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2010 Report to the Community

From the Board Chair From the CEO


I am pleased to present Commitment to Excellence, the 2010 Greenville Hospital Thank you for taking time to review the Greenville Hospital System report to the
System University Medical Center report to the community. Included in this report community for FY 2010. In these pages we share highlights of key accomplishments
are facts and figures that highlight many important achievements of the last year. related to our six Pillars of Excellence: People, Service, Quality, Growth, Finance and
Academics. For every statistic and each achievement reported, there are many
Fiscal Year 2010 was filled with important milestones, and you will read about others that also are compelling. And behind every one of these successes is a
some of them in this report. For the Greenville Hospital System (GHS) Board of team of people working together and living our mission to heal compassionately,
Trustees, the most significant of these milestones happened August 6, 2010, when teach innovatively and improve constantly.
our Board and the board of the University of South Carolina (USC) approved a
formal agreement to move forward with plans for expansion of the USC School of One of our greatest strengths at GHS is a highly diverse and accomplished workforce
Medicine–Greenville to a full four-year medical campus. (from physicians, nurses and other clinical professionals to support and administrative
staff ) constantly working to address the needs of our patients and families. We
The historic nature of this partnership is understood and held with great reverence emphasize interdisciplinary approaches to leadership and problem solving. In 2010,
by all of my colleagues on the GHS Board. We know that serving as a Trustee of clinical and administrative leaders joined forces to react and respond to the shifting
Greenville Hospital System, at any time, is an important responsibility and a high economic environment. As an example, the GHS Operations Council, established
calling of service to our community. To be involved in a decision that promises to early in the year, is a leadership group consisting of physician department chairs,
improve and enrich the health, quality of life, and economics of our community for campus presidents and selected corporate leadership. This group was charged
generations to come is an honor and responsibility that we take very seriously. with working through the critical operational challenges of continuing our
commitment to deliver high-quality care to a broad patient base while simultaneously
It has been a great privilege to serve with the other Trustees of this impressive addressing the need to reduce expenses in response to shifting volumes and
institution. Together, with a skilled executive team and a dedicated and compassionate declining revenue. By year’s end, we had reversed the early trend and ended FY
workforce who are committed to excellence, we at GHS are living our vision to 2010 exceeding our budgeted financial results.
transform health care for the benefit of the people and communities we serve.
Such interdisciplinary partnerships are being fostered at many levels within GHS.
Today, physician and nurse leaders at the unit level work in tandem to ensure the
highest standards of care and service. These partnerships serve as role models for
collaboration in settings all across our health system.
Frances D. Ellison
Chair A highly collaborative workforce is a tremendous asset at any time – and it is
Greenville Hospital System Board of Trustees especially valuable when the environment is in flux. At GHS, we are well prepared
for challenges and poised for change. We are transforming our health system to
serve our many communities today and to be a vital health resource in the future.

Michael C. Riordan
President and CEO
Greenville Hospital System

Frances DeLoache Ellison Harry A. Chapman Jr. Jerry Dempsey Benjamin L. Allen Jr., M.D. R. Dennis Hennett S. Hunter Howard Jr.
Chair Vice Chair Secretary

Margaret L. Jenkins Rita McKinney James C. Morton Thomas E. Simmons Benjamin B. Waters III William M. Webster IV
Pillar: People
Sustain strong employee commitment
GHS’ Pillars of Excellence guide Standards of Behavior
With the unveiling of new Standards of Behavior
employees as to how to achieve our came expectations that all team members will
practice these standards so as to consistently deliver
vision and mission. By consistently care and service
to others as they
using best practices that are evidence- would want
for themselves.
based, GHS can build on its strong The standards
are embedded
foundation of employee commitment, in the word
compassion.
service excellence, and patient- and Creating an
organizational
family-centered care. In the case of culture where personal excellence is expected every
day means that only those applicants who commit
our People goal, sustaining a highly to the Standards of Behavior are considered for
employment at GHS.
committed workforce can boost success
Employee Commitment
across all six pillars. A record 81 percent of employees completed the
2010 Employee Opinion Survey. Results placed
GHS in the top 10 percent among healthcare
Leadership Development Retreats facilities nationwide in employee engagement
Part of GHS’ Commitment to Excellence is to develop and commitment. Workforce commitment among
excellent leaders committed to serving not only the physicians scored very high as well. Areas of
community but also our physicians and employees. strength included safety and quality, community
Presenting quarterly, contributions, being a good place to work and
evidence-based receive care, and being considered the region’s
leadership practices healthcare employer of choice.
helps the entire
GHS team continue
to improve quality
of care and safety,
consistency and
accountability – and
to enhance patient
and employee satisfaction. Recognizing role
models who excel in these practices is important
as well. Evidence-based leadership training also
supports our goal of developing a highly engaged
and committed workforce.
Pillar: Service
Improve patient satisfaction
The core of excellence centers on and enhancing medication management for its
1,926 patients in Greenville and Pickens counties.
delivering outstanding service. In With high quality and employee commitment
marks, it is no wonder that Home Health’s patient
our ongoing quest to enhance patient satisfaction scores also run high – 97.9 out of 100!

satisfaction, GHS team members Discharge Phone Calls


A formal discharge call program began at GHS at
maintain an ever-present focus on the start of FY10. The program, dubbed the “best five
minutes in health
providing the best possible patient- care” or the “final
hug,” reaps many
and family-centered care. benefits. Besides
fielding questions
and reviewing
MD360® discharge and
GHS recently opened its first MD360 urgent care medication
facility, which provides convenient, extended-hour instructions, nurses
care each day. have found that
Staffed by board- their calls boost patient satisfaction and outcomes
certified doctors, as well as reduce readmissions and complaints.
MD360 offers An added bonus is improved service recovery
temporary primary (resolution of concerns that patients may raise about
care, on-site testing, their care).
physical therapy,
sports medicine
and non-emergent
care. It increases
access to medical
care and reduces
unneeded trips
to emergency
rooms. The unique
concept has proven so successful and patient
satisfaction feedback is so high that another facility is
slated to open soon.

Home Health
Marking 25 years of service and 31,494 annual visits,
Home Health boasts low staff turnover and high
performance for
improved patient
outcomes. The
unit has earned
Premier status
for its efforts in
reducing avoidable
hospitalizations
Pillar: Quality
Improve clinical quality and safety
Research shows that quality of Hillcrest a Top Performer
According to Premier QUEST, Hillcrest Memorial
care improves when standardized, Hospital is one of the highest performing hospitals
in three areas: cost of care, evidence-based care
evidence-based practices are provided and mortality.
QUEST recognizes
consistently across the board. hospitals that
demonstrate
Achieving this goal is contingent on excellence in
quality, efficiency,
strong collaboration and teamwork consistency and
safety in patient
among all staff. care. In addition,
the hospital ranked
highest in South Carolina in pneumonia care with a
Ranked Among the Nation’s Best score of 98, as reported by the Centers for Medicare
For the second year in a row, Greenville Memorial & Medicaid Services.
Hospital (GMH) was ranked among the nation’s top
50 hospitals in U.S. News’ 2010-11 guide to America’s
Best Hospitals. GMH ranked high in three specialties:
Diabetes & Endocrinology (#25), Gastroenterology
(#39) and Heart & Heart Surgery (#45). It also ranked
#5 for lowest rate of readmissions and received
a Silver Achievement Award for Coronary Artery
Disease/Congestive Heart Failure/Stroke.

Germ Warfare – Join the Battle!


GHS recently announced the winning slogan of
its hand hygiene campaign: Germ Warfare – Join
the Battle! The
campaign’s
purpose is to
educate staff,
patients and
visitors about the
importance of
good hand hygiene
and to increase
hand hygiene
compliance among
staff. Good hand
hygiene is part of
GHS’ Standards
of Behavior
and is crucial in
preventing the spread of hospital-acquired infection
and illness. At present, GHS is well ahead of its
compliance goals.
Pillar: Growth
Achieve budgeted net revenue
A key goal of the system is to be the the clock and staffed by registered nurses. Customer
satisfaction scores are high, with 5,000+ referrals
area’s healthcare provider of choice. logged in the first year of operation.

Increasing patient and family access Partners Achieving Total Health (PATH)
To provide increased access to services that
to health and wellness services is an promote health and wellness, GHS and the YMCA
of Greenville formed a PATH partnership that
important component in achieving includes low-cost
membership to
and maintaining this strategic objective. both GHS Life
Center® Health &
Conditioning Clubs
Access to Primary Care Practices and the four area
A key factor in becoming the community provider of Y’s. The innovative
choice is improved access to primary care. This year, program focuses
GHS acquired a primary care practice in Easley and on community
one in Greer. Two health, disease
new concepts in prevention and diagnosis, and healthy lifestyles.
primary care also Since the initiative’s rollout in May, the Life Centers
debuted: MD360 have tallied 1,168 PATH members visiting a total of
urgent care (staffed 35,408 times.
by board-certified
physicians) and
Heritage Pediatrics
& Internal Medicine
(doctors double-
boarded in pediatrics and internal medicine). A
recent study shows access has risen – 60 percent
of GHS’ primary care offices can see new patients
within one week!

Patient Referral and Transfer Center


Integrated health care to communities from
Greenville and well beyond is available through GHS’
Patient Referral and Transfer Center. The center was a
response, in part, to feedback from referring doctors
about difficulties
in getting patients
to GHS. This one-
stop shop for
rapid referrals of
trauma, cardiac,
stroke and other
emergent care is
accessible around
Pillar: Finance
Achieve budgeted operating margin
Through responsible financial UPLIFT Program
Now implemented system-wide, UPLIFT (Use
stewardship, GHS strives to manage Portable Lifts in Facilitating Transfers) helps staff
move, lift and transfer patients with less exertion.
revenues in line with operating UPLIFT increases
staff and patient
expenses. The resulting resources safety, and it
improves patient
help support high-quality patient outcomes, with
patient handling
care, stellar academics and valuable injuries plunging
by 65 percent.
community outreach. Financial benefits
also occur: Costs
associated with
Supply Chain Savings staff injury have
Responsible financial stewardship is more important plummeted 75
than ever in these economic times. Cost-saving percent! And in a
measures of $7 million were needed at GHS when three-year study at
it became clear one GHS campus, the turnover rate for nurses was
in summer that cut 48 percent once this equipment was installed.
supply cuts
must occur.
Initiatives focused
on processes
to reduce
prices, achieve
standardization,
eliminate
unneeded products, improve use, maximize existing
contracts, and create and maintain a competitive
environment. Thanks to quick teamwork across GHS,
savings exceeded $7 million!

New Hernia Repair


A GHS surgeon from The Hernia Center became first
in the world to use an absorbable synthetic mesh
to repair a hernia complicated by an infection. This
unique product was developed with input from
the doctor and his colleague. Previously, grafts
from humans, pigs and cows typically were used to
stem infection at prices upward of $20,000. Positive
patient outcomes have eliminated such grafts for
abdominal wall reconstruction at GHS, producing
substantial cost savings.
Pillar: Academics
Strengthen academic affiliations
Academics plays a major role in Medical School Expansion
GHS is hoping to expand the USC School of
transforming medical care. Strong Medicine–Greenville to include first- and second-
year medical students. (Third- and fourth-year
academic ties make it possible students have
trained here since
for the hospital system to educate 1991.) Both USC
and GHS boards
much-needed health professionals, have agreed to
pursue expansion
advance clinical research and develop plans to four years.
An innovative
innovative healthcare delivery. curriculum will
focus on evidence-
based medicine,
Certified Registered Nurse Anesthetist team care and
Training comparative
GHS now is a satellite site for the Masters in Nurse effectiveness
Anesthesia program at the University of South research. GHS
Carolina School of Medicine. (Anyone hoping to is busy preparing a self-study for the Liaison
become a much sought-after CRNA before had to Committee for Medical Education, which is the next
move to Columbia or Charleston.) The first training step in the approval process.
class includes three GHS employees. The program
uses long-distance learning so employees can
“attend” class in Columbia. These students are able
to make use of GHS’ simulation center to prepare for
their clinical experience.

GHS Medical Experience Academy


Tier I of the MedEx Academy launched over the
summer with 12 students and a month-long
slate of classes, hands-on activities, community
service, research,
mentoring and
academic tutoring.
This pioneering
initiative to attract
the brightest high
school students
interested in
healthcare fields
– clinical and
non-clinical – is another way GHS is supporting
workforce development efforts to minimize future
health worker shortages. Tier II begins next year and
will involve college students.
GHS Gives Back: GHS is committed to being a positive force for the benefit of
the people and communities we are privileged to serve. Helping people take charge
of their health through awareness, prevention and education efforts offered by
the system – often in partnership with other area organizations – is an important
part of giving back to the community.

GHS Swamp Rabbit Trail Ungirdled Truths


To help encourage healthy lifestyles and physical Community health education is a key part of GHS’
activity, GHS partnered with the Greenville County role as a good steward. To increase the number of
Recreation District to create the GHS Swamp Rabbit people who can attend such events, the system
Trail. The 10-mile trail has been under construction undertook a novel
since 2007, but the final section between Travelers step: commission
Rest and Greenville was completed in 2010. To a one-act play
celebrate, the hospital system hosted the second that spotlights
annual GHS Swamp Rabbit 5K on May 7, which women’s health
attracted nearly 4,000 people, making it the second issues. Employees
largest 5K in the state! make up the
cast of Ungirdled
SC Mission 2010 Truths, and a
GHS and other upstate healthcare providers joined panel discussion
forces to offer free medical, dental and vision care to featuring physicians follows. The Gunter Theatre
1,200+ low-income, debut was a sellout at 400, garnering rave reviews,
uninsured South with more free performances being booked
Carolinians. The throughout the community.
inaugural two-day
event, called SC Speed Dating to Find Dr. Right
Mission 2010, took Having a medical home where a doctor sees you
place at Carolina regularly and can spot potential problems before
First Center. More they become life-threatening is critical. In 2010,
than 500 clinical GHS found a distinctive way to make accessing
and non-clinical physicians easier for the community – speed dating!
volunteers donated 6,000 hours of service. The event Prospective patients met individually with Greer-area
was hugely successful in providing access to much- internal medicine, pediatric and OB/GYN doctors to
needed health services and will be repeated in 2011. find the “right” physician for them and their family.
Close to 50 people attended the session, with more
Power to Prevent Diabetes planned for 2011.
One in 10 U.S. adults has diabetes – the ratio is even
higher among African Americans. To slow this trend, Safe Kids® Upstate Celebrates 15 Years
GHS joined the S.C. Department of Health and Accidental childhood injury is the top killer of
Environmental Control’s Office of Minority Health to children under age 15 in the U.S. In South
launch Power to Prevent, a 10-week education and Carolina, a child dies every day from such
awareness program to help people prevent, delay injury. If families took the necessary
or control type 2 diabetes through healthy eating precautions, 90 percent of these injuries
and exercise. The program helped 50 adults at risk or could be avoided. In the last 15 years,
with diabetes lose an average of at least five percent targeted efforts by Safe Kids Upstate (led
of their weight, with one person shedding nearly 50 by GHS Children’s Hospital) have led to
pounds and reversing her disease. a 25 percent reduction in deaths and a
17 percent drop in accidental injuries in
Greenville County. Motor vehicle deaths of
children under 5 also have fallen by 43 percent.
Senior Management GREENVILLE HOSPITAL SYSTEM AND
THE ENDOWMENT FUND OF
GREENVILLE HOSPITAL SYSTEM AND
THE ENDOWMENT FUND OF
THE GREENVILLE HOSPITAL SYSTEM, INC. THE GREENVILLE HOSPITAL SYSTEM, INC.
COMBINED BALANCE SHEET COMBINED STATEMENT OF REVENUES AND EXPENSES
September 30, 2010 Year ended September 30, 2010
(In thousands) (In thousands)

Assets Net patient service revenues $1,314,003
Current Assets: Other revenue 32,060
Cash and cash equivalents $154,320
Michael C. Riordan Susan J. Bichel Joseph J. Blake Jr. H. Howell Clyborne Thomas W. Diller, M.D.
President and CEO VP for Financial Services VP for Legal Affairs and VP for Community and VP for Clinical Effectiveness Patient accounts receivable Total revenues 1,346,063
and Chief Financial Officer General Counsel Governmental Affairs and Quality
(Less allowance for uncollectible accounts of $69,751) 192,513
Inventories of drugs and supplies 18,259 Expenses:
Other current assets 27,056 Salaries, wages, benefits and contracted labor 763,684
Current portion of assets with limited use 32,393 Supplies and other costs 455,448
Depreciation 77,809
Total current assets 424,541 Interest 17,676

Assets with limited use 513,929 Total expenses 1,314,617
D. Douglas Dorman Doran A. Dunaway Malcolm W. Isley William P. Marshall, M.D. George F. Maynard III Less current portion (32,393)
VP for Human Resources and VP for Information Services VP for Strategic Services Medical Director for GHS VP for Office of Institutional
Chief Human Resource Officer and Chief Information Officer University Medical Group Advancement Operating income 31,446
481,536
Non-operating Activities:
Property, plant and equipment, net 704,999 Investment income 31,045
Deferred charges and sundry 9,749
Revenues/expenses before capital contributions 62,491
$1,620,825 Capital contributions 391

Gregory J. Rusnak Angelo Sinopoli, M.D. Spence M. Taylor, M.D. Tod N. Tappert Liabilities and Net Assets Excess revenues over expenses $62,882
Executive VP and Chief Medical Officer Chief Academic Officer Corporate Chief of Staff
Chief Operating Officer Current Liabilities:
Accounts payable $48,456 Note: Does not include Greenville Health Corporation.
Accrued liabilities 130,602
Current portion of obligations under capital lease 113
Current portion of long-term debt 12,785

Total current liabilities 191,956

Brenda J. Thames, Ed.D. Suzanne K. White, R.N. Jerry R. Youkey, M.D.


Long-term debt—less current portion 514,617
VP for Academic Development VP for Patient Care Services/
Chief Nursing Officer and
VP for Medical Services and Obligations under capital lease–less current portion 3,749
Dean of Academic Services
President of Greenville Other long-term liabilities 93,555
Memorial Medical Campus

Total liabilities 803,877

Medical Staff Officers Net Assets:
Unrestricted 620,416
Invested in capital assets–net of related financing 178,604
Restricted 17,928

Total net assets 816,948



$1,620,825

Christopher C. Wright, M.D. Martin E. Lutz, M.D. Bruce A. Snyder, M.D.


President Vice President Immediate Past President Note: Does not include Greenville Health Corporation.
Statistics Snapshot
Facilities Procedures & Surgeries
Medical Campuses 5 Radiologic Procedures 526,831
Acute Care Hospitals 4 Outpatient Surgical Procedures 23,306
Specialty Hospitals 3 Vascular Lab Procedures 19,060
Long-term Care Facilities 2 Electrophysiology Procedures 4,837
Wellness Centers 2 Cardiac Catheterizations 6,904
Outpatient Facilities 8 Cardiovascular Surgeries 3,367
Affiliated Practice Sites 130 Inpatient Surgical Procedures (includes CV surgeries) 13,740
Licensed Beds 1,268 Echocardiogram Lab Procedures 22,546
Licensed Neonatal Intensive Care Bassinets 80
Clinical Care Numbers
Academics Air Transports 486
Medical Students 57 Hospital Discharges 42,570
Resident Physicians 180 Outpatient Visits (includes clinic and ER visits) 1,789,240
Residency Programs 7 Emergency Visits 164,883
Fellowship Programs 7 Medical Center Clinic Visits 114,192
Home Health Visits 31,494
The GHS Team Babies Delivered 5,167
Employees 9,778 Clinical Trials 577
Affiliated Medical Staff Physicians 1,264
Employed Physicians (included in affiliated staff ) 542
Registered Nurses 2,774
Volunteers 1,200+

Community Contributions
Greenville Hospital System uses guidelines set by the Catholic Health Association (CHA) and the American Hospital Association
(AHA) that allow for equitable comparisons of community benefits among healthcare institutions. In recognizing the importance of
community outreach in ensuring a high quality of life for all residents in the region, GHS offered support in a variety of ways during
Fiscal Year 2010 (October 2009 through September 2010):

Benefits Recognized by CHA and AHA............................................................................................................$98.6 million

To help meet the medical needs of upstate citizens who have no healthcare coverage and cannot afford to pay for healthcare services,
GHS provided more than $51.9 million in charity and government-sponsored health care (at cost) in Fiscal Year 2010.

Support to the Community and Community Health Partners, $46.7 million

Community benefit programs encompass community health services, education of health professionals, subsidized health services,
research, and financial and in-kind contributions. In addition to offering health fairs, screenings and information sessions, GHS works with
community groups and educational institutions to train healthcare workers and to ensure access to basic medical services for everyone.

Additional Benefits Recognized by AHA....................................................................................................... $177.9 million

Medicare shortfall and bad debt (at cost) also are benefits that the hospital system provides. The Medicare shortfall represents $122.0 million
of unpaid costs when reimbursement falls short of the actual cost of care. Bad debt, which totaled $55.9 million, occurs when patients are
unwilling or unable to pay for services and do not seek charity care.

Total Quantifiable Community Benefit....................................................................... $276.5 million

701 Grove Road • Greenville, SC 29605-5601 • (864) 455-7000


This report also can be found at
ghs.org 100704

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