Central Vermont Medical Center community benefits

The historic national health care reform legislation involves numerous components. One component, also required by the IRS in Schedule H, Form 990, is for increased oversight of tax-exempt hospitals. (Note: There are no for-profit hospitals in Vermont.)

According to the Catholic Health Association of the United States “Tax-exempt hospitals will be required to have written financial assistance policies and a written policy that they provide emergency medical care to individuals ‘regardless of their eligibility’ for the hospital’s financial assistance policy.”

Additionally, “the legislation directs the Treasury to review at least once every 3 years the community benefit activities of tax-exempt hospitals.”

Community benefits are programs or activities that provide treatment or promote health and healing as a response to identified community needs and meet at least one of these objectives:

• Improve access to health care service.
• Enhance the health of the community.
• Advance medical or health care knowledge.
• Relieve or reduce the burden of government or other community efforts.

Community benefits include free and discounted care to those unable to afford health care as well as care provided to low-income beneficiaries of Medicaid and other indigent care programs.

(Source: The Catholic Health Association of the United States)

Charity Care

CVMC maintains records to identify and monitor the level of charity care it provides. These records include the amount of charges forgone for services and supplies furnished under its charity care policy, the estimated costs of those services and supplies, and equivalent service statistics. In FY 2009 (October 1, 2008 – September 31, 2009) CVMC provided $1,522,335 in charity care. Charges foregone based on established rates were actually $2,533,600.

Statistics show that 96.99 percent of uninsured/high balance patients in the hospital meet with financial counselors face to face. Counselors also screen upcoming Same Day Surgery patients and send applications when they have no insurance listed. Financial Counselors will also assist these patients, when requested.

At CVMC, Patient Financial Counselors are Frank Scarano and Denise King. “The best thing about my job is the satisfaction I get in helping so many people,” said Frank. “When you alleviate a patient’s concerns and fears about how they will pay their bills, you allow them to focus on their health.”

While educating our patients about their financial options is a key component of their job, many days it is only the tip of the iceberg. “Some patients don’t realize that they qualify for financial aid and simply need us to give them the proper forms,” explained Denise, “but we meet with many who find the thought of wading through applications, especially at a time when they are most vulnerable, to be overwhelming.”

Fortunately, Frank and Denise are not only experts when it comes to navigating the system, but have the compassion for our patients and their work to go that extra mile. This means that they proactively reach out to patients in many ways, such as taking the time to help patients actually fill out and submit the proper forms; at times, they will even serve as the liaison between the patient and state to make sure all of the paperwork gets properly processed.

Ideally, low-income patients will qualify for one of the state’s programs—Medicaid, VHAP, Dr Dynasaur or Catamount—but there are patients who are literally stuck between a rock and a hard place with incomes that are too high to qualify for state assistance programs, yet too low to afford health insurance or pay their own bills. This critical gap is filled by CVMC’s Healthcare Assurance Program, which will provide up to 100 percent free care based on a patient’s household income and medical bill balance.

A Teaching Environment with a “Home Town Touch”

While many people don’t think of CVMC as a teaching hospital in the classic sense, each year over 50 students pursuing a variety of health-related professions come to CVMC to gain valuable clinical skills under the supervision of our doctors, nurses, physical and occupational therapists, dieticians, and diagnostic technicians.

“Providing a teaching environment for medical students is an important component to the vitality of any hospital,” explained Phil Brown, DO, Vice President Medical Affairs. “When students come into a community medical practice or hospital setting, they get a real taste for what medicine can really be – how enjoyable it can be to practice medicine.” In rural areas, where shortages of doctors and other medical professionals can be a problem, providing this “taste” plants a seed with many students who may not have previously considered working at a community hospital.

“Students discover that CVMC is a very friendly and open environment to work in since we do not have the rigid levels of hierarchy that tend to exist at bigger teaching hospitals,” said Dr. Brown. “Students here don’t have to wait for their turn to ask questions or do procedures, which gives them more one-on-one experiences with both our doctors and patients. At the same time, their inquisitiveness keeps our doctors on their toes, occasionally sending them back to their medical books for a quick refresher.”

An equally important aspect to teaching this next generation of students is the ability to provide high-paying, quality and fulfilling jobs to people in our own community. Nursing students in particular, who come to CVMC from Norwich University, Vermont Technical College and the University of Vermont, tend to be Vermonters.

“My goal is to continue to build our top-notch nursing staff by hiring local, which means we need to provide educational opportunities for those who have grown up in central Vermont and want to stay and work here,” said Alison White, RN, Vice President Nursing at CVMC. “Our nurses invest a lot of time in creating an incredibly rich learning environment that is warm and trusting. This ‘home town touch’ is definitely a deciding factor that makes students want to return to work at CVMC after they graduate.”

Deb Robinson, the Nurse Coordinator for Vermont Technical College’s LPN Nursing students, echoed White’s sentiments. “The environment our nursing students experience while at CVMC is extremely welcoming,” said Robinson. “While some students might think bigger is better, smaller hospitals give them the opportunity to do more and exposes them to a greater variety of patients.”

In addition to college students, CVMC also plays a vital role in helping high school students make career choices by giving them job shadowing opportunities. CVMC Rehabilitation, for example, offers vocational exposure to high school students interested in Physical Therapy (PT), Occupational Therapists (OT) or Speech Language Pathology (SLP).

Community Health Education, Improvement and Support Services

CVMC provided free health education, health screenings and clinical services that benefited over 3,000 members of our community. To find out more about any our classes or services, please call Outpatient Health Education at 802-371-4152.

Diabetes Was Not Going to Happen to Me

Cheryl Foster was diagnosed with pre-diabetes in June of 2009. “My father had diabetes and heart disease, which he eventually died from, and I was determined that this was not going to happen to me,” said Cheryl.

Ready to make some serious changes in her life, Cheryl met with CVMC’s Outpatient Health Education dietician Ilene Siegel, RD, CDE. “I thought I was eating healthy—I had tried every diet out there—but the results were always the same,” said Cheryl. “I’d lose a bunch of weight and gain it right back.”

“I know it was Ilene that made the difference for me,” said Cheryl. “She was so supportive and gave me the self-confidence I needed to succeed.” Siegel also gave Cheryl the tools she needed to make permanent changes in her diet. “I learned that I wasn’t eating the right amounts of food and at the right time and in the right combinations.”

Siegel considers Cheryl one of her star patients. “Cheryl lost 50 pounds in 10 months,” said Siegel. “And even though Cheryl lives on a very limited budget, she is still able to figure out how to afford fruits and vegetables because it is a priority for her now.”

Donations to Community Partners

CVMC made cash and in-kind contributions totaling over $125,000 to support the efforts of many local organizations, including American Cancer Society, American Heart Society, American Red Cross, Berlin Voluntary Fire Department, Peoples Health & Wellness Clinic, Plainfield Health Center, United Way and the Vermont Food Bank.

Community Building Activities

CVMC staff members donated over 500 hours of their healthcare expertise to help guide the work of a variety of community organizations by participating on the boards of the Central Vermont Chamber of Commerce, Central VT Health Care Coalition, Central Vermont Substance Abuse Services, Green Mountain United Way, People’s Health & Wellness Clinic, the Vermont Blueprint For Health, Vermont Dietetic Association, Vermont Ethics Network, Vermont Medical Society Board, and many more.

Economic Impact

Central Vermont Medical Center is a major contributor to the economic health and well-being of our region. As the area’s largest employer, we provide jobs and careers to 1,500 full and part-time employees, who earn salaries of $60,805,107.

Volunteerism

In addition, CVMC also provided meaningful volunteer opportunities to over 236 members of our community in 2009. These wonderful volunteers generously gave over 22,709 hours to the hospital. Worth=$364,934 (equal to 11 full-time employees).

For additional information about CVMC, visit www.cvmc.org.

Research for this article was done by Christine Petersen, CVMC Development Specialist.

Susan Kruthers has over 30 years experience in marketing and public relations and was most recently Chief Lobbyist for the Vermont Chamber of Commerce. She is vice president of community relations and development at Central Vermont Medical Center.