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Emory University Hospital- Overview

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					                Emory Hospitals
                 An Overview
   Emory University Hospital
   Emory Crawford Long Hospital
   Wesley Woods Hospital/Center
    “more than a hospital”

Robert J. Bachman , Chief Operating Officer, EUH
Mark Aycock, Chief Financial Officer, Emory Hospitals
Emory Hospitals - An Overview

   Beginnings
   Current Configuration
   Leadership (Management)
   Services
   Operational Statistics
      Emory University Hospital
       Beginnings/Current Configuration
   Chartered in 1904/Opened as Wesley Memorial
    Hospital in 1905
   Moved to Emory campus in 1920s
   Currently
            Licensed to operate 579 beds
            Actual: 360 Med/Surg Beds
                       82 ICU Beds (new 20 bed NICU open in 1/07)
                       52 Rehab Beds (38 in use)
                       20 Psych Beds (18 in use)
    Emory Hospitals – Leaderhsip
 EUH: Robert J. Bachman, COO
        Mark Aycock, CFO
       Susan Grant, R.N., CNO, EHC
       Ira Horowitz, M.D., CMO
       Nathan Spell, M.D., CQO
ECLH: Albert Blackwelder, COO
      James Steinberg, CMO
      Richard Gitomer, M.D., CQO
WW: Peter Basler, COO
      Joseph Ouslander, M.D., CMO
           Emory Healthcare -
       System Leadership For EHs

   John T. Fox, President/CEO
   James Hatcher, CFO
   Susan Grant, R.N., CNO
   William Bornstein, M.D., Ph.D., CQO
    Emory University Hospital
12,000 surgeries (300 transplants)
700 Heart surgeries/
28,000 ED visits (>28% of pts admitted)
494 - Adjusted Average Daily Census
27,500 – Adjusted Admissions
2,700 FTEs (3,300 employees)
ALOS – 6.4 days
CMI – 2.15
      Emory University Hospital
                     Services
   Cardiology/Cardiovascular Surgery
   Oncology – WCI
   Neurology/NeuroSurgery
   Transplantation
   Orthopaedics
   The Rollins Pavilion
   No OB/No Pediatrics - CHOA
                                                                                                    Emory University Hospital
                                                                                                      Organizational Chart


                                                                                                     President & Chief Executive Officer
                                                                                                          EMORY HEALTHCARE
                                                                                                                              John T. Fox
         Chief Qual ity Officer, Emory
  Heal thcare/Chief Medical Officer, Emory
                  Hospital s                                                                                           Chief Operating Officer — EUH
   William A. Bornstein, MD, PhD                       Medical Staff                                                   Senior Associate Administrator
                                                                                                                              Emory Hospitals
        Infection Control
        EHC Information Systems’
                                                                                                                               Robert J. Bachman
         Medical Director                      Chief Medical Officer                                                                                  Development
        Medical Staff Office
        Risk Management Office
                                                  Ira Horowitz, MD                                                                                    Pathology & Laboratory Services
                                                                                                                                                      Pharmacy
                                                                                                                                                      Imaging Services
                                                                                                                                                      Transplant Services
                                                                                                                                                                                                         Hospital Auxiliary

                                             Associate Medical Director
                                             Donald C. Davis, MD, PhD



           Associate Administrator                     Chief Human Resources Officer
           Chief Operating Officer                                                                     Chief Financial Officer                                                  Chief Nursing Officer                                         Associate Administrator            Associate Administrator
                                                             Emory Heal thcare                           Emory Heal thcare                                                       Emory Heal thcare                                               Emory Hospital s                   Emory Hospital s
              Emory Hospital s                          Margaret A. Bloomquist ,
        CRM, Mental Heal th Services, &                                                               James T. Hatcher, CPA                                                 Susan M. Grant, MS, RN,                                              David E. Pugh                  Toni F. Wimby, CHE
                                                                       SPHR                                                                                                              CNAA
               Wesl ey Woods
                Peter A. Basler, Jr.
        Center for Rehabilitation Medicine               Education & Learning Services                                                                                                                                                                                          Food & Nutrition Services
                                                                                                       Materials Management                                              Gambro                                                               Anesthesiology Services
        Hospital Rehabilitation Services                 Employee Health Services                                                                                                                                                                                               Guest & Volunteer Services
                                                                                                        • Purchasing                                                     Medical Services & Patient Services                                  Facility Planning & Development
        Mental Health Services                            • Workers’ Compensation                                                                                         Information Systems                                                                                   Neurodiagnostics Testing
                                                                                                       Social Services                                                                                                                        Facility Services
                                                         Educational Information & Media Services                                                                        Nursing Systems Integration & Maternity                                                                Pastoral Services
                                                                                                        • Clinical Resource                                                                                                                    • Environmental Services
                                                          • Medical Library                               Management                                                      Services                                                                                              Respiratory Care Services
                                                                                                                                                                                                                                               • Laundry
                                                         EHC Service Performance                       Value Analysis                                                    Oncology Services                                                                                       • Electrocardiography
                                                                                                                                                                                                                                               • Facilities Management
                                                                                                                              Chief Financial Officer                    Perioperative & Endoscopic Services                                   • Property Management
                                                                                                                                                                                                                                                                                 • Pulmonary Function
                                                                                                                                Emory Hospitals                           Support Systems
                                                                                                                                                                                                                                               • Public Safety
                                                                                                                                                                                                                                                                                 • Respiratory Therapy
                                                                                                                                Mark A. Aycock                           General Surgery & Transplant Services
                                                                                                                                                                                                                                               • Safety
                                                                                                                                                                         Surgical Specialties/Community Services
                                                                                                                                                                                                                                              Medical Engineering
       Associate Administrator                                                                                                Financial Services                         Geriatric Nursing Services
                                                                                                                                                                                                                                              Telecommunications
          Emory Hospitals                                                                                                      • Accounts Payable                        Emergency Services
       Barbara E. Hargett, RN                                                                                                  • Decision Support
                                             Assistant Administrator                                                           • Financial Planning                                Assistant Administrator          Assistant Administrator
        Clinical Performance
         Improvement
                                                 Emory Hospitals                                                               • General Accounting                                    Emory Hospitals                  Emory Hospitals
        Regulatory/Accreditation
                                             Larry F. Hodges, CHE                                                              • Payroll                                               Jane Vosloh, RN              M. June Connor, RN
                                                                                                                              Management Engineering
                                              Human Resources                                                                 Medical Records                                   GID
                                                                                                                                                                                                                   Cardiac Services
                                                                                                                              Patient Accounts                                  Operating Room
                                                                                                                                                                                                                   • EP
                                                                                                                               • Admissions                                     PACU
        Chief Quality Officer                                                                                                                                                                                      • Cardiac Cath Lab
                                                                                                                               • Audit Coordinators                             Ambulatory Surgery
                                                                                                                                                                                                                   • Heart Failure Program
         Nathan Spell, MD                                                                                                      • Business Office                                Sterile Processing
                                                                                                                                                                                                                   Cardiac Nursing Services
                                                                                                                                                                                Same Day Surgery
                                                                                                                                                                                Pre Admit Testing




Source: Administration, Emory Hospitals
                                                                                                                                                                                                                                                                                Updated September 2006
Emory Crawford Long Hospital
     Licensed for 511 beds – 420 beds in service
     Emergency Room - 50,000 visits/year
     14,000 surgeries (IP & OP) – 1,100 cardiac
     OB - 4,200 births/year
     “Open Medical Staff”
     Long Term Acute Care Hospital
     CMI – 1.6
     FTEs – 2300
     Adjusted FTEs per AOB – 4.8
     Adjusted Admissions – 33,000/year
     ALOS – 5 days
                                                                                                                    Emory Crawford Long Hospital
                                                                                                                        Organizational Chart

                                                                                                                                          President & Chief Executive Officer
                                                                                                                                               EMORY HEALTHCARE
                                                                                                                                                           John T. Fox

  Chief Qual ity Officer, Emory                                                                                                                 Chief Operating Officer — ECLH
 Heal thcare/Chief Medical Officer,
          Emory Hospital s
                                                                                                                                                 Senior Associate Administrator
William A. Bornstein, MD, PhD                                                                                                                           Emory Hospitals
                                                                        Medical Staff                                                            Albert K. Blackwelder, FACHE
                                                                                                                                                                          Cardiothoracic Research Lab
   Infection Control
                                                                                                                                                                          Development
   EHC Information Systems’
    Medical Director
   Medical Staff Office                                               Chief Medical Officer
   Risk Management Office
                                                                     James P. Steinberg, MD


                                                                                                                                                                                           Hospital Auxiliary
                           Associate Medical Director                            Associate Medical Director
                            James K. Bennett, MD                                William M. McKinnon, MD



                                  Associate Administrator                                  Chief Human Resources Officer                                                                                          Chief Nursing Officer                   Associate Administrator            Associate Administrator
                                  Chief Operating Officer                                                                                               Chief Financial Officer
                                                                                                 Emory Heal thcare                                       Emory Heal thcare                                         Emory Heal thcare                         Emory Hospital s                   Emory Hospital s
                                     Emory Hospital s                                       Margaret A. Bloomquist,                                                                                                                                      Toni F. Wimby, CHE                      David E. Pugh
                                                                                                                                                     James T. Hatcher, CPA                                  Susan M. Grant, MS, RN,
                               CRM, Mental Heal th Services, &                                            SPHR
                                      Wesl ey Woods                                                                                                                                                                           CNAA
                                       Peter A. Basler, Jr.
                                                                                                                                                                                                           Gambro                                                                            Anesthesiology Services
                               Hos pital Rehabilitation Serv ic es                                                                                Financial Services                                                                                     Food & Nutrition Serv ic es
                                                                                               Education & Learning Services                                                                               Medical Services & Patient                                                        Facility Planning &
                               LTAC                                                                                                                • Accounts Payable                                                                                    Gues t & Volunteer Serv ic es
                                                                                               Employee Health Services                                                                                     Services Information Systems                                                      Development
                                                                                                                                                   • Decision Support                                                                                    Neurodiagnos tic s Tes ting
                                                                                                • Workers’ Compensation                                                                                    Nursing Systems Integration &                                                     Facility Services
                                                                                                                                                   • Financial Planning                                                                                  Pas toral Serv ic es
                                                                                               Educational Information & Media Services                                                                     Maternity Services                                                                • Environmental Services
                                                                                                                                                   • General Accounting                                                                                  Res piratory Care Serv ic es
 Associate Administrator                                                                        • Medical Library                                                                                          Oncology Services                                                                  • Laundry
                                                                                                                                                   • Payroll                   Chief Financial Officer                                                    • Elec troc ardiography
     Emory Hospitals                                                                           EHC Service Performance                                                                                     Perioperative & Endoscopic
                                                                                                                                                                                                                                                          • Pulmonary Func tion
                                                                                                                                                                                                                                                                                              • Facilities Management
 Barbara E. Hargett, RN                                                                                                                           Materials Management           Emory Hospitals            Services Support Systems                                                          • Property Management
                                                                                                                                                   • Purchasing                   Mark A. Aycock           General Surgery & Transplant
                                                                                                                                                                                                                                                          • Res piratory Therapy
                                                                                                                                                                                                                                                                                              • Public Safety
Clinical Performance                                                                                                                              Social Services                                           Services                                                                          • Safety
 Improvement                                                                                                                                       • Clinical Resource         Management Engineering      Surgical Specialties/Community
                                                                                                                                                                                                                                                                                             Medical Engineering
Regulatory/Accreditation                                                                                                                             Management                Medical Records              Services
                                                                                                                                                                                                                                                                                             Telecommunications
                                                                                                                                                  Value Analysis               Patient Accounts            Geriatric Nursing Services
                                                                                                                                                                                • Admissions               Emergency Services
                                                                                                                                                                                • Audit Coordinators
   Chief Quality Officer                                                                                                                                                        • Business Office
  Richard Gitomer, MD                                                           Assistant Administrator                                                                                                     Assistant Administrator          Assistant Administrator
                                                                                    Emory Hospitals                                                                                                             Emory Hospitals                  Emory Hospitals
                                                                                Larry F. Hodges, CHE                                                                                                            Jane Vosloh, RN               M. June Connor, RN
                                                                                 Human Resources                                                                                                          GID                               Cardiac Services
                                                                                                                                                                                                          Bronchoscopy                      • EP
                                                                                                                                                                                                          Operating Room                    • Cardiac Cath Lab
                                                                                                                                                                                                          PACU                              • Heart Failure Program
                                                                                                                                                                                                                                            Cardiac Nursing Services
                                                                                                                                                                                                          Ambulatory Surgery
                                                                                                                                                                                                          Sterile Processing
                                                                                                                                                                                                          Same Day Surgery
                                                                                                                                                                                                          Pre Admit Testing




Source: Administration, Emory Hospitals
                                                                                                                                                                                                                                                                                         Updated September 2006
    Wesley Woods Hospital
100 Geriatric Hospital
Long Term Acute Care Hospital
No ED/OR/ICU
“Continuum of Care”
Budd Terace
                                                                                                                            Wesley Woods Center
                                                                                                                            Organizational Chart
                                                                                                                    CEO, Woodruff Health Sciences Center &
                                                                                                                          Chairman of the Board, EHC
                                                                                                                         Chairman of the Board, WWC
                                                                                                                                       Michael M.E. Johns, MD

                                                                                                                      President & Chief Executive Officer
                                                                                                                           EMORY HEALTHCARE
                                                                                                                                                   John T. Fox                                                                                   Chief Qual ity Officer, Emory
                                                                                                                                                                                                                                                Heal thcare/Chief Medical Officer,
                                                                                                                                                                                                                                                         Emory Hospital s
                                                                                                                                                                                                                                              William A. Bornstein, MD, PhD
                                                                                                                                                Chief Operating Officer
                                                                                                                                                                                                                                                  Infec tion Control

                                     Chief Medical Officer                                                                                       Wesley Woods Center                                                                              EHC Information Sy s tems ’
                                                                                                                                                                                                                                                   Medic al Direc tor
                                        Wesl ey Woods Center                                                                                      Peter A. Basler, Jr.                                                                            Medic al Staff Offic e

                               Joseph G. Ouslander, MD                                                                                                                                             Pastoral Services Director                     Ris k Management Offic e

                                                                                                                                                             Development
                                                                                                                                                             Rehabilitation Services                 Elwood H. Spackman
                                                                                                                                                             Mental Health Services                                                                                    Assistant Administrator
                                                                                                                                                                                                                                                                           Emory Hospitals
                                                                                                                                                                                                                                                                       Barbara E. Hargett, RN
   Medical Director                         Medical Director                       Medical Director
   Wesl ey Woods Hospital             Long Term Acute Care Hospital                       Long Term Care                                                                                                                                                                   Clinical Performance

  Frank W. Brown, MD                         Gerry Staton, MD                         Jeff Lesesne, MD                                                                                                                                                                      Improvement
                                                                                                                                                                                                                                                                           Regulatory/Accreditation


                                                                                                                                                                                                                                                                       Director of Quality,
                                                                                                                                                                                                                                                                       Wesley Woods Center
                                                                                                                                                                                                                                                                             Vicki Davis


                                Associate Administrator                      Associate Administrator
                             Chief Human Resources Officer                                                      Chief Nursing Officer
                                                                             Chief Financial Officer             Emory Heal thcare
                                    Emory Hospital s                            Emory Hospital s                                                                        Wesley Woods, Inc.           Budd Terrace                  Health Center
                              Margaret A. Bloomquist ,                                                       Susan M. Grant, MS, RN,
                                                                          James T. Hatcher, CPA                          CNAA                                                 CEO                    Administrator              Administrator & WWC
                                             SPHR                                                                                                                           Ken Weber               Janice Langford              Assoc. Administrator
                                                                                                                                                                                                                                   William J. Such
                               Education & Learning Services              Materials Management                  Medical Services & Patient
                               Employee Health Services                    • Purchasing                          Services Information Systems
                                                                                                                Geriatric Nursing Services                                                SOURCE                  Wesley Woods
                                • Workers’ Compensation                   Social Services
                               Educational Information & Media Services    • Clinical Resource                                                                                            Director              Clinic Adm inistrator
                                • Medical Library                            Management                                                                                                Jennifer Schuck             JoAnn Croley
                               EHC Service Performance                    Value Analysis
                                                                                                                                 Director of Nursing
                                                                                                                                 Wesley Woods Center
                                                                                   Assistant Administrator                        Becky Provine, RN
                                                                                       Emory Hospitals
                  Assistant Administrator                                              Mark A. Aycock
                     Emory Hospitals
                  Larry F. Hodges, CHE                                             Financial Services
                                                                                    • Accounts Payable                                           Wesley Woods LTAC*
                   Human Resources                                                  • Decision Support
                                                                                                                                                    Adm inistrator
                                                                                    • Financial Planning
                                                                                    • General Accounting                                           William J. Such
                                                                                    • Payroll
                                                                                   Management Engineering
                                                                                   Medical Records
                                                                                   Patient Accounts
                                                                                    • Admissions
                                                                                    • Audit Coordinators
                                                                                    • Business Office




*Wesley Woods Long Term Acute Hospital (LTAC) is a separate corporate entity with a management agreement with Wesley Woods Ce nter
  Source: Administration, Emory Hospitals                                                                                                                                                                                                                              Updated September 2006
    Emory Hospitals FY07 Budget
   Total Operating Revenues of $1.025 billion
    from $2.1 billion in billings
    o   Emory University Hospital $586 million (57%)
    o   Emory Crawford Long Hospital $384 million (38%)
    o   Wesley Woods Center $55 million (5%)
   Total Operating Expenses of $957 million
   Operating Income of $68 million or 6.6%
                  Cardiology Services
                        Market Share – 2004
                  Emory Hospitals combined = 15%
14%      13%


12%
                                                               10%
10%                  9%


8%                               7%


6%                                         5%            5%
                                                   4%
4%


2%


0%
      St. Joe's   Piedmont   Kennestone   Grady   Cobb   EUH   ECLH
  Orthopaedics and Spine Services
                       Market Share – 2004
                  Emory Hospitals combined = 8%
                    10%
10%
                                 9%
9%

8%
          7%
7%                                         6%

6%
                                                     5%
5%
                                                              4%     4%
4%

3%

2%

1%

0%
      St. Joe's   Piedmont   Kennestone   Grady   Northside   EUH   ECLH
                 Oncology Services
                     Market Share – 2004
               Emory Hospitals combined = 16%
                                                  10%      10%
10%               9%

9%                                      8%
                              8%
8%
        7%
7%
                                                                  6%
6%

5%

4%

3%

2%

1%

0%
      Dekalb   Piedmont   Kennestone   Grady   Northside   EUH   ECLH
                 Neuroscience Services
                        Market Share – 2004
                  Emory Hospitals combined = 14%
                              8%                        8%
8%
                    7%                  7%
7%
                                                 6%
6%
        5%
5%
                                                              4%
4%


3%

                                                                     2%
2%

1%


0%
     St. Joe's   Piedmont Kennestone   Grady   Dekalb   EUH   ECLH   WW
Emory University Hospital
      FY2007 Payer Mix Information



             Blue Cross    HMO
                12%        21%


  Medicaid
    6%
                                 PPO
                                 8%




                                       Self Pay & Other
                Medicare                     10%
                 43%
Emory Crawford Long Hospital
     FY2007 Payer Mix Information


                  Blue Cross
                     9%
                               HMO
                               22%
     Medicaid
      19%



                                     PPO
                                     6%



                Medicare                   Self Pay & Other
                 37%                              7%
Wesley Woods Hospital
  FY2007 Payer Mix Information




  Medicare                       Medicaid
   86%                            2%

                                  Blue Cross
                      HMO            2%
                       7%

                               PPO
                               2%
                            Self Pay & Other
                                   1%
Emory Crawford Long Hospital
   FY2007 Expense Information ($957M)

                                 Interest &
                                Depreciation
                                     6%

                Supplies                Utilites & Maintenance
                 27%                              5%


                                            EU & EHC Overhead
                                                   6%
     Benefits
       9%
                            All Other
                              11%

                 Salaries
                  36%
Emory Hospitals Cash Flow FY2007
   Cash Generated from Operations: $105 million
   LESS:
    Debt Principal Payments         $30 million
    Capital Expenditures            $37 million
    Clifton Road Development        $12 million
    WHSCAB & SOM Funding            $34 million
Funding Total                        $113 million
This is our biggest financial challenge as a health
  science center.
             Medical Education
   Hospital, via billing from GME office, reimburses
    SOM for residents in accredited programs
   Hospital is then partially reimbursed for this
    expense from the Medicare program through the
    filing of an annual cost report
   Medicare has capped Emory Hospitals resident
    FTEs at 356
   Tightly regulated area, particularly on accounting
    for residents time and the location where they are
    working
                      Research
   The hospitals have a standard rate of 35% of
    charges for research (was 40% in FY2006)
   Hospital rates change each September and a new
    listing of charges is provided to the Clinical Trials
    Office for download into the Siteminder System
   Upfront identification of research patients is a
    must if proper hospital billing is to occur
   Research revenues are budgeted at $1.5 million for
    FY07 (0.1% of hospital revenues)
Emory Hospitals: An Overview




 Q   UESTIONS
                                                                Emory Healthcare
                                                               Organizational Chart
                                                         CEO, Woodruff Health Sciences Center &
                                                                                                                                   Chief of Staff
                                                              Chairman of the Board, EHC                                        Gary L. Teal, MBA
                                                               Michael M.E. Johns, MD



                                                           President and Chief Executive Officer
                                                                       John T. Fox




                                President & CEO,                     Director,                     Chief Operating Officer,
                             Emory Children’s Center            The Emory Clinic                  Emory University Hospital
 Chief Quality Officer        Barbara J. Stoll, MD            Wright Caughman, MD                   Robert J. Bachman
 William A. Bornstein,
       MD, PhD
                                                                                                   Chief Operating Officer,
                                   Senior Director,
                                    Managed Care                Chief Operating Officer,            Wesley Woods Center
Chief Compliance Officer                                          T he Emory Clinic                  Pete A. Basler, Jr.
                                S. Patrick Hammond
   Anne Adams, JD                                                  Donald I. Brunn
                                                                                               Chief Operating Officer,
                                  Senior Director,                                           Emory Crawford Long Hospital
Chief Information Officer           Marketing
    De dra Cantrell                                                                            Albert K. Blackwelder
                                  Una H. Newman

                                                                                             Chief Financial Officer, Emory
 Associate Administrator           Chief Human                                                         Healthcare
  De bra Bloom, APR              Resources Officer                                              James T. Hatcher, CPA
                               Margaret A. Bloomquist

                                                                                                  Chief Nursing Officer,
                                   Senior Director,                                                Emory Healthcare
                                Risk & Insurance Svcs.                                     Susan M. G rant, RN, MS, CNAA-B C
                                  Shulamith Klein

                                                                                                 Executive Director,
                                                                                           Emory Center for Pastoral Services
                                                                                            Elwood H. Spackman, M.Div.

Source: Emory Healthcare, Office of the President and Chief Executive Officer
                                                                                                                                                Updated October 2006

				
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