, urologists Below left: Drs. Leonard DiGiovanni and Melissa Clough, obstetrician/gynecologists Below right: Dr. Philip Cohen, general surgery

9 The new Rehabilitation & Sports Medicine at Franklin opened its doors in September 2013.

Slated to open in 2015, Milford Regional’s new building expansion will include a new emergency department, intensive care unit and private patient rooms.

10 Growth

Growth in our programs, services, facilities and physician The new two-story structure will more than double the size of base is a natural extension of Milford Regional’s ongoing the current ED from 30 to 52 private treatment rooms; increase the commitment to always provide excellence to those we number of patient rooms in the ICU from 10 to 16 expanding their serve. In 2013, the expansion of our facilities and efforts to size to accommodate the latest technology; and add 24 private better serve the needs of a growing population continued patient rooms with the intent to convert all hospital patient to elevate the quality of healthcare for our patients today, rooms to private. tomorrow and into the future. With each expansion or new facility project, Milford Regional

works diligently to balance fiscal responsibility with patient needs New Franklin Rehabilitation Center and governmental compliance. We believe the design and develop- Rehabilitation & Sports Medicine at Franklin, a Milford Regional ment of this, our largest undertaking ever, will position the Medical satellite, opened a custom-built,10,000-square-foot facility in Forge Center well to meet the needs of patients for years to come. Park this summer. This tripled their space from their previous site Grants Address Patient Needs expanding services and access with 14 treatment rooms, a host of While building expansions provide the physical space required new equipment, a 3000-square-foot indoor sports simulation area to offer state-of-the-art medicine, a need for better access to physi- and an industrial conditioning area that provides rehab therapies cians, treatment and a smooth continuum of care also emerge as the specific to the physical requirements of certain jobs. community grows. Milford Regional received several grants this past Plans are also underway to construct a new building in year to address those needs. Whitinsville that will house Milford Regional’s Rehabilitation & Sports The Medical Center was awarded a $200,000 state grant to Medicine serving the Blackstone Valley. This new 23,600-square-foot help develop a physician referral relationship with the Edward M. facility, slated to open in September of 2014 at Osterman Commerce Kennedy Community Health Center for the one in five patients who Park, will also be home to Blackstone Valley Family Physicians, do not have access to primary care. Milford Regional also received a Blackstone Valley Obstetrics & Gynecology, as well as Milford six-month grant to fund a behavioral health nurse that will develop Regional’s radiology and laboratory services. patient care plans to better meet the needs of patients with behav-

Milford Regional Building Project ioral health issues. And lastly, the Medical Center won a $75,000

Milford Regional’s building expansion plans announced last year grant from the MA eHealth Institute (MEHi) to enhance patients’ that will include a new emergency department (ED), intensive care continuum of care by developing a secure electronic system for unit (ICU) and private patient rooms continued to move forward in transmitting patient discharge information to care partners

2013. The Medical Center expects to break ground on the $54 million in the community. project in early 2014, with completion slated by the end of 2015.

11 Physicians

One of the most important components

in any world-class healthcare institution

is always the expertise of the physicians.

Milford Regional is proud to recruit the best

Kerri Batra, MD Robert Canning, MD Philip Cohen, MD Michael Corradetti, MD Donald Czerniach, MD and brightest new physicians graduating Rheumatology General Surgery Bariatric & General Surgery Radiation Oncology Bariatric Surgery

today and attract seasoned professionals

with exceptional credentials in their

areas of specialty.

Salwa Fam, MD Jennifer Gartman, MD Maggie Ham, MD Suhrutha Holla, MD Sergio Korndörfer, MD Exceptional New Physicians Breast Surgery Family Medicine Gastroenterology Hospitalist Pediatric Psychiatry

Over the past year, Milford Regional welcomed

26 new physicians to its staff, expanding primary

care and deepening specialty care for residents

living in our community. In fact, this was the top Monica Krishnan, MD Benjamin Lieberman, MD Michelle McKenney, DO David Mooney, MD Timothy O’Donnell, MD Radiation Oncology Family Medicine Family Medicine General Surgery, Pediatrics Hospitalist year for recruitment in the history of Tri-County

Medical Associates (TCMA), Milford Regional’s

physician practice group.

Sean O’Neil, MD Itai Pashtan, MD Irina Pieleanu, MD Brian Regan, Sr., DO Munjed Salem, DPM Hospitalist Radiation Oncology Internal Medicine Pediatric Gastroenterology Podiatry

Daniel Schwartz, MD Amir Shaikh, MD Danielle Shaper, DPM Natalie Sinclair, MD Radiology Internal Medicine Podiatry Oncology/Hematology

Thanh-Nga Tran, MD Brittany Weber, MD Dermatology Obstetrics & Gynecology

12 Rheumatologist Kerri Batra, MD, (right) joined Bonnie Bidinger, MD, at their new Mendon location in 2013 to expand access to this much needed medical service.

Tri-County Medical Associates

In 2013, Tri-County Medical Associates, Milford Regional’s physician practice group, continued to serve our community through program and practice excellence.

Readers Choice Awards

Several TCMA physicians and practices won Readers Choice New Practices & Locations Awards from the Community Newspaper Company... Along with a record-breaking year in physician recruitment at Franklin Pediatrics & Adolescent Care was voted First Choice, TCMA that added a total of ten primary and specialty doctors to Gold Regional, which encompassed voters from 29 towns. their physician base, TCMA was also fortunate to acquire two excel- The following practices won Honorable Mention or First Choice lent practices in 2013, both entrusted to us by retiring physicians. in their areas: Bellingham Medical Associates, Franklin Family We welcome these new patients to our family and look forward Practice, Franklin Primary Care and Tri-County Internal Medicine. to caring for their healthcare needs. Physicians who received Honorable Mention or First Choice Pediatrician Sang K. Chung, MD, retired after 40 years of pedi- awards were: Dr. Colleen Murphy, Dr. Carrie Diramio, Dr. Reynold atric care to the community of Whitinsville. Dr. Jacques Benun, MD, Dahl, Dr. Erika Pommett, Dr. Fouad Aoude, Dr. Kathryn Cohan, formerly with Community Pediatrics of Milford, moved to care for Dr. Elena Smagina, Dr. Wendy Collins, Dr. Cheryl Hardenbrook, Dr. Chung’s patients and further develop the practice as Whitinsville Dr. Cindy Handler, Dr. Ann Rickert and Dr. Michael Pescatello. Pediatrics at 130 East Street in Whitinsville.

Tri-County Named to Harvard Pilgrim Family Medicine physician Merle F. MacNeil, MD, also retired Physician Group Honor Roll after practicing for 40 years in Whitinsville. TCMA now has the

TCMA was named to Harvard Pilgrim Health Care’s 2013 honor of caring for his 1700 former patients.

Physician Group Honor Roll, in recognition of an outstanding In addition, TCMA has expanded its specialty sites with commitment to high quality care. They were identified as a Rheumatology Associates opening at 2 Uxbridge Road in Mendon, top-performing group within participating provider practices, and Tri-County Obstetrics & Gynecology moving from the Woman’s based upon their performance ratings in providing care to Pavilion at Milford Regional Medical Center to a new office at adult and pediatric patients. 221 East Main Street in Milford.

13 Kate Burke, MD, emergency medicine physician and former medical director of the emergency department at Milford Regional, received the highest award given by the Massachusetts College of Emergency Physicians for exceptional contributions to the chapter and to emergency medicine.

14 Physicians

Physician Achievements Thanh-Nga Tran, MD, PhD, was recently recognized

Each year, members of our medical staff further their education, by the 2013 Dean’s Community Service Award sponsored by the receive notable accolades, help educate the next generation of HMS Office for Diversity, Inclusion and Community Partnership. physicians and receive recognition from those near and far... Monica Woodward, MD, received an academic promotion to Assistant Professor of Medicine at University of Massachusetts

Mary C. (Kate) Burke, MD, MHA, FACEP, received the Medical School.

Massachusetts College of Emergency Physicians’ (MACEP) Pinnacle 2013 Top Doctors Award, the highest award given to MACEP members who have Ten Milford Regional physicians were recognized by Castle made exceptional contributions to the chapter and to emergency Connolly Medical, Ltd. among the Top Doctors in America in 2013, medicine. Dr. Burke received this award for her ongoing dedication a distinction that is highlighted in publications such as U.S. News & to quality patient care, resident education, community service World Report, Boston magazine and Community Health Care Guide, and operational efficiency both at MIlford Regional’s emergency published by the Worcester Telegram & Gazette. Congratulations department, as well as in other emergency departments across to our Top Doctors for 2013... the state of Massachusetts.

Louis Kuchnir, MD, was re-elected President of the Scott Brownstein, MD Cardiology Michael Brunelli, MD Hand Surgery Massachusetts Academy of Dermatology. Frederick Curley, MD Pulmonology Walid Saber, MD, FACC, FSCAI, RPVI, passed the boards Stuart Dunbar, MD Pain Medicine for the American Board of Venous and Lymphatic Medicine and is Karen Jeng, MD Obstetrics & Gynecology now recognized as Diplomate of the American Board of Venous Kathryn Lee, MD Family Medicine Ciaran McNamee, MD Thoracic Surgery and Lymphatic Medicine. Richard Mulroy, Jr., MD Orthopedic Surgery William Tosches, MD, received an appreciation award Carl Schanbacher, MD Dermatology from the neurology department at University of Massachusetts William Shine, MD Cardiology

Medical School for contributions to teaching students.

15 Milford Regional Tri-County Medical Milford Regional Medical Center, Inc. Associates, Inc. Healthcare Foundation, Inc.

2013 Board of Trustees 2013 Board of Trustees 2013 Board of Trustees

OFFICERS OFFICERS Officers John J. Burns Frederick J. Curley, MD Robert L. Kilroy Chairman Co-Chairman Chairman Robert L. Kilroy Kevin P. Meehan David M. Price Vice Chairman Co-Chairman Vice Chairman Francis J. Larkin Philip J. Ciaramicoli Francis M. Saba Treasurer President President Warren S. Heller Edward J. Kelly Clerk Board Members Treasurer Francis M. Saba John J. Burns Jeanne P. Lynskey Chief Executive Officer William G. Burrill Assistant Treasurer Edward J. Kelly Jeffrey B. Hopkins, MD Louis L. Guerriere President Tina Robakiewicz, MD Clerk Monica Woodward, MD Jeanne P. Lynskey Martin S. Richman Chief Financial Officer Executive Director

Board Members Board Members Barbara A. Auger Vascen J. Bogigian Loriann N. Baranauskas Christina W. Brabazon Vascen J. Bogigian Mary C. Burke, MD William G. Burrill Stephanie Burns Steven G. Ellis William G. Burrill Harold D. Gould, Jr. Arthur G. Caputo Jeffrey B. Hopkins, MD Matthew C. Clark Patrick R. McSweeney, MD Anthony M. Consigli Kevin P. Meehan Robert P. DeVita John N. Pandiscio, MD Paul Fitzgerald Delia M. Vetter Christopher Foley Laura A. Mann, Esq. trustees emeritus William G. Muller, MD John Peters, III Nancy F. Gannett Harold S. Rhodes William B. Gannett Andrew L. Salmon John A. Rauth Michael Sayles Lynn Tokarczyk

Milford Regional Medical Center, Inc. (Consolidated) Fiscal Year: October 1, 2012 – September 30, 2013 Statement of Revenues and Expenses 2012 2013 This annual report is a publication Audited Audited of the Milford Regional Public Relations and Marketing Department. Total Operating Revenue 241,124,200 241,337,927 Salaries, Wages & Benefits 138,169,028 141,368,521 Terri McDonald Supplies & Expenses 61,976,090 65,772,224 Director of Public Relations & Marketing Depreciation 10,172,897 10,277,154 Kathy Marceau Interest 4,277,267 4,136,981 Marketing & Website Coordinator Bad Debt & Free Care 14,437,101 15,427,002 Uncompensated Care Pool Assessment 1,675,180 1,675,180 Robert Carlin, John Ferrarone, Gustav Freedman, Terri McDonald and Morin's Studio Total Operating Expenses 230,707,563 238,657,062 Photography The McCoy Group Income from Operations 10,416,637 2,680,865 Copy & Design PrintWorks Production Service to the Community 2012 2013 Inpatient Discharges / Observation Stays 12,682 12,151 Average Length of Stay 3.50 3.60 Day Surgery Visits 5,147 4,976 Emergency Room Visits 56,210 55,289 Outpatient Visits 276,888 277,693 Cardiac Rehab Visits 22,099 21,012 Total Volunteer Hours 35,000 33,214

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14 Prospect Street • Milford, MA 01757

508-473-1190 • www.milfordregional.org