1. health and fitness

Harrison Memorial Hospital
Community Health Needs Assessment
2012
TABLE OF CONTENTS
1Introduction
4
a.
Definition and summary of a community health need assessment
1
b.
Harrison Memorial Hospital description
2
Community served by Harrison Memorial
a.
Summary of inpatient discharges by zip code
6
Harrison Memorial’s community involvement
7
Harrison Memorial community details
8
16
17
25
27
6
a.
Identification and description of geographical community
7
b.
Community population and demographics & U.S. census data
7
Characteristics of the community
a.
Harrison County
9
b.
Pendleton County
11
c.
Robertson County
13
d.
Nicholas County
14
Health status of the community
a.
4
Largest causes of death
16
Health outcomes and factors
a.
Harrison County
17
b.
Pendleton County
19
c.
Robertson County
21
d.
Nicholas County
23
Health care resources
a.
Hospitals and health centers
25
b.
Hospital market share
25
c.
Other health care facilities and Providers
25
Physician Resources
27
30 Interviews
a.
List of interviewees and titles/roles
30
b.
List of questions
30
c.
Results/Key findings
32
TABLE OF CONTENTS
32
Community health surveys
a.
Time period
32
b.
Methodology
32
b.
Copy of Survey
33
d.
Survey results
34
35
Prioritization of identified health needs
35
38
Considerations for meeting identified health needs
38
39
Appendix A
a.
Summary of survey results
39
Community Health Needs Assessment 2012
INTRODUCTION
Community Health Needs Assessment
When the Patient Protection and Affordable Care Act was signed into law on March 23, 2010, additional
requirements were imposed on hospitals seeking to obtain or maintain charitable tax-exempt status as
defined under Section 501 of the Internal Revenue Code of 1986. One of the new requirements is the
completion of a community health needs assessment (CHNA). Impacted hospitals must complete and
document this assessment in a written report, including several key elements:
•
A description of the community served by the facility and how the “community” was determined.
•
A description of the process and methods used to conduct the CHNA, including sources and dates
of data, analytical methods used, information gaps, collaborating organizations, and the identity and
qualifications of third parties contracted with to assist in conducting the CHNA.
•
A description of how the hospital considered input from persons representing the broad interests
of the community served by the facility, including information on individuals and organizations that
provided input.
•
A prioritized description of all the community health needs identified and a description of the
process and criteria used in prioritizing the needs.
•
A description of the existing healthcare resources in the community available to meet the CHNs
identified in the CHNA.
The needs assessment is a critical tool used by the Hospital to understand the needs of the community and
highlight the areas where Harrison Memorial can continue to serve as a community healthcare leader for
years to come.
The community health needs assessment is not only this final published document, but the process of
uncovering the needs, gaps, and concerns of the community served by the Hospital. The process involved
collection and analysis of data, interviews with key stakeholders with expertise in public health and surveying
members of the community. Most of the research, analysis, and development of this report took place
during the months March thru July 2012.
To assist in completion of this assessment, Harrison Memorial Hospital engaged Dean Dorton Allen Ford,
PLLC. Dean Dorton Allen Ford is an accounting and advisory firm with offices in Lexington and Louisville,
KY. The Healthcare team at Dean Dorton Allen Ford is comprised of audit, tax, and consulting professionals
who provide services to clients across the state of Kentucky and beyond.
INTRODUCTION
1
Community Health Needs Assessment 2012
About the Hospital
Harrison Memorial Hospital is a regional medical center located in Cynthiana, Kentucky. For more than
100 years, Harrison Memorial Hospital has been a healthcare leader for our community. Our mission is
to provide high-quality health and medical services to the people of Harrison and surrounding counties.
Evidence of this mission is proven through our recent completion of a new facility, investments in advanced
technology and strong and lasting partnerships with area specialists. These efforts make higher quality,
more convenient care a wonderful end result for our patients and community.
Harrison Memorial Hospital is governed by a Board of Directors and licensed by the state of Kentucky to
operate 61 beds, and certified by both Medicare and Medicaid. Additionally, Harrison Memorial Hospital is
a member in good standing with the agencies below, and we meet or exceed their standards for quality:
•
The Joint Commission
•
American Hospital Association
•
College of American Pathologist
•
Kentucky Hospital Association
•
Kentucky Rural Health Association
Our Services
Allergy
Oncology
Allied Health
Ophthalmology
Anesthesia
Oral and Maxillofacial Surgery
Audiology
Orthopedic Surgery
Cardiac Care
Otolaryngology (Ears, Nose and Throat)
Cardiology
Outpatient Surgery
Cardiothoracic Surgery
Pain Management
Dermatology
Pathology
Emergency Medicine
Pediatrics
Endocrinology
Podiatry
Family Medicine
Pulmonology
Gastroenterology
Radiology
General Surgery
Reconstructive Surgery
Internal Medicine
Rehabilitation Center
Lab
Respiratory Therapy
Nephrology
Rheumatology
Neurology
Sleep Disorders
Neurosurgery
Urology
Obstetrics and Gynecology
INTRODUCTION
2
Community Health Needs Assessment 2012
Our Mission
Harrison Memorial Hospital exists for the purpose of providing high-quality health and medical care
services to the people of Harrison and surrounding counties of our region. In fulfilling this mission, we
strive for excellence:
•
In the care we deliver
•
In the facilities we provide
•
In the recruitment, retention and development of dedicated physicians and personnel
•
In facilitating, coordinating and providing access to general and specialized health services through
our own resources and in collaboration with the resources of others.
Our Vision
To become the Health Care Delivery System of choice for the people we serve.
Our Customer Service Commitment
We promise everyday in every encounter to…
•
Treat you with dignity and kindness
•
Respect your right to confidentiality
•
Educate you about your care
•
Acknowledge you and your concerns
•
Timely response to your need
Our Core Values
•
Integrity, honesty, fairness and ethical behavior in all we do
•
The continual pursuit of excellence and innovation
•
The contribution of each employee in achieving our mission
•
The right of each patient to choose the type and extent of care
•
Caring and sensitivity in all patient interactions
•
Responsible resource management
•
Teamwork, cooperation and flexibility
•
Encouragement of differences among people
INTRODUCTION
3
Community Health Needs Assessment 2012
COMMUNITY SERVED
by Harrison Memorial
Our community was defined based on the geographical proximity to Cynthiana, Kentucky as well
as the number of annual Medicare discharges by zip code.
Identification of Geographical Community
Cynthiana, Kentucky, the county seat of Harrison County, is located approximately 25 miles
northeast of Lexington, Kentucky. Harrison County shares a border with Nicholas, Bourbon, Scott,
Grant, Pendleton, Bracken, and Robertson counties.
COMMUNITY SERVED BY HARRISON MEMORIAL
4
Community Health Needs Assessment 2012
Medicare Discharges by Zip Code
During calendar year 2010, Harrison Memorial Hospital discharged 880 Medicare inpatients. The following
graph outlines the residential zip codes related to those discharged Medicare patients.
Zip Code of
Residence
41031
Zip Code of
Community/County
Cynthiana - Harrison
CY 2010 Medicare
Discharges
535
% of
Total
60.8%
Days of Care
Charges
1,969
$5,945,233
41040
Falmouth - Pendleton
67
7.6%
274
$834,035
41003
Berry - Harrison
52
5.9%
198
$723,916
41064
Mount Olivet - Robertson
45
5.1%
179
$533,701
40311
Carlisle - Nicholas
41
4.7%
146
$444,682
40361
Paris - Bourbon
32
3.6%
127
$316,468
40370
Sadieville - Scott
13
1.5%
55
$182,778
41004
Brooksville - Bracken
12
1.4%
37
$130,802
Other
N/A
83
9.4%
315
$880,418
880
100.0%
3,300
$9,992,033
TOTAL
Source: AHD.com
NOTE: 84% of CY 2010 Medicare Discharges stem from the highlighted five (5) zip codes.
Based on the geographical and Medicare discharge information, Harrison Memorial Hospital has defined
its primary community area as Harrison, Pendleton, Robertson, and Nicholas counties. This methodology
is also consistent with previous regulations set forth by CMS which defines a hospital’s service area as an
“area from which a hospital draws at least 75 percent of its inpatients during the most recent 12-month cost
reporting period.”
COMMUNITY SERVED BY HARRISON MEMORIAL
5
Community Health Needs Assessment 2012
HARRISON MEMORIAL’S
community involvement
Harrison Memorial Hospital takes great pride in serving as a healthcare leader in the community. We believe
that it is our obligation to provide services that extend beyond providing medical care to our patients. Our
community involvement is visible through our commitments to education, providing healthcare resources,
and even financial contributions and support. Below is a sampling of our recent community benefit
activities.
Health Fairs and Screenings
Harrison County Community Health Fair
Bracken County Health Fair
Pendleton County Connections and Health Fair
Robertson County Health Fair
3M Health and Safety Fair
Westside Health and Education Fair
Ladies Day Only
Free Sports Physical Clinic
Free Eye Screenings for Diabetics
Seminars
Go Red for Women Campaign
Women’s Health Issues Seminar
Harrison County Cancer Coalition Blue Hydrangea Tea
Healthy Informed Men
Increase Diabetes Awareness
Harrison County Diabetes Management and Cooking Classes
Bracken County Diabetes Management and Cooking School
Safe Sitter Classes
Community Outreach
Blood Drives
Rotary Career Day
Project Linus
Christmas Angels
HMH Food Drive
Sharing Hope Project Society Hope Lodge in Lexington
Alabama Tornado Relief
Christmas Child Shoebox Project
Junior Achievement
Events
Harrison Memorial Hospital Tours
Harrison County Relay for Life
Buffalo Trace March of Dimes
Longest Day of Play
Harrison County Fair
Events (continued)
Born to Run/Walk 5K
Bracken County Diabetes 5K
Little Feet, Big Feet
Harrison County Second Sunday Event
Harrison County Community Baby Shower
Bracken County Diabetes Walk
Special Night on Church/Hospice Event
Cynthiana Lion’s Club Auction
Cynthiana Rotary Fabulous Fourth
NAACP Gala
Free Friday Night Flicks
Education and Support
Silver Sneakers
Pendleton County Diabetes Support Group
Bracken County Diabetes Support Group
Secondhand Smoking Campaign
WCYN’s Coffee Break
Local Newspapers – Provide press releases on health – related
topics
Harrison Area Technology Center
Licking Valley Community College
Bracken County Extension Monthly Nutrition Classes
Harrison County High School Athletics
Pendleton County Football
Paris High School Football
Wellness Center
Smoking Cessation Classes
Cynthiana – Harrison Chamber of Commerce
Harrison County Community Foundation
Cynthiana Lion’s Club
Cynthiana Rotary Club
Licking Valley Professional Women
Harrison County/Cynthiana Economic Development
Journey Medical Mission
Harrison Memorial Hospital College Scholarship Fund $25,000
HARRISON MEMORIAL’S COMMUNITY INVOLVEMENT
6
Community Health Needs Assessment 2012
HARRISON MEMORIAL
community details
Based on 2010 U.S. Census data, the combined population of Harrison Memorial Hospital’s primary
community area is just over 43,000 people. Children and youth with ages less than 18 years comprise
roughly 25% of the total population, while persons aged 65 or more varies by county, but is higher than the
Kentucky average which shows that just over 13% of Kentuckians are older than 65 years of age.
Demographic
Harrison
County
Pendleton
County
Robertson
County
Nicholas
County
Kentucky
Population (2000)
17,983
14,390
2,266
6,813
4,041,769
Population (2010)
18,846
14,877
2,282
7,135
4,339,367
Population change (2000 to 2010)
4.8%
3.4%
0.7%
4.7%
7.4%
Persons under 18 years - % (2010)
24.3%
24.7%
21.5%
24.2%
23.6%
Persons 65 years and over - % (2010)
14.9%
12.3%
18.7%
15.6%
13.3%
$40,582
$44,670
$27,254
$40,259
$41,576
Persons below poverty level
20.4%
18.6%
25.1%
18.3%
17.7%
High school graduates
% of persons age 25+ (2006 - 2010)
79.2%
77.9%
69.6%
75.7%
81.0%
Bachelor’s Degree or higher
% of persons age 25+ (2006 - 2010)
13.8%
10.5%
7.4%
9.4%
20.3%
306.36
277.16
99.91
195.17
39,486.34
61.5
53.7
22.8
36.6
109.90
Median household income (2006 - 2010)
Land area in square miles (2010)
Persons per square mile (2010)
Source: http://quickfacts.census.gov/qfd/index.html
HARRISON MEMORIAL COMMUNITY DETAILS
7
Community Health Needs Assessment 2012
CHARACTERISTICS
of the community
The Community
Social, economic, and demographic characteristics of a community are significant factors in the perceptions
and realities of the health and wellness of its people. The following tables highlight some of the population,
labor market, and unemployment data that impact the healthcare of the community and its citizens. The
information highlights the statistics for Harrison, Pendleton, Robertson, and Nicholas counties.
As previously addressed, Harrison Memorial Hospital has identified its community as Harrison, Pendleton,
Robertson, and Nicholas counties.
The Labor Market Area is a key component of the demographic and economic aspects of the community.
Labor Market Area
Most of the demographic and workforce data that follows includes totals for the community’s labor market
area. Maps of each county’s labor market areas are provided for reference. Labor market counties are
composed of counties which significantly exist within the sixty (60) minute drive range of the originating
county’s county seat. A county is included within the radius of the centroid point (a point representing
the center of the geographic area of a county) if it falls within the drive zone. Additionally, all contiguous
counties will be classified as part of the labor market with the exception of non-Kentucky contiguous
counties which have been excluded by the above mentioned 60-minute drive range and have a border
with the Mississippi and/or Ohio Rivers.
Harrison County
Pendleton County Robertson County Nicholas County
Population (2010)
18,846
14,877
2,282
7,135
Labor Market Area
Population (2010)
683,413
386,369
150,624
496,765
Total Available Labor
(2010)
1,038
993
118
463
Labor Market Area Total
Available Labor (2010)
33,559
21,254
8,497
24,621
Unemployment Rate
(2011)
9.8%
10.8%
9.6%
10.3%
Labor Market Area
Unemployment Rate
(2011)
8.4%
9.2%
9.4%
8.3%
U.S. Unemployment Rate
(2011)
8.9%
8.9%
8.9%
8.9%
Source: http://thinkky.com/EDIS/cmty/index.aspx?CW=046
CHARACTERISTICS OF THE COMMUNITY
8
Community Health Needs Assessment 2012
Harrison County
With nearly 50% of the 4-county area population, Harrison County is a major economic hub for Harrison
Memorial Hospital’s community.
Harrison County
Employment
Percent
Labor Market Area
Employment
Percent
All Industries
4,800
100.0
310,754
100.0
Agriculture, Forestry, Fishing and
Hunting
N/A
N/A
N/A
N/A
Education and Health Services
902
18.8
N/A
N/A
Mining
N/A
N/A
N/A
N/A
Construction
147
3.1
N/A
N/A
Manufacturing
1,106
23.0
N/A
N/A
Trade, Transportation, and
Utilities
704
14.7
54,967
17.7
Information
59
1.2
N/A
N/A
Financial Activities
158
3.3
N/A
N/A
Services
724
15.1
108,626
35.0
Public Administration
284
5.9
23,314
7.5
Other
2
0.0
N/A
N/A
Source: http://thinkky.com/EDIS/cmty/index.aspx?CW=046 and U.S. Bureau of Labor Statistics
CHARACTERISTICS OF THE COMMUNITY
9
Community Health Needs Assessment 2012
Harrison County (continued)
Below you will find more information regarding Harrison County’s major employers.
Firm
Product(s)/Service(s)
Employees Year Established
Public School System
Full-time teachers
156
Harrison Memorial Hospital
Health services
300
1983
3M
Office supplies and stationary products; 509
repositionable notepads, easel pads, and
packaging tapes
1969
Bullard
Safety hard hats, fire helmets, face
masks, hoods & respirators, thermal
imaging cameras
245
1972
Cynthiana Publishing Co., LLC
Newspaper & shopper’s guide
publishing, computer typesetting & web
offset printing, real estate magazine
publishing
31
1945
Farmers Tobacco Co. of
Cynthiana
Cigarettes
35
2000
Fikeco, Inc.
Sheet metal fabrication, HVAC, welding
22
1985
Harrison Machine Shop
Machine shop; welding, drilling,
boring, cutting, honing, lathe work,
general machining, hand grinding &
sandblasting, mechanics, construction
12
1974
Lucas Engine Equipment, Inc.
Wood & metal farm gates; steel & wood
horse barn window grills, doors & stall
fronts
28
1981
Slade, Inc.
Power coating equine products, stall
doors, gates, handrail. Power coating
metal containers
100
2000
Solution Dispersions
Carbon black dispersions
38
1991
STI Manufacturing Co.
Wiring harnesses, automotive lights
recycling, assembly & packaging
18
1990
TI Group Automotive Systems
Automotive refrigeration coil & steel
tubing
32
1965
Cynthiana
Source: http://thinkky.com/EDIS/cmty/index.aspx?CW=046
CHARACTERISTICS OF THE COMMUNITY
10
Community Health Needs Assessment 2012
Pendleton County
Pendleton County, located directly north of Harrison County is also the second most populous of the four
counties in Harrison Memorial Hospital’s community. Falmouth is the county seat of Pendleton County.
Pendleton County
Employment
Percent
Labor Market Area
Employment
Percent
All Industries
2,279
100.0
132,195
100.0
Education and Health Services
247
10.8
N/A
N/A
Agriculture, Forestry, Fishing and
Hunting
0
0.0
N/A
N/A
Mining
N/A
N/A
N/A
N/A
Construction
N/A
N/A
N/A
N/A
Manufacturing
295
12.9
N/A
N/A
Trade, Transportation, and
Utilities
302
13.3
20,384
15.4
Information
N/A
N/A
N/A
N/A
Financial Activities
66
2.9
6,537
4.9
Services
176
7.7
53,515
40.5
Public Administration
175
7.7
9,028
6.8
Other
0
0.0
N/A
N/A
Source: http://thinkky.com/EDIS/cmty/index.aspx?CW=046 and U.S. Bureau of Labor Statistics
CHARACTERISTICS OF THE COMMUNITY
11
Community Health Needs Assessment 2012
Pendleton County (continued)
Below you will find more information regarding Pendleton County’s major employers.
Firm
Product(s)/Service(s)
Employees Year Established
Public School System
Full-time teachers
154
Carmeuse Lime & Stone, Inc.
Chemical & metallurgical quicklime,
hydrate, & limestone products
205
1967
Griffin Industries, Inc.
Meat meal; tallow & grease rendering;
cookie meal, bio-diesel fuel
85
1942
Hilltop Stone, LLC
Crushed limestone
21
1954
Jay Gee Manufacturing
Machine shop; drilling & boring, arc,
gas, MIG &TIG welding; sheet, plate &
structural metal fabricating
30
1971
Mago Construction Co., Inc.
Bituminous concrete & asphalt
2
1958
Medialog, Inc.
Library catalog card & catalog data
printing
21
2000
Pitssfield of Kentucky, Inc.
Industrial filters
45
1981
Sunrise Corporation
Rendering equipment manufacturer and
heavy equipment installation & movers
10
1994
Williams Manufacturing Co.,
Inc.
Plastic laminated products & cabinets;
counter tops - laminate and solid
surface
14
1980
Butler
Falmouth
Bluegrass Biodiesel, LLC
Process multi-feedstock fats and oils
5
into B100 grade biodiesel fuels. Provides
B100 and blended biodiesel fuels and
highly refined glycerol (glycerin) for sale
2009
Hammer Strength Corporation
Fitness equipment & plate loading
exercise equipment
74
1988
Pendleton DataFarm, LLC
Mortgage document retrieval
nationwide; title search and mortgage
closings in eight states
50
2002
Source: http://thinkky.com/EDIS/cmty/index.aspx?CW=011
CHARACTERISTICS OF THE COMMUNITY
12
Community Health Needs Assessment 2012
Robertson County
Robertson County is located east-northeast of Harrison County and is the smallest county (population)
in the state of Kentucky. In terms of land area, Robertson County is the second smallest in the state, with
approximately 100 square miles of land.
Robertson County
Employment
Percent
Labor Market Area
Employment
Percent
All Industries
290
100.0
48,922
100.0
Education and Health Services
3
1.0
N/A
N/A
Agriculture, Forestry, Fishing and
Hunting
0
0.0
N/A
N/A
Mining
0
0.0
N/A
N/A
Construction
N/A
N/A
N/A
N/A
Manufacturing
0
0.0
N/A
N/A
Trade, Transportation, and
Utilities
4
1.4
8,502
17.4
Information
N/A
N/A
N/A
N/A
Financial Activities
11
3.8
N/A
N/A
Services
79
27.2
9,665
19.8
Public Administration
19
6.6
2,088
4.3
Other
0
0.0
N/A
N/A
Source: http://thinkky.com/EDIS/cmty/index.aspx?CW=046 and U.S. Bureau of Labor Statistics
Major Business and Industry demographics were not available for Robertson County at the time of the
report.
Firm
Product(s)/Service(s)
Employees Year Established
Full-time teachers
28
Mount Olivet
Public School System
CHARACTERISTICS OF THE COMMUNITY
13
Community Health Needs Assessment 2012
Nicholas County
Located east-southeast of Harrison County, Nicholas County is anchored by the town of Carlisle and has
approximately 18% of the four county area community.
Nicholas County
Employment
Percent
Labor Market Area
Employment
Percent
All Industries
952
100.0
241,210
100.0
Education and Health Services
262
27.5
N/A
N/A
Agriculture, Forestry, Fishing and
Hunting
20
2.1
N/A
N/A
Mining
0
0.0
N/A
N/A
Construction
9
0.9
N/A
N/A
Manufacturing
26
2.7
31,464
13.0
Trade, Transportation, and
Utilities
157
16.5
44,819
18.6
Information
N/A
N/A
N/A
N/A
Financial Activities
N/A
N/A
N/A
N/A
Services
302
31.7
86,543
35.9
Public Administration
83
8.7
10,088
4.2
Other
0
0.0
N/A
N/A
Source: http://thinkky.com/EDIS/cmty/index.aspx?CW=046 and U.S. Bureau of Labor Statistics
CHARACTERISTICS OF THE COMMUNITY
14
Community Health Needs Assessment 2012
Nicholas County
Most of the demographic and workforce data that follow include totals for the community’s labor market
Firm
Product(s)/Service(s)
Employees Year Established
Public School System
Full-time teachers
77
Carlisle Mercury
Newspaper publishing
5
1993
Equine Textiles
Equine leg care products: saddle pads,
blankets, coolers; equestrian themed
furniture & novelty items/contract
sewing
14
1984
Lee-Lynn Machining, Inc.
CNC machining of parts for the mining
industry, safety industry, construction
industry, archery industry, and
entertainment industry, (speakers) and
many more
21
1992
Carlisle
Source: http://thinkky.com/EDIS/cmty/index.aspx?CW=106
CHARACTERISTICS OF THE COMMUNITY
15
Community Health Needs Assessment 2012
HEALTH STATUS
of the community
Leading Causes of Death
The table below reflects the leading causes of death for Harrison, Pendleton, Robertson, and Nicholas
county residents. The numbers compare the rates, per thousand, to the state of Kentucky average rates,
per thousand.
Leading and Selected Causes of Resident Deaths, 2005
Harrison
County
Number
Pendleton
County
Rate
Number
Robertson
County
Rate
Number
Nicholas
County
Rate
Number
Kentucky
Rate
Number
Rate
Total Deaths, All Causes
199
1080.6
137
902.6
31
1373.5
87
1241.6
39,471
946.0
Diseases of Heart
56
304.1
33
217.4
5
221.5
27
385.3
10,572
253.4
Malignant Neoplasms
47
255.2
32
210.8
9
398.8
15
214.1
9,343
223.9
Chronic Lower Respiratory
Diseases
13
70.6
13
85.6
-
-
6
85.6
2,545
61.0
Unintentional Injuries
6
2.6
11
72.5
-
-
4
57.1
2,264
54.3
Cerebrovascular Diseases
16
86.9
9
59.3
-
-
7
99.9
2,117
50.7
Diabetes Mellitus
5
7.2
-
-
-
-
6
85.6
1.168
28.0
Influenza and Pneumonia
10
54.3
7
46.1
-
-
-
-
996
23.9
Nephritis, Nephrotic
Syndrome and Nephrosis
6
32.6
4
26.4
-
-
-
-
887
21.3
Septicemia
-
-
-
-
4
177.2
-
-
575
13.8
Lung Cancer
12
65.2
11
72.5
-
-
5
71.4
3,343
80.1
Motor Vehicle Crashes
-
-
6
39.5
-
-
-
-
918
22.0
Source: KY Division of Epidemiology and Health Planning
HEALTH STATUS OF THE COMMUNITY
16
Community Health Needs Assessment 2012
HEALTH OUTCOMES
and factors
This portion of the assessment highlights key health status statistics for the citizens of Harrison, Pendleton,
Robertson, and Nicholas counties. The data used in this analysis was compiled from County Health Rankings
(www.countyhealthrankings.org) and is based on each county’s mortality and morbidity health outcomes.
Mortality (length of life) and morbidity (quality of life) metrics are compiled for each county and the results
are utilized to rank the healthiest counties in each state. The rankings are reflective of a variety of health
measures and each county is ranked relative to other counties in the same state.
For each of the four counties, Harrison Memorial Hospital has included the following data elements:
• Leading causes of death (2005)
• Health Outcomes rankings (Mortality and Morbidity)
• Health Factors rankings
–– Health Behaviors
–– Clinical care
–– Social and Economic Factors
–– Physical Environment
Each county is ranked (out of 120 Kentucky counties) on each of the factors and then compared to Kentucky
and national benchmarks.
Definitions relative to the following charts:
Premature death: Represented by the years of potential life lost before age 75 (YPLL-75). Every death
occurring before the age of 75 contributes to the total number of years of potential life lost. For example, a
person dying at age 25 contributes 50 years of life lost, whereas a person who dies at age 65 contributes 10
years of life lost to a county’s YPLL. The YPLL measure is presented as a rate per 100,000 population and
is age-adjusted to the 2000 U.S. population.
Violent crime: Represented as an annual rate per 100,000 population. Violent crimes are defined as offenses
that involve face-to-face confrontation between the victim and the perpetrator, including homicide, forcible
rape, robbery, and aggravated assault.
Harrison County Health Rankings 2012
Harrison County
Error Margin
National
Benchmark
Kentucky
Rank (of 120)
Health Outcomes
59
Mortality
75
Premature death
9,976
8,330 - 11,622
5,466
8,781
Morbidity
35
Poor or fair health
19%
Poor physical health days
Poor mental health days
Low birthweight
12 - 27%
10%
22%
3.8
2.4 - 5.1
2.6
4.7
2.5
1.2 - 3.8
2.3
4.3
10.2%
8.7 - 11.6%
6.0%
9.0%
Source: countyhealthrankings.org
HEALTH OUTCOMES AND FACTORS
17
Community Health Needs Assessment 2012
Harrison County
Error Margin
National
Benchmark
Kentucky
Health Factors
25
Health Behaviors
26
Adult smoking
40%
30 - 50%
14%
27%
Adult obesity
30%
23 - 38%
25%
33%
Physical inactivity
35%
27 - 43%
21%
31%
Excessive drinking
7%
3 - 19%
8%
11%
Motor vehicle crash death rate
26
17 - 34
Sexually transmitted infections
295
Teen birth rate
67
59 - 75
12
22
84
311
22
52
Clinical Care
38
Uninsured
17%
Primary care physicians
814:1
Preventable hospital stays
113
15 - 18%
11%
17%
631:1
922:1
99 - 127
49
104
Diabetic screening
78%
67 - 88%
89%
82%
Mammography screening
54%
43 - 64%
74%
63%
Social & Economic Factors
High school graduation
Some college
Unemployment
Children in poverty
24
84%
52%
78%
43 - 61%
10.9%
24%
17 - 31%
68%
55%
5.4%
10.5%
13%
26%
Inadequate social support
9%
4 - 16%
14%
20%
Children in single-parent households
28%
19 - 37%
20%
32%
Violent crime rate
162
73
288
Physical Environment
23
Air pollution-particulate matter days
0
Air pollution-ozone days
0
0
2
Access to recreational facilities
11
16
8
Limited access to healthy foods
Fast food restaurants
Rank (of 120)
0
2
3%
0%
7%
59%
25%
54%
Source: countyhealthrankings.org
Harrison County scores 59th out of 120 in the Health Outcomes portion and 25th out of 120 in the Health
Factors elements. Harrison County had the highest scores of the four county community.
HEALTH OUTCOMES AND FACTORS
18
Community Health Needs Assessment 2012
Pendleton County Health Rankings 2012
Pendleton County
Error Margin
National
Benchmark
Kentucky
Health Outcomes
83
Mortality
Premature death
84
10,495
8,598 - 12,393.
5,466
8,781
10%
22%
2.6
4.7
Morbidity
75
Poor or fair health
Poor physical health days
Poor mental health days
Low birthweight
Rank (of 120)
5.0
3.1 - 7.0
5.4
3.2 - 7.6
2.3
4.3
9.3%
7.7 - 10.9%
6.0%
9.0%
Source: countyhealthrankings.org
HEALTH OUTCOMES AND FACTORS
19
Community Health Needs Assessment 2012
Pendleton County
Error Margin
National
Benchmark
Kentucky
Health Factors
73
Health Behaviors
90
Adult smoking
32%
23 - 43%
14%
27%
Adult obesity
36%
29 - 44%
25%
33%
Physical inactivity
32%
26 - 40%
21%
31%
Excessive drinking
10%
5 - 19%
8%
11%
Motor vehicle crash death rate
32
21 - 43
Sexually transmitted infections
127
Teen birth rate
46
17%
12
22
84
311
40 - 53
22
52
15 - 19%
11%
17%
Clinical Care
Uninsured
Primary care physicians
72
631:1
922:1
Preventable hospital stays
128
108 - 148
49
104
Diabetic screening
82%
70 - 94%
89%
82%
Mammography screening
58%
44 - 71%
74%
63%
3,732:1
Social & Economic Factors
63
High school graduation
73%
Some college
43%
Unemployment
12.8%
Children in poverty
23%
16 - 30%
78%
25%
17 - 34%
72
73
288
Air pollution-particulate matter days
0
0
2
Air pollution-ozone days
0
0
2
Access to recreational facilities
7
16
8
Limited access to healthy foods
29%
0%
7%
Fast food restaurants
43%
25%
54%
33 - 53%
Inadequate social support
Children in single-parent households
Violent crime rate
Rank (of 120)
68%
55%
5.4%
10.5%
13%
26%
14%
20%
20%
32%
Physical Environment
80
Source: countyhealthrankings.org
Pendleton County scores 83rd out of 120 counties in the Health Outcomes scorecard and 73rd out of 120
in the Health Factors portion. Scores related to health behaviors, including smoking and obesity caused
Pendleton County to score 90th out of 120 in that sub-category.
HEALTH OUTCOMES AND FACTORS
20
Community Health Needs Assessment 2012
Robertson County Health Rankings 2012
Robertson County
Error Margin
National
Benchmark
Kentucky
Health Outcomes
52
Mortality
65
Premature death
5,466
8,781
Morbidity
Poor or fair health
40
20%
15 - 28%
10%
22%
Poor physical health days
5.6
4.0 - 7.2
2.6
4.7
Poor mental health days
2.9
1.4 - 4.5
Low birthweight
Rank (of 120)
2.3
4.3
6.0%
9.0%
Source: countyhealthrankings.org
HEALTH OUTCOMES AND FACTORS
21
Community Health Needs Assessment 2012
Robertson County
Error Margin
National
Benchmark
Kentucky
Health Factors
68
Health Behaviors
35
Adult smoking
26%
18 - 37%
14%
27%
Adult obesity
32%
26 - 29%
25%
33%
Physical inactivity
36%
28 - 44%
21%
31%
Excessive drinking
13%
8 - 22%
8%
11%
Motor vehicle crash death rate
Sexually transmitted infections
Teen birth rate
363
12
22
84
311
37
21 - 53
22
52
21%
19 - 23%
11%
17%
631:1
922:1
49
104
89%
82%
74%
63%
Clinical Care
Uninsured
88
Primary care physicians
Preventable hospital stays
Diabetic screening
Rank (of 120)
76%
47 - 100%
Mammography screening
Social & Economic Factors
69
High school graduation
79%
Some college
30%
Unemployment
9.5%
Children in poverty
33%
78%
0 - 100%
24 -43%
68%
55%
5.4%
10.5%
13%
26%
Inadequate social support
18%
11 - 29%
14%
20%
Children in single-parent households
37%
19 - 55%
20%
32%
73
288
0
2
Violent crime rate
Physical Environment
104
Air pollution-particulate matter days
0
Air pollution-ozone days
0
0
2
Access to recreational facilities
0
16
8
Limited access to healthy foods
29%
0%
7%
Fast food restaurants
50%
25%
54%
Source: countyhealthrankings.org
Robertson County scored the highest of any of the four counties, obtaining the ranking of 52 out of 120 in
Health Outcomes. In the Health Outcomes component, Robertson County ranked 68th out of 120.
HEALTH OUTCOMES AND FACTORS
22
Community Health Needs Assessment 2012
Nicholas County Health Rankings 2012
Nicholas County
Error Margin
National
Benchmark
Kentucky
Health Outcomes
110
Mortality
Premature death
117
13,938
10,624 - 17, 251
5,466
8781
Morbidity
96
Poor or fair health
10%
22%
Poor physical health days
2.6
4.7
Poor mental health days
Low birthweight
Rank (of 120)
11.3%
8.9 - 13.7%
2.3
4.3
6.0%
9.0%
Source: countyhealthrankings.org
HEALTH OUTCOMES AND FACTORS
23
Community Health Needs Assessment 2012
Nicholas County
Error Margin
National
Benchmark
Kentucky
Health Factors
69
Health Behaviors
61
Adult smoking
40%
30 - 50%
14%
27%
Adult obesity
34%
26 - 42%
25%
33%
Physical inactivity
36%
27 - 46%
21%
31%
8%
11%
Excessive drinking
Motor vehicle crash death rate
Sexually transmitted infections
15
Teen birth rate
73
21%
12
22
84
311
59 - 87
22
52
19 - 23%
11%
17%
Clinical Care
Uninsured
Primary care physicians
105
631:1
922:1
131
107 - 154
49
104
Diabetic screening
76%
61 - 92%
89%
82%
Mammography screening
57%
39 - 73%
74%
63%
Preventable hospital stays
3,447:1
Social & Economic Factors
60
High school graduation
84%
Some college
38%
Unemployment
11.6%
Children in poverty
29%
21 - 38%
78%
23%
13 - 34%
73
288
0
2
27 - 48%
Inadequate social support
Children in single-parent households
Rank (of 120)
Violent crime rate
68%
55%
5.4%
10.5%
13%
26%
14%
20%
20%
32%
Physical Environment
3
Air pollution-particulate matter days
0
Air pollution-ozone days
0
0
2
Access to recreational facilities
0
16
8
Limited access to healthy foods
0%
0%
7%
Fast food restaurants
0%
25%
54%
Source: countyhealthrankings.org and kentuckyhealthfacts.org
Nicholas County fared worse than any of the counties in Health Outcomes, ranking 110 out of 120 total
Kentucky counties. In Health Factors, they ranked much better, securing the 69th spot.
HEALTH OUTCOMES AND FACTORS
24
Community Health Needs Assessment 2012
HEALTHCARE
resources
Access to healthcare resources is critical to providing a continuum of care that supports the health and
well being of a community. If there is an imbalance between supply and demand, then the quality and
timeliness of care can be significantly impacted. Below is a listing of the other hospital facilities available
to the residents of Harrison, Nicholas, Robertson, and Pendleton counties:
Hospitals
Facility Name
Facility Type
Bed Size
Location
Miles from
Cynthiana, KY
Harrison Memorial Hospital
Acute Care
61
Cynthiana, KY
0
Bourbon Community Hospital
Acute Care
33
Paris, KY
15
Nicholas Community Hospital
Critical Access
16
Carlisle, KY
19
Acute Care
67
Georgetown, KY
21
Saint Elizabeth Medical Center
(Grant County)
Critical Access
16
Williamstown, KY
28
Meadowview Regional Medical
Center
Acute Care
100
Maysville, KY
46
Georgetown Community Hospital
Harrison Memorial Hospital - Located in Cynthiana, Kentucky, Harrison Memorial Hospital is an acute care
facility located in the heart of Cynthiana.
Bourbon Community Hospital – Located in Paris, Kentucky, Bourbon Community Hospital is an acute care
facility approximately 15 miles south of Cynthiana.
Nicholas County Hospital – Located in Carlisle, Kentucky, Nicholas County Hospital is a critical access facility
approximately 19 miles east of Cynthiana.
Georgetown Community Hospital – Located in Georgetown, Kentucky, Georgetown Community Hospital is
an acute care facility approximately 21 miles southwest of Cynthiana.
Saint Elizabeth Medical Center Grant County (SEMCGC) – Located in Williamstown, Kentucky, SEMCGC is a
critical access facility approximately 28 miles northwest of Cynthiana.
Meadowview Regional Medical Center (MRMC) – MRMC is an acute care facility located in Maysville, Kentucky
approximately 46 miles northeast of Cynthiana.
Although the hospital is typically the hub of any healthcare community, other resources play a key role in
maintaining the well being and health of its residents. Excluding the physician providers that serve this area,
other important healthcare resources include:
Other Healthcare Facilities and Providers
Buffalo Trace District Health Department – Serving the people of Mason and Robertson counties, The
Buffalo Trace District Health Department, is focused on providing information and resources related to
health education classes, personal, and preventive health services, environmental health services, public
health emergency planning and response as well as information on late-breaking health news.
HEALTHCARE RESOURCES
25
Community Health Needs Assessment 2012
Other Healthcare Facilities and Providers (continued)
Wedco District Health Department – Serving Harrison, Nicholas, and Scott counties, the Wedco District
Health Department service array includes preventive health care such as Well Child and Prenatal Clinics;
early intervention and treatment clinics such as STD and TB; environmental services such as restaurant,
swimming pool and hotel inspections; health education services such as drug prevention and postponing
sexual involvement education; as well as many other vital services such as home visitation to first time high
risk parents (our H.A.N.D.S. Program) and school nursing. Please use the menu to the left to learn more
about the various programs we offer to our community.
Journey Medical Mission - The services offered by the Journey Medical Mission are intended to provide
ongoing medical management of acute and chronic medical conditions (including diabetes, hypertension
and cardiovascular disease) to Harrison County resident patients without other medical resources and to
improve the overall health of the community.
Hospice of the Bluegrass - Hospice of the Bluegrass is a private non-profit organization governed by a Board
of Directors. The program is a member of the National Hospice and Palliative Care Organization, is certified
by Medicare and Medicaid, is licensed by the State of Kentucky and accredited by the Joint Commission on
Accreditation of Healthcare Organizations. Hospice of the Bluegrass serves more than 1,000 patients daily
in 32 central, southeastern and northern Kentucky counties.
Cedar Ridge Health Campus – Located in Cynthiana, KY, Cedar Ridge Health Campus offers senior-centered
care, including rehabilitative services, skilled nursing care, and assisted living.
Edgemont Nursing Home – A 68-bed nursing home located in Cynthiana, Edgemont provides nursing home
services in the community.
Grand Haven Nursing Home – Located in Cynthiana, Grand Haven is a 54-bed nursing home facility providing
services in the community.
Johnson-Mathers Nursing Home – A nursing home facility located in Carlisle, Kentucky.
Robertson County Nursing Home – A nursing care facility located in Mount Olivet, Kentucky.
Three Rivers District Health Department – Provides health and wellness services for Gallatin, Carroll, Owen,
and Pendleton counties.
Parkside Manor – A private facility offering assisted living services. Parkside Manor is located in Cynthiana.
Shady Lawn Facility – A private facility offering assisted living services. Shady Lawn is located in Cynthiana.
Bracken County Nursing & Rehabilitation Center - A 32-bed skilled nursing and 30-bed personal care facility
located in the rural community of Chatham, Kentucky.
River Valley Nursing Home - A 60-bed nursing care facility location in Butler, Kentucky.
Harrison County and Nicholas County Comprehensive Care Centers - Provide outpatient mental health
services, intellectual and developmental disabilities and substance abuse services, case management
services for adults with severe and persistent mental illness, children’s services including intensive outpatient
for children and their families, consultation and education, courts and jails, domestic violence services, and
emergency services. Located in Cynthiana, Kentucky (Harrison) and in Paris, Kentucky (Nicholas).
UTC Georgetown (Urgent Treatment Center) - Provides health and wellness services including 24/7
emergency first, occupational medicine, and worker comp care to central Kentucky.
The Clinic at Walmart (Cynthiana Walmart) - Offers health and wellness services including physicals and
basic care. Located in the Cynthiana Walmart.
Baptist Express Urgent Care - Provides basic healthcare services. Located in the Paris, Kentucky Walmart.
HEALTHCARE RESOURCES
26
Community Health Needs Assessment 2012
PHYSICIAN RESOURCES
In order to identify existing medical services within each county and develop future plans that may affect
Harrison Memorial Hospital, the study includes the analysis of the existing health resources in each county,
compared to the national median.
Definitions relative to the following chart:
Short-term general hospitals: These hospitals are coded as the follows by the American Hospital Association:
Length of Stay = “1”, Short-term; Type of Service = “10”, General medical and surgical. These hospitals
provide non-specialized care, and the majority of their patients stay for fewer than 30 days.
Ambulatory Surgical Center: For Medicare purposes this is a distinct entity that operates exclusively for
the purpose of furnishing outpatient surgical services to patients. The ASC must enter into a “participating
provider” agreement with CMS.
Community Mental Health Center: These centers must provide four core services:
1. Outpatient services, including specialized outpatient services for children, the elderly, individuals
who are chronically mentally ill, and residents of the CMHC’s mental health services area who have
been discharged from inpatient treatment at a mental health facility.
2. 24-hour-a-day emergency care services.
3. Day treatment, or other partial hospitalization services, or psychosocial rehabilitation services.
4. Screening for patients being considered for admission to State mental health facilities to determine
the appropriateness of such admission.
Federal Qualified Health Center: Servicers include all of the Rural Health Clinics (defined as a facility
located in a rural area designated as a shortage area and is neither a rehabilitation agency nor a facility for
the care and treatment of mental diseases; a clinic located on an island may be eligible to be certified as an
RHC even though it does not have a physician assistant, nurse practitioner, or a certified nurse-midwife) as
well as preventative primary services. Preventive primary services must be furnished by or under the direct
supervision of a physician, a nurse practitioner, a physician assistant, nurse midwife, clinical psychologist,
or a social worker. The services must be furnished by a member of the center’s health care staff who is an
employee of the center or by a physician under arrangements with the center.
HPSAs: These are Health Professional Shortage Areas and are defined by HRSA according to certain criteria.
PHYSICIAN RESOURCES
27
Community Health Needs Assessment 2012
Harrison
County
Pendleton
County
Robertson
County
Nicholas
County
National
Median
Primary Care Physicians
Number
13
2
0
2
13
Physicians/Population (number of physicians per
100,000 population)
70.1
13.3
0.0
29.01
54.6
Number
9
2
0
1
9
Physicians/Population
33.8
13.3
0.0
14.5
33.8
Number
3
0
0
1
3
Physicians/Population
16.2
0.0
0.0
14.5
11.1
Number
0
0
0
0
1
Physicians/Population
0.0
0.0
0.0
0.0
4.3
Number
2
0
0
0
1
Physicians/Population
16.2
0.0
0.0
0.0
3.4
Number
2
0
1
0
1
Physicians/Population
10.8
0.0
45.4
0.0
4.9
Number
0
0
0
0
0
Physicians/Population
0.0
0.0
0.0
0.0
0.0
Number
10
5
1
1
7
Physicians/Population
53.9
33.2
45.4
14.5
31.7
Number
23
7
1
3
21
Physicians/Population
124.0
46.5
45.4
43.6
87.6
Number
7
2
0
0
8
Physicians/Population
37.7
13.3
0.0
0.0
33.0
Number of hospitals, total
1
0
0
1
1
Number of beds, total
61
0
0
16
62
Number of short-term general hospitals
1
0
0
1
1
Number of short-term general hospital beds
61
0
0
16
58
Ambulatory Surgical Centers
0
0
0
0
0
Community Mental Health Centers
0
0
0
0
0
Federally-Qualified Health Centers
0
0
1
0
0
Primary Care HPSA
No
Yes
Yes
Partial
1,336
Dental HPSA
No
No
No
No
670
General Practice/Family Practice Physicians
Internal Medicine Physicians
Pediatricians
Obstetricians/Gynecologists
General Surgeons
Psychiatrists
Specialists
Total Physicians
Dentists
Hospitals
Health Centers
HPSA Status (y/n)
Source: http://www.arf.hrsa.gov/arfwebtool/Counties_list.asp
PHYSICIAN RESOURCES
28
Community Health Needs Assessment 2012
Analysis
The lack of full-time pediatricians and psychiatrists is a common problem for rural America. In many rural
communities, mental health services are simply not available. In fact, a recent study by the Center for Rural
Affairs found that 85% of the 1,669 federally designated mental health professional shortage areas are rural.
A 2010 study in the journal Pediatrics pointed out that there are enough children’s doctors in the United
States’ but they just don’t work in rural areas. The study pointed out that nearly 1 million kids live in areas
with no local children’s doctor. By moving doctors, the study suggests, it would be possible for every child
to have a pediatrician or family physician nearby. For rural primary care, a 2009 report by the Rural Health
Research and Policy Centers stated that of the 2050 rural counties in the U.S., 1,582 (77%) are primary care
health professional shortage areas (HPSAs).
The lack of psychiatrists, pediatricians and primary care providers affects most rural areas throughout the
United States.
PHYSICIAN RESOURCES
29
Community Health Needs Assessment 2012
COMMUNITY HEALTH EXPERT
interviews
As part of conducting a compliant Community Health Needs Assessment, the Patient Protection and
Affordable Care Act stipulates that the Hospital must seek input from individuals that represent the broad
interests of the community, including those with special knowledge of or expertise in public health. DDAF
assisted Harrison Memorial Hospital with interviewing community health experts familiar with the health
and wellness of the people in Harrison, Nicholas, Robertson, and Pendleton counties. Harrison Memorial
Hospital selected the community experts they wanted to interview. As part of the interview process, the
experts were asked to openly discuss their roles within the healthcare community and their perspectives
on health, wellness, diseases, and needs of the community. The health experts who participated in the
assessment are listed below:
Dr. Brian Mulberry
Family Medicine Physician
Cynthiana and Falmouth Offices
Dr. Greg Cooper
Family Medicine Physician
Cynthiana and Falmouth Offices
Kelly Kendall and Lisa Ramsey
Community Outreach Representatives
Hospice of the Bluegrass
Crystal Caudill
Director
Wedco District Health Department for Harrison,
Nicholas, and Scott Counties
Debbie Zeck
CEO
Edgemont Nursing Facility
Dr. Gerald Harpel
OB/GYN
Dr. Stephen Moses
Family Medicine Physician and HMH Chief of Staff
Cynthiana Office
Dr. Stephen Besson
Internal Medicine/Pediatric Physician
Cynthiana and Carlisle Offices
Steve Moses
Mayor, Cynthiana
Judy Feeback
Harrison County School System, Student Nurse
Dr. Frank McKemie
Internal Medicine/Pediatric Physician and HMH
Board Chairman
Cynthiana and Carlisle Offices
Beth Smith
Grand Haven Nursing Home
Dr. Derek Clarke
OB/GYN
Dr. Henry Norfleet
Family Medicine Physician
Cynthiana and Falmouth Offices
Allison Adams
Director of Buffalo Trace Health District
Robertson and Mason Counties
As part of the interview process, DDAF specifically asked each individual to provide insight and perspective
on each of the following topics:
•
What gaps, if any, exist in the local healthcare delivery system?
•
Are there barriers to access to healthcare in the community?
•
Define the most prevalent diseases and/or healthcare concerns in the community?
INTERVIEWS
30
Community Health Needs Assessment 2012
The following summarizes the key discussion points from the expert interviews:
Gaps in the healthcare delivery system:
•
Mental health care services – access to and continuity of care
•
Need for additional services and health awareness in Pendleton County
•
Impending shortage of primary care providers due to healthcare reform and generally aging
community, including providers
•
Teen pregnancy and sex education resources
•
Lack of a 24-hour pharmacy in the community
•
Some unmet needs of skilled nursing facility (SNF) residents (eyeglasses, podiatry, dental needs,
and clothing) exist
•
Reluctance of some family members and healthcare providers to utilize Hospice services earlier in
the care process
•
Sometimes there is inadequate communication between community healthcare providers, e.g.
skilled nursing facilities, and Harrison Memorial Hospital
•
Lack of a pediatric-focused practice in the community
•
The absence of primary care, dental care, and local ambulance services in Robertson County
Barriers to access to healthcare:
•
Uninsured population and economic barriers to access to healthcare
•
Lack of understanding about one’s health insurance coverage, including the increasingly common
high deductible health plans
•
The current state of the Medicaid managed care organizations and the complications that exist with
getting reimbursed accurately and timely
•
The use of the hospital Emergency Department for primary care
•
Lack of knowledge throughout the community regarding the available healthcare resources
•
Potential language barriers within the Hispanic community
•
Transportation barriers to and from medical care for some populations within the community
Health diseases and/or concerns in the community:
•
Diabetes and related education
•
Chronic Obstructive Pulmonary Disease (COPD) and overall high heart disease rates
•
Teen pregnancy rates and sex education
•
Mental health and access to psychiatric services
•
Childhood obesity
•
Child neglect
•
Personal motivation to improve one’s own health
•
Drug abuse, specifically the use of prescribed pain medications
•
Tobacco use and education
•
Allergies and asthma complications in children
•
Potential need for increased skilled nursing facility capacity
•
Patients visiting the Hospital Emergency Department instead of primary care providers, health
department, etc.
INTERVIEWS
31
Community Health Needs Assessment 2012
COMMUNITY HEALTH
surveys
In addition to interviewing healthcare experts, Harrison Memorial Hospital also surveyed members of the
community. Surveys were distributed to health fair participants, volunteers, civic groups, hospital patients,
and other members of the community. Surveys were distributed, collected, and analyzed over a period of
four months, March through June 2012, and the results provided insights into the opinions and beliefs of the
community at large. Harrison Memorial Hospital collected in excess of 500 surveys from the community. A
sample of the survey is included on the following page.
COMMUNITY HEALTH SURVEYS
32
Community Health Needs Survey
Harrison Memorial Hospital is seeking community input as it completes a community health needs assessment.
The hospital appreciates your honest responses to the following questions.
1. What is your age?
Less than 18
19 - 29
30 - 39
40 - 49
50 - 59
60 - 69
More than 70
2. What is your sex?
a.
b.
c.
d.
e.
4. Employment Status?
Male
Female
5. Where do you go for routine healthcare?
3. What is your zip code?
Doctor’s office
Health department
Emergency Department
Local clinic
I do not receive routine healthcare
Full-time
Part-time
Retired
Unemployed
Self-employed
10. How would you rate your health?
a.Excellent
b.
Very good
c.Fair
d.Poor
e.
Don’t know
6. How long ago was your last medical exam?
11. Do you currently use tobacco?
a.Yes
b.No
a.
b.
c.
d.
e.
Less than 1 year ago
1-2 years ago
2-5 years ago
Greater than 5 years ago
I’ve never had an exam
7. Are you able to visit with a doctor when needed?
a.Yes
b.No
8. If your answer to #7 was “No,” why?
a.
No insurance
b.
No transportation
c.
Don’t have time
d.
Health services too far away
e.
No time slots available at doctor’s office
f.Other:
9. Do you have any of the following conditions?
a.Asthma
b.Cancer
c.Diabetes
d.Emphysema
e.
Heart disease
f.
Mental health issues
g.Obesity
h.Addiction
i.
I do not face any health challenges
j.Other:
12. Do you regularly travel to larger cities for healthcare
services?
a.Yes
b.No
c.
If yes, where:
13. If you answered “Yes” to #12, why?
a.
The specialty care I need doesn’t exist in this area
b.
I feel that I get better care from other doctors and/or hospitals in Lexington
c.Other:
14. Are you happy with the medical care in Harrison
County?
a.Yes
b.No
c.
If “No,” why:
15. What do you feel is the biggest health issue in your
community?
a.Obesity
b.
Drug abuse
c.
Tobacco use
d.Alcohol
e.
Teen pregnancy
f.Other:
Please return survey to:
HMH
c/o Mollie Smith
1210 KY Highway 36 East
Cynthiana, KY 41031
or drop-off at HMH front lobby
Community Health Needs Assessment 2012
Developed in collaboration between Harrison Memorial Hospital and Dean Dorton Allen Ford, the survey
questions selected were intended to provide feedback on geographical, demographic, socioeconomic, and
health and wellness concerns of the community. A sample of some of the responses are highlighted below:
Sex
Current Age
30%
24%
25%
25%
Male
22%
20%
9%
10%
5%
15%
14%
15%
9%
3%
Female
78%
0%
< than 18
19-29
30-39
91%
64%
22%
40-49
50-59
60-69
> than 70
of the people surveyed indicated that they visit their physician’s
office for routine healthcare
of the participants had their last medical exam within the past year.
Coincidentally, 64% of those surveyed also rated their personal health
as “excellent” or “very good.”
of the respondents stated that they do not currently face any health problems.
However, the most common responses for those who did claim having health
issues were as follows:
27%
•
Obesity
•
Heart disease
•
Diabetes
•
Asthma
of the people responded that they regularly travel to larger cities for
their healthcare. The majority of those people cited that the specialty
care they need doesn’t exist in the area.
For complete survey results, please see Exhibit 8 at the conclusion of this report.
COMMUNITY HEALTH SURVEYS
34
Community Health Needs Assessment 2012
PRIORITIZATION OF
identified health needs
Because Harrison Memorial Hospital takes quite seriously its position as a healthcare leader in its community,
survey and interview results were scored and prioritized based on four key factors:
1.
The scope of the need, e.g., number of people impacted, geographical reach, etc.
2.
The level of necessary resources to address the need.
3.
The impact of not addressing the identified need.
4.
The ability of Harrison Memorial Hospital to positively impact the need.
The following page details the prioritization of community health needs based on the responses from the
interviewees. Sheila Currans, CEO and Jim Spears, CFO then prioritized the needs based on those identified
through the interview and survey process.
PRIORITIZATION OF IDENTIFIED HEALTH NEEDS
35
Community Health Needs Assessment 2012
Harrison Memorial Hospital
Prioritization of Community Health Needs
Instructions:
Score each of the identified community health needs on a scale of 0-5, with 0 representing the low
end and 5 representing the high end.
Scope of the
Need
Level of
Resources
Impact of NOT
addressing the
Need
HMH Ability to
Positively Impact the
Need
Total Weighted
Score
Sometimes there is inadequate communication between community
healthcare providers, e.g. skilled nursing facilities, and Harrison
Memorial Hospital
5
5
4
5
6
The perception of a lack of a pediatric-focused practice in the
community
5
4
5
5
6
Impending shortage of primary care providers due to healthcare
reform and generally aging community, including providers
5
5
5
2
6
Need for health awareness in Pendleton County
5
3
3
5
5
Mental health care services – access to and continuity of care
5
0
5
0
4
The perception of some family members and healthcare providers to
utilize Hospice services earlier in the care process
2
5
3
3
4
The absence of primary care, dental care, and local ambulance
services in Robertson County
3
3
3
1
3
Teen pregnancy and sex education resources
3
2
3
2
3
Some unmet needs of skilled nursing facility (SNF) residents
(eyeglasses, podiatry, dental needs, clothing) exist
1
2
0
0
1
Lack of a 24-hour pharmacy in the community
0
0
0
0
0
Lack of understanding about one’s health insurance coverage,
including the increasingly common high deductible health plans
5
4
5
4
6
The use of the hospital Emergency Department for primary care
5
5
5
3
6
Lack of knowledge throughout the community regarding the
available healthcare resources
5
4
5
4
6
Uninsured population and economic barriers to access healthcare
services
5
3
5
3
5
The current state of the Medicaid managed care organizations and
the complications that exist with getting reimbursed accurately and
timely
4
4
5
0
4
Transportation barriers to and from medical care for some
populations within the community
1
5
1
1
2
Potential language barriers within the Hispanic community
0
0
0
5
1
Gaps in healthcare delivery system:
Barriers to access to care:
PRIORITIZATION OF IDENTIFIED HEALTH NEEDS
36
Community Health Needs Assessment 2012
Harrison Memorial Hospital
Prioritization of Community Health Needs (continued)
Instructions:
Score each of the identified community health needs on a scale of 0-5, with 0 representing the low
end and 5 representing the high end.
Scope of the
Need
Level of
Resources
Impact of NOT
addressing the
Need
HMH Ability to
Positively Impact the
Need
Total Weighted
Score
Diabetes and related education
5
5
5
5
6
Childhood obesity
5
3
5
5
6
Patients visiting the Hospital Emergency Department instead of
primary care providers, health department, etc.
5
5
5
3
6
Tobacco use and education
4
4
5
5
6
Chronic Obstructive Pulmonary Disease (COPD) and overall high
heart disease rates
5
1
5
5
5
Mental health and access to psychiatric services
5
2
5
3
5
Drug abuse, specifically the use of prescribed pain medications
4
2
5
5
5
Teen pregnancy rates and sex education
3
2
3
2
3
Allergies and asthma complications in children
3
3
2
2
3
Child neglect
3
0
5
2
3
Personal motivation to improve one’s own health
3
2
3
0
3
Potential need for increased skilled nursing facility capacity
1
0
5
3
3
Health diseases and concerns:
PRIORITIZATION OF IDENTIFIED HEALTH NEEDS
37
Community Health Needs Assessment 2012
CONSIDERATIONS FOR
meeting identified health needs
CONSIDERATIONS FOR MEETING IDENTIFIED HEALTH NEEDS
38
Community Health Needs Assessment 2012
COMMUNITY HEALTH
survey results
Current Age
1. What is your age?
Less than 18
19 - 29
30 - 39
40 - 49
50 - 59
60 - 69
More than 70
30%
24%
25%
25%
20%
10%
5%
15%
14%
15%
9%
9%
19-29
30-39
3%
0%
< than 18
40-49
50-59
60-69
> than 70
Sex
Male
22%
2. What is your sex?
Male
Female
Female
78%
Zip Code
60%
50%
50%
40%
30%
3. What is your zip code?
20%
15%
14%
10%
7%
6%
41006 Butler
41003 Berry
8%
0%
41040 Falmouth
41031 Cynthiana
41064 Mount
Olivet
Other
APPENDIX A
39
Community Health Needs Assessment 2012
Employment Status
Full-time
Part-time
Retired
4. Employment Status?
Unemployed
Self-employed
6%
Full-time
Part-time
Retired
Unemployed
Self-employed
16%
31%
10%
37%
Where Do You Go for Routine Healthcare?
100%
90%
5. Where do you go for routine healthcare?
a.
Doctor’s office
b.
Health department
c.
Emergency Department
d.
Local clinic
e.
I do not receive routine healthcare
91%
80%
70%
60%
50%
40%
30%
20%
10%
3%
0%
Doctor's office
Health
department
0%
1%
Emergency
department
Local clinic
5%
I do not receive
routine
healthcare
How Long Ago was Your Last Medical Exam?
70%
64%
60%
6. How long ago was your last medical exam? 50%
a.
b.
c.
d.
e.
Less than 1 year ago
1-2 years ago
2-5 years ago
Greater than 5 years ago
I’ve never had an exam
40%
30%
20%
20%
7%
10%
0%
< than 1 year
ago
1-2 years ago
2-5 years ago
5%
3%
> than 5 years I've never had
ago
an exam
APPENDIX A
40
Community Health Needs Assessment 2012
Are you able to visit with a doctor when needed?
Yes
No
7%
7. Are you able to visit with a doctor when needed?
a.Yes
b.No
93%
If You Answered "No," why?
70%
8. If your answer to #7 was “No,” why?
60%
60%
50%
a.
No insurance
40%
b.
No transportation
30%
c.
Don’t have time
d.
Health services too far away 20%
e.
No time slots available at 10%
doctor’s office
0%
f.Other
No insurance
14%
9%
6%
6%
5%
No transportation Don't have time
Health services
too far away
No time slots
available at
doctor's office
Other
Do You Have Any of the Following Conditions?
9. Do you have any of the following
conditions?
25%
22%
19%
20%
a.Asthma
b.Cancer
15%
c.Diabetes
d.Emphysema
10%
e.
Heart disease
f.
Mental health issues
g.Obesity
5%
h.Addiction
i.
I do not face any health 0%
challenges
j.Other
12%
13%
12%
12%
5%
3%
1%
Asthma
Cancer
Diabetes Emphysema
1%
Heart
disease
Mental
health
issues
Obesity
Addiction I do not face
any health
challenges
Other
APPENDIX A
41
Community Health Needs Assessment 2012
How Would You Rate Your Health?
60%
10. How would you rate your health?
a.Excellent
b.
Very good
c.Fair
d.Poor
e.
Don’t know
54%
50%
40%
31%
30%
20%
10%
10%
3%
2%
Poor
Don't know
0%
Excellent
Very good
Fair
Do You Currently Use Tobacco?
100%
91%
90%
80%
11. Do you currently use tobacco?
a.Yes
b.No
70%
60%
Yes
50%
No
40%
30%
20%
9%
10%
0%
Do You Regularly Travel to Larger Cities for
Healthcare Services?
80%
73%
70%
60%
12. Do you regularly travel to larger cities for
healthcare services?
50%
a.Yes
b.No
30%
Yes
40%
27%
No
20%
10%
0%
APPENDIX A
42
Community Health Needs Assessment 2012
If You Answered "Yes," Why?
45%
13. If you answered “Yes” to #12, why?
a.
The specialty care I need doesn’t exist in this area
b.
I feel that I get better care from
other doctors and/or hospitals in Lexington
c.Other
40%
39%
38%
35%
30%
23%
25%
20%
15%
10%
5%
0%
The specialty care I need
doesn't exist in this area
I feel that I get better care
from other doctors and/or
hospitals in Lexington
Other
Are You Happy with the Medical Care in
Harrison County?
14. Are you happy with the medical care in Harrison
County?
20%
Yes
a.Yes
b.No
No
80%
What do you feel is the biggest
health issue in your community?
15. What do you feel is the biggest health
issue in your community?
a.Obesity
b.
Drug abuse
c.
Tobacco use
d.Alcohol
e.
Teen pregnancy
f.Other
Other
Teen
pregnancy 2%
Alcohol 8%
7%
Tobacco
use
14%
Obesity
27%
Drub
abuse
42%
APPENDIX A
43