TUOMEY HEALTHCARE SYSTEM SUMTER, SOUTH CAROLINA
Transcription
TUOMEY HEALTHCARE SYSTEM SUMTER, SOUTH CAROLINA
TUOMEY HEALTHCARE SYSTEM SUMTER, SOUTH CAROLINA 2013 COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN ADOPTED BY BOARD RESOLUTION JULY 22, 20131 1 Response to Schedule H (Form 990) Part V B 2 Dear Community Resident: Tuomey Healthcare System (THS) welcomes you to review this document as we strive to meet the health and medical needs in our community. All not-for-profit hospitals are required to develop this report in compliance with the Affordable Care Act. The “2013 Community Health Needs Assessment” identifies local health and medical needs and provides a plan to indicate how THS will respond to such needs. This document suggests areas where other local organizations and agencies might work with us to achieve desired improvements and illustrates one way we, THS, are meeting our obligations to efficiently deliver medical services. THS will conduct this effort at least once every three years. As you review this plan, please see if, in your opinion, we have identified the primary needs and if our intended response should make appropriate needed improvements. We do not have adequate resources to solve all the problems identified. Some issues are beyond the mission of the hospital and action is best suited for a response by others. Some improvements will require personal actions by individuals rather than the response of an organization. We view this as a plan for how we, along with other organizations and agencies, can collaborate to bring the best each has to offer to address the more pressing, identified needs. The report is a response to a federal requirement of not-for-profit hospital’s to identify the community benefit it provides in responding to documented community need. Footnotes are provided to answer specific tax form questions; for most purposes, they may be ignored. Of greater importance, however, is the potential for this report to guide our actions and the efforts of others to make needed health and medical improvements. Please think about how to help us improve the health and medical services our area needs. I invite your response to this report. We all live and work in this community together and our collective efforts can make living here more enjoyable and healthier. Thank You Tuomey Healthcare System Sumter, South Carolina Community Health Need Assessment Page i Table of Contents Executive Summary ........................................................................................................................................... 1 Project Objectives ......................................................................................................................................... 2 Brief Overview of Community Health Needs Assessment .................................................................... 2 Financial Opportunity Summary ................................................................................................................. 4 Approach............................................................................................................................................................. 5 Findings .............................................................................................................................................................10 Definition of Area Served by the Hospital Facility ................................................................................11 Demographic of the Community ..............................................................................................................12 Leading Causes of Death ...........................................................................................................................15 Primary and Chronic Disease Needs and Health Issues of Uninsured Persons, Low-Income Persons, and Minority Groups ..................................................................................................................16 Findings ........................................................................................................................................................21 Conclusions from Public Input to Community Health Needs Assessment .......................................21 Summary of Observations from Sumter County Compared to All Other South Carolina Counties, in Terms of Community Health Needs ...................................................................................................22 Summary of Observations from Sumter County Peer Comparisons ..................................................23 Conclusions from the Demographic Analysis Comparing Sumter County to National Averages .24 Key Conclusions from Consideration of the Other Statistical Data Examinations ..........................25 Existing Health Care Facilities and Resources and Implementation Plan...............................................27 Significant Needs .........................................................................................................................................29 Other Needs identified during the CHNA process ...............................................................................50 Overall Community Need Statement and Priority Ranking Score:......................................................71 Appendices........................................................................................................................................................73 Appendix A – Area Resident Survey Response ......................................................................................74 Appendix B – Process to Identify and Prioritize Community Need ...................................................80 Appendix C – Illustrative Schedule H (Form 990) Part V B Potential Response .............................86 Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 1 EXECUTIVE SUMMARY Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 2 Executive Summary Tuomey Healthcare System ("THS" or the "Hospital") is organized as a not-for-profit hospital. A Community Health Needs Assessment (CHNA) is part of the required hospital documentation of “Community Benefit” under the Affordable Care Act (ACA), required of all not-for-profit hospitals as a condition of retaining tax-exempt status. A CHNA assures THS identifies and responds to the primary health needs of its residents. This study is designed to comply with standards required of a not-for-profit hospital2. Tax reporting citations in this report are superseded by the most recent 990 H filings made by the hospital. In addition to completing a CHNA, and funding necessary improvements, a not-for-profit hospital must document the following: Financial assistance policy and policies relating to emergency medical care; Billing and collections; and Charges for medical care. Further explanation and specific regulations are available from Health and Human Services (HHS), the Internal Revenue Service (IRS), and the U.S. Department of the Treasury3. Project Objectives THS partnered with Quorum Health Resources (QHR) for the following4: Complete a CHNA report, compliant with Treasury – IRS; Provide the Hospital with information required to complete the IRS – 990h schedule; and Produce the information necessary for the Hospital to issue an assessment of community health needs and document its intended response. Brief Overview of Community Health Needs Assessment Typically, non-profit hospitals qualify for tax-exempt status as a Charitable Organization, described in Section 501(c) 3 of the Internal Revenue Code; however, the term 'Charitable Organization' is undefined. Prior to the passage of Medicare, charity was generally recognized as care provided to the less fortunate without means to pay. With the introduction of Medicare, the government met the burden of providing compensation for such care. Part 3 Treasury/IRS – 2011 – 52 Notice … Community Health Needs Assessment Requirements… As of the date of this report Notice of proposed rulemaking was published 6/26/2012 and available at http://federalregister.gov/a/2012-15537 4 Part 3 Treasury/IRS – 2011 – 52 Section 3.03 (2) third party disclosure notice 2 3 Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 3 In response, IRS Revenue ruling 69-545 eliminated the Charitable Organization standard and established the Community Benefit Standard as the basis for tax-exemption. Community Benefit determines if hospitals promote the health of a broad class of individuals in the community, based on factors including: Emergency room open to all, regardless of ability to pay; Surplus funds used to improve patient care, expand facilities, train, etc.; Controlled by independent civic leaders; and All available and qualified physicians are privileged. Specifically, the IRS requires: 5 Effective on tax years beginning after March 23, 2012, each 501(c) (3) hospital facility is required to conduct a CHNA at least once every three taxable years and adopt an implementation strategy to meet the community needs identified through such assessment; The assessment may be based on current information collected by a public health agency or non-profit organization and may be conducted together with one or more other organizations, including related organizations; The assessment process must take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge or expertise of public health issues; The hospital must disclose in its annual information report to the IRS (Form 990 and related schedules) how it is addressing the needs identified in the assessment and, if all identified needs are not addressed, the reasons why (e.g., lack of financial or human resources); Each hospital facility is required to make the assessment widely available and ideally downloadable from the hospital web site; Failure to complete a CHNA in any applicable three-year period results in a penalty to the organization of $50,000. For example, if a facility does not complete a CHNA in taxable years one, two, or three, it is subject to the penalty in year three. If it then fails to complete a CHNA in year four, it is subject to another penalty in year four (for failing to satisfy the requirement during the three-year period beginning with taxable year two and ending with taxable year four); and An organization that fails to disclose how it is meeting needs identified in the assessment is subject to existing incomplete return penalties.5 Section 6652 Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 4 Financial Opportunity Summary THS intends to work toward maintaining a Community Benefit allocation similar to current expenditures6 and as augmented in the Implementation Strategy in its response to Community Benefit7 obligations (see chart below). 12 Months Ending October 20128 Net Revenue $199,638,080 Bad Debt $10,492,116 Total Net Revenue $189,145,964 $5,674,379 Community Benefit Goal to 3% to 5% of Total Net Revenue $9,457,928 Current Charity $39,112,568 990 Documented Community $5,093,1249 Benefit Response to Schedule H (Form 990) Part V B 6 f “Community Benefit” is defined as the term used in the Affordable Care Act and by the IRS 990 instructions. This term may be defined differently by the Hospital when complying with reporting requirements of “Community Benefit” or “Charity” as defined by the State. Amounts shown are for planning and budgetary purposes only. Actual dollar allocations will vary year to year and are documented on the Corporate 990 return. 8 All values unless otherwise cited are obtained from the QHR comparative database, except “990 Documented Community Benefit” and “CHNA Anticipated Expenditures” both of which are sourced from the hospital. 9 From THS 9/30/2011 Form 990 Schedule H, Line 7K Column (e) 6 7 Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 5 APPROACH Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 6 Approach To complete a CHNA, the hospital must: Describe the processes and methods used to conduct the assessment; o Sources of data and dates retrieved; o Analytical methods applied; o Information gaps impacting ability to assess the needs; and o Identification of with whom the Hospital collaborated. Describe how the hospital gained input from community representatives; o When and how the organization consulted with these individuals; o Names, titles, and organizations of these individuals; and o Any special knowledge or expertise in public health possessed by these individuals. Describe the process and criteria used in prioritizing health needs; Describe existing resources available to meet the community health needs; and Identify the programs and resources the hospital facility plans to commit to meeting each identified need and the anticipated impact of those programs and resources on the health need. QHR takes a comprehensive approach to assess community health needs. We perform several independent data analyses based on secondary source data, augment this with local survey data, and resolve any data inconsistency or discrepancies from the combined opinions formed from local experts. We rely on secondary source data - and most secondary sources use the county as the smallest unit of analysis. We asked our local expert area residents, to note if they perceived the problems, or needs, identified by secondary sources to exist in their portion of the county.10 The data displays used in our analysis are presented in the Appendices. Data sources include:11 Web Site or Data Source Data Element Date Accessed Data Date www.countyhealthrankings.org Assessment of health needs of Sumter County compared to all SC counties October 16, 2012 2002 to 2010 www.communityhealth.hhs.gov Assessment of health needs of Sumter County compared to its national set of “peer counties” October 16, 2012 1996 to 2009 10 11 Response to Schedule H (Form 990) Part V B 1 i Response to Schedule H (Form 990) Part V B 1 d Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 7 Web Site or Data Source Data Element Date Accessed Truven (formerly known as Thomson) Market Planner Assess characteristics of the hospital’s primary service area, at a zip code level, based on classifying the population into various socio-economic groups, determining the health and medical tendencies of each group and creating an aggregate composition of the service area according to the contribution each group makes to the entire area; and, to access population size, trends and socio-economic characteristics; October 16, 2012 2012 www.capc.org and www.getpalliativecare.org To identify the availability of Palliative Care programs and services in the area October 16, 2012 2012 www.caringinfo.org and iweb.nhpco.org To identify the availability of hospice programs in the county October 16, 2012 2012 www.healthmetricsandevaluation.org To examine the prevalence of diabetic conditions and change in life expectancy October 16, 2012 1989 through 2009 www.dataplace.org To determine availability of specific health resources October 16, 2012 2005 www.cdc.gov To examine area trends for heart disease and stroke October 16, 2012 2007 to 2009 www.CHNA.org To identify potential needs among a variety of resource and health need metrics February 15, 2013 2003 to 2010 www.datawarehouse.hrsa.gov To identify applicable manpower shortage designations October 16, 2012 2013 www.worldlifeexpectancy.com/usahealth-rankings To determine relative importance among 15 top causes of death February 28, 2013 2010 published 11/29/12 12 Data Date In addition, we deployed a CHNA survey within the local population for any resident to complete.12 Response to Schedule H (Form 990) Part V B 1 h Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 8 We received community input from 165 area residents; survey responses started Monday, August 27, 2012 at 8:21 a.m. and ended with the last response on Tuesday, October 9, 2012 at 8:45 p.m.; The terms of gaining input stipulated each respondent would remain anonymous; The internet-based survey was promoted through an email list maintained by the Hospital and distributed to local civic and health organizations with a request for participation. Preliminary conclusions were presented to a local group of experts, who were asked to validate prior assessments and establish priority among various identified health and medical issues13; and Information analysis augmented by local opinions showed how Sumter County relates to its peers in terms of primary and chronic needs and other issues of uninsured persons, lowincome persons, and minority groups; respondents commented on if they believe certain population groups (or people with certain situations) need help to improve their condition, and if so, who needs to do what14. When the analysis was complete, we put the information and summary conclusions before our local group of experts15 who were asked to agree or disagree with the summary conclusions. They were free to augment potential conclusions with additional statements of need; and new needs did emerge from this exchange.16 Consultation with 17 local experts occurred again via an internet-based survey (explained below) during the period beginning Friday, November 2, 2012 8:28 A.M. and ending Wednesday November 14, 2012 2:34 P.M. With the prior steps identifying potential community needs, the local experts participated in a structured communication technique called a Delphi method, originally developed as a systematic, interactive forecasting method which relies on a panel of experts. Experts answer questionnaires in a series of rounds. We contemplated and implemented one round as referenced during the above dates. After each round, we provide an anonymous summary of the experts’ forecasts from the previous round, as well as reasons provided for their judgments. The process encourages experts to revise their earlier answers in light of the replies of other members of their panel. Typically, this process decreases the range of answers and moves the expert opinions toward a consensus "correct" answer. The process stops when we identify the most pressing, highest priority community needs. In the THS process, each local expert allocated 100 points among all identified needs, having the opportunity to introduce needs previously unidentified and challenge conclusions developed from the data analysis. A rank order of priorities emerged, with some needs receiving none or virtually no support and other needs receiving identical point allocations. Part response to Schedule H (Form 990) Part V B 3 Response to Schedule H (Form 990) Part V B 1 f 15 Part response to Schedule H (Form 990) Part V B 3 16 Response to Schedule H (Form 990) Part V B 1 e 13 14 Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 9 We dichotomized the rank order into two groups: high priority needs and low priority needs. The determination of the break point - high as opposed to low - was a qualitative interpretation by QHR and the THS executive team where a reasonable break point in rank occurred, indicated by the weight amount of points each potential need received and the number of local experts allocating any points to the need. When presented to the THS executive team, the dichotomized need rank order identified which needs the Hospital considered high responsibility to respond vs. low responsibility to respond. The result provided a matrix of needs and guided the Hospital in developing its implementation response17. 17 Response to Schedule H (Form 990) Part V Section B 6 g, h and Part V B 1 g Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 10 FINDINGS Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 11 Findings Definition of Area Served by the Hospital Facility18 THS, in conjunction with QHR, defines its service area as Sumter County in South Carolina, which includes the following ZIP codes: 29128 – Rembert 29154 – Sumter 29152 – Shaw, AFB 29040 – Dazell 29150 – Sumter 29168 – Wedgefield 29153 – Sumter 29104 – Mayesville 29125 - Pinewood In 2011, the Hospital received 83.5% of its patients from this area.19 18 19 Responds to IRS Form 990 (h) Part V B 1 a Truven MEDPAR patient origin data for the hospital; Responds to IRS Form 990 (h) Part V B 1 a Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 12 Demographic of the Community20 The 2012 population for Sumter County is estimated to be 110,28221 and expected to increase at a rate of 2.7%. This is in contrast to the 3.9% national rate of growth and the South Carolina growth rate of 6.4%. Sumter County in 2017 anticipates a population of 113,207. According to the population estimates utilized by Truven, provided by The Neilson Company, the 2012 median age for the county is 35.8 years, which is younger than the South Carolina median age (37.5 years) and the national median age (36.8 years). The 2012 Median Household Income for the area is $37,403, which is lower than the South Carolina median income of $42,583 and the national median income of $49,559. Median Household Wealth value also is below the National and the South Carolina values. The Median Home Values show the same pattern as Household Wealth. Sumter’s unemployment rate as of October 2012 was 9.5%22, which is worse than the 8.6% statewide and the national civilian unemployment rates. The portion of the population in the county over 65 is 13.6%, the same as the South Carolina average. The portion of the population of women of childbearing age is 20.5%, above the South Carolina and national average of 20.1%. 47% of the population is Black non-Hispanic and 46.3% is White non-Hispanic. The Hispanic population comprises 3.5% of the total. Dem ographics Expert 2.7 2012 Dem ographic Snapshot Area: Sum pter Co SC Level of Geography: ZIP Code DEMOGRAPHIC CHARACTERISTICS Selected Area 106,193 110,282 113,207 2.7% $48,351 2000 Total Population 2012 Total Population 2017 Total Population % Change 2012 - 2017 Average Household Incom e USA 281,421,906 313,095,504 325,256,835 3.9% $67,315 Total Male Population Total Fem ale Population Fem ales, Child Bearing Age (15-44) POPULATION DISTRIBUTION 2012 23,961 4,810 11,760 13,895 28,575 12,289 14,992 110,282 % of Total 21.7% 4.4% 10.7% 12.6% 25.9% 11.1% 13.6% 100.0% 2017 25,230 4,605 11,103 15,822 26,258 13,705 16,484 113,207 % of Total 22.3% 4.1% 9.8% 14.0% 23.2% 12.1% 14.6% 100.0% USA 2012 % of Total 20.2% 4.3% 9.7% 13.5% 28.1% 11.4% 12.9% 100.0% EDUCATION LEVEL 2012 Adult Education Level Less than High School Som e High School High School Degree Som e College/Assoc. Degree Bachelor's Degree or Greater Total 2017 % Change 54,073 3.1% 59,134 2.3% 22,168 -1.7% HOUSEHOLD INCOME DISTRIBUTION Age Distribution Age Group 0-14 15-17 18-24 25-34 35-54 55-64 65+ Total 2012 52,456 57,826 22,559 2012 Household Incom e <$15K $15-25K $25-50K $50-75K $75-100K Over $100K Total Incom e Distribution USA HH Count % of Total % of Total 7,931 19.0% 13.0% 5,984 14.3% 10.8% 13,224 31.6% 26.7% 7,710 18.4% 19.5% 3,516 8.4% 11.9% 3,439 8.2% 18.2% 41,804 100.0% 100.0% RACE/ETHNICITY Education Level Distribution USA Pop Age 25+ % of Total % of Total 4,347 6.2% 6.3% 8,862 12.7% 8.6% 22,044 31.6% 28.7% 22,124 31.7% 28.5% 12,374 17.7% 27.8% 69,751 100.0% 100.0% Race/Ethnicity White Non-Hispanic Black Non-Hispanic Hispanic Asian & Pacific Is. Non-Hispanic All Others Total Race/Ethnicity Distribution USA % of Total % of Total 46.3% 62.8% 47.0% 12.3% 3.5% 17.0% 1.2% 5.0% 2.1% 2.9% 100.0% 100.0% 2012 Pop 51,034 51,794 3,873 1,320 2,261 110,282 © 2012 The Nielsen Com pany, © 2012 Thom son Reuters. All Rights Reserved Responds to IRS Form 990 (h) Part V B 1 b All population information, unless otherwise cited, sourced from Truven (formally Thomson) Market Planner 22http://research.stlouisfed.org/fred2/series/SUMT945URN; http://research.stlouisfed.org/fred2/series/UNRATE 20 21 Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 13 Current Households by Income Group Population Distribution by Age Group 14,992 0-14 3,439 3,516 <$15K 15-17 12,289 23,961 28,575 7,931 18-24 4,810 25-34 11,760 35-54 $25-50K 7,710 65+ Population Age 25+ by Education Level Less than High School 12,374 Some High School 4,347 5,984 13,224 55-64 13,895 1,320 2,261 3,873 $75-100K Over $100K White NonHispanic Black NonHispanic High School Degree 51,034 Some College/Assoc. Degree Bachelor's Degree or Greater $50-75K Population Distribution by Race/Ethnicity 8,862 22,124 22,044 $15-25K Hispanic 51,794 Asian & Pacific Is. Non-Hispanic All Others The population also was examined according to characteristics presented in the Claritas Prizm customer segmentation data. This system segments the population into 66 demographically and behaviorally distinct groups. Each group, based on annual survey data, is documented as exhibiting specific health behaviors. The makeup of the service area, according to the mix of Prizm segments and its characteristics, is contrasted to the national population averages to discern the following table of probable lifestyle and medical conditions present in the population. Items with red text are viewed as statistically important adverse potential findings. Items with blue text are viewed as statistically important potential beneficial findings. Items with black text are viewed as either not statistically different from the national normal situation or not being a favorable nor an unfavorable consideration in our use of the information. Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 14 Health Service Topic Dem and as % of National % of Population Effected Health Service Topic Weight / Lifestyle BMI: Morbid/Obese Vigorous Exercise 94.6% Chronic Diabetes 119.3% 92.7% Very Unhealthy Eating Habits 113.3% 29.1% Routine Screen: Cardiac Stress 2yr 47.9% Chronic High Cholesterol 12.4% Routine Cholesterol Screening 27.5% Chronic High Blood Pressure 3.1% Chronic Heart Disease Behavior I Will Travel to Obtain Medical Care % of Population Effected Heart 113.8% Healthy Eating Habits Dem and as % of National 95.1% 14.8% 102.6% 22.9% 94.1% 47.8% 111.1% 29.2% 127.3% 10.6% 102.4% 90.4% 99.3% 42.0% 89.8% 41.9% 102.4% 19.7% Routine Services 100.0% 31.7% FP/GP: 1+ Visit I Follow Treatm ent Recom m endations 90.6% 36.6% Used Midlevel in last 6 Months I am Responsible for My Health 95.3% 56.3% OB/Gyn 1+ Visit Am bulatory Surgery last 12 Months Pulmonary Chronic COPD 129.5% 6.6% Tobacco Use: Cigarettes 120.8% 31.3% Use Internet to Talk to MD Chronic Allergies 106.7% 22.7% Facebook Opinions Internet Usage Looked for Provider Rating Cancer 79.2% 11.5% 105.0% 10.8% 88.5% 12.7% Mam m ography in Past Yr 95.5% 43.4% Cancer Screen: Colorectal 2 yr 93.9% 23.7% Charitable Contrib: Hosp/Hosp Sys 92.0% 21.9% Cancer Screen: Pap/Cerv Test 2 yr 93.9% 56.5% Charitable Contrib: Other Health Org 89.0% 34.8% Routine Screen: Prostate 2 yr 96.0% 30.6% HSA/FSA: Em ployer Offers 93.2% 47.9% 104.4% 35.8% 97.7% 23.0% Orthopedic Misc Emergency Service Chronic Low er Back Pain 113.8% 25.7% Em ergency Room Use Chronic Osteoporosis 115.5% 11.2% Urgent Care Use Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 15 Leading Causes of Death Cause of Death SC Rank Sumter Rank Condition Rank among all counties in state (#1 rank = worse in state) Rate of Death per 100,000 age adjusted SC Observation Sumter 1 1 Heart Disease 20 of 46 182.1 234.0 As expected 2, 6, 9, 15, 19, 21, 26, 29, 30, 31, 32, 34, 35, 36, 42 2 Cancer 16 of 46 179.5 213.3 Higher than expected 3 3 Stroke 5 of 46 48.8 78.2 Higher than expected 4 4 Lung 16 of 46 46.6 48.7 As expected 11, 23 5 Accidents 43 of 46 47.8 42.5 As expected 7 6 Diabetes 8 of 46 22.4 38.2 Higher than expected 5 7 Alzheimer’s 15 of 46 30.6 33.6 Higher than expected 13 8 Blood Poisoning 22 of 46 13.3 16.3 Higher than expected 12 9 Flue/ Pneumonia 34 of 46 15.6 15.3 Lower than expected 8 10 Kidney 43 of 46 18.0 14.3 As expected 10 11 Hypertension 14 of 46 8.5 14.3 Higher than expected 27 12 Homicide 16 of 45 7.7 10.3 Higher than expected 18 13 Liver 31 of 46 10.2 10.1 16 14 Suicide 42 of 46 13.1 8.0 Lower than expected 24 15 Parkinson’s 34 of 46 5.8 4.0 Lower than expected As expected Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 16 Primary and Chronic Disease Needs and Health Issues of Uninsured Persons, LowIncome Persons, and Minority Groups Some information is available to describe the size and composition of various uninsured persons, low income persons, minority groups, and other vulnerable population segments. Specific studies identifying needs of such groups, distinct from the general population at a county unit of analysis, are not readily available from secondary sources. The National Healthcare Disparities Report results from a Congressional directive to the Agency for Healthcare Research and Quality (AHRQ). This production is an annual report to track disparities related to "racial factors and socioeconomic factors in priority populations." The emphasis is on disparities related to race, ethnicity, and socioeconomic status. The directive includes a charge to examine disparities in "priority populations," which are groups with unique health care needs or issues that require special attention.23 Nationally, this report observes the following trends: Measures for which Blacks were worse than Whites and are getting better: o o o HIV and AIDS – New AIDS cases per 100,000 population age 13 and over; and Functional Status Preservation and Rehabilitation – Female Medicare beneficiaries age 65 and over who reported ever being screened for osteoporosis with a bone mass or bone density measurement. Measures for which Blacks were worse than Whites and staying the same: o o o o 23 Diabetes – Hospital admissions for short-term complications of diabetes per 100,000 population; Cancer – Breast cancer diagnosed at advanced stage per 100,000 women age 40 and over ; breast cancer deaths per 100,000 female population per year; adults age 50 and over who ever received colorectal cancer screening; colorectal cancer diagnosed at advanced stage per 100,000 population age 50 and over; colorectal cancer deaths per 100,000 population per year; Diabetes – Hospital admissions for lower extremity amputations per 1,000 population age 18 and over with diabetes; Maternal and Child Health – Children ages 2-17 who had a dental visit in the calendar year; Children ages 19-35 months who received all recommended vaccines; Mental Health and Substance Abuse – Adults with a major depressive episode in the last 12 months who received treatment for depression in the last 12 months; people age 12 and over treated for substance abuse who completed treatment course; http://www.ahrq.gov/qual/nhdr10/Chap10.htm 2010 Proprietary Tuomey Healthcare System Sumter, South Carolina o o o o Respiratory Diseases – Adults age 65 and over who ever received pneumococcal vaccination; hospital patients with pneumonia who received recommended hospital care; Supportive and Palliative Care – High-risk long-stay nursing home residents with pressure sores; short-stay nursing home residents with pressure sores; adult home health care patients who were admitted to the hospital; hospice patients who received the right amount of medicine for pain; Timeliness – Adults who needed care right away for an illness, injury, or condition in the last 12 months who got care as soon as wanted; emergency department visits where patients left without being seen; and Access – People with a usual primary care provider; people with a specific source of ongoing care. Measures for which Asians were worse than Whites and getting better: o Cancer – Adults age 50 and over who ever received colorectal cancer screening; and o Patient Safety – Adult surgery patients who received appropriate timing of antibiotics. Measures for which Asians were worse than Whites and staying the same: o o Community Health Needs Assessment Page 17 Respiratory Diseases – Adults age 65 and over who ever received pneumococcal vaccination; hospital patients with pneumonia who received recommended hospital care; and Access – People with a usual primary care provider. Measures for which American Indians and Alaska Natives were worse than Whites for most recent year and staying the same: o o o o o o Heart Disease – Hospital patients with heart failure who received recommended hospital care; HIV and AIDS – New AIDS cases per 100,000 population age 13 and over; Respiratory Diseases – Hospital patients with pneumonia who received recommended hospital care; Functional Status Preservation and Rehabilitation – Female Medicare beneficiaries age 65 and over who reported ever being screened for osteoporosis with a bone mass or bone density measurement; Supportive and Palliative Care – Hospice patients who received the right amount of medicine for pain; high-risk, long-stay nursing home residents with pressure sores; adult home health care patients who were admitted to the hospital; and Access – People under age 65 with health insurance. Proprietary Tuomey Healthcare System Sumter, South Carolina Measures for which American Indians and Alaska Natives were worse than Whites for most recent year and getting worse: o Cancer – Adults age 50 and over who ever received colorectal cancer screening; and o Patient safety – Adult surgery patients who received appropriate timing of antibiotics. Measures for which Hispanics were worse than non-Hispanic Whites for most recent year and getting better: o o o Community Health Needs Assessment Page 18 Maternal and Child Health – Children ages 2-17 who had a dental visit in the calendar year; Lifestyle Modification – Adult current smokers with a checkup in the last 12 months who received advice to quit smoking; adults with obesity who ever received advice from a health provider about healthy eating; and Functional Status Preservation and Rehabilitation – Female Medicare beneficiaries age 65 and over who reported ever being screened for osteoporosis with a bone mass or bone density measurement. Measures for which Hispanics were worse than non-Hispanic Whites for most recent year and staying the same: o o o o o o o o Cancer – Women age 40 and over who received a mammogram in the last 2 years; adults age 50 and over who ever received colorectal cancer screening; Diabetes – Adults age 40 and over with diagnosed diabetes who received all three recommended services for diabetes in the calendar year; Heart Disease – Hospital patients with heart attack and left ventricular systolic dysfunction who were prescribed angiotensin-converting enzyme inhibitor or angiotensin receptor blocker at discharge; hospital patients with heart failure who received recommended hospital care; HIV and AIDS – New AIDS cases per 100,000 population age 13 and over; Mental Health and Substance Abuse – Adults with a major depressive episode in the last 12 months who received treatment for depression in the last 12 months; Respiratory Disease – Adults age 65 and over who ever received pneumococcal vaccination; hospital patients with pneumonia who received recommended hospital care; Lifestyle Modification – Adults with obesity who ever received advice from a health provider to exercise more; Supportive and Palliative Care – Long-stay nursing home residents with physical restraints; high-risk, long-stay nursing home residents with pressure sores; short-stay Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 19 nursing home residents with pressure sores; adult home health care patients who were admitted to the hospital; hospice patients who received the right amount of medicine for pain; o o o o Patient Safety – Adult surgery patients who received appropriate timing of antibiotics; Timeliness – Adults who needed care right away for an illness, injury, or condition in the last 12 months who got care as soon as wanted; Patient Centeredness – Adults with ambulatory visits who reported poor communication with health providers; children with ambulatory visits who reported poor communication with health providers; and Access – People under age 65 with health insurance; people under age 65 who were uninsured all year; people with a specific source of ongoing care; people with a usual primary care provider; people unable to get or delayed in getting needed care due to financial or insurance reasons Measures for which Hispanics were worse than non-Hispanic Whites for most recent year and getting worse: o Maternal and Child Health – Children ages 3-6 who ever had their vision checked by a health provider. We asked in the community survey about such unique needs and reviewed their response to identify if any of the above trends were obvious in the service area. Accordingly, we place great reliance on the commentary received to identify unique population needs to which we should respond. Literally, we received a handful of responses from the 165 participants (offering 152 comments), concluding such needs were not dominant considerations and topics presented were not materially different from considerations for the public at large. Specific comments as quoted by participants included: Care of child in K-12; Care of indigents; an aging population, cuts in Medicare and Medicaid; Cost of healthcare for those of us who have to pay for insurance and healthcare; Lack of education to community regarding valid ED visits; need more facilities to see indigent patients with no primary medical doctor; ED waiting room often looks like a place for social gatherings; Mental health facilities not available, especially for children; No help for mentally ill patients; People are not willing to go out and look for employment, thereby depending on not-forprofit hospitals to take care of ALL of their medical needs; Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 20 People not paying for their healthcare, making it the responsibility of others or the government; Lack of Medicare and Medicaid funding and the welfare system being used as a crutch that enables lazy people who just want to milk the system; Need for specialty services for the underserved community. Primary care is available; however, when a patient has a medical need for a referral to a specialist, often times they have to be referred out of town or are not able to go because they can't afford the visit; and Until we get people educated and/or begin correcting the problems of teen pregnancy, drug use, and alcohol abuse, all the other things will be half done because we can't afford to do it all. Statistical information about special populations follows: Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 21 Findings Upon completion of the CHNA, QHR identified several issues within the THS community: Conclusions from Public Input to Community Health Needs Assessment 165 area residents participated in a survey asking opinions about their perception of local health care needs. In descending order of opinion, nine topics were identified as being of "Major Concern" or "Most Important Issue to Resolve": 1. Diabetes - 78% listed as a major concern; 2. Heart disease - 77% listed as a major concern; 3. People Making Unhealthy Food Choices/Obesity - 68% listed as a major concern; 4. Not Having Health Insurance - 66% listed as a major concern; 5. Low Education Level - 66% listed as a major concern; 6. Teen Pregnancy - 65% listed as a major concern; 7. Cancer - 65% listed as a major concern; and 8. Poverty - 58% listed as a major concern. Adult abuse of alcohol and/or drugs was noted by 52% of responses as a concern. In the past two years, 71% observed a problem with Healthy Living; 61% observed a problem with Individual and Family Health Concerns; and 52% observed a problem with Healthcare Availability. The most important issue to resolve was noted as Individual and Family Health Concerns. Written comments emphasized the above points as many people believe health care insurance, education, obesity, safety, and mental problems exist in the community. Violence and emergency are secondary concerns; The typical respondent is a married white, non-Hispanic female living in a tobacco free home in Sumter who has some college education, children living at home, a primary care physician, a dentist, and an eye care provider. 11% had a mental health advisor. 13% of respondents were Black. Responses came from 13 zip codes and all income classifications other than a household income of less than $5,000. 44% had earnings of at least $100,000. 6% of respondents were retired and 2% were unemployed. 4% did not have any health insurance. Respondents averaged 2.8 days of illness in the month preceding taking the survey, with 3% responding being ill all 30 days and 61% reported no illness. Respondents also reported on average of having one mental illness day in the last 30 days, with 83% reporting no days ill. 2/3 of respondents reported not having a medical payment problem in the last two years; Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 22 Overall perceived health status was relatively good - 7.68 on a scale of 1 to 10. The local economy is perceived to have gotten worse during the last year; and The majority of respondents did not leave the county for care. The primary reasons residents left the county for care was for travel to Charleston or Columbia for surgery or pediatric and cardiology conditions. Several minor mentions were made of various subspecialty medicine reasons, with orthopedic and ophthalmology being the more prominent of the minor reasons for leaving. Summary of Observations from Sumter County Compared to All Other South Carolina Counties, in Terms of Community Health Needs In general, Sumter County residents are at about average health for South Carolina; In a health status classification termed "Health Outcomes", Sumter ranks number 20 among the 46 ranked counties (best being #1). On the beneficial side of the ledger, Low Birth Weight births among Sumter mothers is 10.4%, a value approaching the state average but considerably above the national goals. Premature Death rate (death prior to age 75) in Sumter County is statistically above the state average and close to twice the national goal. Self-reported health status measures show Sumter residents at about the state average but above the national goal; and In another health status classification "Health Factors", Sumter County does not fare as well, ranking 26th among the 46 counties. Clinical Care measures are at the state average, except for the physician to population ratio which is more than double the national goal (not enough physicians to serve the population) and about 50% higher than state average. Other conditions where improvement remains to achieving state average rates and then national goals include: o Adult Obesity; o Physical Inactivity; o Sexually Transmitted Disease; o Teen Birth Rate; o Children in Single Parent Households; o Violent Crime Rate; o Limited Access to Healthy Food; and o Percent of Fast Food Restaurant. Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 23 Summary of Observations from Sumter County Peer Comparisons The federal government administers a process to allocate all counties into "Peer" groups. County "Peer" groups have similar social, economic, and demographic characteristics. Health and wellness observations when Sumter County is compared to its national set of Peer Counties and compared to national rates make the following observations: UNFAVORABLE observations occurring at rates worse than national AND worse than among Peers Low Birth Weight; Very Low Birth Weight; Premature Births; Infant Mortality; Post-Neonatal Infant Mortality; Female Breast Cancer; Colon Cancer; Coronary Heart Disease; Homicide; Lung Cancer; Motor Vehicle Injuries; and Stroke. SOMEWHAT A CONCERN observations because occurrence is EITHER above national average or above Peer group average: Neonatal Infant Mortality; Births To Women Under 18; Births To Unmarried Women; and White, Non Hispanic Infant Mortality. BETTER PERFORMANCE than peers and national rates: Births To Women Ages 40 to 54; Black, Non Hispanic Infant Mortality; Suicide; and Unintentional Injury. Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 24 Conclusions from the Demographic Analysis Comparing Sumter County to National Averages Sumter County in 2012 comprises 110,282 residents. During the next five years, it is expected to see a population increase of 2.7% to achieve 113,207 residents. This growth is slower than anticipated state (6.4%) and national (3.9%) growth. The population is younger and has a lower median income than the state or national comparisons. 13.6% of the population is age 65 or older, the same percentage as SC. 3.5% are non-Hispanic White, Asian, and Pacific Island origin; non-Hispanics constitute 1.2% of the population; Blacks comprise 47% of the population; Whites 46.3%. Females ages 14 to 44 comprise 20.7% of the population, slightly more than the percentage in SC (20.1%) or the nation (20.1%). The following areas were identified comparing the county to national averages.24 Metrics impacting more than 30% of the population and which are statistically significantly different from the national average: Pap/Cervix Screening was 6% below average, impacting 56% - an adverse finding; Cholesterol Screening was 6% below average, impacting 48% - an adverse finding; Vigorous exercise was 5% below average, impacting 48% - an adverse finding; Employer Health Savings Accounts was 7% below average, impacting 48% - neither a beneficial or adverse finding; OB/GYN Visit was 10% below average, impacting 42% - an adverse finding; Compliant With Treatment Recommendations was 9% below average, impacting 37% - an adverse finding; Making Charitable Contributions to Non-Health Organizations was 11% below average, impacting 35% - neither a beneficial or adverse finding; and Smoking was 21% above average, impacting 31% - an adverse finding. Situations and Conditions statistically significantly different from the national average, but impacting less than 30% of the population include: Chronic High Blood Pressure was 11% above average, impacting 29% - an adverse finding; Morbid Obese was 14% above average, impacting 29% - an adverse finding; Healthy Eating Habits was 7% below average, impacting 28% - an adverse finding Chronic Lower Back Pain was 14% above average, impacting 26% - an adverse finding; 24 The bullet point following discussion comes from a corrected demographic analysis from what was presented to the local experts for their agreement or disagreement. The significant findings are not materially different as in the prior analysis. The changes are considered minor, technical corrections and do not impact the overall findings of the analysis. Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 25 Colorectal Screening was 6% below average, impacting 24% - an adverse finding; Looked for Provider Ratings was 12% below average, impacting 13% - neither a beneficial or adverse finding; Chronic Allergies was 7% above average, impacting 23% - an adverse finding; Making Charitable contributions to Health Organizations was 8% below average, impacting 22% - neither a beneficial or adverse finding; Chronic diabetes was 19% above average, impacting 12% - an adverse finding; Talked to MD by Internet was 21% below average, impacting 12% - neither a beneficial or adverse finding; Posting/Reading Facebook Healthcare Opinions was 5% above average, impacting 11% neither a beneficial or adverse finding; Chronic Osteoporosis was 16% above average, impacting 11% - an adverse finding; Chronic Heart Disease was 27% above average, impacting 11% - an adverse finding; Chronic COPD 30% was above average, impacting 7% - an adverse finding; and Very Unhealthy Eating Habits was 13% above average, impacting 3% - an adverse finding. Key Conclusions from Consideration of the Other Statistical Data Examinations Additional observations of Sumter County found: Palliative Care programs (programs focused not on curative actions but designed to relieve disease symptoms pain and stress arising from serious illness) exist in the county; and Hospice 2 programs exist in the county. Ranking the causes of death in Sumter finds the leading causes to be the following (in descending order of occurrence): Heart Disease #1 cause of death statewide and in Sumter 234/100,000 ranking #20 among 46 SC Counties; Cancer # 2 cause of death statewide and in Sumter 213.3/100,000 ranking #16 SC County significantly higher than expected; Stroke #3 cause of death statewide and in Sumter 78.2/100,000 ranking #5 SC County significantly higher than expected; Lung Disease #4 cause of death in Sumter, statewide #5 - 48.7/100,000 ranking #16 SC County; Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 26 Accidents #5 cause of death in Sumter, statewide #4 – 42.5/100,000 ranking #43 SC County - significantly higher than expected; statewide Traffic Accidents #5 cause of death for males, #14 for females; Diabetes #6 cause of death in Sumter, statewide #7 – 38.2/100,000 ranking #8 SC County; Alzheimer’s #7 cause of death in Sumter, statewide #6 – 33.6/100,000 ranking #15 SC County - significantly lower than expected; Blood Poisoning #8 cause of death in Sumter, statewide #10 – 16.3/100,000 ranking #22 SC County - significantly higher than expected; Flue #9 cause of death statewide and in Sumter 15.3/100,000 ranking #34 SC County significantly lower than expected; Kidney Disease #10 cause of death in Sumter, statewide #8 14.3/100,000 ranking #43 SC County; and Among other leading causes of death, Hypertension and Homicide are significantly higher than expected; Parkinson’s and Suicide are significantly lower than expected, Suicide ranking is an average, as it is #7 cause of death for males and #22 for females. According to a different organization, the incident of Heart Disease is above state and national average, with a very high comorbidity rate. According to a different organization, the incident of Stroke deaths is above state and national average; diabetes and hypertension also have a high comorbidity incident. According to a different organization, diabetes is well above state average. Life expectancy for Sumter males in 1989 was 68.7 years, 12.9 years behind the top counties, improving in 2009 to 72.3 years, only 9.3 years behind the top counties. Life expectancy for Sumter females in 1989 was 76 years, 9.8 years behind the top counties, improving in 2009 to 79.1 years, only 6.7 years behind the top counties. Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 27 EXISTING HEALTH CARE FACILITIES AND RESOURCES AND IMPLEMENTATION PLAN Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 28 Significant Health Needs We used the priority ranking of area health needs to organize the search for locally available resources.25 The following list identifies locally available resources corresponding to each priority need: Identifies the rank order of each identified Significant Need; Presents the factors considered in developing the ranking; Establishes a Problem Statement to specify the problem indicated by use of the Significant Need term; Identifies THS current efforts responding to the need; Establishes the Implementation Plan programs and resources THS will devote to attempt to achieve improvements; Documents the Leading Indicators THS will use to measure progress; Presents the Lagging Indicators THS believes the Leading Indicators will influence in a positive fashion, and; Presents the locally available resources noted during the development of this report as believed to be currently available to respond to this need. In general, THS is the major hospital in the service area. THS is a 283-bed, acute medical center located in Sumter, SC. The next closest facilities are outside the service area and include: 25 Carolinas Health System – 431-bed regional center in Florence, SC; 45.7 miles from Sumter (57 minutes) Providence Hospital – 314-bed regional center in Columbia, SC; 43 miles from Sumter (1 Hour and 3 minutes) Palmetto Health Richland – 649-bed regional center in Columbia, S.C.; 45 miles from Sumter (1 hour 7 minutes) Palmetto Health Baptist – 489-bed regional center in Columbia, S.C.; 45 miles from Sumter (1 hour 8 minutes) Lexington Medical Center – 414-bed regional center in West Columbia, S.C.; 48 miles from Sumter (1 hour 14 minutes) McLeod Health – 453-bed regional center in Florence, S.C.; 40.2 miles from Sumter (1 hour 1 minute) Kershaw County Medical Center – 121-bed hospital in Camden, S.C.; 30.2 miles from Sumter (45 minutes) Response to IRS Form 990 h Part V B 1 c Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 29 Clarendon Health Center – 56-bed hospital in Manning, S.C.; 25 miles from Sumter (39 minutes) In rank order of need, the local resources, listed in the tables beginning on the next page, could be available to respond to the need. All data items analyzed to determine significant needs are “Lagging Indicators”, measures presenting results after a period of time, characterizing historical performance. Lagging Indicators tell you nothing about how the outcomes were achieved. In contrast the THS Implementation Plan utilizes “Leading Indicators”. Leading Indicators anticipate change in the Lagging Indicator. Leading Indicators focus on short-term performance, and if accurately selected, anticipate the broader achievement of desired change in the Lagging Indicator. In the QHR application Leading Indicators also must be within the ability of the hospital to influence and measure. Significant Needs 1. HEART DISEASE - #1 cause of death, #20 SC county, major concern by 77% of responding consumers, 27% above average incident; incident above national and state average. (Ranked 1 out of 29). Problem Statement: Heat Disease death rate needs to decrease. HOSPITAL SERVICES AVAILABLE TO RESPOND TO THIS NEED INCLUDE: Tuomey Emergency Department and EMS STEMI program. Community Health Initiatives education and screening. SmartBeat Program. Tuomey Health Guides Tuomey Cardiac Cath Lab and Telemetry Services. HOSPITAL IMPLEMENTATION PLAN PROGRAMMATIC INITIATIVES:26 Coordinating efforts with the organizations listed below – regarding services, education, and screening. Tuomey will work closely with Medical Emergency Response services and surrounding hospitals to coordinate care. Promote healthy living and health lifestyle choices. ANTICIPATED RESULTS FROM HOSPITAL IMPLEMENTATION PLAN This section in each need for which the hospital plans an implementation strategy responds to Schedule H (form 990) Part V Section B 6. a. and 6. b. 26 Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 30 Tuomey’s efforts can help address the symptoms of and results from adverse lifestyle choices and other factors. Tuomey can treat heart disease in an aggressive and proactive manner. LEADING INDICATOR HOSPITAL WILL USE TO MEASURE PROGRESS: STEMI Program Statistics o STEMI patients median transfer time less than 30 minutes. LAGGING INDICATOR HOSPITAL WILL USE TO IDENTIFY IMPROVEMENT Production of Sumter County Rate of Heart Disease Death per 100,000 population to less than 234. Opportunity Statement: Promote the use of screening and treatment services Other Local Resources identified during the CHNA process which are believed available to respond to this need include the following: YMCA 50 Willow Drive, 803-773-1404 Sumter, SC 29150 American Heart Association 2381 Peach Orchard Rd, Sumter, SC 29154 Birnie Hope Center 210 S. Purdy St , 803-436-2645 Sumter, SC 29150 North Hope Center 904 N. Main St, 803-436-2691 Sumter SC 29150 South Hope Center 1125 S. Lafayette Blvd, 803-436-2653 Sumter SC 29150 Sumter School District 1345 Wilson Hall Rd, 803-469-6900 Sumter SC 29150 Midlands Cardiology Assoc 213 W. Hampton Ave, 803-773-1379 Sumter SC 29150 Sumter Medical Consultants CV Div 540 Physicians Ln, 803-778-1941 Sumter SC 29150 Proprietary Tuomey Healthcare System Sumter, South Carolina McLeod Cardiology Assoc Community Health Needs Assessment Page 31 115 N. Sumter St, 803-418-5969 Sumter SC 29150 Sumter County Public Health Dept 105 N. Magnolia St, 803-773-5511 Sumter SC 29150 Sumter Family Health Center 1278 N. Lafayette Blvd, 803-774-4500 Sumter SC 29150 2. CANCER and SCREENING– # 2 cause of death, #16 SC County, incident significantly higher than expected, major concern by 65% of responding consumers; FEMALE BREAST CANCER incident higher than national and peer averages; COLON CANCER incident higher than national and peer averages; LUNG CANCER incident above national and peer averages. CANCER SCREENING PAP/CERV screening 6% below average incident; COLORECTAL SCREENING 6% below average incident. (Ranked 2 out of 29). Problem Statement: Cancer cases and death rates need to decrease. HOSPITAL SERVICES AVAILABLE TO RESPOND TO THIS NEED INCLUDE: Tuomey Inpatient cancer treatment services. Tuomey Outpatient Radiation Cancer Treatment Center. Mammography Services and other Imaging Services. Tumor Board Tuomey Foundation and Community Health Initiatives HOSPITAL IMPLEMENTATION PLAN PROGRAMMATIC INITIATIVES: Coordinate efforts with the organizations listed below which offer resources responding to this need by identifying how Tuomey services will establish and/or maintain contact with these organizations to coordinate care. Work through Tuomey’s Community Health Initiatives and Education Department to provide screenings and education. Utilities to Tuomey sponsored the Wig Boutique and support groups to serve cancer victims. Research use of a nurse navigator for cancer patients. ANTICIPATED RESULTS FROM HOSPITAL IMPLEMENTATION PLAN Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 32 Increased screenings leading to earlier intervention. Increased survival rates. LEADING INDICATOR HOSPITAL WILL USE TO MEASURE PROGRESS: Screening Mammography exams should increase. Fiscal Year 2013 volumes expected to be 9500. Contacts with Support Groups > 350 and the Wig Boutique > 75 in Fiscal Year 2014. LAGGING INDICATOR HOSPITAL WILL USE TO IDENTIFY IMPROVEMENT Decrease rate of Cancer Death per 100,000 in Sumter County to less than 215. Opportunity Statement: Promote the use of screening and treatment services Local resources include the following: American Cancer Society 128 Stone Lane, 843-882-9030 Columbia, SC 29210 Tuomey Wig Boutique (From Tuomey with Love) Tuomey Breast Cancer Support Group Contact Phyllis Buckner at 803-774-8678 129 N. Washington Street, 803-774-8678 Sumter, SC Tuomey Look Good Feel Better Support Group 129 N. Washington Street, Sumter, SC Families fighting Prostate Cancer Tuomey Cancer Treatment Center 877-227-9398 or 774-8678 775-1324 130 N. Washington Street, 803-774-8888 Sumter, SC Hematology/Oncology Center 115 N. Sumter Street, 803-934-8348 Sumter, SC Santee Hematology Oncology 1105 N. Lafayette Street, 803-934-0775 Sumter, SC Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 33 3. OBESITY- 68% of responding consumers list as major concern, 14% above average incident, Bad eating habit 13% above average incident, lack of health eating 7% below average incident; improvement to ADULT OBESITY needed to achieve National and State averages; PHYSICAL INACTIVITY below state and national goals; LIMITED ACCESS TO HEALTHY FOOD below state and national goals; VIGOROUS EXERCISE 5% below average incident; PERCENT OF FAST FOOD RESTAURANT above goal level. (Ranked 3 out of 29). Problem Statement: The incidence of the need to decrease. HOSPITAL SERVICES AVAILABLE TO RESPOND TO THIS NEED INCLUDE: The Industrial Medicine and Wellness Program (IMWP) provide wellness education which includes activity encouragement and nutritional advice when appropriate. The THS Medical Library includes provision of information on healthy living and obesity specific information such as “Exercise for the seriously unfit” and the interactive tool “Obesity basics: What is it? How is it treated?” THS DOES NOT INTEND TO DEVELOP AN IMPLEMENTATION PLAN FOR THIS NEED FOR THE FOLLOWING REASON(S): A lack of identified effective interventions to address the need as preventive responses are best addressed by primary care practitioners Need is addressed by other facility or organization including those listed below ANTICIPATED RESULTS FROM IMPLEMENTATION PLAN OF OTHERS The assumption is others are better positioned in the healthcare system to respond LEADING INDICATOR THS WILL USE TO MEASURE PROGRESS: None as THS will not actively engage in implementation efforts but will monitor and support the efforts taken by others, including the organizations shown below as resources. LAGGING INDICATOR THS WILL USE TO IDENTIFY IMPROVEMENT None as THS is not directing implementation efforts in response to this need. Opportunity Statement: Emphasis on healthy eating and exercise programs Local resources include the following: Proprietary Tuomey Healthcare System Sumter, South Carolina Sumter County Public Health Dept. Community Health Needs Assessment Page 34 105 N. Magnolia St., 803-773-5511 Sumter, SC, 29150 YMCA 50 Willow Dr., 803-774-1404 Sumter, SC, 29150 Sumter Mall 1057 Broad St., 803-775-6387 Sumter, SC, 29150 Birnie Hope Center 210 S. Purdy St., 803-436-2645 Sumter, SC, 29150 North Hope Center 904 N. Main St., 803-436-2691 Sumter, SC, 29150 South Hope Center 1125 S. Lafayette Blvd., 803-436-2653 Sumter, SC, 29150 Sumter School Dist 1345 Wilson Hall Rd., 803-469-6900 Sumter, SC, 29150 Wilson Hall Academy 520 Wilson Hall Rd., 803-469-3475 Sumter, SC, 29150 Thomas Sumter Academy 5265 Camden Hwy., 803-499-3378 Rembert, SC, 29128 Shepards Center 24 Council St., 803-773-1944 Sumter ,SC, 29150 4. DIABETES – #6 cause of death, #8 SC county, well above state average, high comorbidity to other conditions, major concern by 78% of responding consumers, 19% above average incident. (Ranked 4 out of 29). Problem Statement: Death rates due to Diabetes need to decrease. HOSPITAL SERVICES AVAILABLE TO RESPOND TO THIS NEED INCLUDE: Tuomey Diabetes Support Group Tuomey Food and Nutrition Department Tuomey Foundation – Community Health Initiatives Tuomey Health Guides Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 35 HOSPITAL IMPLEMENTATION PLAN PROGRAMMATIC INITIATIVES: Coordinate efforts internally and with the organizations listed below with Tuomey Services. Work with the community to develop obesity prevention and intervention programs. Use Community Health Initiatives, Tuomey Health Guides, and the Education Department to identify risk factors and educate citizens on healthy lifestyle choices. ANTICIPATED RESULTS FROM HOSPITAL IMPLEMENTATION PLAN Tuomey efforts can help address the symptoms of and results from adverse lifestyle choices and other factors. LEADING INDICATOR HOSPITAL WILL USE TO MEASURE PROGRESS: Increased enrollment in Tuomey Health Guides program to greater than FY 3013 level of 260. LAGGING INDICATOR HOSPITAL WILL USE TO IDENTIFY IMPROVEMENT Decrease rate of death per 100,000 age adjusted to less than 38 per 1,000 population. Opportunity Statement: Diabetic education and treatment resources should be expanded to enhance education and continue to reduce the impact of this disease. Local resources include the following: Tuomey Diabetes Support Group Education Department, 129 N. Washington Street, Sumter, SC 29150 803-774-8678 Sumter Family Health Center 1278 N Lafayette Dr. 803-774-4500 Sumter, SC 29150, Sumter County Health Department 105 N Magnolia St. 803-773-5511 Sumter, SC 29150 Carolina Diabetes & Kidney Center 635 W Wesmark Blvd. 803-469-7500 Sumter, SC 29150 All Family Practice and Internal Medicine physicians in the area National Diabetes Education Program ndep.nih.gov NDEP is a partnership of the National Institutes of Health, the Centers for Disease Control and Prevention, and more than 200 public and private organizations. Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 36 5. HYPERTENSION – Deaths significantly higher than expected and high incident of comorbidity to other conditions; 11% above average incidence. (Ranked 5 out of 29). Problem Statement: Hypertension death rate needs to decrease. HOSPITAL SERVICES AVAILABLE TO RESPOND TO THIS NEED INCLUDE: Tuomey Health Guides program. Tuomey Smart Beat program. Tuomey Community Health and Wellness – Foundation. Tuomey Education and Food and Nutrition Departments. HOSPITAL IMPLEMENTATION PLAN PROGRAMMATIC INITIATIVES: Coordinate efforts with the organizations listed below to identify how Tuomey services will work with these organizations to coordinate patient care. Increase efforts of Health Guides, Smart Beat, and Community Health Initiatives. Utilize Food and Nutrition dieticians to increase awareness of diet on hypertension. ANTICIPATED RESULTS FROM HOSPITAL IMPLEMENTATION PLAN To increase the awareness and therefore change behaviors that lead to hypertension. LEADING INDICATOR HOSPITAL WILL USE TO MEASURE PROGRESS: Increase enrollment in Tuomey Health Guides program to greater than FY 2013 level of 260. Increase the number of blood pressure screenings through Smartbeat and Community Health Initiatives from Fiscal Year’s anticipated number of 440. LAGGING INDICATOR HOSPITAL WILL USE TO IDENTIFY IMPROVEMENT Decrease the death rate per 100,000 to below 14. Opportunity Statement: Expand education, screening and treatment resources to properly identify problems and manage hypertension Local resources include the following: Tuomey Healthcare System 129 N. Washington St., 803-774-9000 Sumter, SC, 29150 Proprietary Tuomey Healthcare System Sumter, South Carolina Mcleod Cardiology Associates Sumter Community Health Needs Assessment Page 37 115 N Sumter St # 410, 803-883-5171 Sumter, SC 29150 Midlands Cardiology Associates 213 W Hampton Ave., 803-773-1379 Sumter, SC 29150 Columbia Heart Clinic 1017 Professional Ct., 803-433-7434 Manning, SC 29102 Sumter Medical Consultants 540 Physicians Ln., 803-778-1941 Sumter, SC 29150 Lexington Heart Clinic Serving the Sumter Area 803-739-6500 Carolina Cardiovascular Associates PA 108 Palmetto Blvd Palmetto Park Center, Lexington, SC 29072 803-356-0949 Providence Hospital/Heart Institute Providence Hospital Heart VA, 803-256-5320 Columbia, SC 29201 Clarendon Cardiovascular Associates 21 E Hospital St. 803-435-5275 Manning, SC 29102 South Carolina Heart Center 1330 Haile St., 803-432-6771 Camden, SC 29020 Camden Heartcare 1045A W Dekalb St., 803-432-8622 Camden, SC 29020 William L Schoolmeester 2043 W Dekalb St., 803-432-8622 Camden, SC 29020 Providence Hospital 2435 Forest Dr., 803-256-5300 Columbia, SC 29204 All Family Practice and Internal Medicine physicians 6. MATERNITY AND CHILD HEALTH – Teen pregnancy a major concern by 65% of responding consumers; teen birth rate above national and State average; 10% below average use of OB/GYN; Unfavorable performance for LOW BIRTH WEIGHT, VERY LOW BIRTH WEIGHT, PREMATURE BIRTHS, INFANT MORTALITY, POSTNEONATAL INFANT MORTALITY; better than peer but Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 38 worse than national average performance for NEONATAL INFANT MORTALITY, BIRTHS TO WOMEN UNDER 18, BIRTHS TO UNMARRIED WOMEN, WHITE non-HISPANIC INFANT MORTALITY; better than average performance in BIRTHS TO WOMEN AGE 40 to 54 and BLACK non-HISPANIC INFANT MORTALITY; LOW BIRTH WEIGHT births approach State average but above national average. (Ranked 6 out of 29). Problem Statement: Teen pregnancies need to decrease. HOSPITAL SERVICES AVAILABLE TO RESPOND TO THIS NEED INCLUDE: Tuomey’s Women’s and Infants Services. Tuomey Medical Professionals – Sumter OB/GYN. Tuomey Foundation. Tuomey Care Reach program. HOSPITAL IMPLEMENTATION PLAN PROGRAMMATIC INITIATIVES: Coordinate Tuomey Services with the Community Services listed below to educate and serve women and children. Use Care Reach, Safe Kids and Child Birth Programs to serve women and children. ANTICIPATED RESULTS FROM HOSPITAL IMPLEMENTATION PLAN To decrease complication rates due to poor prenatal care and to decrease accident rates related to car accidents or bicycle injuries. LEADING INDICATOR HOSPITAL WILL USE TO MEASURE PROGRESS: Sustain Care Reach encounters expected to be 9300. Safe Kids Program car seats and helmets at or above 400. Sustain enrollment in infant/maternal health classes at or above 600. Implementation of patient-centered pregnancy. LAGGING INDICATOR HOSPITAL WILL USE TO IDENTIFY IMPROVEMENT Reduction of teenage pregnancy per 100,000 population. Opportunity Statement: Promote education about and compliance with prenatal care as a proper intervention for low birth weight/premature births. Local resources include the following: Tuomey Healthcare System Women and Children Education 129 N Washington St., 803-774-8828 Sumter, SC Proprietary Tuomey Healthcare System Sumter, South Carolina March of Dimes Community Health Needs Assessment Page 39 240 Stoneridge Dr., Suite 206, 803-403-8531 Columbia, SC, 29210 Palmetto Health Richland 5 Richland Medical Park Dr., 803-434-7000 Columbia, SC 29203 Palmetto Health Starts 2625 Hardee Cove, 803-905-4343 Sumter, SC Shaw Air Force Base Family Advocacy Program 803-895-6201 Sumter County Department of Health and Environmental Control 105 N Magnolia St., Sumter Family Health Center 1278 N. Lafayette Dr., 803-778-1531 Sumter, SC 803-774-4500 Sumter, SC Sumter OB/GYN Associates 115 N Sumter St. #200, 803-775-8351 Sumter SC Sumter Pregnancy Center 207 N. Main St., 803-773-8858 Sumter, SC The Advocacy Pregnancy & Parenting Center 190 S Lafayette Dr., United Way Diamonds 26 Council St., 803-774-5600 Sumter SC 803-774-2240 Sumter, SC United Way Diamonds Teen Pregnancy Prevention Program 215 N. Washington St., 803-774-2240 Sumter, SC 7. STROKE - #3 cause of death, #5 SC County, significantly higher than expected incident; above state and national average number of expected deaths. (Ranked 7 out of 29). Problem Statement: Death rates as a result of Strokes need to decrease. HOSPITAL SERVICES AVAILABLE TO RESPOND TO THIS NEED INCLUDE: Tuomey Emergency Room. TMP Vascular Surgery Services. Proprietary Tuomey Healthcare System Sumter, South Carolina Tuomey Home Health. Tuomey Rehabilitation. Community Health Needs Assessment Page 40 HOSPITAL IMPLEMENTATION PLAN PROGRAMMATIC INITIATIVES: Teleneurology services. Recruitment of a neurology physician services. Use of Smart Beat program. Coordinate of Tuomey Services with the Community Services listed below. ANTICIPATED RESULTS FROM HOSPITAL IMPLEMENTATION PLAN Tuomey’s patients will receive more timely attention from a neurology physician. LEADING INDICATOR HOSPITAL WILL USE TO MEASURE PROGRESS: Successful recruitment of Neurology Physician. Implementation of Tele-Neurology. LAGGING INDICATOR HOSPITAL WILL USE TO IDENTIFY IMPROVEMENT Rate of Death (age adjusted) per 100,000 population to less than 78. Opportunity Statement: Increase awareness of stroke prevention and treatment resources Local resources include the following: Sumter Neurology and Pain Management 312 Broad St., Sumter Active Day Center 930 Oswego Rd., 803-774-7246 Sumter, SC 803-775-4281 Sumter SC 29153 Magnolia Adult Day Center 20 South Magnolia St., 803-778-1086 Sumter, SC, 29150 Branco Adult Daycare Center, LLC 238 Commerce St., 803-435-9780 Manning, SC, 29102 Omnipresent Adult Day Care 696 Davis St., 843-326-5042 Lamar SC 29069 Ruth Louis Adult Health Day Care, Kingstree Office 111 East Mill Street, 843-221-5848 Kingstree SC 29556 Proprietary Tuomey Healthcare System Sumter, South Carolina Pee Dee Active Day Center Community Health Needs Assessment Page 41 2120 Enterprise Drive, 843-665-1919 Florence SC 29501 New Generations Adult Day Center of Florence 2111 West Jody Road, Florence, SC 29501 843-629-0103 843-629-0794 1-866-760-7065 MUSC Stroke Center 843-792-3020 USC Stroke Clinic 803-545-6050 Long Term Acute Care facilities Regency Hospital in Florence Intermedical - Taylor at Marion Street 843-661-3474 Columbia, SC 803-296-5425 Home Health Agencies – Sumter County Tuomey Home Health 500 Pinewood Rd, Suite 2, 803-773-4663 Sumter, SC 29154 Tri-County AMEDYISYS 2560 Tahoe Dr., Sumter, SC 29150 803-905-3510 Hospice: 803-905-7720 3481 Declaration Blvd., 803-905-5240 Sumter, SC 29154 Bridge Program and Hospice 500 Pinewood Rd., Suite 2, 803-773-4663 Sumter, SC 29154 Gentiva CareCentrics (Cigna Only) 7725 Woodland Center Blvd. Suite 100, Tampa, FL 33614 800-218-2505 CarePro 1800 Main St, Ste. 100, 803-758-4000 Columbia, SC 29210 Heavenly Home Health 1234 Peach Orchard Rd., 803-494-2590 Sumter, SC 29154 Reliable Home Care 2601 Read St., Columbia, SC 29204 Columbia Phone: 803-748-8612 Sumter Phone: 803-236-1415 Proprietary Tuomey Healthcare System Sumter, South Carolina Fairway Home Care Community Health Needs Assessment Page 42 327 North Main Street (Physical) 103 Anne Park (Mailing) Sumter, SC 29150 803-775-9000 Home Health Agencies – Clarendon County Clarendon Memorial Home Health Wateree DHEC 619 South Mill St., Manning, SC 29102 803-495-4494 ; Diane Barwick, Director: 803-435-5211 PO Box 729, 803-435-4355 Manning, SC, 29102 Bridge Program and Hospice 803-773-4663 Gentiva (Cigna Only) 800-218-2505 Home Health Agencies – Lee/Kershaw County Wateree DHEC Lee/Kershaw County PO Box 307, Bishopville, SC 29010 Bridge Program and Hospice (Lee) Kershaw Home Health 877-871-9089 803-484-6612 803-484-6912 803-773-4663 1315 Roberts St., 803-425-1182 Camden, SC 29020 McLeod Home Health (Lee, Darlington, Florence, Hartsville, Mullins) 300 S Dargan St., Florence, SC 29501 Gentiva (Cigna Only) Florence Visiting Nurses 800-382-7161 843-669-3050 800-218-2505 PO Box 4598, 800-638-3445 Florence, SC 29502 Carolinas Home Health and Hospice PO Box 100550, 843-629-6800 Florence, SC 29501 Amedysis Kershaw/Lee County 1110 B Broad St., 803-905-5240 Camden, SC 29020 Home Health Agencies – Williamsburg/Kingstree County Proprietary Tuomey Healthcare System Sumter, South Carolina Total Care Community Health Needs Assessment Page 43 4101 Mayfair St., 843-354-3377 Myrtle Beach, SC 29577 DHEC Williamsburg 520 Thurgood Marshall Blvd., 843-355-9639 Kingstree, SC 29556 Amedisys HHS – Georgetown 1105 Church St., Georgetown, SC 29440 800-946-9244 843-546-1730 Home Health Agencies – Florence County McLeod Home Health 300 S Dargan St., 800-382-7161 Florence, SC 29501 DHEC – Florence/Darlington 1705 West Evans St., 843-398-4401 Florence, SC 29501 Gentiva Florence Visiting Nurses 800-218-2505 PO Box 4598, 800-638-3445 Florence, SC 29502 Home Health Agencies – Lexington/Richland County Amedisys Home Health 714 South Lake Drive, Suite 250, 888-318-7323 Lexington, SC 29072 Carolina Home Health 810 Dutch Square Blvd., 803-791-3704 Columbia, SC 29210 DHEC – Lexington County 2111 Wilson Rd., 803-576-2700 Newberry, SC 29108 DHEC – Richland County D’Loach Home Health 803-576-2700 3600 Fernandina Rd., 803-798-1300 Columbia, SC 29210 Home Health Inc 93 Medical Circle, 803-939-0266 West Columbia, SC 29169 Love/Care Home Health 7340 Parkland Road, Suite 204 D, 803-708-4730 Columbia, SC 29221 Proprietary Tuomey Healthcare System Sumter, South Carolina Palmetto Baptist Home Services Community Health Needs Assessment Page 44 1400 Pickens St., 803-296-3100 Columbia, SC 29201 Southern Care Inc 720 Gracern Rd., Ste 122, 803-750-9600 Columbia, SC 29210 Tri-County Richland, Lexington, Saluda 1950 Bush River Rd., Columbia, SC 29210 800-849-4685 803-561-7680 CarePro 1800 Main St, Ste. 100, 803-758-4000 Columbia, SC 29201 Springs Memorial 902 West Meeting St, Columbia, SC 29720 803-286-1214 Winya Richland, Lexington, Fairfield: 888-318-7323, 803-705-7323 Richland, Lexington, Fairfield Fax: 803-750-7365 Newberry: 803-276-9359 Orangeburg, Calhoun Phone: 888-534-2022 Edgefield Phone: 877-637-6971 Georgetown, Williamsburg Phone: 800-946-9244 Home Health Agencies – Lancaster County Springs Memorial HHS 803-236-1472 Home Health Agencies – Orangeburg County Amedisys Home Health 1708 Village Park Dr., 803-534-2022 Orangeburg, SC 29118 DHEC PO Box 1250, 803-496-3324 Holly Hill, SC 29059 8. AFFORDABLE ACCESS – NOT HAVING HEALTH INSURANCE 66% survey participants listed a major concern; EMPLOYER HEALTH SAVINGS ACCOUNTS 7% below average incident. (Ranked 8 out of 29). Problem Statement: Increase the number of residents enrolled in health insurance which will decrease residents in this category. HOSPITAL SERVICES AVAILABLE TO RESPOND TO THIS NEED INCLUDE: Tuomey’s Financial Assistance Policy. Tuomey’s Medicaid Enrollment program. Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 45 Tuomey’s Emergency Department. Tuomey’s Health Reach Program. Tuomey Medical Professionals Hospitalist Program. HOSPITAL IMPLEMENTATION PLAN PROGRAMMATIC INITIATIVES: Participate in efforts to establish medical homes, especially with the Federally Qualified Health Clinics. Work in cooperation with the Community Resources listed below. Recruit Healthcare Providers to the Community. Encourage enrollment in Medicaid and upcoming Health Insurance Exchanges. ANTICIPATED RESULTS FROM HOSPITAL IMPLEMENTATION PLAN To increase access to mere affordable healthcare. To increase access to primary care. LEADING INDICATOR HOSPITAL WILL USE TO MEASURE PROGRESS: The number of successful applications for Charity Care at or above 800. To increase the number of patients referred to Tuomey’s Financial Assistance program. To recruit 2 new primary care physicians to the community. LAGGING INDICATOR HOSPITAL WILL USE TO IDENTIFY IMPROVEMENT Number of Sumter residents enrolled in Medicaid. Number of Sumter residents enrolled in the upcoming Health Insurance Exchanges. Opportunity Statement: Efforts need to be devoted to achieve enhanced availability of affordable medical and wellness services. Local resources include the following: Sumter County DHEC 105 N Magnolia St., 803-773-5511 Sumter, SC 29150 Governor’s Office, Affordable Care Act 1612 Marion St., 803-737-5682 Columbia, SC 29201 South Carolina State Government Richland County Medicaid Office 3220 Two Notch Rd., 803-714-7562 Columbia, SC 29204 Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 46 Department of Health and Human Services, Medicaid 7499 Parklane Rd. Ste. 164, Blue Cross Blue Shield of South Carolina 7909 Parklane Rd. # 300, 803-741-0826 Columbia, SC 29223 803-741-1656 Columbia, SC 29223 Blue Cross Blue Shield of South Carolina I-20 E & Alpine Rd., 803-788-0222 Columbia, SC 29219 Blue Cross Blue Shield of South Carolina 2501 Faraway Dr., 803-788-0222 Columbia, SC 29223 9. DRUG AND ALCOHOL ABUSE - YOUTH DRUG USE 57% reported as a major concern; ADULT ABUSE of alcohol and/or drugs was noted by 52% of responses as a concern. (Ranked 9 out of 29). Problem Statement: The incidence of Drug and Alcohol abuse needs to decrease. HOSPITAL SERVICES AVAILABLE TO RESPOND TO THIS NEED INCLUDE: Emergency department service to assess and facilitate appropriate referral The THS Medical Library includes provision of information on healthy living and substance use specific information such as “Alcohol and Pregnancy” and the interactive tool “Addiction Quiz?” Psychiatry Associates credentialed medical staff members THS DOES NOT INTEND TO DEVELOP AN IMPLEMENTATION PLAN FOR THIS NEED FOR THE FOLLOWING REASON(S): Lack of expertise of competency (i.e. no inpatient service available) Need is addressed by other facility or organization including those listed below ANTICIPATED RESULTS FROM IMPLEMENTATION PLAN OF OTHERS The assumption is others are better positioned in the healthcare system to respond LEADING INDICATOR THS WILL USE TO MEASURE PROGRESS: None as THS will not actively engage in implementation efforts but will monitor and support the efforts taken by others, including the organizations shown below as resources. LAGGING INDICATOR THS WILL USE TO IDENTIFY IMPROVEMENT None as THS is not directing implementation efforts in response to this need. Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 47 Opportunity Statement: Raise awareness of the problem of drug and alcohol abuse and resources available to respond to incidents Local resources include the following: Outpatient Treatment Facilities Sumter Family Health Center 1278 N Lafayette Dr., 774-4500 Sumter, SC Sumter Behavioral Health Services Gyn Psy P.O. Box 39, Sumter, SC 29151 Glenn Peagler: 803-778-2835 2 Medical Court, 803-774-4020 Sumter, SC Drug & Alcohol Counseling Services 1154 Ronda St., 803- 775-5080 Sumter, SC 29154 Helping Hands 5 Medical Court, 803-773-2088 Sumter, SC Santee Wateree Community Mental Health 215 N. Magnolia St., Healthy Minds 246 W Calhoun St., 803-775-9364 Sumter, SC 803-775-3522 Sumter, SC Loradac 2711 Colonial Drive 803-256-3100, ext. 201 Sumter Psychiatry 1250 Wilson Hall Rd., 803-905-5650 Sumter, SC New Alternatives 441 N Main St., 803-775-5080 Sumter, SC Inpatient Treatment Facilities Aurora Pavilion 302 University Parkway, 803-641-5959 Aiken, SC G Werber Bryan Psych Hospital 220 Faison Dr., 803-935-7143 Columbia, SC Proprietary Tuomey Healthcare System Sumter, South Carolina The Lighthouse Community Health Needs Assessment Page 48 152 Waccamaw Medical Pk Dr., 843-347-8871 Conway, SC Morris Village 220 Faison Dr., 803-935-7101 Columbia, SC Palmetto Health Baptist/Richland Springs 11 Richland Medical Park, Palmetto Behavioral 2777 Speisseger Dr., 803-434-4813 Columbia, SC 843-747-5830 Charleston, SC Three Rivers 2900 Sunset Blvd, 803-796-9911 W. Columbia, SC, William S. Hall Psych Hospital 1800 Colonial Dr., 803-898-1662 Columbia, SC William Jennings Bryan Dorn VA Medical Center 6439 Garners Ferry Rd., Columbia, SC, Phone (803)-7764000 ext 6167 for Tempe Evans or page if she’s not there; at night or weekends, call ext. 7200 10. ACCIDENTS - #5 cause of death, #43 SC County (#1 County rank is the Worst in the State: #46 is the Best possible ranking), significantly higher than expected, statewide Traffic accidents #5 cause of death for males; better performance than national and peer averages; MOTOR VEHICLE INJURY above national and peer average. (Ranked 10 out of 39). Problem Statement: Deaths from accidents need to decrease. HOSPITAL SERVICES AVAILABLE TO RESPOND TO THIS NEED INCLUDE: THS Emergency Department provides accident triage, stabilization and several surgical interventions but not as a designated trauma center THS Pain Treatment Center, Wound Healing Center and Rehabilitation services provide post accident recovery treatments THS DOES NOT INTEND TO DEVELOP AN IMPLEMENTATION PLAN FOR THIS NEED FOR THE FOLLOWING REASON(S): Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 49 A lack of identified effective interventions to address the need because preventive responses are best addressed by others and THS functions best in accident emergency and restorative capacities Need is addressed by other facility or organization including those listed below ANTICIPATED RESULTS FROM IMPLEMENTATION PLAN OF OTHERS The assumption is others are better positioned in the healthcare system to respond LEADING INDICATOR THS WILL USE TO MEASURE PROGRESS: None as THS will not actively engage in implementation efforts but will monitor and support the efforts taken by others, including the organizations shown below as resources. LAGGING INDICATOR THS WILL USE TO IDENTIFY IMPROVEMENT None as THS is not directing implementation efforts in response to this need. Opportunity Statement: Identify and implement actions to reduce the number of accidental injuries Local resources include the following: Alive At 25, South Carolina National Safety Council 121 Ministry Dr., Children’s Trust of South Carolina 1634 Main St, Suite 100, 800-773-6185 Irmo, SC 803-733.5430 Columbia, SC 29201 MADD, South Carolina Chapter 630 St Andrew Rd., 803-748-7333 Columbia SC, 29210 South Carolina Department of Health and Environmental Control, Division of Injury Prevention 1800 St. Julian Place, South Carolina Highway Patrol 10311 Wilson Blvd., 803-545-4330 Columbia, SC 29204 803-896-7920 Blythewood, SC 29016 Sumter Aquatics 1125 Lafayette Dr., 803-774-3998 Sumter SC Sumter County Fire Department 129 N E Hampton St., 803-436-2600 Sumter, SC Proprietary Tuomey Healthcare System Sumter, South Carolina Sumter County Library (internet safety) Community Health Needs Assessment Page 50 180 W Wesmark, 803-469-8110 Sumter, SC Sumter County Parks and Recreation (sports safety) 765 Oakland Av., Sumter County Safe Kids 129 N. Washington St., 803-778-5039 Sumter, SC 803-774-9000 Sumter, SC 29150 Sumter County Commission on Alcohol and Drug Abuse 115 N Harvin St., Sumter County Coroner 17 E. Canal St., 803-775-6815 Sumter, SC 803-774-9000 Sumter, SC 29150 Other Needs identified during the CHNA process 11. SEXUALLY TRANSMITTED DISEASES - Above state and national goals. (Ranked 11 out of 29). Opportunity Statement: More community awareness of sexually transmitted diseases including condition, management, education, prevention and treatment. Local resources include the following: Sumter County Department of Health and Environmental Control STD Clinic 105 N Magnola St., Children’s Trust of South Carolina 1634 Main St., Ste. 100, 803-778-1531 Sumter, SC 803-733.5430 Columbia, SC 29201 Sumter Family Health Center 1278 N. Lafayette Dr., 803-774-4500 Sumter, SC Sumter OB/GYN Associates 115 N Sumter #200, 803-775-8351 Sumter, SC Sumter Pregnancy Center 207 N. Main St., 803-773-8858 Sumter, SC Sumter STD Testing 144 Garrett St Suite B., 803-393-9421 Sumter, SC Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 51 Wateree AIDS Task Force 108B East Liberty St., 803-778-0303 Sumter, SC 29151 12. PREDISPOSING ADVERSE HEALTH FACTORS - Children in SINGLE PARENT HOUSEHOLDS above state and national goals; COMPLIANT with treatment recommendations 9% below average incident; LOW EDUCATION LEVEL 66% listed as a major concern; POVERTY 58% listed as a major concern. (Ranked 12 out of 29). Opportunity Statement: Personal behavioral issues and local societal conditions need investigation to identify meaningful interventions leading to health status improvement. Local resources include the following: Sumter County Health Department 105 N Magnolia St., 803- 773-551 Sumter, SC 29150 South Sumter Resource Center 37 Manning Avenue, 803-436-2277 Sumter, SC 29150 Vocational Rehabilitation 1760 N Main St., 803-469-8045 Sumter, SC 29153 Planned Parenthood 2712 Middleburg Dr., 803-256-4908 Columbia, SC 29204 SC DHEC WIC Program, 105 N Magnolia St., 803-773-5511 Sumter, SC 29150 Vocational Rehabilitation 1760 N Main St., 803-469-8045 Sumter, SC 29153 Planned Parenthood 2712 Middleburg Dr., 803-256-4908 Columbia, SC 29204 SC DHEC – WIC Program 105 N Magnolia St., 803-773-5511 Sumter, SC 29150 13. HOMICIDE - Significantly higher than expected incident; incident above national and peer average; VIOLENT CRIME RATE above state and national goals. (Ranked 13 out of 29). Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 52 Opportunity Statement: Research how the health care delivery system can respond to meaningfully reduce homicide deaths. Local resources include the following: Tuomey Emergency Department All local law enforcement officers 803-774-9111 107 E Hampton Ave., Sumter, SC 29150 Crimestoppers 107 E Hampton Ave., 803-436-2739, Sherriff’s office 436-2158, and SC Highway Patrol 803-7755353 803-436-2718 Sumter, SC 29150 Solicitor’s Office 141 N Main St,. 803-436-2185 Sumter, SC 29150 Department of Social Services 105 N Magnolia St., 803-915-4700 Sumter, SC 29150 Drug & Alcohol Counseling Services 1154 Ronda St., 803-775-5080 Sumter, SC 29154 Domestic Violence Counseling 803-773-7158 14. PHYSICIAN SUPPLY - 50% below State average, half the desired supply to achieve national goal level.(Ranked 14 out of 29). Opportunity Statement: Continue recruitment and retention to enhance local resident ability to access physician and extender services Local resources include the following: South Carolina Office of Rural Health (job board and sourcing) 107 Saluda Pointe Dr. Practice Match (online job board, sourcing and locum tenens physicians) 600 Emerson Rd-Ste 450., Practice Alert (sourcing) P.O. Box 920215, 803-454-3850 Lexington, SC 29072 314-485-6205 St.Louis, MO 63141 866-772-2590 Norcross, GA 30010 Proprietary Tuomey Healthcare System Sumter, South Carolina PracticeLink Magazine (advertising) Community Health Needs Assessment Page 53 415 2nd Avenue, 800-776-8383 Hinton, WV 25951 University of SC School of Medicine (residency programs) 6311 Garner’s Ferry Rd, Medical University of South Carolina (residency programs) 96 Jonathan Lucas St-Ste 601-MSC 617, Charleston, SC 29425 Medical Doctor Associates (locum tenens physicians) 145 Technology Pkwy., The Inline Group (primary care job board and sourcing) 530 E. Corporate Dr-Ste 100, CompHealth (contingency recruiting firm) 6440 South Millrock Dr-Ste 175, The Curare Group (contingency recruiting firm) 2990 E. Covenanter Dr., Southern Hospitalists (contingency recruiting firm) 73 First St., 803-216-3300 Columbia, SC 29209 800-780-3500 Norcross, GA 30092 866-211-3874 Lewisville, TX 75057 800-453-3030 Salt Lake City, UT 84127 800-880-2028 Bloomington, IN 47401 888-368-4177 Hoschton, GA 30548 15. LUNG DISEASE - #4 cause of death, #16 SC County; COPD incident 29% above average; SMOKING 21% above average incident. (Ranked 15 out of 29). Opportunity Statement: Decrease pulmonary related deaths by increasing condition awareness, condition management, education and treatment resources. Local resources include the following: Tuomey Smoking Cessation classes 803-774-8682 Sumter Medical Consultants (pulmonologist) 540 Physicians Lane, American Lung Association 44A Markfield Dr., 803-774-1941 Sumter, SC 803-556-8451 Charleston, SC All Family Practice and Internal Medicine physicians in the area. Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 54 16. HOSPICE AND PALLIATIVE CARE - Programs exist. (Ranked 16 out of 29.) Opportunity Statement: Increase utilization of Palliative care and Hospice services. Local resources include the following: Tuomey Hospice and Palliative Care 500 Pinewood Rd., 803-774-4663 Sumter, SC 29154 Agape Hospice 13 Caldwell St., 803-774-1075 Sumter, SC 29150 Ahava Hospice 1303 W Evans St., 843-468-9700 Florence, SC 29501 Amedisys (Winyah) 55 Lin-Do Ct., 803-469-3047 Sumter, SC 29150 Ascension Hospice 226 State St., 803-796-9296 West Columbia, SC 29169 Beacon Hospice 2635A Hardee Ct., 803-469-9590 Sumter, SC 29150 Care Pro Hospice 1800 Main St., Suite 100, 803-758-4000 Columbia, SC 29201 Community Hospice 125 Broad St., 803-403-9157 Sumter, SC 29150 Heartland Hospice 141 Stoneridge Dr., 803-939-2788 Columbia, SC 29201 Hospice Care of SC 121 N Main St., 803-484-6869 Bishopville, SC 29010 Solaris Hospice 246 Broad St., 803-774-8400 Sumter, SC 29150 Southern Care Hospice 217 Dozier Blvd, #20, 843-664-9889 Florence, SC 29501 Tri-County Hospice 2560 Tahoe Dr., 803-905-7720 Sumter, SC 29150 Proprietary Tuomey Healthcare System Sumter, South Carolina Arista Hospice Community Health Needs Assessment Page 55 1300 Sumter St., 803-256-6868 Columbia, SC 29201 Embrace Hospice 1831 W Evans St., 843-679-4999 Florence, SC 29501 Hospice Care of Sumter 314 N Magnolia St., 803-883-5606 Sumter, SC 29150 Dynamic Hospice 220 Stoneridge Dr., 803-765-2247 Columbia, SC 29201 Gentle Care Hospice 9400 Two Notch Rd., 803-708-2405 Columbia, SC 29223 17. ALZHEIMERS - #7 cause of death, #15 SC County, incident significantly lower than expected. (Ranked 17 out of 29). Opportunity Statement: Increase the awareness of Alzheimer Disease treatment and support resources Local resources include the following: Tuomey Alzheimer Support Group Covenant Place of Sumter 803-905-7720 2825 Carter Rd., 803-469-7007 Sumter, SC Deslys Floyd Russell Hopkins 803-261-5603 Elmcroft of Florence 3006 Hoffmeyer Rd., 843-673-0766 Florence, SC McElveen Manor 2065 McCrays Mill Rd., 803-778-9690 Sumter, SC Northwoods Senior Living and Memory Care 1267 N. Main St., Senior Life Improvement Center 207A N. Washington St., 803-774-5700 Sumter, SC 803-774-2634 Sumter, SC All family practice physicians in the area Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 56 18. CHOLOESTEROL SCREENING - 6% below average incident. (Ranked 18 out of 29). Opportunity Statement: Promote and evaluate programs related to the management and treatment of cholesterol Local resources include the following: Sumter Medical Consultants CV Division 540 Physicians Ln., Sumter County Public Health Department 105 N. Magnolia St., American Heart Association 2381 Peach Orchard Rd., 803-778-1941 Sumter, SC 29150 803-773-5511 Sumter, SC 29150 Sumter, SC 29154 Birnie Hope Center 210 S. Purdy St., 803-436-2645 Sumter, SC, 29150 North Hope Center 904 N. Main St., 803-436-2691 Sumter, SC 29150 South Hope Center 1125 S. Lafayette Blvd., 803-436-2653 Sumter, SC, 29150 Midlands Cardiology Association 213 W. Hampton Ave., 803-773-1379 Sumter, SC, 29150 McLeod Cardiology Association 115 N. Sumter St., 803-418-5969 Sumter, SC, 29150 19. KIDNEY DISEASE - #10 cause of death, #43 SC County. (Ranked 19 out of 29). Opportunity Statement: Kidney Disease education and treatment resources should be expanded to enhance education and continue to reduce the impact of this disease. Local resources include the following: Sumter Dialysis 615 West Wesmark Blvd., 803-469-4225 Sumter, SC 29150 Proprietary Tuomey Healthcare System Sumter, South Carolina Carolina Diabetes & Kidney Center Community Health Needs Assessment Page 57 635 West Wesmark Blvd., 803-469-7500 Sumter, SC 29150 Columbia Nephrology Associates PA 121 Park Central Dr., 803-563-6646 Columbia, SC 29203 Carolina Kidney Specialists 1655 Bernardin Ave # 200, 803-256-1137 Columbia, SC 29204 Peedee Nephrology 1100 E Cheves St., 843-662-6742 Florence, SC 29506 South Carolina Nephrology & Hypertension Center Inc. 3709 Magnolia St., Florence Dialysis Center 435 North Cashua Dr., 803-531-2220 Orangeburg, SC 29118 843-661-5378 Florence, SC 29501 Pee Dee Nephrology 255 Warley St., 843-669-6694 Florence, SC 29501 Pee Dee Nephrology 215 N Brooks St., 843-355-9033 Kingstree, SC 29556 Nephrology Associates 212 Swift Creek Rd., 843-339-9194 Hartsville, SC 29550 Palmetto Nephrology PA 1175 Cook Rd. # 115, 803-531-2677 Orangeburg, SC 29118 Dialysis Access Institute 3000 Saint Matthews Rd., 803 395-2145 Orangeburg, SC 29118 South Caroline Nephrology & Hypertension 1164 Orangeburg Mall Cir., 803-531-2270 Orangeburg, SC 29115 20. MENTAL HEALTH - Presents as an unidentified problem as noted by Local Experts. (Ranked 20 out of 29). Opportunity Statement: Expand prevention and treatment resources Local resources include the following: Outpatient Treatment Facilities Proprietary Tuomey Healthcare System Sumter, South Carolina Senior Life Improvement Center Community Health Needs Assessment Page 58 207A N. Washington St., 803-774-2634 Sumter, SC Santee Wateree Community Mental Health 215 N. Magnolia St., Santee-Wateree Elder Services – Children and Adolescents 1175 N Guignard Dr., Sumter Family Health Center 1278 N Lafayette Dr., 803-775-9364 Sumter, SC 803-775-7898 Sumter, SC 803-774-4500 Sumter, SC Sumter Behavioral Health Services Gyn Psy P.O. Box 39, Sumter, SC 29151 Glenn Peagler 803-778-2835 2 Medical Court, 803-774-4020 Sumter, SC Helping Hands 5 Medical Court, 803-773-2088 Sumter, SC Healthy Minds 246 W Calhoun St., 803-775-3522 Sumter, SC Loradac 2711 Colonial Drive 803-256-3100, ext. 201 Sumter Psychiatry 1250 Wilson Hall Rd., 803-905-5650 Sumter, SC New Alternatives 441 N Main St., 803-775-5080 Sumter, SC Inpatient Treatment Facilities Aurora Pavilion 302 University Parkway, 803-641-5959 Aiken, SC G Werber Bryan Psych Hospital 220 Faison Dr., 803-935-7143 Columbia, SC The Lighthouse 152 Waccamaw Medical Park Dr., 843-347-8871 Conway, SC Proprietary Tuomey Healthcare System Sumter, South Carolina McLeod Behavioral Community Health Needs Assessment Page 59 701 Cashua Ferry Rd., 843-777-4234 Darlington, SC Morris Village 220 Faison Dr., 803-935-7101 Columbia, SC MUSC 67 President St., 843-792-9888 Charleston, SC Palmetto Health Baptist/Richland Springs 11 Richland Medical Park, Palmetto Behavioral 2777 Speisseger Dr., 803-434-4813 Columbia, SC 843-747-5830 Charleston, SC Three Rivers 2900 Sunset Blvd., 803-796-9911 W. Columbia, SC William S. Hall Psych Hospital 1800 Colonial Dr., 803-898-1662 Columbia, SC William Jennings Bryan Dorn VA Medical Center 6439 Garners Ferry Rd., Columbia, SC Ralph H. Johnson, VA Medical Center 109 Bee St., 803-776-4000 ext. 6167 for Tempe Evans or page if she’s not there; at night or weekends, call ext.7200 843-789-7216 Charleston, SC 21. FLU - #9 cause of death, #34 SC County, incident significantly lower than expected. (Ranked 21 out of 29). Opportunity Statement: Increase influenza vaccination and prevention efforts. Local resources include the following: Sumter Family Health Center 12789 Lafayette Dr., 803-774-4500 Sumter, SC Proprietary Tuomey Healthcare System Sumter, South Carolina Faster Care Community Health Needs Assessment Page 60 3440 Declaration Blvd., 803-905-3278 Sumter, SC Doctors Care 2475 Broad St., 803-778-6555 Sumter, SC Colonial Family Practice 325 Broad St., 803-773-5227 Sumter, SC Sumter Internal Medicine Associates 12 Barnett Dr., 803-773-5442 Sumter, SC Cedars Medical Clinic 325 Liberty St., 803-774-7000 Sumter, SC Sandhills Medical Foundation 425 N. Salem St., 803-778-2442 Sumter, SC Excelsior Medical Clinic 448 N. Main St., 803-778-2429 Sumter, SC Sumter Family Medicine 738-A Liberty St., 803-775-6374 Sumter, SC Palmetto Adult Medicine Wilson Hall Rd., 803-436-5974 Sumter, SC Sumter Pediatrics 237 Church St., 803-775-6311 Sumter, SC Palmetto Family Practice 115 N. Sumter St., Suite 315, 803-934-0810 Sumter, SC MacDonald DuBose, M.D. 240 Church St., 803-773-441 Sumter, SC Mayes DuBose, M.D. 240 Church St., 803-775-1001 Sumter, SC Arland Compton, M.D. 430 N. Main St., 803-775-5349 Sumter, SC CVS Pharmacy 41 E. Calhoun St., 803-418-0819 Sumter, SC, Proprietary Tuomey Healthcare System Sumter, South Carolina CVS Pharmacy Community Health Needs Assessment Page 61 1080 Alice Dr., 803-778-0460 Sumter, SC Rite Aid Pharmacy 1077 Broad St., 803-778-6551 Sumter, SC Rite Aid Pharmacy 375 Pinewood Rd., 803-775-5356 Sumter, SC, Rite Aid Pharmacy 225 N. Washington St., 803-778-5436 Sumter, SC Walgreens Pharmacy 1000 Broad St., 803-773-7302 Sumter, SC Walgreens Pharmacy 201. N. Lafayette Dr., 803-773-4959 Sumter, SC Walgreens Pharmacy 1990 McCrays Mill Rd., 803-934-0847 Sumter, SC S.C Department of Health and Environmental Control 105 N. Magnolia St., Center for Disease Control 1600 Clifton Rd., 803-773-5511 Sumter, SC 800-232-4636 Atlanta, GA 22. CHRONIC ALLERGIES - 7% above average incident. (Ranked 22 out of 29). Opportunity Statement: More residents need chronic allergy condition management and education awareness. Local resources include the following: Allergy Asthma & Sinus Center 115 N Sumter Suite # 315, 803-934-1488 Sumter, SC 29150 Sumter Ear Nose Throat 100 N Sumter Suite # 400, 803-778-5970 Sumter, SC 29150 Palmetto Allergy & Asthma PA 9 Richland Medical Park Dr., 803-765-9435 Columbia, SC 29203 Proprietary Tuomey Healthcare System Sumter, South Carolina Allergy Asthma & Sinus Center Community Health Needs Assessment Page 62 701 Medical Park Dr., 843-332-3191 Hartsville, SC 29550 Allergy Partners Of The Midlands 103 Midlands Ct., 803-794-3581 West Columbia, SC 29169 Allergy & Asthma Care Llc. 7045 Saint Andrews Rd., 803-407-0385 Columbia, SC, 29212 Coleman Dewitt TY Jr. MD 1001B Fairlawn Dr., 803-424-2041 Camden, SC 29020 Allen, Harry S III MD 805 Pamplico Hwy, 843-661-0500 Florence, SC, 29505 Allergy Asthma & Sinus Center 800 East Cheves St-Ste 420, 843-679-9335 Florence, SC 29506 All family practice physicians in the area 23. SUICIDE - Deaths lower than expected, but higher for males than females; lower rate than national and peer averages. (Ranked 23 out of 29). Opportunity Statement: Suicide screening and prevention resources need to increase. Local resources include the following: Santee-Wateree Elder Services Children and Adolescents: 1175 N Guignard, Sumter, SC 803-775-7898 Sumter Family Health Center 1278 N Lafayette Dr., 803-774-4500 Sumter, SC Sumter Behavioral Health Services Gyn Psy P.O. Box 39, Sumter, SC 29151 Glenn Peagler, 803-778-2835 2 Medical Court, 803-774-4020 Sumter, SC Helping Hands 5 Medical Court, 803-773-2088 Sumter, SC Proprietary Tuomey Healthcare System Sumter, South Carolina Healthy Minds Community Health Needs Assessment Page 63 246 W Calhoun St, 803-775-3522 Sumter, SC Sumter Psychiatry 1250 Wilson Hall Rd., 803-905-5650 Sumter, SC New Alternatives 441 N Main St., 803-775-5080 Sumter, SC Aurora Pavilion 302 University Parkway, 803-641-5959 Aiken, SC G Werber Bryan Psych Hospital 220 Faison Dr., 803-935-7143 Columbia, SC The Lighthouse 152 Waccamaw Medical Park Dr., 843-347-8871 Conway, SC McLeod Behavioral 701 Cashua Ferry Rd., 843-777-4234 Darlington, SC Morris Village 220 Faison Dr., 803-935-7101 Columbia, SC MUSC 67 President St., 843-792-9888 Charleston, SC Palmetto Health Baptist/Richland Springs 11 Richland Medical Park, Palmetto Behavioral 2777 Speisseger Dr., 803-434-4813 Columbia, SC 843-747-5830 Charleston, SC Three Rivers 2900 Sunset Blvd, 803-796-9911 W. Columbia, SC William S. Hall Psych Hospital 1800 Colonial Dr., 803-898-1662 Columbia, SC Proprietary Tuomey Healthcare System Sumter, South Carolina William Jennings Bryan Dorn VA Medical Center Community Health Needs Assessment Page 64 6439 Garners Ferry Rd., Columbia, SC Ralph H. Johnson, VA Medical Center 109 Bee St., 803-776-4000 ext. 6167 for Tempe Evans or page if she’s not there; at night or weekends, call ext. 7200 843-789-7216 Charleston, SC 24. HEALTH EDUCATION, PREVENTION AND SCREENING - Presents as an unidentified problem as noted by Local Experts. (Ranked 24 out of 29). Opportunity Statement: Awareness and use of health education, wellness and preventative service needs to increase. Local resources include the following: Sumter Public Health Department 105 N. Magnolia St., 803-773-5511 Sumter, SC 29150 American Heart Association 2381 Peach Orchard Rd., Sumter, SC 29154 American Cancer Society 128 Stonemark Lane, 803-750-1693 Columbia, SC 29210 Sumter County Active Lifestyles 155 Haynesworth St., 803-436-2400 Sumter, SC 29150 YMCA 50 Willow Dr., 803-773-1400 Sumter SC 29150 25. BLOOD POISIONING - #8 cause of death, #22 SC County, incident significantly higher than expected.(Ranked 25 out of 29). Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 65 Opportunity Statement: Efforts to identify and treat early infections to reduce incidence of Blood Poisoning (sepsis) Local resources include the following: Sumter County Public Health Department 105 North Magnolia St., Doctors Care Sumter 2475 Broad St., 803-773-5511 Sumter ,SC 29150; 803-778-6555 Sumter, SC 29150 Sumter Family Health Center (Sumter Office) 1278 North Lafayette Dr., Sumter Family Health Center (Pinewood Office) 25 East Clark Street Sumter Medical Clinic (Sandhills Medical Foundation, Inc.) 425 North Salem Avenue, Sumter County Clinic (William Jennings Bryan Dorn VA Medical Center) 407 North Salem Avenue, Wateree Aids Task Force – STD Clinic 108 East Liberty St., Sumter County DHEC PO Box 1628, 803-773-4500 Sumter, SC 29150 803-452-5151 Pinewood, SC 29125 803-778-2442 Sumter, SC 29150 803-938-9901 Sumter SC 29150 803-778-0303 Sumter, SC 29150 803-934-2885 Sumter, SC 29151 Richland County Public Health Department 2000 Hampton St., Centers for Disease Control and Prevention 1600 Clifton Rd., 803-576-2980 Columbia, SC, 29204 Atlanta, GA, 30333 1-800-CDC-INFO 800-232-4636 Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 66 26. PARKINSON’S DISEASE - Death rate lower than expected. (Ranked 26 out of 29). Opportunity Statement: Parkinson’s disease education and treatment resources should be expanded to enhance education and determine proper interventions to reduce the impact of this disease. Local resources include the following: Tuomey Outpatient Rehabilitation Wesmark Boulevard, 803-774-5201 Sumter, SC 29150 Sumter Neurology & Pain Management 312 Broad St., 803-774-7246 Sumter, SC 29150 Colonial Family Practice 325 Broad St. Suite 100, 803-773-5227 Sumter, SC 29150 Carolina Diabetes & Kidney Center 635 W Wesmark Blvd., 803-469-7500 Sumter, SC 29150 South Carolina Neurological Clinic PA 1333 Taylor St., 803-254-6391 Columbia, SC 29201 Palmetto Neurosurgery & Spine 3 Richland Medical Park Dr., 803-434-8323 Columbia, SC 29203 Eastern Carolina Neurological 1594 Freedom Blvd, Ste. 205, 843-347-4196 Florence, SC 29505 Comprehensive Neurological Services 436 W Palmetto St., 843-669-2007 Florence, SC 29501 Florence Neurosurgery & Spine 1204 E Cheves St., 843-673-0122 Florence, SC 29506 Florence Neurosurgery & Spine 701 Medical Park Dr., 843-857-9838 Hartsville, SC 29550 Kammer Kenneth S MD FACS 101 S Ravenel St., 843-665-4758 Florence, SC 29506 Carolinas Pulmonology 805 Pamplico Hwy., 843-673-7529 Florence, SC 29505 Proprietary Tuomey Healthcare System Sumter, South Carolina Access Physical Therapy Community Health Needs Assessment Page 67 198 E Wesmark Blvd-Ste 1, 803-774-2781 Sumter, SC 29150 Sumter Physical Therapy Clinic 1185 Wilson Hall Rd., 803-469-3213 Sumter, SC 29150 Tranquility Green Therapeutic 830 S Pike W Suite 2, 803-773-4404 Sumter, SC 29150 Cathy's Massage Therapy 6135 Dubose Siding Rd., 803-316-6663 Sumter, SC 29153 Total Rehab Services 9600 Two Notch Rd., 803-736-5540 Columbia, SC 29223 Lakeview Physical Therapy 122 N Brooks St., 803-433-9001 Manning, SC, 29102 Camden Rehab 301 E Dekalb St., 803-432-2432 Camden, SC, 29020 First Physical Therapy Of Camden 1202 Mill Street, 803-432-1147 Camden, SC 29020 Excel Physical Therapy LLC 810 Mallet Hill Rd., 803-661-8522 Columbia, SC 29223 First Physical Therapy 21 Gateway Corners Park Suite 102, Columbia, SC 29203 803-699-9775 Heartland of Columbia Rehabilitation & Nursing Center 2601 Forest Dr., 803-256-4983 Morrill Alternative 5060 Sunset Blvd., Columbia, SC 29204 803-957-3116 Lexington, SC Parkinson's Support Group 2720 Sunset Blvd., W. Columbia 29169 Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 68 27. TOBACCO USE - Presents as an unidentified problem as noted by local experts. (Ranked 27 out of 29). Opportunity Statement: The number of local residents who use tobacco products needs to decline Local resources include the following: Sumter County Commission 115 North Harvin St., 803-775-6815 Sumter, SC Chrysalis Center New Alternatives 1430 South Cashua Dr., Florence, SC 843-673-0660 ext 213 441 North Main St., 803-775-5080 Sumter, SC Clarendon City Commission on Alc/Trt 14 North Church St., 803-435-2121 Manning, SC Colonial Family Practice 325 Broad St., Sumter, SC 29150 803-773-5227 ext 5362 SC Department of Health and Environmental Control Tobacco Cessation Program Services, 2600 Bull Street, Columbia, SC 29201 803-898-DHEC Tobacco Cessation Quitline 1-800-QUIT-NOW (784-8669), the South Carolina Department of Health and Environmental Control’s toll-free “quitline” South Carolina Cancer Alliance 2711 Middleburg Dr-Ste 313-A, 1-866-745-5680 Columbia, SC 29204 American Cancer Society 128 Stone Lane, 843-882-9030 Columbia, SC 29210 American Lung Association 1301 Pennsylvania Ave. NW, Suite 800, Washington, DC 20004 202-785 3355 Tobacco Free Kids 1400 I Street NW, Suite 1200, 202-296-5469 Washington, DC 20005 Life Care Center Of Columbia 2514 Faraway Dr., 803-223-7254 Columbia, SC 29223 White Oak Columbia Nursing Home & Rehabilitation 3001 Beechaven Rd, Columbia, SC 29204 803-782-4363 Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 69 Summer House Detox 877-933-3869 28. DOMESTIC ABUSE - Presents as an unidentified problem as noted by Local Experts. (Ranked 28 out of 29). Opportunity Statement: Raise awareness of the problem of domestic violence and resources available to respond to incidents Local resources include the following: Domestic Violence Support Services 3905 Saint Marks Rd., 803-968-1724 Sumter, SC 29154 Criminal Domestic Violence Office Sumter, SC 29150 803-436-2046 Family Violence Services Domestic Violence Office 246 Church St., 803-773-7158 St Eugene Demazenod Shelters 304 W Wesmark Blvd., Sumter, SC 29150 803-469-4312 Sumter, SC 29150 Wateree Community Actions Inc. 32 E Liberty St., 803-773-6512 Sumter, SC 29150 Wateree Community Action Inc. 13 S Main St., 803-432-0743 Sumter, SC 29150 Sumter County Disabilities 13 Kendrick St., 803-775-9466 Sumter, SC 29150 Salvation Army 16 Kendrick St., 803-775-9336 Sumter, SC 29150 Alston Wilkes Society 207 N Main St., 803-773-7334 Sumter, SC 29150 Home Health Services DHEC 105 N Magnolia St., 803-773-5511 Sumter, SC 29150 Child Abuse & Neglect 105 N Magnolia St., 803-773-5531 Sumter, SC 29150 United Way-Sumter/Clarendon 215 N Washington St., 803-773-7935 Sumter, SC 29150 Proprietary Tuomey Healthcare System Sumter, South Carolina Sumter Child Advocacy Center Community Health Needs Assessment Page 70 190 S Lafayette Dr., 803-774-5600 Sumter, SC 29150 Sumter Volunteers 407 W Hampton Ave., 803-775-7423 Sumter, SC 29150 Berea Community Svc Center 675 S Lafayette Dr., 803-773-3077 Sumter, SC 29150 American Legion 28 S Artillery Dr., 803-773-9644 Sumter, SC 29150 29. ENVIORNMENTAL ISSUES - Presents as an unidentified problem as noted by Local Experts. (Ranked 29 out of 29). Opportunity Statement: Raise awareness of the problems originating from environmental and pollution issues and resources available to respond to incidents Local resources include the following: City of Sumter Fire Department 129 E. Hampton Ave., 803-436-2600 Sumter, SC City of Sumter Public Works 303 E. Liberty St., 803-436-2558 Sumter, SC Sumter County Environmental Engineering 13 E. Canal St., Sumter County Department of Health 105 N. Magnolia St., 803-436-2114 Sumter, SC 803-773-5511 Sumter, SC Sumter County Public Works 1289 N. Main St., 803- 436-2241 Sumter, SC Sumter County Emergency Management 141 N. Main St., Shaw AFB Public Health 431 Meadowlark St., 803-436-2158 Sumter, SC 803-895-6193 Shaw AFB, SC S.C. Department of Health and Environmental Control 3600 Bull St., 803-898-3432 Columbia, SC Proprietary Tuomey Healthcare System Sumter, South Carolina Emerald, Inc. Community Health Needs Assessment Page 71 2520 Tahoe Dr., 803-469-5454 Sumter, SC Overall Community Need Statement and Priority Ranking Score: Significant Needs Where Hospital Has an Implementation Plan 1. Heart Disease; 2. Cancer and Screening; 4. Diabetes; 5. Hypertension; 6. Maternity and Child Health; 7. Stroke; 8. Affordable Access. Significant Needs Where Hospital Did Not Develop an Implementation Plan27 3. Obesity 9. Drugs & Alcohol Abuse 10. Accidents Other Needs Where Hospital Did Not Develop an Implementation Plan 11. Sexually Transmitted Disease; 12. Predisposing Adverse Health Factors & Life Expectancy 13. Homicide; 14. Physician Supply; 15. Lung Disease; 16. Hospice and Palliative Care; 17. Alzheimer’s; 18. Cholesterol Screening; 19. Kidney Disease; 27 Reference Schedule H (Form 990) Part V Section B 7. Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 72 20. Mental Health; 21. Flu; 22. Chronic Allergies; 23. Suicide; 24. Health Education, Screening and Prevention; 25. Blood Poisoning. 26. Parkinson’s; 27. Tobacco Use; 28. Domestic Abuse; 29. Environmental (lead, water, etc). Total first year budget for providing services that address the needs identified in the Needs Assessment = $1,265,000.28 28 Reference Schedule H (Form 990) Part V Section B 6. f Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 73 APPENDICES Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 74 Appendix A – Area Resident Survey Response A total of 165 residents participated in an on-line survey to offer opinions regarding their perceptions of community health needs. The following is an analysis of their responses: The first question was open-ended: “What do you believe to be the most important health or medical issues confronting the community?” Answers were placed in a “Word Cloud” format for analysis and generated the following image: Word Clouds are analytical tools which give greater visual prominence to words appearing more frequently in the source text. This information visualization establishes a portrait of the aggregate responses, presenting the more frequently used terms with greater text size and distinction in the visual depiction. Common article word (i.e., “a,” “the,” etc.), non-contextual verbs (i.e., “is,” “are,” etc.) and similar words used when writing sentences are suppressed by this application. The interpretation of the image tracks with the statistical analysis of what are major concerns (topics identified by over 50% of community opinions). Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 75 The second question asked about identifying major concerns: Are Any of the Following a Concern? 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 78% 77% 68% 68% 65% 65% 53% 49% 21% 16% 15% 14% Major Issue Moderate Issue Minor Issue Not an Issue No Opinion/Don't Know Are Any of the Following of Concern? 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 57% Major Issue 49% Moderate Issue 45% 44% Minor Issue 42% Not an Issue 40% 20% No Opinion/Don't Know Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 76 Are Any of the Following of Concern? 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 66% Major Issue 58% 42% 31% Moderate Issue 30% 20% Minor Issue 18% 15% Not an Issue 11% 10% No Opinion/Don't Know We then asked about the experiences of the area resident. Proprietary Tuomey Healthcare System Sumter, South Carolina 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Community Health Needs Assessment Page 77 71% 61% 52% 45% 44% 44% YES I perceive problems NO I do not see concerns 27% 25% No Opinion Individual/Family Health Concerns was the only classification of needs receiving a majority opinion of having a priority need to respond to perceived problems (as shown below). Importance of Resolving Problems 450 400 350 52% 42% 41% 300 250 200 150 21% 18% 16% 12% 100 7% 50 0 Weighted Priority Response with Percent of Total Votes Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 78 We asked if people left the area in search of care and received the following information. In the Last 2 Years Did Any Household Member Leave the County in Search of Medical Care? Don't Know or Remember 9% YES 38% NO 53% Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 79 After gather demographic information and other responses which did not generate actionable information, we asked one final question seeking opinions about issues the respondents wanted to emphasize for our analysis. The additional information continued to confirm earlier expressed opinions. The following image was generated from 18 responding individuals. Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 80 Appendix B – Process to Identify and Prioritize Community Need29 E xp e rts Ca s ting Vo te s T o ta l V o te s Ca s t Cummu % 144 141 125 115 84 74 65 57 50 48 39 38 38 35 31 30 25 25 25 19 16 15 14 14 11 9 7 5 1 13 11 13 12 12 12 11 9 10 11 8 9 8 7 7 7 9 8 7 2 7 7 7 2 7 6 3 2 1 13 144 285 410 525 609 683 748 805 855 903 942 980 1018 1053 1084 1114 1139 1164 1189 1208 1224 1239 1253 1267 1278 1287 1294 1299 1300 11.1% 21.9% 31.5% 40.4% 46.8% 52.5% 57.5% 61.9% 65.8% 69.5% 72.5% 75.4% 78.3% 81.0% 83.4% 85.7% 87.6% 89.5% 91.5% 92.9% 94.2% 95.3% 96.4% 97.5% 98.3% 99.0% 99.5% 99.9% 100.0% 1,300 P o int Bre a k 3 16 10 31 10 9 8 7 2 9 1 0 3 4 1 5 0 0 6 3 1 1 0 3 2 2 2 4 P rio rity D e te rmina tio n High Priority 1. HEART DISEASE 2. CANCER and SCREENING 3. OBESITY 4. DIABETES 5. HYPERTENSION 6. MATERNITY AND CHILD HEALTH 7. STROKE 8. AFFORDABLE ACCESS 9. DRUG & ALCOHOL ABUSE 10. ACCIDENTS 11. SEXUALLY TRANSMITTED DISEASE 12. PREDISPOSING ADVERSE HEALTH FACTORS & 13. HOMICIDE 14. PHYSICIAN SUPPLY 15. LUNG DISEASE 16. HOSPICE AND PALLIATIVE CARE 17. ALZHEIMER’S 18. CHOLESTEROL SCREENING 19. KIDNEY DISEASE 20. Mental Health 21. FLUE 22. CHRONIC ALLERGIES 23. SUICIDE 24. Health Education, Screening and Prevention 25. BLOOD POISONING 26. PARKINSON’S 27. Tobacco Use 28. Domestic Abuse 29. Environmental (lead, water,etc) Total Votes T o ta l V o te s b y Need Low Priority P o te ntia l N e e d T o p ic Individuals Participating as Local Expert Advisors Name: Company or Organization: Title or Position Email Address: Area of Expertise: Michelle DeVine RN BSN NCSN-Assistant Coordinator Care Reach michelle.devine@tuomey.com School Health (Pre-school-12th Grade) in Sumter Community Name: Company or Organization: Title or Position Email Address: Area of Expertise: Mayes DuBose, MD Owner Carplina Geriatric Specialists, LLC Mayes_d@yahoo.com Geriatric Medicine Name: Company or Organization: Title or Position Email Address: Area of Expertise: Tim Hardee President Central Carolina Technical College hardeebt@cctech.edu Higher Education 29 Responds to IRS Schedule H (990) Part V B 1. g. and V B 1. h. Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 81 Name: Company or Organization: Title or Position Email Address: Area of Expertise: GC James Judge SC Judicial Dept gjames82@gmail.com Long time area resident Name: Company or Organization: Title or Position Email Address: Area of Expertise: Kevin Johnson Executive Director Wateree AIDS Task Force watereeaids@sc.rr.com Infectious Disease prevention treatment and care referral service. Name: Company or Organization: Title or Position: Email Address: Area of Expertise: Linda Johnson Interim Regional Health Director SC DHEC johnsole@dhec.sc.gov Public Health Name: Company or Organization: Title or Position Email Address: Area of Expertise: Mary Kolb Assistant Vice President BB&T mkolb@bbandt.com banking and non profits Name: Company or Organization: Title or Position Email Address: Area of Expertise: Lissa C. Lara CEO Colonial Family Practice lissa.lara@colonialfamilypractice.com Patient Centered Medical Homes and Quality Initiatives Name: Company or Organization: Title or Position Email Address: Area of Expertise: Andre McBride Plant Manager International Paper andre.mcbride@ipaper.com resident Name: Company or Organization: Title or Position Email Address: Area of Expertise: C. Suzette McClellan Regional Director of Professional Services/Health Education SCDHEC- Region 4 mcclelcs@dhec.sc.gov Public Health/Health Education Name: Company or Organization: Title or Position Email Address: Area of Expertise: Janice Poplin VP HR & Risk Management Thompson Construction Group jpoplin@thompsonind.com industrial Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 82 Name: Company or Organization: Title or Position Email Address: Area of Expertise: Cindy S Reese Palmetto Family Practice MD drcsr2001@hotmail.com local physician Name: Company or Organization: Title or Position Email Address: Area of Expertise: Nick Shorter Administrative Services Dir. City of Sumter Nshorter@sumter-sc.com Risk Management Name: Company or Organization: Title or Position Email Address: Area of Expertise: Mary Sheridan Public Information Sumter School District mary.sheridan@sumterschools.net Certified guidance counselor and public information with PK-12 school district Name: Company or Organization: Title or Position Email Address: Area of Expertise: Chris Watson Care Reach Manager Tuomey Medical Professionals chris.watson@tuomey.com public health - pediatrics Name: Company or Organization: Title or Position Email Address: Area of Expertise: Robin Watson Director of Nursing Sumter Family Health Center rwatson@sumterfhc.com Community health Name: Company or Organization: Title or Position Email Address: Area of Expertise: Nancy Lee Zimpleman VP of Membership Development Greater Sumter Chamber of Commerce nancylee@sumterchamber.com Small Business Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 83 Advice Received from Local Experts Q. Do you agree with the observations formed about the comparison of Sumter County to all other South Carolina counties? Do You Agree With the Observations Comparing Sumter Within SC I disagree with some or all of the above observations 6% I agree with the above observations 94% I also think that the following conditions should be considered: infant mortality and tobacco use. I believe that the Violent Crime Rate can be addressed through increasing our response from the Department of Social Services and other Social Service Providers to children that are being allowed to remain in homes where there is chronic neglect of their basic needs, as well as children that are witnesses to chronic Criminal Domestic Violence and chronic physical and emotional abuse. I have seen children in elementary school that are either allowed to remain in these environments or are subject to be moved back and forth from foster home to parent home numerous times and as a result, become increasingly angry individuals. These children then reach adolescence and the anger turns into rebellion and ultimately places them at high risk for committing a violent crime in our community in the future. Childhood obesity is very high along with being ranked third for AIDS and fourth for HIV in the state as of last state rankings. Also very high in unintentional injuries. Need improved/increased access to mental health services. I do think there is access to healthy food but patients do not make healthy choices. I agree, but with some justifications. Although we are known for a high crime rate, a lot of it is 'crime on crime' activity, so I feel that it is somewhat inflated. As for limited access to healthy food, there is plenty available but the overall socio-economic climate makes it unobtainable for some. Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 84 Q. Do you agree with the observations formed about the comparison of Sumter County to its Peer counties? Do You Agree With Comparison of Sumter With Its Peers? I disagree with some or all of the above observations 19% I agree with the above observations 81% I am surprised that the Black non-Hispanic infant mortality is listed as better than peers and national rates. Sexually transmitted diseases are not rated. Births to women under 18 should be a greater concern than ranked. Q. Do you agree with the observations formed about the population characteristics of Sumter County? Do You Agree With the Observations Made About Sumter County I agree with the above observations 100% Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 85 Q. Do you agree with the observations formed about the opinions from local residents? Do You Agree With the Summary of Local Resident Opinions I disagree with some or all of the above observations 6% I agree with the above observations 94% I am concerned as to whether or not the survey captured a representative sample of Sumter County's population to complete the survey. There is a need for more mental health providers for children in our community that are Medicaid providers. Not sure survey respondents accurately reflect the "average" citizen (44% have income of $100,000 or more). In #7, it says cancer was listed by 65% as a major concern. #11 says it was listed as a major concern by 51%. One has to be incorrect. Answer: #7 - 65% is correct, #11 is an error in reporting results. Q. Do you agree with the observations formed about the additional data analyzed about Sumter County? Do You Agree With the Summary of Other Data Analyzed? I agree with the above observations I agree with the above observations 100% Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 86 Appendix C – Illustrative Schedule H (Form 990) Part V B Potential Response Illustrative IRS Schedule H Part V Section B (form 990)30 Community Health Need Assessment Answers 1. During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9 Illustrative Answer – Yes If “Yes,” indicate what the Needs Assessment describes (check all that apply): a. A definition of the community served by the hospital facility b. Demographics of the community c. Existing health care facilities and resources within the community that are available to respond to the health needs of the community d. How the data was obtained e. The health needs of the community f. Primary and chronic disease needs and health issues of uninsured persons, low-income persons and minority groups g. The process for identifying and prioritizing community health needs and services to meet the community health needs h. The process for consulting with persons representing the community’s interests i. Information gaps that limit the hospital facility’s ability to assess the community’s health needs j. Other (describe in Part VI) Illustrative Answer – check a. through i. Answers available in this report are found as follows: 1. a. – See Footnotes #18 (page 11) & #19 (page 11) 1. b. – See Footnotes #20 (page 12) 1. c. – See Footnote #25 (page 28) 1. d. – See Footnotes #11 (page 6) 1. e. – See Footnotes #16 (page 8) 1. f. – See Footnotes #14 (page 8) 30 Questions are drawn from 2012 f990sh.pdf Forms and may change when the hospital is to make its 990 h filing Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 87 1. g. – See Footnote #17 (page 9) & #28 (page 80) 1. h. – See Footnote #12 (page8) & #28 (page 80) 1. i. – See Footnote #10 (page 6) 1. j. – No response needed 2. Indicate the tax year the hospital facility last conducted a CHNA: 20 _ _ Illustrative Answer – 2013 See Footnote #1 (Title page) 3. In conducting its most recent CHNA, did the hospital facility take into account input from representatives of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted Illustrative Answer – Yes See Footnotes #13 (page 8), #15 (page 8) 4. Was the hospital facility’s Need Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI. Illustrative Answer – No 5. Did the hospital facility make its CHNA widely available to the public? If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply) a. Hospital facility’s website b. Available upon request from the hospital facility c. Other (describe in Part VI) Illustrative Answer – check a. and b. The hospital will need to obtain Board approval of this report, document the date of approval, and then take action to make the report available as a download from its web site. It may also be prudent to place a notice in a paper of general circulation within the service area noting the report is available free upon request. 6. If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date): a. Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA b. Execution of an implementation strategy c. Participation in the development of a community-wide plan Proprietary Tuomey Healthcare System Sumter, South Carolina Community Health Needs Assessment Page 88 d. Participation in the execution of a community-wide plan e. Inclusion of a community benefit section in operational plans f. Adoption of a budget for provision of services that address the needs identified in the CHNA g. Prioritization of health needs in its community h. Prioritization of services that the hospital facility will undertake to meet health needs in its community i. Other (describe in Part VI) Illustrative Answer – check a, b, f, g, and h. 6. a. – See footnote #26 (page 29) 6. b. – See footnote #26 (page 29) 6. f. – See footnotes #6 (page 4) and #28 (page 72) 6. g. – See footnote #17 (page 9) 6. h. – See footnote #17 (page 9) 7. Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs? Illustrative Answer – No Part VI suggested documentation – See Footnote #27 (page 71) 8. a. Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? b. If “Yes” to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? c. If “Yes” to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form4720 for all of its hospital facilities? Illustrative Answers – 8. a, 8 b, 8 c – No Proprietary