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Fiscal year 2010 was marked by a sluggish economy and the expansion of competition in the NICU market. Performance and growth over the prior year was impacted by the movement of the physicians to Children's Specialty Physicians but received a boost from the strong outpatient activity and the opening of the Children's Specialty Pediatric Center.
As a result, excess revenue over expenses decreased $19 million while total net revenue exceeded $238.8 million. Net assets increased from $250 million in 2009 to $271 million in 2010, reflecting the recovering investment market and capital additions to the hospital campus. Total assets increased by $18 million to $414 million in 2010.
Years of hard work and planning culminated in the 2010 opening of the Children's Specialty Pediatric Center. While a milestone for us, we also celebrated many other accomplishments with our staff, patients and families.
At Children's, quality and patient safety are always the top priorities. We strive for perfection using a systematic organization-wide approach in which multidisciplinary teams review quality and safety data regularly to assure reliable performance, and identify and implement improvements when necessary. Here are areas of focus and achievement related to quality and patient safety outcomes in 2010.
Patient satisfaction data collected by Healthstream, Inc. asks how likely patients' families are to recommend Children's to their friends and families for care. Our results are consistently at the 90th percentile compared to the other pediatric hospitals in the Healthstream database.
Central venous lines are used for patients who need long term intravenous medications, fluids and nutrition, or to obtain blood samples. Central venous lines prevent the patient from having to undergo repeated needle sticks. Unfortunately, central lines also run the risk of carrying germs into the bloodstream.
Our goal for 2010 was to reduce the number of infections associated with the use of central lines in the hospital to less than 1.7 infections per 1000 line days. Although we did not meet this goal, with our year end result of 2.2 per 1000 line days, our efforts continue.
Serious medication errors continue to occur in hospitals throughout the U.S. Although there is no published "average" medication error rate, Children's is very proud of the work we have done to decrease the number of medication errors that make it past all the checks and balances to the patient. By implementing such technologies as computerized provider order entry and automated medication dispensing cabinets, as well as other safety strategies, we have reduced our medication error rate by almost 150% in the last 4 years.
To have ambition is an admirable quality. Defined as a strong desire for success, it can lead to great accomplishments. On behalf of everyone at Children's Hospital & Medical Center, we are proud to report that in 2010 our ambitious efforts culminated in some truly extraordinary achievements.
Children's Hospital & Medical Center is committed to addressing the health care service and educational needs of our community. We focus on improving the lives and health of the children in our region, and we work to meet needs identified in a Community Report Card by Our Healthy Community Partnership.
This report highlights the ways in which Children's Hospital & Medical Center provides health care, education and outreach services as we fulfill our mission, "so that all children may have a better chance to live."
The unpaid costs of Medicaid programs and the total benefits for the poor reflect the shortfall from payment methods employed by government programs versus the actual costs to provide care. It does not reflect the shortfalls from billed charges, ($88.9 million) nor does it include bad debt ($1.5 million).
In 2010, we provided $3.0 million in services (at cost) in the form of uncompensated care or charity care ($1.5 million) and bad debt write-offs ($1.5 million) for families unable to pay the bills associated with their children's medical care. This amount has been steadily increasing, and is expected to continue to rise with an uncertain national economic future.
In response to the patient's increasing responsibility for health care costs, Children's has developed and implemented an uncompensated care policy. Eligibility for financial assistance and uncompensated care is based upon family income, size and other circumstances. Specially trained social workers, financial counselors and patient account representatives assist uninsured or low-income families to apply for financial help through government programs and other funding sources. When outside sources have been exhausted, or when families identify themselves as being unable to pay, the staff helps them apply for uncompensated care.
A hospital incurs bad debt when it cannot obtain reimbursement from patients or providers for care provided. This frequently occurs because patients are unable to pay their bills and do not qualify for charity care.
At Children's, our commitment to children extends beyond the hospital walls. The programs we provide benefit families while their child is receiving health care, as well as educate the community on ways to prevent injury and illness. Through Parenting U, free parent education classes, experts speak on timely topics in pediatrics. Our Children's Advocacy Team is a resource for anyone suspecting child abuse or neglect. Children's provides information through health fairs and assistance through social work, pastoral and spiritual care, child life services, financial counseling and support groups.
Educating tomorrow's healers is an important mission of Children's Hospital & Medical Center. Health professions education amounts include education-focused meeting space, residency stipends, telemedicine and continuing medical and nursing education. In 2010, the hospital supported the joint Creighton-Nebraska Universities Health Foundation pediatrics residency programs at the University of Nebraska Medical Center and Creighton University, as well as many of the region's nursing and health professional schools.
Children's is the region's leader in pediatric-specific continuing medical education reaching health professionals throughout Nebraska, Iowa, South Dakota and Missouri. Grand Rounds are offered weekly at the hospital and are available online. Professional education targets practicing physicians, residents, medical students and mid-level providers.
Nursing staff accompany pediatric specialists to educate community hospitals on the latest trends in the management of critically ill infants and children. Trauma Nursing Core Course training and certification is designed to improve patient care in the emergency setting and increase the skill and confidence of emergency nurses who care for patients.
Children's supports several clinical programs offered despite financial loss because they meet an identified community need. In this category at Children's are emergency and trauma care, behavioral health programs, ambulatory clinic outpatient services, urgent care, Child Development Center and our palliative care program, Hand in Hand.
This number includes hours donated by staff to community boards and committees while on hospital time, facility space for community groups and cafeteria meal tickets provided to families who are in need. This number also includes contributions to charity events and non-profit organizations.
Children's supports an environment of research which includes translational, basic and health outcomes studies facilitated by the University of Nebraska Medical Center College of Medicine.
Children's provides staff time and resources to the Omaha Metropolitan Medical Response System (OMMRS). OMMRS is a program that supports partnerships among a variety of emergency and emergency management systems to prepare the local medical community and public health, fire, law enforcement, major businesses, government entities and community organizations for an integrated medical response to disaster. In addition, Children's staff devotes many hours and resources to tracking, developing and producing the community benefit report.
The promise of outstanding pediatric medical care is hollow if no one is trained to provide it. That's why Children's Hospital & Medical Center takes the lead, both as a highly-respected pediatric teaching hospital and as a valued source of continuing educational opportunities for the region. We teach future caregivers - and we learn from them, too. Because promises are only good when they're kept.
Hope can be seen under a microscope. It can be sensed in the urgency to return to the lab and try a new idea, felt in the excitement of discovery, and revealed in a medical journal or conference presentation. Hope is an element of every innovative research project at Children's Hospital & Medical Center. And because the physicians and specialists who conduct these ground-breaking studies share the virtue of hope, so will the families and children we serve. Hope. We can't wait to pass it on.
Abby Robinson has encountered many obstacles in her son's young life. Little Landon arrived dangerously early and required surgery to help him breathe, eat and grow. But a childhood experience at Children's Hospital & Medical Center gave Abby her own unique perspective. A past patient, she's now a mother watching her little boy thrive.
Imagination fuels discovery and reveals unexpected possibilities. It allows us to exceed expectations and envision new dreams.
In 2010, a beautiful new center opened at Children's Hospital & Medical Center, one we had imagined years ago. The Specialty Pediatric Center, designed especially for children and young people, is a place where pediatric patients of all ages receive specialized outpatient care. It is also where we find an artistic vision, a larger than life creation, appropriately named "Imagine."
Follow our journey, our snapshot of 2010 at Children's Hospital & Medical Center.
