Leadership Team Hadeel Almutairi Francisco V. Hernandez Shweta Sharma

1. Presentation to St. Rose Hospital Board Of Directors“Providing Healthy Hearts through Quality Care and Spirituality”April, 26, 2017 Leadership Team HadeelAlmutairi Francisco V. Hernandez ShwetaSharma Varotkamol (Apple) Tanyakool

2. Presentation to St. Rose HospitalBoard Of Directors“Providing Healthy Hearts through Quality Care and Spirituality”April 26, 2017 Agenda Retrospective Timeline Key Strategies – Ascending Life Initiatives How did Affordable Care Act affect SRH Retrospective Summary

3. St. Rose Hospital TimelineHow We Got Here! • 5-Year Strategic Plan: Ascending Life Initiatives • Increased bed occupancy • Eliminated pension plan for new hires • Occupancy Rate about 55% • No additional remodeling planned in the near future • Increased reimbursement from • Health Care Reform • Measure A fund • Pay for Performance • Occupancy rate above 80% • Increased reimbursement from • Health Care Reform • Measure A fund • Pay for Performance • Occupancy rate close to max capacity • All Americans would have access to health care insurance • Occupancy rate above 65% • Promote and Expand Centers of Excellence: Cardiology, Oncology, Pediatrics and Obstetrics • Increased reimbursement from • Health Care Reform • Measure A fund • Pay for Performance • Occupancy rate continues to grow

4. KeyStrategies AscendingLifeInitiatives • Improve lobbying efforts to obtain higher percentage of Measure A funds to cover a larger ratio our charity care • SRH to drive the market by creating its own Federally Qualified Health Center (FQHC)

5. Key Strategies Ascending Life Initiatives (Con’t) • Operational Initiatives for Cost Containment & Revenue Improvements • Human Resource Strategies • Invest and promote in Strategic Areas of Excellence: Cardiology, Oncology, Pediatric and Obstetrics

6. Ascending Life Initiatives Measure A Funds before Lobby Initiative

7. Ascending Life Initiatives Measure A Funds before Lobby Initiative

8. Ascending Life InitiativesConvert Silva Clinic to a Federally Qualified Health Center (FQHC)

9. Ascending Life InitiativesCost Containment & Revenue Streams • Metrics to drive staffing needs • Eliminate pension plan for all new hires • Reduce supply costs by better managing vendors • Ensure OR is utilized by physicians efficiently • Involve physicians in cost reduction efforts • Outsourcing the management of some services

10. Ascending Life InitiativesCost Containment & Revenue Streams • Partnering with local physicians to reduce competition for outpatient cases • Grow case volume by attracting new physicians to the facility • Possibly expand service line that is needed for the community (Emergency Department) • Hiring hospitalists to manage inpatient care. • Renegotiate managed care contracts

11. Human Resource (HR) Strategies

12. Patient satisfaction

13. Patients who reported that they "Always" received help as soon as they wanted. • More Staff • Decreased wait time • Daily Round by the Chief • Quick Admission SOURCE: Hospital profile. (2012). Retrieved 04/23, 2013, from http://medicare.gov/hospitalcompare/profile.aspx#vwgrph=0&profTab=1&ID=050002&loc=HAYWARD%2C%20CA&lat=37.6688205&lng=-122.0807964&dist=25&type=4&AspxAutoDetectCookieSupport=1

14. Patients who reported that their nurses "Always" communicated well. Effective Communication Throughout SRH SOURCE: Hospital profile. (2012). Retrieved 04/23, 2013, from http://medicare.gov/hospitalcompare/profile.aspx#vwgrph=0&profTab=1&ID=050002&loc=HAYWARD%2C%20CA&lat=37.6688205&lng=-122.0807964&dist=25&type=4&AspxAutoDetectCookieSupport=1

15. Patients who gave their hospital a rating of 9 or 10 on a scale from 0 (lowest) to 10 (highest). SOURCE: Hospital profile. (2012). Retrieved 04/23, 2013, from http://medicare.gov/hospitalcompare/profile.aspx#vwgrph=0&profTab=1&ID=050002&loc=HAYWARD%2C%20CA&lat=37.6688205&lng=-122.0807964&dist=25&type=4&AspxAutoDetectCookieSupport=1

16. Patients who reported YES, they would definitely recommend SRH Thank you THANK YOU Continue Good Services SOURCE: Hospital profile. (2012). Retrieved 04/23, 2013, from http://medicare.gov/hospitalcompare/profile.aspx#vwgrph=0&profTab=1&ID=050002&loc=HAYWARD%2C%20CA&lat=37.6688205&lng=-122.0807964&dist=25&type=4&AspxAutoDetectCookieSupport=1

17. HR And Performance Improvement Performance Improvement • Integrity • Collaboration • Accountability • Enthusiasm • Respect

18. Employee Satisfaction

19. Employee satisfaction • Involve Employees • In Decision Making • Listen • Reward

20. Cardiology Department • 2012 – 21 cardiologists • 2017 • Full service line • Premier site for STEMI in Bay area • Increase in cardiologists > 75 %

21. Market Share 2012 – Cardiology

22. Center Of Excellence - Oncology • Accredited from the Commission on Cancer of the American College of Surgeons • Trendsetting treatment in oncology in the past few years

23. Innovative programs • PCI (Percutaneous Coronary Intervention) Research Program • One of the six in California • Evaluated if elective cardiac intervention can be performed at facilities that don’t have cardiac surgical unit.

24. Innovative Programs • PROMOTED SRH HEALTH FAIR • With A 5 Year Cost Of $ 36,000 – 13,000 Individuals Attended • PROMOTED VOLUNTARY WORK • In 2011 – 780 Volunteer Hours By The Staff – Rising Trend Since Then . • HEALTH EDUCATION CLASS • Annual Budget – Approx. $ 60,000. • Diabetes Management, Alcoholism ,Maternal & Child Health,support Groups Etc.

25. Emergency Department Expansion

26. Affordable Care Act – Insurance Coverage And Charity Expense

27. Affordable Care Act & Pay For Performance

28. AFFORDABLE CARE ACT -MeDICAID EXPANSION Increase in life expectancy More people under Medicaid Increased revenues

29. Retrospective Summary • Ascending Life Initiatives: • Leveraging Measure A funds for charity care • Converting Silva Clinic to FQHC • Improved Quality Measures • Promoting Centers of Excellence

30. THANK YOU