Direct Patient Care

$58,431,893

This includes clinics, charity care and the difference between government reimbursements and actual care costs

Medicare Shortfall - $28,949,138

The Medicare shortfall is the difference between Medicare payments and the cost of providing patient care. Direct medical education payments and costs are excluded from the calculation. For LVH is totaled of $26,489,694. For LVH-Muhlenberg, it totaled $2,329,544.

Bad Debt - $11,916,962

The Hospital’s bad debt at cost was $11,916,962:

Medical Assistance Shortfall - $9,256,629

he Medical Assistance Shortfall includes:

• The Medical Assistance Managed Care shortfall is the difference between Medical Assistance Managed Care payments and the cost of providing patient care. For LVH it totaled $2,179,995. For LVH-M, it totaled $1,872,311.
  
  
  
• The Medical Assistance shortfall is the difference between Medical Assistance payments and the cost of providing patient care. Direct medical education payments and costs are excluded from the calculation. This totaled $1,195,793 at LVH-M, $3,836,415 at LVPG and $172,115 at LVHSD.

Uncompensated Charity Care - $4,830,359

Uncompensated charity care does not include bad debt. The Hospital's determination of inability to pay differentiates charity care from bad debt, which is determined by ability to pay but unwillingness to do so. The total was $4,830,359:

Mental Health/Mental Retardation Program - $1,626,332

The Lehigh Valley Health Network administers the Mental Health/Mental Retardation Programs as a contracted provider for the Lehigh County Department of Human Services. The MH/MR Programs include an Outpatient Mental Health Clinic and two Residential Aftercare Programs, the Transitional Living Center-Full Care and Transitional Living Center-Moderate Care. Although the Programs receive revenue from patients and reimbursements from Lehigh County, these funds do not fully reimburse program operating expenditures. In FY’05, program operating expenditures exceeded program revenues and reimbursements by $1,000,165.

The Mental Health Clinic is an outpatient program that provides evaluations, individual, group, and couple counseling and case management services. It serves persistently mentally ill residents of Lehigh County age 18 and over.

The Transitional Living Centers serve residents of Lehigh County age 18 and over who have been treated for mental illness and would benefit from a structured residential program. The Full Care site is supervised 24 hours per day and teaches the activities of daily living as designated by the State of Pennsylvania's Department of Welfare to those residents who demonstrate the need for on-going intensified supervision due to their mental illness. The Moderate Care site is supervised 10 hours per day and is designed to teach activities of daily living to those individuals who demonstrate the need for community re-entry support in a less intensified structure.

The MH/MR Programs include an Outpatient Mental Health program (Base Service Unit) at the Muhlenberg campus. The Base Service Unit is an outpatient program that provides evaluations, individual, group, and couple counseling and case management services. It serves persistently mentally ill residents of Lehigh County age 18 and over. Program revenues received from patients and insurers do not fully cover program operating expenditures. In FY 2005, program operating expenses exceeded these reimbursements by $626,127.

Clinic Subsidy - $1,473,504

The clinic subsidy of $1,265,900 is the difference between clinic payments and clinic costs. Clinic costs include $372,088 of the wages and benefits expenses of medical residents who provided care to clinic patients. This amount has been deducted from the total value of medical education, which is presented later in this document.

In connection with the Dental residency program, LVH-M operates a dental clinic. The hospital subsidized the clinic operation to the extent that clinic costs exceed the amount of payment it receives. In fiscal year 2005, the subsidy amounted to $207,604. This does not include the cost of the residents, which is included in the value of medical education below.

Blue Cross Special Care Shortfall - $131,000

The Blue Cross Special Care shortfall is the difference between Blue Cross Special Care payments and the cost of providing patient care.

Patient Representative and Interpreting Service - $95,391

Patient Representative--Press, Ganey Survey: LVH

• The Hospital uses the Press, Ganey Patient Survey to assess the needs of the patients in our community regarding care and opportunities to improve that care. Access needs are also assessed for the disabled consumer and family, which enables them to receive care as independently as possible.
  
  
  
• Surveys are sent to every inpatient (both adult and pediatric), ambulatory surgical patient, behavioral health patient, and Transitional Skilled Unit patient. Patients who receive outpatient treatment or visit the Emergency Rooms receive one survey in a 90-day cycle. All patients who receive surgery or treatment at the John and Dorothy Morgan Cancer Center, and all Home Care patients also receive surveys. Results are received on a monthly and quarterly basis for inpatients, and quarterly for all others. The reports are compared to prior results and are benchmarked against other hospitals of the same bed size and visit range. Approximately 2.4 full-time equivalent employees are solely dedicated to evaluating results, with departmental and consumer follow-up and work process redesign to improve care and satisfaction. Survey fees in FY’05 were $38,290.

• The Hospital provides interpreting services at no charge to foreign language and sign language speaking patients and patient family members. In FY’05, the Hospital subscribed to an on-line interpreting service, and also purchased sign language interpreting at a total cost of $45,705.
  
  
  
• Hospital employees who speak a foreign language also provide translation services for activities of daily living situations. The hospital pays their salaries during the translation period.

Pharmaceuticals for Discharged Patients - $88,578

Pharmaceuticals appropriate to their course of treatment are often provided at no charge to indigent patients upon discharge. The cost of these medications in FY’05 for LVH was $88,578.

Free Flu Vaccine - $64,000

The Infection Control Department shares policies, procedures and expertise with other hospitals, nursing homes, and health care providers in solving infection-related problems, helping to develop programs, etc., on an average of six to ten times each month.

The Infection Control Department also provides follow-up to blood/body fluid exposures experienced by pre-hospital personnel and Good Samaritans. This happens on the average two to three times per month. Follow-up is generally complicated and often involves 6 to 8 hours of time per exposure.

The Infection Control Practitioners have done educational presentations for the Burn Foundation, EMS and First Responders, universities, home care agencies, elementary schools, high schools, dialysis centers, professional groups, Girl Scouts, day care centers, adult day care centers, restaurants, group homes, prisons, youth organizations, physician offices and dental practices. We also provide education to industries and other organizations needing yearly infection control information to satisfy requirements for credentials. This service is provided on an average of four times a month. We provide a basic educational program for Communities in School at least annually.

Infection Control communicates regularly with all area Health Bureaus reporting communicable diseases, thus affording continuity of follow-up investigation for potentially exposed community members on an average of two to four times per week.

Infection Control is constantly in pursuit of educating the public about prevention of disease transmission. The Infection Control Department sponsors an annual Infection Control Week demonstration that offers a wealth of educational materials and pamphlets to the staff as well as the public. Lehigh Valley Hospital and Health Network’s web page on the Internet features infectious diseases and related Infection Control issues.

Infection Control provides educational updates via the POPS Newsletter to Physician Office Practices on a monthly basis. Infection Control offers a consulting service that helps physician and dental offices review JCAHO and OSHA requirements and identify plans for remediation.

Infection Control has implemented a new “hands on” visual demonstration and educational program which emphasizes the critical importance of “hand washing.” It is called “GlitterBug.”

It has been advertised in several promotional articles and on television. It is featured in the Healthy You magazine as well as GlitterBug brochures. Calls are fielded through the 402-CARE hotline. It is a “free of charge” program offered to the community. Infection Control has responded to several requests for the GlitterBug demonstration from school districts, daycare centers, community organizations, and organized health fairs. The service offering has been extremely popular. To date programs have reached over 20,000 participants. Requests for demonstrations have averaged between 5-8 times per month. Infection Control has participated in the Senior Horizons program and used GlitterBug to educate our senior citizens about the importance of hand washing. Infection Control has purchased additional equipment that affords them the opportunity to loan out the program to organizations wishing to present their own educational presentation.

The Infection Control Department answers questions from the public and from community agencies about communicable diseases and other related infection control issues on the average of four times each week. The department assists with contact tracing and outbreak investigations, e.g., Hepatitis A, B and C, Cryptosporidiosis, Meningitis, Psittacosis, Pertussis, Tuberculosis, West Nile Fever, Listerioris, E coli 0:157, Salmonella, Shigella, Cryptosporidium, Legionella, Chicken-pox, etc.

Infection control is currently partnering with area Health Bureaus, regional EMS coordinators, the FBI, fire, police, coroners, and other area hospitals in reviewing and revising our regional Bioterrorism Readiness Plan. LVHHN is spearheading the collaborative Counterterrorism Task Force. LVHHN has educated the 402-CARE staff to answer community calls about Bioterrorism issues. Also, the LVHHN Intranet and Internet sites are regularly updated to include the latest facts on Bioterrorism. We have become the region’s Bioterrorism experts. We have provided numerous inservices for the community, and have granted numerous interviews with the media. LVHHN’s Bioterrorism readiness plan has served as a template for other area hospitals and organizations.

LVHHN developed a SARS readiness plan that helped to protect our patients, personnel and visitors from nosocomial spread. Our experience was published in several venues including journals, newspapers, and was broadcast on radio and TV. The media exposure helped to answer questions from the community and other healthcare colleagues across the country. We shared our SARS readiness plan with several healthcare institutions. The SARS information hotline helped to alleviate community fears and anxiety.

Infection Control is again coordinating a community influenza program in which flu vaccine is offered at many area locations free of charge. Last year approximately 6,000 doses of FREE flu vaccine were administered even in the wake of a severe vaccine shortage. (Excess of $60,000 in vaccine and supplies – personnel time was volunteered). Locations included the Agricultural Hall and Stabler Arena. In response to the community request and the unfortunate deaths of children across the country, flu vaccines were offered free of charge to adults and children. This year the program will again be offered at expanded times and locations with the anticipation of delivering 10,000 doses of FREE vaccine to the community.

Infection Control provides four educational programs to physicians and their office staff. It assists them in meeting their annual OSHA mandated educational requirements. The program reviews the topics of the Bloodborne Pathogen Standard and Tuberculosis. It is a service that is offered at a minimal fee, which basically covers the handouts and refreshments.

Infection Control repeatedly provides TV, radio, and newspaper interviews. They serve as expert resources in a variety of infectious diseases including but not limited to Influenza, Cryptosporidium, Salmonella, and Hepatitis.

Last year Lehigh Valley Hospital launched a new program called Partners in Your Care. It encourages our patients to partner with their healthcare workers and ask them “if they washed their hands”. This program was implemented prior to the requirement under the JCAHO’s National Patient Safety Goal #7. As part of the program the patients are given informational pamphlets explaining the concept and a free sample container of waterless hand sanitizer. It is estimated that approximately 10,000 free hand sanitizer samples are distributed annually at a cost of $4,000.

In 9/04 Lehigh Valley Hospital implemented a new program where all inpatients are screened for influenza and pneumococcal vaccine and provided the vaccine if they meet the criteria. This program supports our mission of continuing to help our community improve their health and wellness. Evidence based research demonstrates that this immunization strategy decreases admissions for community acquired pneum

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