COMMUNITY MEDICAL CENTERS
COMMUNITY BENEFITS REPORT
Fiscal Year 2009/2010
Community Medical Centers (Community), the largest provider of health care services in Central
California, is pleased to submit the following report for our three acute-care hospitals – Clovis
Community Medical Center, the Community Regional Medical Center and the Fresno Heart & Surgical
Hospital, while also including information about ancillary clinical services.
This report follows guidelines in Senate Bill 697, which became law in 1994.
Community was established more than 100 years ago. It is a locally owned, not-for-profit, public benefit
corporation. Its chief executive officer is Tim A. Joslin. The chairman of Community’s 15-member
Board of Trustees is Kevin Follansbee.
Community has an annual budget (2010/2011) of approximately $1 billion. Net uncompensated
community benefits for fiscal year 2009/2010 were over $174 million, compared with nearly $149 million
in fiscal year 2008/2009, a reflection of the increase in services provided to the medically underserved,
and the decrease in reimbursement obtained to help pay for these patients.
Community has historically spent more on uncompensated community benefits than all other Fresno-area
hospitals combined. And, some years, nearly double their combined total.
Community Benefits - Audited
$200,000,000
$180,000,000
$160,000,000
$140,000,000
$120,000,000
$100,000,000
$80,000,000
$60,000,000
$40,000,000
$20,000,000
$0
97
98
99
00
01
02
03
04
05
06
07
08
09
10
FY
FY
FY
FY
FY
FY
FY
FY
FY
FY
FY
FY
FY
FY
1
Community has more than 6,000 employees and 1,100 medical staff as well as 900 volunteers.
Community is headquartered in Fresno, providing the Central Valley with acute care, outpatient centers,
clinics, home care, community education, physician groups and a physician residency program in
conjunction with the University of California, San Francisco (UCSF).
Community has a 15,000-square-mile primary service area, which includes Fresno, Madera, Kings,
Tulare and Mariposa counties. It also operates the only combined burn and Level 1 trauma units between
Los Angeles and Sacramento, providing critical care and other specialty services to patients from well
outside the primary service region. Community Regional Medical Center (Community Regional) operates
one of the busiest hospital emergency departments in the nation.
In October 1996, Community entered into a 30-year contract with Fresno County to assume responsibility
for caring for the indigent, inmates and much of the county’s working poor. Community also assumed
management of the former county hospital, which Community renamed University Medical Center
(UMC). Community pledged to build a new burn and Level 1 trauma center, replacing services located at
UMC.
The trauma and critical care building on the 58-acre Community Regional Medical Center campus began
opening in stages in 2004. UMC’s inpatient acute-care services were successfully relocated to
Community Regional in April 2007, and UMC ceased operations as an acute care hospital. In fiscal year
2008/09, Community relocated all of its remaining inpatient acute care services from the former UMC
campus, which has been renamed Community Health Center - Cedar.
In March 2010, the Deran Koligian Ambulatory Care Center moved to a new 79,534-square-foot facility
just north of Community Regional, on the southwest corner of McKenzie Avenue and Wayte Lane. The
building features 104 exam rooms, an X-ray room and three lab drawing stations. The clinics include
dental, eye, women and children services, internal medicine, family and adult practice, HIV/AIDS care
and oral maxillofacial surgery. The diabetes and asthma satellite clinics will remain at the Cedar campus.
Community then returned most of the former hospital campus to Fresno County.
Community is governed by a volunteer board of trustees comprised of local civic leaders and physicians.
The trustees provide vision and policy direction. This process includes an annual review of the prior
fiscal year and a community-needs evaluation to prioritize operational issues and provide direction in
meeting the region’s growing and changing health demands.
The corporate board is also actively involved in approving fiscal appropriations for community benefits
programs, outreach services and education, as well as traditional charity care and unpaid costs of public
programs for the medically underserved. Corporate board members, physicians and Community’s
leadership team have helped identify and fund community benefits programs.
Community continues to seek the views of health care, social justice, business, education and political
leaders through meetings with the system’s chief executive officer and senior leadership.
Mission
Community’s stated mission is:
“To improve the health status of the community. To promote medical education.”
2
In 2007, Community’s leadership team formulated and approved, with board consent, a five-year vision
statement. The entire statement is available to the public online at www.medwatchtoday.com, one of
Community’s Internet sites.
Safety Net
When Community contracted with Fresno County to provide for certain health care needs, Community
committed to serve as the county’s safety-net provider. When reviewing Community’s economic
commitment to charity care, it can be shown that Community continues to provide medical services for
these individuals and families, regardless of payer source.
In February 2010, Fresno County expanded the eligibility range for those seeking to enroll in the
Medically Indigent Services Program (MISP). The earnings limit that had been $509 was raised to
$1,209. However, in August, the court ruled that new range still excluded too many patients. Irrespective
of how the county responds to that ruling, Community is already experiencing a significant increase in the
numbers of MISP patients coming for treatment without any additional recompense from the county.
During its fiscal year, Community treated about 15,000 MISP patients, including jail patients, juvenile
hall patients and Children’s Health and Disability Prevention Treatment Program patients. That was a
23% increase from the nearly 12,200 treated in FY 2009.
The cost of providing that care was $54 million in FY 2009 vs. $71 million in FY 2010, an increase of
32%. Community sustained an estimated loss of $51 million in FY 2010 – the gap between the county’s
$19.7 million payment to Community for the MISP program and the actual cost to Community of
providing the care.
(Please see the submitted charity care policy.)
Community received $52,631,000 in disproportionate share hospital supplemental funding, a reduction of
nearly $5 million over the prior year. These funding sources make up for some, but not all, of
Community’s shortfall for care of a sizable number of needy patients.
Unpaid services provided by Community to the medically underserved and as a benefit to the community
for FY 2009/10 ending August 31, 2010, are as follows:
Traditional Charity Care at unpaid costs $ (16,355,000)
Net Unpaid Costs of Medi-Cal Program (135,347,000)
Net Unpaid Cost of Medically Indigent Program (34,953,000)
Disproportionate Share Funding 52,631,000
Prop 99/Tobacco Tax Funding 347,000
Total Net Benefits for the Poor (133,677,000)
Net Unpaid Costs of Medical Education (39,761,000)
Other Community Benefits (950,000)
Net Community Benefits $ (174,388,000)
Definitions:
Traditional charity care covers services provided to persons who meet certain criteria and cannot afford to
pay. Costs of charity are the estimated costs of services provided to such patients.
3
Unpaid costs of public programs for the medically underserved are the costs in excess of reimbursement for
treating patients covered by the state’s Medi-Cal and MISP programs.
Education and community benefits include the cost of training health professionals and educating the
community through various seminars and classes, net of government and other reimbursement for such
activities.
One example: Community’s Home Health Care program, which includes wound care, rehabilitation
therapy and other services such as home dialysis and ambulatory care dialysis. There were nearly 4,000
patient encounters last fiscal year under the “community benefits” rubric – at an unreimbursed cost to
Community of more than $2.1 million.
Community’s Partnerships and Programs
Medical Education
Community maintains the region’s largest medical staff made up of private and academic physicians. It is
closely affiliated with Santé Community Physicians, central California’s largest independent physicians'
organization. Physicians are involved in decision-making at every level, including as members of our
governing Board of Trustees.
Community promotes medical education through its collaboration with the University of California at San
Francisco medical education program in Fresno, and the Central California Faculty Medical Group
(CCFMG).
Highlights from the UCSF Fresno partnership:
UCSF-Fresno currently has more than 250 residents studying in nine specialties and more than 30
fellows studying in 12 sub-specialties. There are approximately 200 third- and fourth-year
medical students on a rotational basis.
Existing fellowships include cardiology, gastroenterology, hospitalist, infectious diseases,
minimally invasive surgery, pulmonary critical care, surgical critical care, wilderness medicine
and psychosomatic medicine. New fellowships opening this year include hospice and palliative
care, acute care surgery and ultrasound medicine, bringing the total number of fellowship
programs to 12.
Existing residency programs include emergency medicine, family practice, general surgery,
internal medicine, obstetrics/gynecology, pediatrics and psychiatry. New residencies opening this
year include orthopedics. Oralmaxillofacial surgery has changed sponsorship to UCSF- Fresno,
bringing the number of residency programs to nine – eight medical and one dental.
UCSF-Fresno received a $1.9 million Health Resources and Services Administration grant in the
amount to expand the pediatric residency by two residents per year for five years, beginning in
2011.
About 35% of graduating residents in 2010 indicated they planned to practice medicine in the
Valley.
Clinical research and trials:
There were a total of 155 research studies conducted by UCSF-Fresno faculty/fellows/residents last fiscal
year. Thirty-seven are funded by outside organizations. Studies include:
4
Emergency Medicine: testing an experimental antivenin for Black Widow spider bites; placing
patient education computer/interactive kiosks in the emergency department providing information
about urinary tract infections, Chlamydia and family planning; and the cause and diagnosis of
methicillin-resistant Staphylococcus aureus (MRSA).
Surgery: utilizing an experimental vascular access graft for hemodialysis; examining the
correlation of venous and arterial blood gases for trauma patients; and utilizing a medical device
for early operative fixation vs. non-operative management of severe rib fractures in trauma
patients.
Pediatrics: evaluating an infant and toddler developmental curriculum for residents.
Neurology: two experimental medications for amyotrophic lateral sclerosis (Lou Gehrig’s
Disease), and one for myasthenia gravis; one for the secondary prevention of small subcortical
strokes; and one for insulin resistance intervention after stroke.
Pediatrics: an evaluation of an early childhood asthma program.
Family Medicine: an evaluation of the California statewide area health education center program.
OB/GYN: testing the use of a new fetal monitor.
Internal Medicine: 10 studies testing the safety and efficacy of experimental medications for
asthma, chronic obstructive pulmonary disease, emphysema, deep venous thrombosis, acute lung
injury, HIV, and pulmonary arterial hypertension; a study evaluates trophic vs. enteral feeding for
patients with acute lung injury; one testing extravascular lung water in patients with acute lung
injury; three are surveillance registries for patients with H1N1 (swine flu) and asthma and
pediatric HIV/AIDS; and two examining the possible relationship between pesticide exposure and
breast cancer.
Gastroenterology: one study testing medications for hepatitis C, and two testing medications for
hepatic encephalopathy.
Cardiology: evaluating a small- vs. large-bore needle for vascular access for
angiograms/percutaneous intervention.
Awards/Honors during the last year for UCSF Faculty:
Katherine Flores, MD: Appointment to the National Health Care Workforce Committee;
Appointment to the UC President’s Advisory Council on Climate, Culture and Inclusion;
Appointment to the California Workforce Investment Board – Health Workforce Development
Council; James Irvine Leadership Award; West Fresno Health Care Coalition (WFHCC) “This is
Your Life of Service” – 2010, The Community Health Champion Award
Krista Kaups, MD: Community Medical Centers Top 10 Ultimate People
John Scholefield, MD: 2010 Child Advocacy Award
Simon Paul, MD: American Red Cross “Real Heroes”
John Ambrose, MD: Faculty Research Award, UCSF Fresno; Best Doctors in Fresno;
Best Doctors in America; Who’s Who in America
Kathryn Bilello, MD: UCSF Kaiser Award for Excellence in Teaching
Michael Peterson, MD, Karl Van Gundy, MD: Business Street – Health Care Heroes Award for
Lung Nodule Clinic
Jennifer Burnett, MD: UCSF Champions of Diversity Award California Academy of Family
Physician’s GLBT Delegate to the AAFP’s 2009 National Conference of Special Constituencies
Ivan Gomez, MD: Merced residency Program Distinguished Alumni Award, UC Davis Research
Conference, Feb. 27, 2010
Sarkis Baghdasarian, MD: Best Doctors in Fresno
Susanne Spano, MD: UCSF-Fresno Borba Fellow Research Award
5
Christian Faulkenberry, MD: Awarded a CATCH grant (Community Access to Child Health)
Avak Howsepian, MD, Ph.D. 2009 nominated to the Alpha Omega Alpha honor society by the
University of California, San Francisco chapter of Alpha Omega Alpha’s Class of 2010.
Hani Khouzam, MD: 1 of 107 Fresno’s Best Doctors, Fresno Magazine, October 2010;
American Medical Association Physician’s Recognition Award with Commendation in
Continuing Medical Education Service to Service Award, VACCHCS, Fresno
Physician Recruitment: 18 faculty for new positions were hired through CCFMG in the specialties of
hematology/oncology, OB/Gyn, cardiology, surgery, neurology, gastroenterology, infectious diseases,
dermatology and emergency medicine.
Culturally Appropriate Care
Community serves a culturally and linguistically diverse community in which more than 100 languages
are spoken.
For example, Community Regional in downtown Fresno, with 30% of its emergency department patients
being non-English-speaking, has need for hundreds of interpreter interactions daily with patients and their
families. Community is not reimbursed for these services, which last year cost $480,000.
Patients’ language needs are identified during pre-operative appointments and phone calls, when they
register at a facility or are admitted to the hospital. Additionally, referring primary care physicians are
asked to provide information on language needs of patients. Non-English speaking hospital patients wear
a wristband listing their primary language.
Interpreter services are provided at Community facilities 24 hours a day, 7 days a week. Community
relies on certified in-house interpreters, local interpreters trained in medical interpretation (Panational
Inc.), a telephone and American Sign Language video-conferencing interpretation service (Language
Service Line with 3,000 interpreters and 170 available languages) and videoconferencing interpretation
through a cooperative with 13 California public hospitals.
Additionally, employees called “Language Ambassadors” volunteer to help patients and families with
non-medical-related questions in their native language. Bilingual employees wear a special employee
badge to indicate to patients and visitors that they speak another language and can assist with interpreting.
Languages spoken by these employees include Spanish, Hindi, Hmong, Punjabi, Farsi, Vietnamese and
Filipino.
Doctors and nurses at Community Regional can adapt to 170 languages within minutes thanks to
Community Regional’s participation in the Health Care Interpreter Network (HCIN). HCIN is a system of
shared remote interpreter services currently operated by public hospitals in Northern California.
Community Regional provides five interpreters full time for HCIN, in-person interpretation by
appointment and end-of-life family meetings.
Community’s commitment to providing culturally appropriate care was further evidenced in July 2009
when, with the assistance of a $178,000 grant from the California Endowment, the Center for
Multicultural Competence in Healthcare Organizations, an independent assessment group, conducted a
two-day cultural competency review at Community Regional. It was designed to measure the hospital’s
clinical and operational performance against the culturally and linguistically appropriate standards issued
in 2000 by the U.S. Department of Health and Human Services’ Office of Minority Health.
6
The survey identified these strengths, among others, at Community Regional: dedicated leadership and
management; the HCIN; the Target 100 patient, physician and employee satisfaction programs;
community collaboration; a knowledgeable physician community; and employee involvement.
Among other things, surveyors urged that Community Regional develop a strategic vision that includes
cultural competency; assign a champion for that effort; enhance cultural competency training curricula;
incorporate competencies into existing programs and policies; and increase community engagement.
Community Regional appointed a Cultural Competency Steering Committee to follow up on the
surveyors’ findings. This committee includes Community Regional and Corporate team members. Among
the top priorities that were identified and are being addressed:
Identify top 10 policies where strengthening cultural competency language would have the most
impact. Conduct proactive review and revision of those policies. Evaluate the remaining policies
for revision as they come up for normal review. Develop a policy statement which summarizes
Community’s vision and expectations related to culturally competent care.
Continue to focus on improving language access with emphasis on the quality of the service
provided especially as it relates to non‐certified employees providing interpreter services for
critical medical information. Reinforce policy training on use of interpreters in situations where
critical medical information is being interpreted.
Provide training on gender‐competent care aimed at ensuring quality care for all patients
including gay, lesbian, bisexual and transgender patients.
Develop a binder which details each of the 14 culturally and linguistically appropriate standards
and specifically identifies the ways in which Community Regional meets the standard or the
action plan under way to achieve compliance.
Evaluate new Joint Commission standards related to “Advancing Effective Communication,
Cultural Competence, and Patient and Family Centered Care.” These standards go into place in
January 2011 and will be scored beginning in January 2012.
Human Resources is developing an Affirmative Action Plan that will address issues related to
succession planning, talent development and recruitment.
Identify and prioritize outreach efforts to targeted groups in the community including Fresno
Interdenominational Refugee Ministries and the Islamic Cultural Center.
Community Connections
Community continues to seek creative solutions and partnerships that offer health benefits to Valley
residents, ever conscious of the region’s unique and growing needs. For example, last fiscal year
Community partnered with the Hospital Council of Northern and Central California, area hospitals,
emergency services and county staff to address the growing public-health crisis brought on by cutbacks in
Fresno County’s services to the behavioral health, so-called “5150” patients.
Community has also collaborated with the Hospital Council with respect to care of homeless patients and
those who lack access to primary care physicians and, as a result, repeatedly use the emergency
department for their care.
In response to increasing numbers of inappropriate frequent users of the ED as well as patients who have
multiple readmissions, Community Connections was implemented September 2009.
7
The voluntary program provides outreach, engagement and intensive case management services to such
patients. Community Connections Outreach Specialists (CCORS) provides direct client services such as
monitoring and support, linkage to an array of social services, healthcare services, and community based
organizations in efforts to connect patients to more appropriate services in the community that better
address the issues of substance abuse, mental health, homelessness and chronic disease management.
CCORS assist patients in applying for benefits such as Social Security, Fresno County benefits (General
Relief, MISP, Food Stamps), and Medi-Cal. They attend appointments with patients at the Social
Security office, primary care providers, mental health, substance abuse services and elsewhere, often
assisting with completion of forms and follow-up as well as providing supportive counseling.
Community Connections has established a partnership with the Housing Authorities of the City and
County of Fresno securing housing vouchers for individuals who have a disability and are homeless.
Community Connections also collaborates with the Fresno County Department of Behavioral Health,
Holy Cross Clinic, Community Regional Diabetes Care Center, and the Community Regional Chronic
Airway Disease Management programs.
Community Connections enrolled 80 clients in the 2009-2010 implementation year. Of these 80 enrolled
clients, 1% were homeless and linked to housing, 25% did not have a primary care provider and were
linked to either the Deran Koligian Ambulatory Care Center or a community provider.
The following outcomes have been reported for patients enrolled for one year:
60% decrease in ED visits
Significant decrease in re-admissions and length of stay
Patient linkage to Medi-Cal benefits enabling Community Regional to apply for
retroactive reimbursement
Chaplaincy
Community Regional has one full-time and one part-time chaplain, and calls upon a corps of screened
volunteer clerics throughout the community to assist in meeting the diverse needs of its patients.
Assisted by outside donors, including the Gideons, the chaplaincy program has:
Donated to patients about 150 complete Bibles, 200 New Testaments of large print, 50 pocket-
size New Testaments and about 150 bilingual New Testaments.
Donated about 500 rosaries.
Donated 200 copies of Our Daily Bread per quarter.
Donated about 150 copies of Living Faith in English and a similar number in Spanish called La
Fe Viva, paid for by the Roman Catholic Diocese of Fresno.
Donated about 200 copies of the Guidepost, a devotional booklet with inspirational stories of
hope and faith.
Community Chaplain Grimaldo Enriquez serves as the hospital’s representative to the Board of Directors
of the nonprofit Clinical Pastoral Education Program of Central California and as treasurer. The program,
which involves area hospitals and faith groups, is trying to develop a formal educational framework
enabling the Valley to “grow its own” hospital chaplains, with the assistance of the Association of
Professional Chaplains. Community has provided onetime seed money to assist the effort.
8
Enriquez shared a snapshot of what a chaplain encountered over the last year:
“I provided approximately six counseling sessions or encounters with individuals who were not patients,
but just walked in off the street seeking spiritual and emotional support from the hospital chaplain. Other
encounters were by phone with people calling in to the office for support. The encounters lasted from 30
minutes to an hour. Some of these individuals were homeless, others had no connections with organized
religion, and some had psychological issues which made them suspicious of usual sources of support.
“I personally intervened in securing a discounted cost for the cremation and the burial of the remains of
an employee who died and the closest relatives did not want to claim the body nor pay for any final
expenses. Employees took up a collection to pay for the costs. I provided guidance and emotional support
in the process to the co-workers. The county coroner held the body while arrangements were worked out
between everyone involved. …
“One of our chaplains officiated at the funeral of a former patient at the request of the family. They lacked
the financial resources to pay a minister plus they were not connected to any particular church or religious
body. This service was provided free of charge.”
Asthma
The Children’s Health Center lost funding from the Improving Asthma Control program associated with
the California Asthma Public Health Initiative due to budget cuts in Sacramento. The center decided to
absorb the extra costs to ensure the best quality of asthma care for the patients and families it serves.
There were 1,435 asthma patients’ visits to the center last fiscal year.
The Certified Asthma Educators and Registered Respiratory Therapists of Community’s Asthma
Education & Management Program (AEMP) partnered with Community Connections, a Community
Regional initiative tasked with identifying and assisting frequent users of the Emergency Department.
When such a patient has been identified with breathing problems, a Certified Asthma Educator/RRT
accompanies a social worker to the patient’s home to educate, identify needs and begin a plan of action.
Results have shown a significant reduction in ED visits for most of these patients.
The AEMP continues to assist in education of residents from the UCSF-Fresno teaching program.
Education and support is ongoing for pediatric residents in addition to special classes for new interns.
Family practice residents are scheduled at the beginning of the fiscal year in classes designed to introduce
the best practices in asthma as outlined by the National Institutes of Health. Additionally, family practice
and emergency department residents all perform at least one rotation through the Children’s Health
Center and are presented with the best practices for asthma care in children.
The Children’s Health Center continues to have great successes with the Early Childhood Asthma
Program (ECAP) initiative, in partnership with First Five Fresno County. The 133 children and their
families who are enrolled are provided intense education and follow-up, as well as a home environmental
assessment to identify triggers in the home for more than 50 of these children through a grant-funded
community health worker.
In addition, many of these children are followed in the Asthma Clinic, a specialty clinic at the Children’s
Health Center, under the guidance of Maries Joseph, MD. The grant has also allowed for the AEMP case
managers to do educational presentations to a variety of audiences, including preschool/day care settings,
their staffs and client families to improve asthma awareness in their respective communities, as well as
9
physician groups and other ancillary professionals. These were available for both English and Spanish,
and through the interpreter help of Hmong young mothers.
The AEMP continues to educate patients in group as well as individual settings, outpatient as well as
inpatient. In the last fiscal period, more than 200 new patients were seen and case managed for a total of
over 380 visits. As a result, there was a decrease in hospitalizations and emergency room usage as
tracked in the asthma program database. More important is the improved quality of life and degree of
asthma control experienced by the majority of the patients.
The AEMP has made nearly 335 presentations to a variety of audiences, including teachers, physicians,
child care providers and allied health professions, with the intent of improving the understanding of
asthma.
Pulmonary Rehabilitation
Community’s Pulmonary Rehabilitation is now in its 30th year serving individuals with chronic
pulmonary disease. It continues its support and education group, the “Huffers & Puffers.” A luncheon is
included with a guest speaker focusing on topics related to pulmonary disease and lung health. Those with
chronic lung disease, their families and caregivers are encouraged to attend. Average attendance is 25-30.
Huffers and Puffers 2009-2010 Luncheon/Support Group Calendar
Date Speaker Topic
Sept. 9, 2009 Mary Jo Walker Lifeline Medical Alert
Lifeline Representative
Oct. 9, 2009 Tony Peters, Sleep Apnea
Representative for Care Signs & Symptoms
Medical
Nov. 13, 2009 Beverly Kuykendall H1N1 and the Flu Season
Infection Control
for CMC
Dec. 11, 2009 Christmas Party Entertainment
Snoopy Christmas
Music by Nathan & Christie
Jan. 13, 2010 Praveen Buddiga, MD Air Quality in the San Joaquin Valley
Feb. 17, 2010 Group outing Went to Home Towne Buffet for lunch
March 17, 2010 Richard Myer Macrobiotic Nutrition
April 21, 2010 Marie Espinola, Understanding Alzheimer’s
Executive Dir. For
Alzheimer’s Foundation
May 19, 2010 Marilyn Carter, RCP How to Talk with Your Doctor
“Year of the Lung” Seminar – July 15, 2010: This free event, which included lunch, was designed to
encourage and inspire Valley residents with chronic lung disease, their families and caregivers. It
10
included presentations by UCSF physicians and other medical professionals, with vendors sharing
product information. About 80 people attended. Goals of the educational seminar:
Provide social interaction with those sharing a common problem.
Provide self-care management techniques enabling those affected by lung disease and their
caregivers to live a more productive and fulfilling life.
Provide education and awareness of chronic lung disease.
Community’s Pulmonary Rehabilitation clinic, located at Community Health Center -- Sierra, is a
nationally certified program through the American Association of Cardiovascular and Pulmonary
Rehabilitation.
Insurance (Medicare/Medi-Cal/all HMOs) does not reimburse for pulmonary rehab education provided by
a registered respiratory care practitioner. Last year, this program educated 60 patients with moderate to
severe chronic pulmonary disease in 520 office visits. Upon discharge from the program, clients are
eligible to participate in an exercise maintenance program, also not covered by insurance. Last year there
were 650 office visits for this wellness program.
Diabetes
The Community Diabetes Care Center (CDCC) served more than 1,100 patients with diabetes last year
with more than 7,400 office visits. The program serves clients from more than five counties surrounding
Fresno, seeing patients at two sites: the Community Health Center - Sierra and the Cedar Avenue campus
site. The staff includes five diabetes educators, a health educator and four medical office assistants.
The CDCC cares for a high percentage of patients who would not be able to receive diabetes education in
the community: 70% of the clients are insured by Medi-Cal, managed Medi-Cal Blue Cross, managed
Medi-Cal Health Net or MISP. The CDCC is the only American Diabetes Association (ADA)
Recognized Education Program in Fresno that accepts patients with Medi-Cal or MISP. Medi-Cal does
not reimburse for diabetes education or nutrition education by a Registered Nurse or Dietitian/Certified
Diabetes Educator.
Also, the CDCC is the only high-risk diabetes in pregnancy program in the Valley. Many of the women
only have restricted Medi-Cal during pregnancy with limited visits.
The center staff has trained several RN to BSN nursing students from CSU Fresno and Fresno Pacific
University as well as four dietetic interns from United Health Centers, providing clinical experience in
diabetes and diabetes during pregnancy.
The center staff has provided “Diabetes in Pregnancy” continuing education classes to Community’s
high-risk OB nursing staff, and also a “Diabetes Mellitus Standards of Care” presentation to 100 UCSF-
Fresno Medical Education students, family health and internal medicine Interns, residents and faculty.
Last year, the center staff made presentations at community group meetings, In-Home Support Services,
Community Regional departmental meetings and at cancer centers. The center sponsored health fair
booths at the ADA Diabetes Walk in Fresno, Community Health Benefits Fair, Type 1 Diabetes Program
and AADE educational programs. More than 350 people participated in these events.
Finally, the center provided diabetes education articles for the Community physician’s newsletter and
Valley Response magazine, with these publications having a large distribution in Fresno County.
11
Dialysis
In cooperation with the National Kidney Foundation of Northern California’s Kidney Early Evaluation
Program (KEEP), Clovis Community and other volunteers helped coordinate their fourth annual
screening in Fresno in September 2009. Details:
88 people attended the screening (four did not meet KEEP inclusion criteria and one had
incomplete screening information)
Of the 83 who met the criteria and completed the screening, 11 had Stage 3 Chronic Kidney
Disease (CKD), two had Stage 2 CKD and four had Stage 1 CKD
39 volunteers operated the screening; eight were Community employees, including a Registered
Nurse, a Certified Clinical Hemodialysis Technician, Registered Dietitians, social workers and a
unit clerk.
Stroke
Community Regional also provides a stroke program, which in February 2010, received a Joint
Commission Certificate of Distinction as a Primary Stroke Center. This Gold Seal distinction recognizes
Community Regional for providing the latest medical treatment for stroke patients.
Every 45 seconds, someone in America has a stroke. There are nearly 780,000 total strokes each year. It is
the third leading cause of death and a leading cause of long-term disability. Community Regional treats
about 100 stroke patients a month.
As a certified Primary Stroke Center, when acute stroke patients are brought to the hospital they are seen
within 15 minutes by a Stroke Alert Team that assesses whether the patient meets the requirements to
receive the “clot busting” drug, tissue plasminogen activator, known as t-PA. This drug can eliminate or
decrease the disability caused by an ischemic stroke when given within three hours of onset of symptoms.
Community stroke program outreach this year has included the following events.
A Neuroscience Symposium for medical professionals held at the Radisson Hotel.
The Big Fresno Fair Seniors Day booth which served approximately 500 people.
McLane High School Health Fair.
Dr. Tanya Warwick presentations to San Joaquin Memorial High School, CRMC Fresno
Business Group, ERMC Office Manager Luncheon and Downtown Fresno Rotary Club.
Marjaree Mason Fresno Business Women of the Year Award to Dr. Tanya Warwick, who
was nominated for her dedication to improving stroke care in the San Joaquin Valley.
May Stroke Awareness Month booth on CRMC campus to educate visitors and staff on
signs and symptoms of a stroke.
Media advertisement on television and radio on stroke awareness throughout the months
of May and June.
Act FAST is a consumer educational campaign to understand the warning signs of Stroke and what to do
if you think you are having a stroke. The campaign concept is a version of what the National Stroke
Association provides to hospital staff and other health care organizations in the US to educate about
stroke signs.
Community Regional developed a multimedia campaign that included television, web advertising and a
direct mail piece that was mailed to 30,000 households in our five-county, primary market area
12
(households of individuals that are considered at risk of having a stroke). The direct mail campaign was a
postcard mailer with a removable refrigerator magnet that consumers could reference on a daily basis. All
mediums in the campaign conveyed the same message to Act FAST.
The Act FAST represents the following;
F=Face--ask the person to smile. If one side of the face appears crooked or drooping this person
may be having a stroke.
A=Arms--ask the person to lift both of his or her arms in the air--if he or she has difficulty with
one arm this too might be a sign that this person is having a stroke .
S=Speech--ask the person to speak. If his or her words are slurred or they are unable to speak,
they might be having a stroke.
T=T is for time. If any of the above symptoms are present you must call 911 immediately in order
to make sure that this person reaches the hospital FAST.
Organ Donation
Community is an active participant in the California Transplant Donor Network. Last fiscal year, 100% of
expired patients at Community were referred to the network, From January through August 2010, there
were 64 organ transplants, thanks to the generosity and participation of families, Community and the
network.
13
Special Services
Among other activities, staff of the Community Special Services program:
Volunteered with the Fresno County Department of Public Health as an HIV testing counselor
Served as a member and officer of the Community Planning Working Council
Served as a member of the California Planning Group, helping develop an integrated care and
HIV/AIDS prevention plan for the state of California
Served as former president and current volunteer coordinator of the program’s consumer advisory
board: We C.A.R.E.
Served as a volunteer with All About Care, a Fresno non- profit organization assisting those
afflicted with or affected by HIV/AIDS
Helped organize the local World AIDS Day event
Presented at a “Voices” conference in Washington, D.C., on how to start and run an effective
consumer advisory board
Organized a social event for HIV-positive individuals
Participated in a lesbian, gay, bisexual, transgender awareness event and provided information on
HIV and community resources
Participated in the Quality Management Network Meeting with surrounding counties discussing
HIV issues
Volunteered time with Andrew Jackson Elementary School in Selma working with their first-
grade students and helped with their school events
Participated in the AIDS Alliance for Children, Youth and Families, CHOICES through Johns
Hopkins Medicine, the California STD/HIV Prevention Training Center and the Fresno County
Housing Authority and Continuum of Care, including Housing Opportunities for Persons With
AIDS
Trauma
Trauma program staff members are actively involved with trauma system planning on local, regional and
statewide levels. For example:
Local EMS Agency Trauma Audit Committee: The trauma program medical director is the chair
of the local EMS Agency Regional Trauma Operations Committee. The trauma program director
also attends these monthly meetings and participates on an active basis. Issues addressed include
regional trauma destination criteria, trauma process improvement, and EMS trauma policy and
procedure development.
Regional Trauma Coordinating Committee: The trauma program medical director and trauma
program director are both members of the steering committee for the Central California Regional
Trauma Coordinating Committee. Dr. Jim Davis is chair of the committee, and Lynn Bennink is
treasurer.
American College of Surgeons, Committee on Trauma (ACS COT): The trauma program
medical director is the Northern California COT chairman. He also has taken the rural trauma
course and is moving toward implementation in Community’s region.
The trauma medical director is a member of the State Trauma Advisory Committee representing
the Central California Trauma Coordinating Committee.
Trauma Managers Association of California: The trauma program director is treasurer for the
Trauma Managers Association of California, an organization of all trauma managers, EMS
14
trauma coordinators and California EMS Authority representatives. This organization was
formed to provide a public voice on state trauma issues.
Safe Kids USA: During the reporting year, Community Regional was the lead agency for Safe
Kids Central Valley. Debbie Lemaster, CNS, Injury Prevention Specialist, was the coordinator.
This is a multidisciplinary organization addressing injury prevention for children.
Mentor for a hospital desiring to become a Level III center: The trauma program medical director
and trauma program director have worked closely with a hospital in Community’s region to help
them acquire designation as a Level III trauma center, providing policies, protocols and registry
form. Hospital officials attended Community’s Trauma Operations Committee and Peer Review
Committee, observing processes and issues. This hospital was formally designated as a Level III
trauma center on Feb. 1, 2010.
Local law enforcement involvement: One of Community’s trauma surgeons is a reserve officer
and tactical medic for the Fresno Police Department.
Trauma program staff also participated in a variety of injury prevention activities throughout the year,
including:
A partnership with the Fresno Unified School District, Fresno Police Department, California
Highway Patrol and Safe Kids to do a pedestrian safety seminar for elementary school children.
It was part of a national campaign called “walk this way.”
Participating in “Zoo Boo” at the Fresno Chaffee Zoo for Halloween safety, giving away more
than 1,500 Halloween bags and safety information
Car seat check-up events: 6
Car seat technician courses: 2
Safe Day at the Park at Eaton Park: Education for more than 140 children and parents on
burn/fire prevention, water safety and child passenger safety
Participating in the development of a ladder safety flyer through the California Trauma Managers
Association. This flyer was distributed to various home improvement stores and employees at the
holidays when falls from ladders increase. Dr. Krista Kaups also did a public service
announcement on a local radio station for ladder safety.
Several four-minute segments on KMPH’s “Great Day” television program with topics including
vehicle back-up safety, and child abuse/shaken baby syndrome
Participating with Safe Kids in a helmet safety presentation at a health fair in Mariposa
Holding a motorcycle safety course for all Community employees. This involved lectures and
demonstration of defensive driving by trainers for the Fresno Police Department motorcycle unit.
Participating with Safe Kids in two events at Chukchansi Park focusing on various injury
prevention strategies, drawing more than 500 first graders from Fresno Unified and 500 others.
Participating in an employee safety fair at Table Mountain Rancheria. About 200 people were
given a safety material related to burns, water safety, falls and child passenger safety.
Table Mountain Rancheria Trauma Center and Leon S. Peters Burn Center
The contract with Fresno County requires Community to maintain burn and Level 1 trauma services and
an acute care facility in downtown Fresno. Community Regional operates the Table Mountain Rancheria
Trauma Center and Leon S. Peters Burn Center, the only combined burn and Level 1 trauma center
between Los Angeles and Sacramento. With a service area of 15,000 square miles, the burn center covers
the largest service area of all burn centers in California. It provides a total spectrum of care for both
children and adults who have suffered severe burns, including acute wound care, hyperbaric oxygen
15
therapy, rehabilitation, outpatient services, plastic and reconstructive surgery and comprehensive social
services, including survivor support.
Last year, 2,866 people were admitted to Community Regional for treatment of traumatic injuries. Last
year, 685 people were treated for burn injuries, 175 treated as inpatients. Twenty-nine percent of
inpatients and 38% of outpatients were ages 25 or younger.
Cardiac Response Project
The Community Cardiac Response Project (CCRP) began in the early 1990s with the goal of placing
Automated External Defibrillators (AEDs) in churches, businesses, homes and event centers throughout
the Central Valley. These life-saving machines have been crucial in assisting lay people in performing
successful cardiopulmonary resuscitation (CPR). The program has grown to include providing American
Heart Association CPR classes to employees, organizations, families and high school students.
CCRP has now placed more than 500 AEDs. The Fresno Unified School District has achieved its goal of
placing 72 AEDs on high school, middle school and grammar school campuses. The district is now
training high school students to be on safety teams to assist in school disaster drills.
Mothers Resource Center
The Mothers Resource Center (MRC) continues to offer quality breastfeeding education and support to
new parents. The MRC operates as a one-of-a-kind service and receives referrals from throughout the
Valley and elsewhere.
The center’s lactation team encourages exclusive breastfeeding by initiating breastfeeding as soon as
possible following birth. Additionally, skin-to-skin contact increases rates of bonding and adequate milk
supply.
Additional new services are expected to be offered beginning in early 2011. Joining the existing services
of inpatient bedside lactation support and outpatient private consultations, the MRC now offers
Postpartum Depression Screening using the Edinburgh screening tool. The 3M Club (Mommies Making
Milk) continues to grow with excellent outcomes for both mothers and babies in Community’s Level 3
neonatal intensive care unit. Added to the 3M Club will be “The Mama’s Café,” a breastfeeding care and
support group for mothers. New classes such as Breastfeeding ABC’s, Breastfeeding and Going Back to
Work and Breastfeeding in Special Circumstances continue to provide individualized planning.
The Center for Breastfeeding Medicine focuses on breastfeeding best practices, relying on physicians who
specialize in diagnosis, treatment and management of complex problems.
Additionally, the MRC lactation phone line and seven-days-a-week pager availability make the MRC and
Community Regional a state-of-the-art center for all who need the services.
16
NEED
ADDRESSED &
MATERNAL CHILD DESCRIPTION OF BENEFITED GOAL EVALUATION COMMUNITY
SERVICES BENEFIT/ACTIVITY GROUP ACCOMPLISHED PROCESS PARTNERS
Professionals
teaching specific Expectant Safer and fulfilling
techniques and parents, new parenting Written
PARENT recent parents, etc experience evaluations Babies First
EDUCATION advancements in Taught 1,400 Taught 1,400 following each
CLASSES birthing care family units family units series or class First Five
Increased
breastfeeding
rates
Low 17,408 consults Breastfeeding
breastfeeding states and Babies First
Bedside rates; all Increased data collected
INPATIENT breastfeeding breastfeeding exclusive before First Five
LACTATION education & hands- moms and babies breastfeeding from discharge;
EDUCATION on assistance 17,408 consults 26.7 – 28.5% PI Project Medela, Inc
Babies First
Follow-up First Five
breastfeeding
help to Increased Medela, Inc
OUTPATIENT Breastfeeding encourage new breastfeeding Length of time
LACTATION assistance and mothers rates breastfeeding Parenting
EDUCATION education 548 consults 548 consults increases Concepts
Revenue for
lactation services;
Availability of
Availability of breastfeeding
MOTHER'S breastfeeding products to Increased sales Medela, Inc.
RESOURCE products to mothers and and products Monthly
CENTER STORE community babies available Report Zenoff
Mother-infant
Diagnose, treat & pairs who have Babies First
CENTER FOR manage medical issues
BREASTFEEDING complicated Resolved CCFMG
MEDICINE breastfeeding 162 mother/baby breastfeeding Quarterly
(Physician staffed) problems dyads problems Reports UCSF
Breastfeeding Increased
Support group for kangaroo care.
mothers of NICU Increased milk
Breastfeeding babies supply.
3M CLUB education for Approximately Increased Medela, Inc.
(Mommies Making mothers of NICU 123 mother/baby successful latch Current
Milk) babies dyads before discharge. Trends Report WIC
Workforce and Education
The Paradigm Program, a partnership established in 1999 between Community and four other local health
care organizations, will graduate its final class of RNs in May 2011. Through this partnership,
Community will have added 240 new Registered Nurses to its workforce.
17
Last fiscal year, 57 new graduate RNs completed our RN Residency program. (This program provides
the bridge from student to Registered Nurse and is one of Community’s RN retention strategies.)
Among other activities:
Community is a member of the Partnership for Health Professions Education of the UCSF Fresno
Latino Center for Medical Education and Research (LaCMER), which advances development of
health professionals at the junior high, high school and college levels.
Community’s post-graduate year one (PGY1) pharmacy residency program continues to help
address the shortage of pharmacists in the Central Valley.
o In addition, Community further enhances the academic teaching model to promote
evidence-based pharmacotherapy to our patients. It underwent a re-accreditation site
survey and successfully gained continued accreditation by the American Society of
Health System Pharmacists (ASHP), the national accrediting organization for pharmacy
residency programs. Community is currently the only accredited PGY1 pharmacy
residency program in the Fresno area. Community pharmacists also serve as preceptors to
help develop the residents’ skills, knowledge base, and to mentor them with various
projects that help patient care.
o The program encourages residents to participate in research projects that directly impact
patient care, providing cost savings to Community, or to work on performance
improvements within pharmacy services. Each resident is required to present these
findings at a national conference poster presentation each December, as a final
summation of the project at a regional conference towards the end of the residency year,
as well as a “plan, do, study, act” project that is submitted to a best practices summit.
o A new patient satisfaction initiative is called the “Med Check” Program. Pharmacy
residents help educate patients about side effects of selected medications.
o Of 19 residents who successfully completed the residency program, Community currently
employs seven.
o Community’s residents and clinical pharmacists also precept and mentor University of
California, San Francisco (UCSF) and Thomas J. Long, University of Pacific pharmacy
students.
o Community also affords a lecturing opportunity for the residents, which provides
continuing education credits, in conjunction with the UCSF School of Pharmacy.
o Awards and honors received during the last year by our clinical pharmacists/preceptors:
Marisa Méndez, PharmD, BCPS - UCSF Longs Foundation Award for
Excellence in Teaching 2009-2010
Julius Chang, PharmD, BCPS and Daniel Yousef, PharmD, BCPS - UCSF Apple
for Excellence in Teaching Awards 2009-2010
Daniel Yousef, PharmD, BCPS - UCSF Outstanding Non-Physician Teacher
2009-2010
Volunteer Services
The Community Regional Volunteer Services Office received the 2010 NOLI “Excellence in Career
Technical Education” Award from the Fresno County Office of Education.
Community has developed a strong partnership with the University of California, San Francisco-Fresno
Medical Education Program and the Fresno County Office of Education programs that support high
school- and college-level students from the local communities for students of color in the Valley.
18
Totals achieved by the Community Regional Volunteer Services Department for last fiscal year:
Total number of volunteers: 300
Total number of volunteer hours: 69,494
Total number of (HPS) Health Profession Students (non-nursing students, either on internships or
through a school program ): 436
Total number of HPS hours: 37,200
Among other activities involving Community Regional Volunteer Services:
Developed a program with Sunset Elementary School in Coalinga (special needs children) to send
Community Regional tray favors for patients for eight holidays during the year, delivered by food
service at one meal on the holiday.
Developed a crafts program for mothers in the ante-partum unit, showing them how to knit and/or
spending time reading with them.
Promoted Community’s junior volunteer classification to high school students enrolled in health
career programs. (Many students start volunteering as a school requirement class and then stay
on, working after school and on weekends.)
Recruited volunteers at Fresno City College, CSU Fresno and local churches.
Served as a member of “Hands On Central California,” a Central Valley volunteer agency.
Clovis Community Medical Center’s Volunteer Service Department partners with many schools and
programs, enabling students to receive practical experience in their areas of interest and study. These
include but are not limited to:
Schools Programs
Fresno City College Radiology Techs
Pharmacy Techs
Merced College Sonography
CSUF Dietetics
Social Work
Physical Therapy (students currently in the PT
program needing to observe treatments, as well as,
those needing 50 hours to apply to the PT program)
Institute of Technology Computer network Techs
Pharmacy Tech
San Joaquin Valley College Surgical Tech
Fresno County CalWorks
Fresno County Office of Education Clovis Schools ROP Health Careers
CART
Functional Skills
Work Force Connection Sterile Processing Tech
Other Volunteers
Guild Retired Individuals
High School students from the Clovis/Fresno Area Walk-Ins
Unemployed Folks hoping to be hired
Professionals Needing to feel useful
19
Volunteering does not guarantee employment. However, it is a great opportunity for the volunteer to
observe the department and the department can evaluate the volunteer as a potential employee.
Guild volunteers not only provide hours of service but raise funds for the hospital. Their most recent
accomplishment was purchasing flat-screen televisions for all patient rooms. They also provide handmade
blankets, scarves and hats for dialysis patients. Some members make blankets, booties and hats for our
newborns.
In 2009 we hired 13 volunteers into various departments.
Other Examples of Community’s Service
Fresno Heart & Surgical Hospital
In mid-2006, Community became the sole owner of what is now the Fresno Heart & Surgical Hospital, a
non-profit facility focusing on cardiac, bariatric, minimally invasive and general surgery. Education
programs and outreach efforts provided by Fresno Heart & Surgical last fiscal year included:
September 2009: Central California Women’s Conference, American Heart Association walk
January 2010: Jack Schiff Memorial, Donation to Haiti Relief Efforts, Heart Month Display –
Downtown Health Department
February 2010: Blood Pressure Booth FH&SH Lobby for National Wear Red Day, American
Heart Association Red Dress Luncheon, Make-A-Wish Gala, Camp Taylor Dinner, Camp Taylor
Donation
March 2010: Central California Cardiometabolic Risk Symposium, Daffodil Days
May 2010: American Heart Association Heart Ball, National Transplant Assistant Fund
Donation, Fairwinds Woodward Park National Senior Health and Fitness Day
June 2010: Dr. Birnbaum Heart Demonstration at Clovis West High School
August 2010: Bariatric CME Course, American Red Cross Event
Last year’s support for local non-profits included:
o Donation to sponsor eight foster children for Valley Teen Ranch
o Donation of a flat of goods and medical supplies to Haiti earthquake relief efforts
Various members of management volunteered to serve on local not-for-profit boards and
committees including the American Heart Association, Women’s Initiative, Craig School of
Business Advisory Council, Make-A-Wish Foundation
20
Date Name of Class Presenter Attendance
9/17/2009 Inherited Thyroid Cancer Christine Maser, MD 20
9/23/2009 Beating Heart Surgery Pervaiz Chaudhry, MD 18
9/30/2009 Atrial Fibrillation Kevin Boran, MD N/A
10/7/2009 Sleep Apnea Karl Van Gundy, MD 45
10/15/2009 What is A Hospitalist? Gloria Jiminez, MD 16
10/22/2009 Anesthesia –What People need to know Michael Mellenthin, MD 29
10/28/2009 Reflux Disease Keith Boone, MD 39
11/5/2009 Stomach Cancer Brant Kane, MD 29
11/10/2009 The Latest in Vascular Surgery Randall Stern, MD 44
1/27/2010 On Pump vs. Off Pump Cardiac Surgery Richard Gregory, MD 30
2/18/2010 Women & Heart Disease Michael Gen, MD 82
2/24/2010 Blood Pressure & Stress W. Edward Hanks, MD 92
3/10/2010 Healthy Eating on a Budget Kim Tirapelle, RD 48
3/17/2010 Caring for A Family Member Susana Rodriguez 33
3/24/2010 Keeping Mentally Sharp Rick Adams, Ph.D. 65
3/27/2010 Women & Heart Disease Cyrus Buhari, MD 30
3/31/2010 Congestive Heart Failure Kevin Boran, MD 55
4/14/2010 Colon Cancer Prevention & Treatment William Carveth, MD 50
4/22/2010 Endovascular Treatment for Patients with DVT Paul Speece, MD 26
4/29/2010 What is Minimally Invasive Surgery Kelvin Higa, MD 26
5/25/2010 Cardiac Devices, What are they? Khoi Le, MD 24
8/25/2010 Cardiac Assist Devices Subashini Daniel, MD 34
Clovis Community Medical Center
Clovis Community Medical Center’s community outreach in FY 2009/2010 focused on the importance of
breast health and screening mammograms through its participation in several community events
promoting the Marjorie E. Radin Breast Care Center.
In fall 2009, Clovis Community was a sponsor of the annual Central California Women’s Conference
held at the Fresno Convention Center, which drew 3,000 Valley women. Clovis Community also
participated in the annual Susan G. Komen Breast Cancer Foundation’s Race for the Cure held each year
at CSU Fresno, which draws more than 7,000 men and women from the Valley. The Radin Breast Care
Center sponsored the Tough Enough to Wear Pink event held at the Annual Clovis Rodeo held in April
2010 in support of breast cancer awareness.
Clovis Community offered on-site monthly educational seminars on topics such as fertility, weight-
loss/bariatric surgery and weight-loss related procedures, acid reflux disease and diabetes/obesity.
Promotion of these consumer educational seminars included mediums such as television, print and radio
advertising for program awareness and a call to action to encourage consumers to learn more by attending
an educational seminar at our hospital.
Clovis Community also was a sponsor of the following:
Hinds Hospice Angel Babies Walk
Clovis Mayor’s Breakfast
Annual Clovis Rodeo
Central Valley Children’s Partnership “Lights on Afterschool”
21
Clovis Unified School District Foundation “Doc” Buchanan Golf Tournament and high school
athletics and robotics teams
Healthy Families Day at the Picayune Rancheria of the Chukchansi Indians
California Cancer Center
California Cancer Center provided a free skin screening clinic on May 22, 2010. Dermatologists and
residents as well as physicians and staff from the center volunteered their time as did members of the
local chapter of the American Cancer Society. During the event a total of 103 patients were screened; of
those, 22 were referred to a dermatologist for either a biopsy or further care.
Center staff and physicians participated in American Cancer Society’s Annual 24Hr Relay for Life in
May 2010. The team raised more than $3,000 for cancer society programs. In addition, community
Regional organized a running team that raised more than $2,000.
Stewardship
In fiscal year 2008-2010 despite the continuing economic downturn, Community Medical Foundation’s
donor-investors once again responded generously giving a total of $6.22 million in gifts and in-kind
services on behalf of Community programs and services. Much of the larger gifts went to help finish
construction of Terry’s House, to the Clovis Community Medical Center expansion or to provide a new
outpatient and dental clinic for the disadvantaged and underserved.
Terry’s House, which is nearing completion, is a 17,000-square-foot, two-story home that will lodge
families whose loved ones are receiving critical care across the street at Community Regional. Much of
Terry’s House was constructed with donated materials and labor from several local businesses. Members
of the carpenters union volunteered more than 200 hours on weekends or days off to pour concrete, frame
walls, construct the roof, encapsulate the building and finalize the interior finishes. One anonymous
donor generously gave $750,000 to help finish Terry’s House. And Tom Richards, CEO of Penstar
Group, and the Leon S. Peters Foundation each gave $500,000 towards construction.
Physicians also gave to Terry’s House knowing how important it is for their patients’ healing. Omni
Anesthesia Associates and Central California Faculty Medical Group each pledged $100,000 to Terry’s
House. Fresno County Federal Credit Union gave $50,000, and Union Bank of California gave $60,000 to
Terry’s House. Longtime Fresno auto dealer Lou Herwaldt and his wife contributed $50,000.
The largest gift in fiscal year 2010 came from the Radin Foundation, which pledged $1 million to the
Clovis emergency department construction. Upon completion of the $300 million expansion project in
fall 2013, Clovis Community will be the first comprehensive, full-service hospital in the region to have
all private rooms, nearly tripling in size to 739,000 square feet. The expansion calls for a new, five-story
bed tower, a dedicated women’s pavilion, a special care nursery and a new parking garage. The
emergency department also will be expanded to accommodate a projected 50,000 patient visits annually.
Knowing firsthand the need for the expansion, doctor groups have made large contributions to the Clovis
construction project. Community Medical Providers (a primary care physicians group), Community
Hospitalists Medical Group and Community Anesthesia Providers each pledged $100,000, while Eye Q
Vision Care gave $50,000.
22
Dr. Stanley Surabian and his wife Cheryl Surabian provided $500,000 to help create the Surabian Dental
Clinic in the new Deran Koligian Ambulatory Care Center. Their gift helped provide state-of-the art
equipment and new computers for dental residents.
Located on the Community Regional campus on the southwest corner of McKenzie Avenue and Herwaldt
Drive, the 79,534-square-foot Deran Koligian Ambulatory Care Center opened in March 2010. Services
that moved from the former University Medical Center campus included children’s health, family health,
adult health, internal medicine, women’s health, eye care (ophthalmology), oralmaxillofacial surgery,
special services (HIV/AIDS), pharmacy, and the MISP eligibility services. The ambulatory care building
features 104 exam rooms, an X-ray room and three lab drawing stations.
Other examples of last year’s generosity include:
$100,000 from the California HealthCare Foundation to produce educational Spanish- and
English-language videos for patients and their families about cardiovascular procedures and
to assist Community Behavioral Health Center with its outreach efforts.
$220,000 from Pete P. Peters to build a fitness center for medical staff on the Community
Regional campus.
$50,000 from Fresno State Football Coach Pat Hill and his wife to start the Dan Brown
Legacy Fund to benefit the Central California Neuroscience Institute on the Community
Regional campus. Hill also has acted as ambassador to ask other football alumni for help.
Former Fresno State football player Brian Panish, partner in Panish Shea & Boyle law firm,
made a $50,000 donation to the legacy fund honoring the former assistant football coach who
died of a brain tumor.
Political and Other Advocacy
Community’s leadership team continues to provide campus tours, participate in forums and provide issues
briefings involving local, state and federal elected and appointed officials.
Members of the leadership team also traveled to Sacramento and Washington, D.C., to advocate for the
Valley’s health needs. Community is a member of the Maddy Associates program at California State
University, Fresno, which fosters civic engagement, leadership training and policy analysis in the Valley.
Community senior staffers also have participated in the Central Valley Health Policy Institute’s yearlong
leadership program at CSU Fresno.
Community also advocated for the Valley’s health needs through its membership in the California
Hospital Association, Private Essential Access Community Hospitals Inc., the Fresno Economic
Development Corporation and the Fresno and Clovis chambers of commerce. Community has been a
leading public advocate for efforts by the University of California, Merced, to establish a Valley medical
school.
Community also continues to provide strategic leadership via the Fresno Healthy Communities Access
Partners, a nonprofit organization consisting of 11 health and community organizations working together
to improve access to health care for medically underserved communities in Fresno and the Valley.
23
Community is proud of its accomplishments to date, but also mindful of unmet challenges. Community
staff and physicians also contribute thousands of hours as volunteers for civic, cultural, social justice and
health groups, often serving in leadership positions.
These organizations and activities include: California Rural Health Association, California Health Care
Leaders Association, Coalition for Responsible Health Policy, California Alumni Association, National
Association of Community Health Centers, American Society of Health-System Pharmacists, California
Society of Health-System Pharmacists, Sierra Society of Health-System Pharmacists, Leadership Fresno,
the Poverello House, Fresno Rescue Mission, Boy Scouts of America, Rotary Club of Fresno, Fig Garden
Rotary, Central Valley Prison Ministry, Central Valley March of Dimes, Fresno County Child Abuse
Prevention Committee, Perinatal Mental Health Collaborative, Central Valley chapter of the Association
of Women's Health, Obstetric and Neonatal Nurses, United Way of Fresno County, Central Valley Safe
Kids, Trauma Managers of California, Society of Trauma Nurses, Emergency Nurses Association, Camp
Sunshine Dreams, Experimental Aircraft Association Young Eagles, Volunteer Air Squadron, and Earth
Day community clean-up project,
Among other things, Community has:
Provided $25,000 for Fresno First Steps Home, a nonprofit program sponsored by the City of
Fresno, in partnership with public and private agencies, designed to provide safe, stable housing
for the homeless.
Provided $15,000 to help develop the Clinical Pastoral Education Program of Central California,
a partnership of Valley hospitals and religious groups that envisions providing local classroom
and supervised hospital training to increase the numbers of certificated chaplains in the area.
Community also purchased culturally appropriate chaplaincy training manuals from Stanford
University to help meet the diverse spiritual needs of its patients.
Provided $15,000 financial support to the Central Fresno Weed and Seed program, a
public/private partnership to "weed" out crime and drug trafficking in neighborhoods near
Community Regional, and then to "seed" that area with programs for youth, families, and seniors.
Provided financial and volunteer support to All About Care, a non-profit interdenominational
ministry that gives practical, emotional and charitable support to those with HIV/AIDS and their
families, for its Camp Care, a summer gathering for families affected by HIV/AIDS.
Provided financial support to Court Appointed Special Advocates for Children.
Provided financial and advertising support to the West Fresno Health Care Coalition, a nonprofit
group dedicated to the health and well-being of those living in West Fresno.
Provided $2,500 to benefit the Fresno Rescue Mission and the Police Officer’s Chaplaincy of
Fresno County.
Donated, through its Pathology Group, 400 to 500 textbooks on such topics as anatomy,
physiology, chemistry, pathology and lab practices to American Medical Overseas Relief
(AMOR) for a hospital being constructed in Afghanistan.
Media Outreach
Besides working actively with local media to bring important health and medical news to the public,
Community continues to produce its health care advocacy web site www.medwatchtoday.com , which
saw more than 7,600 visitors a month last year and gets e-mail feedback from regular readers from as far
away as North Carolina and even China. The site, launched in 2007, is updated regularly with health
news, videos, feature stories and leadership blogs. It also offers access to a medical library and other
24
resources designed specifically for residents of central California. More than 120 health-related stories
and 65 health-related videos were produced and posted on the site during the past year.
Additionally, Community was the focus of all filming for “Healthcare Heroes,” a nationally syndicated
reality TV show that reached 80% of the U.S. television market, including nine of the 10 largest markets
– reaching nearly 90 million households. In the Fresno area, the show began airing in September 2009 on
ABC 30. Each half-hour episode highlighted Community’s physicians, staff and services through
individual patient stories. Show topics ranged from the birth of twins to awake brain surgery, knee
replacement surgery and a day-in-the-life of Community’s Oakhurst urgent care center.
Episodes of the award-winning, locally produced “MedWatch” television show, which was phased out in
September 2009, continued to be televised twice weekly on KNXT, the local Roman Catholic station.
Here is a sampling of other noteworthy efforts as published on www.medwatchtoday.com:
A woman of ultimate generosity
Sherri Evert has poured her heart into Clovis health care from her
earliest memories. At the age of 10 she began her philanthropic
endeavors by selling home-made lemonade with her best friend at
Cole and 3rd streets in Clovis. Together they donated their profit to
the building fund for the soon-to-be Clovis Hospital built on Dewitt
and Sierra avenues.
Community Medical Foundation is honoring her long and passionate
years of service to the hospital by naming her one of Community‘s
2010 Ultimate People.
There was no looking back after she finished that project and
moved on to later join Community‘s Hospital Guild in 1975 where she served as president
multiple times. During those years, Evert led the Guild in many support and fundraising
endeavors. When the hospital moved to its new site on Herndon, she was integral in giving tours
of the hospital while it was being built and participated in designing the interior of the building -
selecting tiles, fabrics and carpet for the now-Clovis Community Medical Center.
Evert is an expert event planner and says it is her passion and forte. She volunteers through the
Guild planning their annual Installation Luncheon. She also spreads her holiday spirit every year
by decorating the holiday trees in the hospital lobby, cafeteria and Outpatient Care Center.
Of course, her favorite lunch spot in all of Clovis is the Evert Bistro, named in honor of her family
and located in the hospital‘s Outpatient Care Center. The bistro serves gourmet sandwiches,
wraps and salads for hospital visitors and staff.
Sherri and her husband Paul, also have opened their home to many philanthropic events for
Community and other worthy organizations in the Valley.
―The Everts have always been very generous in sharing their home with Community‘s Foundation
for fundraising and in hosting luncheons for the Guild members,‖ said Paulla Sebra, Manager of
Volunteer Services.
25
Her giving goes above and beyond. In addition to her hospital commitments, Evert is a member
of the Clovis Rodeo Association where she sits on the Rodeo Queen Committee as sponsorship
chairperson, helps make tri-tip sandwiches at the rodeo, works in the VIP Pavilion, helps set up
for whatever is needed and works at the Annual Clovis Kiwanis Rodeo Golf Tournament – where
proceeds benefit Community‘s Guild. She also volunteers at Bible Study Fellowship every
Wednesday morning and co-teaches the Good News Club at Bud Rank Elementary for twelve
weeks each autumn and spring.
―I truly love life, maybe because of my faith, my lovely family and great friends,‖ Evert said. ―It
brings me such inner peace and joy to share time, treasure and talent with others.‖
Evert has completed more than 2,000 hours in volunteer work and is always willing to offer her
time and energy. Today, she is the current ways and means chairperson for the Guild. Someday,
Evert hopes volunteering in the hospital‘s gift shop will make it on her list of things to do.
She acknowledges the many blessings that volunteering has brought to her life.
―I have volunteered for so many years I cannot say it impacts my life - it enriches my life,‖ she
said. ―It gives me great joy to be available to give back to my community and it is part of the
Clovis way of life!‖
California HealthCare Foundation pledge will
boost patient education and outreach
Patients and their families at Community Regional Medical Center and Community Behavioral
Health Center will benefit thanks to a $100,000 pledge from the California HealthCare
Foundation.
This is a two-year pledge that will enhance patient education in cardiovascular services at
Community Regional and assist the Behavioral Health Center with its outreach efforts.
―This is an opportunity that we‘re blessed with because of the leadership of Ralph Garcia,‖ said
Rob Saroyan, vice president, Community Medical Foundation.
Garcia is a Community board member who also serves on the board of the California HealthCare
Foundation. Saroyan said he has been instrumental in bringing pledges like these to help
Community and the underserved.
―I want to keep those dollars in the safety nets that are
serving most of the people,‖ Garcia said.
A portion of the funds will be used to produce educational
videos for patients and their families about how to
prepare and what to expect during and after
cardiovascular treatment and procedures. Phyllis Baltz,
chief operating officer at Community Regional said these
videos will be produced in English and in Spanish.
According to Baltz, about 30% of the hospital population
speaks Spanish.
26
―We will be able to provide better service to patients and their families through this enhanced
education,‖ Baltz said.
Outreach efforts at the Behavioral Health Center also will be bolstered by the pledge.
―We feel so grateful to the California HealthCare Foundation,‖ said Dawan Haubursin, chief
executive officer of the Behavioral Health Center. ―Decreased resources throughout the county
and state make it more important than ever to help meet the needs of the underserved in our
community.‖
The California HealthCare Foundation is an independent philanthropy committed to improving the
way health care is delivered and financed in California.
Legacy of late Fresno State football coach to
benefit new Neuroscience Institute
Fresno State‘s head football coach Pat Hill announced a fund to honor the memory of his
longtime friend and coaching colleague Dan Brown who died of brain cancer. The Dan Brown
Legacy Fund supports the Central California Neuroscience Institute at Community Regional
Medical Center.
Brown‘s family and former football players were on hand July 29 at Community Regional to hear
Coach Hill urge others to help in building the new program. ―We have an opportunity to save
some lives here in Fresno,‖ Hill said. ―You don‘t have to go elsewhere. I‘ve said for my 14 years
here that we don‘t have to take a backseat to anybody and this hospital is once again proving it.‖
Hill, who had known Brown more than four decades and coached with him at Fresno State for 12
years, said he watched his friend struggle with a brain tumor for two years, driving back and
forth to San Francisco for treatment while he continued to coach the Bulldogs team.
Brown‘s daughter Tara Mackey said she
hopes Hill‘s generous gift to the fund and
others‘ donations will help other families
avoid the stress her family went through.
―He went through such a hard time, and for
others not to have to travel out of the
Valley is huge,‖ she said. ―Because I
remember the times my parents would
have to travel back and forth to San
Francisco three or four times a month.‖
―This is not just another program,‖ said
Phyllis Baltz, the hospital‘s chief operating
officer. ―We now have physicians of a
higher caliber than ever before in our
Valley. Patients who once had to travel far
from home, family and friends for specialty
Tara Mackey (far left), Travis Brown and Jordan Brown help honor
their father former Fresno State football coach Dan Brown. A medical consultation or to receive care
legacy fund honoring the late Brown will go towards the new can now stay right here at home. They get
Central California Neuroscience Institute at Community Regional the exceptional, leading-edge treatment
Medical Center.
that you previously would have found only
in large urban cities.‖
27
Brown‘s son Travis said he‘s been impressed by what he‘s seen at the hospital. ―It‘s a great
program. I know my dad would be so proud.‖ Jordan Brown, added to his brother‘s sentiments,
―To know that someone as great as my dad could start off all this is an honor. This program is
going to be right here in Fresno for everyone who needs it.‖
Hill said he didn‘t hesitate when he was approached by Vincent Ricchiuti to help build a legacy to
honor Brown and help others with neurological diseases and injuries. Ricchiuti helped form a
group of young professionals last March called Encore to help Community Medical Centers'
foundation raise funds. The group is already halfway to its goal of raising $250,000 by the end
of this year‘s football season.
―Danny Brown was not only a special person and a special coach, he touched so many people‘s
lives,‖ Hill said.
Brown died in March 2009 at the age of 50. He had been a member of the Fresno State coaching
staff for 12 seasons, the last seven as defensive coordinator. He left behind his wife Mindy, six
children and four grandchildren.
For more information or to make a gift to the Central California Neuroscience Institute visit
http://www.danbrownlegacyfund.com/ or call (559) 459-2670.
Cardiac staff brings lessons to students
Cardiac surgeon Peter Birnbaum hopes to spark an interest in medicine with hands on
experience, letting students poke and prod a real heart. For the past few years he‘s
brought in his staff from Fresno Heart & Surgical Hospital and several fresh cow hearts to Clovis
West High School in Fresno to give anatomy lessons.
Clovis West biology teacher Rebecca Avants says such classroom experience is doing the trick
because many of her students go on to college and major in biology. She said real world lessons
such as these engage students and help translate what they learn in books and lectures into
something more concrete. Students said after they got over how ―squishy‖ the fresh heart
muscle felt they really enjoyed the experience and could visualize much better how blood moved
through the heart.
Michael Fridman, a Canadian pre-med student who is spending the summer shadowing Dr.
Birnbaum, fired questions at students during a June 4 heart anatomy lesson. ―So if a muscle
works more would you expect it be hard or soft? If the ventricle works harder, which side would
that be? So which artery feeds blood into the heart?‖ Students were quick to shout out answers
as they crowded in closer to get a better look the
cow heart in his hand.
Dr. Birnbaum, president of the medical staff at
Fresno Heart & Surgical, also brought another
doctor, his surgical nurse and his perfusionist who
runs the heart-lung machine during open heart
surgeries. All of them talked about the academic
path they took to their careers and what studies in
high school helped to get them into their chosen
field of medicine. Dr. Birnbaum said it‘s important
for students to see how many different jobs there
are in health care.
28
Fresno Heart & Surgical is a 48-bed hospital providing cardiac services and specializing in heart
surgery, weight-loss and minimally-invasive surgery. It‘s top rated by HealthGrades for bariatric
surgery, carotid surgery and treatment of heart attacks and has been honored for the past three
years with HealthGrades‘ Outstanding Patient Care Award.
Football great gives
Fresno Heart high
marks
Daryle Lamonica, quarterback for the Oakland
Raiders during the late 60s and early 70s, knows
the value of a great team. And he‘s grateful for the
top-notch team at Fresno Heart & Surgical Hospital
who took care of him when he had quadruple heart
bypass surgery in mid-May.
―I didn‘t realize at the time how fortunate I was to
have the team my cardiologist Dr. (Donald)
Gregory put together,‖ said Lamonica while
recuperating at his Fresno home. ―The entire staff
at the hospital has the same positive attitude he
does. The hospital was so clean and so efficient. I felt so comfortable.‖
For the third year in a row Fresno Heart & Surgical has earned HealthGrades‘ Outstanding
Patient Experience Award, putting it among the top five hospitals in California and the top 5% in
the nation. This year‘s award is based on an analysis of patient surveys from 3,775 hospitals
across the country by HealthGrades, the leading independent healthcare ratings organization.
Mary Lamonica seconded her husband‘s assessment of his surgery experience: ―I think the
hospital is fabulous. We thought the help in the waiting room was just delightful. The intensive
care nurses were just wonderful. The surgeon was an absolute doll. And it was nice having a
private room.‖
But best of all, Mary Lamonica said, is the former NFL player‘s quick recuperation. He was
cleared to drive again just two weeks and three days after his open heart surgery to repair
blocked arteries. Daryle Lamonica credited being an athlete for his recovery, ―I‘ve
29
always stayed very, very fit and I have a great love of the
outdoors. My heart problem was hereditary.‖
Lamonica grew up locally, graduated from Clovis High
School and turned down a professional baseball contract
with the Chicago Cubs to play football with the University
of Notre Dame. And although he was drafted to the
Buffalo Bills and played four seasons for them, he made
his mark as the Oakland Raiders quarterback. It was with
the Raiders that his explosive throw earned him the name
―The Mad Bomber‖ from Monday Night Football
commentator Howard Cosell.
Lamonica shares a photo with visitors in his home that
shows his most memorable football moment. ―This was
during the famous ‗Heidi Bowl‘ when the TV networks took
our game against the New York Jets off the air in the last
two minutes to show the movie ―Heidi.‖ I think the whole
telephone grid shut down with people trying to call the
Daryle Lamonica, number 3, played stations over that.‖
quarterback during the 1970s for the Oakland
Raiders.
He continued, ―The Jets were ahead of us by three points
and I threw a long one to Charlie Smith for a TD. We kicked off, they fumbled the ball, then we
recovered the ball in the end zone. We scored 14 points in about 9 seconds. That one pass I
threw changed how the networks do things. They cannot take the NFL game off today until it‘s
done.‖
TV audiences missed Oakland scoring
twice to take the game from a 32-29
lead by the Jets to a 43-32 win by the
Raiders – all in the last few seconds of
the clock.
Lamonica said although he was under
the care of a cardiologist he wasn‘t
expecting to need surgery. ―Talk
about a shock to the system,‖ he said.
―I was motoring right along thinking I
was fine. I was out turkey hunting
with my grandson and I felt this big
weight on my chest and I thought ‗Uh-
oh! That‘s not good.‘ I called Dr.
Gregory.‖
Dr. Gregory scheduled an angiogram
to look for blocked arteries the next Lamonica's famous long pass in the "Heidi Bowl" game against the New
day and assembled a surgery team, York Jets helped the Raiders win the game in the last 9 seconds and
including cardiac surgeon Dr. Peter forever changed the way network TV broadcasts football.
Birnbaum, in case it was needed. ―I was going on Dr. Gregory‘s opinion,‖ Lamonica said, ―but I
had asked around when I was having problems about where to go. I called around to people and
without a doubt 100%, people said if you need anything, Fresno Heart is where you need to go.‖
Patients answering a national, standardized survey after their discharge felt the same way. They
gave top marks to the hospital on physician and nurse communication, hospital staff
30
responsiveness, hospital cleanliness and noise levels, medication information, and post-discharge
care instructions. Under a program administered by the Centers for Medicare and Medicaid
Services surveys are sent to patients 48 hours after their discharge. This Hospital Consumer
Assessment of Healthcare Providers and Systems survey, or HCAHPS survey, is publicly reported
and was used to make the HealthGrades rankings.
―We‘re honored to have patients validate the top-notch care and service we strive to provide
every day,‖ said Wanda Holderman, the hospital‘s chief executive officer. ―This award recognizes
our staff‘s focus on patients, from providing quality care and top surgical technology to serving
restaurant-quality meals in private hotel-like patient suites.‖
HealthGrades vice president, Dr. Rick May said, ―There is a select group of hospitals that have
made a top-to-bottom commitment to providing their patients with an outstanding patient
experience as part of their overall commitment to quality. Members of their community should
take pride in knowing that, should they need it, there‘s a hospital in their area that puts patients
first.‖
EDC breakfast builds excitement for Clovis
hospital expansion
The massive expansion of Clovis Community Medical Center is just what the local
economy and the development of the city needs, said business people, politicians and
economic development officials at a June 2 breakfast meeting.
Hospital CEO Craig Castro presented details of the expansion at the Economic Development
Corporation‘s Business Expansion and Retention or BEAR breakfast. And Clovis city officials
unveiled plans to develop a large area just west of the hospital across Temperance Avenue as a
retail and medical offices park that would complement the hospital‘s expansion.
EDC President and CEO Steve Geil called it a ―bold move‖ to finance bonds during the current
economy, adding, ―What a great vision to prepare now for increasing demands.‖
Clovis Mayor Pro Tem Jose Flores said, ―The health care industry is very robust in Fresno County
and Community Medical Centers will make it that much stronger – in the short term in the form
of construction jobs and once completed it will provide hundreds of good-paying health care
jobs.‖ Flores added that he hopes his family members just graduating from nursing school will be
among those hired.
Upon completion of the $285 million project in fall 2013, Clovis Community will be the first
comprehensive, full-service hospital in the region to have all private rooms, nearly tripling in size
to 739,000 square feet. The expansion calls for a new, five-story bed tower, a dedicated
women‘s pavilion, a special care nursery and a new parking garage. The emergency department
also will be expanded to accommodate a projected 50,000 patient visits annually.
Castro said Clovis Community, built to deliver 100 babies a month is now delivering the
equivalent of a kindergarten class every day. And with the completion of the outpatient surgery
expansion in fall 2009, the hospital is doing about 1,000 surgeries a month – almost as many as
the downtown Community Regional Medical Center which has seven times as many beds.
The new construction, he said, will strengthen the hospital‘s mission as a true community
hospital by doubling the number of private rooms and providing space to deliver twice as many
31
babies, having the latest minimally-invasive surgery and endoscopy technology for elective and
diagnostic procedures and greatly expanding the emergency room.
Excitement and support for Clovis Community‘s expansion project is building as the triangular,
five-story bed tower begins to take shape. This past month, two local businesses with broad
connections in the community stepped forward with gifts towards the construction. Although
$210 million of it is being financed by bonds, Castro explained, the rest will come from operating
expenses and philanthropy.
Dan Doyle, president and CEO of Central Valley Community Bank,
encouraged the bank to match the contribution he and his wife Pauline
made. It was an easy pitch, he said. ―Thirty years ago we started as Clovis
Community Bank and we have deep roots in this community. A couple of
our founding directors were very involved in building the original Clovis
Community Hospital way out in the orange groves … We have a history of
A rendering shows the not only giving our resources but our time to our community.‖
new five-story bed tower.
Doyle, a member of the Clovis Community Development Council, acts as community liaison and
ambassador for the hospital expansion. ―It‘s a privilege to work with the hospital and do some
missionary work out in the community, indentifying philanthropic opportunities ...There‘s a great
mission here and it‘s going to be a great asset to our community.‖
Scott Bridgeman, CEO of Eye-Q Vision Care, says the company‘s gift to the Clovis expansion fits
with the company‘s philosophy of giving back to the community where their doctors live. He sees
Community Medical Centers‘ mission and Eye-Q‘s as similar – to improve the region‘s health. He
said donating is part of Eye-Q‘s culture and should be part of other businesses.
―The trick is you have to do it on a regular basis and if everyone in the Fresno area gave just a
little bit, we could accomplish so much,‖ Bridgeman said.
Private support from corporate donors, individuals, physicians, employees and others is being
sought by Community Medical Foundation to help fund the Clovis Community expansion. To find
out more about the Clovis hospital expansion campaign, call Community Medical Foundation at
(559) 459-2670.
Dr. Higa teaches surgery internationally
Increasingly, countries with government-run health care or a more socialized medical
system are recognizing bariatric surgery as a cost-effective treatment that improves
lives and longevity, said Dr. Kelvin Higa, director of Fresno Heart & Surgical Hospital‘s bariatric
program and a frequent lecturer internationally.
―For many countries, bariatric surgery is seen for what it is, the most effective treatment for
patients with diseases of morbid obesity,‖ explained Dr. Higa, a UCSF clinical professor of
surgery and past president of the American Society for Metabolic and Bariatric Surgery.
He recently flew to Taiwan to lecture and demonstrate to doctors the latest in weight-loss
surgery techniques. And in mid-April, when the Iceland volcano‘s eruption grounded airplanes
and kept him from a bariatric conference in Switzerland, Dr. Higa lectured remotely via Fresno
Heart & Surgical‘s teleconference center.
32
―Many countries find it more cost effective to treat diabetes with surgery,‖ Dr Higa explained.
―Take away all the emotional, pre-conceived ideas and prejudice regarding obesity and what
you‘re left with is a growing number of patients who do not have access to the most effective
treatment for type 2 diabetes – surgery. This has been proven through randomized, controlled
studies.‖
More and more physicians are making the same
assertions about a cure for diabetes. At the recent
International Diabetes Surgery Task Force summit
in Italy, attendees issued a consensus statement
pronouncing bariatric surgery to be a ―legitimate
approach‖ for diabetes treatment. Dr. Higa, who
participated in this summit, said research
supports a much more positive position. ―Even the
best medical practices cannot match the results
we obtain with surgery.‖
Dr. Higa was one of a handful of American
surgeons invited in spring 2007 to an international
conference in Rome to take a closer look at
hormonal changes and what‘s happening on a
cellular level when parts of the intestine are
removed.
Dr. Kelvin Higa is using Fresno Heart & Surgical Hospital's
high-tech operating rooms to teach surgeons worldwide.
Obesity and diabetes are worldwide epidemics.
Even in Asia and India, where malnutrition was once an issue, obesity is now a bigger health
problem. Dr. Higa explained that metabolic issues develop in much lower BMI (body mass index)
in Asians than in Americans or Europeans, so surgical treatment is offered to much lighter
individuals.
―This underscores the importance of not just relying on height and weight ratios in determining
eligibility for surgical treatment. We must also consider ethnic and cultural issues – treat the
patient, not just the numbers,‖ Dr. Higa said.
When possible, Dr. Higa prefers teaching from the operating room as he‘s doing surgery. Fresno
Heart & Surgical‘s two new minimally invasive surgical suites are set up for exactly that. Each
suite features state-of-the-art, high-definition plasma screens and the capability of transmitting
live video images worldwide from cameras inside the overhead lights and handheld wands
inserted into the body. The technology also allows Fresno Heart & Surgical surgeons to interact
with other surgeons and operating rooms, obtaining and providing consultations in real time.
Because of Dr. Higa‘s expertise and experience, and the state-of-the-art capabilities of the
Fresno Heart & Surgical Hospital, Fresno has become known as an important center for the
education and training of surgeons throughout the world.
Train horns quiet near Community
Regional
It‘s not what you hear – it‘s what you don‘t hear any longer near the railroad
tracks by Community Regional Medical Center. Thanks to a partnership
between Community Regional Medical Center, the City of Fresno, Burlington
33
Northern Santa Fe Railroad and others, the train horns have ceased while safety has improved
near the track crossings.
The $1.2 million Railroad Quiet Zone project silenced train horns along the Burlington Northern
Santa Fe Railroad from Ventura Street to Hammond Avenue. It was completed on April 23, and
the first two weeks of implementation have proven to be successful, said City of Fresno public
works director Patrick Wiemiller.
The project, in development since 2006, was completed ahead of the original fall 2011
completion date as a result of Community Regional‘s donation of $245,000 and its interest-free
loan of $600,000 to the city. This is an investment Community officials said they were compelled
to make to not only improve the quality of care and aesthetics, but to give the neighborhood an
added measure of safety.
This is the first area in Fresno to be designated as a Railroad Quiet Zone.
The city suggests that citizens traveling in these areas can help keep the train horns silenced by
following a few simple guidelines:
Cross tracks only at designated pedestrian or roadway crossings. These are the only legal
and safe places to cross.
Flashing red lights signal that a train is approaching from either direction. Flashing red
lights must be treated like a stop sign. Pedestrians can be fined for failure to obey these
signals.
Observe and obey all warning signs and signals.
Do not cross the tracks immediately after a train passes. A second train might be blocked
by the first. Wait until the lights have stopped flashing.
Never walk down a train track; it's illegal and it's dangerous.
Community Regional chief operating officer Phyllis Baltz said at a news conference on May 7, that
pedestrians, motorists, homeowners, Community Regional patients, visitors and staff have all
benefitted from this project.
―Once again, thanks to everyone involved in this collaborative partnership and for giving us this
win-win situation,‖ Baltz said.
34
Nurse recognized
for work in Haiti
and Valley
A Haitian mother pushed her little girl
into Julie Bowen‘s arms as she was
leaving her 10-day stint as a volunteer
in a Haiti hospital. The mother asked
through a translator that Bowen take
3-year-old Sophie home with her,
believing Sophie could have a better
life in the United States because of the
conditions after the devastating Haiti
earthquake that killed more than
100,000 people in January.
―She, her mother and her grandmother
live in a tent,‖ Bowen said. ―I believe
her father was killed in the
earthquake.‖
Community Regional Medical Center pediatric nurse Julie Bowen shows
Sophie came to the Haiti hospital to photos of Sophie, a 3-year-old patient she met while volunteering in
have surgery on her club feet. Bowen, Haiti.
a pediatric nurse supervisor for Community Regional Medical Center who‘s passionate about
caring for children, formed a bond with Sophie while volunteering.
―Before surgery I was taking care of her, playing with her,‖ Bowen said. ―She was a very happy,
loving, beautiful child. She would come running up to me and wrap her arms around my knees.‖
Bowen told Sophie‘s mother she could tell she loved her and ―that love would help her get
through the tough times.‖
―[Bowen] told me she had tears in her eyes and pressed money into Sophie‘s mothers hands to
help support her and her daughter,‖ said registered nurse Lynn Emas, director for women and
children's services at Community Regional.
Bowen said finding supplies in the Haiti hospital was like going on an ―Easter egg hunt‖ and
conditions in the hospital were hot, humid and bug infested. She oversaw the pre-op room with
eight cots, intensive care unit post-op with eight cots and hallway with four to six cots.
―Clean, but not Community Regional standards clean,‖ Bowen said. ―Sharps, bio-hazardous
waste and trash all went to the same place. It was me and another nurse who was Haitian, who
usually spoke Creole, and we did have a couple of translators.‖
As a pediatric nurse, Bowen has worked with children for more than 19 years and has been with
Community for more than five. Her mother and two sisters also are nurses. While most people
use their vacation time to rest and travel, Bowen uses hers to take care of children here in the
Valley and now around the world. Haiti was the first stamp in her passport.
35
―It was rough before the earthquake,‖ Bowen said. ―The people
of Haiti are resilient, but were so grateful that we came to their
country.‖
Some of the notes to Bowen from Haiti said: ―Thank you for
your compassion and love,‖ and, ―I am sorry I have nothing to
give you.‖
―She advocates for those little ones who do not have a voice for
themselves,‖ Emas said.
Emas and her colleagues at Community Regional nominated
Bowen for the First 5 Fresno County ―Hands-On‖ Hero award
and she was selected out of seven other Valley health care
nominees.
―Julie's nomination was very compelling and her constant Julie Bowen arrives with a special toy
dedication to young children is a great benefit to our delivery for some of her Community
Regional Medical Center patients.
community,‖ said Elizabeth Campos, First 5 communications
specialist.
Besides working in pediatrics at Community Regional and dedicating her time to help children in
third-world countries, Bowen has another passion called Camp Sunshine Dreams, a camp for
children with cancer. She dedicates a week every August at Huntington Lake to serve as the
camp nurse.
She still finds time to fundraise, organize events, wash sleeping bags and shop for supplies.
―I‘ve always been passionate about kids and to be in a job that allows me to work with kids and
make a difference in their lives is truly rewarding,‖ Bowen said. ―I think I am more blessed by
them than they are by me.‖
To Bowen, the more children she can impact, the better.
―I don‘t consider myself a hero, I just want to look back on my life years from now and know
that I mattered to people both at a world-class hospital and in a third-world country.‖
1st Valley use for smallest heart pump
Tim Volk, a 51-year-old ex-Marine and nuclear engineer, was facing the prospect of a
risky third open heart surgery after blockages were again found in arteries leading to
his heart. But cardiologist Bipin Joshi offered him another choice with a new technology – the
―Impella‖ or world‘s smallest heart pump.
The tiny device – used for the first time in the Valley on Volk at Community Regional Medical
Center – acts the opposite of a boat‘s propeller. It‘s slightly smaller in diameter than a No. 2
pencil, about a third as long and is inserted into the heart via catheter from an incision in the
groin. Once in the heart, the Impella pulls blood out of the heart‘s chambers, propelling blood to
the rest of the body. It can stay in after surgery to help patients recover.
36
―The Impella provides an assist during risky procedures,‖ explained Dr. Joshi. ―Without this the
heart might stop or it might not be able to pump well enough and that would be a disastrous
situation. This gives us the time and support to do what we need to fix his heart.‖
After studying the Impella‘s technology and reviewing his options, Volk said he was more than
willing to be the first patient in the Fresno region to try it. ―This technology is so amazing,‖ he
said, ―that I called several friends and told them they needed to invest in this company.‖
Volk‘s had several heart attacks, two
surgeries to do multiple bypasses of blocked
arteries and stents put in other blocked
arteries. And still, just months after his last
surgery, he was experiencing chest pain and
shortness of breath. ―He‘s a very smart guy
and he takes his medications well. He just
has genetics we don‘t understand,‖ said Dr.
Joshi.
For the historic first Impella implantation,
two cardiologists, three cardiology residents,
four cardiac technicians, and four cardiac
intensive care nurses gathered in
Community Regional‘s cath lab to watch and
assist. The world‘s smallest heart pump
went in easily and took just a small
adjustment to get pulled into the optimum
TV cameras were rolling to capture the world's smallest heart spot for pumping blood.
pump being inserted into a Valley patient for the first time.
The academic regional medical center partners with top medical school UC San Francisco to train
200 resident physicians annually in the Fresno Medical Education Program. Nearly a third of
family practice physicians and specialists practicing in the Valley were educated through this
program.
―It‘s a new era at the cath lab,‖ declared Dr. John Ambrose, director of cardiology at Community
Regional and a UCSF clinical professor, as he and Dr. Joshi finished opening a critical blockage in
Volk‘s artery.
―I‘ll absolutely use it again,‖ Dr. Joshi said afterwards. ―The Impella did just what it was
supposed to do. Now we‘ll able to do more high-risk cases more safely for our patients.‖
Community Regional offers
Valley‟s only primary
stroke program
Dr. Tanya Warwick is passionate about limiting the effects
of strokes on her patients – and it only takes one
conversation to figure that out.
Dr. Warwick leads a team of specialists at Community
Regional Medical Center, which recently earned the Gold
37
Seal of Approval ™ from the Joint Commission for Primary Stroke Centers.
―Community Regional Medical Center demonstrated that its stroke care program follows national
standards and guidelines that can significantly improve outcomes for stroke patients,‖ says Jean
E. Range, The Joint Commission‘s executive director for disease-specific care certification.
A stroke, or ―brain attack,‖ occurs when a blood clot blocks an artery or a blood vessel breaks,
stopping blood flow to an area of the brain. When brain cells die during a stroke, abilities
(speech, movement, memory) controlled by that area of the brain are lost.
With May‘s designation as ―Stroke Awareness Month,‖ MedWatchToday.com got the chance to sit
down with Dr. Warwick, medical director of Community Regional‘s stroke program and assistant
clinical professor of neurology for UCSF Fresno, to discuss stroke care:
Do people in America today take stroke as seriously as they should?
Unfortunately they do not. Every three minutes in the United States someone will
suffer a stroke. It is the third leading cause of death and the leading cause of
adult disability, yet most people cannot tell you what a stroke is or what causes it.
The majority of patients cannot tell you the signs or symptoms of a stroke or
what to do if you are having one. What we are seeing is that people do not
become interested until they or a loved one are affected personally.
Dr. Tanya
Warwick The goal of May’s stroke awareness campaign is to reduce the incidence
and impact of stroke. How will raising awareness bring that type of result?
By increasing the public's knowledge about the signs and symptoms of stroke as well as issues
revolving around stroke prevention, we can decrease morbidity and mortality because people will
seek help sooner in the event they are having a stroke. So many times people will go to bed or
wait to see if symptoms will resolve on their own – by the time they go to the hospital it is too
late to offer them the care they need.
Why is it so important to act fast if you or a loved one show stroke symptoms?
The FDA has approved just one drug for the acute treatment of stroke – it is called tPA. It is a
strong blood thinner that many refer to as the "clot buster." For some people having an acute
stroke, tPA is a great treatment option that can decrease their long-term disability. The problem
with tPA is that it can only be given within three hours from the time of symptom onset, so time
is of the essense. Time lost is brain lost.
What are the symptoms to watch for, and what should someone do if they notice these
symptoms?
At Community Regional Medical Center we teach the easy
acronym "FAST" for the signs and symptoms of stroke:
Face: Look in the mirror to see if your smile is uneven.
Arms: Try to raise your arms.
Speech: Are your words slurred or are you unable to
repeat a phrase?
Time: Time is critical. Get to the hospital immediately
Community Regional Medical Center was just awarded
the Gold Seal in stroke care by The Joint Commission.
What does that mean for patients in the Valley?
This means that patients of the Central Valley now have access to the most up-to-date, state-of-
the-art stroke care. We are the only certified stroke center between the Bay Area and
Bakersfield.
38
Do you see patients who ignore early signs and symptoms, where you know you could
have helped them more if they would have come in earlier?
Without question. Many people will develop symptoms and think they are just tired or under
stress. They will lie down to take a nap only to wake up hours later with much more serious
symptoms. At that point it is almost always too late to give them the clot busting drug they
would have otherwise been a candidate for.
How are strokes treated once a patient arrives at Community Regional until the time
he/she goes home?
From the time a patient arrives in the emergency department until the time they are discharged
to home or rehabilitation, they are treated by a team of specialists dedicated to the care of
stroke patients. This team consists of internists, neurologists, neurosurgeons, a
neurointerventionalist, neuroradiologists, cardiologists, physical therapy, occupational therapy,
speech therapy and stroke certified nurses. Patients undergo a series of tests to try and establish
the cause of the stroke and the team works to come up with a treatment plan that can decrease
the risk of future stroke.
Security director earns „Patriot Award‟
Kevin Weaver, director of security for Community Medical Centers, received the
―Patriot Award‖ from the United States Department of Defense.
The award is given by the Employer Support of the Guard (ESGR), a Department of Defense
agency, to recognize employers that support a strong National Guard and Reserve force.
Employers qualify for recognition by practicing leadership and personnel policies that support
employee participation in the Guard and Reserve.
Arturo Alvarez Jr., ombudsman for the ESGR, presented Weaver with the award.
―It‘s the highest award that‘s given to an employer from the military,‖ Alvarez said.
Weaver was nominated by Spc. Jason Jensen of the Army National Guard. Jensen is on active
military duty but also works as a security officer at Community. Alvarez said the only way to
receive this award is to be nominated by a member of the military.
―I feel incredibly honored to not only be
recognized by the U.S. military, but also by
my staff who took the time and effort to
nominate me for such an award,‖ said
Weaver.
Weaver said the training that officers receive
in the military really prepares them for
security careers.
―They have to make quick decisions on their
feet and that experience from the military
goes hand-in-hand with what we do within
Kevin Weaver (right) was presented with the "Patriot Award"
from Arturo Alvarez Jr., ombudsman for the Employer Support of
security.‖
the Guard, a Department of Defense agency.
39
Community Regional welcomes high-speed
rail officials
Community Regional Medical Center was part of
a city and county collaborative effort on April 15
dubbed ―Fresno Works,‖ designed to
attract interest to build a heavy maintenance
facility for high-speed rail in Fresno. The proposed
facility would bring thousands of jobs and millions
of dollars in revenue to the area.
Chairman of the California High-Speed Rail
Authority Curt Pringle, along with Fresno Mayor
Ashley Swearengin and Fresno County Supervisor
Susan Anderson, arrived in a helicopter on the
rooftop of the downtown hospital to meet County Supervisor Henry Perea for a tour of the
region‘s only comprehensive burn and Level 1 trauma centers.
―Fresno is competing very strongly for the heavy maintenance facility,‖ Pringle said. ―This has
been a good experience and the community has stepped forward significantly. It‘s important to
see the vital values it [the high-speed rail system] will add along the way.‖
Community Regional houses the only burn and Level 1 trauma centers between Los Angeles to
Sacramento and was listed as a unique attribute of the city and county for the tour by Fresno
Works. As one of the main points in its executive summary, Fresno Works touted the ―extensive
emergency response and medical services headquartered in Fresno.‖
―We are excited the city chose to feature our facilities and impressive care team to the
authorities for the high-speed railway project,‖ said Phyllis Baltz, Community Regional‘s chief
operating officer. ―This demonstrates again the significant resource our regional medical center
operations provide to the community and region.‖
Community Regional and the Fresno Redevelopment Agency earned state recognition in March
for its 15-year partnership which transformed a blighted downtown area into the 58-acre
academic regional medical center campus it is today.
40
Herwaldt family helps Clovis Community
Community Medical Centers is pushing ahead with
major expansion plans for its Clovis hospital,
despite tough economic times that have put some
hospitals at risk of going out of business. The sour
economy has led to perhaps the biggest need for
donor-investors in Community‘s 113-year history,
and a familiar family is helping to answer the
need.
Lou and JoAnn Herwaldt gave a gift in March to
support Clovis Community Medical Center‘s
expansion into the first full-service hospital in the
region with all private beds. Lou Herwaldt, who‘s
A rendering shows what Clovis Community's new five- been nationally recognized for the success of his
story, 122,235-square-foot bed tower is projected to look automobile dealerships, has been active in Valley
like upon completion. health care since he first volunteered for
Community‘s board of trustees in 1984 and later became board chair in 1991.
He was part of a board vision that acquired property for Clovis Community‘s current location,
tucked in a lush orange grove on the corner of Herndon and Temperance avenues.
―Being a board member for 13 years, it‘s one of the things that we really wanted to
do well – have a hospital system in Fresno and Clovis that will provide first-class
medical service to this community so we didn‘t have to run to Los Angeles or San
Francisco to have our needs met,‖ Herwaldt said. ―And now Community Medical
Centers is a big asset to this whole community. Without it, I don‘t know how this
community would survive. It‘s a privilege to be a part of it as well as a
Lou Herwaldt responsibility.‖
Clovis Community‘s four-year, $285 million expansion was launched in February with the
demolition of the former administration building. A new five-story, 122,235-square-foot bed
tower will be constructed, nearly doubling the hospital‘s capacity to 205 private rooms.
The expansion will also add a 38-bed emergency department projected to serve 50,000 patients
annually, a dedicated women‘s pavilion, a special care nursery, 11 high-tech surgical suites and
a multi-level parking structure.
Clovis Community‘s service area is projected to see a population increase of 15,000 within the
next five years and a 43% increase in overall growth in the next 20 years. Area residents ages
45 to 64 and 65-plus are predicted to have the most aggressive growth rates, translating into
the need for more hospital beds in the area, Clovis Community CEO Craig Castro said.
―With the very needs this community has and the success the hospital‘s having, we certainly
need to expand to provide the services that are needed,‖ Herwaldt said.
―I can‘t think of a better place to invest money, that would pay the dividends that Community
pays. So many people have been helped by this place over the years, that you can‘t even count
them.‖
And patients won‘t be the only ones getting help with this expansion project – it‘s also expected
to boost the local economy by supplying work for 4,000 construction people over four years.
41
―It could be the single largest job-creation project in Fresno County over the next several years,‖
Castro said, noting that once expansion is completed, it‘s likely to generate surrounding
development to support a growing work force.
The expansion also will ultimately create nearly 600 new hospital jobs with an average salary of
$86,000 per year.
Clovis Community will remain fully operational during construction, and has added free valet
parking for patient convenience.
Herwaldt‘s Clovis expansion gift is the most recent of many Community projects he‘s invested in.
As a donor-investor since 1987, Herwaldt has also contributed to California Cancer Center, burn
and Level 1 trauma services and the cardiac catheter lab. Last year, a street on the 58-acre
Community Regional Medical Center campus was renamed Herwaldt Drive in his honor. Herwaldt
served as board chairman for six years.
Community Medical Foundation officials hope Herwaldt‘s gift and others, including a recent gift
from longtime supporter OfficeMax, bring increased awareness to the expansion need at Clovis
Community. Private gifts are being sought for the project.
For more information on the project, or to find out how to help, call 559-459-2670 or visit
communitymedical.org/foundation.htm.
Emergency physician trains in wilderness
medicine
In the past 10 years, Dr. Susanne Spano ran, bicycled, fished, hiked, camped, snowshoed, skied,
paddled and backpacked in 35 of the 50 states in the United States. Dr. Spano, native to Fresno,
is the only wilderness medicine fellow in the Central Valley.
As a physician in the Community Regional Medical Center emergency department, she teaches
residents through the UCSF Fresno Medical Education Program.
UCSF Fresno‘s wilderness medicine fellowship program began in August 2008 and is the only
place in the United States to train park medics. The training encompasses the study of
environmentally caused diseases such as high-altitude illness, exposure illness, knowledge of
poisonous plants, ramifications of encountering insects and snakes and tropical medicine. To gain
hands-on experience, Dr. Spano takes the residents for three-day intensive wilderness medicine
training in nearby national parks.
―Wilderness medicine employs the imagination to create improvisations for medical equipment,‖
she said. ―You can‘t take the hospital with you, but there is an art in teaching how to make
lifesaving improvisations with safety pins and duct tape.‖
There are about 250 search and rescue calls in Yosemite National Park per year and 75 in
Sequoia/Kings Canyon National Parks, Dr. Spano said. All three parks are just a 1-2 hour drive
from Fresno.
42
―I was born at Valley Medical Center (former University Medical Center) prior to being adopted,
so theoretically I have been a part of residency training since birth,‖ Dr. Spano said. ―I think
Fresno is one of the greatest places to live anywhere … we are in exciting times. There are so
many fantastic things to do in Fresno that I did not appreciate before I returned from eight years
of college.‖
Residents in wilderness medicine are trained as
hospital-based physicians, provide direction for
Sequoia and Kings Canyon National Parks and are
responsible for Parkmedic Program calls.
―It was not until I was in emergency medicine
residency training that I realized I could combine
my love of the outdoors with my medical
background,‖ Dr. Spano said.
Since that realization, she has shared wilderness
medicine topics to wide audiences including guest
Dr. Susanne Spano ran, bicycled, fished, hiked, camped, speaking at national medical conferences, leading
snowshoed, skied, paddled and backpacked in 35 of the skills training for National Park Service Medics,
50 states in the United States. developing hands-on workshops and lectures for
emergency medicine residents and teaching in an immersive two-week course designed for
medical students.
She recently spoke at the Wilderness Medicine Conference in Yosemite National Park hosted by
UCSF Fresno. Her topic: ―Exposure!‖
Dr. Spano has established national protocols for delivery of pre-hospital aid in wilderness
settings and recently joined with leaders in the field as a contributing author for an emergency
medicine service (EMS) textbook on delivering care in rugged environments.
Many outdoor enthusiasts can unknowingly put themselves in a vulnerable set of circumstances
every time they venture into the wilderness, whether it be an unexpected night out, an
accidental trauma or exacerbation of medical conditions.
―When I first learned to snowshoe, I traveled through gorgeous snow-coated bowl shaped slopes
near alpine lakes, without any real consideration that my activity could trigger an unstable snow
pack to mobilize. Had my movements released an avalanche, disaster would have ensued,‖ Dr.
Spano said.
Her small group did not pack a shovel, avalanche beacon or snow probe for the short day-hike.
―We failed to consider or discuss a rescue plan. I am chilled by the scenario in retrospect,‖ she
said. ―You can fix a medical problem, but it won‘t matter if you can‘t survive long enough to get
out alive.‖
43
State
applauds
Community
Regional
project
Downtown Fresno has
captured the state‘s
attention – in a good way.
At a time when bringing a
more positive image to
downtown Fresno has
become a priority at city
hall, Community Regional Medical Center and the Fresno Redevelopment Agency won the
California Redevelopment Agency‘s Award of Excellence for their 15-year partnership. The
hospital and redevelopment agency collaborated to transform a blighted downtown area into the
58-acre academic regional medical center campus – the largest and longest redevelopment
project ever undertaken in Fresno County.
The California Redevelopment Agency (CRA) gives the annual award to recognize redevelopment
projects from throughout California that have significantly benefited their communities. Jim
VanDeVelde, director of business development and outreach at Community Medical Centers, and
Marlene Murphey, executive director of the Fresno Redevelopment Agency, accepted the award
at the 2010 CRA Annual Conference and Expo in Pasadena.
VanDeVelde said it was both humbling and inspiring to accept the award for Community
Regional.
―I realized at that moment that there were more than 4,000 employees at Community Regional
that all had a part in that award and should be standing with me,‖ VanDeVelde said. ―It was
inspiring because it is such a remarkable achievement to think that the organization has had the
vision and fortitude to see it through over such a long span of time. It affirms for me that, as an
organization, we can do anything we set our mind to.‖
Award nominees were evaluated based on efforts to improve the physical conditions in their
communities, the extent of community participation and benefit, the economic and fiscal
viability, stability of the project, unique and effective project designs and other criteria.
44
―The $350 million dollars of investment was
pivotal to downtown rejuvenation and paved the
way for over a billion dollars in new development
in recent years,‖ Murphey said. ―The world-class
Community Regional project represents the very
best in public-private partnerships.‖
Community Regional is home to the only
combined, comprehensive burn center and Level 1
trauma center between Los Angeles and
Sacramento, a 52-bed Neuroscience Center of
Excellence, a 50-bed cardiovascular unit, the
region‘s only high-risk antepartum unit and a 65-
Community Regional Medical Center and the Fresno bed Level III neonatal intensive care unit. The
Redevelopment Agency earned recognition for their 15- hospital campus also houses the University of
year partnership that resulted in the largest and longest
redevelopment project in Fresno County history. California San Francisco Fresno Medical Education
Program, with more than 200 residents and
fellows training to be physicians of the future. Community also is the area‘s safety net, providing
nearly $149 million in uncompensated services to the medically underserved in fiscal year 2008-
2009. Community has historically spent more on uncompensated community benefits than all
other Fresno-area hospitals combined, and in some years nearly double their combined total.
―The expanded campus replaced blight with state-of-the-art medical facilities that deliver quality
health services to a seriously underserved population,‖ Murphey said.
Construction is ongoing at Community Regional with the Deran Koligian Ambulatory Care Center
opening to patients in March 2010.
Award nominees were evaluated by 20 professionals who are elected from the development,
public service, economic development and redevelopment fields.
―This project helps everyone in the Central Valley,‖ VanDeVelde said. ―More and more people are
turning to Community Regional for their most acute health care needs and no longer need to
travel outside of the Valley.‖
Dr. Simon Paul becomes a
“Real Hero”
For countless parents of children with HIV or full-blown
AIDS, and for 80% of the adults in Fresno County with the
deadly immune deficiency, Dr. Simon Paul has been a true
hero. And now the American Red Cross is recognizing the
medical director of Community Medical Centers‘ Special
Services program as such with its 2010 ―Real Heroes‖
award for health care.
For the last seven years the American Red Cross has
celebrated and awarded selfless acts of courage and
humanitarian services by real people – ―Real Heroes.‖ The
American Red Cross ―Real Heroes‖ event celebrating Dr.
45
Paul‘s win will be held March 19, 2010 at the Fresno Art Museum.
The health care award is given to nurses, physician‘s assistants or doctors, who have
demonstrated an outstanding level of service to the people of their community. Dr. Paul, 47, has
done exactly that. He leads the only multidisciplinary program treating HIV/AIDS patients in the
Central Valley and is the only pediatric HIV/AIDS provider between San Francisco and Los
Angeles.
Dr. Paul improved access to care for a number of patients who would otherwise have been forced
to seek care in the emergency department, by implementing a sliding fee payment process for
patients in Community‘s Special Services program.
Additionally, Dr. Paul developed the Special Services‘ pharmacy to serve HIV patients directly.
Patients now have on-site access to a pharmacist who has special expertise in HIV infections,
medications, and management of side effects and drug interactions.
―He is an integral part of the day-to-day clinic operations,‖ said Jack Chubb, CEO Community
Regional Medical Center, who nominated Dr. Paul for the ―Real Heroes‖ award. ―He approaches
emerging issues and changes in a rational, thoughtful manner and with compassion toward all
patients, staff and program providers.‖
Chinese delegation researches Fresno Heart &
Surgical Hospital‟s
technology
Fresno Heart & Surgical showed off the latest in
operating room technology on March 8 to a delegation
from China being sponsored by the Lyles Center for
Innovation and Entrepreneurship at California State
University, Fresno.
The Chinese information systems professionals, hospital
administrators and physicians were visibly impressed by
a ―Live from the OR‖ demonstration of bariatric weight-
loss surgery by Dr. Kelvin Higa. Dr. Higa, who teaches
his surgical techniques internationally, was able to interact from the operating room with the
delegation watching from the hospital‘s conference room.
―The audience was very enthusiastic and asked lots of questions. The cultural difference made it
exciting and challenging to demonstrate our technology. I felt the ―Live from OR‖
demonstration was a great way for them to view it,‖ said registered nurse Robin Ryder,
coordinator of the hospital‘s Bariatric & Metabolic Surgery Program.
―The demonstration was well received and there was a noticeable reaction by the delegates as
Dr. Higa inserted the camera into the patient showing a better than live view of the digestive
system and laparoscopic surgical instruments,‖ said Jonathon Anderson, head of the IT
department at Fresno Heart & Surgical.
Fresno State officials chose Fresno Heart & Surgical Hospital as one of a few options to host this
event, because of such technological advances and the hospital‘s innovative approaches.
46
Fresno Heart & Surgical‘s representatives discussed the current health information system and
future plans to integrate with the Epic system to put clinical records online so they would be
accessible at portable bedside computers and remotely from physicians‘ offices.
The Chinese delegation asked about technology uses, specific challenges at Fresno Heart &
Surgical and regulation compliance matters. Government involvement in healthcare was also on
the list of topics discussed as well as the contracting process for reimbursement rates. The
event ended with a brief view of the Electronic Medical Record software and a tour of the
hospital.
TV show reaches millions
Television viewers across the nation are getting a glimpse of what Community Medical
Centers is all about. They are also able to see how the people who serve central
California‘s health care needs make a difference every day in the lives of patients and their
families. Healthcare Heroes, a new nationally syndicated reality TV show – filmed entirely at
Community Medical Centers‘ hospitals – has been on the air for six months and is touching lives.
Debbie Travis lives in Michigan and had a special reason for watching the program. Dr. Christina
Maser was diagnosing a football sized tumor on her nephew, Brent Jackson, at Community
Regional Medical Center in Fresno. Even though they now live thousands of miles apart, the
show enabled her to finally see her loved one.
―It was so good to see him even on TV,‖ Travis said. ―We haven‘t seen him since August when he
moved.‖
Travis says having a show like this can help ease some fears and give a family more confidence
about the care their loved one is receiving so many miles away at Community.
―I was there the night Brent told his mother about it [the tumor], we cried together,‖ Travis said.
―Brent told his mother it was about the size of half a cantaloupe, but on TV they said it was
‗football-sized‘ and then when I saw it in the surgery I couldn‘t believe how big it was.‖
Healthcare Heroes is a dramatic and educational show that is now syndicated in more than 85%
of TV markets nationally – including nine of the 10 largest markets in the United States. Each
week, there are approximately 250,000 to 350,000 people watching the show. This is the same
weekly viewership as The CW, Discovery Channel, the History Channel and TruTV.
The Travis home is one of the 85 million households that have access to Healthcare Heroes over
digital networks and an additional 70-million households can view the show on other broadcast
and cable outlets including: Dish Network, My Family TV and GCN (Global Christian Network).
Travis says she now wants Brent‘s mother to see the show. She thinks it could bring her some
comfort.
―His mother hasn‘t seen the show yet, but I think it will be good for her to see Brent and see for
herself how he‘s doing.‖
47
Physicians, others
help build lodging
facility
The Central California Faculty Medical Group,
Inc. (CCFMG) and University Centers of
Excellence are helping to ensure Valley
residents can remain at the bedsides of their
loved ones receiving critical care – this time
with a $100,000 gift toward Terry‘s House, a
20-room guest house within walking distance
of the main entrance to Community Regional
Medical Center.
Ground broke on the 17,000-square-foot, two-story Terry‘s House, at the corner of Fresno and R
streets, in January.
―Community Regional Medical Center prides itself on providing great care to our patients,‖ said
Lynn Bennink, trauma program director for Community Regional. ―We care for patients from all
over the Valley and beyond. Terry‘s House will enable us to care for the families as well. It will be
a home for families of critically injured or burned patients that have to travel long distances to be
close to their loved ones. Currently, these families are sleeping in our waiting room or staying in
expensive hotels.‖
Giving to Community has become a tradition for CCFMG, a group of more than 200 physicians,
nurse practitioners, physician assistants and certified midwives headquartered in Fresno. Last
year, CCFMG pledged $500,000 to help care for the underserved at the soon-to-open Deran
Koligian Ambulatory Care Center. In 2008, the group completed a seven-year, $1 million pledge
for Community‘s burn and trauma programs – the only comprehensive burn and Level 1 trauma
programs between Los Angeles and Sacramento.
―We, at CCFMG and the University Centers of Excellence offices, are very
pleased to be able to contribute to Terry‘s House,‖ said Charlene Chessum,
CCFMG marketing director. ―It‘s very important to have family close by during
the healing process and Terry‘s House makes this possible.‖
CCFMG physicians treat patients at University Centers of Excellence offices
throughout Fresno, but they are core faculty for the UCSF Fresno Medical
Education Program – teaching the next generation of local physicians.
Dr. Steven Parks,―CCFMG‘s philanthropic generosity over the years, and specifically their recent
gift towards Terry‘s House, has been key in helping us to extend the highest
board president of
CCFMG. level of care and offer the most comprehensive services to the people of this
region,‖ said Rob Saroyan, chief development officer for Community Medical Foundation.
Building and maintaining Terry‘s House is dependent upon private support from Community‘s
donor-investors. While enough funds have been raised to construct the house, the hospital
system‘s fundraising campaign continues to seek support for furnishings, operations and families
who cannot otherwise afford to stay.
48
Some help in that area came recently from both corporate citizens and individuals who share in
the vision for this facility. John R. Lawson Rock & Oil and Jeff Lion each contributed $10,000
while California Bank and Trust gave $4,000.
―We are grateful for the organizations and individuals that have graciously made gifts in support
of this important project,‖ Saroyan said.
For more information on Terry‘s House, or to find out how to give, log on to
http://www.terryshousefresno.com/.
Automated defibrillator helps save teen
Oct. 14 was a routine day for Community Medical Centers nurse Naomi Isaak. It‘s her
job to place automated external defibrillator (AED) units in public places all over the
Central Valley. She helps schools and businesses purchase the lifesaving equipment, instructs
people on the use and does routine maintenance checks on the 475 units in Community‘s Public
Access Defibrillator program (PAD). The AED is a portable device that automatically diagnoses
cardiac arrhythmias and can shock the heart back to normal rhythm. It was a routine day, and
Isaak was busy as usual.
Oct. 14 started out as a routine day for 17-year-old Yosemite High School junior Doug Berg of
Coarsegold. But during his fourth-period Spanish class, that all changed. He stopped breathing,
lost consciousness and fell back in his chair. That‘s when, unbeknownst to Isaak, one of her AED
units was about to help save Berg‘s life.
Yosemite High math teacher Bob Kernaghan was alerted to Doug‘s situation when a student from
the Spanish class ran in to say teacher Rebecca Brokaw needed help – one of her students was
having a seizure. Kernaghan, a trained emergency medical technician (EMT), sprang into action.
―I got my oxygen and trauma kit and ran to the room. The student was unconscious and
breathing badly. I pulled out the oxygen mask and got a mask ready. When I turned around, I
realized he was no longer breathing.‖
Campus supervisor Lina Moberly and teacher Terri LeQuia showed up and started CPR
compressions. Kernaghan had called for the AED unit. When it showed up, he pulled out the
pads and applied them.
―The machine said [Berg‘s] heart had a shockable rhythm, so we used the
defibrillator to shock him. There was still no pulse or respirations,‖ Kernaghan
said. ―The machine said to start CPR, we did that and within a minute he
started breathing and had a strong pulse. The ambulance showed up at that
point.‖
Berg had no family history of heart problems. He underwent surgery so an
internal cardiac defibrillator could be planted inside his chest. Data from the
AED helped physicians diagnose his condition. The avid drummer went back
to school two weeks after the incident. Besides no contact sports and no
Doug Berg
more roller coaster rides, his life is pretty much back to routine again.
49
However, the memory of Oct. 14 will never be routine again for the Bergs, the staff at Yosemite
High or for nurse Isaak.
―I can‘t stress the importance of the AED enough,‖ Kernaghan said. ―If we hadn‘t had the
machine on campus that day and available and serviced, I believe that young man would have
died right in front of me. I can‘t describe how awful that would have been. I‘m just really happy
that he gets another chance. The people at Community Medical Centers are heroes for
coordinating this effort.‖
Principal Edward VanHoose concurs and credits the quick, decisive action by his well-trained
staff.
―The defibrillator device was definitely the life-saver. It was available. It was used. I don‘t know
what we would have done without it. We have three on campus.‖
Doug‘s father Jerry Berg sums it up. ―We were actually kind of amazed that the defibrillator was
there, but even more importantly, it was located in a place where people knew where to get it
and how to use it.‖
Doug is happy to be back to his friends and normal school life, but he, along with his family, will
always be grateful to the staff.
―I don‘t know how to repay any of them. I owe them my life,‖ Doug said. ―That‘s priceless. I am
glad that there was [an AED unit] there for me. I know my family is glad that there was one for
me.‖
Isaak also recently placed an AED unit at an elementary school in Oakhurst. She is passionate
about her program and the chance her ―routine‖ work could save lives.
―It just makes everything worthwhile when we have a positive outcome like this,‖ Isaak said. ―All
the long nights and extra miles, it‘s all worth it. He‘s the fifth one since I‘ve worked with the
program that we‘ve been able to send home successfully. That‘s the goal of the whole program.‖
50
Patients cheered by Santa visit, Shakers‟ gifts
Four-year-old Cassandra Hernandez‘ eyes were as big
as saucers when Santa Claus walked into the
emergency department exam room at Community
Regional Medical Center. Then her face lit up like a
Christmas tree when the hospital Santa reached into
his bag and pulled out a purple teddy bear.
Respiratory therapist Bear Campbell – known as
―Santa Bear‖ this time of year – delivered presents to
children throughout the hospital on the Tuesday
before Christmas. He rode in on his red motorcycle
and side car and brought two Santa‘s helpers from his
motorcycle club. This is the second year Campbell has
played Santa for children in the pediatric burn unit
and for children brought to the emergency room.
Cassandra bumped her head and passed out while
playing with cousins, said her mother Sandra
Machura. She rushed her in to the emergency room
to make sure she was okay. Santa cheered her up
and she seemed to be her bouncy self, Machura said
The Shakers, a volunteer group of emerging young
professionals, delivered gifts to Leon S. Peters Burn
Another group spread more cheer to the hospital-
Center patients. The Shakers pictured from left to
bound patients just hours after ―Santa Bear‖ rode
right are president Vincent Ricchiuti, Cindy Saavedra,
Scott Grossman and Derek Morrison. through. For the third straight year, Community
Medical Centers‘ volunteer group of emerging young professionals, The Shakers, made the
holidays a little brighter for burn survivors and their families. On Dec. 22, The Shakers gave gifts
to patients at the Leon S. Peters Burn Center, the only comprehensive regional burn center from
Los Angeles to Sacramento, located at Community Regional Medical Center.
Each Shaker adopted a patient and their family from a list given by the burn center. They read
their list and checked it twice, spending more than $50 of their own money, and presented the
survivors and their families gift cards and gifts.
―Instead of just giving the money to The Foundation, The
Shakers wanted to buy and deliver the presents personally and
we thought that was a very wonderful gesture,‖ said Nicole Lyon,
Community Medical Foundation development officer.
The Shakers not only delivered the gifts on their list to the
inpatient burn center and survivors recovering in the Leon S.
Peters Rehabilitation Center, but they also had presents ready to
deliver to patients visiting the outpatient burn center, where they
receive follow-up treatment.
Respiratory therapist Bear Campbell,
known as "Santa Bear," delivered
―To see the smiles on the patients‘ faces and be able to bring presents to children throughout
Community Regional, bringing a big
some cheer this holiday season is what it‘s all about,‖ said smile to 4-year-old Cassandra
Vincent Ricchiuti, president of The Shakers. ―The families may Hernandez' face.
not have the time, energy or monetary means to give to their
loved ones, so we thought we should step in and lend a helping hand.‖
51
Campbell said he takes his day off to return to the workplace and play Santa for the same
reason. ―I just like to see the smiles on the kids‘ faces,‖ he said.
Karla Sanchez and her 4-month-old Camila Sanchez were definitely grinning after Santa Bear left
their room Tuesday. It was Camila‘s first meeting with Santa but she knew just what to do,
reaching out to grab his whiskers and then hug a cuddly stuffed toy.
Radin Foundation pledges $1 million
With Clovis Community Medical Center‘s October announcement to move forward with a four-
year, $285 million expansion and renovation, a longtime Community Medical Centers supporter
stepped up to help complete the vision.
The Radin Foundation pledged $1 million to support expansion of Clovis Community‘s emergency
department (ED). The ED will grow from 13 to 38 stations and will have two resuscitation rooms.
The growth is designed to accommodate a projected 50,000 patient visits annually.
―We‘re excited about Clovis Community‘s vision to bring more
world-class health care amenities to our Valley, and thankful we‘re
in a position to help make that vision a reality,‖ said Jason Liao,
executive director of the Radin Foundation. ―It‘s great to see a gift
make such a large impact on so many people, and that‘s what this
one will do once the expansion is complete.‖
The ED additions make up just a portion of Clovis Community‘s
expansion plans. The massive construction project also will
increase the hospital‘s 109 inpatient beds to 205 private beds,
Marc and Marjorie Radin founded the increase intensive-care beds from 7 to 24 and expand the number
Radin Foundation in 1971. The of operating rooms from 4 to 11.
foundation has been a longtime
supporter of Community Medical
Centers. Upon completion in fall 2013, Clovis Community will be the first
comprehensive, full-service hospital in the region to have all
private rooms, nearly tripling in size to 739,000 square feet.
Clovis Community‘s service area is projected to see a population increase of 15,000 within the
next five years and a 43% increase in
overall growth in the next 20 years.
―This investment by Community clearly
demonstrates the health care system‘s
long-term dedication to bringing top-
notch physicians and technology to
patients in one of the Central Valley‘s
fastest growing regions,‖ said Craig
Castro, Clovis Community‘s chief
executive officer. ―And this additional
lead gift by the Radin Foundation
demonstrates their ongoing
commitment to touching the lives of so
many Valley residents.‖
A rendering shows an exterior view of what the expanded Clovis
While the nonprofit Community Medical Community emergency department will look like.
Centers has secured financing to cover most of the project‘s cost and ensure groundbreaking,
52
private gifts such as this one from the Radin Foundation will be needed to complete the vision.
The Radin Foundation, under the direction of Les Findley and Liao, was founded by the late Marc
and Marjorie Radin in 1971 and has been a longtime benefactor of Community.
―After decades of giving, the Radin Foundation has again stepped up to answer a big need in the
region. We couldn‘t deliver such a high level of care at Community without such generous
people,‖ said Rob Saroyan, vice president for Community Medical Foundation. ―The Radin
Foundation will inspire others to join their lead gift and the campaign for Clovis Community
Medical Center.‖
Earlier this decade, the Radin Foundation made two separate $1 million gifts to name the
Marjorie E. Radin Breast Care Center at Clovis Community, and also gifted $1 million in support
of Community Regional Medical Center‘s da Vinci robotic surgery system. The family also has
supported other areas of cancer care, endoscopy, cardiology and urology at Community.
The Radin Breast Care Center was also recently expanded, and is unique in its team approach to
treatment with a team of physician specialists who work together on behalf of each patient
diagnosed with a breast condition. This team concept speeds up the process from evaluation to
treatment by offering a single appointment in one location with specialists in radiology, oncology,
pathology, surgery and nursing.
The expansion projects are part of Community‘s 10-year growth plan, and the 25- to 30-year
growth plan calls for even more additions. Clovis Community will remain fully operational during
construction, and has added free valet parking for patient convenience.
PG&E rewards hospital for energy-saving
retrofit
Pacific Gas and Electric Company awarded a $15,632
rebate to Fresno Heart & Surgical Hospital for a
project that is expected to significantly reduce the 57-
bed hospital‘s energy usage and could save the
hospital nearly $45,000 annually on its energy bills.
Timothy Lockwood, mechanical engineer and senior
project manager at PG&E, said this is just one in a
long line of green projects initiated by Community
Medical Centers‘ facilities. ―We meet regularly with
facilities people,‖ he said. ―Community always has a
project on our books…We‘re expecting to award more
energy-saving rebates when the new ambulatory care
center opens‖ on the Community Regional Medical Center campus.
―It is one piece of our corporate-wide approach to becoming a sustainable corporation and being
socially responsible toward our environment,‖ said Mark Mathieson, Community‘s senior vice
president of facilities management. ―Our new construction projects have a smaller carbon
footprint, are made of recycled materials, manufactured from plants and carried on trucks that
are more energy efficient. We‘re also promoting bike riding and car/van-pooling, we recycle our
waste, and use paper products from recycled materials.‖
53
Brian Steinhauer, Fresno Heart & Surgical‘s plant service manager, enhanced energy efficiency
by installing a variable frequency drive on the buildings heating, ventilating and air-conditioning
(HVAC) system. By slowing down the motors that operate the HVAC system, the retrofit
decreases energy usage, but without reducing the pressure needed to maintain air flow and
temperatures.
―This is a very big deal,‖ said Lockwood as he presented the rebate check on Nov. 10 to
Steinhauer. ―This absolutely reduces the hospital‘s carbon footprint and saves on carbon dioxide
emissions.‖
Steinhauer said he‘s also working on smaller projects to reduce energy usage, such as installing
motion-detector lights in housekeeping closets and looking at pump controls in the central
energy plant. It‘s estimated the changes could add up to more than $3,500 a month when
completed. Steinhauer said with the PG&E rebate and energy savings, he expects the retrofit
project to pay for itself within 110 days.
Clovis expansion aided by gift from CMI
Radiology Group
Amid ongoing expansion efforts, Clovis Community Medical
Center received a boost to its radiology department.
The boost came in the form of a $300,000 gift to the hospital
from CMI Radiology Group. The funds from CMI will help provide
the hospital with additional and updated medical imaging space.
With more than 35 radiologists, CMI Radiology is the largest
radiology group in central California.
Dr. Mariela Resendes, managing partner for CMI Radiology
Group, said radiology plays a key role in helping doctors, and
therefore, patients. ―Patient care pivots around radiology,‖ she
said. ―With all the wonderful instruments we have, we are able to
guide doctors toward diagnosis and better patient care.‖
CMI is the physician group that provides medical imaging
services to all three of Community‘s acute-care hospitals –
Community Regional Medical Center, Fresno Heart & Surgical
Glen Hirata, a radiology technician at
Hospital and Clovis Community. In conjunction with Community,
Clovis Community, comforts a patient CMI also owns and operates two of Fresno‘s largest outpatient
in the region's first 128-slice CT imaging facilities – Advanced Medical Imaging and California
scanner. Imaging Institute. CMI consists of 20 radiologist partners with
specialties and fellowships that encompass areas such as body imaging, musculoskeletal
imaging, women's imaging (ultrasound & mammography), vascular and interventional radiology,
nuclear medicine (positron emission tomography, or PET), neuroradiology and pediatric imaging.
―We are so grateful for CMI Radiology Group‘s leadership and outstanding promise to make this
transformational gift,‖ said Craig Castro, chief executive officer of Clovis Community. ―It is a
strong statement of how much physicians care about Clovis, the hospital in which they work, and
the quality of care they deliver. It will certainly make a difference and impact the lives of many
for years to come.‖
54
This gift will help Clovis Community – already home to the region's first 128-slice CT scanner –
continue to provide leading-edge technology to help diagnose and treat its patients.
"This gift will help allow Clovis Community Medical Center to remain at the forefront of medical
imaging, which is vital to diagnosing, treating and caring for our patients." Castro said.
In a continued effort to serve the area‘s growing population, Clovis Community began
construction on the $20 million first phase of its expansion in October 2008 – the largest
expansion project in the hospital‘s history. The first phase features a two-story, 22,500-square-
foot addition to the outpatient care center. Plans call for expansion of the Radin Breast Care
Center, a dedicated four-room endoscopy (a method of looking inside the body using a flexible
tube with a small camera on the end) suite with associated operating rooms and the Valley‘s
highest and only Level 3 in vitro fertilization center between Los Angeles and Sacramento.
Private support from corporate donors, individuals, physicians, employees and others is being
sought by Community Medical Foundation to help fund the Clovis Community expansion.
―We are very excited about the expansion vision that has been proposed, and we want to do our
part to be sure it happens,‖ Dr. Resendes said. ―It‘s a very serious commitment to Clovis
Community.‖
Vols tip their helmets for burn survivors
With helmets in hand, Valley firefighters, Community
Regional Medical Center burn staff and volunteers
collected dollars and change from Fresno and Visalia
area motorists on Sept. 9 and 16, 2009, as part of the
annual ―Fill the Helmet‖ campaign.
Nearly $120,000 was raised when dozens of volunteers
took to area street corners, collecting funds to help
burn survivors and their families at the Leon S. Peters
Burn Center – the only comprehensive, round-the-
clock, fully-staffed burn center from Los Angeles to
Sacramento.
Rob Villa and his mother Dorothy are happy to
―First of all I‘d like to thank the motorists in the
give back to the Leon S. Peters Burn Center after
community – in these hard economic times they were
staff there helped him recover from a house fire
that burned 85% of his body.
still so generous to give what they could,‖ said Sandra
Yovino, director of the Peters Burn Center and co-founder of Fill the Helmet. ―A special thanks to
the firefighters who volunteered their time to greet the public, give a wave and give a smile, and
our many wonderful volunteers. Everyone involved in the event felt the campaign this year was
extremely successful.‖
55
Yovino says anyone who missed donating on the street corners can
log on to FillTheHelmet.org and help the cause online. Electronic
giving will be available through September 2009.
―This just makes it easier to give when you‘ve missed that person at
the corner or the light was green and you couldn‘t stop,‖ Yovino said.
Almost a decade ago, Fresno City Fire Department chief Chuck Leach
and Yovino came up with the idea to start Fill the Helmet. Local
firefighters and the burn team committed to the event, knowing first-
Fresno fire captain Chuck Leach
hand the impact it has on the lives of burn survivors – young and old.
and Peters Burn Center director
Not only does it help raise needed funds, but it helps raise awareness Sandra Yovino were among the
of burn prevention. many volunteers who helped
raise money for burn survivors.
Volunteers were at 17 major intersections for the first day of the event in the Fresno, Clovis and
Oakhurst areas. On Sept. 16, south Valley volunteers collected funds on street corners in the
Sanger, Selma, Porterville and Visalia areas. The top intersection overall was Mooney Boulevard
and Noble Street in Visalia with $7,498.93 raised, edging out Fresno‘s Blackstone and Shaw
avenues with $7,484.23.
More fire departments than ever before joined in the effort this year, and Yovino hopes to see
that trend continue.
RockStir event to benefit Terry‟s House
―The Shakers‖ of Community Medical Centers have teamed up with marketing agency Astone to
help raise money and awareness for Terry‘s House through RockStir, an evening of music and
fashion, from 6 to 10 p.m. on Sept. 26 in the RiverView Shopping Center on the corner of Friant
and Ft. Washington roads.
Proceeds from each RockStir ticket purchased through Community
Medical Foundation for will go toward Terry‘s House, a future
hospitality home built for families and loved ones of patients
receiving critical care at Community Regional Medical Center.
Family members of patients can‘t always afford a hotel room and
often sleep in the waiting room or even in their cars. Terry‘s House
will offer convenient and affordable lodging.
―Terry‘s House is the future flagship of Community Medical Centers‘ families,‖ said Vincent
Ricchiuti, director of operations for P-R Farms, Inc. and president of The Shakers.
Ricchiuti said his motivation behind becoming president of The Shakers comes from his desire to
make the community the best it can be and ―health care is where it begins.
―I wanted to give back to a community that has given my family so much,‖ Ricchiuti said.
Three-hundred tickets have been allotted for the public and will sell prior to the event for $25 per
person and $30 at the door. The event will feature live music from Vans Warped Tour performer
Midori & Audioclique, a fashion show, a full bar and food from some of Fresno‘s finest
restaurants.
To purchase tickets to RockStir, call Community Medical Foundation at 559-459-2670.
56
The construction and maintenance of Terry‘s House is entirely dependent upon private gifts and
contributions. Community Medical Foundation is reaching out to the community to help build
Terry's House. To learn more about Terry‘s House and how you can help, visit
TerrysHouseFresno.com.
Educator inducted to nurse hall of fame
With 47 years of nursing experience, Gloria Fitzgerald was inducted into the 2009
Central San Joaquin Valley Nursing Hall of Fame and honored at an awards ceremony
on Sept. 16 at the Smittcamp Alumni House at Fresno State.
―I hope I‘ve made a difference somewhere for someone,‖ said Fitzgerald, a registered nurse at
Community Health Center-Sierra. ―Obviously I have.‖
The award honors the lifetime achievement of nursing leaders serving the seven-county region of
the Central San Joaquin Valley – Fresno, Kern, Kings, Tulare, Merced, Madera and Mariposa
counties.
Amongst her contributions to the nursing field, Fitzgerald served as the state president of the
California Section of the Nurses Association of Obstetrics and Gynecology in 1986 and on the
board for the Association of California Nurse Leaders from 2001 to 2002. Fitzgerald has also
served twice as the president of the Nursing Leadership Council.
Fitzgerald has been with Community Medical Centers for 30 years and is the director of education
for the new registered nurse program at the Sierra campus. Throughout her career, she
designed, implemented and directed hospital programs on management training and guest
relations and was responsible for the successful openings of many nursing facilities, including the
opening of an outpatient physical therapy service/rehabilitation center at the Sierra campus.
―I love working with the young nurses,‖ Fitzgerald said. ―They‘re enthusiastic and they want to
do the right thing.‖
Claudia Sanders, a Community educator, and Mary Contreras, Community‘s chief nursing officer,
nominated Fitzgerald for the award and decorated her office as a congratulatory surprise.
―She [Fitzgerald] defines the true meaning of nursing,‖ Sanders said. ―Whether she was working
directly with patients on the floor, helping a new mother adjust to parenthood, teaching and
mentoring new staff and new nurse leaders or overseeing all aspects of nursing, her calm
demeanor, compassion, sense of humor and genuineness have propelled her into the leader she
is today.‖
This is the fifth year the award has been in existence, and the hall of fame has awarded 10 prior
inductees. Fitzgerald will be featured in Nursing Week Magazine, a regional publication circulated
in multiple states, and will have her name added to the Nursing Hall of Fame located near the
department of nursing at Fresno State.
―I want to be able to look back and say that I helped move the profession forward as best as I
could from where I was and what I did,‖ Fitzgerald said.
Two other Community nurses have been inducted previously – Marylyn Hawkins, who was
inducted the first year of the award‘s existence, and Pilar De la Cruz, who was inducted while
working at Fresno Heart & Surgical Hospital.
57
The award is jointly sponsored by the nursing department at Fresno State, Sigma Theta Tau
International Nursing Honor Society, Mu Nu Chapter and the Nursing Leadership Council of the
Central San Joaquin Valley.
Interpreter services get a boost
Community Regional Medical Center publicly debuted its new high-tech medical interpretation
system with an Aug. 19 demonstration for members of the California HealthCare Foundation who
helped make it possible with a $170,000 grant.
The grant helped pay for Community Regional‘s participation in the Health Care Interpreter
Network (HCIN), a language-interpretation service enabling doctors and staff to connect non-
English-speaking patients with interpreters in 170 languages via live video conference within as
fast as one minute. HCIN is a system of shared remote interpreter services currently operated by
public hospitals in Northern California. There are 13 hospitals currently in the network.
The program began in the spring and will continue for a six-month trial period.
Community has 35 Spanish interpreters to provide the bulk of interpretations in
Spanish to Community Regional patients.
Additionally, employees called ―language ambassadors‖ volunteer to help patients and families
with non-medical-related questions in their native language. Bilingual employees wear a special
employee badge to indicate to patients and visitors that they speak another language and can
assist with interpreting. Languages spoken by these employees are Spanish, Hindi, Hmong,
Punjabi, Farsi, Vietnamese and Filipino.
With 30% of its emergency department patients being non-English-speaking, Community
Regional has need for hundreds of interpreter interactions per day with patients and their
families.
―It‘s very important that it‘s all human [interaction] because when you‘re in a hospital, there‘s a
level of fear, always,‖ said Geoffrey Cowan, chair of the California HealthCare Foundation. ―And it
may be you, it may be your family that‘s feeling fear, it may be simply the explanation needs to
be clearer. And so what happens is that you‘re able to get that information in a language that
you understand better. You might have a working knowledge of English, but that knowledge of
English might not be at a level where you feel comfortable talking about medical information.‖
Interpreter services are provided 24 hours a day, 7 days a week, which last year cost more than
$700,000 – a figure Community Medical Centers is not reimbursed for. Seeing someone who
speaks the patient‘s language on the HCIN video monitor adds a sense of comfort, dignity and
makes for a better overall experience, said registered nurse Bruce Kinder, executive director of
Community Regional‘s clinical operations and informatics.
Community provided nearly $137.1 million in uncompensated services to the medically
underserved in fiscal year 2007-2008. Community has historically spent more on uncompensated
community benefits than all other Fresno-area hospitals combined, and in some years, nearly
double their combined total.
Community board member Ralph Garcia, who also serves as a board member with the California
HealthCare Foundation, was instrumental in facilitating this grant for the hospital.
58
―We need to reach out to the resources,‖ Garcia said. ―Community Medical Centers is doing
everything humanly possible to provide their best service, and we showed that, but it‘s going to
require a lot more. And hopefully the California HealthCare Foundation, with all its partners, with
other foundations, that we can bring more attention here on then needs to provide much better
care.
―In my career, I‘m going to look back at this as one of the high points in my community
involvement.‖
Here‘s how the interpreter network system works:
A request for an interpreter is made.
The system searches for interpreter availability within the hospital.
If local resources are unavailable, the system searches other participating hospitals.
If the network cannot find an interpreter, the call is routed to a company that provides an
audio-only interpreter.
Calls can also indicate priority and be sorted by characteristics requested, such as male
or female or specialized training.
Anonymous donor gives $750,000 toward
Terry‟s House
In the past several months, local radio
and television stations PEAK
Broadcasting, LLC, ABC 30, KSEE 24
and KMPH FOX 26 have stepped in to
help create awareness of the private
support needed to build Terry‘s
House. Through these efforts, one
Valley family stepped in and gifted
$750,000 to help build the home.
―We are ecstatic about Terry‘s House
becoming a reality,‖ said Tim Joslin,
CEO of Community Medical Centers.
―It‘s another piece to becoming a
world-class regional medical center
and another step in the right direction
as we serve our community and Community board of trustees chair Kevin Follansbee announced in
November that construction on Terry's House will begin in January. The
beyond. We appreciate the support of project depends on private gifts and contributions to build and maintain
this family and other individuals and the facility.
families who have come through these
rough economic times to give back.‖
The anonymous donors asked only that Community Medical Centers adds a chapel to the home.
The gift will guarantee a quiet, comfortable and spiritual space is available for the families at
Terry's House.
59
Currently, Community Regional Medical Center and Clovis Community Medical Center have
chapels, offering people of all denominations and religions a place to go to pray or meditate.
Hospital chaplains are available for patients and families, 24 hours a day, seven days a week, for
emotional and spiritual support, regardless of their faith.
―My role is to find out what their needs are and help them in any way possible emotionally and
spiritually,‖ said Grimaldo Enriquez, Community‘s chaplain services
supervisor.
Having gone through a recent family tragedy, registered nurse Lynn
Bennink, trauma director for Community Regional, understands the
importance of faith-based support both at the hospital and away
from the hospital. She says family members often try to stay strong
and supportive while at the hospital, but can break down once they
leave.
―Our anonymous donors truly fit the definition of people we want involved in Terry‘s House,‖
Bennink said.
―They understand that at Terry‘s House, we will not be able to change the outcome of the patient
in the hospital but we can impact the journey of the family going through this difficult time.
Having a chapel or a place for reflection at Terry‘s House will help with this mission by providing
additional support and comfort to many of our families during their difficult journey.‖
The 17,000-square-foot home also will have an outdoor healing garden where people can go to
retreat.
―People seek comfort and find peace in different ways,‖ Bennink said. ―A healing garden and a
chapel complement each other in that they will provide our families with options.‖
For more information on Terry‘s House and how you can give, visit www.TerrysHouseFresno.com
or call 559.459.2670.
Rain doesn‟t dampen burn survivors‟ spirits
at holiday celebration
Even heavy rain couldn‘t keep Santa Claus away
from more than 350 burn survivors, their families,
supporters and volunteers at Community Regional
Medical Center‘s Leon S. Peters Burn Center and
Alisa Ann Ruch Burn Foundation holiday party.
Santa dashed from the waiting fire truck outside,
into the Clovis Rodeo Hall where he was greeted
by excited children all ready to sit on his lap, give
him their Christmas wish lists and pose for a photo
with the jolly man in red.
Representatives from seven different fire
departments attended the party and volunteers
60
helped to make it a success.
―It is an important time for burn survivors and their family members to remember their blessings
and meet with others who have been through a similar experience, said Peters Burn Center
director Sandra Yovino.‖
The families also had a chance to make holiday crafts and local fire departments collected and
donated toys for the children to take home.
Rachel Ochoa, the wife of burn survivor Jose Ochoa, said she thinks the party is amazing. ―We
love coming here. The kids have a great time.‖
Her husband Jose was burned in August 2004 when a tire on the diesel truck he was driving blew
out, causing sparks and exploding both of the diesel‘s fuel tanks. Ochoa was taken to Community
Regional – home to the only Level 1 trauma and comprehensive burn center between Los
Angeles and Sacramento. Ochoa had first-, second- and third-degree burns on his face and
arms.
Rachel Ochoa said her husband was a model patient during his recovery and he went back to
work in September 2005. She feels blessed her husband made such a recovery and can now be
back with their four children – 7-year-old Jocelyn, 3-year-old Jose Daniel, 13-year-old Vivian and
15-year-old Julian.
―This event also is special to the burn team who are able to come and celebrate the survivors‘
successes,‖ Yovino said. ―Sharing time with our survivors allows us to be grateful for the
differences we make every day.‖
Rachel spoke for Jose, who is Spanish-speaking, when she said, ―Thanks to the burn center, he
is complete.‖
Dinuba man in right place, right time for
heart attack
Cleofus ―Felix‖ Gonzalez was sure he‘d ―have no words‖
sufficient to express his gratitude to a hospital worker who
found him clutching his chest in the rose garden outside
Community Regional Medical Center on Sept. 16.
But when the rescuer peeked into Gonzalez‘s hospital room
a day later, grateful tears started flowing and words poured
out: ―I thought I was going to die. Thank you is not enough
… I was afraid I was going to die right there.‖
Jacob Isaac, a patient care advocate in Community
Regional‘s emergency department, engulfed Gonzalez in a
bear hug and confessed, ―To be honest, I was a little
terrified myself.‖
Patient care advocate Jacob Isaac got a
heartfelt thank you from Cleofus "Felix" Isaac was hurrying a specimen to the lab adjacent to the
Gonzalez after coming to his rescue a day hospital when he came across Gonzalez moaning in pain
earlier. and collapsed against a raised planter box. He ran to get a
61
wheelchair and rushed Gonzalez into the emergency department‘s red zone for critically ill and
trauma patients. Within 36 minutes, Gonzalez was in the fourth-floor cardiac catheter lab having
a stent put in a blocked artery.
Gonzalez‘ nurses say he was lucky. He was having his third heart attack. A few more minutes
and the 63-year-old Dinuba man might not have made it,
they said.
The Dinuba father of six and grandfather of 13 had come to
Community Regional to visit his aunt in critical care. He
excused himself from the family gathering around her bed. ―I
wasn‘t feeling well. I didn‘t want to worry everyone when
they were all so happy together. We had cousins come from
Mexico, from Pomona,‖ Gonzalez explained. Instead going
down the hall to the bathroom, he made his way outside to a
quiet garden area away from the hospital‘s main entrances.
Isaac said he almost missed his chance to help. ―I‘m just so
happy I didn‘t take that specimen a little earlier and I was
there for you … The copy machine was acting up and then I
Community Regional's Jacob Isaac and
had to take a patient to the bathroom.‖ Dinuba man Cleofus "Felix" Gonzalez.
Gonzalez nodded. ―And if my cousin hadn‘t come and picked me up to take me to the hospital, I
might have died.‖
Erika Gonzalez dabbed tears and hugged her mother as her father talked about his ordeal and
how fate intervened. ―He‘s had three heart attacks,‖ she said. ―I always hear three strikes and
you are out. But not this time for him. Three times they had to shock his heart in the emergency
room.‖
Coworkers said Jacob Isaac‘s caring and quick thinking carry on the legacy of his father, Brad
Isaac, a longtime emergency department nurse supervisor at Community who died in 2007 in a
car accident.
―He‘s our angel,‖ Erika Gonzalez said of Jacob.
Scelzi races in to help patients‟ families
Melvin Bell‘s life nearly came to an end when he and two friends were in a car accident
in Chowchilla. The car they were in ran a stop sign, hit a truck and caught fire, killing
Melvin‘s two friends. Melvin was pulled from the wreckage and airlifted to Community Regional
Medical Center, where emergency crews fought to keep his vitals and badly burned body stable.
Back in Chowchilla, Teresa Bizzell, Melvin‘s mother, was waiting for her 17-year-old son to arrive
home around 4 p.m.
―I kept paging, paging and paging him on the cell phone and finally at 5:26 p.m. I got a phone
call and they said my son had been airlifted here to the [Leon S. Peters] Burn Center,‖ Bizzell
said. ―When we got to speak to the doctor, they came in and told us they didn‘t believe he was
going to survive.‖
Melvin did survive, but not without worry from physicians and medical staff.
62
―We were called by his bedside in the first four weeks — four times — and told that he was not
going to make it. But he did,‖ Bizzell said. ―God and the doctors and the nurses, they‘re all
angels.‖
Bizzell said Melvin suffered burns over 70% of his body, lost half of his left foot, half of his right
leg and will only have 30% to 40% use of his left hand. She and her family were by his side
every step of his recovery.
―We‘re just getting better day by day,‖ she
said. ―We exercise his hands and his legs and
I help do the dressings. He has to have
dressings done every two days … and just
little other things that need to be done that
he needs help with.‖
The family lived in Chowchilla at the time of
the accident and for months drove back and
forth, spending more than $9,000 on travel
and food, getting help from a Chowchilla
racetrack fundraiser.
After a few months, Bizzell and her family
were able to move from Chowchilla to Clovis,
just 15 minutes away from the hospital, to be
closer to Melvin. But during the first few
critical months of Melvin‘s recovery, Bizzell
and her family found themselves sleeping in
a small waiting room across the hall.
―I stayed at nights in the room, brought my
clothes, slept on the floor, finally got air
mattresses and slept on there,‖ she said. ―I
lived there and was in and out of the room at
night to see him and see how he was doing.‖
Teresa‘s story is not unique. Many families from out of town have loved ones receiving critical
care at Community Regional and find themselves unable to afford expensive hotel rooms and end
up sleeping by the bedside, in waiting rooms or in their cars.
Community Regional‘s comprehensive regional burn and Level 1 trauma centers serve a 15,000-
square-mile service area – patients may come in from anywhere between Los Angeles and
Sacramento. To help families like Bizzell‘s, Community Medical Centers is building Terry‘s House,
a home where families can stay on the hospital campus while their loved ones are receiving
critical care.
Months into his stay, Melvin got a surprise visit from four-time National Hot Rod Association
(NHRA) champion Gary Scelzi, an advocate of Terry‘s House. He and many other supporters are
encouraging the community to come together to raise funds to start construction on the lodging
facility. Melvin, a motor sports enthusiast, was thrilled to see Scelzi.
Melvin was an all-terrain vehicle (ATV) quad rider and had won many racing championships.
63
―He loved his quad,‖ Bizzell said. ―His dad Kurt got him into quad riding and he was the best you
could see out there, that kid. He won practically every one of his races, he must have 120
trophies, plus he won six of the championships. He was so good, he ‗s an awesome kid, rode it
like he owned it‖
Like Melvin, Scelzi has experienced fire, but he was fortunate enough to be wearing a fire suit
while racing.
―I had my first crash in 1999, it was pretty bad, there was nothing left of the car but myself,‖
Scelzi said. ―I can describe the fire, the sounds, all the things that took place while the accident
was happening and I got out of the car and I was fine. The fire suit was burned and the car was
totaled.‖
Scelzi lost many friends while racing and understands the hardships their families had to endure.
That‘s why he wants to give back to the Fresno region, helping families like Melvin‘s have a place
to stay.
―One of the things, as I went away racing, I would say, ―Go Fresno,‖ and everywhere I would go
in town they would say, ―Hey Scelzi thanks for mentioning Fresno, you‘re putting us on the
map,‘‖ he said. ―It always meant a lot to me.‖
When Scelzi was approached by the idea, he was eager to get started on creating awareness for
Terry‘s House within the Fresno community and beyond.
―I want to be a part of it. It touched me, you know, just like talking to Melvin,‖ Scelzi said. ―I
saw a young man with a lot of injuries … I couldn‘t imagine going through what Melvin is going
through now and to have the care that we can give him here and to know that we can put up a
house like Terry‘s House, where his family can stay and not have to travel all these miles. It‘s
just something that needs to happen, and so I want to be a part of it.‖
Although Terry‘s House was not available at her time of need, Bizzell is excited that Scelzi and
many other supporters are on board, pushing for future families who need it.
―Terry‘s House would bring much more comfort to families where they would have a place to
stay and not have to worry as much and feel more at home.‖
To learn more about Terry‘s House or how you can give log on to
http://www.terryshousefresno.com/ or call Community Medical Foundation at (559) 459-2670.
Investing in Valley’s Future
Community is more than 100 years old. We are locally owned. We reinvest whatever we earn into
bettering the health of this community. We don’t send it to Wall Street or to a remote corporate
headquarters. Community has a long history of growth, of doing more for the Valley’s well-being than
any other health care institution and of having a vision for the future.
The 2009/2010 Community Benefits Report was prepared by John G. Taylor, director of public affairs,
Community Medical Centers, Fresno, CA
64