horizons spring/summer 2013

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Many families will never know the fear and uncertainty of a serious neurological diagnosis. Unfortunately, Annie Knowles and her family have experienced firsthand multiple life-changing neurological conditions. Annie’s father, Paul Schweinfurth, MD, was a respected neurosurgeon in southern California and closely managed the care his family received. “Dad was very particular about our medical care,” Annie recalls. “He knew all too well that the facility and doctor made a big difference in the care and outcome of a medical problem. He made very careful choices for his family.” So when a visit to the ophthalmologist led to a referral to a neurologist for Annie, her father thoroughly researched the physician Annie planned to see – John Schafer, MD, a physician with the Mercy Neurological Institute. “Dad talked to his colleagues and did his research and he was impressed,” Annie says. Unfortunately for Annie, Dr. Schafer confirmed what her father had suspected – she had multiple sclerosis (MS). While the diagnosis was difficult to hear, especially as an active mother of five children, Annie says for the most part her MS has been manageable due to Dr. Schafer's care. “Other than a few problems over the years, my MS has been very benign. It hasn’t affected my life to a great degree. I have been very fortunate.” Horizons MERCY FOUNDATION President’s message At this time of year, many students mark a milestone in their lives with graduation. Mercy Foundation is marking a milestone of its own. We are excited to share that Mercy Foundation is on track to raise $6 million by the end of our fiscal year on June 30, 2013. This is a record accomplishment and one which can be attributed to you, our donors and supporters, and to the many worthwhile ministries sponsored by the Sisters of Mercy. We are proud to raise support for Sisters of Mercy health care ministries that include Mercy Folsom, Methodist, Mercy San Juan and Mercy General hospitals. Mercy Foundation is also unique in that 100 percent of every contribution goes directly to the program designated—an extremely important differentiator among charitable organizations. As we begin a new fiscal year, we are happy to welcome Mark Read as the new Chair of the Mercy Foundation Board and thank Mike Genovese for his leadership as Chair during the past year. Thank you for partnering with us so the Sisters of Mercy can continue to change lives in the Sacramento community. President and CEO A gift of gratitude – Annie Knowles (right) and her mom, Marge Schweinfurth, gave to the Mercy MS Center, to help others like them receive support and solutions for MS. Mercy MS Center changes lives with specialized team care Spring/Summer 2013 Joan Gann's lifelong support of the Sisters of Mercy and their mission. | 7 Continued on page 2 Inspiring Philanropy. Changing Lis.

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Mercy Foundation's quarterly newsletter. Inspired by the Sisters of Mercy mission to connect those with resources with those in need, Mercy Foundation raises philanthropic support and community awareness to enhance lives in the Sacramento region. For Mercy Foundation, philanthropy is one of the most powerful expressions of compassion. Just as many people in the community need a hand, countless others are reaching out to them with comfort and hope. The Foundation strives to forge enduring connections between them, empowering the community to make a difference by giving.

TRANSCRIPT

Page 1: Horizons Spring/Summer 2013

Many families will never know the fear and uncertainty of a serious neurological diagnosis. Unfortunately, Annie Knowles and her family have experienced firsthand multiple life-changing neurological conditions. Annie’s father, Paul Schweinfurth, MD, was a respected neurosurgeon in southern California and closely managed the care his family received. “Dad was very particular about our medical care,” Annie recalls. “He knew all too well that the facility and doctor made a big difference in the care and outcome of a medical problem. He made very careful choices for his family.”

So when a visit to the ophthalmologist led to a referral to a neurologist for Annie, her father thoroughly researched the physician Annie planned to see – John Schafer, MD, a physician with the Mercy Neurological Institute. “Dad talked to his colleagues and did his research and he was impressed,” Annie says.

Unfortunately for Annie, Dr. Schafer confirmed what her father had suspected – she had multiple sclerosis (MS). While the diagnosis was difficult to hear, especially as an active mother of five children, Annie says for the most part her MS has been manageable due to Dr. Schafer's care. “Other than a few problems over the years, my MS has been very benign. It hasn’t affected my life to a great degree. I have been very fortunate.”

HorizonsM E R C Y F O U N D A T I O N

President’s messageAt this time of year, many students mark a milestone in their lives with graduation. Mercy Foundation is marking a milestone of its own. We are excited to share that Mercy Foundation is on track to raise $6 million by the end of our fiscal year on June 30, 2013. This is a record accomplishment and one which can be attributed to you, our donors and supporters, and to the many worthwhile ministries sponsored by the Sisters of Mercy.

We are proud to raise support for Sisters of Mercy health care ministries that include Mercy Folsom, Methodist, Mercy San Juan and Mercy General hospitals. Mercy Foundation is also unique in that 100 percent of every contribution goes directly to the program designated—an extremely important differentiator among charitable organizations.

As we begin a new fiscal year, we are happy to welcome Mark Read as the new Chair of the Mercy Foundation Board and thank Mike Genovese for his leadership as Chair during the past year.

Thank you for partnering with us so the Sisters of Mercy can continue to change lives in the Sacramento community.

President and CEO

A gift of gratitude – Annie Knowles (right) and her mom, Marge Schweinfurth, gave to the Mercy MS Center, to help others like them receive support and solutions for MS.

Mercy MS Center changes lives with specialized team care

Spring/Summer 2013

Joan Gann's lifelong support of the Sisters of Mercy and their mission. | 7

Continued on page 2

Inspiring Philanthropy. Changing Lives.

Page 2: Horizons Spring/Summer 2013

2

Partners in PhilanthropyM E R C Y F O U N D A T I O N

Annie relied on Dr. Schafer and his team to help her learn about her condition and how to best manage it. Annie and her mother Marge also turned to Dr. Schafer when her father was diagnosed with frontal temporal aphasia. “Both Mom and I knew there was only one place to take him for top notch medical care – Dr. Schafer. He cared for Dad with such respect. Dr. Schafer made my father’s passing a much more tolerable event for us, knowing that Dad was confident in the care he was receiving.”

While mourning the loss of her beloved father, Annie and her mother saw an opportunity for greater good. “Having experienced these somewhat traumatic events, we knew firsthand how patients are treated and cared for through the Mercy Neurological Institute,” Annie explains. “We have been the recipients of

‘bad news’ from Dr. Schafer and we have been the recipients of his care, time and concern. Because of this, it is with the utmost confidence that we support Dr. Schafer and the Mercy MS Center with our time and our money.”

Annie’s mother Marge, a retired registered nurse, is overwhelmed with gratitude for the care that both her daughter and her husband have received from Dr. Schafer over the years and says her philanthropic support is an expression of that gratitude. “Our gift to the MS Center is really due to our continued belief in him and his work and the care he provides to so many people. This is an opportunity to not only remember and pay tribute to my husband but to support an organization that he knew to be one of the best in the nation.”

Mercy MS Centers offers patients one-of-a-kind care

After caring for people living with multiple sclerosis for more than 25 years, Dr. John Schafer created the Mercy MS Center in 2009. “MS is a complex condition that is easily missed or misdiagnosed,” explains Dr. Schafer. “The Mercy MS Center offers patients a unique, specialized and multi-disciplinary approach to their treatment. Our team can help patients navigate their care as well as offer tools for improving their quality of life.”

Patients living with MS face a broad range of issues, including cognitive difficulties, bladder control problems, pain management challenges, struggles with family dynamics, depression and fatigue. With two neurologists, a dedicated MS nurse, an MS physician assistant, a clinical trial nurse and experienced office staff, the center is uniquely equipped to provide patients support and solutions.

Since its inception, the center has treated more than 700 patients with more than 3,400 office visits, and patient referrals continue to increase. Mercy MS Center is the only National Multiple Sclerosis Society (NMSS) affiliated Center for Comprehensive Care in Northern California. The Mercy MS Center is a Dignity Health Center of Excellence within the Mercy Neurological Institute.

Conrad N. Hilton Foundation awards $890,000 grant to Mercy FoundationDignity Health is moving forward with plans to open a Multiple Sclerosis Achievement Center, the first of its kind in Northern California, thanks to a generous $890,000 grant to Mercy Foundation by the Conrad N. Hilton Foundation. The Mercy MS Achievement Center will be a day program for people with progressive multiple sclerosis and will provide ongoing wellness, fitness and recreation opportunities which are otherwise very limited or unavailable. The Achievement Center will greatly extend the comprehensive services of the Mercy MS Center and Mercy’s commitment to improving not only physical function but also quality of life for both patients and their families.

Page 3: Horizons Spring/Summer 2013

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Living their passions with gratitude through the circle of life

Jan and Harry Campbell hope that their commitment will inspire families who have been touched by Mercy Hospice.

On a different side of the life spectrum, Harry enjoys bonding with infants as he volunteers weekly to rock NICU babies.

After 43 years of marriage, Jan and Harry Campbell’s values for service are clearly aligned. At their core, they share a passion for supporting individuals and families through life’s spectrum.

Each has observed, through different lenses and experiences, challenging and precious moments with Mercy patients and their loved ones that they hold dear.

When Jan retired as manager of Mercy Hospice in the spring of 2012, after working for more than three decades in oncology and hospice nursing, she wanted to stay connected to the mission-driven work of the Sisters of Mercy. She has done just that.

On a different side of life’s spectrum, Harry, a retired military officer and businessman, who has always had a soft spot in his heart for infants, has been rocking babies weekly for more than five years at Mercy San Juan Medical Center’s Neonatal Intensive Care Unit (NICU), where bonding is critical for growing, yet fragile babies.

Through the years Jan has been asked how she gravitated toward hospice work with

questions like, “Isn’t it depressing?” From Jan’s perspective it is not. “The way you care for people at the end of life is where the rubber meets the road,” she says. She believes that the hospice model is the right way to treat people and to honor their lives.

Jan came to hospice after taking care of her father at the end of his life. Through that experience, she saw how helpful hospice was, the continuity it provides and the benefits to family members who are navigating through unchartered waters. She learned the value of the hospice team care model. “People are so caring and see it as a calling,” she says.

“This has been a love of mine for a long time,” Jan continues. So walking away from it in retirement wouldn’t have been an option. “Being able to stay connected with the program is a very small measure of my gratitude,” she adds. “I have had the opportunity to live my passion. I feel very blessed.”

To express their appreciation, Jan and Harry made a five-year philanthropic pledge to Mercy Hospice, which they hope will benefit families needing support

directly and inspire others to support hospice. Jan continues volunteering with the Mercy Hospice speaker’s bureau, connecting with people who have been touched by hospice and have given to the program through the years.

Reflecting back on her career and the complexities of health care, Jan believes that the hospice model is among those that work well. “The vast majority of people want to be at home at the end of their lives. Through its interdisciplinary approach, hospice can create an environment that helps support families as they manage through difficult times,” she adds.

Today, Jan and Harry are balancing their volunteerism with their love for family and their growing grandchildren. They are looking forward to traveling, spending time with their family and keeping their passions alive.

To find out more about supporting Mercy Hospice, call (916) 851-2700.

Page 4: Horizons Spring/Summer 2013

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The Sisters of Mercy

For Sister Mary Katherine Doyle, RSM, the calling came early, as an urge to teach. “I had a burning desire to teach,” she recalls. “I’ve always been drawn to teaching young people. I wanted to pass on what I had received.” Sister Katherine (as she is known) pursued that passion by entering the Sisters of Mercy in

September 1962. A native of Sacramento, Sister Katherine spent many years serving as a teacher and principal for Sacramento-area schools. She also was a writer and archivist for the Sisters of Mercy, publishing books on spirituality as well as a biography of California's leader, Sister Mary Baptist Russell.

Over time, Sister Katherine enhanced her focus on spirituality. “I think I am called to help people get in touch with their deepest identity and longing… To help them realize how precious they are in God’s sight.” Sister Katherine carries out that calling in various ways, filling whatever need the Sisters and their communities have at the moment. Recently, her roles have included pastoral associate at Holy Spirit Parish in Sacramento and continuing to grow Spiritual Ministries Outreach, where her responsibilities include a combination of retreat work, spiritual direction, teaching and facilitation.

For the past five years, Sister Katherine has also shared her talents and time with Mercy Foundation, serving as the President’s designee to the Foundation for the West/Midwest. She views this role as a vital opportunity for the Sisters to tell their story. “I think we sometimes think actions tell the story. But today there is a need for others to hear the story – not just about the Sisters, but about the works and the ministries. Through the Foundation, you find that you are not by yourself; you’re part of a much larger tradition.”

Sister Katherine’s passion for teaching continues to be brought to life daily through her varied roles at Mercy Foundation and elsewhere. “When you center your life in God, when you extend yourself to those in need around you, there is abundant energy and joy that flows from that path. It’s an investment into something that is so much bigger than yourself.”

Called to share joy: Sister Mary Katherine Doyle

M E R C Y F O U N D A T I O N

Sister Bridget McCarthy named Safety Net HeroOn March 22, Sister Bridget McCarthy, RSM, accepted the award at Spring Surge, an annual fundraiser held by Serotonin Surge for health safety net clinics. “She’s been a safety net hero for so long in this community,” said Michael Taylor, Senior Vice President, Operations, Greater Sacramento-San Joaquin Service Area, “She is a leader in the region in her ability to see what the needs of our community are on a mission basis as well as on a business basis, and the ability to merge those two together in her example as a legacy is a history that we’ll all be proud of.”

Sister Libby Fernandez, RSM, executive director of Loaves & Fishes, says one of the vows of the Sisters of Mercy is service to the poor, sick and uneducated. She says Sr. Bridget has volunteered at Loaves & Fishes for as long as she can remember, working as a nurse in MercyClinic Loaves & Fishes and serving meals to the homeless in the Loaves & Fishes dining room. “She’s great at emotionally touching our homeless guests with her heart and her passion,” said Sr. Libby. “She’ll come into your space in a very peaceful, calm way and her energy is centered around peace, passion and presence. So you leave with a sense of ‘I’ll be all right. I may be homeless today but I’ll be all right.’ ”

Pictured from left to right: Sister Kathleen Horgan, Sister Bridget McCarthy and Sister Susan McCarthy.

Page 5: Horizons Spring/Summer 2013

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Biplane angiography suite

The new biplane angiography suite at Mercy San Juan Medical Center (pictured above) offers the latest version of the imaging technology and is the first of its kind on the West Coast. It is used for less invasive performance of neurological procedures to treat a variety of conditions–both emergent and non-emergent–including acute stroke, brain aneurysms, head and neck tumors, spine compression fractures and more.

Mercy Foundation's donors bring biplane suite funding to the finish lineMercy San Juan Medical Center’s new $7 million state-of-the-art biplane angiography suite and wide bore 3 Tesla MRI suite expands Mercy Neurological Institute of Greater Sacramento’s interventional neuroradiology care even further.

Dignity Health made a significant $4 million investment to make these suites possible, and Mercy Foundation and our philanthropic partners helped fill the funding gap. Thanks to a number of major gifts donated by some very generous donors – including physicians and management staff at Mercy San Juan – $600,000 was raised to help make this project a reality. Additionally, a substantial $250,000 bequest to Mercy Foundation in support of this effort helped complete the funding needs.

Since opening in February 2013, the new angiography suite is already seeing significant use for advanced treatment of stroke and other neurological procedures. For instance, one 66-year-old patient who had a stroke was treated successully with tPA and a mechanical thrombectomy in the biplane suite. Another 98-year-old patient was treated similarly after being brought in by her daughter, who had experienced a stroke herself and was able to recognize the symptoms in her mother.

Ministry NewsM E R C Y F O U N D A T I O N

3940 H Street Apartments ribbon cuttingCouncilmembers Steve Cohn and Kevin McCarty joined more than 100 neighbors and East Sacramento business owners at a March 21 ribbon-cutting and open house event at the new 3940 H Street apartments on Mercy General Hospital’s campus. The hospital is providing the Craftsman-style neighborhood replacement housing as part of its expansion project for the Alex G. Spanos Heart & Vascular Center.

Pictured left to right: Bob Kuchman, Kuchman Architects; Sister Clare Dalton, RSM, VP Mission Integration at Mercy General Hospital; Councilmember Steve Cohn; Mercy General Hospital President Edmundo Castañeda; Councilmember Kevin McCarty; Mark Schope, Ascent Builders.

Page 6: Horizons Spring/Summer 2013

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Exceptional achievement in cardiac careIn April, both Mercy General Hospital and Mercy San Juan Medical Center achieved high quality marks among the 120 California hospitals performing coronary artery bypass graft (CABG) procedures, and Mercy General Hospital continues to be the highest volume CABG provider in the state. These findings were reported in the 2013 California (CABG) Outcomes Reporting Program’s (CCORP), California Report on Coronary Artery Bypass Graft Surgery, 2009-2010: A Measurement of Hospital and Surgeon Performance released April 24. These are the latest in a series of quality awards for Mercy Heart & Vascular Institute's cardiac programs in Sacramento in 2013.

Mercy General Hospital• The only California hospital to achieve

a “better than expected” mortality rate (0.2% MGH vs 2.0% California) and one of only two hospitals to rank better than expected on readmissions for CABG procedures on the 2013 CCORP Report

• Cardiac Surgical Excellence Award, 2011, 2012, and 2013 from HealthGrades

• Top 50 Cardiovascular Hospital, 2013 from Truven Health Analytics

Mercy San Juan Medical Center• CABG mortality rate lower than

California State average on the 2013 CCORP Report (0.86% MSJMC vs 2.0% California)

• Cardiac Care Excellence Award, 2013 from HealthGrades

• Cardiac Surgical Excellence Award, 2013 from HealthGrades

Not only do these Mercy Heart & Vascular Institute programs lead in CABG, but the cardiac physicians and providers are the West Coast leaders in complex valve procedures, including minimally invasive daVinci cardiac surgery, transcatheter aortic valve replacement (TAVR) and complex aortic disease treatment.

These awards clearly demonstrate the commitment of the physicians and staff in providing the highest level of advanced cardiac care to patients.

For Carmen Kaufhardt, Mercy San Juan Medical Center’s patient registration and telecommunications manager, selecting Cristo Rey High School as the recipient of her annual Employees Lend a Hand donation was simple, almost second nature.

Among the simplicities was the decision to contribute to something meaningful and close to home. Kaufhardt pledges "Paid Time Off" hours each pay period, which she says she doesn’t even miss. “As employees we have great jobs and benefits. I firmly believe that everyone who can give should.”

Kaufhardt has worked within California hospitals in patient registration for the past 30 years and has always participated in employee giving campaigns. Kaufhardt, who has been with the Dignity Health system for almost five years, joined Mercy San Juan's team at the end of October after spending more than four years at Methodist Hospital. “I have been truly blessed working for Dignity Health,” she says. And so, giving back is easy.

The driving force behind Kaufhardt’s selection of Cristo Rey is its principal, Sister Eileen Enright, RSM, a person for whom Kaufhardt has tremendous respect. Carmen met Sr. Eileen when she was working at Methodist visiting with patients prior to surgeries. “I love Sr.

Eileen. That’s why I give to Cristo Rey.”

Kaufhardt had the opportunity to attend a Mercy Foundation tour of Cristo Rey where she saw firsthand the benefits. “They provide a great program for economically challenged students to receive the preparation needed to attend college and become happy, productive adults,” she says.

Prior to supporting Cristo Rey, Kaufhardt gave to Mercy Foundation's Windows to the World campaign for Bruceville Terrace to complete the purchase of new flat screen televisions in resident rooms, providing a vital connection to the outside world for patients who might otherwise become isolated.

When giving is simple

Inspired by the works of the Sisters of Mercy, Carmen Kaufhardt makes participation in the Employees Lend a Hand campaign an annual tradition.

Partners in PhilanthropyM E R C Y F O U N D A T I O N

Cristo Rey High School Work StudyWork study opportunities are needed for Cristo Rey High School students for the 2014 school year. Make a difference for your company and community today by becoming part of a program that directly impacts the lives of highly motivated students who are gaining experience, confidence and self-respect. If you can help, please call Cristo Rey’s Director of Work Study, David Brown, at (916) 400-3386.

Page 7: Horizons Spring/Summer 2013

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Joan Gann’s connection to the Sisters of Mercy began, literally, at birth… She was born at Mater Misericordiae – the hospital the Sisters of Mercy founded in East Sacramento that would become what is known today as Mercy General Hospital. Years later, she would deliver all four of her own children at Mercy General and she and her husband Richard would both undergo surgeries inside Mercy General’s walls. “Mercy General and the Sisters have always been part of my life,” Joan says.

Having seen the works of the Sisters firsthand over the years, Joan has always felt committed to supporting them in their mission. Throughout that time, her support has taken many shapes. She has served on the Mercy Foundation Board, she has been a member of the Mercy General Guild, and she and her husband Richard have supported the Sisters ministries through philanthropic gifts. “The Sisters have given so much to this community over the past 150 plus years,” Joan says. “They are so deserving of any support they receive.”

Perhaps the role where Joan has had the greatest impact is in her 14 years spent as a member of the Mercy General Community Leadership Council, which she also chaired for six years. As a member of the Community Leadership Council, Joan viewed her role as an advocate for the Sisters. “I wanted to make sure that the community knew what wonderful things the Sisters were doing not only healing the sick inside Mercy General but also serving the poor and those in need throughout our area,” Joan reflects.

A lifelong supporter of the Sisters of Mercy and their mission

Focus on planned givingMany savvy donors over the age of 70 ½ with a traditional IRA have supported their favorite Mercy ministries by making a tax-free gift, thanks to legislation that Congress has extended through Dec. 31, 2013. Here’s how this type of gift works: If you are age 70 ½ or older, and do not need all or part of the mandatory distributions from your traditional IRA, you can make tax-free gifts totaling up to $100,000 to qualified charities (until Dec. 31, 2013). If your spouse has a separate IRA account, you may each make a gift up to $100,000. Although you cannot claim a charitable deduction for IRA gifts, your gift amount will reduce your taxable estate, and you will not be required to pay federal income tax on any amounts you distribute to qualified charities.

If you would like to make a gift from your IRA to benefit one of the ministries supported by Mercy Foundation, or you would like more information regarding making a gift through your IRA, please contact Mercy Foundation at (916) 851-2700.

Richard and Joan Gann have supported the Sisters of Mercy with their philanthropic gifts and with the invaluable gift of time.

Her role as advocate became critical in 2001 when the hospital announced plans for the Alex G. Spanos Heart & Vascular Center. “I knew how important this facility would be to the world class cardiac care Mercy General provides to this community,” Joan says. “However, some neighbors of the hospital didn’t really understand the plans and had strong feelings against the project. My job was to get the facts out there.” Joan did just that and was vital in increasing public awareness and support for the project. Joan has also been instrumental in the capital campaign associated with the center.

Now Joan is anxiously awaiting the ribbon cutting for the Alex G. Spanos Heart & Vascular Center later this year. “I will be so happy when those doors open. It has been a long time coming. For the Sisters, this is the next step in their mission to heal and serve those in need.”

Whatever Joan's next role is, one thing is certain – her passion for the Sisters of Mercy and their mission will not wane. In fact, she recently was honored with Mercy Foundation's Distinguished Service Award for her longtime service and commitment. “The Sisters have touched so many lives with their love and their care. They have supported so many and I am proud to have supported them.”

Page 8: Horizons Spring/Summer 2013

3400 Data Drive Rancho Cordova, CA 95670 SupportMercyFoundation.org

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Questions or comments about this newsletter? We welcome your feedback. Contact us at [email protected] or (916) 851–2700 to share your comments or sign up for an electronic version.

2012–13 Mercy Foundation Board of Trustees

Officers

Michael T. Genovese Chair

Mark Read Vice Chair

Alan Shatzel, DO Secretary

Linda Van Rees Treasurer

Katherine Doyle, RSM Sisters of Mercy West Midwest President’s Designee

Kevin B. Duggan Mercy Foundation President and CEO

Trustees

Jose Abad, MD Gene Bassett Brenda W. Davis Costanzo DiPerna, MD Roxanne Elliott Eileen Enright, RSM Joan Gann Brian Ivie Jack M. Kimmel Garry P. Maisel Sharon Margetts Careyann Morris Tim Rogers Inder Singh, MD John Stevenson, MD Terry Street Michael Taylor Merrily Wong William Yee

Mercy Medical Group golf tournament benefits Mercy Foundation

Thank you to the Mercy Medical Group tournament organizers, pictured from left to right: Ben Balatbat, MD, Department Chair, Internal Medicine; Robert Bellinoff, MD, Division Head, Ophthalmology; Adam Berman, Vice President; and Eric Morse, MD, Department Chair, Surgical Specialties. Joining them is Kevin Duggan, Mercy Foundation President and CEO (far right).

Mercy Medical Group held its first golf tournament at the Empire Ranch Golf Club on June 8 to benefit Mercy Foundation and people in need throughout the Sacramento region. Local ministries supported by Mercy Foundation and the Sisters of Mercy that will benefit from tournament proceeds include MercyClinic Loaves & Fishes, Cristo Rey High School Sacramento, Mercy Housing California and Sacramento Loaves & Fishes.