Sisters of Mercy Health System-St. Louis Stewardship Report FY 1995-1996
Preserving Traditions, Preparing for the Future: Our First 10 Years
The shamrock A heritage of service to the poor and sick forms the roots for today’s Sisters of Mercy Health System-St. Louis (Mercy), a thriving health care organization still driven by a ministry of healing.An ancient symbol of Ireland, the shamrock represents the country from which Mercy traces its roots. Today, Mercy honors its heritage through fidelity to the tradition of service established by Catherine McAuley, foundress of the Sisters of Mercy. Just as she and her followers sought out the sick of 19th century Dublin, during its first 10 years Mercy strove to identify the health care needs of the communities it serves and develop the services and programs best suited to fulfill those needs.
Throughout Mercy’s first decade, this assessment prompted a re-evaluation of existing services and an examination of new directions upon which to embark. Consistent with Mercy’s commitment to address the real needs of its communities, over the years difficult decisions had to be made by Mercy leadership. Among these were the sale of hospitals in New Orleans and Vicksburg, Mississippi, and the closing of Mercy Hospital in Mansfield, Missouri, in the early 1990s. The closing of one door, however, often means the opening of another, and that is what happened in these cases. The System now more effectively uses its resources within these areas by sponsoring advocacy efforts, outpatient and outreach programs, and community-based ministries.
By the mid-’90s, Mercy’s assessment process indicated the need to form new delivery systems and pursue growth opportunities consistent with Mercy’s mission and vision of improving community health. The creation of Unity Health System in St. Louis in 1995 was a major result of this focus. This regional holding company brought together three of St. Louis’ largest hospital organizations – St. Anthony’s Medical Center, St. John’s Mercy Health System and St. Luke’s Hospital – to create the second-largest hospital network in the region, with combined assets of more than $1 billion.
The long history of cooperation and collaboration among the three hospital organizations, and the shared values and traditions that existed within each, made this joining together a natural progression in light of the need to improve services while achieving cost efficiencies. United under a single holding company, the organizations now are better able to leverage each other’s strengths and effectively respond to community health needs.
Unity’s roots continue to expand. In May 1996, a co-sponsor agreement signed by Mercy and the Adorers of the Blood of Christ, Ruma Province, made St. Clement Hospital and MariaCare Nursing Home in Red Bud, Illinois, a member of Unity. Additional growth is expected in positioning Unity to serve even greater numbers of people throughout the St. Louis area.
Other growth opportunities for Mercy came with the acquisition of hospitals in Oklahoma and Arkansas during 1995 and 1996. Mercy Health System Oklahoma was strengthened with the addition of two hospitals: St. Mary’s Hospital in Enid, acquired in the fall of 1995 from the Sister Adorers of the Blood of Christ of Wichita, Kansas, and Memorial Hospital of Southern Oklahoma in Ardmore, acquired during the summer of 1996 from Southern Oklahoma Healthcare Corporation. The addition of these two facilities extends Mercy’s Oklahoma City-based health ministry to include northwestern and southern parts of the state. Also joining Mercy in late 1995 was St. Mary-Rogers Memorial Hospital in Rogers, Arkansas, previously owned and operated by the Dominican Sisters of Springfield, Illinois. From its location in northwest Arkansas, the hospital benefits from the resources and support of neighboring Mercy facilities in Arkansas, southwest Missouri and southeast Kansas.
Finally, in the fall of 1996 Breech Medical Center in Lebanon, Missouri, entered into an agreement to be managed by St. John’s Health System, Mercy’s Springfield, Missouri-based Strategic Service Unit. The agreement extends St. John’s reach into rural southwest Missouri.
New facility construction is another demonstration of Mercy’s commitment to meet changing community needs. In the summer of 1996, Mercy Regional Medical Center in Laredo, Texas, began construction of a new, 50-acre medical campus more centrally located to serve the area’s burgeoning population. Compared to a current hospital building designed in 1957 primary to serve inpatient, acute-care needs, Mercy Regional’s new facility will reflect the changes taking place within health care delivery, such as increased outpatient services and patient-focused care. More accessible ambulatory facilities, convenient parking and a new medical office park will add to the facility’s service-oriented design.
Establishing new ministries and leaving others are decisions that demand insight and a great leap of faith: attributes directly traceable to the heritage passed down from Catherine McAuley. Her steadfast commitment to service, in whatever form it may take or what it may require, remains the foundation upon which Mercy is building its future.
Offering families help and hopeWhile conducting research on adolescent pregnancy for a doctoral dissertation, Sister Sarah Ducey, RSM, and her colleague Mindy Malik traveled frequently to an outlying, economically poor parish of Louisiana. During their travels, their discussions invariably centered on the families they were interviewing and the psychological needs they often encountered.
The friends began to dream. “We realized that these people, and many others in New Orleans – especially children – didn’t have access to mental health services,” said Sister Sarah. “We talked about the possibility of beginning a program that offered quality psychological services to children and families, regardless of their ability to pay.”
With start-up funding from the former Mercy Hospital in New Orleans, Mercy Family Center was established in 1992. From its beginnings in a patient room at Mercy Hospital, staffed by two full-time and one part-time mental health professionals, Mercy Family Center now operates two offices and has 10 full-time employees, including psychologists, social workers, a psychiatrist, an administrator and support staff. Since 1994, the center has been sponsored and funded by the Sisters of Mercy Health System-St. Louis.
One of the focal points of the center is the accurate evaluation of children referred for services. Children are frequently identified as needing help because they are having problems in school. An accurate diagnosis helps determine the type of remediation needed, and enables the school and family to respond quickly and appropriately, Sister Sarah explained.
“Often these children would wait years for the school district to evaluate them, increasing their chances of failure and loss of self-esteem,” said Sister Sarah.
Other services include assessments for attention deficit and hyperactivity disorders, individual counseling, behavior management, parent training, group therapy, and school consultations and observations. Fee assistance is offered depending on income, with fees as low as $2.
Sister Sarah believes the work being done at the center is a logical extension of the mission handed down by Catherine McAuley.
“This is a service no one else was offering, and that is exactly the need Catherine tried to address – providing help where none was offered before,” she said.
Building a system of systemsEnid, Ardmore, Rogers, Chesterfield, South St. Louis County, Red Bud. Over the past two years, these are the communities in which the Sisters of Mercy Health System has extended its roots. They represent how Mercy’s long-term development strategy began to bear fruit in 1995 and 1996: In just over a year’s time beginning in August 1995, a total of six hospitals in four states joined Mercy, adding approximately 9,000 employees, 1,800 medical staff members and $777.3 million in assets to the System.
Ronald B. Ashworth, Mercy executive vice president and chief operating officer, sees the System’s growth as the result of a fine balance between two elements – a strong mission orientation and an equally strong business sense.
“Over the past several years, the organization has come to better understand that these two aspects go hand in glove – they are not two different issues,” he said. “Size is only important to the extent that the stronger you are as an organization, the better able you are to support the mission.”
It’s mission-based expansion efforts continually provide Mercy with the opportunity to re-examine its values and vision. “Our development strategy has helped us redefine who we are and to understand more clearly what we want to be,” said Ashworth. “We’ve determined that we can best serve if we concentrate our efforts in a defined area and become a major presence in those areas.”
Beyond adding hospitals, the System’s expansion extends to the formation of physician/hospital organizations, growth in employed physician groups and partnerships with other area providers.
“We have become a system of systems,” explained Sister Mary Roch Rocklage, RSM, Mercy president and chief executive officer. “And with that has come a stronger sense of what it means to be a faith-based system.”
But as has been true throughout Mercy’s history, being part of a system does not mean doing everything the same way. “Our style always has been to render services in the manner appropriate for the community,” said Sister Roch.
She concluded, “Forming partnerships with individuals and organizations outside of the System might have diluted our ministry. Instead, it has strengthened it. I think we have a gift in that, and we have an obligation to carry it forward.”
An extended hand A commitment to caregiving remains the hallmark of Mercy, continually manifested in ways that meet changing community needs.An extended hand is a universal symbol representing friendship, openness and giving. For Mercy, it is best illustrated by the System’s efforts to provide compassionate, appropriate care to those in need.
During the 1980s, extending the hand of caregiving involved new challenges as the country’s health care reimbursement system changed from one based on fee-for-service to fixed payment fees. Pressure began building from business, government and consumers to take as much cost out of health care as possible.
Forming the Sisters of Mercy Health System-St. Louis was a response to those changing demands. By uniting its various entities under one parent company, Mercy gained the strength to explore new means of caregiving – those best suited to the health care needs of today’s consumer – while providing its individual hospitals the freedom to function effectively in their own communities.
The ways in which Mercy readied new paths for its caregiving mission proved diverse. To maximize resources, the System began a constant self-examination to identify areas of improvement. For example, a 1993 study confirmed the need for Mercy to move forward in strengthening and centralizing its information systems infrastructure, a process now under way. As part of this effort, Mercy is establishing a Clinical Data Repository (CDR) that will provide a standard system for centrally storing and retrieving information over each regionally integrated service unit. The CDR is a first step toward implementing a computer-based patient record system.
Other initiatives included a Pharmaceutical Care Advisory Council formed to act as a clearing house for information regarding cost-effective drug alternatives and promote a consistent approach to drug use throughout the System.
With the goal of improving the delivery and measurement of quality patient care, Mercy implemented the use of clinical pathways, a multidisciplinary approach to documenting and sequencing treatment. As another means of enhancing care, Mercy is now developing a System-wide initiative for case management, the process that seeks to effectively balance the resources available with the needs of patients and their families.
Over the years, Mercy and its facilities have explored new approaches to where and how patients receive health care. New ambulatory care centers in growing areas of Laredo, Texas; a sports medicine and rehabilitation center in Springfield, Missouri; a facility housing hospice, home care and senior health programs in Fort Scott, Kansas; an ambulatory surgery center in Fort Smith, Arkansas; and an emergency care center in Oklahoma City all are the result of Mercy’s understanding that the traditional acute-care hospital setting is not always the best way for patients to access health care.
During the past two fiscal years, Mercy further demonstrated its forward-thinking philosophy by taking a major step in responding to the growing presence of managed care. Mercy Health Plans, Inc. (MHP), a provider-based managed care organization formed in October 1994, expanded its initial St. Louis and Springfield, Missouri, markets to include Laredo, Texas; Fort Smith, Arkansas; and southeast Kansas. A joint venture arrangement with Arkansas Blue Cross and Blue Shield will further MHP’s reach in all Arkansas markets served by Mercy, with regional headquarters in Fort Smith, Hot Springs and the Fayetteville/Rogers area.
Mercy Health Plans found the health care market receptive to its entrance into the managed care arena. By the end of FY 1996, MHP had an estimated enrollment of more than 30,000 health maintenance organization members and another 45,000 individuals benefiting from third-party administrator services.
As has been true since the first Sisters of Mercy practiced their charitable works, none of the progress made by Mercy during its first 10 years could have been realized without the dedication of thousands of employees. The importance of each individual working within the System was brought into focus with Mercy’s “Worker of the Future” initiative. In development for more than a year and introduced in early 1995, the initiative supports employees in their efforts to respond to the changing health care delivery system. As Workers of the Future, Mercy employees receive ongoing education and training opportunities to help them develop the 12 competencies that serve as the foundation for the initiative. With this knowledge, employees will have the tools to contribute to the future of Mercy and progress personally.
Other endeavors by Mercy also sought to enhance System-wide understanding of the changes taking place within health care and their impact on the organization. These included a 1995 study of the changing role of sponsorship and a 1996 study on the essential elements of governance. Both efforts served to advance awareness of ministry changes among Mercy’s sponsors and stakeholders, and to foster a common understanding of the sponsorship role and the principles of governance within the System.
Conscientious resource management, innovative patient care, creative delivery systems, dedicated employees, sponsors and trustees: All of these elements contributed to Mercy’s caregiving efforts during its first decade. While the System’s journey has taken many new paths, its destination remains the same – an extended hand leading people to the care they need.
A different kind of health planWith eight employees, Freeman’s Menswear in Springfield, Missouri, is a small business. But it has at least one concern it shares with larger companies: providing affordable health insurance to the people it employs.
“We got tired of our insurance company continually lowering health benefits while increasing our premiums. We decided we had to find a better solution,” said Tommy Freeman, who co-owns the family-operated clothing store with his brother, Jim.
The solution came in the form of Premier Health Plans, the Springfield-based division of Mercy’s managed care organization, Mercy Health Plans. Premier’s reasonable rates and co-payments sold the Freemans on the health plan initially. The service and care they and their employees are receiving have kept them satisfied with Premier and its participating providers, including St. John’s Health System.
“Both my brother and I have undergone outpatient surgery since signing with Premier. I couldn’t be more pleased with the care I received. Everyone seemed to be concerned about me as a person, and the surgery went off like clockwork,” commented Freeman. He also is impressed with the low cost of services.
“I paid $5 for a physical, $5 for three visits to my surgeon and $5 for medication on the way home from my surgery. You would have to be at the top of the list of complainers to have a problem with those fees,” he said.
When introducing the health plan to the five Freeman’s employees who signed up for it, the Premier account executive encouraged them to get physical exams, and each one has. As Freeman commented, “That’s what we are after, right? Catch a problem before it gets bad.”
It is certainly the goal of Mercy – to extend the hand of health care services in an affordable way and stress prevention so that those served can liver longer, happier lives.
Information technology paves way to progressWith all the technological advances in health care over the last century, one thing has remained essentially the same – a patient’s chart. “A physician practicing 100 years ago would have little difficulty reading today’s patient charts; their make-up just hasn’t changed that much,” said Gary Hoos, MD, an oncologist practicing at St. John’s Regional Health Center in Springfield, Missouri.
The Sisters of Mercy Health System is working to bring patient charting into the 21st century by developing a Clinical Data Repository (CDR) system. St. John’s and St. Joseph’s Regional Health Center, Hot Springs, Arkansas, are functioning as “early adopters” of the system.
At St. John’s, the system is called ELMeR, Electronic Lifetime Medical Records. Dr. Hoos serves as the physician champion for the project, and Alex Hover, MD, a gastroenterologist and medical director of quality resource, is a member of the Steering Committee.
“The first phase of the project involves defining how we currently do real business within St. John’s,” said Dr. Hover. “That means researching what types of information are kept in charts, who uses the information, and how and where they use it. Once we determine these parameters, we can begin designing a software program that provides patient information in a simple, user-friendly fashion.”
In designing the program, Mercy’s Information Architecture Council is working with Cerner Corporation of Kansas City to develop a CDR system with basic features that can be tailored for individual Strategic Service Unit needs.
Both Drs. Hoos and Hover agree on the advantages the CDR system will bring to St. John’s and all of Mercy. “Right now we struggle getting information from one place to another, for instance, from the X-ray or testing labs to a physician’s office,” said Dr. Hoos. “With the CDR, once the results of these tests are entered into the system, the information is immediately available.”
Dr. Hover also likes another feature of the CDR, knowledge information modules or KIMS. “The CDR is a wonderful interactive tool that not only stores information, but also is capable of reminding users about vital patient follow-ups,” he said. “The system will remind me of patients who are due for mammograms or whose medicine needs checking. Then it has the capability of sending out reminders to those patients.”
The process of designing, testing and implementing the CDR program will unfold at St. John’s over the next two years. Dr. Hover looks forward to it.
“This is a powerful tool for the physician in providing quality care and service,” he said. “In the end, the beneficiaries of it will be our patients.”
The Ixthus Dedication to Christian values underlies a strong mission and core values, and opens the door to collaborative efforts.The Ixthus, an early symbol for Christ, represents Mercy’s Christian heritage and a commitment to the values inherent in this belief system. With the understanding that these values are shared by individuals and groups outside the System, over the years Mercy has sought opportunities to work collaboratively with others in the health care field. These efforts have served to extend the Mercy mission beyond the reach of its own facilities.
An early example of Mercy’s collaborative spirit is Saint Anthony’s Hospital in Alton, Illinois, sponsored by the Sisters of St. Francis of the Martyr Saint George, which joined Mercy as an affiliate in 1988. In recent years, collaborative relationships with other religious communities and congregations have taken a more dramatic turn. During 1995 and 1996, Mercy entered into co-sponsorship agreements with the Dominican Sisters of Springfield, Illinois, and the Adorers of the Blood of Christ in Ruma, Illinois, involving, respectively, St. Mary-Rogers Memorial Hospital, Rogers, Arkansas, and St. Clement Hospital and MariaCare Nursing Home, Red Bud, Illinois. In addition, St. Luke’s Hospital in St. Louis, sponsored by the Episcopal/Presbyterian congregations, became a vital part of Unity Health System, organized by Mercy in 1995.
Recognizing the need to extend health services beyond the walls of acute care facilities, Mercy has sought opportunities to support these endeavors in partnership with other organizations. In Mississippi, Mercy and Coastal Family Health Center teamed up to provide primary care services to Gulf Coast communities through a mobile van unit.
The System’s other initiative in the state is the Mississippi Advocacy Program (MHAP). It strives to improve the health status of all Mississippians by building support among lawmakers for appropriate health and welfare policies and by strengthening community-based grassroots advocacy efforts. A recent effort focuses on proposed federal legislation calling for the implementation of block grants to replace traditional federal funding supporting state programs. MHAP formed a coalition to develop a set of principles related to block grant implementation, collected endorsements from more than 50 organizations throughout the state and presented the principles to Mississippi policy makers as recommended guidelines for developing block grant programs.
Guiding all of these actions is Mercy’s mission statement, developed from the foundation of Christian values. In the fall of 1994, representatives from Mercy and its Strategic Service Units worked to refine this statement and to identify five core values. By the spring of 1995, an effort was under way to ensure that the mission remains at the heart of the work done by all those associated with Mercy through the introduction of a “Model for Mission Integration in Changing Times.” The model envisions a kaleidoscope of relationships where multiple gifts and experiences come together to enhance Mercy’s mission and values, assuring that they are a lived reality to all those with whom the System ministers and interacts. Teams are now at work determining how to integrate mission into everyday life at each Mercy Strategic Service Unit.
Christian values and Mercy’s core values – dignity, justice, service, excellence and stewardship – played a significant role in the development of the System’s stance on welfare reform in 1995. Six principles define Mercy’s beliefs with regard to this important issue, and these were used to establish a set of guidelines that serve as the basis of the System’s public policy efforts:
- Welfare reform must address and diminish the causes of poverty as its first priority.
- Welfare reform must invite welfare recipients to be involved as partners in making policy.
- Welfare reform, through education, job training, and full and equal employment, must support and enable recipients to realize their human dignity and contribute to the common good.
- Welfare reform must focus on the need for nurturing, providing education and development for children.
- Since federal income tax deductions, such as for mortgage interest, comprise a more significant portion of total federal entitlement than traditional “welfare,” the tax system must be formed to be more just, progressive, and to promote the common good.
- Any welfare reform must ensure that our children and frail elderly have a safety net to meet their basic human needs.
Health System decisions are further influenced by the Corporate Ethics Program, developed early in Mercy’s existence to strengthen ethical decision making in clinical, business and management areas.
Christian values remain at the heart of all Mercy endeavors, as demonstrated by the actions taken by the System during its first 10 years and those that will carry forward into the future. Just as early followers of Christ found safe haven at dwellings marked by the Ixthus, Mercy strives to ensure that its facilities continue to be seen as safe dwellings by all those served.
Blending cultures, sharing valuesDorothy Barnard refers to gifts given and received when she talks about the formation of Unity Health System, the Mercy Strategic Service Unit created by the merger of St. Anthony’s Medical Center, St. John’s Mercy Health System and St. Luke’s Hospital in St. Louis. Barnard serves as St. Luke’s first director of mission, a position created when the hospital became part of Unity.
“When seeking to become part of a health care network, St. Luke’s was concerned with finding partners who shared our core values as a hospital committed to providing care in a compassionate environment,” she explained. “We found a match with those values in the Sisters of Mercy.”
Barnard sees the graciousness with which Mercy received the uniqueness and differences of St. Luke’s, an Episcopal/Presbyterian hospital, into its Catholic organization as the gift given. The gift received by St. Luke’s from Mercy is a greater emphasis on the Christian tradition that was central to the hospital’s founding in 1866 by Episcopal ministers and physicians.
“St. Luke’s has always emphasized compassionate care, as well as excellence of service and teamwork,” she said. “But the knowledge of our roots, why we approach care in this way, was not often spoken of. Mercy’s faith traditions are an integral part of its daily operation, and employees are taught about the organization’s roots in Catherine McAuley’s work. This is a practice we are beginning to emulate.”
Rather than a major change in philosophy, Barnard sees the emphasis on mission at St. Luke’s as a simple shift toward expressed tradition. “Talking about how long St. Luke’s has been around, how it has been rooted in the healing ministry for more than 130 years, is important,” she said. “It brings into focus for employees who we are and how we got here. I am convinced people learn by hearing these stories and in so doing, our traditions and mission become real.”
Helping people help themselvesOn any given day, you may find Sister Martha Milner, RSM, on her hands and knees looking for Mediterranean geckos infesting a home, sitting at a computer researching information on the Internet, digging trash out of a ditch or helping a group establish a nonprofit neighborhood organization. As founder of Project WiTH (Walking Together in Hope), a Mississippi-based community outreach ministry sponsored by the Sisters of Mercy Health System, Sister Martha describes herself as an educator of the poor who teaches not by talking, but by doing.
“Project WiTH’s objective is to change power relationships so that poor people can achieve self-determination and political participation. As part of our social justice principles, it is a human right for people to have control over the decisions that affect their lives. The poor seldom do,” explained Sister Martha. “I help people gain this power by teaching them how to organize their communities and become advocates for change.”
Formerly the director of the office of social justice within the Catholic diocese in Biloxi, Sister Martha left that position in 1995 to begin Project WiTH for Mercy. For several years, Mercy has sponsored a mobile health unit along the Mississippi gulf coast, targeting isloated, low-income communities. Project WiTH was created as another way to suppport the needs of the area’s poor and underserved residents.
“It is hard work. It takes the ability to do research, have patience teaching people organizational skills, make contacts within the community – it is really a renaissance existence,” said Sister Martha. “But at the same time, Project WiTH represents the Christian tradition of the Catholic Church and the gospel: The needs of the poor are more important than the wants of the rich. I would like to think that everyday I am betting dirt on my feet, just like Jesus did.”
A cup of tea Mercy’s concern for the comfort and well-being of those in need is evidenced by its charitable works and funding of outreach programs.Offering a guest a cup of tea is considered an act of hospitality. For the Sisters of Mercy Health System-St. Louis, this symbol represents an attitude that goes beyond making visitors comfortable: It is a genuine desire to be of humble service to each other and to those ministered.
The financial stability built by Mercy over the past 10 years has supported the System in establishing charitable foundations to fund services and programs that meet the unique needs of the communities it serves. The first of these initiatives came into existence in 1987 as the Fund for the Poor, now known as Mercy Caritas. With total contributions of more than $2 million over the years, Mercy Caritas grants have provided support to thousands in need. Recent recipients range from Mercy Casita in Laredo, Texas, which provides sustenance support for needy families, to “Let’s Start,” a St. Louis-based program that supports women ex-offenders as they make the transition from prison to society.
In 1991, the System established a charitable fund to provide seed money for new ministries offering innovative ways of responding to relevant health and human service needs. The first Catherine’s Fund recipient, Mercy Regional Medical Center, Laredo, Texas, received $1 million over a three-year period to establish its “Primary Health Care Initiatives,” a broad-based program that addresses the unmet health needs of area women and children. The program continues to flourish today with support from the state and other resources.
For the second three-year funding cycle that began in 1994, Catherine’s Fund increased the grant amount to $3 million over a three-year period, shared by two programs: Catherine’s House in Little Rock, Arkansas, a family development center for low-income pregnant and parenting adolescents and their families; and The McAuley Project in Hot Springs, Arkansas, a community facility offering support, care and hope to older adults.
Within the System, providing charity care and supporting community benefit services is central to the organization’s mission. In Fiscal Year 1995, Mercy’s Strategic Service Units (SSUs) supported a variety of community services, with particular focus on programs aiding women and children. As reported through the System’s Agenda for Social Accountability, SSUs fulfilled this pledge by supporting nearly 100 different community service programs directly benefiting approximately 300,000 people and involving more than 2,700 Mercy employees and volunteers. Community benefit programs focused on preventive care, education, medical care, services to the economically disadvantaged, support groups, community economic development and advocacy. Many were marked by collaboration with other health care providers and community organizers.
During Fiscal Year 1995, Mercy expended more than $1.8 million in support of these efforts, and employees and volunteers provided services valued at more than $2 million in terms of time, material and financial contributions. For Fiscal Year 1996, SSUs selected as their community-benefit focus programs that address violence prevention.
In fidelity to its mission, Mercy provides significant charity care to patients who lack financial resources and are deemed medically indigent. In addition, Mercy provides services to other medically indigent residents through state-operated Medicaid programs. Charity care and shortfalls in Medicaid reimbursement underwritten by Mercy totaled $163 million for Fiscal Year 1995 and $179 million for Fiscal Year 1996. The totals well exceed Mercy’s charity care goal, which is to provide an annual charity care amount that exceeds the System’s net income for the year.
The System’s hospitality extends to employees’ families as well through the Charles E. Thoele Scholarship Program. Established in 1993, the program awards 20 $1,000 scholarships annually to dependents of Mercy employees. In 1996, scholarship funds are helping students gain higher education in such areas as nursing, engineering, teaching, physical therapy and communications.
The System’s commitment to charitable service extends beyond the boundaries of the communities it serves. Outside the United States, Mercy is aiding the Sisters of Mercy of Belize, Central America, and the Regional Community of Providence, Rhode Island, in their work at St. Joseph Mercy Clinic, Mercy Kitchen in Belize City, and the House of Mercy in the Toledo District. In 1996 Mercy representatives traveled to Belize to help develop a strategic plan for the ministries’ services and potential for expansion, and to provide a medical appraisal of the clinics and their clientele.
During her last illness, Catherine McAuley asked her followers to be sure to have a “comfortable cup of tea” ready for those visiting her. The comfort afforded through Mercy’s funding of outreach programs and its charitable care carry that tradition of hospitality to its most meaningful level.
Clinic builds bridge of cooperation“Our emergency room was doing more and more primary care. People either were uninsured and couldn’t afford to go to a private physician, or they were unaware of programs they could go to for help,” said Sister Jane Winterson, RSM, vice president of St. Mary’s Mercy Hospital in Enid, Oklahoma. “With the changes taking place in funding for government health care programs and a greater emphasis on managed care, we realized there was a need to develop an outreach program that could help the uninsured and underinsured population of Enid.”
The answer was the Enid Community Clinic, a free health care facility opened on August 6, 1996, and whose first funding came from Mercy’s Mercy Caritas program. From that initial investment the project snowballed, receiving support from local and federal government and community agenices, health care professionals, interested citizens and even Enid’s other major hospital.
“Historically, there has been a rivalry between the two hospitals here in Enid, but this project helped bridge the differences that existed in the past,” said Sister Jane. “Integris Bass Baptist Health Center has donated supplies, and a Bass pharmacist is coordinating the clinic’s pharmacy.”
Betty Collingsworth, RN, nurse manager of St. Mary’s emergency department and clinic coordinator, saw firsthand the generosity of the Enid community. The list of contributions is impressive: The clinic building’s owner agreed to reduce the monthly rent from $850 to $300. A retiring physician donated office furniture and equipment. Physicians contributed drugs from their supplies. Both hospitals pledged to keep the clinic stocked with supplies not donated. And more than 50 physicians, together with nurses, pharmacists and others interested in the project, are volunteering their time to staff the clinic, initially for one night a week.
“We plan to see about 30 patients each week. But there is so much potential for other programs to run on other nights. Another group in town has already approached us about the possibility of providing adolescent health screenings here. Eventually, we also would like to offer diabetes screenings and immunization clinics,” said Collingsworth.
The spirit of cooperation continues, as St. Mary’s and Bass Baptist discuss sponsoring another joint program that would provide hospital-based, shared services. Mercy is demonstrating to Enid that the old adage is true: Charity begins at home.
Taking stock of community benefitsSince 1989, Mercy Strategic Service Units have documented a portion of their charitably activities through the Agenda for Social Accountability, a systematic approach to identifying and reporting various services provided to the community. Although the method offered some means of quantifying each SSU’s charitable and community benefit work, it did not ensure truly consistent or comprehensive documentation.
“Traditionally, Mercy and many other nonprofit health care organizations have taken a low-key approach to documenting and reporting charity care and other community benefits provided without reimbursement. This work was viewed as the fulfillment of our mission as a Church-sponsored organization,” said Nancy VonderHaar, accounting supervisor for Mercy’s corporate offices. “But in recent years we have come to recognize the importance of taking a true accounting of all charitable activities and helping our communities understand the value of these services.”
How better to capture the full scope of all uncompensated care is the goal of Mercy’s Community Benefits Task Force. Formed in June 1996 and chaired by VonderHaar, the task force is working to create a policy that will reflect a more complete view of charitable and community benefit services, and to provide a methodology for measuring and accounting for these services. The task force, made up of corporate office staff from finance, mission, planning and community outreach as well as SSU representatives, is reviewing a software package that may aid in documenting services provided. It is also talking with other health care systems that already have tackled this complicated process.
“It’s important that the reporting process have integrity. A true accounting of our charity care and community benefits will help to ensure our continued nonprofit status, and thus ensure continuation of these much-needed benefits,” Vonder Haar explained. “And, by more accurately documenting our work, we can better identify areas of unmet need. Currently, we tend to address needs on a reactive basis. We hope to develop a means of helping our SSUs be more proactive in meeting community needs.”
“Projects such as this also help us learn so much about the amazing things going on within the System,” added Sister Juliana Casey, IHM, Mercy vice president – Mission Services, and a member of the task force. “In the future, our reporting of these efforts will be more precise and comprehensive, enabling Mercy to show the depth of its commitment to charitable works.”
