Quality Care and Community Strength

We all recognize the role hospitals play in providing critically important healthcare to the community. As a non-profit provider of hospital and healthcare services to the Main Line, however, Main Line Health is also an irreplaceable part of our community's economic and social fabric.

Main Line Health was founded in 1985, and includes Bryn Mawr, Lankenau, Paoli, and Bryn Mawr Rehab Hospitals; Main Line Clinical Laboratories; the Lankenau Institute of Medical Research; Great Valley Health, a primary care network; the Wayne Center, a skilled nursing facility; Main Line Health Centers in Exton, Lawrence Park, Shannondell and Upper Providence; The Home Care Network, and other related subsidiaries.

Our non-profit status means that we are a charitable organization fulfilling a community-based mission. It also means that the donations, revenues, and other income we receive are reinvested into our services and facilities so we may improve our service to patients and the community.

The following describes the 'big picture' of your hospitals' importance to the community, and describes some of the challenges we face in meeting our community's healthcare needs.

Main Line Health is Essential to the Health and Prosperity of the Community
Everyday, residents of the Main Line and beyond seek care and service from Main Line Health. Each patient's needs are unique and can range from a routine physical, to a complicated surgery, to sophisticated testing and diagnosis. Over the course of a year, the Main Line Health hospitals:

• Admit almost 50,000 inpatients
• Deliver more than 5,500 babies
• Perform more than 28,000 surgeries
• Treat over 95,000 emergencies
• Provide more than 300,000 episodes of outpatient care

A workforce of almost 8,000 people makes this care possible, 24-hours-a-day, seven days a week. Our team includes:

• Care givers such as doctors, nurses, therapists, and technicians
• Medical residents and other students of medicine, nursing, and allied health professions
• Support staff who provide a clean and safe environment, maintain sophisticated equipment and computer systems, ensure that our buildings function properly with heat and air conditioning, or serve tasty and nutritious food
• Administrators who provide management, focusing on the effective and efficient use of resources, and on improving services.

In addition, each year more than 1,500 community volunteers give more than 200,000 hours of their time and talent to assist patients, visitors, and staff.

Overseeing our mission is a volunteer Board of Governors - men and women who live and work on the Main Line and who are committed to maintaining strong healthcare for the community.

Charity Care
Part of the mission of Main Line Health is to provide care, regardless of a person's ability to pay. In 2003, Main Line Health provided almost $9 million in uncompensated care. Main Line Health also aims to improve the health status in communities we serve. In 2003, we spent almost $2 million on improving community health through efforts such as health screenings, preventive care, and education for young and old alike. We reached 42,500 local residents with these services.

Main Line Health Creates Economic Vitality
Main Line Health is good for the economy. The impact of our spending - on supplies and services, payroll, and taxes - reverberates throughout the community. According to an economic impact study, in the year 2000 our organization had a total impact of $266.4 million on the economy of Lower Merion Township, and $68 million on the economy of Willistown Township (the two townships in which our Hospitals are located). Within Montgomery, Chester, and Delaware counties, Main Line Health had a combined impact of more than $617 million.

Main Line Health Provides Jobs
Main Line Health is among the largest locally based private employers in southeastern Pennsylvania. In the year 2000, we directly employed 5,700 full-time-equivalent jobs, and indirectly supported another 5,300 jobs throughout the region and state. These jobs represent a wide range of employment, from entry-level to highly sophisticated positions.

Main Line Health Generates Tax Revenue
Even though Main Line Health is a non-profit, charitable organization, we are a significant source of direct and indirect tax revenue for local school boards and townships in which our Hospitals are located. In fiscal year 2000, for example, Main Line Health paid over $500,000 in township and school board taxes and fees in Lower Merion, and indirectly generated an additional $360,000 in township revenue. In Willistown Township, Main Line Health is responsible for more than $300,000 in tax revenue annually. Our home counties and state benefit as well: $1 million in tax revenue to Montgomery County, $600,000 for Chester County, and almost $19 million direct and indirect taxes for the Commonwealth of Pennsylvania.

Stewardship Challenges
Main Line Health is an irreplaceable part of the quality of life along the Main Line. Over more than 100 years, our Hospitals have grown and adapted to meet changing demographic, technological, and economic realities. We must continue to change to ensure community access to quality healthcare, along with positive economic and social impact.

Several Factors are Driving Change at the Main Line Health Hospitals

• As the population of the Main Line and western suburbs grows, demand for healthcare services increases.
• As our community ages, those with health conditions related to aging - such as heart disease, cancer, and orthopedic problems - require more care.
• Public health problems such as obesity, diabetes, asthma, and tobacco use create demand for these services.
• Other local hospitals have closed or cut back. Patients once served by those hospitals are turning to Main Line Health.
• Patients expect their hospitals to have modern facilities, the latest technology, and convenient parking.
• A renewed emphasis on patient safety and reduction of medical error demands new investments in technology and people.
• Ongoing public concern about healthcare costs require hospitals to operate as efficiently and effectively as possible.

Updating Facilities
Many of the facilities and buildings that make up our Hospitals need to be expanded and updated. At Bryn Mawr, for example, many inpatient rooms are located within an 80-year old building that is inefficient to operate and expensive to maintain. At Lankenau, our Critical Care units are too small to accommodate modern technology or to provide sufficient patient privacy. At Paoli Hospital, booming demand for inpatient services requires more beds to meet community needs. Shortages of parking on all our campuses frustrate patients, physicians, and visitors.

We also need additional space for doctors, who desire modern offices that are close to the hospitals.

Technology
Patient demand for new technologies that improve clinical care remains high and is very expensive. Our Hospitals and doctors need these new technologies to stay on the leading edge of medical practice. Technology is also a factor in our effort to improve patient safety and reduce chances for error. Federally mandated changes in billing and patient privacy processes are also demanding new technology spending by hospitals.

Recruiting and Retaining Employees and Doctors
Healthcare has labor shortages among nurses, technicians, therapists, pharmacists, and other caregivers. Main Line Health must work hard to attract and retain quality staff necessary to provide care. Successful nurse recruitment and retention efforts reduced our overall vacancy rate to less than 8 percent in 2003, well below the national and local averages of 15 to 20 percent.

Great doctors look for strong hospitals that can provide them with modern facilities and equipment, convenient medical office space, and a highly skilled, dedicated hospital staff. At the same time, the medical liability crisis and poor insurance reimbursement make it difficult to attract quality physicians to Pennsylvania. Overcoming these challenges is necessary if we are to attract and retain the best doctors, without whom we cannot serve the community.

Insurance Costs and Regulatory Burdens
By now the impact of the medical liability crisis in Pennsylvania is well documented in terms of patient access to care, the loss of physicians, and cost. This year, Main Line Health will spend more than $20 million on liability insurance, more than five times what we spent three years ago.

Hospitals are monitored and regulated by numerous state and federal agencies, as well as by professional associations. Regulation can be helpful, but it comes at a cost in time and money. The American Hospital Association has documented that each hour of care in a typical hospital requires a minimum of an additional 30 minutes of mandated paperwork. In the emergency department, the ratio is 1:1. By some estimates, regulation adds up to 25 percent to the cost of care at a hospital.

We Are In It Together
The issues facing the Main Line Health hospitals are the issues facing our community. Each presents a serious challenge to our ability to care for the community and to provide all the other benefits that vibrant and growing hospitals bring to the Main Line and surrounding area.

Our goal is to help the community understand all the benefits we provide, and to understand what is at stake as we work to remain strong, vital, and thriving community institutions.

We rely on community support - from patients, residents, elected officials, donors, employees, physicians, volunteers, and others - for our success. We invite our community to learn more and to get involved in protecting and enhancing the important community assets represented by Main Line Health.

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