Providence Health System in Oregon

2006 Community Benefi ts Report

Providence Cares

[2] Providence cares

Cover photo:At Providence’s Center for Medically Fragile Children, Millie Clark, C.N.A., spends some rocking-chair time with Trinity Thomas.

Elizabeth McCabe Chief Mission Integration Offi cer, Providence Health System,Oregon Region

Russ Danielson Vice President and Chief Executive, Providence Health System,Oregon Region

Providence cares

Whether tenderly holding a special-needs child who requires round-the-clock care, or easing the way for a stroke patient who faces both physical and fi nancial struggles, the people of Providence are called to a mission of service. Our lifework is to provide excellent care for everyone, at all stages of life, regardless of ability to pay.

This has been the Providence mission since the Sisters of Providence arrived on the shores of the Columbia River 150 years ago, committed to the care and healing of poor and vulnerable frontier neighbors.

We are honored to carry on this mission. In 2006, Providence

Health System in Oregon provided $125,907,218 in community bene-fi ts, services that we underwrote fully or in part.

In this report, we seek to express just a few of the ways – often immeasurable – that Providence cares.

OUR MISSION

As people of Providence, we reveal God’s love for all, especially the poor and vulnerable, through our compassionate service.

OUR CORE VALUES

Respect ■ Compassion ■ Justice ■ Excellence ■ Stewardship

A drive to reach out

When Silvia Ochoa learned that a Mobile Health Unit would be hitting the rural roads of Hood River County, the young Willamette University graduate felt drawn to its mission. Helping the uninsured and the vulnerable appealed to her. So did being back home with her parents in Hood River, and giving care along-side physician assistants.

“I also like working with the Latino community,” adds Silvia, and about half the patients she now serves share this heritage.

Silvia works as a medical assistant aboard the colorful, four-wheeled

walk-in clinic, “Mission in Motion,” launched in September 2006 by Providence Hood River Memorial Hospital. “I always like to make sure,” she says of all her patients, “that they know they’re taken care of and know they’re in good hands.”

Silvia sees her younger self in the little girl with a bad cold who often has to translate for her non-English-speaking mother. She sees her own father – as he once lived – in the seasonal farm worker who misses his family back home. Grateful to her dad, now a local fruit packer, and her mom for their lifelong encouragement, Silvia aims to become a physician’s assistant or a medical doctor.

Silvia Ochoa loves educating patients about their health and helping them fi nd regular medical care.

Providence Hood River Memorial Hospital gave $2,857,000 in community benefi ts during 2006, including $2,335,000 in free patient care. The Mobile Health Unit provides care in Cascade Locks, Odell, Parkdale and Pine Grove.

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Providence cares [3]

Help for the way back

Vicki Moore never made it to meet her friend that September 2006 day she boarded an eastbound MAX train to Gresham. After a stroke felled her on the way, though, she found a host of new friends and supporters – from the three women riders who comforted her and summoned help to the health care providers who likely saved her life.

Vicki’s stroke was severe. At Providence Portland Medical Center, stroke team members removed the life-threatening clot. Physical, occupa-tional and speech therapists helped the athletic, craft-loving grandma make dramatic improvement.

Yet with no health insurance from her bindery job, Vicki started to worry about medical bills. “I thought, ‘You know, there’s no way I can pay it. It would be impossible.’” But, she says of the hospital staff, “All they cared about was me, and they always asked how I was doing.” Providence wrote off almost the entire cost of her care.

On the day before Vicki left the hospital, the three good Samaritans from the MAX train stopped in to visit. They presented her with a book: “This Is My Wish for You.”

Providence Portland Medical Center provided $39,580,000 in community benefi ts during 2006, including $18,351,000 in free patient care. The hospital’s stroke services are part of the award-winning Providence Stroke Center in Providence Brain Institute.

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“Gosh, it almost made me cry that they thought to bring me a present,” Vicki Moore says of her good Samaritans.

Off to a healthier start

Eager for their upcoming fi rst day of kindergarten, 108 children thronged into the Seaside Convention Center on Sept. 6, 2006. The kids, with parents in tow, followed little yellow footprints from one health screen-ing station to the next, collecting colorful stickers along the way.

The scene was Seaside School District’s annual Multiphasic Clinic, held the day before kindergarten begins. This event provides child-friendly health screenings ranging from vision and vital signs to well-child exams and dental. At the 2006

clinic, staff diagnosed such condi-tions as an irregular heartbeat and hearing defi cits and referred kinder-gartners for further evaluation. Many of the children have seldom visited a doctor.

Each year, medical providers from Providence North Coast Clinic and Providence Seaside Hospital help to staff the Multiphasic Clinic. “I am so blessed to be able to work with this [Providence North Coast] clinic and this hospital,” says school nurse Gina Kytr, R.N., who coordinates the screenings. “People there are so supportive of the schools and our community’s kids.”

Providence Seaside Hospital gave $1,932,000 in community benefi ts during 2006, including $1,479,000 in free care to patients. The free Providence Community Care clinics on Tuesday nights provided care to 324 patients.

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Gathered around school nurse Gina Kytr, R.N., are kinder-gartners (from left) Thaddeus Sparks, Yaneli Aguilera, Emily Ortega,Cori Biamont and Jacob Mendenhall.

Providence cares [5][4] Providence cares

[6] Providence cares

With hustle and heart “To see an empty basketball court when it’s a nice, sunshiny day” – this bothers Bruce “Bubba” Jones. Raised in North Portland, he volunteers as a youth basketball coach and moti-vational speaker, urging kids to set their sights above drugs and gangs. “Sports was like an outlet for me,” the former three-sport star recalls of his school years.

The heart and hustle he champions on the court carry into his personal life. In 1993, while coaching minor-league pro basketball, Bruce was

shocked to learn he had type 2 diabetes. Since then he’s worked hard to manage his blood glucose levels through exercise, diet and medication. He also copes with a back injury caused by a drunk driver.

Lacking health insurance, Bruce values the care he receives on a sliding scale at the Providence Medical Group North Portland clinic.

“I just stay positive,” says Bruce, who is his mother’s caregiver and a family mainstay. “Having two kids, you want to be a leader.” His daughter encourages him to pursue his dream: coaching in the NBA.

The Providence Medical Group North Portland clinic provided $749,568 in community benefi ts in 2006, including $123,000 in free patient care. Providence subsidizes this and six other safety net clinics serving vulnerable populations.

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Bruce Jones drives for the hoop at a North Portland community center.

Opening the door tohope for immigrants

Some have come to America to escape religious persecution in Eastern Europe, only to fi nd them-selves closed in by depression and isolation in their new land. Others, fl eeing the horrors of civil war in East Africa, arrive here burdened with post-traumatic stress disorder. Yet barriers of language, culture and cost can prevent Portland-area immigrants and refugees from reaching the mental health services they may so badly need.

Many fi nd a haven in Lutheran Community Services Northwest. With a staff whose members speak 33 languages, the nonprofi t agency counts refugee resettlement and multicultural outreach among its array of services. Its Multicultural Counseling Program provides immi-grants with culturally sensitive mental health services, from classes to counseling to case management.

A 2006 grant from Providence Health Plans will expand services for low-income Russian-speaking, East African and Hispanic people.

Lonely, depressed elders from Eastern Europe have found new life through a senior social group tailored just for them. One sign of success, notes a staff member, is “seeing the brightness return to previously sad faces.”

Providence Health Plans provided donations and grants for 140 non-profi t organizations as part of the $6,490,179 it gave back to the community in 2006.

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Uzbekistani immigrants Iosif and Lidiya Blashchishin enjoy the Eastern European Elders Adjustment Group.

Providence cares [7]

A sporting chance

No youngster should be left on the sidelines just because the family can’t afford a required sports physi-cal, believes Elizabeth Klein, M.D. Her personal credo of “caring for my community,” including its younger members, led her to champion offering sports physical exams at Providence Milwaukie Hospital’s free Community Health in Motion clinics.

“Also, as a family physician I’m very interested in people’s health, and exercise has to be part of that – and we really need to encourage our young people to exercise,” Dr. Klein

says. The free physicals remove a hurdle for youth in fi nancial need who want to participate in after-school sports. “The kids are great, and the parents – that’s another fun part of this – they’re absolutely thrilled that they can get these physicals done.”

A faculty member with the Providence Milwaukie Family Medicine Residency, Dr. Klein is joined by residents, other physicians, physical therapy staff and dozens of volunteers in offering the physi-cals. In 2006 Community Health in Motion provided more than 225 of these free exams.

Providence Milwaukie Hospital gave $7,911,000 in community benefi ts during 2006, including $3,419,000 in free patient care. The hospital held three free Community Health in Motion clinics, which offer immunizations and sports physicals.

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Family physician Elizabeth Klein, M.D., gives her attention to a teenage patient.

[8] Providence cares

Nourishing work to do

“I welcome the new day,” Charles Hanson says of his life, and the long-retired service station operator greets each Tuesday with a mission. He heads down to open the Newberg FISH (Friends in Service to Humanity) Center and, for the next several hours, applies his quiet enthusiasm to providing food for people in need.

From restocking shelves to fi lling food boxes, Charles has been volun-teering for 13 years with FISH, a nonprofi t organization that brings food and other assistance to those in the Newberg-Dundee community who could use a helping hand. “People are just coming more and more with needs,” he notes. Providence Newberg Medical Center assists FISH by holding food collection drives and making cash donations.

A volunteer at heart, Charles will happily ring a Salvation Army bell or swing a hammer on a Quaker service project. “The Bible tells us that we are to serve our fellow man, and I’ve always felt that I could help in organizations or in places where I meet people who need help.”

Providence Newberg Medical Center provided $3,367,000 in community benefi ts during 2006, including $2,257,000 in free patient care. The hospital donated to more than 35 charitable organizations and causes in the community.

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Charles Hanson feels right at home amid the food shelves at the Newberg FISH Center.

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A culturally sensitive look toward life’s end

As a hospice chaplain, Simon Ho knows how cultural differences can deepen the anguish at the end of a life. He sees the heartache Korean Americans face in a medical culture that often looks to families for direction in making tough health care decisions.

“Unfortunately, it can be extremely diffi cult for children of Korean parents to talk about their parents’ end-of-life care because it is culturally taboo,” says the South Korea native serving with Providence St. Vincent Hospice. What’s more, children’s traditional role “is not letting go” of their dying parents; “it is holding on.”

To help Korean Americans plan for their end-of-life care, Simon helped present a “well-ending” forum in August 2006 sponsored by Providence and the Oregon Korean Community Center. The day-long event focused on medical preparedness – including advance directives – along with emotional and legal preparedness and funeral planning.

Providence is nationally recognized for providing compassionate, innova-tive end-of-life care for patients and their loved ones.

Providence St. Vincent Medical Center gave $35,855,000 in commu-nity benefi ts during 2006, including $18,693,000 in free patient care. In the Latino community, the hospital began a program training volunteer health promoters, or promotores.

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Among those who attended the “well-ending” forum was Sa Oun Kim (seated), shown with daughter Youn Lee and chaplain Simon Ho.

Certifi ed nursing assistant Millie Clark and her coworkers are dedicated to helping children such as Trinity Thomas live their lives to the fullest.

For special children, a very special home

What makes Providence’s Center for Medically Fragile Children a home away from home for kids with devel-opmental delays and complex medical conditions? “We love the children,” Millie Clark, C.N.A., answers softly. “It’s as simple as that.” She adds, “I don’t see these children’s disabilities. I see the people they are.”

In 6-year-old Trinity Thomas, Millie sees a “cuddlebug” with both a sweet spirit and the liveliness to kick a footplate off her wheelchair.

A congenital brain disorder left Trinity with cerebral palsy and devel-opmental delays. She is legally blind in both her big blue eyes. She cannot talk. But Trinity can enjoy everything from hugs and swimming to zoo trips and special education class.

“They do care,” the girl’s mother, Christina Jeans, says of the center’s highly skilled staff, “and they take the time to try to make things as normal as they can be for the kids.” Christina and her younger daughter visit Trinity regularly. “Despite her disabilities, she’s very, very happy in her life.”

The Center for Medically Fragile Children at Providence Child Center provides 24-hour skilled nursing care for 58 children in a residential setting. In 2006, Providence gave $1,581,000 to cover the shortfall between what Medicaid pays and the actual cost of providing many of the children’s care.

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African American Health Coalition

Albertina Kerr Centers

Big Brothers Big Sisters

Boys and Girls Aid Society

Cascadia Behavioral Health

Central City Concern

Children’s Relief Nursery

Citizens Commission on Homelessness

Domestic Violence Resource Center

Essential Health Clinic

Juliette’s House

La Clinica del Cariño

Medical Teams International Dental Van

Northwest Down Syndrome Association

Oregon Food Bank

Oregon Vietnamese Community Association

Portland Opportunities Industrialization Center

Portland Rescue Mission

Rogue Community College Nursing Program

St. Vincent de Paul Society

Sunshine Pantry

Volunteers of America

Providence partners with

scores of community

organizations that share

our commitment to serving

the poor and vulnerable.

They reach out to people

who are hungry, homeless

and mentally ill, to children

at risk, to the uninsured

and to so many more.

Here are just some of

the partners in caring we

are pleased to work with

through our fi nancial

sponsorships, grants and

other support.

Partners In Caring

Amid the anxiety,reassurance

Shannon Pizzuto has no health insurance. But that didn’t stop her from getting the mammogram and breast ultrasound she needed at Providence Medford Medical Center’s Leila J. Eisenstein Breast Center. “I am so thankful,” says Shannon. “The breast center staff was just wonderful to tell me about the Sister Therese Kohles Fund.”

The charitable fund was estab-lished in 2003 to honor Sister

Therese upon her retirement from Providence Medford Medical Center. Donations to the fund pay for breast health services for women who need fi nancial assistance. Each year, more than 80 women benefi t from this support.

For Shannon, who fi rst came to the breast center in July 2006, the fund also helps pay for her follow-up diagnostic procedures. She feels strongly about sharing her experi-ence: “It’s hard to come in here – it’s scary. But if you can’t pay, don’t let that stop you. There’s help and your life may depend on it.”

Shannon Pizzuto (left) has benefi ted from breast center staff members such as Katy Byrne, R.T., a mammography technologist.

[12] Providence cares

Providence Medford Medical Center gave $12,456,000 in community bene-fi ts during 2006, including $5,880,000 in free patient care. One in four patients who were cared for in the Emergency Department had no health insurance.

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2006 Financial Overview of Community Benefi ts

Providence Health System in Oregon

PortlandService

Area

NorthCoast

ServiceArea

YamhillService

Area

ProvidenceBenedictine

NursingCenter

Columbia GorgeServiceArea

SouthernOregonService

Area

OtherStatewidePrograms

ProvidenceHealthPlans

2006OregonTotal

Cost of charity $ 40,463,000 $ 1,479,000 $ 2,257,000 $ 6,656 $ 2,335,000 $ 6,187,000 $ 2,104,000 $ 0 $ 54,831,656 care provided 1

Cost of Medicaid $ 23,912,000 $ 0 $ 0 $ 0 $ 0 $ 6,644,572 $ 2,434,000 $ 1,058,000 $ 34,048,572 charity services 2

Other government $ 1,706,000 $ 328,000 $ 184,000 $ 0 $ 0 $ 54,211 $ 320,000 $ 0 $ 2,592,211 programs 3

Unpaid cost of $ 12,917,233 $ 56,174 $ 24,233 $ 20,181 $ 26,402 $ 388,344 $ 1,300,905 $ 5,000 $ 14,738,472education andresearch 4

Cost of non-billed $ 1,519,503 $ 23,958 $ 387,612 $ 755 $ 378,596 $ 763,521 $ 2,641,791 $ 2,543,211 $ 8,258,947 services 5

Unpaid cost of $ 3,776,752 $ 1,181 $ 459 $ 0 $ 0 $ 53,414 $ 1,720,742 $ 0 $ 5,552,548negative-margin services for importantcommunity needs 6

Cash/in-kind $ 644,309 $ 15,209 $ 513,973 $ 951 $ 109,020 $ 157,619 $ 1,392,078 $ 2,872,968 $ 5,706,127donations 7

Community $ 128,510 $ 28,710 $ 0 $ 0 $ 7,823 $ 0 $ 2,642 $ 11,000 $ 178,685 building 8

TOTAL $85,067,307 $1,932,232 $3,367,277 $28,543 $2,856,841 $14,248,681 $11,916,158 $6,490,179 $125,907,218

2006 Community Benefi ts by Percentage

Comparison of Community Benefi t Giving, 2005 and 2006

This comparison is based on the eight categories listed on the opposite page and in the chart above. The total dollar amounts do not include the growing unpaid cost of Medicare services or the cost of bad debt. ■ Charity care giving remained constant in 2005 and 2006. ■ Medicaid subsidies increased by 67.8 percent in 2006. ■ Subsidies for services to other government programs rose 169.6 percent. ■ Subsidies to our negative-margin services, such as mission clinics (safety net clinics), increased by 41.7 percent. ■ Cost of non-billed services increased by 41.1 percent.

We’ve adopted the gold standard in reporting

In 2006 Providence Health System adopted the Catholic Health Association’s revised guidelines for reporting community benefi ts. These guidelines are considered the gold standard for clearly describing how not-for-profi t hospitals give back to their communities. Starting with this 2006 report, we no longer include the unpaid cost of Medicare services as part of the community benefi ts we provide. Otherwise, our reporting remains the same as in past years. We continually look for ways to improve our community benefi t report-ing and our communities’ understanding of how we care through giving.

140

120

100

80

60

40

20

02005 2006

$107.6

$125.9

Total Community Benefi ts(in millions)

1 Cost of providing for people who have no insurance or are otherwise unable to pay for their health care.2 Difference between reimbursement from Medicaid and the actual cost of providing care.3 CHAMPUS health benefi ts program.4 Unreimbursed cost of medical residency programs, other education and training, and medical research.

5 Cost of community services such as patient education, health screenings, immunizations, resource centers and support groups.

6 Unreimbursed cost of vitally needed medical services that do not provide a fi nancial return, such as primary care clinics in underserved neighborhoods and mental health and chemical dependency services.

7 Donations of cash, equipment, medical supplies, child safety seats, food, etc.

8 Miscellaneous community improvement activities such as neighborhood cleanups and training in language/cultural skills.

Cost of Medicaid charity services 27%

Unpaid cost of education and research 11.7%

Unpaid cost of negative-margin services for important community needs 4.4%

Cash/in-kind donations 4.5%

Community building <1%

Cost of non-billed services 6.6%

Other government programs 2%

Cost of charity care provided 43.5%

Total community benefi ts for Providence Health System in Oregon: $125,907,218

Providence Health System in Oregon

1235 NE 47th Avenue, Suite 299 Portland, Oregon 97213

Providence Resource Line503-574-6595 ■ 1-800-562-8964

www.providence.org/oregon

Providence St. Vincent Medical Center, Portland ■ Providence Portland Medical Center Providence Milwaukie Hospital ■ Providence Hood River Memorial Hospital Providence Newberg Medical Center ■ Providence Seaside Hospital Providence Medford Medical Center ■ Providence Child Center, PortlandProvidence ElderPlace, Portland and Gresham ■ Providence Benedictine Nursing Center, Mt. AngelProvidence Senior Village, Hood River ■ Providence Seaside Extended Care Providence Home and Community Services ■ Providence Health PlansProvidence Medical Group clinics - North and South ■ Providence Graduate Medical Education clinics Providence North Coast clinics ■ Providence Hood River clinics

Providence Health System in Oregon is a not-for-profi t network of hospitals, care centers, health plans, physicians, clinics, home health services and affi liated services. We continue a tradition of caring that the Sisters of Providence began in the West 150 years ago.

“The angel of the nursery” is how colleagues remember Sister Dolores Schulte, S.P., a nurse and administrator who served Providence Child Center for 41 years. “She had this little twinkle in her eye,” recalls a retired nurse who worked with Sister Dolores. “She loved the children. She was just crazy about them.”

Providence: a tradition of caring