all day. every day.

2 0 1 3 a n n u a l r e p o r t

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Day after day, year after year, we share our time, resources, expertise and caring with

the community we call home.

Each service we add, each physician we welcome, each program we fund

exemplifies our commitment to the families we serve.

table of contents

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Letter from the President

New Services

Quality and Safety

Community Outreach

Autism News

New Physicians

Community Benefit Report

Board of Directors

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table of contents

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dear friend and neighbor,

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All day, every day, we continue to improve your Highlands Health System. As you read this 2013 Annual

Report, countless patients and families are reaping the benefits of new services, new specialists, quality

initiatives, community outreach and more.

2013 was a landmark year. We celebrated our 40th anniversary with renovations to Highlands Regional

Medical Center. New paint and window caulking brightened and unified our main campus while

improving energy efficiency.

It was also a year of firsts. After rigorous evaluation and refinement of our cardiac care processes, we achieved

Chest Pain Center Accreditation from the Society of Cardiovascular Patient Care. We also implemented a new medication safety system and added pediatric

speech therapy, lactation consultation, fitness classes and more.

Our extended family grew as well. As a founding member of the Eastern Kentucky Healthcare Coalition,

we welcomed UK HealthCare and St. Mary’s Medical Center to our clinically-integrated network of healthcare

providers.

Thank you for choosing and supporting Highlands Health System. We appreciate your trust and are

honored to give back to you and your family.

To Your Good Health,

Harold C. Warman, Jr., FACHE President & CEO, Highlands Health System

dear friend and neighbor,

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newservicesAfter Hours Care ExpandsFamily health needs seldom follow a 9 to 5 schedule, which is why Highlands After Hours Care is so important to the community. After successfully opening the first After Hours location in Paintsville, Highlands expanded its After Hours Care to Salyersville and Inez. Those communities can now receive walk-in care after work and on weekends for minor illnesses and injuries, including X-ray and lab services.

Lactation CounselingNew mothers are often overwhelmed by the daunting task of breastfeeding. To give them the help they need, two Highlands employees completed a five-day training course to become Certified Lactation Counselors. Amy Hyden, a registered dietitian, and Ashley Spriggs, a labor and delivery nurse, were certified by the Healthy Children Project to

support and educate new moms.

g i v i n g b a c k w i t h

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newservicesPediatric Speech TherapyAmber Fleming, a Louisa native, returned to serve the Big Sandy Area as a speech pathologist. She has a Master’s of Science in Speech Pathology and more than 12 years of experience. Amber evaluates and treats a variety of speech language disorders including articulation, phonological processing disorders, receptive and expressive language disorders, fluency, oral motor and feeding disorders.

New Fitness ClassesThe Highlands Wellness Center introduced three new fitness classes to the community: Zumba®, Xtreme Fit and Yoga. The classes are held in the lower level of the Highlands Medical Office Building on the HRMC campus.

Black & Blue ClinicDr. Robert Royalty, Orthopaedic and Sports Medicine Surgeon, offers sports medicine evaluation and treatment to student athletes. The Clinic’s services include free drop-in evaluations, arthroscopy, cartilage repair, fracture treatment, joint replacement, labrum/shoulder instability treatment, ligament reconstruction and repair of the meniscus and rotator cuff.

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quality and safetyAppropriate Care MeasuresThe Appropriate Care Measure (ACM) is a composite measure of whether patients received all the care they were eligible for based on applicable, publicly-reported measures. These percentages compare Highlands Regional Medical Center to the average for all Kentucky hospitals. Source: Kentucky Inpatient Hospital Quality Measures Report (HCE)

e n s u r i n g

HEART FAILURE ACMHeart failure (HF) is a weakening of the heart’s ability to pump blood to the body. With heart failure, the body doesn’t get enough oxygen and nutrients to meet its needs. Heart failure can cause shortness of breath, fatigue, rapid or irregular heartbeat and many other severe symptoms that should not be overlooked.

SURGICAL CARE ACMHospitals can reduce the risk of infection after surgery by making sure they provide care that’s known to get the best results for most patients. Examples of that care would be giving the recommended antibiotics at the right time before surgery, stopping the antibiotics within the right time frame after surgery, maintaining the patient’s temperature and blood glucose (sugar) at normal levels and removing catheters that are used to drain the bladder in a timely manner after surgery.

HRMC 92%

KY 95%

HRMC 91%

HRMC 99%

HRMC 89%

KY 95%

KY 91%

KY 94%

HEART ATTACK ACMAn acute myocardial infarction (AMI)—or heart attack —happens when one of the heart’s arteries becomes blocked and the supply of blood and oxygen to part of the heart muscle is slowed or stopped. When the heart muscle doesn’t get the oxygen and nutrients it needs, the affected heart tissue may die. These measures show some of recommended treatments provided, if appropriate, for most adults who have had a heart attack.

PNEUMONIA ACMPneumonia (PN) is a serious infection in one or both lungs which usually causes difficulty breathing, fever, cough and fatigue. This infection can also lower the oxygen level in the blood. Some of the care measures include pneumococcal vaccination, blood cultures, antibiotics and adult smoking cessation counseling.

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quality and safetye v e r y d a y

Medication Safety SystemTo better protect patients, Highlands Regional Medical Center installed the Bar Code Medication Administration (BCMA) system. All day, every day, our nurses scan and compare the bar codes on each patient’s wristband and medication to be sure they match and to avoid medication errors.

Disaster DrillHighlands coordinated the “Operation Omega Shield” disaster drill with the Health Planning Coalition. Local Anthrax “victims” from Prestonsburg High School were treated in a decontamination tent and taken to the ER for further “evaluation.” We organized communications and resources at our “Incident Command Center,” where administrators, doctors, managers and staff all took part in the successful simulation.

Chest Pain Center AccreditationHighlands Regional Medical Center performed a rigorous reevaluation of our cardiac care processes and received Chest Pain Center Accreditation from the Society of Cardiovascular Patient Care (SCPC). It ensures that patients who arrive at the hospital with heart attack symptoms receive timely treatment to preserve heart muscle.

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reachingoutLadies in RedOver 75 guests attended our second annual women’s heart-healthy luncheon event. Participants received preventive information on heart disease risk, heart attack symptoms, nutrition and exercise by Highlands personnel.

Elder Abuse AwarenessHighlands hosted a staff luncheon featuring Leslie Caudill, RN, BSN, from the Big Sandy Council on Elder Maltreatment. Over 30 attendees learned about recognizing and reporting types of abuse.

Colon Cancer Lunch and LearnAs part of our employee professional development, Drs. Kirti Jain, Jason Clark and Phil Crace met with 20 Highlands employees to present information on colonoscopy, tumor classification and treatment options.

Prostate ScreeningOur annual screening at the Highlands Cancer Center included a PSA blood test, physician exam and information. Volunteers included Dr. Brett Akers, PA Krista Welch and Dr. Jeremy Parsons.

Think PinkIn October, Highlands hosted a series of free breast cancer luncheons. Our representatives shared information on signs, symptoms, detection and treatment options.

Community Health FairsHighlands gave back to our communities with various health fairs across our area, offering flu shots and free screenings for blood sugar, cholesterol, glycohemoglobin, blood pressure and more.

CPR TrainingHighlands Regional Medical Center was once again designated a Regional CPR Training Center by the American Heart Association. Our 270 CPR instructors processed nearly 6,000 certification cards.

t o o u r c o m m u n i t y

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on autismw o r k i n g o v e r t i m e

Securing health coverage for Applied Behavior Analysis at the Highlands Center for Autism continued to be a struggle for families in 2013. Even though state law mandates that insurance companies cover this form of treatment, many were still denied. Highlands Center for Autism Program Director Dr. Shelli Deskins, Ph.D. BCBA, worked closely with Anthem and other insurance carriers to resolve these issues.

Ashley Ratliff Receives Board CertificationAs one of only 120 Board-Certified Behavior Analysts (BCBA) in the state, Ashley helps her patients make improvements in socially significant behaviors. She works with individuals diagnosed with autism spectrum disorder, attention deficit hyperactivity disorder, obesity, addictions and more. Applied Behavior Analysis (ABA) is the only treatment proven effective in improving their quality of life. The Highlands Center for Autism is the first center-based program in Kentucky exclusively using ABA in a clinical setting.

To achieve this ranking, Ashley received her master’s in Clinical Psychology, then completed an extra 15 credit hours of behavior analytic coursework and over 1,500 hours of clinical work under the supervision of Dr. Shelli Deskins.

Fourth Annual Autism Jigsaw 5KApproximately 275 people registered for this spring event, which yielded about $17,000 for the Highlands Center for Autism. The event kicked off with a Kids’ Fun Run. Our 5K walk/run age categories included teen to 25, 25 to 50, and 50 plus. Awards were also given to overall best men’s and women’s categories.

Fourth Annual Poker RunThis summer motorcycle event raised over $1,500 for the center and included about 30 bikes. Riders enjoyed a scenic route through John’s Creek in Pikeville and a lunch at Highlands. Organized by Jimmy Williamson, our Director of Facility Services, the Poker Run raised funds for fee assistance awards, allowing more students to participate in the Center for Autism’s treatment program.

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quality physiciansJason Clark, M.D. PathologistDr. Clark recently moved to the Prestonsburg area after completing a fellowship at the University of North Carolina, specializing in Cytopathology (the study of cells for diagnosing cancer and infectious diseases).

He earned his medical degree from Indiana University School of Medicine and completed his residency at Baylor University Medical Center in Dallas, TX.

Leslieann Dotson, D.O. Board-Certified PediatricianChoosing to give back to her community, this Paintsville native returned to practice at Highlands. Dr. Dotson graduated from Georgetown College with a Bachelors of Science degree and earned her medical degree from Pikeville College of Osteopathic Medicine. She continued her training in pediatrics at Charleston Area Medical Center in Charleston, WV.

She offers preventative care to children from birth through age 19 and specializes in childhood obesity and attention deficit/hyperactivity disorder (ADHD).

Chad Patterson, M.D. Board-Certified General SurgeonDr. Patterson graduated from the University of Louisville with both his B.S. and medical degrees. He continued his training with a surgical residency at the University of Toledo in Toledo, OH. Dr. Patterson then practiced for six years at Lake Cumberland Regional Hospital in Somerset.

He performs many laparoscopic and minimally-invasive procedures, including gallbladder removal, tumor removal, hernia repair and appendectomy.

r e c r u i t i n g

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Community Health Education – GeneralCancer Education 724 $12,547

CPR & First Aid 40 $654

Diabetes Education 70 $1,472

Donation of Used Laptops $2,500

Family Parenting & Sibling ED 106 $116

Health Fairs 8,320 $66,353

Heart Disease/Healthy Heart Education 452 $12,729

Nutrition & Weight Management 240 $740

Mental Health/Depression Education 824 $20,264

Prenatal & Family Planning 100 $486

School Based Programs 5,769 $77,820

Seniors Education and Outreach 1,164 $18,611

Tobacco/Smoking Cessation 170 $229

Worksite Based Programs 1,032 $2,428

Health Care Support Services – Meals/Nutrition Services

Financial Donations for the CommunityFinancial Assistance (includes Bad Debt at cost) $3,395,176

Charity Food Trays 7,848 $76,056

Subsidized Services $699,835

Unreimbursed Medicaid Services $5,285,244

TOTAL COMMUNITY BENEFIT $9,673,260

persons total benefit

community benefit report

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HIGHLANDS HEALTH SYSTEM BOARD OF DIRECTORS

Harold C. Warman, Jr., FACHE PRESIDENT & CEO

Dewey L. Bocook, Jr. CHAIRMAN

Dennis T. Dorton VICE CHAIRMAN

Edward R. Nairn SECRETARY

Paul D. Nunn TREASURER

Robert M. Duncan

Mark E. McKenzie

Gregory A. Wilson

HIGHLANDS REGIONAL MEDICAL CENTER BOARD OF TRUSTEES

Harold C. Warman, Jr., FACHE PRESIDENT & CEO

Edward R. Nairn CHAIRMAN

Gregory A. Wilson VICE CHAIRMAN

Robert M. Duncan SECRETARY

Paul D. Nunn TREASURER

Charles Arnett, M.D.

Sabrina Arnett

Dewey L. Bocook, Jr.

James Booth

Dennis T. Dorton

Mark E. McKenzie

Bertie Kaye Salyer

Joanna Santiesteban, M.D. CHIEF OF STAFF, HIGHLANDS REGIONAL MEDICAL CENTER

Chris Tackett

Mark J. Veronneau, D.O.

board members and trustees

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board members and trusteesHIGHLANDS HOME HEALTH BOARD OF DIRECTORS

Harold C. Warman, Jr., FACHE PRESIDENT & CEO

Edward R. Nairn SECRETARY

Jack Blackwell TREASURER

Charles Arnett, M.D.

Burl W. Spurlock

HIGHLANDS CENTER FOR AUTISM BOARD OF DIRECTORS

Harold C. Warman, Jr., FACHE PRESIDENT & CEO

K. Kate Shutts, M.D. CHAIRPERSON

Edward R. Nairn VICE CHAIRPERSON

Moriah Kinzer SECRETARY & TREASURER

Gregory A. Wilson

HIGHLANDS FOUNDATION BOARD OF DIRECTORS

Harold C. Warman, Jr., FACHE PRESIDENT & CEO

Dennis T. Dorton CHAIRMAN

Edward R. Nairn SECRETARY

Connie Prater TREASURER

Robert Allen II

Sabrina Arnett

Lindsey Case

Leah Castle

Harry Childress

Fran Jarrell

Mark E. McKenzie

Dwayne Moore

John Reed

Bob Shurtleff

Beau Spurlock

Burl W. Spurlock

Chris Tackett

Joseph Buz Tharp III

Neil Turner

Lisa Veronneau

Gregory A. Wilson

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