METROHEALTH ANNUAL REPORT 2016
Our
Leading the way to a healthier you and a healthier community through service, teaching, discovery and teamwork.
“Some call it Cleveland’s renaissance; I call it great. The rest of the country has noticed our region’s expansive cultural scene, ethnic restaurants, beautiful parks and sports teams. Now they’re noticing MetroHealth. We’re excelling by national measures and boldly planning our campus restructuring because every member of our community deserves quality care in a quality environment. We are rebuilding for you.”
THOMAS MCDONALD
Chairman, Board of Trustees
The MetroHealth System
Chief Executive Officer & President
McDonald Partners LLC
“I proudly represent The MetroHealth Foundation and the thousands of donors who are emotionally and financially invested in MetroHealth’s future. Philanthropy is playing a big role in the transformation of MetroHealth’s campus and neighborhood. Donors in 2016 generously contributed almost $10 million — a strong beginning — toward the transformation that will benefit our entire community.”
To see a list of donors, visit
metrohealth.org/2016-donors.
BRENDA KIRK
Chair, Board of Directors
The MetroHealth Foundation
Senior Vice President
Product & Strategy
Hyland Software
“It was our Board of Trustees who had the foresight and courage to sell bonds to rebuild our hospital, revitalize our West 25th Street campus and bring new energy to the rejuvenation of our West Side neighborhood.
What they’re really building is hope and promise and a healthy future for all of us.
And they’ll go down in history for that – with our endless thanks.
AKRAM BOUTROS, MD
President and Chief Executive Officer
The MetroHealth System
FINANCES
STRONGER EVERY YEAR!
OPERATING REVENUE FOR THE LAST 5 YEARS
2012
$783M
2013
$855M
2014
$905M
2015
$934M
2016
$1.04 Billion
AN
INCREASE OF 28%
FROM 2012-2016
CUYAHOGA COUNTY SUBSIDY
(TAXPAYER SUPPORT)
3.1%
OF TOTAL OPERATING REVENUE
$22.7M
ADJUSTED OPERATING INCOME*
*Adjusted operating income excludes non-recurring charges for one-time investments and transitional costs relating to the integration of new locations and the non-cash expenses associated with the recognition of GASB 68 (pension).
COMMUNITY
BENEFIT
$226 M
Investing in Cuyahoga County through programs to increase access to health care services and improve community health.
Includes uncompensated care, financial assistance and 100+ community programs. Program descriptions can be viewed here.
PORTION OF OPERATING EXPENSES THAT
GOES BACK TO OUR COMMUNITY
THE METROHEALTH SYSTEM* (2.5 X NATIONAL AVERAGE)
22.2%
CLEVELAND CLINIC**
10.3%
UNIVERSITY HOSPITALS**
9.4%
U.S. HOSPITALS AVERAGE***
8.8%
*MetroHealth community benefit calculation for the year ended 2016
**From Schedule H of the 2015 IRS Form 990
***From Ernst & Young 2015 Schedule H Benchmark Report for the American Hospital Association, based on 2012 data (most current available).
STATISTICAL HIGHLIGHTS
MOST PATIENT VISITS EVER
34%
INCREASE IN 4 YEARS
Outpatient visits increased 13.3% in 2016 and hospital patient days decreased by 1.5%. Both point to better health care — preventive care to keep people healthier longer and out of the hospital, which reduces overall health care costs for everyone.
Total Patient Visits
1,349,723
Inpatient
26,774
Outpatient
1,198,419
Emergency Department*
124,530
Babies Delivered
3,073
Metro Life Flight Transports
2,937
Helicopter
1,470
Ground
1,467
Trauma Activations
4,923
* at our West 25th Street verified Level I Trauma and Burn Center, and our three new emergency departments in Brecksville, Cleveland Heights and Parma
EMPLOYEES
20% INCREASE IN LAST 4 YEARS
2012
6,155
2013
6,387
2014
6,617
2015
6,759
2016
7,376
Increase in one year: 2016
Nurses
.8%
Physicians*
13%
Residents
2%
All other employees
10%
Total of 617 employees
9%
Inclusion and Diversity
As an organization, we are committed to reflecting the diverse patient population and community we serve.
IN 2016, 40% OF ALL HIRES WERE RACIALLY/ETHNICALLY DIVERSE AND/OR VETERANS.
LOCATIONS
REACHING EVERY CORNER OF THE COUNTY
FEBRUARY
Emergency Department at Cleveland Heights Medical Offices 
Emergency Department at Parma Medical Offices and Ambulatory Surgery Center
APRIL
Bedford Medical Offices 
Cleveland Heights Medical Offices
Parma Medical Offices and Ambulatory Surgery Center
Rocky River Medical Offices
JULY
Critical Care Pavilion 100,000-square-foot expansion
AUGUST
Brecksville Health and Surgery Center, with helipad
SEPTEMBER
Lyndhurst Health Center
OCTOBER
Clinic at Discount Drug Mart, North Royalton
Former HealthSpan site Pharmacy at site 24/7 Emergency Department at site
NOW,
97%
OF CUYAHOGA COUNTY
RESIDENTS ARE WITHIN
A 10-MINUTE DRIVE
OF PERSONALIZED
METROHEALTH CARE.
LOCATIONS AS OF DECEMBER 2016:
1
MetroHealth Medical Center — with verified Adult Level I Trauma and Burn Center, centrally located
3
Community Emergency Departments — Brecksville, Cleveland Heights, Parma
4
Clinics in Discount Drug Marts — Independence, North Royalton, Olmsted Falls, Parma Heights
5
MetroExpressCare
9
Pharmacies
13
Cleveland Metropolitan School District schools — served through the School Health Program
23
Health Centers
30+
Additional community sites offering MetroHealth care
FULFILLING OUR MISSION
OHIO:
44th
HIGHEST
INFANT
MORTALITY
IN THE U.S.
INFANT MORTALITY
HELPING OUR SMALLEST RESIDENTS IN A BIGGER WAY
It’s devastating to families and it’s devastating to us. In 2015 (the most recent data), 155 babies in Cuyahoga County were born alive but didn’t live to their first birthday. That’s part of the reason Ohio ranks 44th in the country in infant mortality.
Though we were already offering a lot of support parenting classes, excellent prenatal care including for highrisk pregnancies, doulas, a Level III Neonatal Intensive Care Unit (NICU), breastfeeding specialists, cribs, baby clothing and specialized pediatrics the infant mortality statistics told us more had to be done. We know we can have an effect on the main causes of infant mortality premature birth, unsafe sleep environments and birth defects.
That’s why we’ve partnered with the city of Cleveland,Cuyahoga County and others in First Year Cleveland, a community-wide response to infant mortality. Three programs that we initiated in 2016 are making a difference:
- Centering Pregnancy, bringing together pregnant women for group prenatal care, with opportunities for discussion and bonding
- Nurse-Family Partnership, home visits by a nurse during pregnancy and for the first 2½ years of a child’s life — funded by multiple grants
- Long-Acting Reversible Contraception (LARC), enabling women to plan and space pregnancies. With more women getting prenatal care, more support during pregnancy and after, and with more spacing between births, surely more babies will reach their first birthday, and well beyond.
OPIOIDS
COMBATING THE EQUAL OPPORTUNITY DESTROYER
In 2016, Cuyahoga County saw more than 500 deaths due to heroin and fentanyl overdoses, more than doubling the deaths in 2015. Joan Papp, MD, one of our Emergency Department physicians, said “not doing something felt morally wrong.” She explained that during the last decade she was witnessing a “slow-motion train wreck” — the steady rise in the number of opioid overdoses locally and nationally.
She did “something,” and much more. Dr. Papp is the leading force behind Project DAWN (Deaths Avoided With Naloxone), a community-based overdose education program that distributes naloxone, the drug that reverses opioid overdoses. Since its beginning in 2013, more than 5,000 kits have been distributed in Cuyahoga County, accounting for more than 799 known opioid overdose reversals.
Dr. Papp helped create and get passage of two state bills that get naloxone into the hands of emergency responders and friends and family members of those likely to overdose. She also worked with Senator Rob Portman for passage of the Comprehensive Addiction and Recovery Act (CARA), which authorizes an increase of more than $180 million a year for federal opioid programs. The next step? The Office of Opioid Safety, which MetroHealth will launch in summer 2017. Its goals are to help providers better recognize patients at risk of addiction, connect patients to recovery services and educate providers about safer prescribing. We’re trying to get to the front end of the epidemic through prevention.
EDUCATION
TAKING FLIGHT AT LINCOLN-WEST SCHOOL OF SCIENCE & HEALTH
A year ago if you had asked Endia what she wanted to do as an adult, she wouldn’t have imagined what she is so sure about now. She wants to be a nurse with Metro Life Flight.
As a Cleveland Metropolitan School District 10th grader, Endia, with encouragement from her father, chose to attend Lincoln-West School of Science & Health when it opened last August inside MetroHealth Medical Center. Probably the fi rst high school in the country to be in a hospital, it offers students shadowing experiences in the varied careers health care offers. These include direct medical care, of course, and also areas such as accounting, food service, pastoral care, strategic planning and, yes, being part of the helicopter flight crew.
Endia said life can be impersonal, with so much daily technology. But seeing the Metro Life Flight dispatchers in action and watching the medical team’s expertise with patients, she saw how human interaction made it all work. And that was it, she was smitten. Now, every morning at school she asks if she can observe Life Flight that day.
School has become an exciting place for Endia who has impressed teachers with her determination and academic success. The youngest of eight kids, Endia will be the first in her family to go to college. Her siblings are proud of her and expect her to soar.
NUTRITION
MIXING TRADITION WITH WHOLESOME INGREDIENTS: A RECIPE FOR HEALTHIER COMMUNITIES
It all started in the Hispanic community near MetroHealth Medical Center. A MetroHealth community health advocate met with Latina faith leaders and other community partners to ask them about what they thought could improve the health of the community. The enthusiastic response resulted in the formation of VIDA!, a coalition with an initial focus on food. There was a lot of interest in learning to prepare traditional dishes, like pollo guisado (stewed chicken) and arroz con habichuelas (rice and beans) in ways that wouldn’t perpetuate the high rates of diabetes, obesity and liver disease in their community. The outgrowth was “Community Health Cooks,” a training program that works in partnership with the women’s ministries of four Hispanic congregations in the Clark-Fulton neighborhood.
A local chef adapted the dishes the nucleus of women chose, creating recipes that are affordable, accessible to the neighborhood, nourishing and culturally appropriate. A nine-week training program was structured so that the women — some in mother/daughter teams — perfected the preparing and presentation of nutritional, ethnic meals. Their graduation night saw the serving of Mexican, Columbian and Guatemalan dishes, and a commitment to perpetuate what they learned. The newly-trained cooks are teaching their families, friends and other church members. Cooking together, socializing and encouraging each other has already resulted in families exercising more, losing weight and being able to wean off some medications as their health improves.
NOW NUTRITIOUS INGREDIENTS CAN BE PURCHASED AT METROHEALTH’S FARM STAND, OPEN TO THE PUBLIC, SPRING AND SUMMER AT METROHEALTH MEDICAL CENTER.
TRANSFORMATION
TO BETTER SERVE OUR COMMUNITY
The two-story expansion of our Critical Care Pavilion was the first construction in our planned multi-year transformation. The addition of 85 state-of-the-art ICU rooms and a Special Disease Care Unit, 100,000 square feet in all, was built above our Emergency Department. Finished in July 2016, the $82 million project was completed on time and under budget. That’s the way we like to do business!
From now through 2023, we’ll be building new, tearing down old and building new again so we ultimately have facilities that match our technology and expertise. It’s what you, our community, deserve.
A new parking garage will be completed in 2018, followed by a central utility plant, other support buildings and a 12-story hospital to replace the current one. The new hospital will back up to the southern part of our campus. This will make room for a large grassy area planned as a neighborhood recreation and gathering spot. And we’re helping revitalize the West 25th Street corridor, too.
Throughout the entire process, we’re committed to a diverse workforce with many local and minority-owned businesses. At the same time, we’ll continue growing the number of our locations across Cuyahoga County so everyone will be close to great MetroHealth care. All this progress is estimated to support 5,618 jobs and result in $873.3 million in economic benefit for the county.