dramatically different.

Health System
DRAMATICALLY
DIFFERENT.
2014 ANNUAL REPORT
An Academic Health System Affiliated with the University of Tennessee
ERLANGER DOES WHAT OTHERS
CAN’T…OR WON’T.
A message from
Kevin M. Spiegel, FACHE
President & CEO,
and Donnie Hutcherson,
Chair, Board of Trustees
Erlanger’s Southeast Regional Stroke Center
helps lead the world in techniques that can
reverse a stroke’s devastating effects.
“WHERE OTHER
HOSPITALS SEND
THEIR TOUGHEST
CASES.”
U.S. NEWS & WORLD REPORT
2
IT’S A FACT.
The region’s essential
safety net providing $86
Erlanger is the one system of hospitals, doctors
million in uncompensated care
and services that the people of Chattanooga,
last year, far more than anyone
Tennessee, and 63 surrounding counties cannot
else, despite being “the least
do without.
No one else in the region provides so much for
so many—essential services that others can’t or
won’t offer. Yet Erlanger does, for more than
300,000 patients every year.
That alone makes Erlanger unique. But it’s far from
the only way. So we encourage you to fully explore
this Annual Report to learn even more about:
The region’s only Academic Health
System. As a campus of the University of
Tennessee College of Medicine, Erlanger is among
the elite 6% of all hospitals proven to provide
higher standards and better outcomes.
The region’s only Children’s Hospital.
A leading Pediatric Teaching Hospital with the
region’s only pediatric emergency room, highestlevel NICU and a cancer program that treats more
than 90% of all area children with cancer.
financially supported public
health system in the nation,” according to the
national organization America’s Essential Hospitals.
The 10th-largest public health system in
the country, which, unlike most public systems,
is both the region’s market-share leader and the
provider of choice for more people, even those
who are commercially insured.
One of the most culturally diverse
organizations in the region, with people from
all over the world and all walks of life, whose
commitment to diversity is an indispensable
component of healthcare excellence.
A health system that’s thriving. Today, many
healthcare systems are struggling and, until very
recently, Erlanger was among them. In fact, our
challenges are often greater than most, given our
unique position as both an elite academic health
system and a safety net for millions. That’s two
Clinical Centers of Excellence providing
the region’s highest level of quality care in
essential roles—and two reasons for us to find new
ways to not only survive, but thrive.
essential specialties like neurosciences, cardiology,
oncology, orthopedics, urology, surgery and
organ transplantation.
The region’s only Level 1 Adult & Pediatric
Trauma Centers providing the highest level
of care to the most critically injured and ill
throughout our 31,400 square-mile region.
We are pleased to report that, in less than 18
months, we’ve done just that.
So we urge you to read on and learn about one
of the most remarkable health system
turnarounds ever. And, how one incredibly
unique and essential health system is capturing
national attention for elevating quality of life with
LIFE FORCE, the region’s only hospitalbased air ambulances, transporting patients
everything we do.
to Erlanger from throughout a 100-mile radius.
The region’s most complete OB/GYN
services, including multiple childbirth facilities
that deliver more than 80% of the area’s babies
every year.
East Tennessee’s highest-rated health
system, named U.S. News & World Report’s
Kevin M. Spiegel, FACHE
President & CEO
Erlanger Health System
Donnie Hutcherson
Chair, Board of Trustees
Erlanger Health System
best health system four years in a row, all
while remaining the region’s low-cost provider.
3
4
THE
REGION’S
ONLY
ACADEMIC
HEALTH
SYSTEM.
Dr. Jennifer Dooley, Assistant Professor, and
Dr. Mukta Panda, Professor and Assistant
Dean, make rounds with students from the
UT College of Medicine.
5
A CLINICAL,
EDUCATIONAL
AND RESEARCH
POWERHOUSE.
Dr. David C. Seaberg, Dean of the UT College of
Medicine Chattanooga, leads more than 400 Erlanger
physician faculty members system-wide.
6
The power of the Erlanger/UTCOM partnership
extends far beyond any campus boundaries
and has a positive effect on virtually everyone
who lives in this area. For example, Erlanger and
UTCOM train more than 60% of all doctors
in the region, and help attract and recruit
countless others, ensuring that all area residents
have access to the physicians they need.
Erlanger President & CEO Kevin M. Spiegel, FACHE, and Assistant
Professor of the UT College of Medicine, talks with his son Josh,
a third year medical student at UTCOM/Erlanger.
More directly, another powerful Erlanger/UTCOM
If there’s one factor most responsible for
care physicians and specialists where
Erlanger’s ability to excel in so many ways,
they’re needed most. With more than 170
it’s the Health System’s role as a campus of
members, many of whom are UTCOM faculty, the
the University of Tennessee College of
region’s fastest-growing medical group is
Medicine (UTCOM). This places Erlanger among
bringing the high standards of academic medicine
the ranks of our country’s leading academic
to more than 45 locations throughout Erlanger’s
health systems—an elite group of only 6% of
vast service area.
partnership, the UT Erlanger Physicians
Group, is fulfilling its mission of placing primary
all hospitals in the U.S.—and the only health
system in the region held to the high, evidence-
based standards of academic medicine.
The benefits of academic medicine are welldocumented. Academic health systems like
Erlanger are where patients can expect better
outcomes, along with superior care for complex
conditions. Patients also benefit from the latest
treatments and technologies, which are most
often found at teaching hospitals first, along with
access to more clinical trials than anywhere
else in the region.
More subtly, but just as important, is the
atmosphere of education and collaboration that
permeates the entire system. With more minds
working together, the patient always benefits.
It’s a continual cycle of education, and it’s not
only UTCOM students and residents who learn.
With more than 400 physicians serving as UTCOM
faculty, Erlanger’s medical staff must remain
Internal medicine resident Dr. Mindy Smith studies at the
UT College of Medicine’s library at Erlanger.
on the leading edge of the latest treatments
and techniques.
7
A Southeast Regional Stroke Center team, led by
Dr. Blaise Baxter, performs an interventional
procedure to reverse the effects of a stroke.
8
CENTER OF EXCELLENCE
THE REGION’S ONLY
CERTIFIED ACADEMIC
COMPREHENSIVE
NEUROSCIENCES CENTER.
9
Dr. Biggya Sapkota, Dr. Thomas Devlin and Jennifer Nichols, APN,
discuss a case at one of the nation’s busiest stroke centers.
NO PLACE ON EARTH
CAN DO MORE TO
STOP A STROKE.
“World class” is a phrase that is often overused
in healthcare. But at Erlanger, the field of
neurosciences is truly attracting the attention of
the world.
Strategically located at the buckle of the “Stroke
Belt” (where adults are four times more likely to
suffer a stroke), the Erlanger Southeast Regional
Stroke Center has emerged as a world leader
in reversing the effects of a stroke. As the
region’s only Certified Comprehensive
Stroke Center, it alone has earned the Joint
No other
Commission’s highest accreditation.
provider in the region
has earned The Joint Commission’s
highest accreditation for stroke care.
At the program’s core are elite physicians, led by
the stroke center’s founder and co-director Tom
Devlin, M.D. He and co-directors Abdelazim
Sirelkhatim, M.D. and Biggya Sapkota, M.D.
10
Erlanger is the only health system in the region to offer
brain surgery. Pictured here: Dr. Daniel Kueter.
are supported by an elite team of stroke
neurologists and interventional neuro-radiologists
who are ready to respond at any time with
breakthrough techniques available at
Erlanger—and nowhere else in the region.
Using these techniques, interventional neuroradiologists remove stroke-causing clots from
the brain using intravenous catheter techniques
and real-time nuclear imaging. Once the clot is
removed and blood flow restored, some patients
regain sight, speech and movement of limbs
within minutes.
The capabilities of Erlanger’s Neurosciences
Center of Excellence don’t end with stroke.
As the primary practice location for the region’s
leading group of surgeons treating diseases
As the sixth-busiest stroke center in the nation,
of the brain and spinal injuries, Erlanger offers
Erlanger’s patient volume and experienced
more neurosurgical services than any other area
specialists attract some of the world’s leading
health system. These include the region’s only
technology companies for help developing and
brain surgery program and the region’s most
evaluating their best ideas. Virtually every
comprehensive program for treating back
new stroke technology comes through
pain with neurosurgical techniques.
Erlanger—along with stroke specialists from all
over the world, eager to learn these next-generation
Dr. Josh Alpers is fellowship trained in the
techniques. In fact, physicians from Saudi Arabia,
treatment of neuromuscular disorders such
India, Vietnam and China have all traveled to study
Erlanger’s approach.
as ALS and Parkinson’s disease. And, under the
leadership of Dr. Nikesh Ardeshna, Erlanger also
offers the region’s only epilepsy monitoring
unit. More vital services from the region’s
undisputed leader in neurosciences: Erlanger.
Grammy-winning guitarist Norman
Blake is only one of thousands who
credits the Southeast Regional
Stroke Center with saving his life—
and livelihood.
11
12
The region’s most advanced PET scanner
is only one of Erlanger’s latest-generation
tools to diagnose and treat cancer.
CENTER OF EXCELLENCE
ACADEMIC ONCOLOGY:
THE HIGHEST LEVEL
OF CARE, INNOVATION
AND RESEARCH.
13
MORE TECHNOLOGY.
MORE TRIALS.
MORE WAYS TO BEAT CANCER.
A patient undergoes radiation treatment with CyberKnife, which
uses robotics to painlessly target tumors with incredible accuracy.
14
Erlanger’s approach to fighting cancer is exactly
the region’s only low and high-dose
what you would expect from a major academic
brachytherapy. It is also the region’s only
health system: it’s leading the way. As the
provider to offer yttrium-90 (Y-90) for the
region’s only Academic Comprehensive
treatment of liver cancer and metastatic
Cancer Center, only Erlanger meets the high
colon cancer.
accreditation standards and outcome benchmarks
for that designation as established by the
American College of Surgeons.
Erlanger is also at the forefront of radiation
technology. In our region, only Erlanger has
CyberKnife, a next-generation technology that
employs robotics to treat tumors painlessly and
with pinpoint accuracy. CyberKnife is so effective
that many cases, including prostate cancer,
can be treated and cured in as few as
five treatments.
Erlanger is also one of the most successful
centers in the nation treating lung cancer
As a result, patients benefit from evidence-based
with CyberKnife and among the first to offer
standards of academic oncology, along with
Lung Optimization Treatment, using new
access to more clinical trials than anywhere
software that allows tumors to be tracked without
in the region. Through its membership in the
implanting fiducial markers.
East Central Oncology Group, a cooperative of
other elite academic medical centers, Erlanger
is able to offer even more trials—yet another
advantage for our patients.
Personalizing each patient’s treatment plan is
key to winning the fight, and at Erlanger, that
personalization begins at the cellular level.
Erlanger pathologists provide the region’s
most advanced genomic testing, or
molecular profiling, for each patient’s specific
cancer or tumor. This provides Erlanger’s medical
oncologists with the information they need to
create targeted, patient-specific therapies.
Similarly, Erlanger also provides the region’s
only board-certified genetics counselors.
These counselors have specialized training to
help identify genetic predisposition in cancer
patients and help tailor interventions and
treatments accordingly.
Erlanger offers the widest range of
treatments for cervical cancer, including
Dr. Larry Schlabach, Chief of Oncology, and other specialists
meet regularly as part of Erlanger’s multi-disciplinary
approach to fighting cancer.
15
CENTER OF EXCELLENCE
ACADEMIC
CARDIOLOGY:
A HEART CENTER AT
ITS HIGHEST LEVEL.
16
Dr. Robert Huang performs a radial cardiac catheterization,
which accesses the coronary arteries through the wrist,
decreasing the risk of bleeding and complications.
17
VIRTUALLY EVERY
CARDIOLOGY INNOVATION
HAPPENS AT ERLANGER.
A patient undergoes a 3-D cardiac
CT scan at Erlanger.
18
From the region’s first open heart surgery to the
first cardiac catheterization; from the first bypass
surgery to the first balloon angioplasty—Erlanger’s
Cardiologist Dr. Michael Love chats
with new Chief of Cardiovascular
Diseases Dr. Charles Campbell.
history of heart “firsts” is well-documented.
Today, powered by UT Erlanger Cardiology,
the region’s only academic cardiology
group, innovations are happening faster than
ever, elevating Erlanger to the area’s highest
level of cardiac care.
This year, for example, Erlanger became the
only provider in the region certified by
The Joint Commission for Acute Myocardial
Infarction (AMI), more commonly known as a
heart attack. This means that only Erlanger meets
the Commission’s rigorous standards for speed,
quality and outcomes, providing care for
heart attacks up to 28 minutes faster than
the national average.
Finally, Erlanger is partnering with
Columbia University, an internationally
Likewise, Erlanger is accredited as a Cycle
recognized leader in medicine and research.
IV Chest Pain Center with Percutaneous
Through the Columbia HeartSource program,
Coronary Intervention (PCI) by the Society of
Erlanger patients benefit from the combined
Cardiovascular Patient Care. This designation
knowledge and experience of an elite group
means Erlanger meets or exceeds the Society’s
of cardiac leaders, and can even access
stringent criteria for assessing, diagnosing and
Columbia’s extensive program of biomedical and
treating chest pain patients quickly.
device-oriented clinical trials.
Erlanger also continues to be first with new
It’s just the latest way that only Erlanger
procedures and techniques, like the implantation of
practices evidence-based standards of
the region’s first subcutaneous implantable
academic cardiology, and puts them to work
cardioverter-defibrillator. This breakthrough
for patients, every day.
device, the first of its kind, is implanted through
a minimally invasive procedure, and provides
protection from sudden cardiac arrest while
leaving the heart and vasculature untouched.
Similarly, Erlanger performs more radial
cardiac catheterization procedures, in
which the catheter is inserted through the wrist
rather than the leg. This promotes faster recovery
and reduces the chance of excessive bleeding
No other provider
in the region has
earned The Joint
Commission’s
highest
accreditation for
fast heart attack
treatment.
after the procedure.
19
20
CENTER OF EXCELLENCE
THE REGION’S
ONLY ADULT AND
PEDIATRIC LEVEL 1
TRAUMA CENTERS.
Dr. Robert Maxwell, a UT College of Medicine professor
and Critical Care Program Director, is part of an elite
team that performs critical surgeries anytime, 24/7.
21
THE HIGHEST LEVEL
OF TRAUMA CARE.
PERIOD.
22
On a training ride for Ironman Chattanooga,
Mike Biddle broke his collarbone and 3 ribs
in an incredible collision…with a deer! Even
more amazingly, the skillful care of Erlanger’s
orthopedic trauma team enabled Mike to
finish in the top 50 just 6 weeks later, and
qualify for the World Championships.
Anyone who lives in Erlanger’s 63-county service
Southeast to carry blood, use ultrasound and
area will agree: Erlanger is far and away the
perform in-flight surgical procedures.
region’s undisputed leader in caring for the most
critically ill and injured. And for good reason. As
the region’s only adult and pediatric Level 1
Trauma Centers, there’s simply no higher level
of care available anywhere.
Erlanger’s leadership in emergency and trauma
care reaches even farther into the communities
we serve. For example, only Erlanger provides
medical support and control for all EMS
services in the area—not just those en route to
The lynchpin of the Centers’ lifesaving mis-
Erlanger. By assuming responsibility for this vital
sion lies with their staff of physicians—not only
service, including tracking ambulances, routes and
the region’s most experienced trauma
available beds, Erlanger ensures countless area
surgeons, but also the only trauma, general
residents get the care they need.
and pediatric surgeons on duty 24/7.
Finally, as you’d expect from Erlanger, the
With these specialists on duty around the clock,
Level 1 Trauma Centers fulfill a teaching role. As
along with coverage for orthopedics, plastics
the region’s only academic emergency
and neurosurgery, no other area hospital is
medicine residency and fellowship
better prepared for any emergency. In fact,
programs, many of the region’s ER physicians
only Erlanger has dedicated operating
were trained at Erlanger.
rooms and teams ready anytime for any
surgical emergency.
Transporting patients to these lifesaving
resources is LIFE FORCE, the region’s
largest air ambulance fleet. LIFE FORCE
aircraft can transport a patient from virtually
anywhere within minutes, all the while providing
lifesaving care, thanks to the region’s only
specialized flight nurses and paramedics.
It is one of the few air ambulance fleets in the
23
CENTER OF EXCELLENCE
COMPREHENSIVE
ACADEMIC
ORTHOPEDICS:
NEXT LEVEL CARE.
24
Arthroscopic surgery, like this one performed by
Dr. Jesse Doty on a patient’s ankle, allows for faster
recovery times and a quicker return to normal activities.
25
THE REGION’S
ONLY ACADEMIC
ORTHOPEDICS
PROGRAM.
Radiologist Dr. Eric Zimmerman
examines a knee replacement candidate’s MRI.
26
UT Erlanger Institute for
Sports and Health physicians,
including Dr. Bill Moore Smith,
serve as team doctors for the
UT Chattanooga Mocs and
other regional teams.
You might expect an academic health system that
The UT Erlanger Institute for Sports and
leads in healing traumatic injuries to be strong in
Health is yet another recent milestone. As
orthopedics, and, in the case of the region’s only
the region’s most comprehensive sports
Academic Orthopedics program, you’d be correct.
medicine practice, this unique collaboration
And now that Erlanger includes two of the
between leading specialists in sports medi-
region’s leading orthopedics groups,
cine, primary care, orthopedics, neurology and
OrthoSouth and University Orthopedics, this
rehabilitation represents the most compre-
Center of Excellence is even stronger.
hensive care available for athletes and active,
This elite orthopedics team now includes 13
sports-loving families.
surgeons providing a full range of services,
Of course, in addition to its clinical excellence,
including trauma coverage at the region’s only
Erlanger orthopedics never stops flexing its
Level 1 Trauma Centers. As a result, no one has
academic muscle. Two Erlanger surgeons serve
more experience dealing with “worst
as examiners for the American Board of
case” injuries—experience that more than
Orthopedic Surgery, while other team mem-
prepares them for the wide range of more
bers routinely publish research and have written
common injuries most of us are likely to suffer.
chapters of textbooks used all over the world.
In addition, Erlanger continues to lead the way in
Even more evidence of how the region’s
joint replacement, offering:
strongest orthopedics program is only
The region’s only minimally invasive
getting stronger.
hip surgery
The region’s only complex tendon
transfers
The region’s only total ankle
replacement, and
The region’s only reconstruction for
stroke-related and traumatic brain
injury deformities
Dr. Richard Alvarez, Professor and Chair of the
Department of Orthopedics, follows up with a total
ankle replacement patient.
27
Dr. Amar Singh, Assistant Professor and Chair of the
Department of Urology, uses the da Vinci robotic surgery
system, a leading tool in the fight against cancer.
28
CENTER OF EXCELLENCE
ACADEMIC UROLOGY:
THE REGION’S HIGHEST
LEVEL BY FAR.
29
THE REGION’S
ONLY ACADEMIC
UROLOGISTS AND
SURGEONS.
Dr. Colin Goudelocke, fellowship trained
in female urology and incontinence,
operates at Erlanger East.
30
When it comes to Erlanger urology, it’s no
which helps predict a tumor’s behavior and
exaggeration: the region’s only academic
assess risk, Erlanger urologists are elevating
urologists and surgeons are not only unmatched
care by operating less. In fact, as many as 1/3
anywhere in the region, they’ve also earned
of prostate cancer patients are currently being
national recognition, particularly in the
treated not with surgery, but through careful
diagnosis and treatment of urological cancers,
observation and other non-invasive means.
such as kidney, bladder and prostate.
With their advanced fellowship training, spe-
Erlanger urologists and surgeons provide the
cialization and experience, the Erlanger team also
most comprehensive care for all urologic
plays a crucial role in training tomorrow’s
diseases. They are the only group with multiple
doctors, particularly when, with our aging
physicians who are urological fellowship
population, more urologists are so desperately
trained in a wide range of specialties, including
needed. As one of the few programs in the
cancer, pelvic floor, incontinence, infertility and
entire country qualified to teach, each
pediatric urology.
group member serves as faculty at the UT College
of Medicine and is widely published.
In addition, most Erlanger urologists are actively
involved in ongoing research projects. In fact,
as of this writing, new clinical trials involving
prostate, bladder and kidney cancer are
currently underway—just the latest ways this
In addition, the department chair, Dr. Amar Singh,
Center of Excellence is helping define the
is the region’s only urologist to complete a
future of urology.
National Cancer Institute fellowship. This
breadth of training and experience allows Erlanger
to do things other providers simply can’t.
For example, with unequalled experience in
laparoscopic techniques, the group performs
more kidney-preserving cancer surgeries
than anywhere else in the region.
And with the region’s only da Vinci Xi
surgical robot, along with the region’s most
extensive experience with robotic surgery,
the group continues to innovate and push the
limits of what can be accomplished through
one tiny incision.
Meanwhile, even more advances are happening
outside of the operating room. Assisted by the
region’s most advanced genomic profiling,
Dr. Anand Shridharani, a specialist in male infertility and
urology, reviews treatment options with colleagues.
31
32
CENTER OF EXCELLENCE
THE REGION’S
ONLY KIDNEY
TRANSPLANT
PROGRAM.
Drs. Dan Fisher and Phillip Smith, two of
Erlanger’s elite transplant surgeons.
33
THE REGION’S
HIGHEST-PERFORMING
HEALTH SYSTEM IN
NEPHROLOGY.
U.S. NEWS & WORLD REPORT
34
Kidney disease is responsible
program’s patient outcomes are among the
for more than 90,000 deaths
best in the nation. They serve an ever-growing
in America each year—more
number of patients who are happy to learn they
than breast and prostate cancer
don’t need to travel to Nashville or Atlanta
combined. As the number of cases increases along
with our aging population, Erlanger is responding
with the region’s most comprehensive
nephrology services—and the only program
to receive “best of” accolades from U.S. News &
World Report.
for a transplant.
Surrounding these physicians is a team of
dedicated transplant educators and
nurses led by transplant administrator Asad
Zaman. Together, they work diligently to match
individuals awaiting a transplant with suitable
These next-level services include the region’s only
donated organs, all while providing comfort
kidney transplant program, which, in FY 2014,
and counseling through what is often a very
celebrated 25 years of saving lives while
emotional process.
offering hundreds of Chattanooga-area kidney
patients freedom from a lifetime of dialysis.
With some 80 candidates currently on waiting
lists, wait times for a new kidney at Erlanger are
Under the leadership of nephrologists Drs. Don
significantly shorter than the national average.
Franklin and Ralph Stafford, and surgeons Drs.
Still, more donors are always needed. To learn
Dan Fisher, Phillip Smith and Michael Roe, the
more, visit organdonor.gov.
Paula Palmer, whose own kidneys were
failing due to polycystic disease, is
thankful to an anonymous donor and
Erlanger’s Kidney Transplant Team for
saving her life.
35
36
CENTER OF EXCELLENCE
THE REGION’S
LEADER IN
WOMEN’S CARE
AND CHILDBIRTH.
Erlanger’s state-of-the-art birthing suites are
chosen by thousands of families every year.
37
Erlanger is among the first in the
state to qualify as an accredited
Baby-Friendly Hospital.
MORE THAN 80% OF ALL
BABIES IN THE AREA
ARE BORN AT ERLANGER.
38
Dr. Garrett Lam, Associate Professor and
Chair of the Department of Obstetrics &
Gynecology, teaches new doctors and also
cares for women with high-risk pregnancies.
Ask anyone born in the Chattanooga area. Odds
Erlanger East also offers a newly expanded
are, they drew their first breath at Erlanger. Each
Neonatal Intensive Care Unit for prema-
year, Erlanger delivers 80% of the area’s babies,
ture and at-risk babies. All this, plus a convenient
far more than any other health system.
suburban location, explains why Erlanger East is
Erlanger offers state-of-the-art childbirth services
at two locations. Downtown, Erlanger’s Main
perennially ranked #1 in a poll of best places to
have a baby.
Campus provides the region’s most advanced
Of course, being a leader in women’s services
care for high-risk babies and moms. Spacious
is about more than delivering babies. Erlanger-
labor and delivery rooms are equipped to deliver
affiliated subspecialists cover every aspect,
babies of every gestational age, while the region’s
including general OB/GYN, maternal fetal
only high-risk perinatal unit provides
medicine, gynecological oncology and pelvic
specialized rooms in which mothers can stay and
floor physiology & treatment. Plus, as the
receive care weeks before delivery.
region’s only academic OB/GYN program,
The downtown campus is also home to the region’s
only obstetrical emergency department, and
of course, the region’s highest level of neonatal
intensive care at Children’s Hospital at Erlanger.
In addition, the downtown campus provides the
region’s leading maternal fetal medicine
Erlanger physicians are heavily involved in
research and clinical trials to improve care and
outcomes, including trials of a new treatment
for preeclampsia, studies to reduce pain following
surgery and new ways to prevent and treat
diabetes in pregnancy.
specialists, who work with in-house neonatolo-
Furthermore, Erlanger partners with the UT
gists to further promote healthy deliveries for high
College of Medicine to offer Tennessee’s only
risk babies and their mothers.
fellowship program in Minimally Invasive
Meanwhile, Erlanger East Hospital features
27 large, single-care maternity units, providing a
comfortable, home-like birthing environment.
Gynecological Surgery. It also educates regional
doctors and nurses through an annual symposium
on women’s health.
39
40
CENTER OF EXCELLENCE
THE REGION’S ONLY
CHILDREN’S HOSPITAL.
Children’s Hospital at Erlanger provides the region’s
highest level of care for premature and sick newborns.
41
Dr. Jennifer Keates, pediatric
hematologist-oncologist, takes a
moment to play with a young patient.
MORE THAN 90% OF
THE REGION’S CHILDREN
WITH CANCER ARE
TREATED RIGHT HERE.
As the only hospital serving children and families
across southeast Tennessee, Children’s Hospital at
Erlanger is a resource the region simply could not
do without.
A leading academic medical center
in its own right, Children’s Hospital at
Erlanger provides a level of comprehensive
care for children often found only in cities
more than twice the size of Chattanooga. It is
the region’s only hospital staffed with
pediatric subspecialists, who, along with
highly-trained pediatric surgeons, nurses,
respiratory therapists, pharmacists and child
life professionals, have devoted their careers to
working with children.
42
The leadership of Children’s Hospital at Erlanger
includes Dr. Alan Kohrt, CEO, and Cindy Rhodes,
Chief Operating Officer.
Dr. Darwin Koller examines a patient at the region’s only
pediatric emergency room and trauma center.
As a result, Children’s Hospital at Erlanger offers
services unmatched anywhere in the
region, including:
The region’s highest level of
neonatal intensive care for premature
and sick newborns, including 24-hour,
in-house neonatology
The region’s only pediatric
emergency department, with board-
No entity in the
region does more
to protect and
care for children.
certified pediatric emergency physicians
The region’s only pediatric trauma
center, serving critically ill and injured
children, 24/7
LIFE FORCE, the region’s leading air
ambulances and neonatal/pediatric
ground transport teams, making the
hospital accessible throughout its vast
service area
The region’s only pediatric surgical
suites designed exclusively for children
As mentioned earlier, the lifeblood of Children’s
Hospital is its staff of physicians, representing
more than 21 pediatric specialties and
subspecialties. Among them are pediatric
oncologists who have helped the Hospital’s
cancer program earn a commendation
from the American College of Surgeons
Commission on Cancer, along with an
overwhelming vote of confidence from parents.
In fact, more than 90% of the region’s children
with cancer are treated here.
Dr. Larry Sargent, Professor and Chair of Plastic Surgery, uses
advanced 3-D printing to pre-visualize skull reconstructions
at the Tennessee Craniofacial Center, a world-renowned
resource for children with facial deformities.
43
44
Dr. Melanie Blake, Associate Chief Medical Officer
at Erlanger, is one of the more than 170 members
of the UT Erlanger Physicians Group.
MORE SERVICES.
MORE EXPERTISE.
MORE LOCATIONS.
45
THE REGION’S MOST
COMPREHENSIVE
NETWORK OF HOSPITALS AND
PHYSICIANS.
LIFE FORCE Base
Sparta, TN
75 mi.
Erlanger Bledsoe
Hospital
50 mi.
111
127
27
Erlanger
Sequatchie Valley
Emergency Dept.
127
111
25 mi.
27
Erlanger North
Hospital
CHATTANOOGA
10 mi.
Erlanger at
Volkswagen Drive
LIFE FORCE Base
75
Erlanger
University Hospital
& Children’s Hospital
at Erlanger
153
Erlanger East
Hospital
24
24
TENNESSEE
GEORGIA
59
75
LIFE FORCE Base
Blue Ridge, GA
LIFE FORCE Base
Calhoun, GA
46
For Erlanger, providing the region’s highest
dementia. Erlanger North also includes an
level of care isn’t enough. It’s also the Health
Accredited Sleep Disorders Center and the
System’s mission to make that care easily
new UT Erlanger Institute for Sports
accessible for everyone in its service area. As
and Health.
previously mentioned, the UT Erlanger Physicians
Group plays a critical role by placing more than
170 top physicians throughout the region,
including primary care in 12 locations.
Erlanger Bledsoe Hospital
A critical safety net, providing residents of
a rural three-county area with the most
comprehensive care available, including
Erlanger’s extensive network of quality care
a 24/7 ER, primary care, urgent care, pediatrics,
includes the region’s most comprehensive
imaging and more.
network of hospitals providing a wide range
of services where they are needed most. Among
these vital locations:
Erlanger University Hospital
Sequatchie Valley
Emergency Department
A service of Erlanger Bledsoe in partnership
with Sequatchie County government, providing
Erlanger’s 813-bed flagship campus in
the only 24/7 emergency care for more
downtown Chattanooga is home to the
than 15,000 underserved county residents.
University of Tennessee College of
Medicine Chattanooga Unit, as well as the
region’s only Level 1 Trauma Center, the
Southeast Regional Stroke Center and
many other Centers of Excellence featured
throughout this report.
Children’s Hospital at Erlanger
Located adjacent to Erlanger University
Hospital, the region’s only children’s
hospital includes the only pediatric
emergency department, the highestlevel Neonatal Intensive Care Unit and
an acclaimed pediatric oncology program,
which treats more than 90% of the area’s
children with cancer.
Community Health Centers
Erlanger’s Dodson Avenue and Southside
Community Health Centers provide essential
primary care for people in underserved
neighborhoods.
With these and other locations, Erlanger can
simply do more for more people—and in more
places. For example, Erlanger has far more
surgical suites than any other regional provider.
Plus, only Erlanger provides in-house
surgeons on-site 24/7 at its main campus,
along with the region’s largest team of
hospitalists and intensivists who coordinate
each patient’s care.
Erlanger East Hospital
Offering comprehensive inpatient and
outpatient surgery, women’s services, stateof-the-art birthing suites, the new Erlanger
Center for Breast Health and a new 24/7
emergency department. Future expansions
will include 107 new inpatient beds, making
it the only full-service hospital in East
Hamilton County.
Erlanger North Hospital
In addition to the highest level of 24/7
emergency care north of the river, Erlanger
North is also home to a comprehensive Senior’s
Program for patients with Alzheimer’s and
The new Sequatchie Valley Emergency
Department brings essential 24/7 care
to more than 15,000 residents.
47
THE STATE OF THE HEALTH SYSTEM
ONE OF THE MOST
REMARKABLE
TURNAROUNDS IN
HEALTHCARE.
48
49
Spring 2013 marked the beginning of a new era
There was no single effort or “magic bullet,” but
when, after an extensive nationwide search, the
rather a multi-faceted plan involving Erlanger
Erlanger Health System’s Board of Directors
leadership, the health system’s many local
named Kevin M. Spiegel President and
supporters and lawmakers at the state and even
CEO of the Erlanger Health System.
national level.
Spiegel, a seasoned healthcare administrator
For example, after tireless lobbying, and
who had most recently served as CEO at
with the support of Tennessee’s legislative
Methodist University Hospital in Memphis,
delegation and local advocates, Spiegel and
wasted no time in rallying his executive
team identified and secured $19.6 million
management team. Together, they led Erlanger
in new funds as part of Erlanger’s fair share of
through one of the most remarkable
federal payments to safety-net health systems.
turnarounds the industry had ever seen. In
fact, as of the end of fiscal year 2014, Erlanger
has rebounded from $8 million in losses to
$18 million in operating income in just
16 months.
Erlanger leadership secured an additional
$8.5 million from the state’s Disproportionate
Share Hospitals fund, along with $13.2 million
in savings by renegotiating vendor contracts,
(From left) Executive team members Britt Tabor, Kevin Spiegel,
Gregg Gentry, Robert Brooks, Jan Keys and Phillip Jackson.
ERLANGER LEADERS
IDENTIFIED $47 MILLION
IN ADDITIONAL EARNINGS,
FUNDING AND SAVINGS
IN 16 MONTHS.
50
leveraging outsourcing, and improving supply
chain management. Leaders also introduced new
market-based employee benefits, reducing
annual expenses by $8.3 million.
These savings were complemented by another
$6 million in savings through expanded
utilization of the 340B Drug Pricing Program,
a federal initiative enabling healthcare
organizations that care for underserved patients
to purchase drugs at a discount.
All told, Erlanger leadership identified
$47 million in additional earnings, funding
and savings in just the first 16 months of the
Spiegel era.
Dr. Steve J. Schwab (left), Chancellor of the University
of Tennessee Health Sciences Center, chats with
Erlanger President & CEO Kevin Spiegel at a conference
on the future of health care.
As FY 2014 came to a close at Erlanger, earnings
and savings weren’t the only things on the rise.
Incredibly, at a time when most U.S. hospitals
were flat or declining, Erlanger’s admissions
increased by 4.6%. In addition, among those
with a choice of providers, more consumers
chose Erlanger than any other health system.
In fact, unlike many other public health systems,
Erlanger is the regional leader in market share
and the largest provider of care to those who are
commercially insured.
Finally, helping to boost already-improving morale
among its more than 4,500 employees, Erlanger
was once again named Chattanooga’s #1
health system for the fourth year in a row
Erlanger CEO Kevin Spiegel meets with Tennessee Governor
Bill Haslam and state TennCare Director Darin Gordon.
by U.S. News & World Report.
A fitting end to a remarkable year for the
re-energized health system.
Erlanger CEO Kevin Spiegel and U.S. Rep. Chuck Fleischmann,
one of many key partners in government who helped bolster
Erlanger’s historic turnaround efforts.
51
PARTNERS
IN A VITAL
MISSION.
It’s impossible to operate a health system,
For example, as previously mentioned,
particularly one that performs at Erlanger’s
Hamilton County government and
high level, without building and renewing vital
Erlanger leaders worked together
partnerships. In addition to its key relationship
to launch the health system’s participation
with the University of Tennessee, Erlanger
in the State of Tennessee’s Public Hospital
maintains many other important partnerships
Supplemental Payment Pool. Likewise, Erlanger
critical to the very core of our mission.
leadership, partnering with local advocates
Partners in Government
from both the public and private sectors,
Erlanger thrives on open communication
and collaboration with area government
and elected officials. These relationships
contributed greatly to Erlanger’s
financial turnaround in FY 2014.
52
successfully lobbied the U.S. Centers for
Medicare and Medicaid to provide nearly
$20 million in new funding in 2014, with
additional funding in 2015-2016.
Volkswagen
As Volkwagen’s preferred healthcare partner
(and their only Tier 1 provider), Erlanger
continues to care for more than 2,500
VW employees at its Chattanooga auto
plant. In addition to providing on-site health,
urgent care and occupational medicine
services, Erlanger also operates Erlanger at
Volkswagen Drive, adjacent to the plant.
This multi-purpose, standalone facility is open
to the public, providing much-needed primary
care, urgent care and child care services to this
once-underserved area of Hamilton County.
BlueCross BlueShield
Through an exclusive five-year
partnership with the region’s leading payor,
BlueCross BlueShield of Tennessee, Erlanger
created “Network E,” an exclusive network
of physicians and services built to provide
high-quality care and real value for BCBSTinsured consumers. During the rollout of
Nursing Schools
Erlanger’s role as the region’s essential
resource for medical education also extends
to nursing. Each year, Erlanger trains more
than 700 nurses through partnerships
with the University of Tennessee at
Chattanooga, as well as Chattanooga State
Community College, Southern Adventist
University and Covenant College.
plans associated with the Affordable Care
These are just three of the countless partners
Act, more than 7,000 consumers chose
that help Erlanger fulfill its essential mission.
this exclusive Erlanger network, with an
We are grateful to all of them.
additional 10,400 choosing a second network
featuring Erlanger and only one other provider.
Countless public and private-sector partnerships make Erlanger stronger. From left: State General Assembly Majority Leader
Gerald McCormick, BlueCross BlueShield of Tennessee CEO Bill Gracey, and Erlanger President & CEO Kevin Spiegel.
53
VISIONS FOR
THE FUTURE.
Artist’s rendering of the future hospital for
children and women planned for the corner
of 3rd and Hampton.
54
Future plans include a world-class
neurosciences center.
As you’ve discovered throughout this report,
PHASE IV
the Erlanger Health System is indeed the one
A new, 85,000 square foot stroke and
provider that people simply cannot do
neurosciences center on Erlanger’s
without. Today, as the population of our region
downtown campus.
grows, so too must Erlanger.
PHASE V
This is the philosophy driving not only the
A new, state-of-the-art children’s and
largest expansion in Erlanger’s history,
women’s hospital.
but one of the largest capital campaigns ever
launched in the region. This path forward, the
PHASE VI
Erlanger Health System Master Facilities
A new health sciences center to house
Plan, will meet needs for new facilities over the
the Chattanooga facilities of the University of
next two decades.
Tennessee College of Medicine.
PHASE I
Additional development along the 3rd street
Expansion of surgery areas at the
corridor at the downtown campus.
main campus, including new vascular
The extension of Central Avenue to Amnicola
operating suites.
Highway, creating a new entrance for
A new orthopedic center with dedicated
faster and easier access to Erlanger’s
operating rooms and new inpatient facilities.
main campus.
PHASE II
Completion of a $68 million expansion at
These plans and renderings, while still under
Erlanger East Hospital, including inpatient
development, represent a bold new chapter
beds and expanded outpatient services.
in the story of the region’s essential health
PHASE III
system—bold but necessary in order for Erlanger
A new 100,000 square foot children’s &
to continue its mission.
women’s ambulatory center, providing
It will take time. It will take cooperation. And, most
expanded outpatient services and specialty
of all, it will take your support.
clinics for women and children in an easy-toaccess setting.
55
THE ERLANGER FOUNDATIONS
SUPPORTING
THE REGION’S
LARGEST
NOT-FOR-PROFIT.
Pet therapy is one of the many
programs supported by the
Erlanger Foundations that create a
better healing environment.
56
Chief Development Officer
Julie Taylor, center, leads a board
meeting of the Erlanger Foundations.
It’s clear that Erlanger is always there for the
capital campaigns in this region’s history.
people of our region. Today, it’s not only easier
The Erlanger Foundations will take the lead role in
than ever to return the favor, it’s also vitally
these efforts, coordinating giving from corporate
important, through gifts to the Erlanger
sponsorships to private trusts to individual gifts.
Foundations. Together, these two organizations, the Baroness Erlanger Foundation and
Children’s Hospital Foundation, are building a
powerful philanthropic engine to help drive the
region’s largest and most essential notfor-profit organization, the Erlanger Health
System, into the future.
Quite simply, gifts to the Foundations are the
easiest way to support Erlanger and its
essential missions.
Of course, in addition to helping fund Erlanger’s
long-term plans, the Foundations will also
continue to invest in “here and now” projects to
improve clinical quality, provide new technologies,
expand access to care, and contribute to a more
positive, healing environment for adult and
pediatric patients alike. We invite you to learn
more at ErlangerFoundations.org.
Then, to make a gift, simply return the
envelope included in this report.
As mentioned previously, Erlanger’s plans for
the future will depend upon one of the largest
Since 1986, the
Foundations and
Children’s Hospital
at Erlanger have
partnered with the
Children’s Miracle
Network to raise
funds and elevate
care for kids.
The 800-member Erlanger Auxiliary contributes more than
100,000 volunteer hours each year—plus $300,000 through
gift shop sales and other efforts.
57
THE ERLANGER HEALTH SYSTEM
LEADERSHIP TEAM
BOARD OF TRUSTEES
Donnie Hutcherson
Michael J. Griffin
Jack Studer
Chair
Vice Chair
Secretary
CPA, Managing Partner
Henderson, Hutcherson
& McCullough, PLLC
Community President
First Tennessee Bank,
Cleveland, TN
Partner
Lamp Post Group
Daniel F. Fisher,
MD, FACS
Ronald A. Loving
Phyllis E. Miller, MD
Consultant
Retired Vice President
Tennessee Valley
Authority
Gynecologist
Women’s Institute for
Specialized Health
Nita W. Shumaker, MD
Jennifer E. Stanley
Gerald Webb II, Esq.
Pediatrician
Galen North Pediatrics
Associate Principal
McKinsey & Company
Attorney
Speek, Webb, Turner
and Newkirk, PLLC
Tom Edd Wilson
Richard G. Youngblood
Retired President
& CEO
Chattanooga Area
Chamber of Commerce
President & CEO
Blood Assurance
Chief of Medical Staff
Surgeon
University Surgical
Associates
Associate Professor,
UT College of Medicine
58
EXECUTIVE LEADERSHIP
Kevin M. Spiegel, FACHE
Elizabeth D. Appling
President & CEO
Chief Diversity Officer
W. Woods Blake,
MD, FAAP
Assistant Professor
UT College of Medicine
Liz.Appling@erlanger.org
Chief Quality Officer
Clinical Instructor
Department of Pediatrics
UT College of Medicine
Kevin.Spiegel@erlanger.org
Woods.Blake@erlanger.org
Donna L. Bourdon
Robert M. Brooks, FACHE
Steven H. Burkett
President, ContinuCare
HealthServices, Inc.
Executive Vice President
& Chief Operating Officer
Senior Vice President
Physician Services
Donna.Bourdon@erlanger.org
Instructor
UT College of Medicine
Steve.Burkett@erlanger.org
Robert.Brooks@erlanger.org
James H. Creel,
MD, FACEP
Chief Medical Officer
Assistant Professor &
Vice Chair, Department of
Emergency Medicine, UTCOM
Program Director, Emergency
Medical Services Fellowship
James.Creel@erlanger.org
Stephen E. Johnson, CPA
Vice President
Government and
Payer Relations
Steve.Johnson@erlanger.org
Bruce A. Komiske
Vice President
New Hospital Design
and Construction
Bruce.Komiske@erlanger.org
Gregg T. Gentry
Senior Vice President
Chief of Staff to the
President & CEO
Chief Administrative Officer
Chair, ContinuCare
HealthServices, Inc.
Phillip E. Jackson,
DSL, FACHE
Vice President
CEO, Erlanger East Hospital
and Erlanger North Hospital
Phillip.Jackson@erlanger.org
Gregg.Gentry@erlanger.org
Jan C. Keys,
DNP, RN, FACHE
Senior Vice President
Chief Nursing Executive
Alan E. Kohrt, MD, FAAP
CEO, Children’s Hospital
at Erlanger
Adjunct Faculty, Regional
Schools of Nursing
Professor & Chair
Department of Pediatrics
UT College of Medicine
Jan.Keys@erlanger.org
Alan.Kohrt@erlanger.org
David C. Seaberg,
MD, CPE, FACEP
Sherwin L. Stewart
Senior Vice President
Physician Alignment
Dean & Professor,
UT College of Medicine
Chattanooga
Sherwin.Stewart@erlanger.org
Associate Administrator
David.Seaberg@erlanger.org
Alana B. Sullivan
J. Britton Tabor, CPA
Julie Y. Taylor
Senior Vice President
Chief Compliance Officer
Executive Vice President
& Chief Financial Officer
and Treasurer
President, Erlanger Health
System Foundations
& Chief Development Officer
Britt.Tabor@erlanger.org
Julie.Taylor@erlanger.org
Laurene S. Vamprine
Joseph M. Winick, FACHE
Jeffrey N. Woodard, Esq.
Vice President
Chief Information Officer
Senior Vice President
Planning, Analytics
& Business Development
Senior Vice President
Chief Legal Officer
Alana.Sullivan@erlanger.org
Laurene.Vamprine@erlanger.org
Jeffrey.Woodard@erlanger.org
Joe.Winick@erlanger.org
59
FY 2014
FINANCIALS
Erlanger Health System
Performance Summary
Year Ended June 30, 2014
K E Y S TAT I S T I C S
Total Operating Revenue
$618,531,945
Operating Expenses
$600,519,155
Operating Income
$18,012,790
Total Assets
$483,727,484
Total Admissions
30,394
Admissions Adult
27,327
Admissions Pediatric
3,067
Total Emergency Visits
131,978
Total Helicopter Patients
1,870
Total Inpatient Surgeries
9,198
Total Outpatient Surgeries
19,612
Total Births
5,396
As one of the region’s largest
employers, Erlanger’s economic
impact approached $3 billion
Where Does Erlanger
Patient Revenue Come From?
last year alone.
Medicare
33%
Other Patient Revenue 4%
Self Pay 10%
Commercial
Insurance
31%
Medicaid/
TennCare
22%
Where Does The Erlanger Dollar Go?
Insurance/Taxes 1%
Depreciation 4%
Salaries
& Benefits
53%
Purchased
Services
22%
Supplies/
Misc.
20%
60
Erlanger provided a total of $86,160,513
to the community in the form of uncompensated
care and free services in FY 2014. Erlanger is
among the state’s leaders in providing charitable
benefits to the communities we serve.
Health System
975 East Third Street | Chattanooga, TN 37403 | 423-778-7000 | erlanger.org