“Our balance sheet is very strong,” Dewerff said. “We have very low debt.”

TRMC’s well-being is important for the broader community not only because of the health care it provides. The medical center is also one of the region’s largest employers. With more than 1,100 employees, it contributes roughly $70 million to the Webster County economy each year, according to data provided by officials at Trinity and the Iowa Hospital Association.

Dewerff said 2017 was a good year for UnityPoint Health — Fort Dodge and Trinity Regional Medical Center. He said key developments included:

1. Continued participation in an innovative Accountable Care Organization collaboration.

-Submitted photo
An entrance to the UnityPoint Health — Fort Dodge site is pictured at dusk.

2. Evolution and enhancement of the medical center’s ongoing commitment to quality-of-care initiatives.

3. Success in recruiting new physicians.

4. An array of certifications and recognitions that attest to the excellence of the services offered by many of the components of the system in this region.

Dewerff said helping keep UnityPoint Health — Fort Dodge remain a success story is immensely rewarding to him on a very personal level.

“My greatest satisfaction is helping the doctors, nurses and care givers make an impact on people’s lives,” he said. “I get almost daily stories about the positive impact our people have had on the lives of other people.”

-Messenger photo by Hans Madsen Pharmacy manager Jake Crimmins poses at the customer counter at the soon to open Trinity Pharmacy. The new space brings a retail pharmacy to Trinity Regional Medical Center.

Physician recruitment

Physicians are at the heart of the health care system. Recruiting outstanding ones is a major concern for hospitals everywhere.

Finding and keeping the right physicians and other providers is a complicated undertaking

Competition among communities and hospitals for top-quality physicians is quite intense. It is certain to become moreso in the decade ahead.

According to a fact sheet released by the American Association of Medical Colleges, there is already a physician shortage in the United States that could grow to a shortfall of 124,000 to 159,000 physicians by 2025. In rural America, the problem is especially severe. The National Rural Health Association has estimated that about one-quarter of the U.S. population lives in rural areas, but only one in 10 physicians practices in these regions.

-Messenger photo by Hans Madsen
ARNP Sarah Kelly, left, along with LPN Paula Ayala, look over a case recently in their office at the Trinity Connects Program.

That means an ongoing focus on recruitment remains a major concern at UnityPoint Health — Fort Dodge.

The positive news locally is that physician recruitment is going well, Dewerff said.

He is quick to acknowledge, however, that getting physicians to consider relocating to a rural community isn’t always an easy sale. He said the excellent work environment Trinity affords its physicians makes it relatively easy to convince candidates that working there would be professionally rewarding. Living in a rural community, however, is not always so appealing for the prospective recruit’s spouse and family members.

“The spouses usually look at the amenities in the community,” he said, noting that the tight housing market in Fort Dodge is also a challenge.

As 2018 begins, TRMC is recruiting physicians and midlevel providers in an assortment of specialties. Dewerff said, however, the need is more immediate in certain categories because of recent retirements and departures.

“Orthopedics is one area of emphasis,” he said. “Neurology is also a priority.”

Accountable Care Organization

In 2012, Trinity Regional Medical Center became a pilot site for a redesign of the health care delivery system to improve its flexibility to serve the full-range of patient needs.

TRMC and what was then named the Trimark Physicians Group were selected to participate in the federal government’s Pioneer Accountable Care Organization initiative for Medicare patients. The local initiative was one of only 32 such pilots nationally. Importantly, it was one of just two that were focused on health care in a rural setting.

The federal government’s Centers for Medicare & Medicaid Services Innovation Center characterized to the goal of the Pioneer ACO as to provide “Medicare beneficiaries with higher quality care, while reducing growth in Medicare expenditures through enhanced care coordination.”

That undertaking proved so successful that UnityPoint Health — Fort Dodge has now progressed to be part of the next phase of ACO development, according to Dewerff.

In January 2016, according to information provided by the medical center, UnityPoint Health Partners, the ACO of UnityPoint Health, was selected to participate in the new Accountable Care Organization approach implemented by CMS called the Next Generation ACO Model. This next-stage endeavor builds on the experience gained from the Pioneer ACO Model.

“Under the Pioneer ACO, it was just the Fort Dodge region — Trinity and Trimark,” Dewerff said. “We were standalone in the Pioneer ACO. Now in the next generation ACO we’re part of the larger UnityPoint Health. Before, we were responsible for about 10,000 lives in our region. Now we are part of an ACO through UnityPoint that is responsible for 80,000 Medicare lives.”

Dewerff said the underlying philosophy for the ACO project is unchanged.

“The principles are still the same,” he said. “If you lower the cost of care and improve on your quality metrics, you will share in the savings.”

Dewerff said the ACO experience has been beneficial to both UnityPoint Health — Fort Dodge and area patients. He said the enhanced care coordination is intended to improve the quality of care while introducing efficiencies that will keep the cost of care within acceptable limits. That is a win for both providers and patients, he said.

Certifications and recognitions

Evidence that UnityPoint Health — Fort Dodge is an outstanding health care entity keeps mounting. In that regard, here are a few of the positive indicators from the last year:

• Trinity Regional Medical Center for the second consecutive year was named one of the Top 100 Rural & Community Hospitals in the United States by iVantage Health Analytics and The Chartis Center for Rural Health.

• UnityPoint at Home Fort Dodge and Storm Lake received Five Star ratings from the Centers for Medicare and Medicaid Services. They were the only Five-Star agencies in the state.

• Fort Dodge and Storm Lake continued its success with exceptional patient outcomes, providing quality home care services. The Home Care Elite Report, an annual recognition of the top performing Medicare-certified home health agencies in the United States, released and UnityPoint at Home — Fort Dodge was recognized as a “Top 100” agency and UnityPoint at Home — Storm Lake as a “Top 500” agency.

• UnityPoint Clinic Nephrologywas recognized as a Quality Top Performer for the Fort Dodge region for Patient Experience Access to Care with a score of 97.7 percent.

• Trinity Wound Healing Center team was recognized as a Center of Excellence. The Center has achieved patient satisfaction rates higher than 92 percent, a healing rate of at least 91 percent in less than 31 median days along with several other quality standards for four years in a row.

• UnityPoint Clinic Pediatrics — Fort Dodge was given a Pediatric Recognition Award by Blank Children’s Hospital for their dedication and support to Blank’s Pediatric Residency Program.

• ECOSURE, a third party inspection organization, gave Trinity Nutrition Services a 96.9 percent passing rate. This is an unannounced survey. Evaluations involve both retail and kitchen areas.

• UnityPoint Health made Becker’s Hospital Review “52 Great Health Systems to Know 2017.”

• Trinity Regional Medical Center successfully completed the DNV Stroke Survey.

UnityPoint at Home moves

UnityPoint at Home in Fort Dodge, which is gaining a national reputation as one of the state’s top home care agencies, was on move in 2017 both physically and as a provider of top-quality care.

Late in 2017, most of its services moved to a new consolidated location at 214 S. 24th St. This new 12,000-square-foot base of operations for the agency is the building previously occupied by Hy-Vee Drugstore. The move allows the local outlet of UnityPoint at Home to base many of its services at a single site.

Jennifer Crimmins, executive director of operations/post-acute strategy for UnityPoint Health — Fort Dodge, said this arrangement will benefit both her 85-person team and the community.

The three main components of UnityPoint at Home — home care, hospice and home medical equipment — often collaborate to meet diverse patient needs. That’s why being housed in one building will make their work easier, Crimmins said.

She said coordinating the care provided in various settings is a major focus of UnityPoint at Home and distinguishes it from some other organizations that may provide similar services.

There is strong evidence that the approach being undertaken by UnityPoint at Home is producing beneficial results for patients. Its Fort Dodge and Storm Lake agencies received a coveted national distinction from the Centers for Medical and Medicaid Services. They were the only two entities of this type in the Hawkeye State to earn the highest ranking CMS awards for quality of care — its Five Star rating. According the CMS, its ranking system offers a comprehensive overview of home health care quality. It was developed to make it easier for members of the public to compare home health care agencies.

Trinity opens retail pharmacy

There is now a convenient new option on TRMC’s Kenyon Road campus. A retail pharmacy was launched in 2017.

According to officials at the medical center, the new pharmacy will make life easier for patients being discharged from the hospital and that is one of the major reasons it is being established. Having a pharmacy close at hand will also benefit outpatients.

Year in Review 2017

January

• The two new K9 Units started their training on the Fort Dodge campus.

February

• Dr. Ilene Olson, OB/GYN, presented on how hormones affect a woman’s heart at Heart of the Hormones.

• Mike Dewerff, UnityPoint Health – Fort Dodge president and chief executive officer, started his Top 10 List. Once a month he worked alongside a department or shadowed them in order to better understand their work and get a great appreciation for the work they do.

• Darlene Turner, ARNP, joined UnityPoint Clinic Nephrology.

March

• Trinity Regional Medical Centerfor the second consecutive year was named one of the Top 100 Rural & Community Hospitals in the United States by iVantage Health Analytics and The Chartis Center for Rural Health.

• Charity Andrew, RN, Infusion, was awarded the DAISY Award. Andrew was nominated by a patient’s wife for her excellent care, sense of humor and kindness she provided her husband.

• Teresa Morlan, Trinity paramedic, received the 2016/2017 Serving Our Servants Award for demonstrating compassion and caring for her patients both in the field and in the ER.

• Kayla Habhab, CCU, was awarded the DAISY Award. Habhab was nominated for the care and relationships she establishes with her patients.

April

• Erin Eide, ARNP, joined Trinity Emergency Medicine.

• Anne Doolittle-Cheyne, Palliative Care, was chosen as one of 100 Great Iowa Nurses.

• Dr. Michael Lee and Darlene Turner presented at the Diabetes Health Fair on available diabetes therapies and different medication classes.

May

• UnityPoint Health — Fort Dodge partnered with UnityPoint Health urologists in Waterloo to start a satellite clinic in Fort Dodge.

• UnityPoint at Home Fort Dodge and Storm Lake received 5 STAR ratings from the Centers for Medicare and Medicaid Services. They were the only 5 star agencies in the state.

• UnityPoint Clinic Nephrologywas recognized as a Quality Top Performer for the Fort Dodge region for Patient Experience Access to Care with a score of 97.7 percent.

• Trinity Wound Healing Center team was recognized as a Center of Excellence. The Center has achieved patient satisfaction rates higher than 92 percent, a healing rate of at least 91 percent in less than 31 median days along with several other quality standards for four years in a row.

• Kelly Kraft, RN, Wound Healing Center, was award the DAISY Award. Kraft was nominated for her commitment to her patients.

• Teresa Morlan, EMS, was awarded the 2017 UnityPoint Health — Trinity Regional Medical Center Employee of the Year.

• Dr. James Mueller joined UnityPoint Clinic Orthopedics.

• Dr. Viinay Bhooma joined Trinity Regional Medical Center as the Hospital Medicine director.

• UnityPoint Clinic Pediatrics — Fort Dodge was given a Pediatric Recognition Awardby Blank Children’s Hospital for their dedication and support to Blank’s Pediatric Residency Program.

• ECOSURE (Third Party Inspection Organization), gave Trinity Nutrition Services a 96.9 percent passing rate. This is an unannounced survey. Evaluations involve both retail and kitchen areas.

• UnityPoint Health — Berryhill Center announced a partnership with Genoa, to provide a full-service, on-site pharmacy. It was the first pharmacy in Iowa to be co-located in a mental health center.

June

• UnityPoint Health made Becker’s Hospital Review “52 Great Health Systems to Know 2017.”

• Trinity Regional Medical Center started offering walk-in interviews every Wednesday.

• UnityPoint Clinic Pulmonology moved to the ground level in Physician’s Office Building East.

July

• Stewart Memorial Community Hospital entered into an enhanced partnership with UnityPoint at Home to provide home care and hospice services. This transition is expected to occur between January and May of 2018.

• Trinity Regional Medical Center successfully completed the DNV Stroke Survey.

• Mahesh Shrestha, M.D., joined UnityPoint Clinic Pediatrics.

• Alexis Woodley, RN, CCU, was awarded the DAISY Award. Woodley was nominated by a patient.º

• UnityPoint Clinic Family Medicine — Sac City successfully renewed its Patient Centered Medical Home recognition. It was recognized on the 2011 standards and are now renewed on the 2014 standards. It received a Level 3 with 94.12 points.

• UnityPoint Clinic Center for Urology started coming every Monday to the Fort Dodge satellite clinic.

August

• UnityPoint Clinic Family Medicine — Eagle Grove was recognized for recertification of a Level III Medical Home.

September

• Abbi Egli, RN, CCU, and Kim Pearson, RN, Patient Flow, received the ACE Award (Always Committed to Excellence). Egli and Pearson were nominated by Anne Magruder, who said: “My husband’s grandfather, was hospitalized on July 6 with a fractured hip. We were to get married on July 8 meaning he would be unable to attend the wedding. Abbi and Kim went way above and brought in equipment, computers, etc., so that the wedding could be live streamed for him to see, which made his day.”

• Lori Algoe was recognized as the UnityPoint Health — Fort Dodge Good Samaritan of the Year. Algoe completed 141 hours of community service in 2016.

• Eric Andresen, M.D., joined the team from UnityPoint Health — Center for Urology in its satellite clinic.

October

• Katelyn Thompson, D.O., joined UnityPoint Health — Berryhill Center.

• Laurie Connolly, M.D., joined UnityPoint Clinic — Urgent Care.

• Jennifer Hansch, RN, charge nurse patient flow/care coordinator, was awarded the DAISY Award. Hansch was nominated by the daughters of a patient.

• Dr. Rachael Sokol from UnityPoint Health Des Moines joined Trinity Regional Medical Center as the medical director for the Emergency Department.

• Amanda Lyon accepted the role as human resources manager for UnityPoint Health — Fort Dodge. Since 2015, Lyon has served as the human resources business partner for UnityPoint at Home and UnityPoint Clinic for the Fort Dodge, Storm Lake and Sioux City regions.

• Trinity Pharmacy, an on-site retail pharmacy, opened on Nov. 6. Trinity Pharmacy is located within Trinity Regional Medical Center next to Java City, to allow patients to fill their prescriptions before being discharged or leaving their doctor’s appointment.

• Trinity Bio-Med Department was recognized by the FDA for the roll itplayed in a recall of the Philips Medical Systems Brilliance iCT system. Jim Guldenpfennig’s reporting led to a significant patient safety action. Hereceived a certificate from the FDA for “Outstanding Contribution in Promoting Patient Safety With Medical Devices MedSun.”

November

• Fort Dodge and Storm Lake continued its success with exceptional patient outcomes, providing quality home care services. The Home Care Elite Report, an annual recognition of the top performing Medicare-certified home health agencies in the United States, released and UnityPoint at Home – Fort Dodge was recognized as a “Top 100” agency and UnityPoint at Home — Storm Lake as a “Top 500” agency.

• Trinity Valet Services parked and retrieved more than 50,000 cars since Jan. 1.

• UnityPoint Clinic — Family Health Center in Storm Lake was the Fort Dodge Region’s Quality Top Performer for November in Diabetes HgA1C Control (<8 percent). It also received NCQA PCMH Level 3 Recognition. December • UnityPoint Clinic Family Medicine -- Buena Vista received NCQA PCMH Level 3 Recognition. • UnityPoint Clinic Family Medicine -- Laurens was the Quality Top Performer for the Patient Experience Clinic Access Domain. • UnityPoint Clinic Family Medicine -- Kenyon Road implemented Reach Out and Read, a national program aimed at increasing literacy and language skills. The program assists in developing a love of reading from an early age and helps youths develop to their full potential. The program serves all children 6 months to 5 years of age receiving care at UnityPoint Clinic -- Family Medicine Kenyon Road. The program trains physicians and advance practice providers to deliver literacy anticipatory guidance to parents of children during their well child visits. A developmentally appropriate book is given at each visit over five years. • UnityPoint at Home moved to a new facility located at 214 S. 25th St., formerly the Drugtown space. The Home Equipment Store on Trinity compass will remain at the same location. • Roxanne Amhof, physical therapist, was awarded the A.C.E. Award (Always Committed to Excellence). Roxanne received the award for going above and beyond helping a Home Health Care client receive basic home needs, many of us take for granted. • UnityPoint Clinic Humboldt -- Walk-In opened. Located at the main entrance of Humboldt County Memorial Hospital, the clinic offers convenient care for non-emergent injuries and illnesses on the weekend.