2012 Annual Report Speech

State of the System Speech: “Living our Mission, Living Our Vision”

Sister Judith Ann Karam, CSA, president and CEO, Sisters of Charity Health System
Presented May 2013


Welcome to our first State of the Sisters of Charity Health System presentation. Today, you will hear much about the people and the mission that truly serve this community. We are blessed to have so many individuals who join with us.  

The Sisters of Charity Health System is a family of five acute care hospitals, two elder care facilities, three grantmaking foundations, and six outreach organizations. In this community, our ministries include:

  • In Cleveland: St. Vincent Charity Medical Center, St. John Medical Center (in partnership with University Hospitals), Regina Health Center, Light of Hearts Villa (partnership with the Sisters of Charity of Cincinnati), Independent Physician Solutions, Sisters of Charity Foundation of Cleveland, Catholic Community Connection, Joseph’s Home, Building Healthy Communities and the SCHS captive insurance company.
  • In Canton:  Mercy Medical Center, Sisters of Charity Foundation of Canton and the Early Childhood Resource Center.
  • In South Carolina: Providence Hospitals, Sisters of Charity Foundation of South Carolina, Healthy Learners and the South Carolina Center for Fathers and Families.

Today, I am pleased to share how we are living our mission, making a significant impact on the communities we serve and preparing for the future. As I reflect on the video we just watched, my hope is that you clearly see our mission, our vibrant future and our great commitment to the community.

We have a bold vision to be a beacon of hope devoted to healing and addressing the unmet needs of individuals, families and communities through a network of innovative services. 

And, we carry out our mission to extend the healing ministry of Jesus in many important ways: By providing the very best care, by meeting unmet needs, by solving problems creatively, by investing strategically, by delivering on our mission and by working together.

Through all of this, we must be inventive. We must be innovative. More has changed in the past two years than in the past 20. As dramatic changes occur in technology, regulations, economics and health care delivery, we experience many challenges. We journey forward to meet these challenges with extensive skills and competencies, with vision and collaborators, and with dedication to the community.

Our success is based on how well we serve and partner with the community.

Our health care entities have a long legacy of providing service and delivering critical health services. In 2012, our ministries collectively provided more than $60 million in community benefit, including $26 million in charity care. Our caregivers go far beyond hospital walls to provide many services to underserved neighborhoods.

We endeavor every day to increase health access through programs such as: the Bethlehem Project for oral health in Canton; the medical home at St. Paul Square in Canton; Healthy Learners for removing health barriers to education for children in South Carolina; and the expansion of primary care through our hospitals, and occupational medicine at St. Vincent Charity Medical Center. Our health ministry also responds to the needs of seniors and aging religious through Light of Hearts Villa and Regina Health Center, which recently welcomed the Ursuline Sisters of Cleveland.

This commitment to meeting unmet needs extends much further. The Sisters of Charity Foundations reflect a singular focus on addressing the root causes of poverty. Solidly grounded in Catholic social teaching, our foundations are a critical expression of our mission and commitment to the materially poor. In the past year alone, our foundations have provided 290 grants totaling approximately $6.7 million.

The foundations expand our ministry to serve God’s people in new and meaningful ways. With the charge to address health, education and social services, the foundations reach people in their neighborhoods, schools and families. For 16 years, the foundations have led and contributed to sustainable community change for the betterment of vulnerable people.

The foundations carry out nationally recognized work in early childhood education, health access, fatherhood engagement, supportive housing, neighborhood transformation and the support of the ministries of women religious.  

Some of their accomplishments include:

  • Supporting thousands of children and families in early learning, and working with partners to replicate those efforts across Ohio
  • Re-engaging thousands of low-income fathers in South Carolina with their children
  • Reducing chronic homelessness in Cuyahoga County by 62% since 2006 through convening and supporting the Housing First initiative in Cleveland

The foundations are unafraid to tackle complex social problems in service to the most vulnerable and to invite others to participate with them in this challenging work. They do so by identifying critical needs, forming partnerships and leveraging dollars to meet those needs.

Similarly, the Sisters of Charity Health System’s outreach ministries are noted for their ability to appropriately respond to emerging community needs. By expanding direct services, these organizations continue to earn national and statewide recognition.

In a few short weeks, the national Catholic Health Association will present a video at their national assembly featuring the South Carolina Center for Father and Families. The association holds up the center and its work with low-income single fathers as an example of living the mission of Catholic health care in a changing world. The center was selected for its incredible work as an expression of the health system’s mission in response to the needs of today. Also, the Sisters of Charity Foundation of Canton’s president, Joni Close, was recently appointed as the chair of the Governor of Ohio’s statewide Early Childhood Advisory Council and was selected as one of seventy people nationwide to participate in the Clinton Global Initiative on Early Childhood.  

The president of the Sisters of Charity Foundation of South Carolina, Tom Keith, was selected to serve on the board of Foundations and Donors Interested in Catholic Activities, a national organization also known as FADICA.

And, Mercy Medical Center’s Palliative Care team is receiving a national award in June for quality in palliative care at the annual meeting of the Supportive Care Coalition: Advancing Excellence in Palliative Care.

Truly, our ministries are integral partners in meeting ever-changing community needs. Through all of these efforts, we continually see that to best serve the community, we must focus on identifying and understanding unmet needs, responding with strong quality and achieving impactful outcomes.  

Also, we know that we must go beyond direct service to be advocates for those we serve; to be a voice for the voiceless.

As we all know, implementation of the Affordable Care Act is full of challenges, such as states’ decisions on whether or how to go about extending Medicaid to people earning up to 138% of poverty. Throughout these challenges, we have been actively engaged in critical public policy issues that can have great impact in our communities. In Washington, D.C.; Columbus, Ohio and Columbia, South Carolina, we work tirelessly on behalf of the people we serve.

We cannot carry out this mission alone. Our ministry includes every person here today. Each of you has given of yourself because you have been called to serve as co-ministers devoted to healing. You serve as our board members, as caregivers and staff members, as physicians, as volunteers and trusted community partners carrying forward our healing mission. For that, I am incredibly grateful.

Because you are our hearts and hands, we work to steep all of those who serve with us in our founding congregation’s mission, philosophy and values. And, we are always working to help our co-ministers to live our mission in all actions.

In support of this, we dialogue through mission and values programs. We conduct mission audits and present ongoing education programs on our faith-based identity, mission, philosophy and values. We also work to cultivate leaders who exemplify compassionate, person-centered care. And, we provide resources and technology to hold ourselves accountable to community benefit.

Today, we are together to celebrate our mission and also to take an important look at how we as a health system are responding to the complex challenges all around us.

We live in an era of rapid change and increasing need. Like countless others, we are challenged by the uneven economic recovery. We are challenged by growing poverty and protracted unemployment. We are challenged by funding cuts for programs that serve the poor and vulnerable, as well as significant shifts in public policy.

From the view of our hospital ministry, the current environment includes demands for new technology, cuts in reimbursement and increased demand for charity care.

It also includes health care reform demands for new models of care, payment for value-based outcomes, a need for more primary care physicians, shortened hospital stays and increased services in outpatient settings.

From the view of our foundation ministry, this current environment includes reduced grants dollars as a result of the economic recession; growing demand for programs to serve the poor and vulnerable; and tenuous public funding for mission-focused issues such as supportive housing, fatherhood engagement and early childhood education.

And, from the view of our outreach ministry, the current environment includes growing need for services, reduced availability of philanthropic and public dollars, and increased demand for sustainability.

As a result, we are called every day to exercise wise stewardship of our ministries. This stewardship is ensured through strong financial management, sound strategic planning and ongoing dedication to creating lasting impact. And, that is what we deliver every day.

By working together to respond strategically to the needs of our times, we can best support our ministries to have the highest success well into the future.

We have a significant responsibility to the Church and to those we have been called to serve to ensure the sustainability of this mission for which we have been entrusted.

Across the nation, health and human service leaders must focus on the tangible aspects of their enterprises. Managing money can dominate conversations, focus attention and determine priorities. This is also true for the Sisters of Charity Health System. However, where our distinction will always be is in our ever-present commitment to balance practical financial results with the impact on our mission. And, I commend all of our boards and leadership for their mission-based, strong financial stewardship. 

We continue this stewardship by challenging every ministry to become self-sustaining through strong operational performance. We have already seen positive trends thanks to this hard work.

Despite improved operating performance, our cash and unrestricted investments were essentially flat from 2011 to 2012.  However, there are some positive indicators of our financial position.

Very recently, Fitch Ratings affirmed its 'A' rating on our Providence Hospitals with a stable outlook.

For 2012, our investment return was 9.5 percent, which materially exceeded market benchmarks with a similar target asset allocation.

Also, we continue to have the ability to access funding from the capital markets.

From 2010 to 2012, we have been able to collectively invest more than $95 million in construction and capital improvements. Our investments in these areas are very important. The future calls for us to have the best technology to support high quality care at our hospitals.  To prepare, we are undertaking a 3-year effort to harness new information technology to help clinicians ensure quality, safety and efficiency of care. Overall, the plan ensures information in the hospital setting is delivered in a reliable and consistent format to support patient safety, outcomes and performance. The health system and our hospitals have committed to a total investment of more than $24 million in this effort with the anticipation to receive federal meaningful use dollars.

Also, we continue to invest in cutting-edge equipment, technology and spaces that improve the delivery of care. We have conducted these and a number of other modernization and facility improvements. 

Last year, we also had to make heart-wrenching staff-level and service line decisions to respond to the changing environment. Although those decisions were tremendously difficult, they were well-informed in the context of our mission and demands for service. In each case, we have sought the best way to sustain our ministry and mission, and care for our staff.

We will continue to take steps for a secure financial future. Throughout this work, we are truly thankful for our ability to engage community leaders who understand the times and are willing to support our vision.

We are also thankful for the generous friends who share in our ministry by making financial gifts. Our donors are important partners to our work. Last year, ministries received $14 million in support from those who share our vision, which is a true blessing. We will continue to need our partners’ firm commitment as we roll out additional fund-raising campaigns to achieve our vision.

There are many more positive steps under way to strengthen our future. 

Importantly, we know we must work together as a family of ministries to create, refine and implement our strategic plans and actions. We also know we must focus on three very important priorities.

First, is our cultivation and retention of talented leaders. The executives leading our system and ministries must have the knowledge and experience to successfully achieve goals amid many challenges. Given the environment we serve in today, we have put great effort into assembling a leadership team with the significant skills needed to face the transformation of health care. We have also put great care into ensuring that these leaders live and breathe our mission in all that they do.

Our second focus is to remain nimble, adaptive and decisive to the needs of the times. In holding ourselves accountable to necessary results, we must always ask: How can we be more effective in our service delivery?  Are we working in the most efficient manner?  Listening to those we serve, we are called to respond quickly and effectively. Our hospitals, especially, have made many changes to respond to the needs of the time while providing the highest quality, person-centered care.

And, the third and most significant focus is to partner with others to extend our ministry. We cannot do it alone. We have never done it alone.  We have innovative partnerships and relationships with many physicians, other providers, higher education institutions, community organizations, and public and private funders.

Collaborations are integral to our success and are embraced among our own family of ministries. For example, we are collaborating to prepare for health care reform, including working with other providers to conduct community needs assessment, joining accountable care organizations and potentially collaborating with health plans.

These three guiding principles of talent cultivation, adaptation and collaboration are reflected across much important work, including our health care entities’ strategic plans. Our strategies in this area include:

  • Reengineering how care is provided through clinical redesign
  • Working toward maintaining wellness and preventing illness among the people we serve and our staff members
  • Striving for quality and service excellence
  • Raising dollars to meet capital needs through the establishment of hospital development foundations
  • And, partnering with physicians

Additionally, our philanthropic foundations are acting on strategies to build on their accomplishments. These strategies are:

  • Effectively communicating their impact
  • Increasing the use of non-grantmaking tools to enhance effectiveness
  • Revising spending rate policies to respond to the needs of the times
  • And, enhancing dialogue between the hospital and foundation in each community

Our outreach ministries are also taking strategic steps by ensuring that best practices are being implemented, by measuring the impact of the services they provide, and by building comprehensive fund-raising programs to support ongoing sustainability. To this end, our outreach ministries have engaged experts to evaluate programs and services and to quantify the services provided to the community.  Given their reliance on fund-raising, each outreach ministry has engaged its board in determining strategies to diversify the funding received from individuals, corporations and foundations.

Overall, the outcomes of these significant efforts are already taking shape. 

In the video and the handout shared earlier, you saw dozens of highlights of the collective accomplishments of our ministries this year. Those numbers fill me with hope and inspiration.

They also make me think about the stories of the people behind them, including those who receive the innovative and life-saving services provided at our hospitals. Countless patients have shared stories with me of remarkable recoveries, and also of the great compassion they received through our hands.

Compassion is a vital part of every caregiver in our system, and we endeavor to inspire it also in the nurses, physicians, pharmacists, chaplains and technologists who come to us for education. NEOMED, Case Western Reserve University, Cleveland State University, the University of South Carolina, the Ohio University Heritage College of Osteopathic Medicine and Cuyahoga Community College are among many partners with us in clinical education and research. 

Our holistic healing and compassion … our responsiveness to needs … our commitment to quality and excellence – all of these efforts are visible every day throughout our health system. They are all vital to the success of our mission.

And, we are doing them well, as evidenced by the many quality recognitions we receive from organizations, including from the U.S. News & World Report, Leapfrog, the American Heart Association, Thomson Reuters, the Catholic Health Association, the American Hospital Association and more.  In fact, U.S. News & World Report ranked Mercy Medical Center and St. John Medical Center among the best hospitals in Ohio. They also named Regina Health Center as one of the best nursing homes in the country. And, for the 13th consecutive year, Providence Heart & Vascular Institute received the highest quality rating from the Society of Thoracic Surgeons.

Amid these and other recognitions, we continue to do our work even better. 

Physicians are critical collaborators and leaders in achieving our outcomes. They serve on boards and in leadership roles throughout our organizations. We are blessed with their partnership in many ways.

Both independent and employed physician practice relationships serve other physicians, hospitals and patients. Most importantly, they are leaders in clinical innovation and high quality care. It is all about the person we serve.

At our hospitals, we can point to partnership in excellence and quality with all who provide patient care. The people we work with, and for, come from a wide variety of cultures, ethnicities and faith traditions. Our charism of love reaches out and embraces all people.

We are among a small number of organizations nationally who are rated as providing the highest quality, as well as implementing the best practices to achieve change in our community. Because of our efficiency, we also are among the lowest cost providers in each of the communities we serve. Also, we are preparing well for the transition to a new and much expanded set of codes to report medical diagnoses and inpatient procedures for billing purposes. And, we are aligning our clinical processes, internal structures and operations to be successful in today’s reimbursement environment.

The health system, too, has carefully reviewed how we can best support our ministries through centralized approaches.  Together, we exponentially increase the amount of positive change and value we can effect by collaborating and consolidating as sister organizations, achieving efficiencies, leveraging resources and engaging in best practices.

Last year, the health system and our ministries implemented a number of system-wide initiatives to this effect, including:

  • Restructuring employee benefits
  • Conducting supply chain strategies that have identified $8 million in savings
  • Enhancing monitoring of quality, HR, operations and service delivery
  • Continuing initiatives in clinical pastoral education, diversity and palliative care
  • And, becoming one brand across 20 ministries

Today, we can proudly say that all of our hospitals have moved with the times. We have become stronger entities within the markets we serve, and can quantify our successes, especially in our provision of high quality care to patients.

Every step we take is focused on responding to the needs of the time, while balancing the strategic needs of the future.  And, on behalf of the Sisters of Charity Health System, I am proud of the progress we have achieved.

At the heart of these and all of our efforts, is the continuity of our faith-based mission.

In 1851, when our Sisters came from France, they planted a seed of ministry as they became Cleveland’s first public health nurses. From that seed, our ministry to our communities has expanded and flourished. Together, we are extending the healing ministry and empathy of Jesus into this world.

Jesus fed the thousands, comforted the grieving, cared for the lepers, educated the poor and provided love unconditionally to all those that He came in contact with.  That’s what has motivated us for more than 162 years. Throughout that time, millions of lives have been positively impacted by our ministry. 

We have become community and industry leaders in healing and showing compassion, in listening and collaborating, and in developing common ground and building bridges. Through all that we have done and will do, we are devoted to healing. This devotion shapes who we are and how we serve.

Each ministry of the Sisters of Charity Health System carries forward the mission and ministry of our founding Congregation. To carry out their charism, the Sisters of Charity of St. Augustine created a permanent sponsorship structure called a Public Juridic Person of Pontifical Rite. This structure, which reports to the Vatican, ensures the continuity and strength of our ministries as an integral ministry of the Catholic Church. Ours is the legacy of the Sisters of Charity of St. Augustine. Over time, small things may change, but our healing legacy will remain.  

Together, our future is vibrant and we will continue to provide much-needed ministry to the communities we serve.

To be successful, we need all of you to join us as we:

  • Listen to those we serve and understand unmet needs in the community
  • Enhance our operations amid health care transformation
  • Use best practices to bring quality outcomes
  • Respond strategically to challenges and take actions to grow our ministry
  • And, invite others to commit to our vision

The Sisters of Charity Health System is committed to continuing our mission as a family of ministries. Our collective mission responds to the needs of the people we serve in ways like no one else. We provide the very best care, we address unmet needs, we solve problems creatively, we invest strategically, we deliver on our mission and we do this best by collaborating with each other. Together, we light the way. 

We are and will continue to be the healing presence of Jesus to all of God’s people. And you are the heart and hands of our ministry. Search out how you can recommit to our mission today and always. There is so much to do to respond holistically to the needs of the people we serve.

Together, we light the way to healing for individuals, families and communities.  May our commitment shine as a light for those who struggle in darkness. May we and our ministries be beacons of hope.

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