Mission: Dickenson community hospital is committed to bringing loving care to health care. We exist to identify and respond to the health care needs of individuals and communities in our region and to assist them in attaining their highest possible level of health. Part i, line i - organization's primary activities: dch is a federally designated critical access hospital. Federal critical access hospital designation requires that a hospital be small and located in a rural area and located more than a 35-mile drive from another hospital or more than a 15-mile drive from another hospital in an area with mountainous terrain or only secondary roads, and be state-designated as a "necessary provider" of health care services to residents in the area. Dch is located in one of the poorest and most unhealthy regions of virginia. Out of a statewide ranking of 1 to 134 (with 134 being the worst), dickenson county is ranked 130 for length of life, 129 for health factors (factors that influence the health of
Programs: Emergency services: our fully staffed 24-hour emergency department is available for patients in a life threatening situation. We can provide air medical transportation to a larger regional hospital for any patient needing a higher level of care. There were 7,128 ed visits during fy17.
behavioral health: our newly expanded ten bed inpatient behavioral health unit (green oak behavioral health) focuses on senior citizens and is the only inpatient behavioral health unit in southwest virginia specifically for older adults. We continued to offer our outpatient behavioral health program, senior life solutions. There were 2,212 inpatient days and 2,726 outpatient visits during fy17.
laboratory: our experienced staff offers complete and comprehensive services including: outpatient services, stat testing, comprehensive chemistry studies, occupational drug testing, high sensitive coumadin monitoring, transfusion services, and more. We provide lab services 24 hours a day, 7 days a week. During fy17, 62,929 lab tests were processed.
during fy17, we experienced 7,128 visits to our er, 26,032 outpatient visits and 232 inpatient admissions. Inpatient admissions increased by 103. 5% over fy16 primarily due to the expansion of our behavioral health unit. With financial assistance from a usda rural development grant, mountain states health alliance (msha) established a telemedicine network connecting icu doctors at johnson city medical center (msha's flagship hospital) with the system's six rural hospitals, including dickenson community hospital. Mountain states already practices telemedicine for pediatrics, emergency room and psychiatrics, providing a high-quality, live video and audio link between a provider at one facility and a patient and provider at another facility. The new usda grant is specifically for the intensive care unit, allowing specialists at jcmc to conduct real-time consultations with patients and caregivers in the icu at our rural hospitals. Many patients in rural towns do not have cars or disposable income to spend on gas, meals or lodging to come to jcmc for care, so telemedicine brings the care to them. This new service is projected to serve about 5,000 patients per year. The usda grant is one of the usda's distance learning and telemedicine projects. Dickenson community hospital (dch) and mountain states health alliance donated supplies and equipment to ridgeview high school's nursing program. The donation provided relevant equipment and tools used in the healthcare industry to supplement students' learning experience. Carts, beds, blood pressure cuffs, stethoscopes, gloves, and other items were donated. In addition, msha and dch leaders visited the school to meet with the students. Our triumph cancer navigator program celebrated its one-year anniversary and has expanded its scope to cover all types of cancer. The program is designed to support cancer patients and their families, advocate for the patient, and to help coordinate the patient's care throughout the continuum of treatment - from diagnosis to survivorship. There is no charge for these services regardless of whether a patient chooses to receive their treatment at a msha facility or an unrelated facility. Those that join the program receive one-on-one assistance from specially trained oncology professionals. Our cancer navigators communicate with the patient's doctor, will coordinate transportation, set up appointment reminders and provide emotional support for both the patient and the patient's family. Our navigators will also coordinate support services such as treatment planning, prosthesis selection, nutrition counseling, and identification of resources for spiritual care, financial assistance and other needs. Our navigators participate in community events such as health fairs, cancer education events, and cancer support groups. They visit physician offices, seniors' groups, attend meetings with local business organizations, and they work with many other organizations to explain the navigation program and provide cancer awareness/education through the community. The program has made an impact, with the triumph program receiving a patient satisfaction score of 93. As the sixth leading cause of death in the united states, alzheimer's disease is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks. According to the national institute on aging, the number of people diagnosed is increasing each year. Alzheimer's is one of the many conditions treated at our green oak behavioral health unit, which focuses on senior citizens and the elderly. Green oak is the only inpatient behavioral health unit in southwest virginia specifically for older adults. The unit, in conjunction with senior life solutions - the hospital's outpatient geriatric behavioral health program - treats patients over the age of 55, and some over the age of 45 (on a case-by-case basis), keeping families that would normally have to travel for these services close to home. Green oak started out with five beds, but due to the growing need in the region, recently doubled its capacity and is now at 10 beds. The population in our region is aging and with the next closest inpatient behavioral facility about two hours away, green oak provides care close to home for patients from southwest virginia and southeastern kentucky. Our outpatient behavioral health program, senior life solutions, allows seniors access to behavioral health services without having to travel outside of the area. 20% of our residents are 65 years of age or older and with mountainous terrain especially dangerous in winter months, residents needing behavioral health services previously had to leave the area or do without needed care. Similar to our green oak inpatient unit, the benefit of this outpatient program extends benefit to patients' families and friends since they often provide transportation for seniors to medical care appointments. Despite both our inpatient green oak unit and our outpatient senior life solutions program operating at a loss, dch recognizes the need in our service area for these valuable services. Mountain states health alliance is one of only 32 organizations in the country that were chosen recently to be part of the u. S. Centers for medicare & medicaid services' (cms) new program aimed at improving the health of medicare and medicaid beneficiaries. The new program - cms' accountable health communities (ahc) model - will seek to improve the overall health of medicare and medicaid beneficiaries by helping to address patients' health-related social needs. The program seeks to bridge the gap between clinical and community service providers to address issues such as housing instability, food insecurity, utility needs, interpersonal violence and transportation. Mountain states will serve as the bridge organization for the project locally, leading a collaborative with multiple other organizations and care sites to bring the needed services to beneficiaries who live in southwest virginia. The virginia department of medical assistance services will also partner in the program. The ahc model provides federal funding to hire patient navigators, along with additional support staff who will be located at community services boards throughout southwest virginia. All of mountain states' virginia hospitals, including dickenson community hospital, will participate in the new region-wide program. The united states department of health and human services made the selection near the end of our fiscal year so we were in the very early stage of planning at june 30, 2017. Our wound care program began as an outgrowth from norton community hospital in an effort to reach patients that could not access care. Wound care patients often have multiple health issues and many times travel is very difficult for them. These hardships often caused patients the inability to access necessary care. Patients served at dch include those with diabetic ulcers, venous stasis ulcers, arterial ulcers, non-healing traumatic and surgical wounds and other chronic wound conditions. Despite sustaining losses in the program, dch recognizes the value our wound care program provides to the community. Dickenson community hospital continues to subsidize a rural physician clinic to provide some relief of the physician shortage in our area. Our fy17 subsidy was 135,340. The primary care physician ratio in our county is 3,060:1 compared to 1,320:1 for the state of virginia. Recruiting physicians to a rural county such as ours is often challenging due to a myriad of factors, such as geography, economics, culture and education. Geographically, rural communities are often far removed from suburban and urban centers that provide access to educational, cultural and economic opportunities. These limitations influence the relocation decision of the physician candidate and his/her spouse/children to locate to a rural area. This year, dch invested just under 34,000 in the community for mental health public education for seniors. Rural life often includes hazardous occupations, which is certainly true of dickenson county due to the high employment rates in the coal mining industry and trauma accidents related to rural occupations and activities. Deaths from injury in dickenson county is 116% higher than the state of virginia's average. Rural trauma is generally different from urban trauma. Rural trauma is more likely to be from accidents related to farming, hiking, horseback riding, use of four-wheelers, etc. When more advanced care is needed, our patients can be transferred to mountain states health alliance's flagship facility, johnson city medical center, which is a tertiary care facility. The university of virginia's college at wise hosted an inaugural girls day in stem-h for sixth-grade girls in the region to show the young girls that careers in science, technology, engineering, mathematics and he